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Iusupova AO, Slepova OA, Pakhtusov NN, Popova LV, Ageev AA, Lishuta AS, Privalova EV, Khabarova NV, Dadashovа GМ, Belenkov YN. Assessment of the Level of Matrix Metalloproteinases, VEGF and MicroRNA-34a in Patients With Non-obstructive and Obstructive Lesions of the Coronary Arteries. Kardiologiia 2024; 64:14-21. [PMID: 38742511 DOI: 10.18087/cardio.2024.4.n2622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/26/2024] [Indexed: 05/16/2024]
Abstract
AIM To assess the levels of matrix metalloproteinases (MMP), vascular endothelial growth factor (VEGF), and miRNA-34a expression in patients with ischemic heart disease (IHD) and obstructive and nonobstructive coronary artery (CA) disease. MATERIAL AND METHODS This cross-sectional observational study included 64 patients with IHD (diagnosis verified by coronary angiography or multislice computed tomography coronary angiography), of which 33 (51.6%) were men aged 64.9±8.1 years. 20 patients had nonobstructive CA disease (stenosis <50%), and 44 had hemodynamically significant stenoses. The control group consisted of 30 healthy volunteers. MMP-1, -9, -13, and -14, miRNA-34a, and VEGF were measured in all patients. RESULTS The concentration of MMP-1 was significantly higher in patients with ischemia and nonobstructive CA disease (INOCAD) (p=0.016), and the concentration of MMP-9 was the highest in the group with obstructive CA disease (p<0.001). The concentrations of MMP-13 and MMP-14 did not differ significantly between the groups. The highest VEGF concentrations were observed in the INOCAD group (p<0.001). The expression of miRNA-34a significantly differed between the IHD groups with different types of CA disease and controls (p <0.001). Patients with hemodynamically significant stenosis showed moderate relationships between the concentrations of MMP-14 and VEGF (ρ=0.418; p=0.024), as well as between VEGF and miRNA-34a (ρ=0.425; p=0.022). Patients with INOCAD had a significant negative correlation between the concentrations of MMP-13 and VEGF (ρ= -0.659; p=0.003). Correlation analysis showed in all IHD patients a moderate relationship of the concentrations of MMP-1 and MMP-14 with VEGF (ρ=0.449; p=0.002 and p=0.341; p=0.019, respectively). According to ROC analysis, a MMP-9 concentration above 4.83 ng/ml can be a predictor for the presence of hemodynamically significant CA obstruction in IHD patients; a VEGF concentration higher than 27.23 pg/ml suggests the absence of hemodynamically significant CA stenosis. CONCLUSION IHD patients with INOCAD had the greatest increase in MMP-1, whereas patients with obstructive CA disease had the highest level of MMP-9. According to our data, concentrations of MMP-9 and VEGF can be used to predict the degree of CA obstruction. The expression of miRNA-34a was significantly higher in IHD patients with INOCAD and CA obstruction than in the control group, which suggested a miRNA-34a contribution to the development and progression of coronary atherosclerosis. In the future, it may be possible to use this miRNA as a diagnostic marker for IHD.
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Affiliation(s)
- A O Iusupova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - O A Slepova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - N N Pakhtusov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - L V Popova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Ageev
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A S Lishuta
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Privalova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - N V Khabarova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Yu N Belenkov
- Sechenov First Moscow State Medical University, Moscow, Russia
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Belenkov YN, Lishuta AS, Slepova OA, Nikolaeva NS, Khabarova NV, Dadashova GM, Privalova EV. The EXCEL Study: Long-term Observation of the Effectiveness of Drug and Non-drug Rehabilitation in Patients with Ischemic Heart Failure. Kardiologiia 2024; 64:14-24. [PMID: 38323440 DOI: 10.18087/cardio.2024.1.n2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/26/2023] [Indexed: 02/08/2024]
Abstract
AIM To study the long-term effect of enhanced external counterpulsation (EECP) therapy on exercise tolerance, quality of life (QoL), and indicators of the structural and functional state of the cardiovascular system in patients with stable ischemic heart disease (IHD) complicated by chronic heart failure (CHF). MATERIAL AND METHODS This open randomized EXCEL study included 120 patients with verified IHD complicated by NYHA II-III functional class CHF with reduced or mid-range left ventricular (LV) ejection fraction. Patients were randomized into group 1 (n=40), optimal drug therapy (ODT) and EECP (35 hours, 2 courses per year); group 2 (n=40), ODT and EECP (35 hours, 1 course per year); and group 3 (control; n=40), ODT and placebo counterpulsation (35 h, 1 course per year). All patients underwent a 6-minute walk test (6MWT), evaluation of clinical status, QoL with the MLHFQ and SF-36 questionnaires, structural and functional state of large blood vessels and microvasculature, measurement of brain natriuretic peptide precursor (NT-proBNP), and echocardiography at baseline and after 12 months. RESULTS In groups 1 and 2 after 12 months, the 6MWT distance increased statistically significantly (44.5 and 24.9%, respectively) and the following indexes improved: QoL (SF-36, MLHFQ), the condition of large blood vessels (phase shift, radial augmentation index, central aortic systolic pressure (CASP)) and microvasculature (occlusion index, percentage of perfused capillaries, percentage of capillary recovery), and the LV systolic function (from 40.6±7.5 to 47.5±10.2% and from 41.3± 6.8 to 43.9±10.3%, respectively). The proportion of patients with a >20% increase in the 6MWT at 12 months was 97.5, 72.5, and 7.7%, respectively. A statistically significant decrease in NT-proBNP was observed in all groups. In group 3, the incidence of hospitalizations for CHF and the risk of the composite endpoint were significantly higher. CONCLUSION For the 12-month study period, the effects of EECP in patients with IHD complicated by CHF included improvements in exercise tolerance, QoL, vascular and cardiac functional parameters, and a decrease in the incidence of adverse outcomes.
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Affiliation(s)
- Yu N Belenkov
- Sechenov First Moscow State Medical University, Moscow
| | - A S Lishuta
- Sechenov First Moscow State Medical University, Moscow
| | - O A Slepova
- Sechenov First Moscow State Medical University, Moscow
| | - N S Nikolaeva
- Sechenov First Moscow State Medical University, Moscow
| | - N V Khabarova
- Sechenov First Moscow State Medical University, Moscow
| | | | - E V Privalova
- Sechenov First Moscow State Medical University, Moscow
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Fomina EV, Kardanova SA, Bochkarnikova OV, Murtuzaliev SM, Appolonova SA, Markin PA, Privalova EV, Ilgisonis IS, Belenkov YN. [Assessment of systemic inflammation activity, myocardial structure and functional features, their relationship in patients with multiple myeloma, receiving bortezomib therapy]. Kardiologiia 2023; 63:29-38. [PMID: 37970853 DOI: 10.18087/cardio.2023.10.n2489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/30/2023] [Indexed: 11/19/2023]
Abstract
AIM To study the dynamics of calculated indices [neutrophil-lymphocyte ratio (NLR); systemic inflammation index (SIV)] and biomarkers of systemic inflammation [interleukin-1β (IL-1β); high-sensitivity C-reactive protein (hsCRP)], parameters of the structure-and-function state of the myocardium and intracardiac hemodynamics, and their relationship in patients newly diagnosed with multiple myeloma (MM) at the onset of the disease and after 6 courses of chemotherapy (CT) containing the proteasome inhibitor bortezomib. MATERIAL AND METHODS This prospective study included 30 patients aged 63.8±10.0 years diagnosed with MM; 17 (56.7 %) of them were men. The following tests were performed for all patients: measurement of IL-1β and hsCRP, calculation of the inflammation indexes NLR and SIV, transthoracic echocardiography before and after 6 courses of bortezomib-containing CT. At the time of study completion, 9 patients dropped out due to reasons not related to cardiovascular complications of CT. RESULTS The antitumor therapy was associated with increases of immune-inflammation indexes: NLR increased from 1.54 [1.02; 1.83] to 2.9 [1.9; 4.35] (p=0.009) and SIV increased from 402.95 [230.5; 534.0] to 1102.2 [453.1; 1307.9] (р=0.014). IL-1β increased from 5.15 [4.05; 5.77] to 6.22 [5.66; 6.52] pg/ml remaining within the reference range (p=0.142) whereas hsCRP decreased from 1.02 [0.02; 2.71] to 0.02 [0.02; 0.82] IU/l (p=0.138). Statistically significant changes in parameters of heart remodeling and clinical picture of cardiovascular complications were not observed. A correlation analysis showed significant inverse correlations of hsCRP with left ventricular ejection fraction (LV EF) (r= -0.557; p=0.003), the number of plasma cells (PC) with LV EF (r= -0.443; p=0.023), and a direct correlation of the number of PC with hsCRP (r=0.433; p=0.022). CONCLUSION During the study, the accepted criteria for cardiotoxicity of bortezomib-containing chemotherapy in patients with MM, were not met. The identified correlations between the level of markers for acute inflammation, indexes of intracardiac hemodynamics, and the immediate MM substrate may indicate the role of chronic low-intensity inflammation in the pathogenesis of myocardial remodeling in patients with MM. This necessitates further studies on larger samples of patients to assess the prognostic significance.
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Affiliation(s)
- E V Fomina
- Sechenov First Moscow State Medical University
| | | | | | | | | | - P A Markin
- Sechenov First Moscow State Medical University
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Belenkov YN, Ilgisonis IS, Kirichenko YY, Murtuzaliev SM. Cardio-oncology today: digest of the first European clinical guidelines (2022). Kardiologiia 2023; 63:3-15. [PMID: 37522822 DOI: 10.18087/cardio.2023.7.n2445] [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] [Received: 02/26/2023] [Accepted: 03/17/2023] [Indexed: 08/01/2023]
Abstract
Over the past few decades, due to the extensive implementation of cancer screening programs, up-to-date early diagnostic methods, and effective combinations of antitumor therapy, it has become possible to significantly improve survival of cancer patients. At the same time, despite the effective treatment of malignancies, most patient face adverse and often life-threatening effects of specific treatment on the heart and blood vessels. All this resulted in active development of a new field in cardiology, cardio-oncology. In recent years, based on the experience of leading experts, data from large studies, and meta-analyses, both international and Russian Consensuses, conciliation documents, have been formed and published. These documents regulate principal methodological approaches to management and control of the cardiovascular conditions in cancer patients. Finally, 2022 was marked by issuing the first official European Guidelines on Cardio-Oncology in the history of medicine. This article highlights the most relevant, in our opinion, positions of these guidelines as well as controversial and unresolved issues.
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Belenkov YN, Kozhevnikova MV. [Soluble guanylate cyclase: restoration of the NO-sGC-cGMP signaling pathway activity. A new opportunity in the treatment of heart failure]. Kardiologiia 2023; 63:68-76. [PMID: 37307211 DOI: 10.18087/cardio.2023.5.n2422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 06/14/2023]
Abstract
Studying the key mechanisms of cardiovascular diseases has opened new possibilities for the pharmacological impact on the pathophysiological mechanisms of heart failure (HF). The signaling pathway, nitric oxide - soluble guanylate cyclase - cyclic guanosine monophosphate (NJ-sGC-cGMP), provides normal functioning of the cardiovascular system in healthy people and serves as a potential target for medicines in HF with reduced ejection fraction (HFrEF). In HFrEF progression, the sGC activity decreases due to endothelial dysfunction and oxidative stress. The increased synthesis of cGMP resulting from sGC stimulation can restrict myocardial fibrosis, reduce stiffness of the vascular wall and induce vasodilation; in this process, the mechanism of action of sGC stimulators does not overlap with other therapeutic targets. According to the results of the international randomized clinical study VICTORIA, the use of the sGC stimulator, vericiguat, in patients with HF, ejection fraction <45%, and a recent episode of decompensation in their history reduced the risk of repeated hospitalization and cardiovascular death. Also, this treatment was characterized by a favorable safety profile when added to standard therapy.
