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Results in Journal Cardiovascular Therapy and Prevention: 1,093

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, A. L. Borisova, , I. A. Efimova, , , Z. Z. Serebryanskaya, , , A. V. Pustelenin, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2958

Abstract:
The success and quality of large-scale epidemiological studies depends entirely on biomaterial quality. Therefore, when arranging the third Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF-3) study, increased attention was paid to specifics of collection, processing and further transportation of biological samples and related clinical and anthropometric data of participants from regional collection centers to Biobank. Aim. To develop a methodology for collection of high-quality biomaterials within the large-scale epidemiological study, involving the sampling, processing, freezing of blood and its derivatives (serum, plasma) in the regions, followed by transportation and storage of obtained biomaterial in the Biobank of National Medical Research Center for Therapy and Preventive Medicine (Moscow). Material and methods. To conduct the ESSE-RF-3 study, a design was developed, according to which the collection of venous blood samples in a total volume of 29,5 ml from each participant is planned in all participating regions in order to obtain and store samples of whole blood, serum and two types of plasma. Results. On the basis of international biobanking standards, ethical norms, experience from ESSE-RF and ESSE-RF-2, and literature data, a protocol for biobanking of blood and its derivatives was developed. The type and number of serum and plasma aliquots obtained, the required standard technical means and consumables, as well as logistic biomaterial requirements were determined. Training programs for regional participants were developed. By the beginning of August 2021, 180 thousand samples of whole blood, serum and plasma from more than 23 thousand participants from 28 Russian regions were collected, processed and stored. Conclusion. The presented work made it possible to assess and confirm the compliance of developed biobanking protocol with quality requirements. However, due to the coronavirus disease 2019 pandemic, by August 2021, the Biobank did not reach the maximum effectiveness predicted for the ESSE-RF-3 project.
, , А. В. Загребельный, M. I. Chernysheva, , , , O. V. Lerman, Yu. V. Lukina, S. V. Blagodatskikh, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2856

Abstract:
Aim. To assess the quality of medication treatment in the polyclinic within 2 years after discharge, depending on presence/absence of diarecommended for patients with stroke before its development and betes. Material and methods. The study included 684 patients assigned to the City Polyclinic № 64 (Moscow), discharged from F.I. Inozemtsev City Clinical Hospital (Moscow) for a period from January 1, 2012 to April 30, 2017 with a diagnosis of stroke/transient ischemic attack, of which 122 were diagnosed with diabetes. Results. Before stroke, therapy was recommended for 67,3% of patients with diabetes and 54,7% without diabetes (p<0,01): statins — 15,5 and 14,4%, antiplatelet agents — 32,7 and 25,5%, angiotensinconverting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) — 41,4 and 37,9%, beta-blockers (BBs) — 9,1% and 7,8%, respectively. For the first 6 months after stroke, the rate of statin therapy increased to 39,6 and 39,2%, antiplatelet drugs — to 62,6 and 51,9%, ACE inhibitors/ARBs — to 68,2 and 66%, BBs — to 51,6 and 37,2%, respectively. Then, after 6 months it decreased again to 28,8 and 27,1% for statins, to 30,7 and 35,2% for antiplatelet agents, to 43,3 and 42,6% for ACE inhibitors/ARBs and remained the same for BBs, respectively. There were no significant differences in the prevalence of prescribing most drugs to patients with and without diabetes, both before and after stroke, with the exception of hypoglycemic medications. Conclusion. The therapy of patients with previous stroke, both with and without diabetes, recommended in the polyclinic, is characterized by an insufficient prescription rate of main drug classes necessary for secondary cardiovascular prevention at all follow-up stages.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3011

Abstract:
See: Shalnova S. A., Drapkina O. M., Kontsevaya A. V., Yarovaya E. B., Kutsenko V. A., Metelskaya V. A., Kapustina A. V., Balanova Yu. A., Litinskaya O. A., Pokrovskaya M. S. Pilot project to study the association of troponin I with cardiovascular events in the population of Russian region in Original articles, pp. 185-192.
Zh. V. Maksimova, D. M. Maksimov
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2782

Abstract:
Alcohol abuse is the regular or episodical alcohol consumption that can cause adverse medical and social consequences without signs of dependence. In Russia, 35% of the population regularly consume alcoholic drinks in very high doses. At the same time, abuse often remains undiagnosed or is not considered a medical problem. However, it is precisely this that causes the massive prevalence of alcohol-related physical and mental health problems, as well as social functioning. The situation can be improved, including through early detection and effective behavioral counseling, especially in primary health care. The World Health Organization recommends a five-step approach to identify and correct alcohol abuse: — identify the alcohol consumption level using the Alcohol Use Disorders Identification Test (AUDIT); — recommend decreasing alcohol consumption; — assess readiness and barriers to cessation or decrease of alcohol use; — help the patient to develop motivations; — continue monitoring and support on follow-up visits. Behavioral counseling for alcohol abuse is provided in a non-judgmental manner as part of the routine medical appointment for any other medical condition. The content of the counseling depends on the motivation of a patient. For hesitant patients who are uncertain about the appropriateness or their ability to reduce alcohol use, a so-called motivational interviewing is conducted, which allows a patient to speak out about the problem and helps to correct unhealthy behaviors. This article is a guideline for health care professionals on brief preventive counseling for alcohol abuse patients.
E. Kobelev, , , , O. V. Kamenskaya, V. Yu. Usov, A. M. Chernyavsky
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2844

Abstract:
Coronavirus disease 2019 (COVID-19) is a poorly understood and dangerous medical problem. COVID-19-related pulmonary vessels involvement is a complex set of interrelated pathophysiological processes associated with vascular endothelial dysfunction and accompanied by thrombosis of various localization, vasomotor disorders, severe respiratory failure, as well as pulmonary embolism (PE) resulting in chronic thromboembolic pulmonary hypertension (CTEPH). According to computed tomographic pulmonary angiography, the incidence of PE in patients with COVID-19 ranges from 23 to 30%. The aim of this work was to focus the doctors' attention on the risk of pulmonary hypertension in patients after COVID-19. Despite the ability of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) to infect various organs and systems, the main and most serious complications are pulmonary infiltration, acute respiratory distress syndrome, acute respiratory failure and PE, which in some cases becomes the triggering mechanism for CTEPH development. The literature review presents data on main pathological abnormalities developing in target organs during COVID-19 and playing an important role in increasing the CTEPH risk. The paper describes the main methods of instrumental investigations of CTEPH and an algorithm for its use in COVID-19 survivors. The revealed data demonstrated that the absence of obvious signs of pulmonary hypertension/CTEPH, the cardiopulmonary system abnormalities cannot be ruled out. Therefore, it seems appropriate to actively follow up COVID-19 survivors. A thoroughly, purposefully collected anamnesis, pulmonary function tests and stress echocardiography in an ambiguous clinical situation will play a leading role as they identify cardiopulmonary disorders and provide the doctor with basic information for further planning of patient management.
D. A. Golovin, T. M. Rostovtseva, Yu. S. Kudryavtsev, , S. E. Lelyuk,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2778

Abstract:
Among the causes of brain ischemia, including stroke, the impaired straightness of internal carotid arteries (ICAs) are considered. The article discusses modern views on the causes of ICA geometry disorders, their pathogenetic and hemodynamic significance, and a possible contribution to cerebral lesions. Aim. To study the relationship between the anomalies of ICA configuration and the brain perfusion parameters using cerebral multislice computed tomographic angiography. Material and methods. Seventeen patients after ischemic stroke who had ICA elongation on the contralateral side of infarction: 7 women aged 60-87 years (median [1st quartile; 3rd quartile]: 73 [64; 75]) and 10 men aged 54-80 years (62 [60; 73]). There were also 10 patients of the control group with normal ICA configuration on the contralateral side of infarction: 5 women aged 50-71 years (59 [50; 68]) and 5 men aged 55-81 years (58 [57; 62]). Brain multislice computed tomographic angiography and magnetic resonance imaging were performed. Results. A significant perfusion decrease within normal values in the blood systems of the elongated ICAs was established. The relationship between the degree of ICA elongation and the age of patients, in the absence of such for brain white matter lesions, was recorded. There is the need to continue the study to clarify the nature of the severity and causes of the revealed phenomena.
, V. L. Doshchitsin
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2962

