1
|
Tarlovskaya EI, Arutyunov AG, Konradi AO, Lopatin YM, Rebrov AP, Tereshchenko SN, Chesnikova AI, Hayrapetyan HG, Babin AP, Bakulin IG, Bakulina NV, Balykova LA, Blagonravova AS, Boldina MV, Vaisberg AR, Galyavich AS, Gomonova VV, Grigorieva NY, Gubareva IV, Demko IV, Evzerikhina AV, Zharkov AV, Kamilova UK, Kim ZF, Kuznetsova TY, Lareva NV, Makarova EV, Malchikova SV, Nedogoda SV, Petrova MM, Pochinka IG, Protasov KV, Protsenko DN, Ruzanau DY, Sayganov SA, Sarybaev AS, Selezneva NM, Sugraliev AB, Fomin IV, Khlynova OV, Chizhova OY, Shaposhnik II, Shсukarev DA, Abdrahmanova AK, Avetisian SA, Avoyan HG, Azarian KK, Aimakhanova GT, Ayipova DA, Akunov AC, Alieva MK, Aparkina AV, Aruslanova OR, Ashina EY, Badina OY, Barisheva OY, Batchayeva AS, Bitieva AM, Bikhteyev IU, Borodulina NA, Bragin MV, Budu AM, Burygina LA, Bykova GA, Vagapova KR, Varlamova DD, Vezikova NN, Verbitskaya EA, Vilkova OE, Vinnikova EA, Vustina VV, Gаlova EA, Genkel VV, Gorshenina EI, Gostishev RV, Grigorieva EV, Gubareva EY, Dabylova GM, Demchenko AI, Dolgikh OY, Duyshobayev MY, Evdokimov DS, Egorova KE, Ermilova AN, Zheldybayeva AE, Zarechnova NV, Zimina YD, Ivanova SY, Ivanchenko EY, Ilina MV, Kazakovtseva MV, Kazymova EV, Kalinina YS, Kamardina NA, Karachenova AM, Karetnikov IA, Karoli NA, Karpov OV, Karsiev MK, Кaskaeva DS, Kasymova KF, Kerimbekova ZB, Kerimova AS, Kim ES, Kiseleva NV, Klimenko DA, Klimova AV, Kovalishena OV, Kolmakova EV, Kolchinskaya TP, Kolyadich MI, Kondriakova OV, Konoval MP, Konstantinov DY, Konstantinova EA, Kordukova VA, Koroleva EV, Kraposhina AY, Kriukova TV, Kuznetsova AS, Kuzmina TY, Kuzmichev KV, Kulchoroeva CK, Kuprina TV, Kouranova IM, Kurenkova LV, Kurchugina NY, Kushubakova NA, Levankova VI, Levin MЕ, Lyubavina NA, Magdeyeva NA, Mazalov KV, Majseenko VI, Makarova AS, Maripov AM, Marusina AA, Melnikov ES, Moiseenko NB, Muradova FN, Muradyan RG, Myshak AO, Nikitina NM, Ogurlieva BB, Odegova AA, Omarova YM, Omurzakova NA, Ospanova SO, Pahomova EV, Petrov LD, Plastinina SS, Pogrebetskaya VA, Polyakov DS, Ponomarenko EV, Popova LL, Prokofeva NA, Pudova IA, Rakov NA, Rakhimov AN, Rozanova NA, Serikbolkyzy S, Simonov AA, Skachkova VV, Soloveva DV, Soloveva IA, Sokhova FM, Subbotin AK, Sukhomlinova IM, Sushilova AG, Tagayeva DR, Titojkina YV, Tikhonova EP, Tokmin DS, Tolmacheva AA, Torgunakova MS, Trenogina KV, Trostianetckaia NA, Trofimov DA, Tulichev AA, Tursunova AT, Ulanova ND, Fatenkov OV, Fedorishina OV, Fil TS, Fomina IY, Fominova IS, Frolova IA, Tsvinger SM, Tsoma VV, Cholponbaeva MB, Chudinovskikh TI, Shevchenko OA, Sheshina TV, Shishkina EA, Shishkov KY, Sherbakov SY, Yausheva EA, Musaelian SN, Belenkov YN, Arutyunov GP. Analysis of influence of background therapy for comorbidities in the period before infection on the risk of the lethal COVID outcome. Data from the international ACTIV SARS-CoV-2 registry («Analysis of chronic non-infectious diseases dynamics after COVID-19 infection in adult patients SARS-CoV-2»). ACTA ACUST UNITED AC 2021; 61:20-32. [PMID: 34713782 DOI: 10.18087/cardio.2021.9.n1680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022]
Abstract
Aim To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients' privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).Results The analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.