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Affiliation(s)
- Yu N Belenkov
- Sechenov First Moscow State Medical University, Moscow
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Belenkov YN, Arutyunov GP, Mareev VY, Koziolova NA, Sitnikova MY, Ageev FT, Gilyarevsky SR, Chesnikova AI, Yakushin SS, Perepech NB, Mareev YV. [Prospects for use of Vericiguat in HFrEF: Implications of VICTORIA Trial Results. Advisory Board Summary]. Kardiologiia 2023; 63:3-10. [PMID: 37165988 DOI: 10.18087/cardio.2023.4.n2403] [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] [Received: 01/12/2023] [Accepted: 02/10/2023] [Indexed: 05/12/2023]
Abstract
In September 2021, an online meeting of the Council of Experts was held. The proposed focus of discussion was publishing the results of an international prospective, randomized, double-blind, placebo-controlled study VICTORIA. The objective of the VICTORIA study was evaluation of the efficacy and safety of supplementing a standard therapy with vericiguat at a target dose of 10 mg twice a day as compared to placebo for prevention of cardiovascular death and hospitalization for heart failure (HF) in patients with clinical manifestations of chronic HF and left ventricular ejection fraction <45% who have recently had an episode of decompensated HF. The aim of the meeting was interpretation of the VICTORIA study results on efficacy and safety of vericiguat for a potential use in a Russian population of patients after a recent episode of decompensated chronic HF with reduced ejection fraction.
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Affiliation(s)
| | - G P Arutyunov
- Pirogov Russian National Research Medical University
| | - V Yu Mareev
- Medical Research and Educational Center of the Lomonosov Moscow State University
| | | | | | - F T Ageev
- Chazov National Medical Research Center of Cardiology
| | - S R Gilyarevsky
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - Yu V Mareev
- National Medical Research Center of Therapy and Preventive Medicine
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Ageev AA, Kozhevnikova MV, Emelyanov AV, Krivova AV, Shumskaya YF, Musaeva LM, Popova LV, Naymann YI, Abdullaeva GB, Privalova EV, Belenkov YN. The Effect of COVID-19 on Long-Term Cardiac Function in Patients With Chronic Heart Failure. Kardiologiia 2022; 62:23-29. [PMID: 36636973 DOI: 10.18087/cardio.2022.12.n2265] [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] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/16/2022] [Indexed: 01/14/2023]
Abstract
Aim To evaluate functional changes in the heart in the long-term following COVID-19 in patients with chronic heart failure (CHF).Material and methods Case reports of 54 patients aged 69.1±9.7 years who had COVID-19 from January 2021 through January 2022 and had been previously diagnosed with NYHA functional class II-III CHF were studied. Two comparison groups were isolated: HF with LV EF >50 % (n=39) and <50 % (n=15). Echocardiography was used to evaluate changes in LV EF and pulmonary artery systolic pressure (PASP) 5-6 months following COVID-19.Results In all CHF patients after COVID-19 at 5.8 months on average, LV EF decreased (median difference, 2.5 %; 95 % confidence interval (CI): 6.99×10-5- 4.99) and PASP increased (median difference, 8 mm Hg; 95 % CI: 4.5-12.9). In the HF group with LV EF <50 %, the decrease in EF was greater than in the group with LV EF >50 % (6.9 and 0.7 %, respectively; p=0.037); furthermore, the CHF phenotype did not influence the change in PASP (p=0.4). The one-factor regression analysis showed that the dynamics of LV EF decrease was significantly influenced by the baseline decrease in LV EF, whereas the change in PASP was influenced by the dynamics of LV EF decrease, presence of dyslipidemia, and statin treatment. Furthermore, the multifactorial analysis showed that prognostically significant factors for long-term changes in LV EF following COVID-19 were male gender (odds ratio (OR), 5.92; 95 % CI: 1.31-26.75; p=0.014), LV EF at baseline <50 % (OR, 0.88; 95 % CI: 0.8-0.96; p<0.001); changes in PASP depended on the presence of dyslipidemia (OR, 0.08; 95 % CI: 0.01-0.84; p=0.018).Conclusion This study showed that COVID-19 in the long term can influence the course of CHF; in this process, HF patients with EF <50 % have progression of systolic dysfunction and PASP, whereas patients with EF >50 % have an isolated increase in PASP.
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Affiliation(s)
- A A Ageev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A V Emelyanov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A V Krivova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu F Shumskaya
- Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Moscow
| | - L M Musaeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - L V Popova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu I Naymann
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - G B Abdullaeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V Privalova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
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Kardanova SA, Kirichenko YY, Bochkarnikova OV, Antyufeeva ON, Kochkareva YB, Vinogradova OY, Privalova EV, Ilgisonis IS, Belenkov YN. Relationship Between Markers of the Acute Phase of Inflammation, Parameters of Blood Lipid Composition and Intracardiac Hemodynamics During Chemotherapy in Patients With Multiple Myeloma. Kardiologiia 2022; 62:18-26. [PMID: 36206134 DOI: 10.18087/cardio.2022.9.n2183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/01/2022] [Indexed: 06/16/2023]
Abstract
Aim To evaluate in a pilot study time-related changes in the clinical state, indexes of the acute phase of inflammation, parameters of blood lipid profile, intracardiac hemodynamics, and disorders of cardiac rhythm/conduction in patients who are not candidates for autologous hemopoietic stem cell transplantation, during three bortezomib-containing chemotherapy courses (VCD) followed by a correlation analysis.Material and methods This pilot study included 20 patients diagnosed with myeloma, who were not candidates for autologous hemopoietic stem cell transplantation and who had undergone three courses of VCD chemotherapy (bortezomib, cyclophosphamide and dexamethasone). In addition to mandatory examinations, measurement of blood lipid profile, transthoracic echocardiography (EchoCG), and 24-h Holter electrocardiogram (ECG) monitoring were performed for all participants before and after a specific therapy.Results Following three bortezomib-containing courses of chemotherapy, patients of the study group had significant increases in the neutrophil-lymphocyte ratio (NLR) (1.6±0.2 and 2.5±0.4; р=0.05), cholesterol concentration (4.8±1.1 and 5.6±1.1 mmol/l, р=0.05), and low-density lipoprotein concentration (2.8±0.4 and 3.5±0.8 mmol/l, р=0.02). In comparing the changes in parameters of intracardiac hemodynamics, criteria for genuine cardiotoxicity were not met, however, a tendency to emergence/progression of myocardial diastolic dysfunction was noted. No clinically significant disorders of cardiac rhythm/conduction were observed. The correlation analysis performed prior to the start of chemotherapy, showed significant strong, direct correlations between the C-protein concentration and left atrial (LA) volume (r=0.793; p=0.006), right atrial (RA) volume (r=0.857; p=0.002), left ventricular (LV) end-diastolic dimension (EDD) (r=0.589; p=0.043), and LV end-diastolic volume (EDV) (r=0.726; p=0.017). Following the specific treatment, significant, medium-power and strong correlations were found between NLR and EDV (r= -0.673; p=0.033), NLR and end systolic volume (ESV) (r= -0.710; p=0.021), respectively. Significant direct correlations were found between the bortezomib dose per one injection and the serum concentration of triglycerides following the treatment (r=0.78; p=0.05); a single bortezomib dose and parameters of intracardiac hemodynamics: LA (r=0.71; p=0.026), RA (r=0.74; p=0.014), EDD (r=0.837; p=0.003), EDV (r=0.749; p=0.013), ESV (r=0.553; p=0.049).Conclusion For the first time, a comprehensive evaluation was performed in patients with multiple myeloma, including the dynamics of blood lipid profile, intracardiac hemodynamics and disorders of cardiac rhythm/conduction during bortezomib-containing antitumor therapy, with an analysis of correlation with levels of acute inflammation phase markers. Although in the observation window for genuine cardiotoxicity, clinically significant cardiovascular complications were not detected, the found correlations may evidence a potential role of systemic inflammation activity in myocardial remodeling in the studied patient cohort.
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Affiliation(s)
- S A Kardanova
- Sechenov First Moscow State Medical University, Moscow
| | | | | | | | - Yu B Kochkareva
- S.P. Botkin City Clinical Hospital of the Moscow Department of Health
| | - O Yu Vinogradova
- S.P. Botkin City Clinical Hospital of the Moscow Department of Health
| | - E V Privalova
- Sechenov First Moscow State Medical University, Moscow
| | - I S Ilgisonis
- Sechenov First Moscow State Medical University, Moscow
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University, Moscow
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Sokolov DV, Zhelyakov EG, Koval'chuk VV, Kondratova NV, Snezhitskij VA, Kalatsei LV, Belenkov YN, Ardashev AV. [Clinical case of the cardiovascular system involvement in a patient with Charcot-Marie-Tooth disease]. Kardiologiia 2022; 62:67-71. [PMID: 35692176 DOI: 10.18087/cardio.2022.5.n1810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 06/15/2023]
Abstract
Hereditary motor and sensory type 1A neuropathy (known as Charcot-Marie-Tooth disease) is a disease of peripheral nerves characterized by symptoms of progressive polyneuropathy with preferential damage of distal extremity muscles. Damage to the cardiovascular system is extremely rare and heterogenous in this pathology. This disease is not included in the list of indications for interventional antiarrhythmic aid. We could not find in available literature a clinical description of the development of sinus node dysfunction associated with this pathology. The present clinical report presents a case of detection and successful treatment of a damage to the cardiovascular system that manifested itself as sinus node dysfunction/sick sinus syndrome in the tachy-brady variant. A combination treatment approach using radiofrequency catheter ablation, implantation of a permanent pacemaker, and antiarrhythmic therapy associated with drug and non-drug treatment of motor sensory neuropathy resulted in recovery and long-term maintenance of sinus rhythm as well as in beneficial changes in the patient's neurological status.
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Affiliation(s)
- D V Sokolov
- JSC «Medicine» (Academician Roytberg's clinic)
| | - E G Zhelyakov
- Medical Research and Educational Center of Lomonosov Moscow State University
| | | | | | | | | | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A V Ardashev
- Medical Research and Educational Center, Lomonosov Moscow State University
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Mareev YV, Polyakov DS, Vinogradova NG, Fomin IV, Mareev VY, Belenkov YN, Ageev FT, Artemjeva EG, Badin YV, Bakulina EV, Galyavich AS, Ionova TS, Kamalov GM, Kechedzhieva SG, Koziolova NA, Malenkova VY, Malchikova SV, Smirnova EA, Tarlovskaya EI, Shcherbinina EV, Yakushin SS. Epidemiology of atrial fibrillation in a representative sample of the European part of the Russian Federation. Analysis of EPOCH-CHF study. Kardiologiia 2022; 62:12-19. [PMID: 35569159 DOI: 10.18087/cardio.2022.4.n1997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/04/2022] [Indexed: 06/15/2023]
Abstract
Aim To study true prevalence of atrial fibrillation (AF) in a representative sample from the European part of the Russian Federation; to describe characteristics of patients with AF; and to provide the frequency of anticoagulant treatment.Material and methods Cross-sectional data of the EPOCH epidemiological study (2017) were used. Data were collected in 8 constituent entities of the Russian Federation; the sample size was 11 453 people. The sample included all respondents who had given their consent for participation and were older than 10 years. Statistical tests were performed in the R system for statistical data analysis.Results The prevalence of AF in the representative sample from the European part of the Russian Federation was 2.04 %. The AF prevalence increased with age and reached a maximum value of 9.6% in the age group of 80 to 89 years. The AF prevalence among females was 1.5 times higher than among men. With age standardization, the AF prevalence was 18.95 and 21.33 per 1,000 people for men and women, respectively. The AF prevalence increased in the presence of concurrent cardiovascular diseases (CVDs) or diabetes mellitus as well as with an increased number of comorbidities in the same person and reached 70.3 and 60.0 % in patients with 4 and 5 comorbidities, respectively. Patients with AF had a greater number of comorbidities and higher CHA2DS2VASc scores (5.0 vs. 2.0, p<0.001) compared to patients with CVDs without AF. Only 22.6 % of patients with CVD and AF took anticoagulants. Only 23.9% of patients with absolute indications for the anticoagulant treatment received anticoagulants.Conclusion The AF prevalence in the European part of the Russian Federation was 2.04 %; it increased with age and in patients with concurrent CVDs or diabetes mellitus. Most of AF patients (93.2 %) required a mandatory treatment with oral anticoagulants.