Abstract:
The treatment of atrial fibrillation (AF) remains one of the most difficult tasks in modern cardiology. In 2020, the European Society of Cardiology (ESC), together with the European Association for Cardio-Thoracic Surgery (EACTS), published guidelines for the diagnosis and management of AF, which include several new directives. ESC experts have formulated a novel concept for treatment of AF patients. The first component of treatment ‘A' (Anticoagulation/ Avoid stroke) is anticoagulant therapy in patients with increased risk of thromboembolic events. The second line of treatment ‘B' (Better symptom control) is the control of arrhythmia symptoms, selection of a rhythm control strategy or ventricular rate control. The third direction ‘C' includes cardiovascular risk factors and comorbid conditions management. The most challenging tasks in AF treatment are the control of arrhythmia symptoms. As in the previous version of 2016 guidelines, the latest ones identify 2 following strategies in treatment of AF: rhythm control and ventricular rate control. According to the current ESC/EACTS guidelines (2020), antiarrhythmic therapy continues to be one of the important directions in AF management. Early prescription f antiarrhythmic and anticoagulant agents with an increased risk of thromboembolic events, catheter ablation can not only improve the quality of life, but also the prognosis of patients with AF.
, A. I. Rytova, O. B. Shvabskaya, Yu. K. Makarova, , , S. E. Evstifeeva, , A. V. Kapustina, , et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2982

Abstract:
The presence of a disease, the prognosis of which can be improved by dietary modification, motivates a patient to change their eating habits. Aim. To study the associations of dietary patterns and alcohol consumption with cardiovascular diseases (CVDs), diabetes, myocardial infarction (MI), and stroke in the adult population. Material and methods. The analysis was carried out using data from representative samples of population from 13 Russian regions aged 2564 years (n=19520; men, 7329; women, 12191). The response rate was ~80%. Dietary characteristics were assessed by frequency method. Results. In the diet of people with CVDs, the daily intake of vegetables/ fruits increases by 84% in men and by 19% in women, while the use of animal fats in cooking decreases by 28% and 20%m respectively (p<0,0001). Women with CVDs reduce the consumption of processed meat and sweets by 16 and 19%, respectively (p<0,005). Persons with prior MI reduce the consumption of sweets in the diet: men by 38% and women by 30%. Men with prior MI have higher daily consumption of cereals by 31%, vegetables and fruits by 46%, low-fat dairy products — 2,4 times. In addition, they are more adherent to a healthy and cardioprotective diet by 3,65 and 1,75 times, respectively. Dietary changes in those with prior stroke were noted only in women in the form of a 29% decrease in excess salt intake (p=0,0075). In the diet of people with diabetes, there is decreased consumption of sweets and an increased intake of vegetables/fruits: by 77 and 69% in men and by 79 and 69% in women, respectively (p<0,0001). Men with diabetes are 3 times more likely to adhere to a healthy diet, and women — 2,3 times (p=0,0039 and p<0,0001, respectively). Conclusion. Patients with CVDs, MI, and diabetes have a healthier diet than healthy persons.
, , K. M. Tolkunova, E. V. Moguchaia, A. S. Alievа, A. V. Orlov, E. P. Kolesova, A. M. Erina, , V. N. Solntsev, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2970

Abstract:
Aim. To assess the association of cardiovascular risk factors with various vascular aging phenotypes using the St. Petersburg population sample as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Material and methods. The current analysis, performed within the ESSE-RF multicenter observational study, included 1600 St. Petersburg residents. The participants filled out a questionnaire to assess risk factors. In addition, blood biochemical parameters, anthropometric characteristics, and blood pressure were evaluated. Pulse wave velocity (PWV) was assessed by applanation tonometry using the SphygmoCor device (AtCor, Australia) in 524 people. For analysis, 485 participants without prior cardiovascular events were selected. PWV ≤10 percentile of PWV for healthy individuals in each age group was considered as the criterion for supernormal vascular aging (SUPERNOVA) phenotype, the PWV ≥90 percentile — early vascular aging (EVA), the PWV of 10-90 percentile — normal vascular aging (NVA). Results. The prevalence of SUPERNOVA phenotype was 9,7%, EVA — 18,8%, NVA — 71,5%. Patients with EVA phenotype were more likely to have HTN (60,4%) in comparison with those with SUPERNOVA phenotype (17%) and, less likely — high physical activity (39,6 vs 53,2%). Obesity, hyperglycemia, insulin resistance, hypercholesterolemia, dyslipoproteinemia, and excessive alcohol consumption were significantly less common in participants with SUPERNOVA phenotype compared with those with EVA phenotype. Conclusion. In addition to HTN and dyslipoproteinemia, a significant predictor of premature aging was the cumulative effect of obesity, insulin resistance and hypertriglyceridemia. Among behavioral risk factors, higher physical activity and adequate alcohol consumption were factors associated with supernormal aging.
, D. A. Andreev, M. I. Chashkina, Z. K. Salpagarova
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2974

Abstract:
Catheter ablation (CA) of atrial fibrillation and flutter is associated with a high risk of both perioperative thromboembolic events and bleeding. Adequate anticoagulation is imperative to reduce the risk of complications. The aim of this review was to analyze modern approaches to anticoagulant therapy for CA of atrial fibrillation and flutter, as well as provide practical information based on a comparison of current guidelines and evidence base. The search for literature sources on anticoagulant therapy in CA was carried out in the PubMed, Scopus, Web of Science databases. The results of key randomized trials and meta-analyzes are presented, and a comparison of current Russian and international guidelines is given. Unresolved issues requiring further research are discussed.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3007

Abstract:
The growing weight of noncommunicable diseases, primarily cardiovascular diseases (CVDs), is a great threat to the health of population worldwide, worsening the quality of life and reducing life expectancy. Realization of this threat led to initiation of epidemiological study by the Russian Ministry of Health to investigate the prevalence of CVDs and their risk factors, since it is CVDs that specify the high allcause mortality in Russia. In the modern history of epidemiology of non-infectious disease, the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study occupies a special place. This is the largest epidemiological study, which is considered as a continuation of preventive activity in order to obtain unbiased information on epidemiological characteristics of population in Russian regions. To conduct the study, the Research Organizing Committee of ESSE-RF study was created and a protocol was developed. All interested scientists and experts from following three centers took part in the work: National Medical Research Center for Therapy and Preventive Medicine, Almazov National Medical Research Center, National Medical Research Center of Cardiology. The Russian regions were justified and selected for participation. In 2012-2014 ESSE-RF study, 13 following Russian regions took part: Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Tyumen Oblasts; Krasnoyarsk and Primorsky Krai; the Republic of North Ossetia (Alania); cities of Orenburg, Samara, St. Petersburg and Tomsk. All participated regions used a single study protocol, while biochemical parameters were determined in Federal centers using the same equipment and reagent kits. The paper presents some of the most interesting results that indicate a change in Russian epidemiological situation over the past few years. After the end of cross-sectional study, a field of priority research areas was formed in each center. Conclusion. Epidemiological studies are the most important scientific tool for assessing the prevalence of diseases, their risk factors, as well as predicting adverse events. Based on the results obtained, healthcare system and medical community determine priorities and develop related strategies (population-based and high-risk strategies). For their implementation, a regulatory and legal framework is being created.
, , A. S. Zhuravlev, D. G. Ioseliani, I. Kh. Kamolov, I. S. Melnichenko, O. V. Zakharova, , I. A. Kovalchuk
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2761

