The study investigated the association between cardiac arrhythmias and hemodynamic parameters in patients with myocardial infarction and mitral regurgitation of varying severity. In total, 70 men (mean age 62 years) were examined, including 35 individuals with cardiac arrhythmias. Left ventricular (LV) systolic and diastolic myocardial function, arrhythmia characteristics, and mitral regurgitation severity were assessed. A significant decrease in LV ejection fraction and more advanced diastolic dysfunction was observed in patients with ischemic mitral regurgitation and cardiac arrhythmias. In this group, patients with severe mitral regurgitation demonstrated ventricular extrasystoles of high Lown classes. Therefore, mitral regurgitation progression and subsequent diastolic dysfunction could be associated with higher risk of ventricular arrhythmias.

The retrospective univariable and multivariable analyses of 263 medical histories of patients with acute myocardial infarction, AMI (61 cases of external myocardial rupture), identified predictors of myocardial rupture during AMI. Myocardial rupture was more common in primary AMI, among female patients and elderly individuals. Pre-rupture period was characterised by prolonged anginal attack and persistent sinus tachycardia. AMI, complicated by myocardial rupture, was characterized by “early” pathological Q wave (in the absence of thrombolytic therapy); ST segment elevation >5 mm in two or more adjacent leads; prolonged QTc interval; substantial hypokinesis of intact left ventricular (LV) myocardium, combined with LV ejection fraction (EF) <40%; aneurysm deformation of LV chamber; local dyskinesis with involvement of apical LV segments; deceleration time (DT) for early diastolic filling <150 ms. Independent predictors of myocardial rupture included hypokinesis of intact LV myocardium combined with LV EF <40%; involvement of apical LV segments; ST segment elevation >5 mm; prolonged QTc interval; “early” pathological Q wave; primary AMI; and prolonged anginal attack at early AMI stages.

To investigate the association between late ventricular potentials and cardiac arrhythmias, 35 patients with cardiac connective tissue dysplasia (CTD), 34 patients with cardiac CTD and arterial hypertension (AH), and 39 relatively healthy people were examined. All participants underwent 24-hour ECG monitoring, echocardiography, and high definition ECG, in accordance with the 1999 clinical guidelines by the European Society of Cardiology. The duration of filtered QRS signal and low-amplitude signals at 40 mkV level in the end of QRS, as well as mean quadratic amplitude of the last 40 ms of filtered QRS signal, were assessed. High definition ECG and Holter ECG monitoring facilitates the prediction of life-threatening ventricular arrhythmias in patients with cardiac CTD.

Vascular reactivity and heart rate variability (HRV) were assessed in smoking adolescents at rest and during physical stress test. In total, 75 adolescents aged 16-18 years, were examined: 45 smokers and 30 healthy, physically active non-smokers. In all participants, vascular parameters were assessed by volume compression oscillometry and HRV measurement before, during, and after veloergometry. Among smoking adolescents, disturbed vascular reactivity and reduced physical stress tolerability, together with increased sympathetic activity, were registered. In healthy controls, adequate vascular reactivity, high physical stress tolerability, and preserved vagal-sympathetic balance were observed.

The study was aimed at assessing qualitative characteristics of late ventricular potentials (LVP) in 104 patients with various clinical forms of coronary heart disease (CHD). LVP assessment was performed at Days 3, 7, and 14 after admission to the acute cardiac care unit. The control group included 49 relatively healthy volunteers. For the majority of LVP and LVP spectre records, the amplitudes were consistent with the Gaussian random distribution. In addition, short and long-term dynamics of LVP parameters was investigated, after calculation of wavelet spectre and complex spectre module for each signal. To identify the high-correlation frequencies for paired leads, the cross-wavelet LVP analysis was used.

In young people with high normal blood pressure, individually developed programme of physical training could normalise cardiovascular reactivity, lipid peroxidation, and platelet hemostasis parameters. Twelve-month physical training programme completely optimised platelet adhesion and aggregation in vitro, which was increased at baseline. This beneficial effect could be even stronger, if physical training continues.

The paper presents clinical, instrumental, and pathologo-anatomical data for an elderly female patient with non-obstructive hypertrophic cardiomyopathy (DCMP), complicated by biventricular heart failure, pulmonary artery thromboembolia, and death. The problems of DCMP diagnostics, clinical variants, and possible outcomes are discussed.

In total, 100 patients aged 45-70 years, with Functional Class (FC) II-III chronic heart failure (CHF) and compensated or sub-compensated Type 2 diabetes mellitus (DM-2) were examined. All participants were randomised into two groups, including 50 individuals each. In the main group, the standard CHF therapy was combined with mildronate treatment (1,0 g/d). The study lasted for 12 weeks. In DM-2 patients, adding a cardioprotective agent mildronate to complex CHF therapy was associated with improved carbohydrate and lipid metabolism, significantly reduced oxidative stress, reduced CHF FC, increased physical stress tolerability, anti-anginal effect, and improved quality of life.