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Affiliation(s)
- Yu V Mareev
- National Medical Research Center for Therapy and Preventive Medicine; Medical Research and Educational Center, Lomonosov Moscow State University
| | | | - N G Vinogradova
- Privolzhsky Research Medical University; Municipal Clinical Hospital #38 of the Nizhny Novgorod Region
| | - I V Fomin
- Privolzhsky Research Medical University
| | - V Yu Mareev
- Medical Research and Educational Center, Lomonosov Moscow State University; School of Fundamental Medicine, Lomonosov Moscow State University
| | | | - F T Ageev
- Scientific Medical Research Center of Cardiology
| | | | | | | | | | | | | | | | | | | | | | - E A Smirnova
- Academician Pavlov Ryazan State Medical University
| | | | | | - S S Yakushin
- Academician Pavlov Ryazan State Medical University
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Kardanova SA, Ilgisonis IS, Ershov VI, Privalova EV, Belenkov YN. Characteristic of cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of antitumor therapy. Kardiologiia 2022; 62:4-11. [PMID: 35272602 DOI: 10.18087/cardio.2022.2.n1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
AIM assessment of risk factors, cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of specific antitumor therapy. Materials and methods: The study included 2 equal groups of patients: the first group - 25 patients with a newly diagnosed diagnosis of multiple myeloma (MM), the comparison group - 25 patients with proven cardiovascular diseases (CVD) (hypertension (HD) and coronary heart disease (CHD)). All patients included in the study underwent standard laboratory diagnostics, instrumental research methods (ECG, Echo-KG, 24-hour Holter monitoring); proven CVD risk factors were also evaluated. Results: When comparing the two groups, it was reliably shown that the state of CVD in patients with MM is comparable to that in patients with proven CVD. In patients from the main group, were revealed significant positive correlations of average strength between indicators of systemic inflammation, the lipid spectrum and intracardiac hemodynamics: between the levels of CRP and triglycerides (r=0,415, p<0,05); between the values of CRP and LDL (r=0,345, p=0,09); CRP and LA volume (r=0,434, p<0,05); CRP and final diastolic volume (r=0,30, p<0,05). At the beginning, a high risk of developing CV- events in patients with MM may be due to cardiac remodeling associated with the activity of systemic inflammation. CONCLUSION in view the use of potentially cardiovasculartoxicity drugs for the treatment of multiple myeloma, the assessment of the CV status and consultation with a cardiologist/cardiologist with the selection of the necessary therapy should be obligatory step before starting specific treatment.
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Affiliation(s)
- S A Kardanova
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - I S Ilgisonis
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - V I Ershov
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V Privalova
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow
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12
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Privalova EA, Belenkov YN, Danilogorskaya YA, Zheleznykh EA, Kozhevnikova MV, Zektser VY, Lishuta AS, Ilgisonis IS. To study the dynamics of serum levels of vascular remodeling in patients with hypertension, including in combination with type 2 diabetes mellitus during 12‑month therapy with perindopril A. Kardiologiia 2022; 62:24-31. [PMID: 35168530 DOI: 10.18087/cardio.2022.1.n1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
Aim To study the dynamics of serum markers for vascular remodeling in patients with arterial hypertension (AH), including AH associated with type 2 diabetes mellitus (DM2) during the 12-month treatment with the angiotensin-converting enzyme (ACE) inhibitor, perindopril A.Material and methods The study included patients with grade 1-2 AH with or without type 2 DM (30 and 32, respectively). Perindopril A 10 mg/day was administered for the outpatient correction of previous, ineffective antihypertensive therapy. The following biomarkers were measured for all patients at baseline and at 12 months: matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), E-selectin, endothelin 1, transforming growth factor β-1 (TGF-β1), and von Willebrand factor (WF). Laboratory tests were performed with enzyme immunoassay.Results After 12 months of the perindopril A (perindopril arginine) 10 mg/day treatment, both groups achieved the goal blood pressure. Evaluation of biomarker dynamics during the perindopril A treatment showed significant decreases in MMP-9, TIMP-1, and endothelin 1 in the AH group; then the level of TIMP-1 returned to normal values (р<0.05). In the AH+DM2 group, the MMP-9 concentration was significantly decreased (р<0.05); the other values did not show any significant differences. In both groups, MMP-9 was significantly decreased (28.6 % (р=0.01) in group 1 and 33.2 % (р=0.00) in group 2. Notably, in none of these groups, did this index reach normal values. Also, there were no significant differences in this index between the groups (р=0.66). It should be noted that the decreases in TIMP-1 were significantly different between the groups (р=0.001). Thus, this biomarker did not significantly decrease in patients with AH and DM2 (р=0.26) whereas in group 1 (AH without DM2), the level of TIMP-1 decreased by 39.3 % and reached the normal range (р=0.005).Conclusion Concentrations of biomarkers were decreased in both groups. However, in the AH group, there were statistically significant decreases in the markers that reflect processes of fibrosis and vasoconstriction. At the same time in the AH+DM2 group, there was no significant dynamics of the biomarkers, which was most likely due to more pronounced damage of blood vessels. However, the decrease in MMP-9 may indicate an alleviation of fibrotic processes in arterial walls. These results allow a conclusion that the long-term treatment with the ACE inhibitor, perindopril A, may reverse remodeling of the vascular changes that are called "early vascular ageing".r aging".
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Affiliation(s)
- E A Privalova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | | | - E A Zheleznykh
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - V Y Zektser
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - A S Lishuta
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - I S Ilgisonis
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
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13
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Belenkov YN, Kozhevnikova MV. [Mobile health technologies in cardiology]. Kardiologiia 2022; 62:4-12. [PMID: 35168528 DOI: 10.18087/cardio.2022.1.n1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Digital medicine is becoming an essential part of the healthcare system. The intense development of mobile technologies, the global coverage of mobile networks, and the growing attachment in the society to mobile devices have prompted the creation of mobile healthcare (mHealth). At present, mobile healthcare technologies have been tested in various cardiovascular diseases. Among the main tasks set for telemedicine, it is necessary to note improvements of general medical care, monitoring of patients' condition, accuracy of clinical diagnoses, timely correction of therapy, and improvement of emergency care. Clinical studies are performed in parallel with active work in the field of informational technologies to provide safety of data storage and intellectual processing. Finally, despite the broad public support for the development of this area of medicine, the search continues for methods to improve patients' compliance with the prescribed therapy. This article presents current information about the use of mHealth in cardiology, study results, prospects of mobile healthcare, and major difficulties in implementing projects in this area.
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Affiliation(s)
- Yu N Belenkov
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
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14
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Safonova JI, Kozhevnikova MV, Danilogorskaya YA, Zheleznykh EA, Ilgisonis IS, Privalova EV, Khabarova NV, Belenkov YN. Possible pathway for heart failure with preserved ejection fraction prevention and treatment: the angiotensin-converting enzyme inhibitor effect on endothelial function in comorbid patients. Kardiologiia 2022; 62:65-71. [PMID: 35168535 DOI: 10.18087/cardio.2022.1.n1952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Aim To evaluate the effect of perindopril on the endothelial function and levels of endothelial dysfunction markers in groups of patients with heart failure with preserved (HFpEF) and mid-range (intermediate) left ventricular ejection fraction (HFmrEF).Material and methods 40 patients with HFpEF (n=20) and HFmrEF (n=20) were evaluated. At baseline, parameters of the morpho-functional state of large blood vessels and of microvessels were evaluated with photoplethysmography, and levels of E-selectin and endothelin-1 (ET-1) were measured. The patients were prescribed perindopril, and after 12 months of treatment, photoplethysmographic parameters and endothelial dysfunction markers were determined again.Results After 12 months of the perindopril treatment, improvements in the endothelial function of both large blood vessels and microvessels were noted. The phase shift increased from 10.1 to 10.9 ms in the HFpEF group (р=0.001) and from 8.35 to 9.65 ms in the HFmrEF group (р=0.002). Furthermore, the occlusion index increased from 1.45 to 1.75 in patients with HFpEF (р=0.004) and from 1.5 to 1.75 in patients with HFmrEF (р=0.010). The Е-selectin concentration decreased in both groups, from 57.25 to 42.4 ng/ml (р=0.00008) and from 40.5 to 35.7 ng/ml (р=0.010) in patients with HFpEF and HFmrEF, respectively. The ET-1 concentration decreased from pg/ml (р=0.010) in patients with HFpEF whereas in patients with HFmrEF, there was no significant change in the ET-1 concentration after 12 months of the perindopril treatment.Conclusion At 12 months, the endothelial function improved and E-selectin and ET-1 levels decreased in patients with HFpEF and HFmrEF.
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Affiliation(s)
- Ju I Safonova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | | | - E A Zheleznykh
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - I S Ilgisonis
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - E V Privalova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - N V Khabarova
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M. Sechenov First Moscow Medical University (Sechenov University), Moscow
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15
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Belenkov YN, Popova LV, Ilgisonis SI. [Management of patients with atrial fibrillation and minor bleeding during therapy with direct oral anti-coagulants]. Kardiologiia 2021; 61:72-81. [PMID: 35057724 DOI: 10.18087/cardio.2021.12.n1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 06/14/2023]
Abstract
The recommended tactics for prevention of thromboembolic complications of atrial fibrillation (AF) is the oral anticoagulant (OAC) treatment. The drugs of choice for preventing stroke for most patients with AF, excluding some valvular defects, are direct OACs (DOACS). Regardless of the drug class, all anticoagulants, even at appropriate doses, increase the risk of bleeding. However, the development of minor bleedings is not an absolute indication for DOAC withdrawal. This review presents a tactics for management of patients with minor bleeding associated with the DOAC treatment.
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Affiliation(s)
- Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University, Moscow
| | - L V Popova
- I.M. Sechenov First Moscow State Medical University, Moscow
| | - S I Ilgisonis
- I.M. Sechenov First Moscow State Medical University, Moscow
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16
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Bogatyreva FM, Kaplunova VRY, Kozhevnikova MV, Shakaryants GA, Khabarova NV, Privalova EV, Belenkov YN. [Assessment of the structural and functional state of blood vessels in patients with hypertrophic cardiomyopathy]. Kardiologiia 2021; 61:16-21. [PMID: 35057717 DOI: 10.18087/cardio.2021.12.n1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/07/2021] [Indexed: 06/14/2023]
Abstract
Aim To evaluate the structural and functional condition of the vasculature using fingertip photoplethysmography and computerized videocapillaroscopy in patients with hypertrophic cardiomyopathy (HCMP).Material and methods The study included patients with HCMP (n=48; 28 (57 %) men; age, 54.3±13.6 years) and healthy volunteers (control group, n=33, 15 (45 %) men; age, 58.2±8.8 years). Standard laboratory and instrumental examination (blood count and biochemistry, electrocardiography, echocardiography, Holter electrocardiogram monitoring) were performed for all HCMP patients. The condition of vascular wall at various levels of the vasculature was evaluated by fingertip photoplethysmography (apparatus Angioscan-01) and computerized nail-fold videocapillaroscopy (apparatus Capillaroscan-01). The photoplethysmography study analyzed structural parameters, including the arterial wall stiffness index (aSI) of large blood vessels and the resistance index (RI) of small muscular arteries. Endothelial dysfunction was evaluated by the occlusion index (OI) and phase shift (PS). The capillaroscopy study assessed structural parameters, including the resting capillary density (rCD) and the capillary density following venous occlusion (voCD), and functional parameters, including the percentage of perfused capillaries (PPC), the percentage of restored capillaries (PRC), and the capillary density after the reactive hyperemia test (rhCD).Results The study showed increases in aSI (8.8 [6.8; 12.2] and RI (32.5 [17.4; 47.9] in the HCMP group. The OI was significantly lower in the HCMP group (1.3 [1.1; 1.5]) than in the control group (1.8 [1.5; 2.7], р<0.001). Also, PS values were significantly decreased in the HCMP group (4.4 [2.3; 8.6]) compared to the control group (8.4 [5.1; 12.1]. p=0.018). Disorders of structural and functional capillary indexes were observed in HCMP patients compared to the control group; rCD and voCD were decreased in the HCMP group (60 [52.6; 68] and 88 [75; 90], respectively) compared to the control group (75.8 [60; 87] and 90 [73; 101]), however, no intergroup difference reached a statistical significance. The rhCD, PPC, and PRC values were decreased in the HCMP group (66.3 [55; 72], 86.7 [70.9; 104.2] and 1.7 [-6.95; 20.3], respectively) compared to the control group (86 [68.6; 100], 103 [96; 114] and 18.4 [8.1; 27.4], respectively); PPC and PRC values were significantly different (р<0.005 and p<0.004, respectively).Conclusion In patients with HCMP, fingertip photoplethysmography and computerized videocapillaroscopy showed increased wall stiffness in both large blood vessels and microvasculature, pronounced endothelial dysfunction, and decreases in capillary density and percentage of restored capillaries following respective tests.