Abstract:
Aim. To assess whether delayed coronary artery stenting (CAS) can reduce the slow/no-reflow incidence in patients with ST-segment elevation myocardial infarction (STEMI) and massive thrombosis (TTG ≥3) of the infarct-related coronary artery (IRCA) compared with immediate CAS within primary PCI. Material and methods. Out of 3651 primary PCIs performed for acute STEMI in the period from January 2016 to May 2020 at the Mytishchi City Clinical Hospital, the retrospective analysis included 105 patients with massive IRCA thrombosis (TTG ≥3). The patients were divided into two groups: first group (n=55) — delayed CAS, second group (n=50) — immediate CAS. In the immediate CAS group, the PCI procedure ended with routine stent implantation, and in the delayed CAS group, stent implantation was delayed for at least 5 days. Results. In the delayed CAS group in comparison with immediate one, the slow/no-reflow phenomenon developed much less frequently in the form of a significant increase in the prevalence of TIMI 3 flow, better myocardial perfusion of myocardial blush grade (MBG) 2-3 (81,8 vs 64%; odds ratio (OR) 2,53; p=0,039) and ST segment resolution ≥70% (87,3% vs 58%; OR 4,97; p=0,001). Conclusion. Delayed CAS in patients with STEMI with massive thrombosis (TTG ≥3) of IRCA reduces the risk of slow/no-reflow phenomenon and can be considered as a possible alternative treatment vs immediate CAS, provided that stable coronary flow is restored before TIMI 3.
, E. A.-I. Aidu, Yu. K. Makarova, , , V. G. Trunov, , A. V. Kapustina, S. E. Evstifeeva, A. Yu. Efanov, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3000

Abstract:
Aim. To study the associations of increased spatial QRS-T angle (sQRS-Ta ≥90°) with cardiovascular risk factors (RFs). Material and methods. We analyzed 1411 electrocardiography (ECG) records of men and women aged 25-64 years from a random regional sample of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Relationships of sQRS-Ta with the following RFs were assessed: hypertension (HTN), systolic blood pressure (SBP) ≥140 mm Hg, diastolic BP (DBP) ≥90 mm Hg, pulse pressure (PP) ≥60 mm Hg; glucose ≥7,0 mmol/l, hypercholesterolemia; hypertriglyceridemia; high-density lipoprotein cholesterol (HDL-C) ≤1,0/1,2 mmol/l in men/women, low-density lipoprotein cholesterol (LDL-C) >3,0 mmol/l; C-reactive protein (CRP) >1 mg/L; overweight, obesity and abdominal obesity; heart rate (HR) >80 bpm; age >52 years. Results. Weak but significant correlations of sQRS-Ta with age (in women), SBP, DBP, PP, body mass index, waist circumference, lipids, glucose, CRP were revealed. Univariate logistic regression demonstrated significant associations of increased sQRS-Ta with HTN, elevated SBP and PP, overweight, obesity and abdominal obesity, hypercholesterolemia, elevated LDL-C and CRP, hyperglycemia, age >52 years and heart rate >80 bpm. There were no associations of increased sQRS-Ta with male sex, elevated DBP, smoking, hypertriglyceridemia, and low HDL-C levels. The sQRS-Ta associations characteristic of women was similar with associations found among the entire sample. Men with increased sQRS-Ta had no associations with any of analyzed RFs. In multivariate models, increased sQRS-Ta was associated with the following combination of RFs: age >52 years, heart rate >80 bpm, HTN, increased PP, overwaight, and male sex. According to direct stepwise selection among all subjects and in women, the main contribution to sQRS-Ta was made by SBP, age, HDL-C and heart rate. Conclusion. Despite the significance of stepwise regression model (p=0,0001), the low coefficient of determination R2 may indicate other not yet identified determinants with relevant associations with sQRS-Ta.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3003

Abstract:
Aim. To study the contribution of hypertension (HTN) to survival and mortality in the Russian population. Material and methods. This prospective observational cohort included representative samples from 11 Russian regions (men and women aged 25-64 years, n=18251) examined in 2012-2014 as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. The examination included a questionnaire (12 modules), anthropometric and blood pressure (BP) measurements, as well as biochemical blood tests. HTN was considered aa a systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or when a subject receives antihypertensives. Treatment efficacy was considered as the proportion of persons (%) who achieved target BP among those taking antihypertensives. Depending on HTN status, all participants were divided into 4 groups: 1) those without HTN; 2) those with HTN, taking antihypertensive agents and having systolic BP ≤140 mm H. and diastolic BP ≤90 mm Hg (effective therapy); 3) those with HTN, taking medications, but not achieving target BP (ineffective therapy); 4) those with HTN, not taking antihypertensives. The life status of participants was updated every 2 years. Kaplan-Meier survival curves, as well as univariate and multivariate Cox proportional hazards models were created. Results. The presence of HTN significantly reduced survival (p<0,001) in the cohort, which is significant when adjusted for age (men — relative risk (RR)=1,47, p<0,001, women — RR=1,17, p<0,001). In the multivariate model, the male sex (RR=2,3 p<0,001), age increase, smoking, tachycardia, and HTN are significant for all-cause mortality only for men, but not for women. However, for women, absence of higher education was significant. The presence of HTN significantly worsens cardiovascular survival in both sexes (p<0,0001). HTN increases the risk of a composite endpoint for both men and women (p<0,001). Analysis of Kaplan-Meier curves showed the worst survival rate in persons with HTN, taking antihypertensive drugs, but not reaching target BP levels. Conclusion. The presence of HTN significantly worsens the survival rate of men and women. Special attention of medical community should be directed to increasing the proportion of effectively treated patients with HTN.
E. A. Rezukhina, O. V. Rodnenkov, T. V. Martynyuk
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3010

Abstract:
We present a 48-year-old patient with World Health Organization class III idiopathic pulmonary arterial hypertension (IPAH), taking specific therapy with macitentan 10 mg a day, who was readmitted to the National Medical Research Center of Cardiology due to increase in exercise dyspnea and decrease in effort tolerance. According to a comprehensive examination, single factors of high risk and unfavorable prognosis were identified. Due to systemic hypotension when using inhaled iloprost, selexipag was added to therapy. According to control hospitalization, 8-month selexipag therapy improved the patient's condition, as well as high risk factors were not revealed. Selexipag is a selective oral prostacyclin receptor agonist recommended for longterm IPAH therapy in adult patients.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2987

Abstract:
The largest population-based study in Russian modern history the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) for 8 years has become a platform for public health research and projects, relevant for the whole country. Results of the ESSE-RF study were used to identify Demography National Project parameters, to model mortality and morbidity risk at the population level, to estimate the economic burden of risk factors, to predict the economic effect of population prevention measures, to assess the feasibility of using novel biomarkers for risk stratification, as well as for external evaluation of health care system. Further, results can be used to develop a novel cardiovascular risk score, to analyze COVID-19-related risk factors, and to study health protection environment. Epidemiological studies ESSE-RF1 and ESSE-RF2 have already become a significant component of public health system in Russia, and taking into account the scope of the ESSE-RF3 study (30 regions), the role of epidemiology will increase.
I. A. Viktorova, M. V. Moiseeva, , ,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2971

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Aim. To compare dietary patterns of the Omsk region male and female representatives with and without abdominal obesity (AO). Material and methods. Wthin the second study of Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF2) using a representative sample of Omsk region population aged 25-64 years (n=1648), dietary habits, including 21 food groups, were assessed by the questionnaire method. Eating habits of Omsk region representatives with (n=936) and without AO (n=712) were compared. Results. Insufficient consumption of vegetables and fruits practically does not differ in those with or without AO. Depending on sex, insufficient fruit consumption is more typical for both men and women without AO. In addition, there is insignificant increase of fruit consumption in AO people, especially women (p=0,09). Both men (p=0,05) and women (p=0,045) are less likely to consume meat daily but more often consume fish weekly compared to those without AO. This mainly applies to women, because women with AO, in contrast to those without AO, are significantly less likely to consume insufficient amount of fish (p=0,0001). Compared to women with, men with AO significantly more often daily and weekly consume seafood (p=0,001). Daily milk consumption is much less common in individuals with AO, but only at the expense of men with AO (p=0,0001). Kefir and yogurt, on the contrary, are more often consumed in patients with AO both daily and weekly. Omsk people with AO are less likely to introduce yogurt into their daily diet, mainly at the expense of women with AO (p=0,02). Excessive consumption of pasta is more typical for persons without AO (p=0,0001), and by means of men (p=0,001). Omsk residents with AO more often exclude the sweets and confectionery from diet. In the daily diet, they are much less common in individuals with AO (p=0,0001), especially in men with AO (p=0,0001). The respondents with AO daily consume pickles 1,4 times more often compared with those without AO, and mainly by means of men (p=0,03). Conclusion. Presence of AO somewhat changed the dietary habits of Omsk residents. AO patients are less likely to consume pasta, sweets and confectionery products, but more likely to eat pickles and to add more salt to cooked food, which requires targeted preventive measures, taking into account the identified sex priorities, depending on AO presence.
M. G. Chashchin, ,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2806

