The study investigated the rational antihypertensive therapy in 966 patients with essential arterial hypertension (AH) and various renin-angiotensin blood profiles. Mean age was 51,4±10,2 years, mean systolic blood pressure (SBP) – 193,3±7,4 mm Hg, and mean diastolic BP (DBP) – 113,3± 4,8 mm Hg. Plasma renin activity (PRA; normal levels 1,0-3,0 ng/ml/h) and plasma aldosterone concentration (PAC; normal levels 5-23 ng/dl) were measured by radio-immune methods. The normal ratio of PAC (ng/dl) to PRA (ng/ml/h) is 5-23. It was demonstrated that in patients with PRA<0,22 ng/ml/h, the main monotherapy medications were angiotensin II receptor antagonists (ARA) and angiotensin-converting enzyme inhibitors (ACEI). In patients with PRA 0,22-1,0 ng/ml/h and PAC: PRA ratio 5-23, the main monotherapy medications were calcium antagonists (CA) and hydrochlorothiazide; in patients with PAC: PRA ratio >< 0,22 ng/ml/h, the main monotherapy medications were angiotensin II receptor antagonists (ARA) and angiotensin-converting enzyme inhibitors (ACEI). In patients with PRA 0,22-1,0 ng/ml/h and PAC: PRA ratio 5-23, the main monotherapy medications were calcium antagonists (CA) and hydrochlorothiazide; in patients with PAC: PRA ratio >23 – ACEI and ARA; in patients with PRA 1,0-3,0 mg/ml/h and normoaldosteronism – CA; in patients with PRA >3,0 ng/ml/h and PAC: PRA ratio< 5 – beta-adrenoblockers.

 

The study was aimed at investigating the potential of complex therapy (irbesartan, pioglitazone, and non-pharmaceutical treatment) in the correction of anticoagulant, fibrinolytic, and anti-aggregant activity of vascular wall among patients with arterial hypertension, metabolic syndrome, and oculo-vascular occlusion in anamnesis. The four-month complex therapy improved anticoagulant, fibrinolytic, and anti-aggregant vascular wall activity, with the evaluated parameters reaching the lower level of control range, but not being normalized. These results were relatively stable and persisted up to the end of the follow-up period, even with non-strict compliance to non-pharmaceutical therapy.

The effects of lipid profile (LP) parameters on endothelium-dependent vasodilatation were studied in patients with coronary heart disease (CHD) and metabolic syndrome during the lipid load (LL) test. CHD diagnosis was confirmed by selective coronary angiography (CAG). According to CAG results, all participants were divided into 2 groups: Group 1 – without coronary artery (CA) stenosis, or with one-vessel CA stenosis <50%; and Group 2 – with CA stenosis >50% in 2 or more vessels. In Group 2, low-density lipoprotein cholesterol (LDL-CH) levels were significantly higher at baseline and 6 hours after the LL test, while atherogenicity index (AI) was significantly higher after the LL test. In addition, for both groups, fasting triglyceride (TG) levels were higher than normal, doubling after the LL test. At baseline, endothelial function (EF) parameters were lower than normal in both groups. The LL test resulted in vasospastic reaction, with a significantly greater EF reduction among Group 2 patients. Therefore, this test of endothelium-dependent vasodilatation provides an opportunity to identify the patients with more advanced coronary atherosclerosis.

The study was aimed at investigating endothelial function of common carotid arteries in patients with isolated arterial hypertension (AH), isolated chronic obstructive pulmonary disease (COPD), and their combination. The study included 67 patients with AH and COPD, as well as 45 patients with either AH or COPD (the comparison group), aged from 40 to 50 and from 51 to 60 years. Ultrasound assessment of common carotid artery (CCA) intima-media thickness (IMT) demonstrated significantly increased IMT in patients with a combination of AH and COPD, comparing to participants with isolated AH or COPD. In addition, CCA stenosis was observed in COPD patients and individuals with AH combined with COPD.

The paper presents the results of the ultrasound echocardiography among 126 hypertensive women in late fertile period (LFP). The comparative analysis of left heart structure, geometry, and volume-spherical parameters demonstrated that in LFP women with arterial hypertension (AH) and disturbed estradiol levels, heart remodelling is characterised by more advanced left heart geometry disturbances than in their peers with normal estradiol levels. The most prevalent variant of disturbed left heart geometry was heart remodelling with left ventricular hypertrophy, specifically eccentric hypertrophy.