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Affiliation(s)
- F M Bogatyreva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - V Ra Yu Kaplunova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - G A Shakaryants
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - N V Khabarova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V Privalova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
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17
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Mareev YV, Dzhioeva ON, Zorya OT, Pisaryuk AS, Verbilo SL, Skaletsky KV, Ionin VA, Drapkina OM, Alekhin MN, Saidova MA, Safarova AF, Garganeeva AA, Boshchenko AA, Ovchinnikov AG, Chernov MY, Ageev FT, Vasyuk YA, Kobalava ZD, Nosikov AV, Safonov DV, Khudorozhkova ED, Belenkov YN, Mitkov VV, Mitkova MD, Matskeplishvili ST, Mareev VY. [Focus ultrasound for cardiology practice. Russian consensus document]. Kardiologiia 2021; 61:4-23. [PMID: 34882074 DOI: 10.18087/cardio.2021.11.n1812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
This document is a consensus document of Russian Specialists in Heart Failure, Russian Society of Cardiology, Russian Association of Specialists in Ultrasound Diagnostics in Medicine and Russian Society for the Prevention of Noncommunicable Diseases. In the document a definition of focus ultrasound is stated and discussed when it can be used in cardiology practice in Russian Federation.
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Affiliation(s)
- Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - O N Dzhioeva
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Moscow State Medical and Dental University named after Evdokimov, Moscow, Russia
| | - O T Zorya
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - A S Pisaryuk
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - S L Verbilo
- LLC «Centre for Family Medicine MEDIKA», St. Petersburg, Russia
| | - K V Skaletsky
- Scientific Research Institute «Ochapovsky Regional Clinical Hospital №1», Krasnodar, Russia
| | - V A Ionin
- Pavlov University, St. Petersburg, Russia
| | - O M Drapkina
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Moscow State Medical and Dental University named after Evdokimov, Moscow, Russia
| | - M N Alekhin
- Central Clinical Hospital of the Presidential Administration of Russian Federation, Moscow, Russia Central State Medical Academy of the Presidential Administration of Russian Federation, Moscow, Russia
| | - M A Saidova
- Scientific Medical Research Center of Cardiology, Moscow, Russia
| | - A F Safarova
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - A A Garganeeva
- "Research Institute for Cardiology", Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - A A Boshchenko
- "Research Institute for Cardiology", Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia Siberian State Medical University, Tomsk, Russia
| | - A G Ovchinnikov
- Moscow State Medical and Dental University named after Evdokimov, Moscow, Russia Scientific Medical Research Center of Cardiology, Moscow, Russia
| | - M Yu Chernov
- Center for Diagnostic Research, N.N. Burdenko Main Military Clinical Hospital, Moscow, Russia
| | - F T Ageev
- Scientific Medical Research Center of Cardiology, Moscow, Russia
| | - Yu A Vasyuk
- Moscow State Medical and Dental University named after Evdokimov, Moscow, Russia
| | - Zh D Kobalava
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - A V Nosikov
- Acibadem City Clinic Mladost, Sofia, Bulgaria
| | - D V Safonov
- Privolzhsky Research Medical University, Nizhniy Novgorod, Russia
| | - E D Khudorozhkova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Yu N Belenkov
- Sechenov Moscow State Medical University, Moscow, Russia
| | - V V Mitkov
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - M D Mitkova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - S T Matskeplishvili
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
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18
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Kondratieva TB, Popova LV, Khlevchuk TV, Kanevskaya MZ, Aksenova MB, Bokarev IN, Belenkov YN, Golub AV, Ptrushev LI, Kovalenko TF, Gerasimov AN. Impact of thrombophilia and waist circumference on the risk of venousthromboembolism. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2637] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) represents a major health problem. In the general population, the absolute risk of any kind of VTE is 0.1%–0.2% per year, and it increases with age. VTE is an important and preventable cause of morbidity and mortality, with almost a third of survivors experiencing long term effects. Obesity is well-known risk factor of VTE. The extent of the effects of obesity on VTE depends not only on total body fat, but also on the distribution of adipose tissue (e.g., central obesity) and the interplay among risk factors for VTE, such as genetic mutations, and other risk factors.
Thrombophilia, venous thromboembolism, obesity, waist circumference
Purpose
The aim of this study is to investigate the impact of waist circumference on the risk of venous thromboembolism
Methodology
The study involved 68 patients with VTE (33 females and 34 males, mean age 56.8 years ±15.3) and 84 patients without VTE (38 males and 46 females, 44.4 years±18.6). From 2015 to 2017, data have been collected from records of patients admitted to department of internal medicine. All subjects were recruited to the study during their stay in the hospital. The reasons for hospitalization were: acute event of DVT or PE for the main group, the absence of acute event or history of VTE for the control group. DVT was diagnosed by ultrasonic Doppler examination, and PE was confirmed by intravenous radiocontrast computed tomography. Anthropometric measures were performed with subjects wearing short-sleeved garments and no shoes; waist circumference was measured in centimeters at the umbilical line. For all patients genetic testing for inherited thrombophilia – Factor V Leiden G1691A, Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism – was performed by real-time PCR technique.
Results
Factor V Leiden G1691A increase the risk of VTE in 2.11 (CI: 1.79–2.48), p=0.049, prothrombin G20210A in 3.21 (CI: 1.66–6.211), p=0.049. MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism also increase the risk of VTE, but it was no significant. Study have shown that waist circumference >80 cm increase the risk of VTE in 3.19 (CI: 1.35–7.58), p=0.019. Combination of inherited thrombophilia (Factor V Leiden G1691A, Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism) and waist circumference >80 cm increase the risk of VTE in 3.51 (CI: 1.76–7.04), p<0.001.
Conclusion
Previous results of our work indicate influence of waist circumference >80 cm on the risk of VTE, especially risk of thrombosis is higher in patients with combination inherited thrombophilia and waist circumference >80 cm.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T B Kondratieva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - L V Popova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - T V Khlevchuk
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - M Z Kanevskaya
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - M B Aksenova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - I N Bokarev
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Y N Belenkov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - A V Golub
- Eramishancev Moscow City Hospital, Department of Laboratory Medicine, Moscow, Russian Federation
| | - L I Ptrushev
- Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry Russian Academy of Sciences, Moscow, 117, Department of Genomic Analysis and Correction Group of the Laboratory of Biotechnology, Moscow, Russian Federation
| | - T F Kovalenko
- Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry Russian Academy of Sciences, Moscow, 117, Department of Genomic Analysis and Correction Group of the Laboratory of Biotechnology, Moscow, Russian Federation
| | - A N Gerasimov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Belenkov YN, Koroteev AV, Mareev VY. Mitral valve replacement and implantation of an extracardial mesh frame in patients with severe heart failure: results of a clinical study and a description of a clinical case 18 years after surgery. Kardiologiia 2021; 61:4-10. [PMID: 34713780 DOI: 10.18087/cardio.2021.9.n1769] [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] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
Aim Dilated cardiomyopathy (DCMP) is a major cause for severe heart failure. Development of a combination (drug and surgery) treatment of this disease is relevant. This prospective observational study was aimed at evaluating short- and long-term results of extracardiac mesh implantation in DCMP patients with heart failure resistant to the optimum drug therapy.Material and methods The extracardiac mesh ACOR-1 was implanted in 15 patients with DCMP. All meshes were produced individually for each patient and made of Gelweave (great Britain) vascular graft strips. The mesh size corresponded to the heart diastolic size, which was measured after achieving a maximum possible clinical improvement for the patient. Long-term results were followed for up to 4 years. Mean age of patients was 43.1±10.8 years (from 28 to 62 years). One patient was followed up for 18 years. Data of that patient were presented as a clinical case report.Results From October, 2003 through October, 2007, 15 DCMP patients received mesh implants. Cases of in-hospital death were absent. In 3 mos. after the surgery, left ventricular volumes decreased (end-diastolic volume decreased from 251.7±80.7 to 229.0±61.3 ml; end-systolic volume decreased from 182.3±73.6 to 167.7±46.2 ml), and the left ventricular pump function improved (ejection fraction increased from 25.2±6.0 to 27.1±5.1 %; cardiac index increased from 2.0±0.5 to 2.4±0.7 ml /min /m2). The functional state of patients improved by one NYHA class, from 3.7±0.3 to 2.8±0.6. In some cases, the left ventricular size and the systolic function completely normalized. There were no episodes of circulatory decompensation in the long term after surgery. Actuarial survival for the observation period was 100%.Conclusion Implantation of extracardiac mesh prevented progression of heart dilatation and, in combination with drug therapy, it may represent an effective method for treatment of DCMP.
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Affiliation(s)
- Yu N Belenkov
- Sechenov Moscow State Medical University, Moscow, Russia
| | - A V Koroteev
- Sechenov Moscow State Medical University, Moscow, Russia
| | - V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
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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.
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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
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Abstract
Heart failure (HF) is the ending of practically all cardiovascular diseases and the reason for hospitalization of 49% of patients in a cardiological hospital. Available instrumental diagnostic methods and biomarkers not always allow verification of HF, particularly in patients with preserved left ventricular ejection fraction. Prediction of chronic HF in patients with risk factors faces great difficulties. Currently, natriuretic peptides (NUP) are widely used for the diagnosis, prognosis and management of patients with HF and are included in clinical guidelines for diagnosis and treatment of HF. Following multiple studies, the understanding of NUP significance has changed. This resulted in a need for new biomarkers to improve the insight into the process of HF and to personalize the treatment by better individual phenotyping. In addition, current technologies, such as transcriptomic, proteomic and metabolomic analyses, provide identification of new biomarkers and better understanding of features of the HF pathogenesis. The aim of this study was to discuss recent reports on NUP and novel, most promising biomarkers in respect of their possible use in clinical practice.
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Affiliation(s)
- M V Kozhevnikova
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
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22
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Belenkov YN, Arutunov GP, Barbarash OL, Bondareva IB, Villevalde SV, Galyavich AS, Gilarevsky SR, Duplyakov DV, Koziolova NA, Lopatin YM, Mareev YV, Martsevich SY, Panchenko EP, Fomin IV, Yavelov IS, Yakhontov DA. Value of comparative studies of "real clinical practice" in modern cardiology. Position paper based on the expert council discussion dated 12/18/2020. ACTA ACUST UNITED AC 2021; 61:79-81. [PMID: 34112079 DOI: 10.18087/cardio.2021.5.n1646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
On December 18, 2020, an expert council was held with the participation of members of the Russian Society of Cardiology, the Eurasian Association of Ther-apists, the National Society for Atherothrombosis, the National Society for Evi-dence-Based Pharmacotherapy, and the Russian Heart Failure Society. The event was devoted to the discussion of the correct use of research data of "real clinical practice" in decision making.