Abstract:
Acute coronary syndrome (ACS) is caused by an acute mismatch between myocardial oxygen demand and its supply. This mechanism is largely associated with the progression of coronary atherosclerosis in combination with an inflammatory response, hypoxemia, and blood procoagulation. Patients with the coronavirus disease 2019 (COVID-19), aggravated by cardiovascular diseases and comorbidities, are at high risk of ACS. Aim. To analyze the publications, which reflects the development of ACS in patients with COVID-19, its pathogenesis, and clinical course. Material and methods. Literature data were searched using Google Scholar, PubMed, ScienceDirect, and Cyberleninka services. The analysis included data from clinical guidelines on COVID-19, data from clinical studies, reports, and systematic reviews. Results. This literature review summarizes and systematizes the data presented in modern publications, highlights the aspects of the clinical course and pathogenetic mechanisms underlying ACS in patients with COVID-19. Conclusion. The pathogenesis of COVID-19 is inextricably associated with the widespread cytopathic effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), uncontrolled immune response that causes systemic inflammation, as well as the coagulation system activation. In patients with COVID-19, along with the atherosclerosis, these mechanisms significantly increase the risk of ACS and can worsen its in-hospital course.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2781

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Aim. To assess the contribution of genetic and inflammatory factors to the development of arrhythmogenic right ventricular cardiomyopathy (ARVC). Material and methods. The study involved 54 patients with ARVC (age, 38,7±14,1 years; men, 42,6%; mean follow-up period, 21 [6; 60] months). All patients underwent electrocardiography (ECG), 24-hour ECG monitoring, echocardiography, determination of anticardiac antibodies and DNA of cardiotropic viruses in the blood, molecular genetic ARVC testing, as well as cardiac magnetic resonance imaging (n=49), high-resolution ECG (n=18), right ventricular endomyocardial biopsy (n=2), and autopsy (n=2). Results. Following four clinical types of ARVC were identified: I. Latent arrhythmic form: characterized by frequent premature ventricular contractions and/or nonsustained ventricular tachycardia (VT). II. Manifested arrhythmic form (n=11) — SVT/ventricular fibrillation (VF). III. ARVC with progressive heart failure (HF, n=8). IV. Combination of ARVC with left ventricular noncompaction (LVNC, n=8). Superimposed myocarditis was identified in 74%, 36%, 87,5% and 85,7% of patients in forms I-IV, respectively. Mutations were detected in 11%, 46%, 50%, and 38% of patients in forms I-IV, respectively. Clinical forms were stable: there was no transition from one clinical form to another during follow-up period. Conclusion. The contribution of genetic and inflammatory mechanisms to the clinical picture is different: in the latent arrhythmic form, the leading role belongs to inflammation; in the manifested arrhythmic form, the contribution of pathogenic mutations prevails, and in ARVC with progressive HF and in combination with LVNC, the contribution of genetic and inflammatory factors is equally important.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2980

Abstract:
Aim. As part of a pilot study, to investigate the potential significance of cardiac troponin I (cTnI) in assessing the risk of cardiovascular diseases (CVD) in general population aged 35-64 years of one of the regions from the ESSE-RF study. Material and methods. The study is based on the ESSE-RF observational prospective study using a sample from one Russian region. The analysis included socio-demographic variables, risk factors, history of CVD. The cTnI level was measured from November to December 2021 in serum samples stored at -70° C using high sensitivity chemiluminescent microparticle immunoassay using Architect Stat High Sensitivity Troponin I (Abbott) reagents on an Architect i2000SR immunoassay analyzer (Abbott, Abbot Park IL USA). The endpoints were hard (cardiovascular death and myocardial infarction) and composite endpoints (cardiovascular death, new cases of myocardial infarction, stroke, coronary artery disease and revascularization). The median follow-up was 5,5 years. In total, the analysis included 1120 people aged 35-64 years. Results. Analysis of the associations between Systematic Coronary Risk Evaluation (SCORE) and cTnI showed a significant difference in risk stratification for these two parameters. In women from cTnI-related high-risk category for cardiovascular events (CVE), there were no endpoints at all. In men of moderate and high risk, the proportion of endpoints increases with increasing cTnI-related risk. The survival curves corresponding to first 3 quintiles of cTnI risk distribution did not diverge, and, therefore, the number of CVEs in these groups did not differ. At the same time, the curves corresponding to 4th and 5th quintiles significantly differed from the first 3 quintiles, which indicates a higher CVE risk in subjects from these groups (p<0,001). Considering that there were only 3 endpoints in cTnI-related high-risk group, a survival analysis was performed for low-risk versus moderate-high risk. The curves obtained diverge significantly (p=0.006). Cox proportional hazards models were analyzed to assess the relationship between the cTnI level and endpoints. It was shown that cTnI itself or its logarithm is significantly associated with hard and composite endpoints. The cTnI cut-off point of 12/10 pg/ml (males/females) was associated with hard endpoint, and 6/4 pg/ml — with composite one. It should be noted that the recommended cut-off point of 6/4 pg/ml is close to the upper quartile of cTnI distribution in the European population. For the Russian population, the upper quartile corresponds to cTnI level of 3,5/2,1 pg/ml, which indicates the need to reduce the critical cTnI values in Russia. To assess risk reclassification, Cox models were analyzed using the Net Reclassification Index (NRI), as well as NRIsurvival for survival analysis. For categorical variables, the NRIcategorial was used. Both methods of including cTnI in the model significantly improve the risk classification of severe endpoints in men. Conclusion. The results obtained confirm the need to lower the threshold values for predicting combined endpoints, in particular, in Russian men. cTnl has an independent effect on CVE risk and its addition to SCORE improves the prediction of CVEs among men. However, the data obtained are preliminary and require clarification sing larger sample. At the same time, it is obvious that the determination of cТnI level can play a significant role in cardiovascular risk assessment and be an unfavorable prognosis marker among Russian population.
A. I. Ershova, T. V. Balakhonova, , , , , N. E. Lishchenko, A. S. Novikova, E. L. Aleksandrova, E. A. Shutemova, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2994

Abstract:
Aim. To study the prevalence of carotid (CA) and femoral artery (FA) atherosclerosis among Russian population, mainly in middle age group, using a representative sample of one of the Central Russian regions. Material and methods. The analysis included participants of the ATEROGEN-Ivanovo study (sub-study of the ESSE-RF conducted in the Ivanovo region) aged 40-67 years, who were invited for CA and FA ultrasound to assess plaque presence. A total 1102 people were examined, which was >80% of the original sample. Results. The age of subjects was 54 [48; 60] years (men, 28%). Only 11,2% of participants took statins; 30,9% had low cardiovascular risk (CVR), 35,6% — moderate CVR, 21,8% — high CVR, and 11,8% — very high CVR. The incidence of at least one plaque in CA or FA was 73,6%. The prevalence of CA atherosclerosis was 76,4% in men and 59,1% in women, FA atherosclerosis — 54,9% and 28,3%, respectively. Furthermore, plaques were detected already at the age of 40. The incidence of plaques significantly increased with age, with the exception of carotid atherosclerosis in men, a significant increase in the incidence of which stopped at 45 years of age. Conclusion. Among the Ivanovo population aged 40-67 with a predominance of low-to-moderate CVR patients, there is a high prevalence of carotid and femoral atherosclerosis, which indicates a high potential for using ultrasound for diagnosing subclinical atherosclerosis in assessing CVR in people of this age range.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2965