Collapse
Affiliation(s)
- E I Tarlovskaya
- Eurasian Association of Therapists, Moscow; Privolzhsky Research Medical University, Nizhny Novgorod
| | - A G Arutyunov
- Eurasian Association of Therapists, Moscow; N. I. Pirogov Russian National Research Medical University, Moscow
| | - A O Konradi
- V. A. Almazov National Medical Research Center, St. Peterburg
| | | | - A P Rebrov
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | | | - H G Hayrapetyan
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - A P Babin
- Nikolae Testemitanu Sate University of Medicine and Pharmacy, Kishinev
| | - I G Bakulin
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N V Bakulina
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - L A Balykova
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - M V Boldina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A R Vaisberg
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A S Galyavich
- Interregional Clinical Diagnostic Center, Kazan; Kazan State Medical University, Kazan
| | - V V Gomonova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N Yu Grigorieva
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | | | - I V Demko
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
| | | | | | - U K Kamilova
- National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | - Z F Kim
- Kazan Municipal Clinical Hospital №7, Kazan
| | | | | | - E V Makarova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | | | - M M Petrova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - I G Pochinka
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Clinical Hospital #13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | - K V Protasov
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | | | | | - S A Sayganov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A S Sarybaev
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - N M Selezneva
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - A B Sugraliev
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - I V Fomin
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - O V Khlynova
- Akademician E. A. Vagner Perm State Medical University, Perm
| | - O Yu Chizhova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | | | - A K Abdrahmanova
- Kazakh Medical University of Continuous Education, Alma-Ata; I. Zhekenova Municipal Clinical Hospital for Infectious Diseases, Alma-Ata
| | - S A Avetisian
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - H G Avoyan
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - K K Azarian
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - G T Aimakhanova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - D A Ayipova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - A Ch Akunov
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - M K Alieva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A V Aparkina
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | - E Yu Ashina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - O Yu Badina
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A S Batchayeva
- N. I. Pirogov Russian National Research Medical University, Moscow
| | - A M Bitieva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I U Bikhteyev
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - M V Bragin
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A M Budu
- Municipal Clinical Hospital №1, Kishinev
| | - L A Burygina
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - G A Bykova
- Akademician E. A. Vagner Perm State Medical University, Perm
| | - K R Vagapova
- Polyclinic №1 at the Administrative Department of the President of the Russian Federation, Moscow
| | | | | | - E A Verbitskaya
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - O E Vilkova
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - E A Vinnikova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - E A Gаlova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - V V Genkel
- South Ural State Medical University, Chelyabinsk
| | - E I Gorshenina
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - E V Grigorieva
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | - G M Dabylova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | | | | | - M Y Duyshobayev
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - D S Evdokimov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - K E Egorova
- V. A Baranov Karelia Republic Hospital, Petrozavodsk
| | - A N Ermilova
- Eurasian Association of Therapists, Moscow; V. P. Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow
| | | | | | - Yu D Zimina
- Municipal Clinical Hospital №25, Novosibirsk
| | | | | | - M V Ilina
- Kirovsk Inter-District Hospital, outpatient department, Kirovsk
| | | | - E V Kazymova
- Clinical Hospital at the Samara Station "Russian Railways Medicine", Samara
| | - Yu S Kalinina
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - N A Kamardina
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - I A Karetnikov
- Irkutsk Regional Clinical Hospital, recipient of the "Badge of Honor" award, Irkutsk
| | - N A Karoli
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - O V Karpov
- P. B. Gannushkin Psychiatric Clinical Hospital #4, Moscow
| | - M Kh Karsiev
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - D S Кaskaeva
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - K F Kasymova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - Zh B Kerimbekova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | - E S Kim
- Kazan State Medical University, Kazan; Kazan Municipal Clinical Hospital №7, Kazan
| | - N V Kiseleva
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | - A V Klimova
- N. I. Pirogov Russian National Research Medical University, Moscow; Municipal Polyclinic №134, Moscow
| | | | - E V Kolmakova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - M I Kolyadich
- South Ural State Medical University, Chelyabinsk; Chelyabinsk Municipal Clinical Hospital №1, Chelyabinsk
| | | | - M P Konoval
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | | | - V A Kordukova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - E V Koroleva
- Municipal Clinical Hospital №5 of the Nizhny Novgorod Nizhegorodsky District, Nizhny Novgorod
| | - A Yu Kraposhina
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk; Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | | | - T Yu Kuzmina
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - K V Kuzmichev