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Affiliation(s)
- Yu N Belenkov
- I. M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia
| | - G P Arutunov
- Russian National Research Medical University named after Pirogov, Moscow, Russia
| | - O L Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - I B Bondareva
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - S V Villevalde
- Almazov National Medical Research Center, St. Petersburg, Russia
| | | | - S R Gilarevsky
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - D V Duplyakov
- Samara Regional Clinical Cardiological Dispensary, Russia Samara State Medical University, Samara, Russia
| | - N A Koziolova
- Perm State Medical University named after Academician Wagner E.A., Perm, Russia
| | - Yu M Lopatin
- Volgograd State Medical University, Volgograd, Russia
| | - Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - S Yu Martsevich
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | - E P Panchenko
- Scientific Medical Research Center of Cardiology, Moscow, Russia
| | - I V Fomin
- Privolzhsky Research Medical University of the Ministry of Health of the Russia, Nizhny Novgorod, Russia
| | - I S Yavelov
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | - D A Yakhontov
- Novosibirsk State Medical University, Novosibirsk, Russia
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23
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Polyakov DS, Fomin IV, Belenkov YN, Mareev VY, Ageev FT, Artemjeva EG, Badin YV, Bakulina EV, Vinogradova NG, Galyavich AS, Ionova TS, Kamalov GM, Kechedzhieva SG, Koziolova NA, Malenkova VY, Malchikova SV, Mareev YV, Smirnova EA, Tarlovskaya EI, Shcherbinina EV, Yakushin SS. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. ACTA ACUST UNITED AC 2021; 61:4-14. [PMID: 33998403 DOI: 10.18087/cardio.2021.4.n1628] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
Aim To study the etiology and the dynamics of prevalence and mortality of CHF; to evaluate the treatment coverage of such patients in a representative sample of the European part of the Russian Federation for a 20-year period. Material and methods A representative sample of the European part of the Russian Federation followed up for 2002 through 2017 (n=19 276); a representative sample of the population of the Nizhny Novgorod region examined in 1998 (n=1922).Results During the observation period since 2002, the incidence of major CHF symptoms (tachycardia, edema, shortness of breath, weakness) tended to decrease while the prevalence of cardiovascular diseases has statistically significantly increased. During the period from 1998 through 2017, the prevalence of I-IV functional class (FC) CHF increased from 6.1 % to 8.2 % whereas III-IV FC CHF increased from 1.8 % to 3.1 %. The main causes for the development of CHF remained arterial hypertension and ischemic heart disease; the role of myocardial infarction and diabetes mellitus as causes for CHF was noted. For the analyzed period, the number of treatment components and the coverage of basic therapy for patients with CHF increased, which probably accounts for a slower increase in the disease prevalence by 2007-2017. The prognosis of patients was unfavorable: in I-II FC CHF, the median survival was 8.4 (95 % CI: 7.8-9.1) years and in III-IV FC CHF, the median survival was 3.8 (95 % CI: 3.4-4.2) years.
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Affiliation(s)
- D S Polyakov
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - I V Fomin
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - Yu N Belenkov
- Sechenov Moscow State Medical University, Moscow, Russia
| | - V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - F T Ageev
- Scientific Medical Research Center of Cardiology, Moscow, Russia
| | - E G Artemjeva
- State Autonomous Institution of the Chuvash Republic Postgraduate Doctors Training Institute of HealthCare Ministry, Russia
| | - Yu V Badin
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | | | - N G Vinogradova
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia City Clinical Hospital #38, Nizhny Novgorod, Russia
| | - A S Galyavich
- Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, Russia
| | - T S Ionova
- Regional Clinical Cardiological Dispensary, Saratov, Russia
| | - G M Kamalov
- Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan, Russia
| | - S G Kechedzhieva
- Stavropol State Medical Universityof the Ministry of Health of the Russian Federation, Stavropol, Russia
| | - N A Koziolova
- Perm State Medical University named after Academician E.A. Wagner, Perm, Russia
| | - V Yu Malenkova
- Budget institution Republican clinical hospital of the Ministry of health of the Chuvash Republic
| | | | - Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - E A Smirnova
- Ryazan State Medical University of the Ministry of Health of the Russian Federation, Ryazan, Russia
| | - E I Tarlovskaya
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - E V Shcherbinina
- «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - S S Yakushin
- Ryazan State Medical University of the Ministry of Health of the Russian Federation, Ryazan, Russia
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Ardashev AV, Belenkov YN, Matsiukevich MC, Snezhitskiy VA. [Atrial Fibrillation and Mortality: Prognostic Factors and Direction of Prevention]. ACTA ACUST UNITED AC 2021; 61:91-98. [PMID: 33715615 DOI: 10.18087/cardio.2021.2.n1348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 11/18/2022]
Abstract
This review focuses on major causes and risk factors for death of patients with atrial fibrillation (AF). The authors analyzed current therapeutic strategies for managing patients with AF with respect of their effects on prediction and mortality. Special attention is paid to the strategy of rhythm control and the clinical significance of catheter ablation in the treatment of patients with AF and heart failure.
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Affiliation(s)
| | | | | | - V A Snezhitskiy
- State Healthcare Institution "Grodno City Policlinic #1", Grodno
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25
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Pakhtusov NN, Iusupova AO, Privalova EV, Khabarova NV, Belenkov YN. Endothelial dysfunction and inflammation in patients with non-obstructive coronary arteries. Kardiologiia 2021; 61:52-58. [PMID: 33734056 DOI: 10.18087/cardio.2021.1.n1423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 10/26/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
Aim To determine levels of markers for endothelial dysfunction and inflammation, endothelin-1, E-selectin, and tumor necrosis factor α (TNF-α) in patients with ischemic heart disease (IHD) and non-obstructive and obstructive coronary artery (CA) disease.Material and methods This study included 32 patients with verified IHD and non-obstructive (main group, n=19) and obstructive (comparison group, n=13) CA disease. Endothelial dysfunction was diagnosed by photoplethysmography and videocapillaroscopy. Serum concentrations of endothelin-1, E-selectin, and TNF- α were measured in all patients.Results Patients with non-obstructive CA disease showed a tendency towards more pronounced endothelial dysfunction (alternative stiffness index, 7.8 m /s [6.35; 9.08]; reflection index, 36.95 % [23.4; 52.65]; capillary density following reactive hyperemia, 54.33 cap /mm2 [48.92; 75.83]; capillary density following venous occlusion, 74.33 cap /mm2 [67.83; 93.00]) compared to the comparison group (alternative stiffness index, 9.05 m/s [7.08; 10.58]; reflection index, 28.25 % [23.35; 53.75]; capillary density following reactive hyperemia, 66.83 cap /mm2 [50.83; 78.67]; capillary density following venous occlusion, 87.0 cap /mm2 [77.58; 78.67]), although statistically significant differences were not found. Concentration of endothelin-1 was significantly higher in the IHD group with non-obstructive CA disease (0.45 ng/ml [0.28;0.65]) compared to patients with CA atherosclerotic stenosis (0.35 ng/ml [0.25; 0.38], p=0.035). Concentrations of E-selectin did not significantly differ between the groups (main group, 21.1 ng/ml [18.45; 35.03]; comparison group, 28.55 ng/ml [19.08; 35.01], p=0.29). In both groups, concentrations of TNF-α did not exceed the lower threshold of sensitivity (<2.3 pg/ml).Conclusion Endothelial dysfunction and increased endothelin-1 in patients with non-obstructive CA disease along with inflammation may additionally contribute to the pathogenesis of IHD in the absence of hemodynamically significant CA stenoses. Too low level of TNFα in both groups prevented us from using it as a diagnostic marker. Further study is needed that would include a greater number of patients and a search for alternative markers.
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Affiliation(s)
- N N Pakhtusov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A O Iusupova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - E V Privalova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - N V Khabarova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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26
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Ovchinnikov AG, Ageev FT, Alekhin MN, Belenkov YN, Vasyuk YA, Galyavich AS, Gilyarevskiy SR, Lopatin YM, Mareev VY, Mareev YV, Mitkov VV, Potekhina AV, Prostakova TS, Rybakova MK, Saidova MA, Khadzegova AB, Chernov MY, Yuschuk EN, Boytsov SA. [The role of diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation. Expert consensus developed under the auspices of the National Medical Research Center of Cardiology, Society of Experts in Heart Failure (SEHF), and Russian Association of Experts in Ultrasound Diagnosis in Medicine (REUDM)]. ACTA ACUST UNITED AC 2021; 60:48-63. [PMID: 33522468 DOI: 10.18087/cardio.2020.12.n1219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/18/2022]
Abstract
Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.
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Affiliation(s)
- A G Ovchinnikov
- National medical research center of cardiology, Moscow A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - F T Ageev
- National medical research center of cardiology, Moscow, Russia
| | - M N Alekhin
- Central State Medical Academy of the Presidential Administration of Russian Federation, Moscow, Russia
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Yu A Vasyuk
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | | | - S R Gilyarevskiy
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Y M Lopatin
- Volgograd State Medical University, Volgograd, Russia Volgograd regional clinical cardiology center, Volgograd, Russia
| | - V Yu Mareev
- Lomonosov Moscow State University, Moscow, Russia
| | - Yu V Mareev
- National Research Center for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - V V Mitkov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - A V Potekhina
- National medical research center of cardiology, Moscow, Russia
| | - T S Prostakova
- National medical research center of cardiology, Moscow, Russia
| | - M K Rybakova
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - M A Saidova
- National medical research center of cardiology, Moscow, Russia
| | - A B Khadzegova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - M Yu Chernov
- N.N. Burdenko Main Military Clinical Hospital, Moscow, Russia
| | - E N Yuschuk
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - S A Boytsov
- National medical research center of cardiology, Moscow, Russia
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Antyufeeva ON, Budanova DA, Ilgisonis IS, Gadaev IY, Bochkarnikova OV, Sokolova IY, Belenkov YN, Ershov VI. [Assessment of the Dynamics of Oxidative Stress Indicators and Early Markers of Myocardial Damage and Dysfunction in Patients with Aggressive Lymphoproliferative Diseases During of Anticancer Therapy]. Kardiologiia 2021; 60:76-82. [PMID: 33522470 DOI: 10.18087/cardio.2020.12.n1394] [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] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
Aim To evaluate the dynamics of indexes of oxidative stress and markers of myocardial injury and dysfunction in patients with aggressive type lymphomas during the antitumor therapy.Material and methods This study included 75 patients with lymphoproliferative diseases of aggressive type. The main group consisted of 53 patients who received one course of antitumor therapy during the study. The comparison group consisted of 22 patients who have not received any specific treatment so far. Troponin I (TnI), high-sensitivity troponin (hsTnI), heart-type fatty acid binding protein (Н-FAВР), N-terminal pro-brain natriuretic peptide (NT-prоBNP), superoxide dismutase (SOD), and myeloperoxidase (MPO) were measured in patients of both groups at baseline, and in the main group, they were measured at 4 hours after administration of antitumor agents and on completion of the course. Functional status of the cardiovascular system was evaluated by electrocardiography in all patients at baseline and after the course of antitumor treatment and by echocardiography.Results The chemotherapy was associated with increased levels of NT-prоBNP, SOD, and MPO (30.670±15.367 vs. 52.309±25.718 pmo l/l; 1.61±0.135 vs. 1.74±0.193 U/ml; and 507.54±91.51 vs. 742.3±49.01 ng/ml, respectively). The study results indicated activation of oxidative stress on the background of the administered antitumor therapy, progressive myocardial dysfunction, and increased frequency of arrhythmic episodes.Conclusion The study results allowed identifying NT-prоBNP, MPO, and SOD as important indexes for determining a patient group at high risk of cardiotoxicity during the antitumor treatment.
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Affiliation(s)
- O N Antyufeeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - D A Budanova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I S Ilgisonis
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I Yu Gadaev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - O V Bochkarnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I Ya Sokolova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V I Ershov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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28
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Mareev VY, Garganeeva AA, Ageev FT, Arutunov GP, Begrambekova YL, Belenkov YN, Vasyuk YA, Galyavich AS, Gilarevsky SR, Glezer MG, Drapkina OM, Duplyakov DV, Kobalava ZD, Koziolova NA, Kuzheleva EA, Mareev YV, Ovchinnikov AG, Orlova YA, Perepech NB, Sitnikova MY, Skvortsov AA, Skibitskiy VV, Chesnikova AI. [The use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure Society]. ACTA ACUST UNITED AC 2021; 60:13-47. [PMID: 33522467 DOI: 10.18087/cardio.2020.12.n1427] [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: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations.