Abstract:
Aim. To assess regional living conditions with cardiovascular outcomes based on prospective stage of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Material and methods. We used data from a 3- and 5-year prospective stage of the ESSE-RF study (2012-2013). For initial screening, 16210 people aged 25-64 were included. To characterize the regions of residence, 5 regional indices (RIs) were used. The following endpoints were considered: cardiovascular death, myocardial infarction, stroke, composite endpoint (cardiovascular death + myocardial infarction + stroke). To assess the correlations, generalized estimating equations with nested data structure (individuals in the regions) were used. The studied associations were adjusted for a wide range of potential effect modifiers. Results. There are multiple direct associations of RIs with the likelihood of all endpoints. The exception was the reverse association of Industrial RI with cardiovascular death. The most stable associations regarded Mixed RI, Industrial RI and Socio-geographical RI, with a high RI significance in endpoint development, compared with well-known individual cardiovascular risk factors. Separate associations were noted for Economic RI and Demographic RI. Conclusion. The results indicate a significant contribution of a number of regional living conditions to individual risk of fatal and non-fatal cardiovascular outcomes.
A. V. Shirshov
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3019

Abstract:
See “Carotid artery elongation (dolichoarteriopathy) and cerebral perfusion: results of a pilot study” Golovin D. A., Rostovtseva T. M., Kudryavtsev Yu. S., Berdalin A. B., Lelyuk S. E., Lelyuk V. G. in the Original articles section, pp. 14-22.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2878

Abstract:
The pandemic of noncommunicable diseases, which is currently one of the main threats to health and well-being of mankind, makes us look for ways to prevent their development early. Low cardiorespiratory endurance due to a sedentary lifestyle is associated with high cardiovascular risk, all-cause and cancer mortality. Skeletal muscles are the most important secretory organ and is characterized by outstanding metabolic performance and endurance. Exercise-induced low-dose stress contributes to mitochondrial biogenesis and remodeling of not only the muscular system, but also other systems involved in maintaining muscle activity, including regulating glucose and fat metabolism, maintaining immunity, and stimulating angiogenesis. These and other effects of physical activity are implements through the myokine system discovered in recent years. Shutting off the paracrine, exocrine and endocrine functions of muscles cannot be replenished in any other way and leads to disruption of vital adaptive processes. This review describes currently available evidence of unique role of aerobic physical activity in maintaining the human health, as well as to define the chain of pathological reactions during physical inactivity. The search was carried out in the Medline and PubMed Central databases for the keywords: cardiorespiratory endurance, non-communicable diseases, maximum oxygen consumption, myokines, interleukin-6, aerobic exercise.
A. R. Zairova, , E. V. Oshchepkova, , , , I. A. Trubacheva, V. S. Kaveshnikov, V. N. Serebryakova,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2967

Abstract:
Aim. To determine the role of cardio-ankle vascular index (CAVI) in predicting cardiovascular events (CVEs) in adult Russian population using model of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study (Tomsk). Material and methods. We analyzed the data of 1342 people aged 25-64 (4,3±11,6) years, in whom arterial stiffness was assessed as part of the ESSE-RF study using the vascular screening system VaSeraVS-1500, followed by phone contacts, on average, 4,7 years later. We studied the prognostic role of CAVI in relation to primary composite (cardiovascular death, nonfatal myocardial infarction (MI) or stroke) and secondary composite (all CVEs) endpoints. Results. We revealed that prior myocardial infarction or stroke (n=52) is associated with an increase in CVE incidence from 2,3 to 11,5% (p=0,0003) and from 5% to 23% (p<0,001) for primary and secondary composite endpoints, respectively. In a group of 1290 people (without prior MI or stroke), CAVI was significantly higher in men than in women: 7,4±1,4 vs 7,1±1,3 (p=0,002), despite more young age: 45,4±11,8 vs 48,0±11,3 years (p7,8 (relative risk (RR): 5,06; 95% confidence interval (CI): 2,32-11,06) (p<0,001) and (RR: 3,95; 95% CI: 2,37-6,58) (p<0,001), which retains its predictive value when adjusted for conventional risk factors (RR: 3,13; 95% CI: 1,26-7,75) (p=0,014) and (RR: 2,16; 95% CI: 1,18-3,98) (p=0,013) — primary and secondary composite endpoints, respectively. Conclusion. CAVI has a significant independent value in predicting CVEs in Tomsk adult urban population aged 25-64 years. To clarify the cardiovascular risk, vascular screening with identifying CAVI should be carried out during preventive and screening examinations for men over 35 and women over 45.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2823

Abstract:
Aim. To assess the diagnostic value of standard and modified ultrasound criteria for left ventricular noncompaction (LVNC). Material and methods. The study included 37 patients. All patients underwent echocardiography and magnetic resonance imaging (MRI). Patients with any of the standard echocardiographic criteria for LVNC (Chin, Jenni, Stollberger) were included in the study. We studied modified echocardiographic criteria of LVNC in 4 and 3-chamber apical views in systole and diastole in the anterolateral (ALsist and ALdiast) and posterolateral (PLsist and PLdiast) walls with the non-compact to compact layer ratio (NC/C) >2. To assess the diagnostic value of the echocardiographic LVNC criteria, the specificity (SP) and sensitivity (SN), the likelihood ratio for positive (LR+) and negative (LR-) test results were calculated, and the operating characteristic curve (ROC) was analyzed. Results. The study included 19 women (51,4%) and 18 men (48,6%), aged 18 to 69 years. The mean age of the patients was 37,7±12,6 years. Relative to the Petersen's MRI-criterion for the Chin's criterion, SN was 55%, SP — 53% (LR+ =1,2, LR- =0,9); for the Jenni's criterion, SN — 55%, SP — 35% (LR+ =0,9, LR- =1,3); for the Stollberger's criterion, SN — 70%, SP — 18% (LR+ =0,9, LR- =1,7); for PLsyst criterion, SP — 82%, SN — 50% (LR+ =2,8, LR- =0,6). Relative to the Grothoff's MRI-criterion, which determined the LVNC mass as a percentage, for the Chin's criterion, SN was 69%, SP — 58% (LR+ =of 1,7, LR- =0,5); for the Jenni's criterion, SN — 85%, SP — 54% (LR+ =1,9, LR- =0,3); for the Stollberger's criterion, SN — 77%, SP — 25% (LR+ =1,0, LR- =0,9); for PLdiast criterion SP — 79%, SN — 62% (LR+ =3,0, LR- =0,5); for PLsyst criterion SP — 63%, SN — 84% (LR+ of 2,2, LR- =0,3); for ALdiast criterion, SP — 83%, SN — 69% (LR+ =4,1, LR- =0,4); for ALsyst criterion, SP — 71%, SN — 92% (LR+ =3,1, LR- =0,1). Relative to the Grothoff's MRI-criterion, which determined the LVNC mass index, for the Chin's criterion, SN was 59%, SP — 70% (LR+ =2,0, LR- =0,6); for the Jenni's criterion, SN — 67%, SP — 60% (LR+ =1,7, LR- =0,6); for the Stollberger's criterion SN — 78%, SP — 30% (LR+ =1,1, LR- =0,7); for the PLdiast criterion, SN — 33%, SP — 60% (LR+ =0,7, LR- =1,3); for PLsist criterion, SN — 59%, SP — 60% (LR+ =1,5, LR- =0,7); for ALdiast criterion, SN — 41%, SP — 80% (LR+ =2,0, LR- =0,7); for ALsist criterion, SN — 67%, SP — 90% (LR+ =6,7, LR- =0,4). Using ROC analysis with NC/C ratio of 2,3 for the ALsyst criterion, SN was 62%, SP — 92%; with NC/C ratio of 2,2 for PLsyst criteria in a posterolateral view in systole, SN — 62%, SP — 83%; with NC/C ratio of 2,1 for ALdiast criterion in an anterolateral view in diastole, SN — 54%, SP — 88%; with NC/C ratio of 2,1 for PLdiast criterion in a posterolateral view in diastole, SN — 46%, SP — 96%. Conclusion. Standard echocardiographic criteria are characterized by moderate sensitivity and low specificity. To improve the diagnostic accuracy of LVNC, the combined use of modified echocardiographic criteria is possible. As a screening of LVNC, using NC/C of 2,2 for the PLsist and NC/C of 2,3 for the PLsist to improve the specificity of the study should be useful.
S. E. Evstifeeva, , Yu. K. Makarova, , , , A. V. Kapustina, , , , et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-3009

