Cardiovascular Therapy and Prevention
ISSN / EISSN : 1728-8800 / 2619-0125
Current Publisher: Silicea - Poligraf, LLC (10.15829)
Total articles ≅ 838
Latest articles in this journal
Cardiovascular Therapy and Prevention, Volume 20, pp 3-99; doi:10.15829/1728-8800-2021-1s
XXVIII RUSSIAN NATIONAL CONGRESS “MAN AND MEDICINE”. COLLECTION OF ABSTRACTS.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2629
It is known that even in spite of timely revascularization of the infarct-related artery, the myocardium in some patients remains hypoperfused. This condition is known as the no-reflow phenomenon, which is associated with an unfavorable prognosis. The systematic review is devoted to the effectiveness of deferred stenting in noreflow prevention. In patients with severe thrombosis, the two-stage revascularization technique is very promising. It is a primary intervention in the form of aspiration thrombectomy and/or balloon angioplasty followed by stenting after a certain period of time. This interval represents a certain therapeutic space, which allows various drugs to act resulting in reduction of blood clot size and risk of procedure-related distal embolization.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2669
Aim. To study the prognostic significance of atherosclerosis of one and several vascular systems in patients with high and very high cardiovascular risk (CVR). Material and methods. The study included 171 patients with high (26,9%) and very high (73,1%) CVR. All patients underwent duplex ultrasound of the carotid and lower limb arteries. The composite endpoint (CE) was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization. Results. The follow-up period lasted 31,1 (17,8; 47,9) months. CE events occurred in 29 (16,9%) patients: cardiovascular death — 3 (1,75%) patients; nonfatal myocardial infarction — 7 (4,09%) patients; nonfatal stroke — 6 (3,51%) patients; coronary revascularization — 13 (7,60%) patients. Cumulative survival of patients with high and very high CVR with atherosclerotic plaques in the same vascular system did not significantly differ from that in patients with intact peripheral arteries (p=0,977). The event-free survival of patients with combined lesions of the carotid and lower limb arteries was significantly lower in comparison with patients with one vascular system involvement (p=0,011). The combined lesion of the carotid and lower limb arteries was associated with an increase in the relative risk (RR) of adverse cardiovascular events (RR, 3,15 (95% CI, 1,02-9,74; p=0,046), adjusted for sex, age, and peripheral arterial disease symptoms. Conclusion. In patients with high and very high CVR, atherosclerotic lesion of two vascular systems of peripheral arteries is associated with an increase in the RR of adverse cardiovascular events, adjusted for sex, age, and peripheral arterial disease symptoms. The presence of atherosclerotic plaques in one vascular bed was not associated with an increase in the risk of CE events.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2583
The article describes prevalence and risk factors of cardiovascular in patients with cancer. The problems of anthracycline-induced cardiotoxicity, the deleterious effects of doxorubicin on the heart, as well as the cardioprotective effects of beta-blockers and agents acting on the renin-angiotensin-aldosterone system pathway are discussed. By cardiotoxicity is implied the development of various adverse cardiovascular events against the background of drug therapy for cancer patients. Depending on the severity of myocardial damage, there are type I (anthracycline-mediated cardiotoxicity, myocardial damage is irreversible) and type II (trastuzumab-mediated cardiotoxicity, myocardial dysfunction is reversible) cardiotoxicity. Anthracycline-induced cardiotoxicity, in turn, is divided into acute, early-onset chronic and late-onset chronic. At the same time, the main mechanisms of anthracycline cytotoxicity in relation to healthy cardiomyocytes are stimulation of intracellular oxidative stress, a decrease in reduced glutathione concentration, inhibition of cell redox potential, and a change in iron metabolism. The article discusses in detail the risk factors (age, hypertension, diabetes, asymptomatic left ventricular dysfunction, documented cardiovascular diseases, heart failure, etc.), as well as the mechanisms and treatment of anthracycline-mediated cardiotoxicity.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2678
Aim. To study the long-term effect of renal denervation (RDN) on left ventricular mass (LVM) and inflammatory markers in resistant hypertensive patients. Material and methods. Forty-one patients with resistant hypertension and 24-h blood pressure (BP) 158,7±15,8/87,3+14,6 mmHg, aged 56,6+10,2 years, were enrolled in the study and undergone RDN. Mean 24-h BP, left ventricular mass (transthoracic echocardiography), high sensitivity C-reactive protein (hsCRP), interleukin- 1β (IL1β), IL-6, IL-10) and tumor necrosis factor alpha (TNF- α) were assessed at baseline and 2 years after the RDN. Results. A baseline prevalence of left ventricular hypertrophy (LVH) was 90,2%. Two years after RDN LVM and interventricular septum (IVS) decreased significantly (p0 g) was documented in 24 patients. The regression of LVM was accompanied by a significant decrease in levels of inflammatory markers — hsCRP by 38,3% (p=0,031), TNF-α by 60,7% (p=0,009), IL- 1β — by 71,1% (p=0,001), and IL-10 by 58,2% (p=0,001). In patients in the absence of LVM regression only TNF-α decreased significantly (-68,8%, p=0,001). There was no correlation between changes of LVM and the inflammatory markers at 24 months after RDN. Conclusion. The RDN in RH patients may have long-term cardioprotective effect in terms of significant regress of LVH, which may be partly attributed to the regress in systemic or myocardial inflammation.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2640