Acute coronary syndrome (ACS) is a form of coronary heart disease (CHD), combining acute myocardial infarction with ST segment elevation (STE ACS), acute myocardial infarction without ST segment elevation, and unstable angina (non-STE ACS). These clinical forms are considered as one syndrome, due to a high risk of acute myocardial infarction and sudden coronary death. Therefore, the problem of ACS treatment is particularly important. The management of non-STE ACS should always include anticoagulants – specifically, enoxaparin or unfractionated heparin. This study was aimed at identifying the anticoagulant with the best clinical and pharmaco-economic characteristics in conservative treatment of non-STE ACS.

In total, 40 patients with various stages of arterial hypertension (AH) were examined. All patients received nifedipine GITS as monotherapy or in combination with hydrochlorothiazide for 6 months. Nifedipine GITS demonstrated not only good antihypertensive activity, but also substantial organo-protective effects. Cardioprotection manifested in the reduction of left ventricular (LV) hypertrophy and LV diastolic dysfunction, as well as in correction of pathological LV geometry types. Vasoprotection was manifested in the correction of pathological microcirculation types. In addition, retinal functional status was improved.

The study assessed the effectiveness of an ACE inhibitor zofenopril in the treatment of patients with dilated cardiomyopathy (DCMP), complicated by chronic heart failure (CHF). The effects of the medication on clinical status, left ventricular (LV) remodelling, systolic and diastolic function were examined. This six-month study included 35 patients (28 men and 7 women; mean age 49 years). The control group, comparable by age and gender distribution, included 30 healthy people. All patients in the main group received zofenopril (7,5-15 mg/d). Clinical status was evaluated by NYCA Functional Class (FC) of CHF, 6-minute walk test results, and the CHF clinical status assessment scale. The analysed echocardiography parameters reflected LV myocardial remodelling, systolic and diastolic function. In 6 months, zofenopril therapy was linked to improved clinical status, quality of life, and LV systolic function, together with reduced CHF symptoms and LV remodelling. Long-term zofenopril therapy resulted in the reversion of restrictive diastolic dysfunction type into non-restrictive in most patients.

As a part of the Russian epidemiological survey EPOCH, a representative Ryazan Region sample was examined (953 families, 2098 individuals; mean age 44,8±0,01 years). The prevalence of potential symptoms of Functional Class (FC) I-IV chronic heart failure (CHF) reached 11,1%. In total, 222 patients with clinical symptoms of CHF were examined at hospital, and the diagnosis was confirmed in 75,2%. The prevalence of verified FC I-IV CHF in Ryazan Region was 7,9%. The CHF etiology was represented by arterial hypertension (92,8%), in combination with coronary heart disease (79,6%) and diabetes mellitus (16,2%). Most CHF patients had preserved left ventricular (LV) ejection fraction. In the majority of the patients with sinus rhythm, the first type of LV diastolic dysfunction, with impaired relaxation, was observed.

Endothelial dysfunction (ED) is currently considered as a key factor in atherosclerosis pathogenesis, and is manifested in disbalance between endothelial vasodilatators and vasoconstrictors. It has been demonstrated that virtually all atherogenic risk factors (RFs) act via ED. Therefore, ED parameters could be used as markers of early vascular atherosclerosis in people with atherogenic RFs. Early pathogenetic therapy in this group, as well as the treatment of the patients with confirmed atherosclerosis, could significantly improve prognosis.

The evidence on the role of Toll-like receptors (TLR) and their ligands in atherosclerosis development has been summarised. Bacterial lipopolysaccharides (LPS) could interact with TLR4 and induce macrophage transformation into foam cells, triggering atherosclerotic lesion development in the vascular wall. TLR4 mutations are associated with reduced atherosclerosis risk. Other microbial ligands and heat shock proteins could also induce atherosclerosis. A universal theory of atherogenesis is proposed, considering atherosclerosis induction and progression as an adverse effect of the interaction between exogenous and endogenous ligands and TLR.

In all actual clinical guidelines, dihydropyridine calcium channel blockers (CCBs) belong to the recommended first line antihypertensive drugs to treat essential hypertension. Several recent large clinical trials have confirmed their efficacy not only in lowering blood pressure but also in reducing cardiovascular morbidity and mortality in hypertensive patients with a normal or high cardiovascular risk profile. In clinical trials such as ALLHAT, VALUE or ASCOT, an amlodipine-based therapy was at least as effective, when not slightly superior, in lowering blood pressure and sometimes more effective in preventing target organ damages than blood pressure lowering strategies based on the use of diuretics, beta-blockers and blockers of the renin-angiotensin system. One of the main clinical side effects of the first and second generation CCBs including amlodipine is the development of peripheral edema. The incidence of leg edema can be markedly reduced by combining the CCB with a blocker of the renin-angiotensin system. This strategy has now led to the development of several fixed-dose combinations of amlodipine and angiotensin II receptor antagonists. Another alternative to lower the incidence of edema is to use CCBs of the third generation such as lercanidipine. Indeed, although no major clinical trials have been conducted with this compound, clinical studies have shown that lercanidipine and amlodipine have a comparable antihypertensive efficacy but with significantly less peripheral edema in patients receiving lercanidipine. In some countries, lercanidipine is now available in a single-pill association with an ACE inhibitor thereby further improving its efficacy and tolerability profile.