Abstract:
Aim. To study the associations of subclinical and clinical anxiety and depression, assesed by the Hospital Anxiety and Depression Scale (HADS), ≥8 points and ≥11 points, respectively, with all-cause mortality and cardiovascular mortality, as well as with the total number of nonfatal cardiovascular events (CVEs) in Russia. Material and methods. The study included male and female population aged 25-64 years from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study who signed an informed consent. The study included 16941 people (men, 6811 (40,2%)). To assess the anxiety and depression, HADS scale was used. The statistical analysis included individuals with subclinical/clinical (HADS ≥8) and clinical (HADS ≥11) anxiety and depression (HADS-A and HADS-D). The median of prospective follow-up was 5,5 years (from 2012 to 2019). The composite endpoint (CE) (cardiovascular death and nonfatal CVE occurred in 268 (4,2%) men and 203 (2,1%) women, while all-cause — in 220 (3,2%) men and 152 (1,5%) women. Results. The results obtained showed that the survival rate of men and women with varying degrees of anxiety (HADS-A ≥8 and ≥11) was associated with all-cause mortality and CE in women. However, this relationship has not been confirmed in multivariate models. In the multivariate Cox proportional hazards model 1 (M1), a significant association of depression with all-cause mortality in women was revealed — HADS-D ≥8: relative risk (RR), 2,22; 95% confidence interval (CI): 1,56-3,15 and ≥11: RR, 2,43; 95% CI: 1,65-3,59 (p<0,005), as well as in men — HADS-D ≥8: RR, 1,51; 95% CI: 1,10-2,08 (p=0,01). In model 2 (M2), when added to M1 as a predictor of prior cardiovascular disease (≥3), depression was significantly associated with all-cause mortality only in women — HADS-D ≥8: RR, 2,23; 95% CI: 1,53-3,24 (p<0,005); HADS-D ≥11: RR, 2,61; 95% CI: 1,74-3,92 (p=0,01). In addition, only in women, subclinical/clinical depression (HADS-D ≥8) was significantly associated with fatal and non-fatal CVE — HADS-D ≥8: RR, 1,46; 95% CI: 1,08-1,98 (p=0,02). Conclusion. Depression (HADS-D ≥8 and ≥11) in Russian women was significantly associated with all-cause mortality and CE (HADS-D ≥8). In men, depression (HADS-D ≥8) was significantly associated with allcause mortality when only conventional risk factors were included in the model, without taking into account prior cardiovascular disease. Anxiety in multivariate models was not associated with all-cause mortality and CE in both sex groups.
T. M. Uskach, A. A. Safiullina, Yu. Sh. Sharapova, V. A. Amanatova, A. A. Petrukhina, M. I. Makeev, S. N. Tereshchenko
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2811

Abstract:
The article presents a case report of a 28-year-old male patient with mixed dilated cardiomyopathy: myocardial noncompaction and chemotherapy-related cardiotoxicity, which led to severe heart failure (HF). With optimal drug therapy, the patient was implanted with a cardiac contractility modulation device in order to improve exercise tolerance, quality of life and relieve HF symptoms. Complex therapy has led to significant clinical and echocardiographic improvement. This case demonstrates a 4-year follow-up of a patient with a reduced left ventricular ejection fraction and an implanted cardiac contractility modulation device, whose condition, after several severe HF decompensations, was stabilized.
, O. T. Kim
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2860

Abstract:
The rapid increase in the prevalence of obesity and related diseases has prompted researchers to seek novel effective therapeutic targets. Recently, brown adipose tissue has been in the spotlight as a potential target for treatment of metabolic diseases due to its ability to increase energy expenditure and regulate glucose and lipid homeostasis. The review presents the latest data on approaches aimed at activating and expanding brown adipose tissue in order to combat obesity.
, , , Б. Э. Горный, V. A. Dadaeva, L. Yu. Drozdova, R. A. Yeganyan, S. O. Eliashevich, O. V. Izmailova, E. A. Lavrenova, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2952

Abstract:
The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.
, A. I. Golovin, O. N. Belousova, O. A. Zemlyansky, T. P. Golivets, S. L. Konstantinov
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2985

Abstract:
Aim. To study age-related specifics of the concentration of fibrosis markers and monocyte chemotactic protein-1 (MCP-1) in patients with ST-segment elevation acute coronary syndrome (STE-ACS). Material and methods. A total of 140 STE-ACS patients were examined. Depending on the age, participants were divided into following groups: middle age — 42 patients, elderly — 50 patients, senile — 48 patients. The control group (CG) consisted of 20 people without cardiovascular disease. The level of matrix metallopeptidase 9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), MCP-1 was determined by enzyme immunoassay. Statistical processing was carried out using the MATLAB 2020software. Results. It was found that in STE-ACS patients, the MMP-9 level in middle-aged patients is 2,9 times higher than in the CG (p<0,001), elderly — 4,1 times (p<0,001), senile — 6 times (p<0,001). A strong direct relationship was found between age and MMP-9 level (r=0,86088, p<0,001). The TIMP-1 level was higher in all patients (p<0,05) compared with CG. A strong direct relationship was found between levels of MMP-9 and TIMP-1 (r=0,7801; p<0,01). The MMP-9/TIMP-1 ratio was higher in the group of middle-aged people by 85,7% (p<0,05), elderly — 1,2 times (p<0,001), senile — 2,3 times (p<0,001) compared to CG. MCP-1 was elevated in all age groups (p <0,001). A direct correlation was found between levels of MCP-1 and MMP-9 (r=0,726, p<0,001). Conclusion. In STE-ACS patients, an age-associated increase in concentrations of MMP-9 and MMP-9/TIMP-1 ratio was found in comparison with CG, which indicates the predominance of intercellular matrix degradation marker in patients with ACS. At the same time, MMP-9 increase is possibly induced by MCP-1.
, V. A. Perepelov, E. M. Perepelova, С. П. Бордовский, , I. S. Preobrazhenskaya, , , D. A. Napalkov
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2915

Abstract:
Aim. To test a hypothesis of hypoperfusion-induced white matter changes in patients with atrial fibrillation (AFib) and to present statistics to compute sample size for the upcoming studies. Material and methods. We included 30 inpatients with AFib and investigated them with magnetic resonance imaging (MRI) with standard sequencies and diffusion tensor imaging (DTI). DTI data were analyzed with conventional ROI analysis in the Olea Sphere software and with watershed areas (WSA) mask in the FSL toolbox after nonlinear transformation of images to the Montreal Neurological Institute (MNI) space. Wilcoxon test was used to compare diffusion characteristics across subgroups. Results. Median age of participants was 73 years (69-78), 18 (60%) patients had moderate signs of small vessel disease with Fazekas score of one. Twenty-one patients had paroxysmal AFib. Analysis of WSA revealed decreased white matter integrity in the parieto-occipital cortical WSA with a pattern of significantly increased mean diffusivity (p=0,039), and marginally significant decrease in fractional anisotropy (p=0,056). Rank-based effect size across areas under comparison was either small (0,2) or negligible, and with statistical power in the range of 0,05-1. Conclusion. Atrial fibrillation could have pathophysiologically feasible mechanism to affect white matter integrity in the watershed areas.
M. D. Smirnova, O. N. Svirida, , Z. N. Blankova, , ,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2762

