Cardiovascular Therapy and Prevention

Journal Information
ISSN / EISSN : 1728-8800 / 2619-0125
Current Publisher: Silicea - Poligraf, LLC (10.15829)
Total articles ≅ 804
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O. V. Vorobieva, N. E. Gimaldinova, A. V. Lastochkin
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2413

Abstract:
Атеросклероз является социально значимой нозологической формой, утяжеляющей течение основных заболеваний, в виде прогрессирующего нарастания ишемии органов и тканей. К одним из тяжелых последствий прогрессивного течения атеросклероза относится развитие ишемических поражений кишечника.Цель исследования - изучение патоморфологических изменений органов желудочно-кишечного тракта при ранее диагностируемом прогрессирующем течении атеросклероза на примере рассмотрения собственного секционного случая.Материал и методы исследования. Проведен анализ полученной сопроводительной медицинской документации (амбулаторная карта пациента, история болезни). Применена стандартная методика патологоанатомического вскрытия. Для обработки гистологических срезов аутопсийного материала использовали окраску гематоксилин-эозин.Результаты. На основании анализа данных медицинской документации и результатов секционного исследования было выявлено, что основной причиной смерти явилась атеросклеротическая гангрена дистальной части тощей, всей подвздошной, слепой, восходящей ободочной кишки, осложненная разлитым серозно-геморрагическим перитонитом с развитием острой сердечно-сосудистой недостаточности, которую следует считать непосредственной причиной смерти пациента.Заключение. Таким образом, у врачей терапевтического и хирургического профиля должна быть настороженность в плане высокого риска развития некротических изменений тонкого и толстого кишечника на фоне прогрессирующего течения атеросклероза.
O. M. Drapkina, O. T. Kim
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2632

Abstract:
The pathophysiology of obesity is complex and includes changes in eating behavior, genetic, epigenetic, environmental factors, and much more. To date, ~40 genetic polymorphisms are associated with obesity and fat distribution. However, since these options do not fully explain the inheritance of obesity, other options, such as epigenetic changes, need to be considered. Epigenetic modifications affect gene expression without changing the deoxyribonucleic acid sequence. In addition, environmental exposure during critical periods of development can affect the epigenetic tags and lead to obesity. A deeper understanding of the epigenetic mechanisms underlying obesity can aid in prevention based on lifestyle changes. This review focuses on the role of epigenetic modifications in the development of obesity and related conditions.
A. S. Safaryan, V. D. Sargsyan
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2693

Abstract:
The article is devoted to the influence of sympathetic nervous system (SNS) on the cardiovascular system. Influence of SNS activity on the blood pressure level and the pathogenesis of hypertension development, as well as the effect of SNS on many biochemical and metabolic parameters playing a key role in the development of metabolic syndrome and hypertension are considered. Possible mechanisms of action of various methods that reduce the SNS activity, restore the function of autonomic nervous system and normalize the cardiovascular system and blood pressure are considered.
Yu. V. Doludin , Alena S. Limonova, V. A. Kozlova , I. A. Efimova, A. L. Borisova, Alexey Meshkov , Maria Pokrovskaya , O. M. Drapkina
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2730

Abstract:
The advances of biomedicine include the new technologies, diagnosis and treatment techniques, as well as the practical use of new types of biological targets, in particular, nucleic acids. Genomic deoxyribonucleic acid (DNA), extracellular DNA (exDNA) and microbiome DNA obtained from different types of samples (tissues, blood and its derivatives, feces, etc.) are used as objects of genetic research. The use of new technologies for DNA analysis required the development of standardized methods for processing biological samples in order to obtain high-quality DNA samples. The research uses various methods for collecting, preparing samples and storing various DNA-containing biomaterials and isolated DNA, as well as methods for assessing the quality of samples and biobank standards. It is obvious that the use of uniform standards will allow large-scale genetic research on the basis of biobanks and research laboratories. Specialists from professional organizations such as International Society for Biological and Environmental Repositories (ISBER), Biobanking and BioMolecular Resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC), European, Middle Eastern & African Society for Biopreservationa and Biobanking (ESBB) and the Russian National Association of Biobanks and Biobanking Professionals.
V. I. Podzolkov , A. I. Tarzimanova , A. E. Bragina , K. K. Osadchiy, R. G. Gataulin, K. A. Oganesyan, Z. B. Jafarova
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2707

Abstract:
Obesity is a progressing epidemic, the prevalence of which has doubled over the past 30 years. The distribution of adipose tissue is an important factor in predicting the risk of cardiovascular events. The most significant inflammatory activity is characteristic of epicardial adipose tissue (EAT), the role of which in the development of atrial fibrillation (AF) remains a subject of discussion.Aim. To study the effect of EAT size on the development of AF in hypertensive (HTN) patients.Material and methods. The study included 95 patients with HTN aged 38-72 years (mean age, 61,5±1,8 years), including 45 patients with paroxysmal AF (group I) and 50 patients in the comparison group (group II). In order to assess the severity of visceral obesity, all patients underwent a general examination and echocardiography. To determine the EAT volume, cardiac multislice computed tomography was performed.Results. Echocardiography revealed that the EAT thickness was significantly greater in hypertensive patients with paroxysmal AF than in the comparison group: 11,6±0,8 and 8,6±0,4 mm, respectively (p10 mm and volume >6 ml can serve as integral markers of the onset of paroxysmal AF.Conclusion. Integral markers of AF in hypertensive patients are an increase in the EAT thickness >10 mm (odds ratio, 4,1; 95% confidence interval, 1,1-5,6) and volume >6 ml (odds ratio 3,7; 95%, confidence interval 1,0-4,2).
S. S. Bunova, N. I. Zhernakova, Yu. P. Skirdenko, N. A. Nikolaev
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2665

