Aim: To investigate echocardiography (EchoCG) parameters and clinical prognosis in elderly patients with chronic heart failure (CHF) and complete left bundle branch block (LBBB). Material and methods: The study included 248 patients (163 men and 85 women), aged 60–85 years, with Functional Class II–IV CHF (NYHA classification) due to coronary heart disease (CHD) and arterial hypertension (AH). All participants were divided into two groups: Group I (n=37) included patients with complete LBBB, while Group II (n=211) included patients without LBBB. Results: In 14,9% of the elderly CHF patients, complete LBBB was observed. Group I and II patients were comparable by age, gender, CHF duration, and hemodynamic parameters. However, clinical course of CHF was more severe in participants with complete LBBB. LBBB was associated with myocardial infarction (MI) in anamnesis (p=0,029; odds ratio, OR, 5,11; 95% confidence interval, CI, 1,19–22,03), anterior MI (р=0,020; OR 3,03; 95% CI 1,19–1,71), left ventricular (LV) end-diastolic dimension (р=0,001; OR 2,09; 95% CI 1,35–3,26), LV end-systolic dimension (р=0,001; OR 1,98; 95% CI 1,34–2,95), LV end-diastolic volume (р=0,001; OR 1,012; 95% CI 1,01–1,02), LV end-systolic volume (р=0,002; OR 1,01; 95% CI 1,01–1,02), and low LV ejection fraction (EF) (р=0,003; OR 1,05; 95% CI 1,02–1,08). Over the follow-up period, the survival levels in elderly CHF patients with or without LBBB were 59,5% and 76,8%, respectively. The leading mortality cause in patients with LBBB was sudden death. Conclusion: Complete LBBB was associated with LV remodelling progression. Sudden death was the leading mortality cause in LBBB patients.

In general population and among diabetic patients, insulin resistance (IR) is regarded as a cardiovascular risk factor. The aim of this study was to assess the dynamics of IR markers among non-diabetic and diabetic (Type 2 diabetes mellitus, DM-2) patients with acute myocardial infarction and ST segment elevation (STEMI) in the acute and early reconvalescent phases. In non-diabetic patients, clinical course of STEMI was characterised by IR development, postprandial hyperglycemia and hyperinsulinemia, as well as elevated levels of free fatty acids (FFA) and plasminogen activator inhibitor (PAI). Persistent high levels of FFA and PAI during stabilization phase in STEMI patients could justify the use of IR markers as one of the criteria for DM-2 risk and for the start of secondary prevention of metabolic MI complications.

The paper presents the results of the ambulatory Holter electrocardiogram (ECG) monitoring, according to the levels of estradiol and follicle-stimulating hormone (FSH), as well as to the presence of cardiac and non-cardiac comorbidity, in 126 premenopausal women with Stage I-II arterial hypertension (AH) and cardialgia syndrome (non-coronary cardialgia). Painless myocardial ischemia (PLMI) risk was higher in AH women with chronic ovarian disease, medical abortions, smoking, and family history of AH in anamnesis. Among premenopausal women with AH, cardialgia, chronic reproductive system pathology, compromised gynecological anamnesis, premenstrual syndrome, and disturbed estradiol and FSH levels, the prevalence of PLMI was 18,8%.

The study assessed cardiac rhythm in young patients with mild arterial hypertension (AH). Gender-specific features of cardiac rhythm were associated with the baseline autonomic tonus. In particular, among women, there was a stronger link between cardiac rhythm and cardiovascular parameters, as well as a greater involvement of central mechanisms in cardiovascular regulation. The association between cardiac rhythm and central hemodynamic parameters was to a considerable extent influenced by the baseline autonomic tonus.