Abstract:
Aim. To assess the contribution of anxiety (A) and depression (D) to the increased risk of cardiovascular events (CVEs) in patients with Systematic Coronary Risk Evaluation (SCORE) <5% according to 10-year follow-up. Material and methods. The work included 190 patients with SCORErisk <5%, examined in 2009-2010. In addition to the standard examination, a questionnaire was carried out using Hospital Anxiety and Depression Scale (HADS). In 2019, we contacted participants by telephone to identify CVEs over the past time: death from cardiovascular diseases (CVDs), acute myocardial infarction (MI), unstable angina, stroke, revascularization. The response was 86,3%. Results. CVEs occurred in 17 (10,2%) patients and included following outcomes: 3 deaths from CVDs, 6 acute MIs, 4 cases of unstable angina, 12 revascularizations. Patients with and without CVEs differed only in the depression level — 7 (5; 7) vs 5.0 (4; 5) points (p=0,0001). HADS-D score >6 increased the probability of CVEs — odds ratio (OR) 2,9 (1,1-7,7). In individuals with HADS-D score >6 and/or HADS-A score >7, the probability of CVEs increased — OR 4,9 (1,4-17,9). A combination of impaired two or more parameters of the lipid profile, systolic blood pressure >130 mm Hg and HADS-D score >6 and/or HADS-A score >7 increased the risk of CVE — OR 7,3 (2,48-21,36). Conclusion. Depression, including subclinical depression, is associated with an increased risk of CVEs in patients with a SCORE risk <5%.
S. S. Bunova, P. I. Okhotnikova, Yu. P. Skirdenko, N. A. Nikolaev, , N. I. Zhernakova
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2953

Abstract:
Cardiovascular diseases (CVDs) remain the leading cause of death worldwide and significantly affect patient quality of life and socioeconomic status. Numerous reports consistently demonstrate that CVDs are a major risk factor for severe course of coronavirus disease 2019 (COVID-19), including higher risks of hospitalizations and inpatient mortality. In the context of the current pandemic, managing patients with CVDs requires special attention from doctors. There are now more and more reports of the long-term effects of COVID-19. The long-term effects on cardiovascular system of millions of COVID-19 survivors are currently unknown. The aim of the review was to systematize the accumulated knowledge about the mutual influence of COVID-19 and CVDs. The features of CVD impact on the course and outcomes of COVID-19, as well as the reasons for the worsening of CVD course in patients with COVID-19 are considered. The impact of redistribution of health care resources and large-scale isolation measures on the management of patients with CVDs is discussed. The review also presents the most relevant data on long COVID. Predictors of a long-term disease course were identified for risk stratification in order to timely implement preventive measures and develop an individualized treatment. The authors focused on finding novel approaches to reduce CVD mortality during a pandemic.
, , A. S. Galus, A. R. Shanina
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2773

Abstract:
Aim. During one-year follow-up, to assess the effect of genetic and nongenetic factors on the risk of poor outcomes in patients after myocardial infarction (MI) with high medical adherence. Material and methods. The study included 250 patients admitted to the hospital due to MI in the period from September 1, 2018 to May 1, 2019 and with a potentially high medical adherence. Twelve months after MI, patients were assessed for adherence to therapy and the effect of genetic and nongenetic factors on the patient prognosis. Results. Within 12 months after MI, 70 (28,0%) patients had a composite endpoint: all-cause death, MI, cerebral stroke, and nonelective coronary revascularization. There were following factors increasing the risk of composite endpoint: non-Q-wave MI (relative risk (RR), 2,63; 95% confidence interval (CI): 1,63-4,25 (p=0,001); left ventricular ejection fraction ≤35% — RR, 2,03; 95% CI: 1,17-3,50 (p<0,0001); CYP2C19 GA/AA genotype (RR, 1,58; 95% CI: 1,06-2,37 (p<0,00001)). Conclusion. The study results allow identifying patients with a high risk of poor outcome: patients with non-Q-wave MI, left ventricular ejection fraction ≤35%, and CYP2C19 GA/AA genotype.
A. N. Volovchenko, D. A. Andreev, D. F. Mesitskaya
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2939

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The article discusses the issues of anticoagulant preparation for elective electrical cardioversion in patients with persistent atrial fibrillation. Updated preparation regimens for electrical cardioversion are proposed, as well as the potential of using direct oral anticoagulants for this purpose is discussed.
, A. I. Rytova, O. B. Shvabskaya, , , , S. E. Evstifeeva, , А. Вл. Капустина, , et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2883

Abstract:
The alcohol consumption is associated with dietary patterns. Aim. To study the associations of alcohol consumption and dietary patterns in the adult population. Material and methods. The analysis was carried out using representative samples of male and female population aged 25-64 years (n=19437; men, 7306; women, 12131 women) from 13 Russian regions. The response rate was 80%. We assessed nutrition by the frequency of consuming basic food groups. The low alcohol intake (LI) category includes women and men who consume <42 g and <84 g, moderate consumption (MI) — 42 g and 84 g, high intake (HI) — 84 g and 168 g ethanol per week, respectively. Results. In comparison with men who do not drink alcohol, MI and HI category representatives more often consume red meat — by 22 and 36%, meat and sausages — by 37 and 48%, and less often: fish products — by 34 and 33%, cottage cheese — by 51 and 53%, respectively. More rare consumption of poultry is significant in the MI group, vegetables/fruits — in the HI group, sweets — in the LI group. Consumption of pickles, cereals, pasta, liquid dairy products, cheese and sour cream does not differ between the groups in men. Compared to women who do not drink alcohol, women in the LI, MI and HI groups significantly more often consume meat and sausages — by 16, 28 and 85%, respectively. Women of the LI and MI groups more often consume red meat — by 15 and 33%, confectionery — by 29 and 24%, less often: cereals — by 9 and 18%, legumes — by 44 and 53% and cottage cheese — by 19 and 44 %, respectively. Women of the LI category more often daily consume milk, kefir and yogurt — by 26%, and less often fish products — by 18%. Women of the HI group are less likely to consume fruits/vegetables. Consumption of poultry, pickles and cheese do not differ between groups among women. Conclusion. People who consume alcoholic beverages have a pronounced nutritional imbalance, characterized by a higher consumption of red meat, especially processed, high-fat dairy products, salt, and in women, confectionery.
A. N. Kaburova, , S. M. Yudin, , V. V. Makarov, , S. A. Kraevoy, B. B. Shoybonov, I. A. Efimova
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2834

Abstract:
Aim. To study the relationship of gut microbiota (GM) with serum myocardial fibrosis markers in patients with heart failure with preserved ejection fraction (HFpEF). Material and methods. The composition of the gut microbiota among 42 patients with HFpEF aged 67,0 [64,0; 71,5] years (men, 57,1%) was assessed by 16S ribosomal ribonucleic acid sequencing. The quantitative determination of myocardial fibrosis markers was carried out by enzyme-linked immunosorbent assay. Correlation and multivariate regression analysis of relationships between the relative abundance of intestinal bacteria and the concentration of the procollagen type I carboxy-terminal propeptide (PICP) and N-terminal propeptide of procollagen type III (PIIINP) was carried out. Results. The PICP and PIIINP concentrations were 918,0 [700,0; 1032,8] pg/ml and 6,2±2,7 pg/ml, respectively. Correlation analysis revealed a direct relationship between the relative abundance of Allisonella and PICP (r=0,32), as well as Blautia, Enterobаcteriaceae (unclassified) and PIIINP (r=0,37 and r=0,32), p<0,05. The inverse relationship was determined for the relative abundance of the genera Ruminococcus (r=-0,37), Ruminococcaceae (unclassified) (r=-0,31), Gemmiger (r=(-0,35) and PICP, as well as Bilophila and PIIICP (r=(-0,34). Multivariate regression found (normalized coefficient in parentheses) that the abundance of Butyricimonas (0,27) и Blautia (0,35) was directly related to the PICP levels, while the abundance of the genus Intestinimonas ((-0,23) showed an inverse association with the marker level. The abundance of most genera had an inverse relationship with PIIINP: Atopobium (-0,25), Cellulosilyticum (-0,31), Solobacterium (-0,32), Turicibacter (-0,47), Bilophila (-0,30). The directness of the association with PIIINP concentration was demonstrated for the relative abundance of Paraprevotella (0,32) и Desulfovibrio (0,28). The p-value for all associations is <0,05. Conclusion. The relative abundance of GM genera in patients with HFpEF is associated with fibrosis markers (PICP and PIIINP). The results obtained make it possible to deepen the understanding of the relationship between GM and pathogenesis of HFpEF, which may become a step towards understanding the GM role in the progression of left ventricular diastolic dysfunction and rationale for future studies.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2940