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Affiliation(s)
- V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A A Garganeeva
- "Research Institute for Cardiology", Siberian State Medical University, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - F T Ageev
- Scientific Medical Research Center of Cardiology, Russia
| | - G P Arutunov
- Russian National Research Medical University named after Pirogov, Moscow
| | - Yu L Begrambekova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Yu N Belenkov
- Sechenov Moscow State Medical University, Moscow, Russia
| | - Yu A Vasyuk
- Moscow State Medical and Dental University named after Evdokimov, Moscow, Russia
| | | | - S R Gilarevsky
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - M G Glezer
- Sechenov Moscow State Medical University, Moscow, Russia
| | - O M Drapkina
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | - D V Duplyakov
- Samara Regional Clinical Cardiological Dispensary, Russia
| | - Zh D Kobalava
- Russian State University of Peoples' Friendship, Moscow, Russia
| | - N A Koziolova
- Federal State Budgetary Institution of Healthcare of Higher Education "Perm State Medical University named after Academician E.A. Wagner ", Russia
| | - E A Kuzheleva
- "Research Institute for Cardiology", Siberian State Medical University, Tomsk National Research Medical Center, Russian Academy of Sciences, Russia
| | - Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | | | - Ya A Orlova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | | | - M Yu Sitnikova
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - A A Skvortsov
- Scientific Medical Research Center of Cardiology, Russia
| | - V V Skibitskiy
- Kuban State Medical University" of the Ministry of Health of the Russian Federation, Russia
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29
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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]
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30
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Budanova DA, Antyufeeva ON, Ilgisonis IS, Sokolova IY, Belenkov YN, Ershov VI, Bochkarnikova OV, Gadaev IY. [Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow]. ACTA ACUST UNITED AC 2020; 60:1390. [PMID: 33487150 DOI: 10.18087/cardio.2020.11.n1390] [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: 10/04/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
Aim To study changes in markers for myocardial direct injury and dysfunction and endothelial dysfunction (ED) indexes in patients with indolent lymphoma during the antitumor treatment.Material and methods Current antitumor therapy for lymphoma is often associated with cardio- and vasculotoxicity, studying of which is a relevant scientific direction. Markers for myocardial direct injury and dysfunction and ED indexes were studied in patients with indolent lymphomas receiving polychemotherapy (PCT). The study included 77 patients with newly diagnosed indolent type lymphoma. The main group (n=52): mean age, 63.4±2.8 years, 15 (28.8 %) men who had received one course of PCT. The comparison group (n=25): mean age, 61.8±3.7 years, 8 (32 %) men who had not received PCT. Troponin I (TnI), high-sensitivity troponin I (hs-сTnI), heart-type fatty acid binding protein (h-FAВР), and N-terminal pro-B-type natriuretic peptide (NT-prоBNP) were measured in patients of both groups. ED was evaluated by measuring the level of vascular cell adhesion molecule (VCAM) and by assessing the structure and function condition of small blood vessels using photoplethysmography. In both groups, the study parameters were determined at the start of the study (T1) and following the PCT course in the main group; if the PCT schedule included anthracycline antibiotics, the second point (T2) was assessed at 6 h following the drug administration.Results In both groups, the level of NT-proBNP was increased. This increase was significantly more pronounced in the comparison group (49.896±23.228 vs 20.877±8.534 pmol/l, respectively, p=0.011) whereas a tendency to its increase was observed after the PCT course. Before the start of the treatment, laboratory and instrumental signs of ED were noticed: the level of VCAM was 4951±1297 and 3225±757 ng/ml in the comparison group and the main group, respectively (р=0.246); reflection index was <1.8 in 23 (44.2%) patients of the main group and in 16 (64%) patients of the comparison group (р=0.098). During the PTC course, the endothelial function significantly improved; the level of VCAM decreased by 748 ng/ml (p=0.016), which was associated with significant decreases in erythrocyte sedimentation rate by 2.71 mm/h (р=0.027) and lactate dehydrogenase level by 62.38 U/l (р=0.026). Statistically significant decreases in other inflammatory markers (alpha-2-globulin, fibrinogen, C-reactive protein, neutrophil count) were not observed.Conclusion The level of NT-proBNP showed the highest sensitivity in assessing the cardiotoxic effect of PCT. The dynamics of VCAM level suggested a possible role of the disease itself in the development of ED in this patient group.
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Affiliation(s)
- D A Budanova
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - O N Antyufeeva
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - I S Ilgisonis
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - I Ya Sokolova
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - V I Ershov
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - O V Bochkarnikova
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
| | - I Yu Gadaev
- Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow
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31
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Shchendrigina AA, Zhbanov KA, Privalova EV, Iusupova AO, Bytdaeva AH, Danilogorskaya YA, Zheleznykh EA, Suvorov AY, Zektser VY, Mnatsakanyan MG, Lyapidevskaya OV, Khabarova NV, Naymann YI, Belenkov YN, Starostina ES. [Circulating Neuregulin-1 and Chronic Heart Failure with Preserved Ejection]. ACTA ACUST UNITED AC 2020; 60:1222. [PMID: 33487159 DOI: 10.18087/cardio.2020.11.n1222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/08/2020] [Indexed: 11/18/2022]
Abstract
Chronic heart failure (CHF) with preserved ejection fraction (CHFpEF) is an unsolved, socially relevant challenge since it is associated with a high level of morbidity and mortality. Early markers for this pathology are unavailable, and therapeutic approaches are undeveloped. This necessitates extensive studying the mechanisms of CHFpEF to identify therapeutic targets. According to current notions, systemic inflammation and endothelial dysfunction play an important role in the pathogenesis of CHFpEF. These processes induce the development of myocardial fibrosis and impairment of cardiomyocyte relaxation, thereby resulting in diastolic dysfunction and increased left ventricular (LV) filling pressure. Neuregulin-1 (NRG-1) is a paracrine growth factor and a natural agonist of ErbB receptor family synthesized in the endothelium of coronary microvessels. The NRG-1 / ErbB4 system of the heart is activated at early stages of CHFpEF to enhance the cardiomyocyte resistance to oxidative stress. Preclinical and clinical (phases II and III) studies have shown that the recombinant NRG-1 therapy results in improvement of myocardial contractility and in LV reverse remodeling. Results of recent studies suggest possible anti-inflammatory and antifibrotic effects of NRG-1, which warrants studying the activity of this system in patients with CHFpEF.
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Affiliation(s)
- A A Shchendrigina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - K A Zhbanov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V Privalova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A O Iusupova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A H Bytdaeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu A Danilogorskaya
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E A Zheleznykh
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | | | - V Yu Zektser
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - M G Mnatsakanyan
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - O V Lyapidevskaya
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - N V Khabarova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu I Naymann
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
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Chikhireva LN, Chikhirev OA, Pikin DA, Bychkova OP, Cherkashov AM, Belenkov YN. [Myopericaditis as a late manifestation of the probable COVID-19]. Kardiologiia 2020; 60:27-32. [PMID: 33155956 DOI: 10.18087/cardio.2020.8.n1232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
The article describes a clinical case of myopericarditis as a late manifestation of possible COVID-19.
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Affiliation(s)
- L N Chikhireva
- Multidisciplinary Medical Center of the Bank of Russia, Moscow
| | - O A Chikhirev
- Multidisciplinary Medical Center of the Bank of Russia, Moscow
| | - D A Pikin
- Multidisciplinary Medical Center of the Bank of Russia, Moscow
| | - O P Bychkova
- Multidisciplinary Medical Center of the Bank of Russia, Moscow
| | - A M Cherkashov
- Multidisciplinary Medical Center of the Bank of Russia, Moscow
| | - Yu N Belenkov
- Pervyj Moskovskij gosudarstvennyj medicinskij universitet imeni I. M. Secenova, Moscow
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Safonova JI, Kozhevnikova MV, Danilogorskaya YA, Zheleznykh EA, Zektser VY, Shchendrygina AA, Ilgisonis IS, P EV, Khabarova NV, Belenkov YN. [Positive Effects of Perindopril on Microvascular Vessels in Patients With Chronic Heart Failure]. Kardiologiia 2020; 60:65-70. [PMID: 33155960 DOI: 10.18087/cardio.2020.8.n1216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
Aim To evaluate the effect of 12-month perindopril treatment on structure and function of microvasculature (MV) in patients with chronic heart failure with preserved (HFpEF) and intermediate (HFiEF) left ventricular ejection fraction.Material and methods 30 patients with HFpEF and HFiEF were evaluated. Perindopril at a maximum tolerated dose was administered to all patients for 12 months. Changes in MV structure and function were assessed with photoplethysmography and capillaroscopy prior to the treatment onset and at 12 months, i.e., after completion of the perindopril treatment.Results The 12-month perindopril treatment was associated with improvement of the endothelial function evident as increases in the occlusion index (OI) and the phase shift (PS). OI increased from 1.45 [1.3; 1.6] to 1.8 [1.6; 2.2] (p=0.00004). PS increased from 7.1 ms [4.8; 10.2] to 9.2 ms [6.7; 13.2] (p=0.0003). Stiffness of muscular large blood vessels was decreased. Arterial stiffness index (aSI) decreased from 8.8 [6.6; 11.0] to 7.45 [6.5; 9.4] m /s (р=0.01). The perindopril treatment was associated with increased density of the capillary network at rest (р=0.008) and in tests with venous occlusion (р=0.003) and reactive hyperemia (р=0.0003).Conclusion The study showed an improvement of endothelial function associated with the 12-month perindopril therapy in patients with HFpEF and HFiEF.
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Affiliation(s)
- J I Safonova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu A Danilogorskaya
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E A Zheleznykh
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - V Y Zektser
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A A Shchendrygina
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - I S Ilgisonis
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V P
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - N V Khabarova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
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Kirichenko YY, Belenkov YN, Privalova EV, Naymann YI, Gitel EP, Novikova OV, Ilgisonis IS. [Vasculotoxicity of Chemotherapy: Assessment оf Endothelial Dysfunction Biomarkers' Levels in Gastric Cancer Patients]. Kardiologiia 2020; 60:1069. [PMID: 32515702 DOI: 10.18087/cardio.2020.5.n1069] [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] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022]
Abstract
Aim To evaluate dynamics of biomarkers for endothelial dysfunction (ED), including endothelin-1 (ET-1) and von Willebrand factor (VWF) in patients with stomach cancer (adenocarcinoma) before and after polychemotherapy (PCT); to compare these results with respective values in healthy volunteers and patients with cardiovascular diseases (CVD); to study correlations of the ED biomarkers with indexes of instrumental evaluation of endothelial dysfunction.Material and methods The study included 75 participants, including 25 healthy volunteers (control group), 25 patients with documented CVDs (arterial hypertension + ischemic heart disease), and 25 patients of the main group with histologically documented stage II-IV stomach cancer (adenocarcinoma) who received different courses of PCT with platinum-based agents (oxaliplatin, cisplatin) and fluoropyrimidines (5 fluorouracil, capecitabin). Laboratory measurement of ED biomarkers, computerized nailfold video capillaroscopy (CNVC), and finger laser photoplethysmography (PPG) (methods for noninvasive evaluation of vascular wall and ED), electrocardiography, 24-h ECG Holter monitoring, and echocardiography (EchoCG) were performed for all patients of the main group prior to PCT and within one months after the last course completion. This evaluation was performed once for healthy volunteers and patients of the CVD group upon inclusion into the study.Results In the main group, ET-1 levels were non-significantly lower than normal and did not change during the courses of antitumor treatment (0.95 [0.6; 1.4] and 0.94 [0.7; 1.4] pg /ml (р<0.9) before and after PCT, respectively). Statistically significant differences were found between the control group and oncological patients after the treatment (р<0.04). Levels of VWF remained within the normal range in all examined participants and did not significantly differ between study groups, including oncological patients before and after the specific treatment (р>0.05 for all comparisons). The correlation analysis detected significant correlations of ET-1 levels with functional disorders of microcirculation, ET-1 with the occlusion index (rs=0.56; p=0.005), ЕТ-1 with percentage of capillary restoration (PCR, rs= -0.72; p=0.018) and with the incidence rate of supraventricular extrasystole (rs=0.48; p=0.032).Conclusion The dynamics of ED biomarkers was studied for the first time in patients with stomach cancer receiving a specific antitumor therapy. Although no significant changes in ЕТ-1 and VWF were observed during the PCT (probably due to exhaustion of the endothelial system and a small patient sample), these indexes can be considered as early vasculotoxicity markers due to the presence of significant correlations with indexes of impaired endothelial function according to the results of instrumental evaluation.
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Affiliation(s)
- Yu Yu Kirichenko
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu N Belenkov
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Privalova
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu I Naymann
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E P Gitel
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - O V Novikova
- M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - I S Ilgisonis
- M. Sechenov First Moscow State Medical University, Moscow, Russia
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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.