Abstract:
Aim. To study the quantitative parameters of adherence to lifestyle modification, medical support, and therapy in patients with cardiovascular diseases (CVD).Material and methods. This cross-sectional study included 683 respondents: 168 patients with hypertension (HTN); 196 patients with stable angina; 141 patients with atrial fibrillation (AF); 178 patients with heart failure (HF). We used N. A. Nikolaev questionnaire for adherence assessment. For all adherence parameters, the level ≤75% was regarded as insufficient. The study was carried out in accordance with Good Clinical Practice and Declaration ofHelsinki. The study protocol was approved by the Ethics Committees of all participating clinical centers. All patients signed written informed consent.Results. Approximately 1/3 of respondents agreed to receive therapy. The adherence level was >75%. Patients with angina and AF were more likely to receive therapy. It turned out that that approximately 2/3 of patients were not ready for medical support. Patients with angina were less ready for medical support, while those with HTN and HF hadhigher values of adherence. Adherence to lifestyle modification was owest among analyzed parameters. Only 18,5% of hypertensive patients, 25,5% of patients with angina, 26,2% of AF patients and 23,1% of patients with HF were ready to change the lifestyle.Conclusion. The study revealed a significant number (~2/3) of CVD patients with insufficient adherence, which specifies the need to assess the effectiveness of therapy and course of the disease in conditions of low adherence and to develop individualized therapeutic strategies.
D. K. Vasiliev, B. A. Rudenko, A. S. Shanoyan, F. B. Shukurov , D. A. Feshchenko
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2697

Abstract:
The main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed.Aim. To assess the rationale of complete myocardial revascularization in patients with multivessel coronary artery disease (CAD) with chronic total occlusion and high surgical risk.Material and methods. This retrospective, open-label, non-randomized clinical trial was carried out included 180 patients multivessel CAD and CTO. The patients underwent endovascular surgery for complete myocardial revascularization. Depending on the success of surgery, the patients were divided into groups of complete and incomplete myocardial revascularization. Endpoints were death, acute coronary syndrome, re-revascularization after 1-year follow-up. Left ventricular (LV) contractility and clinical status of patients in the study groups after 1 year of observation was assessed.Results. The median follow-up was 12,1 months. The successful rate of revascularization was 79,4%. The incidence of main composite endpoint in the group of complete myocardial revascularization was 5,59%, while in the group of incomplete revascularizations — 21,6% (p=0,005).Conclusion. The study showed that low incidence of intraoperative complications and a high successful rate of revascularization are characteristic of complete myocardial revascularization in patients at high surgical risk with multivessel CAD and CTO. Complete myocardial revascularization leads to a significant decrease in the incidence of major coronary events.
S. A. Chepurnenko, G. V. Shavkuta, A. D. Nasytko
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2418

Abstract:
The article discusses a case of episodes of asymptomatic ST-T depression during exercise in a 37-year-old patient with complaints of irregular heartbeat, tachycardia up to 100 bpm, not related to exercise. According to contrast-enhanced multislice computed tomography, in the middle third, a muscle bridge with stenosis of up to 30% was found. The diagnosis was made: Congenital coronary artery anomaly: transmyocardial muscular bridge of the middle third of left anterior descending artery with stenosis up to 30%. Class 1 silent myocardial ischemia. Stage 0, class 0 chronic heart failure. Using non-invasive coronary imaging, it was possible to identify the cause of transient ST-T depression and to choose the appropriate therapy.
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2649

Abstract:
The review discusses the participation of patients with coronary artery disease after acute myocardial infarction and revascularization surgeries in cardiac rehabilitation (CR) and secondary prevention programs. The problems of patients not being included in rehabilitation programs and the reasons for low adherence to these programs are considered. The contribution of non-drug therapy to achievement of CR and secondary prevention goals is discussed. Various strategies are proposed for involving and increasing adherence of patients to CR programs.
Nana Pogosova , R. G. Oganov, Sergey Boytsov , A. K. Ausheva , O. Yu. Sokolova, A. A. Kursakov, I. V. Osipova, O. N. Antropova, Yu. M. Pozdnyakov, A. O. Salbieva, et al.
Cardiovascular Therapy and Prevention, Volume 19; doi:10.15829/1728-8800-2020-2739

Abstract:
Цель. Оценить ключевые показатели вторичной профилактики у больных ишемической болезнью сердца на отдаленном этапе после перенесенного острого инфаркта миокарда, острого коронарного синдрома (ОКС), чреcкожного коронарного вмешательства и/или операции аортокоронарного шунтирования, полученные в исследовании EUROASPIRE V (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) в российских центрах в сравнении с общей популяцией исследования.Материал и методы. EUROASPIRE V – поперечное исследование с участием 27 стран, включая Россию, где в одном или нескольких регионах идентифицировали такие стационарные учреждения кардиологического профиля, в которые все пациенты с ОКС или показаниями к реваскуляризации миокарда из данной местности имели шансы на госпитализацию. В участвующих центрах идентифицировались последовательно поступающие пациенты, госпитализированные по поводу ОКС или для проведения чреcкожного коронарного вмешательства или аортокоронарного шунтирования. Через ≥6 мес. и
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