Abstract:
Aim. To assess the distribution of cardiac troponin I (cTnI) in a sample of the region from the ESSE-RF study and to study its associations with risk factors (RFs) and the Systematic Coronary Risk Evaluation (SCORE) system. Material and methods. This observational cross-sectional study includes a representative sample of the population aged 25-64 years of the Vologda region (n=1591). The analysis included sex, age, behavioral and cardiometabolic RFs, biomarkers, prior cardiovascular diseases (CVDs), and SCORE. The differences between age-sex groups were considered significant at p<0,05. Results. According to study results, asymmetry in cTnI distribution among population was revealed. The median cTnI level in the sample was 1,5 pg/ml (95% confidence interval, 0,80-2,50). Noteworthy is the high level of the 99th percentile of cTnI in men aged 45-54 years (55,3 pg/ml). At the same time, the 99th percentile for the entire sample in men was 47,7 pg/ml, while in women — 13,3 pg/ml. The cTnI level log increases significantly with age in both men (p<0,0001) and women (p<0,0001), but faster in men. There was a higher level of cTnI in young men compared to same-age women. In multivariate analysis, significant associations of cTnI levels with sex, age, blood low-density lipoprotein cholesterol, abdominal obesity, hypertension, and brain natriuretic peptide level were obtained. Insufficient accuracy of classification of study participants by SCORE risk was revealed. Conclusion. The distribution of cTnI in the sample of the Russian region from the ESSE-RF study is sharply shifted to the left (median, 1,5 pg/ml). Higher cTnI levels were revealed in young men compared to their female peers. Significant associations of cTnI with obesity (body mass index, hypertension, elevated low-density lipoprotein cholesterol, and brain natriuretic peptide concentration) were found. It was demonstrated that SCORE does not accurately classify individuals with high and moderate cТnI levels.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2865

Abstract:
Aim. To study the prevalence of a combination of two major cardiovascular risk factors, hypertension (HTN) and lipid metabolism disorders, among the Krasnoyarsk Krai population as a whole, as well as among men and women in different age groups. Material and methods. We analyzed the data from a random representative sample of 1603 residents of the Krasnoyarsk city and Berezovsky district aged 25-64 years within the ESSE-RF epidemiological study. Statistical processing was performed using IBM SPSS 22 and Microsoft Office Excel 2007. The proportion of people with hypertension and dyslipidemia and 95% confidence intervals was calculated. The significance of differences in the prevalence of hypertension and dyslipidemia was tested using the chi-squared test with Yates’ correction. Differences were considered significant at p≤0,05. Results. The prevalence of a combination of HTN and any dyslipidemia was 40%, HTN + hypercholesterolemia — 31,6%, HTN + high low density lipoprotein cholesterol (LDL-C) — 32,3%, HTN + hypertriglyceridemia — 16,4%, HTN + reduced high density lipoprotein cholesterol (HDL-C) — 10,8%. This characteristic increased with age. The prevalence of a combination of HTN with hypercholesterolemia, with an increased LDL-C level, as well as HTN with any dyslipidemia in women aged 55-64 years was significantly higher than in men. Conclusion. The prevalence of a combination of HTN with any dyslipidemia in the Krasnoyarsk Krai among the adult population aged 25-64 years was 40% and increased with age. In women aged 55-64 years, the prevalence of a combination of HTN with hypercholesterolemia, with an increased LDL-C level, as well as HTN with any dyslipidemia was significantly higher than in men.
A. V. Svarovskaya, A. A. Garganeeva
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2746

Abstract:
Adipose tissue is currently regarded as a key organ for excess dietary lipids, which determine whether the body will maintain normal homeostasis or whether inflammation and insulin resistance will develop. In recent years, there is more information about novel prognostic models — the visceral adiposity index and the lipid accumulation product. The aim of this review was to analyze the results of studies examining the relationship between various indices of obesity and cardiometabolic risk. We analyzed 105 literature sources, 53 of which were ruled out, becausethe processes of interest were not described in detail or included anassessment of the relationship of various obesity indices with metabolic parameters. The results obtained indicate the advisability of using novel obesity indices, which have a good predictive ability and are simple and convenient to use. It is necessary to use additional methods of anthropometric and clinical examination in order to assess the metabolic phenotype of obesity, which will make it possible to stratify patients by the level of cardiometabolic risk.
A. M. Fahad, H. А. Al-Khalidi,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2885

Abstract:
COVID-19 infection is a major cause for acute respiratory distress syndrome, multi-organ dysfunction, coagulopathy, and intravascular thrombosis; therefore, it is the main causative factor for acute limb ischemia. Aim. To compare the treatment outcome of two limb ischemic groups post COVID-19 infection in a single center and detect at least which is better for the patients in the period of COVID-19 pandemic. Material and methods. Here, in this study, we collect 26 patients and divided them into two groups, G1 (14) patients treated conservatively and G2 (12) patients treated with surgical thrombectomy. Data were analyzed to look for the outcome of groups after 24 hours and 30 days. Results. The successful rate of conservative treatment was 85,72% in G1, while it was 75% in G2. There were two amputations below the knee joint in each group. Three patients died in both groups. Conclusion. In conclusion, both conservative treatment and surgical thrombectomy have a comparable successful rate in the selected group of COVID-19 patients.
D. G. Ioseliani, D. A. Asadov, V. V. Fomenko, ,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2864

Abstract:
The presented case report describes a five-year outcomes of bifurcation stenting of the left anterior descending artery and large diagonal branch with Absorb bioabsorbable vascular stent (BVS) according to selective coronary angiography and optical coherence tomography. The example demonstrates not only the successful implantation of biodegradable stents into the bifurcation area, but also the complete restoration of the arterial wall with the formation of neocarina. Optical coherence tomography made it possible to study in detail all stages of vascular wall alterations from the inside. This case report prompts a fresh look at the biodegradable BVS Absorb stents and does not rule out the potential of returning these stents to clinical practice in the future. Currently, the production and use of Absorb BVSs has been suspended, but they have filled a certain niche in the endovascular treatment of patients with coronary artery disease.
Article Editorial
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2910

Abstract:
On April 27, 2021, at the initiative of the Indonesian Heart Association, an online meeting was held with one of the leading cardiology experts in Russia, Professor Mamedov M. N.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2900

Abstract:
Preventive workplace programs are one of the optimal organizational models for the prevention of noncommunicable diseases in the workingage population. Corporate health programs allow to effectively influence the lifestyle of employees, which makes it possible to reduce human resource risks due to morbidity and increase labor efficiency. First, programs for the prevention of cardiovascular diseases are being implemented. A number of researchers report that implementing prevention programs in the workplace can reduce the number of people with bad habits. The effectiveness of preventive workplace programs largely depends on the mechanisms of their implementation. A feature of railway companies is the presence of a large staff of employees of various specialties. Many factors affecting health are, in one way or another, related to the workflow, since most railway companies operate continuously. Low health literacy of railway workers on health protection and disease prevention was noted. Measures such as financial incentives, preventive counseling, the creation of personalized health profiles and the availability of healthy food in the workplace have been shown to be effective. The review also discusses Russian corporate preventive workplace programs.
, , N. A. Nikolaev, Y. P. Skirdenko, , I. A. Viktorova, M. V. Kuznetsova, A. V. Mordyk, K. A. Andreev, V. G. Berezhnoy, et al.
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2916

Abstract:
The paper presents algorithms for adult outpatient care of coronavirus disease 2019 (COVID-19) and its assumption.
O. V. Zimnitskaya, ,
Cardiovascular Therapy and Prevention, Volume 20; https://doi.org/10.15829/1728-8800-2021-2677

Abstract:
There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.
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