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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
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Belenkov YN, Snezhitskiy VA, Ardashev AV, Abzaliyeva SA, Cappato R, Karpenko JI, Konev AV, Nechepurenko AA, Raviele A, Puodziukynas A, Sayganov SA, Santini L, Shugaev PL, Yakovleva MV, Zateyshchikov DA, Yuzvinkevitch SA, Zhelyakov EG. [Recommendations of the Eurasian Arrhythmology Association (EURA) for the diagnosis and treatment of patients with arrhythmias and conduction disorders during the COVID-19 pandemic]. ACTA ACUST UNITED AC 2020; 60:4-8. [PMID: 32515698 DOI: 10.18087/cardio.2020.5.n1130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
The beginning of 2020 was characterized by the development of a new coronavirus pandemic (COVID-19). Information about the epidemiology, etiology, pathogenesis, clinical and laboratory diagnostics, as well as prevention and therapy for this disease is constantly being expanded and reviewed. The COVID-19 pandemic creates the need for the emergence of new conditions of specialized care for patients with heart rhythm and conduction disorders [1]. These recommendations are intended for general practitioners, internists, cardiologists, electrophysiologists/arrhythmologists, cardiovascular surgeons, functional diagnostics doctors, anesthesiologists-resuscitators, laboratory diagnostics specialists, health care organizers in the system of organizations and healthcare institutions that provide specialized care to patients with heart rhythm and conduction disorders.
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Affiliation(s)
| | | | | | - S A Abzaliyeva
- Казахский национальный университет им. Аль-Фараби, Almaty, Kazakhstan
| | - Riccardo Cappato
- Arrhythmia and Electrophysiology Center at Humanitas Research Hospital, Milan, Italy
| | | | - A V Konev
- Federal Science and Clinical Center of FMBA, Moscow, Russia
| | - A A Nechepurenko
- Federal Center for Cardiovascular Surgery of the Ministry of Health of Russia, Astrakhan, Russia
| | | | - Aras Puodziukynas
- Cardiology Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - S A Sayganov
- North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia
| | | | - P L Shugaev
- Federal Center for Cardiovascular surgery, Chelyabinsk, Russia
| | | | | | - S A Yuzvinkevitch
- South-Western center for interventional Arrhythmology, hospital #26, Saint-Petersburg, Russia
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Zhito AV, Iusupova AO, Kozhevnikova MV, Shchendrygina AA, Privalova EV, Belenkov YN. [E-Selectin as a Marker of Endothelial Dysfunction in Patients with Coronary Artery Disease Including Those with Type 2 Diabetes Mellitus]. Kardiologiia 2020; 60:24-30. [PMID: 32394853 DOI: 10.18087/cardio.2020.4.n1066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
Aim To determine concentration of the endothelial dysfunction (ED) marker, serum E-selectine, in patients with ischemic heart disease (IHD) in combination with type 2 diabetes mellitus (DM) and without DM.Material and methods The study included 60 IHD patients; 31 of them also had type 2 DM. E-selectin was measured in blood of all patients. In addition, a comprehensive evaluation of the morpho-functional condition of large blood vessels and microvasculature (MV) was performed by laser finger plethysmography (LFP) and nailfold computed videocapillaroscopy (CVC).Results Concentration of E-selectin was increased in IHD patients with type 2 DM (35.2 [29.0; 47.35] ng / ml vs. 31.7 [20.85; 36.68] ng / ml for IHD patients; p=0.028). A significant (p=0.018 and 0.016, respectively) decrease in the phase shift was observed in IHD patients with type 2 DM ( - 4.4 [ - 8.7; - 2.45] ms) compared to IHD patients ( - 1.9 [ - 3.95; - 0.38] ms). The capillary density evaluated in the venous occlusion test was reduced in IHD patients with type 2 DM (67.70 [57.83; 80.69]) compared to IHD patients (80.80 [69.05; 99.08]).Conclusion The signs of ED observed in patients of both groups were more pronounced in IHD patients with type 2 DM.
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Affiliation(s)
- A V Zhito
- I. M. Sechenov First Moscow State Medical University
| | - A O Iusupova
- I. M. Sechenov First Moscow State Medical University
| | | | | | - E V Privalova
- I. M. Sechenov First Moscow State Medical University
| | - Yu N Belenkov
- I. M. Sechenov First Moscow State Medical University
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Shakaryants GA, Kozhevnikova MV, Kaplunova VY, Privalova EV, Lishuta AS, Korobkova EO, Belenkov YN. [Focus on the Myocardial Hypertrophy from the Perspective of Transcriptomics and Metabolomics]. Kardiologiia 2020; 60:120-129. [PMID: 32394866 DOI: 10.18087/cardio.2020.4.n1063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
This review presents major directions in studies of myocardial hypertrophy from the aspect of transcriptomics and metabolomics. Understanding of trigger mechanisms of myocardial hypertrophy will permit transition from basic studies to individualized clinical application of innovative technologies in the treatment of heart diseases, such as targeted therapy. At the present time, methods have been developed for diagnostics and prediction of cardiovascular diseases based on the metabolomic profiling and the evaluation of microRNA expression. Progress in studying molecular and genetic processes underlying the development of cardiovascular diseases may provide invaluable information for clinical cardiology.
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Affiliation(s)
- G A Shakaryants
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - V Yu Kaplunova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E V Privalova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A S Lishuta
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E O Korobkova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Korobkova EO, Kozhevnikova MV, Ilgisonis IS, Shakaryants GA, Appolonova SA, Kukharenko AV, Larcova EV, Maltseva AA, Khabarova NV, Belenkov YN. [Metabolomic profiling in patients with metabolic syndrome]. Kardiologiia 2020; 60:37-43. [PMID: 32375614 DOI: 10.18087/cardio.2020.3.n903] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/28/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To identify biomarkers, which are most specific for patients with metabolic syndrome (MS) using metabolomic profiling. MATERIALS AND METHODS Metabolomic profiling of patients with MS and comparison of their profile with the profile of volunteers was performed using high-performance liquid chromatography-mass-spectrometry. RESULTS The metabolomic profile of MS patients differed in several amino acids, including choline, cysteine, and serine and in the acylcarnitine group (р<0.05 for all comparisons). CONCLUSION The metabolites most specific for MS patients were identified. Increased concentrations of a combination of amino acids and carnitines can be considered as possible additional risk factors for cardiovascular diseases.
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Affiliation(s)
- E O Korobkova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - M V Kozhevnikova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - I S Ilgisonis
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - G A Shakaryants
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - S A Appolonova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - A V Kukharenko
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - E V Larcova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - A A Maltseva
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - N V Khabarova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
| | - Yu N Belenkov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
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40
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Shakaryants GA, Budanova DA, Lobastov KV, Khabarova NV, Kirichenko YY, Belenkov YN. [Treatment and secondary prevention of venous thromboembolism in cancer patients]. ACTA ACUST UNITED AC 2020; 60:71-79. [PMID: 32375618 DOI: 10.18087/cardio.2020.3.n904] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/09/2019] [Indexed: 11/18/2022]
Abstract
Oncological patients are a high-risk group for venous thromboembolic complications. These complications significantly impair the outcome of antitumor treatment and take a leading place in the structure of mortality. Treatment of venous thromboembolic complications in oncological patients is a serious challenge. When selecting an anticoagulant, the physician should consider its efficacy and safety and possible drug interactions. Based on results of multiple studies presented in this article, physicians will be able to choose an optimum therapeutic tactics and secondary prevention of thromboembolic complications for this group of patients.
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Affiliation(s)
- G A Shakaryants
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). Russian Federation, Moscow
| | - D A Budanova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). Russian Federation, Moscow
| | - K V Lobastov
- Federal State Budget Educational Institution of Higher Education N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Federation, Moscow
| | - N V Khabarova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). Russian Federation, Moscow
| | - Yu Yu Kirichenko
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). Russian Federation, Moscow
| | - Yu N Belenkov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). Russian Federation, Moscow
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Kirichenko YY, Ilgisonis IS, Belenkov YN, Privalova EV, Naymann YI, Lyamin AM, Kozhevnikova MV, Korobkova EO, Khabarova NV, Ogorodnikov NV. [The effect of chemotherapy on endothelial function and microcirculation in patients with gastric cancer]. Kardiologiia 2020; 60:89-95. [PMID: 32345204 DOI: 10.18087/cardio.2020.2.n908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate and study the dynamics of endothelial dysfunction instrumental indicators, vascular wall stiffness and microcirculation state in patients with gastric cancer (adenocarcinoma) before and after chemotherapy; compare it with the results obtained from healthy volunteers and patients with cardio-vascular diseases. MATERIALS AND METHODS The study included 65 people: 25 healthy volunteers, 15 patients with known cardio-vascular diseases (CVD) and 25 patients with histologically confirmed gastric cancer (adenocarcinoma) stage 2-4 who underwent surgical treatment followed by chemotherapy according to the FOLFOX, XELOX, and XP regimes. For non-invasive assessment of the vascular wall's state of large vessels and microcirculation, all patients in the main group underwent computer nailfold capillaroscopy and finger photoplethysmography before chemotherapy and within a month after the completion of the last course. For healthy volunteers and patients with CVD, the above studies were performed once during the examination. RESULTS The data obtained indicate a significant increase in the reflection index of small muscle arteries (RI) and the stiffness index of large conducting arteries (aSI) during chemotherapy. In cancer patients, even before the treatment, endothelial dysfunction was detected, which significantly worsened after treatment (occlusion index (IO) before and after chemotherapy 1.7 (1.38; 1.9) vs. 1.3 (1.2; 1.5), p<0.0002, respectively). Significant differences in the compared indices in cancer patients and CVD group were revealed only after chemotherapy. Significant structural and functional disorders of capillaries were noted in the studied groups, which also worsened during chemotherapy in the main group (density of the capillary network at rest 43.23cap/mm2 vs. 42.19cap/mm2, p <0.01, respectively; density of the capillary network after the reactive hyperemia test 46.77cap/mm2 vs. 44.11cap/mm2, p<0,02, respectively). CONCLUSION In this study, for the first time, the dynamics of endothelial dysfunction indicators, vascular wall stiffness and microcirculation state in patients with gastric cancer were studied, and a reliable increasing of these changes was proved during chemotherapy. The results indicate the need for a further search for accurate and effective methods of identifying early signs of close and distant vasculotoxicity, the development of individual prevention programs in order to significantly reduce the risk of cardiovascular events during and after chemotherapy.
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Affiliation(s)
- Yu Yu Kirichenko
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - I S Ilgisonis
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - Yu N Belenkov
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - E V Privalova
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - Yu I Naymann
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - A M Lyamin
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - M V Kozhevnikova
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - E O Korobkova
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - N V Khabarova
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
| | - N V Ogorodnikov
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow
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Danilogorskaya YA, Zheleznykh EA, Privalova EA, Belenkov YN, Shchendrigina AA, Kozhevnikova MV, Shakaryants GA, Zektser VY, Lishuta AS, Khabarova NV. [Vasoprotective Effects of Prolonged Therapy With Perindopril A in Patients with Hypertension Including Concomitant Type 2 Diabetes Mellitus]. ACTA ACUST UNITED AC 2020; 60:4-9. [PMID: 32245348 DOI: 10.18087/cardio.2020.1.n888] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/20/2019] [Indexed: 11/18/2022]
Abstract
Objective Investigate the dynamics of morphological and functional markers of vascular remodeling in patients with arterial hypertension (AH), including those with concomitant type 2 diabetes mellitus (DM2), during 12-month administration of perindopril A.Material and Methods The study included patients with grade I-II AH, with and without DM2 (30 and 32 patients, respectively), who underwent outpatient correction of initially ineffective antihypertensive therapy and administration of perindopril A, 10 mg/day. Morphological and functional parameters of vascular remodeling were evaluated in all patients at baseline and at 12 months using photoplethysmography. Stiffness index (SI) and phase shift (PS) were measured in large vessels. Reflection index (RI) and occlusion index (OI) were measured in microvessels. Computed nailfold videocapillaroscopy was used to determine capillary density (CD) at rest (CDr), CD during venous occlusion test (CDvo), and CD during reactive hyperemia test (CDrh). Data are medians [interquartile range].Results After 12-month administration of perindopril A, the morphological and functional parameters of vascular remodeling in AH patients without DM2 significantly improved at all vascular levels. SI decreased to 9.25 [7.8; 10.93 ] m/s and PS increased to 7.4 [5.6; 9.05] ms. In microvasculature, a statistically significant reduction was observed in RI, 31 [27; 36.5]%, and an increase was observed in OI, which characterizes endothelium function, 1.75 [1.68; 1.9]. Capillary CDr significantly increased to 40.5 [34.93; 46] cap/mm2, as did CDvo and CDrh. At the same time, in the group of patients with AH and DM2, a significant improvement was observed for the large vessels. SI decreased to 9.8 [9.08; 10.58] m/s, and PS increased to 6.95 [5.13; 10.08]. The RI index, reflecting the structural condition of arterioles, significantly decreased to 34 [25.9; 45.53]%, and the OI index, characterizing endothelial function, did not change significantly, 1.4 [1.3; 1.6]. Capillary CDr significantly increased to 31.55 [27.68; 34.7 ] cap/mm2; however, CDvo and CDrh did not change significantly. Renal function improved in both groups.Conclusion Both groups demonstrated improvement of morphological parameters at all levels of the arterial bed. However, patients with AH and concomitant DM2 showed no improvement of the endothelial function of arterioles and capillaries compared to improvement in AH patients without DM2. This reflected the more severe endothelial dysfunction present in AH patients with DM2.