- Municipal Clinical Hospital №13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | - Ch K Kulchoroeva
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | | | | | | | - N A Kushubakova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | - M Е Levin
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - N A Lyubavina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - N A Magdeyeva
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - K V Mazalov
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A S Makarova
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | - A M Maripov
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - A A Marusina
- Kirovsk Inter-District Hospital, outpatient department, Kirovsk
| | - E S Melnikov
- Eurasian Association of Therapists, Moscow; I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N B Moiseenko
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - F N Muradova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - R G Muradyan
- Global Medical System Clinics and Hospitals, Moscow
| | | | - N M Nikitina
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - B B Ogurlieva
- N. I. Pirogov Russian National Research Medical University, Moscow; Municipal Clinical Hospital №4, Moscow
| | | | - Yu M Omarova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - N A Omurzakova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - Sh O Ospanova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - E V Pahomova
- GBUZ RK "Republican tuberculosis dispensary", Petrozavodsk
| | | | - S S Plastinina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - V A Pogrebetskaya
- Municipal Clinical Hospital №38 of the Nizhny Novgorod Nizhegorodsky District, Nizhny Novgorod
| | - D S Polyakov
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | | | - N A Prokofeva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I A Pudova
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Polyclinic №4 of the Nizhny Novgorod Kanavinsky District, Nizhny Novgorod
| | - N A Rakov
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A N Rakhimov
- 21 National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | | | - S Serikbolkyzy
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - A A Simonov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - D V Soloveva
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - I A Soloveva
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk; Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - F M Sokhova
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - A K Subbotin
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A G Sushilova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - D R Tagayeva
- National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | - Yu V Titojkina
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - E P Tikhonova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | - A A Tolmacheva
- Novosibirsk State Medical University, Novosibirsk; Clinical Consultative and Diagnostic Polyclinic №27, Novosibirsk
| | - M S Torgunakova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | | | - D A Trofimov
- Kazan State Medical University, Kazan; Kazan Municipal Clinical Hospital №7, Kazan
| | - A A Tulichev
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Clinical Hospital №3, Nizhny Novgorod
| | - A T Tursunova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - N D Ulanova
- Municipal Clinical Hospital #13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | | | - O V Fedorishina
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | - T S Fil
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I Yu Fomina
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Polyclinic #1, Nizhny Novgorod
| | - I S Fominova
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - I A Frolova
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - V V Tsoma
- Volgograd State Medical University, Volgograd
| | - M B Cholponbaeva
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | | | - T V Sheshina
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - E A Shishkina
- Akademician E. A. Vagner Perm State Medical University, Perm
| | | | - S Yu Sherbakov
- Kazan State Medical Academy, Branch of the Russian Medical Academy of Continuing Professional Education, Kazan
| | - E A Yausheva
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - Yu N Belenkov
- The First Moscow state medical University I. M. Sechenov
| | - G P Arutyunov
- Eurasian Association of Therapists, Moscow; N. I. Pirogov Russian National Research Medical University, Moscow
| |
Collapse
|
2
|
Arutyunov AG, Kolesnikova EA, Ilyina KV, Rylova AK, Arutyunov GP, Scherbacova NV, Kulagina NP. Selection of the optimal respiratory muscle training mode in patients with class II-III chronic heart failure. ACTA ACUST UNITED AC 2021; 61:69-75. [PMID: 33734046 DOI: 10.18087/cardio.2021.2.n1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/11/2020] [Accepted: 12/19/2020] [Indexed: 11/18/2022]
Abstract
Aim To study the effect of various types of respiratory muscle training (RMT) in patients with functional class (FC) II-III chronic heart failure (CHF) and more than 70% preserved diaphragm muscle mass.Material and methods 53 patients (28 men and 25 women) aged 50-75 years with NYHA FC II-III ischemic heart disease (IHD) and arterial hypertension with more than 70% preserved diaphragm muscle mass of >70% were randomized to one of four RMT types: static loads, dynamic loads, their combination, and breathing without applied resistance as a control. Peak oxygen consumption (VO2 peak) and maximum inspiratory pressure (MIP) were evaluated at baseline and in 6 months.Results All study groups showed significant improvement of physical endurance indexes compared to baseline values (р<0.05). In pairwise comparison, the groups significantly differed (р<0.01). The greatest improvement was observed for patients of dynamic and combined training groups. Furthermore, in the combined training group, results were significantly higher than in the group of isolated dynamic loads. The most significant (р <0.01), positive changes in the force of inspiratory muscles were observed in groups of dynamic and combined trainings with the best results displayed by patients of the combined training group.Conclusion With preserving more than 70 % of diaphragm muscle tissue (as determined by MIP >60 cm H2O), a combination of static and dynamic RMT is most effective for patients with FC II-III CHF.
Collapse
Affiliation(s)
- A G Arutyunov