Arterial hypertension (AH) is one of the most prevalent components of metabolic syndrome (MS). At the same time, AH is a major risk factor predicting the development and progression of cardiovascular disease. The available literature provides inconsistent evidence on the association between the number of present MS components, blood pressure (BP) levels, and disturbed circadian BP profile. This study demonstrated that a higher number of MS components is linked to a higher AH stage and higher mean levels of most circadian, daytime, and nighttime parameters of 24-hour BP monitoring. Moreover, there was a significant increase in the numbers of “non-dippers” (patients with inadequate nighttime BP reduction), which is associated with a higher risk of cardiovascular events.

The study analysed the circadian blood pressure (BP) profile in patients with arterial hypertension (AH) before planned surgery, and also investigated the association between pre-surgery BP parameters and the risk of intra- and post-interventional complications. The study included 52 AH patients with cholelithiasis, admitted to a surgery department for a planned laparoscopic cholecystectomy. All participants underwent office BP measurement, as well as 24-hour BP monitoring (BPM) 2 weeks and 24 hours before the intervention. The incidence of peri-interventional complications was assessed. According to the 24-hour BMP results 2 weeks before the intervention, 50% of the patients had a normal circadian profile (“dipper”) of both systolic and diastolic BP (SBP, DBP). 24 hours before the intervention, pathological circadian SBP and DBP indices became more prevalent (mostly “non-dipper” type), and heart rate levels increased for both nighttime and daytime. Preinterventional AH features predicted the risk of peri-interventional complications. Therefore, pre-surgery 24-hour BPM can facilitate the identification of the patients with high risk of peri-interventional complications.

This study investigated the effects of hemodialysis, age, and gender on the development of various myocardial remodelling types. In total, 399 patients were examined: 184 on planned hemodialysis, 117 with pre-dialysis chronic kidney failure (CKF), and 98 with renal disease, but no CKF. All participants underwent standard clinical, laboratory, and instrumental tests. In both genders, the prevalence of pathological types of myocardial remodelling increased from CKF-free patients to patients with pre-dialysis CKF and to hemodialysis patients. Hemodialysis was associated with eccentric left ventricular hypertrophy (LVH), as one of the most adverse remodelling types, only in young women. The effects of age on structural myocardial remodelling differed by gender. In particular, among older hemodialysis patients, compared to their younger peers, concentric LVH was more prevalent in women, while concentric remodelling was more prevalent in men.

The comparison of biochemical and immunological parameters of venous blood in patients with varying clinical course of coronary heart disease (CHD) demonstrated that systemic inflammation in acute coronary syndrome is associated with increased H. Pylori antibody titers.

The paper is focused on the specific features of arterial hypertension (AH) and circadian blood pressure (BP) profile in climacteric women. Cardiovascular disease in climacteric women is an important clinical problem, due to declined hormonal effects on vascular wall, lipid profile, and BP levels. The study included 154 climacteric women, divided into four groups, based on the climax stage and AH presence. In all participants, climacteric and cardiovascular symptoms were analysed, with the calculation of modified menopausal index and circadian BP profile. Women with AH demonstrated circadian BP profile disturbances. These findings have important implications for early diagnostics and optimal treatment of AH.

The study included 60 patients, aged 45-65 years, with Functional Class II-III chronic heart failure (CHF) in early post-infarction period and Type 2 diabetes mellitus (DM-2). The participants were randomised into two groups (n=30 for each group). In the main group, Mexicor (0,4 g/d) was added to the standard CHF treatment. The treatment phase was 16 weeks. It was shown that a cytoprotector Mexicor, as a part of combination therapy in CHF patients with DM-2, reduced CHF severity, demonstrated antianginal effect, and improved quality of life. Adding Mexicor to the combination therapy of CHF and DM-2 also improved diastolic function, reduced the number of patients with adverse types of cardiac remodelling, beneficially affected lipid and carbohydrate metabolism parameters, significantly reduced the severity of insulin resistance and chronic inflammation syndrome, and demonstrated a marked antioxidant effect. Moreover, 16-week Mexicor therapy, as an addition to the standard CHF and DM-2 treatment, had beneficial effects on alanine and aspartate aminotransferase activity.