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Affiliation(s)
- Yu A Danilogorskaya
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - E A Zheleznykh
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - E A Privalova
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - Yu N Belenkov
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - A A Shchendrigina
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - M V Kozhevnikova
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - G A Shakaryants
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - V Yu Zektser
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - A S Lishuta
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
| | - N V Khabarova
- I.M. Sechenov First Moscow State Medical University, Department of Hospital Therapy #1
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Arystan AZ, Khamzina YT, Benberin VV, Fettser DV, Belenkov YN. [Lung Ultrasound: new Opportunities for a Cardiologist]. Kardiologiia 2020; 60:81-92. [PMID: 32245358 DOI: 10.18087/cardio.2020.1.n617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/13/2019] [Accepted: 09/17/2019] [Indexed: 06/11/2023]
Abstract
This review focused on ultrasound examination of lungs, a useful complement to transthoracic echocardiography (EchoCG), which is superior to chest X-ray in the diagnostic value. The lung acoustic window always remains open and allows obtaining high-quality images in most cases. For a cardiologist, the major points of the method application are determination of pleural effusion and lung congestion. This method has a number of advantages: it is time-saving; cost-effective; portable and accessible; can be used in a real-time mode; not associated with radiation; reproducible; and highly informative. The ultrasound finding of wet lungs would indicate threatening, acute cardiac decompensation long before appearance of clinical, auscultative, and radiological signs of lung congestion. Modern EchoCG should include examination of the heart and lungs as a part of a single, integrative ultrasound examination.
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Affiliation(s)
- A Z Arystan
- Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan
| | - Y T Khamzina
- Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan
| | - V V Benberin
- Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan
| | - D V Fettser
- Municipal Clinical Hospital #52 at the Health Care Department of Moscow City
| | - Y N Belenkov
- I.M. Sechenov First Moscow State Medical University
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44
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Kulagina TY, Belenkov YN, Sandrikov VA. [New Algorithms for Evaluation Myocardial Function According to Echocardiography]. ACTA ACUST UNITED AC 2019; 59:48-55. [PMID: 31849299 DOI: 10.18087/cardio.2019.11.10273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 11/18/2022]
Abstract
The article is devoted to the novel methodological approach to assessment of function of the myocardium and the left ventricle as a whole with the help of modern methods of processing ultrasound images obtained by echocardiography. It contains presentation of theoretical prerequisites for elaboration of a new direction, as well as mathematical computations basing on which quantitative parameters for assessment of myocardial function and blood flows within chambers of the heart were obtained. The fundamental principle in assessing these parameters was the use of the phase structure of the cardiac cycle.
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Affiliation(s)
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University)
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45
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Tkacheva ON, Belenkov YN, Karpov YA, Zyryanov SK. [Gerontology Issues in Cardiology Practice]. ACTA ACUST UNITED AC 2019; 59:54-63. [PMID: 31849312 DOI: 10.18087/cardio.2019.12.n876] [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: 10/04/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
Increase in life expectancy during the second part of the 20th century is accompanied by increase in proportion of elderly and senile age population. However, despite the increase in life expectancy, the prevalence of most chronic diseases and functional impairments rises with age. Elderly and senile age is associated with the risk of cardiovascular diseases (CVD), therefore the problem of managing elderly patients with CVD becomes especially urgent.
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Affiliation(s)
- O N Tkacheva
- Pirogov Russian National Research Medical University (RNRMU)
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - Yu A Karpov
- National Medical Research Center for Cardiology
| | - S K Zyryanov
- Peoples' Friendship University of Russia (RUDN University)
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46
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Mareev VY, Gilyarevskiy SR, Mareev YV, Begrambekova YL, Belenkov YN, Vasyuk YA, Galyavich AS, Gendlin GE, Glezer MG, Kobalava ZD, Lelyavina TA, Orlova YA, Fomin IV, Shaposhnik II. [Position Paper. The role of iron deficiency in patients with chronic heart failure and current corrective approaches]. ACTA ACUST UNITED AC 2019; 60:99-106. [PMID: 32245360 DOI: 10.18087/cardio.2020.1.n961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 11/18/2022]
Affiliation(s)
| | | | - Yu V Mareev
- National Medical Research Center for Preventive Medicine
| | | | | | - Yu A Vasyuk
- Moscow State Medical and Dental University named after Evdokimov
| | | | - G E Gendlin
- Russian National Research Medical University named after Pirogov
| | - M G Glezer
- Sechenov Moscow State Medical University
| | | | | | | | - I V Fomin
- Nizhny Novgorod State Medical Academy
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47
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Belenkov YN, Ilgisonis IS, Naymann YI, Privalova EA, Zhito AV. [The Use of Selective Inhibitor of If-Channels Ivabradine in Patients with Ischemic Heart Disease, Heart Failure with High Heart Rate]. ACTA ACUST UNITED AC 2019; 59:60-65. [PMID: 31615388 DOI: 10.18087/cardio.2019.10.n601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/16/2019] [Indexed: 11/18/2022]
Abstract
Ischemic heart disease (IHD) and chronic heart failure (CHF) belong to leading causes of death among patients with cardiovascular diseases (CVD). Modern medical approaches to the treatment of patients with CHF do not always provide a significant improvement in the quality of life, a decrease in the frequency of CHF exacerbations and hospitalizations, and an improvement of the long-term prognosis. According to the neurohumoral theory of IHD and CHF development, the blockade of the sympathoadrenal system with β-adrenoblockers (β-AB) is pathogenetically substantiated, and preparations of this group are recommended as one of the main classes of drugs for the treatment of patients with CHF. However, selection of heart rhythm slowing therapy in patients with CHF of ischemic genesis is often difficult due to the development of undesirable side effects of β-AB, intolerance and/or due to the presence of contraindications for their use. Randomized studies have shown that prescribing a combination of β-AB and If-channel blocker ivabradine for heart rate (HR) reduction or solely ivabradine when use of β-AB is impossible in complex CHF therapy, improves the left ventricle (LV) diastolic function, reducing mortality from CHF decompensation. However, the prognostic significance of the use of ivabradine in patients with CHF with preserved left ventricular ejection fraction of ischemic genesis with heart rate higher than 70 beats/min receiving maximum tolerated doses of β-AB remains not fully investigated.
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Affiliation(s)
- Yu N Belenkov
- First Moscow State Medical University (Sechenov University)
| | - I S Ilgisonis
- First Moscow State Medical University (Sechenov University)
| | - Yu I Naymann
- First Moscow State Medical University (Sechenov University)
| | - E A Privalova
- First Moscow State Medical University (Sechenov University)
| | - A V Zhito
- First Moscow State Medical University (Sechenov University)
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48
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Belenkov YN, Ershov VI, Antyufeeva ON, Budanova DA, Kochkareva YB, Gadaev IY, Bochkarnikova OV, Sokolova IY, Kirichenko YY. [Assessment of the Role of Oxidative Stress Indicators and Early Markers of Myocardial Injury and Disfunction in Patients with Lymphoproliferative Diseases]. Kardiologiia 2019; 59:47-53. [PMID: 31397229 DOI: 10.18087/cardio.2019.8.n682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE to study dynamics of indicators of oxidative stress and their role in development of cardiotoxicity in patients with lympho-proliferative diseases at the background of polychemotherapy. MATERIALS AND METHODS We included into this study 30 patients with newly detected Non-Hodgkin lymphomas. The control group comprised 15 healthy volunteers. For registration of dynamics of formation of oxygen active forms (OAF), we used highly sensitive chemiluminescence assay. The state of initial stage of lipoperoxidation OAF and radicals of organic compounds) was assessed by dynamics of the leukocyte chemiluminescence. The state of final stage of lipoperoxidation (formation of nonmetabolizing lipid hydroperoxides and other compounds) was assessed by the level of malonic dialdehyde. We also determined indicator of leukocyte chemiluminescence intensity (both basal and zymosan-stimulated). For assessment of the cardiovascular system functional state before and after chemotherapy we used electrocardiography (ECG), echocardiography (EchoCG) and 24-hour ECG monitoring. RESULTS The data obtained were indicative of increased generation of free radicals by leukocytes during polychemotherapy. After chemotherapy course we detected various types of cardiotoxicity. We noted substantial elevation of frequency of supraventricular and ventricular extrasystoles. There was direct correlation between rate of appearance of supraventricular extrasystoles and level of chemiluminescence of leukocytes (r=0.7; p=0.03). According to data of EchoCG although the left ventricular ejection fraction remained within the normal range during chemotherapy, there was a persistent tendency to its decrease (р<0.001). CONCLUSION In this study we for the first time in patients with Non-Hodgkin lymphomas detected an elevation of level of free radical reactions and lipid peroxidation with simultaneous lowering of antiperoxidative activity of blood plasma and their relation to development of cardiotoxic effects. The results obtained indicate to necessity of search for novel early markers of oxidative stress activation, myocardial injury and disfunction able to help to substantially decrease risk of development of cardiovascular complications during and after chemotherapy.
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Affiliation(s)
- Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - V I Ershov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - O N Antyufeeva
- Sechenov First Moscow State Medical University (Sechenov University)
| | - D A Budanova
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - I Yu Gadaev
- Sechenov First Moscow State Medical University (Sechenov University)
| | - O V Bochkarnikova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - I Ya Sokolova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - Yu Yu Kirichenko
- Sechenov First Moscow State Medical University (Sechenov University)
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49
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Belenkov YN, Tsvetkova OA, Privalova EV, An GV, Ilgisonis IS, Voronkova OO. [Comorbidity of Chronic Obstructive Pulmonary Disease and Cardiovascular Diseases: Place of Therapy with Modern β-Adrenoblockers]. Kardiologiia 2019; 59:48-55. [PMID: 31242841 DOI: 10.18087/cardio.2019.6.n458] [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] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 11/18/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth largest cause of worldwide mortality. Presence of comorbidities is registered in 96% of COPD patients. The most important of these are cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure), which contribute to COPD patients' mortality in every third case. COPD and cardiovascular diseases have common risk factors and pathogenesis mechanisms. Cardioselective beta-blockers reduce morbidity risk and frequency of COPD exacerbation, are effective and safe in treatment of COPD patients.
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Affiliation(s)
- Yu N Belenkov
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
| | - O A Tsvetkova
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
| | - E V Privalova
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
| | - G V An
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
| | - I S Ilgisonis
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
| | - O O Voronkova
- I.M. Sechenov's First Moscow State Medical University of Ministry of Health (Sechenov University)
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50
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Belenkov YN, Privalova EV, Iusupova AO, Zhito AV. [Markers of Vascular Wall Fibrosis Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinases-1 in Patients with Ischemic Heart Disease with and without Concomitant Type-2 Diabetes Mellitus]. Kardiologiia 2019; 59:61-66. [PMID: 31131769 DOI: 10.18087/cardio.2019.5.10258] [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] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 05/25/2019] [Indexed: 11/18/2022]
Abstract
The prevalence of ischemic heart disease (IHD) and diabetes mellitus type 2 (DM type 2) is permanently increasing both worldwide and in theRussian Federation. That is why studies of mechanisms of pathogenesis of both diseases is continuing for prevention of complications and mortality. DM type 2 contributes a lot to deterioration of IHD. One of pathogenetic features these two pathologies share is pronounced blood vessel wall fibrosis. In this review we present analysis of studies devoted to the determination of the role of metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 indevelopment of vascular wall fibrosis.
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Affiliation(s)
- Y N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - E V Privalova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A O Iusupova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A V Zhito
- Sechenov First Moscow State Medical University (Sechenov University)
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