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - E A Kolesnikova
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - K V Ilyina
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia Сity clinical hospital №4, Moscow, Russia
| | - A K Rylova
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - G P Arutyunov
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - N V Scherbacova
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | | |
Collapse
|
3
|
Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YN, Konradi AO, Lopatin YM, Tereshchenko SN, Rebrov AP, Chesnikova AI, Fomin IV, Grigorieva NU, Boldina VM, Vaisberg AR, Blagonravova AS, Makarova EV, Shaposhnik II, Kuznetsova TY, Malchikova SV, Protsenko DN, Evzerikhina AV, Petrova MM, Demko IV, Saphonov DV, Hayrapetyan HG, Galyavich AS, Kim ZF, Sugraliev AB, Nedogoda SV, Tsoma VV, Sayganov SA, Gomonova VV, Gubareva IV, Sarybaev AS, Ruzanau DY, Majseenko VI, Babin AP, Kamilova UK, Koroleva EV, Vilkova OE, Fomina IY, Pudova IA, Soloveva DV, Doshchannikov DA, Kiseleva NV, Zelyaeva NV, Kouranova IM, Pogrebetskaya VA, Muradova FN, Badina OY, Kovalishena OV, Gаlova AE, Plastinina SS, Grigorovich MS, Lyubavina NA, Vezikova NN, Levankova VI, Ivanova SY, Ermilova AN, Muradyan RG, Gostishev RV, Tikhonova EP, Kuzmina TY, Soloveva IA, Kraposhina AY, Kolyadich MI, Kolchinskaya TP, Genkel VV, Kuznetsova AS, Kazakovtseva MV, Odegova AA, Chudinovskikh TI, Baramzina SV, Rozanova NA, Kerimova AS, Krivosheina NA, Chukhlova SY, Levchenko AA, Avoyan HG, Azarian KK, Musaelian SN, Avetisian SA, Levin ME, Karpov OV, Sokhova FM, Burygina LA, Sheshina TV, Tiurin AA, Dolgikh OY, Kazymova EV, Konstantinov DY, Chumakova OA, Kondriakova OV, Shishkov KY, Fil ST, Prokofeva NA, Konoval MP, Simonov AA, Bitieva AM, Trostianetckaia NA, Cholponbaeva MB, Kerimbekova ZB, Duyshobayev MY, Akunov AC, Kushubakova NA, Melnikov ES, Kim ES, Sherbakov SY, Trofimov DA, Evdokimov DS, Ayipova DA, Duvanov IA, Abdrahmanova AK, Aimakhanova GT, Ospanova SO, Gaukhar MD, Tursunova AT, Kaskaeva DS, Tulichev AA, Ashina EY, Kordukova VA, Barisheva OY, Egorova KE, Varlamova DD, Kuprina TV, Pahomova EV, Kurchugina NY, Frolova IA, Mazalov KV, Subbotin AK, Kamardina NA, Zarechnova NV, Mamutova EM, Smirnova LA, Klimova AV, Shakhgildyan LD, Tokmin DS, Tupitsin DI, Kriukova TV, Polyakov DS, Karoli NA, Grigorieva EV, Magdeyeva NA, Aparkina AV, Nikitina NM, Petrov LD, Budu AM, Rasulova ZD, Tagayeva DR, Fatenkov OV, Gubareva EY, Demchenko AI, Klimenko DA, Omarova YV, Serikbolkyzy S, Zheldybayeva AE. [International register "Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients (ACTIV SARS-CoV-2)"]. Kardiologiia 2021; 60:30-34. [PMID: 33487147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
|
4
|
Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YN, Konradi AO, Lopatin YM, Tereshchenko SN, Rebrov AP, Chesnikova AI, Fomin IV, Grigorieva NU, Boldina VM, Vaisberg AR, Blagonravova AS, Makarova EV, Shaposhnik II, Kuznetsova TY, Malchikova SV, Protsenko DN, Evzerikhina AV, Petrova MM, Demko IV, Saphonov DV, Hayrapetyan HG, Galyavich AS, Kim ZF, Sugraliev AB, Nedogoda SV, Tsoma VV, Sayganov SA, Gomonova VV, Gubareva IV, Sarybaev AS, Ruzanau DY, Majseenko VI, Babin AP, Kamilova UK, Koroleva EV, Vilkova OE, Fomina IY, Pudova IA, Soloveva DV, Doshchannikov DA, Kiseleva NV, Zelyaeva NV, Kouranova IM, Pogrebetskaya VA, Muradova FN, Omarova YV, Badina OY, Kovalishena OV, Gаlova AE, Plastinina SS, Grigorovich MS, Lyubavina NA, Vezikova NN, Levankova VI, Ivanova SY, Ermilova AN, Muradyan RG, Gostishev RV, Tikhonova EP, Kuzmina TY, Soloveva IA, Kraposhina AY, Kolyadich MI, Kolchinskaya TP, Genkel VV, Kuznetsova AS, Kazakovtseva MV, Odegova AA, Chudinovskikh TI, Baramzina SV, Rozanova NA, Kerimova AS, Krivosheina NA, Chukhlova SY, Levchenko AA, Avoyan HG, Azarian KK, Musaelian SN, Avetisian SA, Levin ME, Karpov OV, Sokhova FM, Burygina LA, Sheshina TV, Tiurin AA, Dolgikh OY, Kazymova EV, Konstantinov DY, Chumakova OA, Kondriakova OV, Shishkov KY, Fil ST, Prokofeva NA, Konoval MP, Simonov AA, Bitieva AM, Trostianetckaia NA, Cholponbaeva MB, Kerimbekova ZB, Duyshobayev MY, Akunov AC, Kushubakova NA, Melnikov ES, Kim ES, Sherbakov SY, Trofimov DA, Evdokimov DS, Ayipova DA, Duvanov IA, Abdrahmanova AK, Aimakhanova GT, Ospanova SO, Dabylova GM, Tursunova AT, Kaskaeva DS, Tulichev AA, Ashina EY, Kordukova VA, Barisheva OY, Egorova KE, Varlamova DD, Kuprina TV, Pahomova EV, Kurchugina NY, Frolova IA, Mazalov KV, Subbotin AK, Kamardina NA, Zarechnova NV, Mamutova EM, Smirnova LA, Klimova AV, Shakhgildyan LD, Tokmin DS, Tupitsin DI, Kriukova TV, Polyakov DS, Karoli NA, Grigorieva EV, Magdeyeva NA, Aparkina AV, Nikitina NM, Petrov LD, Budu AM, Rasulova ZD, Tagayeva DR, Fatenkov OV, Gubareva EY, Demchenko AI, Klimenko DA, Serikbolkyzy S, Zheldybayeva AE. International register “Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients (ACTIV SARS-CoV-2)”. Kardiologiia 2020. [DOI: 10.18087/cardio.2020.11.n1398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
5
|
Shlyakhto YV, Arutyunov GP, Belenkov YN, Tarlovskaya EI, Konradi AO, Panchenko EP, Yavelov IS, Tereshchenko SN, Ardashev AV, Arutyunov AG, Grigorieva NY, Dzhunusbekova GA, Drapkina OM, Koziolova NA, Komarov AL, Kropacheva ES, Malchikova SV, Mitkovskaya NP, Orlova YA, Petrova MM, Rebrov AP, Sisakian H, Skibitsky VV, Sugraliyev AB, Fomin IV, Chesnikova AI, Shaposhnik II, Zhelyakov EG, Kanorskii SG, Kolotsey LV, Snezhitskiy VA. [Use of Statins, Anticoagulants, Antiaggregants and Antiarrhythmic Drugs in Patients With COVID-19. The Agreed Experts' Position of Russian Society of Cardiology, Eurasian Association of Therapists, National Society on Atherothrombosis, Societies of Experts in Urgent Cardiology, Eurasian Arrhythmology Association]. ACTA ACUST UNITED AC 2020; 60:1180. [PMID: 32720611 DOI: 10.18087/cardio.2020.6.n1180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/25/2020] [Indexed: 12/12/2022]
Abstract
This article discusses relevant aspects in the treatment of patients with COVID-19. Up-to-date information about principles for administration of statins, antithrombotics, and antiarrhythmics is presented. The authors addressed in detail specific features of reversing heart rhythm disorders in patients with coronavirus infection and the interaction of antiarrhythmic and antiviral drugs. Recommendations are provided for outpatient and inpatient antithrombotic therapy for patients with COVID-19. Issues of antithrombotic and antiviral drug interaction are discussed.