The prevalence of anemia and its effects on chronic heart failure (CHF) course in ambulatory patients of various age were examined. The study included 282 patients (86 women, 196 men) with NYHA Functional Class (FC) II-II CHF, aged from 39 to 85 years (median age 67 [62-73] years). In CHF patients, anemia prevalence reached 18,8%, and in those aged over 60 years – 20,2%. The prevalence of anemia in elderly men (11%) and women (9,2%) was similar. There was no significant difference in anemia prevalence between elderly individuals with normal (21%) or reduced left ventricular ejection fraction, LVEF (19,3%). In elderly CHF individuals with renal dysfunction, anemia prevalence was as high as 36,9%. In the majority of participants, anemia was normocytic, while iron deficiency was observed in 36,9%, vitamin B12 deficiency – in 6,5%, and folic acid deficiency – in 10,9%. In 45,6% of the patients, anemia genesis was unclear. There was a strong association between anemic syndrome in CHF and age, creatinine clearance, diabetes mellitus, and the incidence of hospital admission due to CHF decompensation.

The study assessed the effects of psychotropic therapy on quality of life (QoL) among patients with diastolic chronic heart failure (CHF) and concomitant affective disorders. In total, 76 patients (70 women, 6 men) were examined; in 48, anxiety and depressive disorders were observed. All participants underwent the assessment of QoL, physical functioning and affective disorder severity at baseline and 3 months after the start of the therapy. The antidepressant therapy was associated with improved physical and psychological status, as well as with improved health-related QoL.

Electrocardiography is the most accessible and widely used method for diagnosing myocardial infarction (MI) and predicting MI outcomes. This paper presents the results of the prospective study, assessing ST segment dynamics in 248 MI patients and evaluating its role in predicting short-term (3 months) post-hospital MI outcomes. At least once (at admission, at Days 6-8, or at discharge), ST segment elevation was registered in 117 MI patients (47%), and ST segment depression – in 134 (54%). Among these participants, persistent ST elevation/depression, registered at all control points, was observed only in 15%: two thirds (26 out of 37) had persistent ST elevation, and the others – persistent ST depression. During the three-month follow-up period, a combined endpoint (cardiovascular death, non-fatal MI, stroke, or unstable angina) was registered in 48 participants (19,7%; the endpoint was evaluated in 245 patients with known post-hospital outcomes). Independent predictors of poor post-hospital MI prognosis included persistent ST elevation (odds ratio 2,9; 95% confidence interval 1,2-7,0) and persistent ST depression (odds ratio 4,3; 1,2-14,8), but not episodic, non-persistent ST elevation/depression.

Paecilomycosis is a new mycosis, included in the WHO classification. For the first time, paecilomycotic heart pathology was studied in animals and humans. In particular, 218 children were examined, using various bacteriological, clinical, cardiological, biochemical, and immunological methods. In 150 white mice, an experiment paecilomycosis model was used to confirm the diagnosis and investigate the potential of various registered medications, identifying the most effective and the least toxic ones. According to evidence-based medicine principles, the clinical diagnoses of paecilomycotic cardiomyopathy and myocardites were specified. Aetiopathogenetic therapy with nizoral and immunomodulin improved clinical course of pecylomycotic heart disease, due to prevention of complications, chronisation, and long hospitalization time. The best treatment effectiveness in 4-7-year-old children with pecylomycotic cardiomyopathy and myocardites was observed for the combination of diflucan, mycosyst, cardiac glycosides from medicinal plants, and polyoxydonium.

The review is focused on the use of cardio-selective beta-adrenoblockers (BAB) in patients with cardiovascular disease combined with chronic obstructive pulmonary disease (COPD). The data of meta-analyses, clinical trials and reviews are presented, which demonstrate cardio-selective BAB safety in COPD patients. In addition, all-cause and cardiovascular mortality in COPD patients, as well as cardio-selective BAB effects on these mortality parameters, are discussed.

The effectiveness of urgent medical care was retrospectively compared in 662 patients with atrial fibrillation (AF) paroxysms, arterial hypertension, and coronary heart disease; in addition, pre-hospital treatment tactics was evaluated. Prehospital AF treatment was minimally effective in the first hour of the follow-up. The majority of the AF paroxysms (>92%) were resolved within the first 24 hours, regardless of the main pathology. The authors propose the pre-hospital treatment tactics for patients with persistent AF paroxysms lasting up to 24 hours. This tactics gives an opportunity to reduce costs and the time spent on urgent medical care visits, therefore, increasing the capacity of urgent medical care service.