The treatment strategy was developed and monitored in a child with paecilomycotic atypical myocarditis (PAM), who was observed from the age of one to four years. The treatment included a combination of two homeopathic medications, Aconite C6 and Latrodectus mactans C6, which are permitted to use in clinical practice by the Russian Ministry of Health and Medical Industry Decree No. 335 (Supplement 2, November 29th 2005). The diet was corrected by pediatric dietologists. In one week, fever and pain syndrome disappeared; in one month, the blood levels of mycotic spherules normalized (4,500 per 1 μl). Diflucan was used as a fungicide medication. At the moment, the child’s growth and development are normal.

In patients with various clinical forms of coronary heart disease (CHD), essential arterial hypertension (EAH), or chronic heart failure (CHFD), roentgen-structural and roentgen-spectral analysis of serum facies was performed. In total, 159 patients were examined (mean age 57,2±6,08 years). All participants were divided into six groups: Group I – with Functional Class (FC) III effort angina (n=19); Group II – with healing myocardial infarction, MI (n=10); Group III – with paroxysmal recurrent atrial fibrillation, PRAF (n=19); Group IV – with Stage II EAH (n=34); Group V – with FC III–IV ischemic CHF (n=17); and Group VI – relatively healthy people (n=30). Microphotography of the serum facies was performed using electronic microscopy (S-3400N); energy-dispersive spectral analysis of the facies was also performed. Increased peripheral zone with spherical crystals, together with globular formations and decalcination in the centre was linked to the diagnosis of stable angina. Peripheral zone decrystallization, increased central zone with rosette-like crystals, and weight percentage of phosphorus >0,5% was observed in MI patients. No obvious zone separation, increased number of radial fissures, migration of crystal mass from central to peripheral area, and weight percentages of carbon, magnesium, and calcium in the central area of >10%, <0,01%, and <0,4%, respectively, were registered in EAH. PRAF was characterised by several crystallization centres in the central zone, absence of calcium, and weight percentage of phosphorus of 0,6±0,12 in the centre. CHF patients demonstrated total crystallization of the centre, singular peripheral crystals, and maximal weight percentage of carbon in the peripheral zone (72,0±0,43%), with phosphorus and calcium identified, respectively, in the central zone only and both central and peripheral zones. Atherosclerosis and associated clinical conditions are among the diseases with an important pathogenetic role of crystallization.

Heart rate variability (HRV) is a new method of non-invasive assessment of functional status, various levels of regulatory systems, and adaptation to internal and external factors. This review describes the development of HRV analysis, its physiological basis, some methodological aspects, and clinical potential.

In developed countries, cardiovascular disease is currently the leading cause of death for women aged over 55 years. Coronary heart disease (CHD) mortality is higher in women than in men, which is partly explained by CHD diagnostic problems due to different, gender-specific clinical manifestations of the disease.

The review outlines the main mechanisms of protective estrogen effects on cardiovascular system and the role of estrogen deficiency in cardiovascular disease (CVD) development. The position of the International Menopause Society (2009) on CVD in women is summarized. The importance of non-pharmaceutical measures in lifestyle modification and CVD risk factor (RF) management is discussed. The main principles of pharmaceutical treatment in premenopausal women are presented, together with the clinical evidence on mildronate in CVD prevention. The specific features of antihypertensive therapy in menopausal women are discussed. The authors justify the use of an angiotensin II receptor antagonist losartan as a first-choice medication for the management of arterial hypertension (AH) and metabolic disturbances. The role of lipid-lowering and glucose-lowering therapy is also demonstrated. Mutual efforts of cardiologists and gynecologists, together with active monitoring, are important components of RF management and primary CVD prevention in women.

Some typical limitations of the publications in selected Russian cardiology journals are analysed, and the potential methods to resolve these limitations are discussed.