Collapse
Affiliation(s)
- Ye V Shlyakhto
- Almazov National Medical Research Centre of Ministry of Healthcare of Russia, Saint- Petersburg
| | - G P Arutyunov
- Pirogov Russian National Research Medical University, Moscow
| | - Yu N Belenkov
- First Moscow state medical University I. M. Sechenov, Moscow
| | | | - A O Konradi
- National research medical center V. A. Almazov of Ministry of Healthcare of Russia, Saint-Petersburg
| | - E P Panchenko
- National Medical Research Center of Cardiology, Moscow
| | - I S Yavelov
- National Medical Research Center for Therapy and Preventive Medicine, Moscow
| | | | | | - A G Arutyunov
- Pirogov Russian National Research Medical University, Moscow
| | | | | | - O M Drapkina
- National Center for Therapy and Preventive Medicine, Moscow
| | - N A Koziolova
- State funded educational institution of the highest education "E.A. Wagner Perm State Medical University" Public Health Ministry of Russian Federation, Perm
| | - A L Komarov
- Department of clinical problems of atherothrombosis "NMIC cardiology" of the Ministry of health of the Russian Federation, Moscow
| | | | - S V Malchikova
- Kirov State Medical University Kirov State Medical University, Kirov
| | - N P Mitkovskaya
- Cardiology and internal diseases of BSMU, Republic of Belarus, Minsk
| | | | - M M Petrova
- Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk
| | - A P Rebrov
- Saratov State Medical University named after V.I. Razumovsky, Saratov
| | - H Sisakian
- Yerevan State Medical University, Yerevan
| | | | - A B Sugraliyev
- Asfendiyarov Kazakh National Medical University, Alma-Atyu
| | - I V Fomin
- Volga Research Medical University, Nizhny Novgorod
| | | | | | | | - S G Kanorskii
- Kuban State Medical University of the Ministry of Healthcare of the Russian Federation, Krasnodar
| | | | | |
Collapse
|
6
|
Arutyunov GP, Koziolova NA, Tarlovskaya EI, Arutyunov AG, Grigorjeva NY, Dzhunusbekova GA, Malchikova SV, Mitkovskaya NP, Orlova YA, Petrova MM, Rebrov AP, Sisakyan AS, Skibitsky VV, Sugraliev AB, Fomin IV, Chesnikova AI, Shaposhnik II. [The Agreed Experts' Position of the Eurasian Association of Therapists on Some new Mechanisms of COVID-19 Pathways: Focus on Hemostasis, Hemotransfusion Issues and Blood gas Exchange]. ACTA ACUST UNITED AC 2020; 60:9-19. [PMID: 32515699 DOI: 10.18087/cardio.2020.5.n1132] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Abstract
The article discusses pathogenesis and treatment of COVID-19. The authors presented state-of-the-art insight into hemostatic disorders in patients with COVID-19 and clinical recommendations on prevention of thrombosis and thromboembolism in patients infected with SARS-CoV-2. The article discussed in detail a new hypothesis proposed by Chinese physicians about a new component in the pathogenesis of COVID-19, namely, about the effect of SARS-CoV-2 virus on the hemoglobin beta-chain and the formation of a complex with porphyrin, which results in displacement of the iron ion. Thus, hemoglobin loses the capability for transporting oxygen, which aggravates hypoxia and worsens the prognosis. The article stated rules of hemotransfusion safety in the conditions of COVID-19 pandemic.
Collapse
Affiliation(s)
- G P Arutyunov
- N. I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - N A Koziolova
- Academician E. A. Vagner Perm State Medical University, Perm, Russia
| | - E I Tarlovskaya
- Privolzhsky Research Medical University, Nizhniy Novgorod, Russia
| | - A G Arutyunov
- N. I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - N Yu Grigorjeva
- Privolzhsky Research Medical University, Nizhniy Novgorod, Russia
| | - G A Dzhunusbekova
- Kazakh Medical University of Postgraduate Education, Almaty, Republic of Kazakhstan
| | | | - N P Mitkovskaya
- Belorussian State Medical University, Minsk, Republic of Belarus
| | - Ya A Orlova
- M. V. Lomonosov Moscow State University, Moscow, Russia
| | - M M Petrova
- V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia
| | - A P Rebrov
- V. I. Razumovsky Saratov State Medical University, Saratov, Russia
| | - A S Sisakyan
- M. Geratsi Erevan State Medical University, Erevan, Armenia
| | | | - A B Sugraliev
- S. D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
| | - I V Fomin
- Privolzhsky Research Medical University, Nizhniy Novgorod, Russia
| | | | - I I Shaposhnik
- South Ural State Medical University, Chelyabinsk, Russia
| |
Collapse
|
7
|
Simbirtseva AS, Arutyunov GP, Bylova NA, Arutyunov AG, Simbirtsev SY. [Significance of adipose tissue mass for the clinical course of pneumonia associated with decompensated CHF]. Kardiologiia 2019:61-68. [PMID: 30362430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Pneumonia is one of most important causes of in-hospital mortality in patients with decompensated chronic heart failure (CHF). AIM To evaluate the effect of adipose tissue mass and body weight index (BWI) on prognosis for patients with communityacquired pneumonia and decompensated CHF. MATERIALS AND METHODS The study included 286 patients aged 53-90 with BWI 18.5-24.9 kg/m2 who were hospitalized in cardiology and therapy departments of an emergency care hospital for decompensated CHF and pneumonia, which was verified within the first day of admission. Body composition was analyzed using a bioimpedance analyzer of body water sectors (ABC-01, Medass); BWI was calculated for all patients. Sputum samples collected with proper observation of sterility rules were analyzed in a specialized microbiological laboratory. Statistical analysis was performed with methods of binary logistic regression, Kaplan-Meier, Cox regression, and two-step cluster analysis using the IBM SPSS Statistics 20 software. RESULTS Assessing the body composition showed that groups with sputum Str. Pneumonia and mixed infection differed in indexes of lean body mass and adipose tissue mass but not in BWI. In-the mixed group, the in-hospital mortality was 38.71% and the one-year mortality - 95.16%. In the group with Str. Pneumonia in the sputum culture, the in-hospital mortality was 18.52% and the one-year mortality - 42.59%. The two-step cluster analysis allowed to isolate two clusters in the structure of the studied totality. All patients of the first cluster died during the first 9 months of the year following hospitalization. They were distinguished by lower values of lean body mass and BWI, older age, and the presence of mixed infection in the sputum culture in 39.1% of cases. CONCLUSION In the structure of the studied totality, the most important risk factor for in-hospital mortality and one-year death was the value of adipose tissue mass.
Collapse
Affiliation(s)
- A S Simbirtseva
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - G P Arutyunov
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - N A Bylova
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - A G Arutyunov
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - S Y Simbirtsev
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| |
Collapse
|
8
|
Arutyunov AG, Ilyina KV, Arutyunov GP, Kolesnikova EA, Pchelin VV, Kulagina NP, Tokmin DS, Tulyakova EV. Morphofunctional Features of The Diaphragm in Patients With Chronic Heart Failure. ACTA ACUST UNITED AC 2019; 59:12-21. [PMID: 30710984 DOI: 10.18087/cardio.2019.1.2625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 01/27/2019] [Indexed: 11/18/2022]
Abstract
AIM to study changes in the volumes of muscle, fat, and connective tissue in postmortem issue samples (autoptates) from diaphragm, right ventricle, lower limb (gastrocnemius muscle), as well as morphological changes of the diaphragm muscular structure in patients with different functional classes of heart failure (HF), and to compare them with some intravital parameters of external respiration (with maximal inspiratory pressure and its amplitude simultaneously measured by ultrasound method in particular). MATERIALS AND METHODS Autoptates of the diaphragm muscle, right ventricle, lower limb (n=39) from 20 men and 19 women (with in vivo diagnosis CHF NYHA functional class (FC) I-IV, hypertension, ischemic heart disease) were examined within 24 hours after the fatal outcome. Light optical microscopy was used to assess the percentages of muscle, connective, adipose tissue, numbers of fibroblasts, and collagen fibers. Spirometric measurements, measurement of respiratory muscles strength, and examination of the diaphragm contractile function were performed by echolocation 56.7±11.9 days before death. RESULTS In patients of all NYHA FCs most pronounced changes of volume of muscle tissue were observed in the right ventricle and diaphragm, while less pronounced - in the gastrocnemius muscle. The increase in the volume of adipose tissue in patients with I-III FC CHF was most pronounced in the right ventricle and diaphragm, and less pronounced - in the gastrocnemius muscle. The greatest increase in the adipose tissue volume was recorded in the diaphragm of patients with IV FC. Changes of connective tissue volume did not follow linear dependence. The largest "leap-like" increase in the volume of connective tissue occurred in the diaphragm of patients with III FC, what significantly outstripped this process in peripheral muscles and right ventricular myocardium. There was stable relationship between structure of tissue of the diaphragm, maximal inspiratory thickness of diaphragmatic muscle, and maximal inspiratory pressure. This relation (correlation) was positive for pairs muscle tissue volume - muscle thickness and muscle tissue volume - inspiratory pressure, and negative for pairs connective tissue volume - muscle thickness, connective tissue volume - inspiratory pressure, adipose tissue volume - inspiratory pressure (r>0.85, p<0.01 for all these correlations). CONCLUSION Morphofunctional changes in the diaphragm are caused by progressive decrease in the content of muscle tissue, increases of volumes of adipose and connective tissues. These changes correlate with the CHF FC, maximal inspiratory thickness of diaphragmatic muscle, and maximal inspiratory pressure. Severity of these morphological changes is maximal in patients with FC III CHF.
Collapse
Affiliation(s)
- A G Arutyunov
- Pirogov Russian National Research Medical University.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Arutyunov AG, Nozdrin AV, Shavgulidze KB, Tokmin DS, Osadchiy IV. Differences between passport and biological (actual) age in the population of Russian patients suffering from arterial hypertension (analysis of the «Hyperion» register). TERAPEVT ARKH 2018; 90:21-28. [PMID: 30701870 DOI: 10.26442/terarkh201890421-28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM The aim of the study was to analyze the severity of the difference in these values in real clinical practice in patients suffering from arterial hypertension (AH) on the basis of an open multicenter register to monitor the effectiveness of therapy in patients with hypertension "HYPERION", conducted by the Eurasian Association of Therapists with the support of the company "Gedeon Richter" (Hungary). MATERIALS AND METHODS The study was carried out within the open multi-center register "HYPERION". The final analysis of the register included 1441 patients, including 638 men (44%), 803 women (56%) aged 24 to 90 years. All patients were observed in primary health care (55 centers in 47 cities of Russia) for hypertension, received at least two hypotensive drugs. According to the data on 1424 patients using the qrisk-2 scale of 2017 modification, the biological age was calculated. RESULTS The absolute majority of patients (83,7%) had biological age >70 years, while the passport age of the absolute majority (65,3%) is in the range ≥50, but ≤69 years. Median difference between biological and passport age was 15 years. On average, in men suffering from hypertension, the biological age exceeded the passport age by 17.6 years, and in women - by 13.4 years. The difference between the value of biological and passport age and the level of systolic pressure in all age groups had a direct correlation. At systolic blood pressure >181 mm Hg. the difference between biological and passport age was the maximum, reaching the highest values in the youngest age group (30-39 years). CONCLUSION Analysis of the actual (biological) age should be a mandatory procedure that allows a more complete assessment of the initial therapeutic status of the patient, which is especially important in patients aged 30-50 years. This is necessary not only from the standpoint of changing the current procedure, but also to understand the patient's prognosis.
Collapse
Affiliation(s)
- A G Arutyunov
- N.I.Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | | | | | | | | |
Collapse
|
10
|
Bylova NA, Arutyunov GP, Rylova AK, Simbirtseva AS, Arutyunov AG. [Prognostic role of body composition in patients with pneumonia associated with decompensated CHF]. Kardiologiia 2017; 57:343-350. [PMID: 29276901 DOI: 10.18087/cardio.2392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To evaluate the effect of body composition on prediction of community-acquired pneumonia caused by Str. pneumoniae in patients with decompensated CHF. MATERIALS AND METHODS The study included 216 patients. The pneumonia agent was identified by sputum culture. Body composition with determining lean body mass and fat mass was evaluated using a bio-impedance analysis; body mass index (BMI) was calculated. Patients with BMI 18.5-24.9 kg/m2 were included into the study. Statistical analysis of obtained data was performed using the IBM SPSS Statistics 20 software. RESULTS The in-hospital mortality was 13.4 %; the one-year mortality was 29.6 %. Fat mass strongly, negatively correlated with a fatal outcome within a year, and the degree of lean body mass shortage moderately, positively correlated with the life span of patients. CONCLUSION Body composition is significantly predictive for patients with decompensated CHF and community-acquired pneumonia caused by Str. pneumoniae.
Collapse
Affiliation(s)
- N A Bylova
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - G P Arutyunov
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - A K Rylova
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - A S Simbirtseva
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| | - A G Arutyunov
- Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation
| |
Collapse
|
11
|
Arutyunov AG, Dragunov DO, Arutyunov GP, Sokolova AV. [Impact of the dosing of basic drugs on the risk of rehospitalization in patients with chronic heart failure]. TERAPEVT ARKH 2016; 88:29-34. [PMID: 26978606 DOI: 10.17116/terarkh201688129-34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To investigate the impact of doses of the drugs, which have been achieved during adjustment and account for less or more than 50% of the maximal therapeutic ones on the risk of rehospitalization. SUBJECTS AND METHODS The data of the Pavlov Register were used to assess the treatment of patients with chronic heart failure. To assess the risk of rehospitalization in relation of the dose of a drug, all the doses were represented in percentage terms depending on the maximum therapeutic one. RESULTS The risk of hospitalization during 6 months in the patients receiving angiotensin-converting enzyme inhibitors at a dose of 25% or less of the therapeutic one was 21.18% (odds ratio (OR), 1.41; 95% confidence interval (CI), 1.13-1.76), that at doses of 50 and 100% of the therapeutic one was 16% (OR, 0.71; 95% CI, 0.56-0.88) and 34% (OR, 0.51; 95% CI, 0.43-0.60), respectively. The risk of rehospitalization in the patients taking β-blockers at doses of 25, 50, and 100% of the therapeutic one was 26% (OR, 1.05; 95% CI, 0.94-1.17), 23% (OR, 0.902; 95% CI, 0.75-1.07), and 6.25% (OR, 0.19; 95% CI, 0.07-0.56), respectively. The combined analysis of the dose and use frequency of diuretics showed that the highest risk of rehospitalization turned was noted in the patients using a single dose of 100 mg of furosemide (4.2% of cases) once weekly and was as high as 39% (OR, 0.45; 95% CI, 1.04-1.98). CONCLUSION The risk of rehospitalization is largely determined by the dosing factor in outpatient settings. Increasing the doses during adjustment reduces the risk of rehospitalization.
Collapse
Affiliation(s)
- A G Arutyunov
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - D O Dragunov
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - G P Arutyunov
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - A V Sokolova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| |
Collapse
|
12
|
Arutyunov AG, Dragunov DO, Arutyunov GP, Rylova AK, Pashkevich DD, Viter On Behalf Of The Study Group KV. [First Open Study of Syndrome of Acute Decompensation of Heart Failure and Concomitant Diseases in Russian Federation: Independent Registry ORAKUL]. Kardiologiia 2015; 55:12-21. [PMID: 28294906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Aim of the study was to assess mortality and rate of repetitive hospital admissions on days 30, 90, 180, 360 of observation as well as prevalence of concomitant diseases in patients with congestive heart failure (CHF). The register was formed in 41 centers of 20 cities.
Collapse
Affiliation(s)
- A G Arutyunov
- N.I. Pirogov Russian National Research State Medical University, 1, Ostrovityanova str., 117997 Moscow, Russia
| | - D O Dragunov
- N.I. Pirogov Russian National Research State Medical University, 1, Ostrovityanova str., 117997 Moscow, Russia
| | - G P Arutyunov
- N.I. Pirogov Russian National Research State Medical University, 1, Ostrovityanova str., 117997 Moscow, Russia
| | - A K Rylova
- N.I. Pirogov Russian National Research State Medical University, 1, Ostrovityanova str., 117997 Moscow, Russia
| | - D D Pashkevich
- N.I. Pirogov Russian National Research State Medical University, 1, Ostrovityanova str., 117997 Moscow, Russia
| | | |
Collapse
|
13
|
Arutyunov AG, Dragunov DO, Arutyunov GP, Rylova AK, Pashkevich DD, Viter KV. [First Open Study of Syndrome of Acute Decompensation of Heart Failure and Concomitant diseases in Russian Federation: Independent Registry ORAKUL]. Kardiologiia 2015; 55:12-21. [PMID: 26615619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Aim of the study was to assess mortality and rate of repetitive hospital admissions on days 30, 90, 180, 360, of observation as well as prevalence of concomitant diseases in patients with congestive heart failure (CHF). The register was formed in 41 centers of 20 cities of Russian Federation. Number of included patients with signs of chronic heart failure (CHF) was 2498. Data on 2404 was available for final analysis. Rehospitalization rate was 31, 11, 11, and 9.5% during 30 days, and during periods 31-90, 91-180, 181-360 days after discharge from hospital, respectively. Hospital mortality was 9%, 30 days and 1 year total mortality was 13 and 43%, respectively. Risk of death was most strongly affected by pneumonia, liver cirrhosis, and chronic kidney disease (mortality 49.5, 45.7, and 47.2%, respectively). Prognostic value of factors was ranked in the following order (descending): age, body mass index < 19 kg/m2, systolic blood pressure < 100 mm Hg, heart rate (HR) > 70 bpm, body temperature < 36.5 C. Each predictor was assigned weight of 1 point. Score 5 meant that risk of death with a high degree of probability approached 100%. Patients included into ORAKUL compared with those included in Euro HF register were more severely ill: in ORAKUL ejection fraction < 40% was observed 1.89 times more often, and more patients had "wet-cold" profile. Patients in ORAKUL had greater HR, smaller ejection fraction, lower glomerular filtration rate, and worse compliance to scientifically based treatment.
Collapse
|
14
|
Postnikov AB, Smolyanova TI, Kharitonov AV, Serebryanaya DV, Kozlovsky SV, Tryshina YA, Malanicev RV, Arutyunov AG, Murakami MM, Apple FS, Katrukha AG. N-terminal and C-terminal fragments of IGFBP-4 as novel biomarkers for short-term risk assessment of major adverse cardiac events in patients presenting with ischemia. Clin Biochem 2012; 45:519-24. [PMID: 22306170 DOI: 10.1016/j.clinbiochem.2011.12.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 12/08/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Pregnancy Associated Plasma Protein A (PAPP-A)-derived N- and C-terminal fragments of IGF-binding protein-4 (NT- and CT-IGFBP-4) released from vulnerable atherosclerotic plaques are proposed to be used for cardiovascular risk assessment. DESIGN AND METHODS NT- and CT-IGFBP-4 were measured by novel immunoassays in EDTA-plasma of 180 patients admitted to the emergency department with symptoms of myocardial ischemia but without ST-segment elevation. Six-month incidence of major adverse cardiac events (MACE), including myocardial infarction, cardiac death, percutaneous coronary interventions, and coronary artery bypass grafting was recorded. RESULTS Sixteen patients met the endpoint. NT- and CT-IGFBP-4 were strong predictors of MACE: area under ROC curve (AUC) 0.856 and 0.809, respectively. NT-IGFBP-4 concentrations≥214μg/L and CT-IGFBP-4 concentrations≥124μg/L were associated with increased risk of future MACE: adjusted hazard ratio 13.79 and 7.93, respectively. CONCLUSIONS IGFBP-4 fragments can be utilized as biomarkers for MACE prediction in patients with suspected myocardial ischemia.
Collapse
Affiliation(s)
- A B Postnikov
- HyTest Ltd, Intelligate 6th floor, Joukahaisenkatu 6, 20520 Turku, Finland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|