Aim. To study the relationship between plasma aldosterone level and left ventricular (LV) structure and function in heart failure with preserved ejection fraction (HFpEF). Material and methods. This prospective study included 158 patients (58 men and 100 women, mean age, 62,3±7,4 years) with compensated HFpEF. Patients had no history of primary aldosteronism and did not use the mineralocorticoid receptor antagonists during the last 6 weeks. The plasma aldosterone was determined by enzyme immunoassay in all patients and the severity of structural and functional cardiac changes was assessed. The concentration of 40160 pg/ml was considered the reference values. Assessment of cardiac structure and function was carried out using transthoracic echocardiography. Results. According to the laboratory results, all patients were divided into two groups: group 1 — 99 (62,7%) patients (95% confidence interval (CI), 55,0-70,0%) with normal aldosterone levels; group 2 — 59 (37,3%) patients (95% Cl, 30,0-45,0%) with hyperaldosteronism. End-diastolic volume, left atrial volume, LV mass index, severity of LV diastolic dysfunction and the prevalence of concentric hypertrophy were significantly higher in group 2 patients compared with group 1 (p<0,05 for all). Blood aldosterone levels positively correlated with E/e’ (r=0,63, p<0,001). Regression analysis, adjusted for age and comorbidity, demonstrated that plasma aldosterone levels were closely associated with E/e’ (odds ratio, 3,42; 95% CI, 1,65-9,64, p=0,001) and LV concentric hypertrophy (odds ratio, 1,12; 95% CI, 1,08-3,16, p=0,042). Conclusion. The development of secondary hyperaldosteronism in patients with HFpEF is an independent predictor of LV diastolic dysfunction and unfavorable prognostic types of LV remodeling.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2590
Recently, there have been some important changes in the laboratory diagnosis of patients with acute coronary syndrome, due to the introduction into routine practice of new high- and ultra-sensitive techniques for detection of myocardial damage biomarkers — cardiac troponins. Each method for cardiac troponins’ detection, among the existing wide variety of troponin immunoassays, has different analytical characteristics and allows the detection of different concentrations of troponins in the same patient. With an increasing number of companies developing high-sensitivity troponin immunoassays receiving regulatory approval, there is an urgent need for independent analytical and clinical evaluation of each method. This article discusses high- and ultrasensitive techniques for detection of cardiac troponins. The modern data on biochemical and metabolic characteristics of troponins, obtained using high- and ultra-sensitive techniques, are described: sex, age, circadian features and potential for detecting troponins in other biological fluids. Considerable attention is paid to the analytical characteristics of troponin immunoassays: limit of blank, limit of detection and limit of quantitation, coefficient of variation, as well as the 99th percentile and factors influencing it.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2774
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2634
Aim. To study the levels of thyroid-stimulating hormone (TSH) and thyroid hormones (TH), frequency and amplitude parameters of alpha wave, parameters of heart rate variability, hemodynamics and their relationship in patients with hypertension (HTN) and healthy individuals. Material and methods. We studied 75 patients with stage 2 HTN and 70 healthy individuals. All patients underwent an electroencephalography, 24-hour blood pressure monitoring. Weighted average heart rate variability was calculated. We determined blood plasma levels of TSH and TH. Statistical processing, multiple regression and correlation analysis were carried out using the Statistica v. 10.0.1 software package (StatSoft Inc). Results. In patients with HTN, TSH and TH were lower than in the control group by 50% and 38%, respectively. The а-index was also 40% lower. Patients with HTN were characterized by lower amplitude, frequency and power of а-wave, and weighted average heart rate variability by 35%, 13-35%, and 30%, respectively. Pulse wave velocity in patients with HTN exceeded the control group by 18%, and the systemic dynamic response was 2,2 times higher. The groups differed in the characteristics of the relationship of а-wave between the brain lobes and hemispheres with TSH, TH, heart rate variability and hemodynamics. Conclusion. The concentration of TSH and TH is interrelated with the frequency and amplitude parameters of alpha wave, heart rate variability and hemodynamic parameters in hypertensive patients.
Cardiovascular Therapy and Prevention, Volume 20; doi:10.15829/1728-8800-2021-2557
Aim. To assess the associations between depression and coronary artery disease (CAD) in an open female and male population of a middle-urbanized city of Western Siberia. Material and methods. Two cross-sectional epidemiological studies were carried out on an open population of a middle-urbanized Siberian city among men and women aged 25-64 years old. The prevalenceof CAD was assessed based on standard epidemiological methods. To determine the severity of depression, the algorithms of the WHO program MONICA-Psychosocial were used. The severity of depression was assessed as low, moderate, and high. On the basis of the algorithm, the levels of depression were established: low and moderate levels — no sign, high level — presence of a sign. Results. In an open population of 25-64 years old, a moderately urbanized Siberian city, the prevalence of CAD according to extended and lax epidemiological criteria prevailed in men, while strict epidemiological criteria did not reveal significant differences in the male and female subpopulations. In the female subpopulation, a tendency towards an increase in the prevalence of a high level of depression was revealed due to its predominance in young age groups. It has been shown that the depression increases the probability of detecting CAD in accordance with the expanded epidemiological criteria in men and women by 21,07 and 16,04 times, respectively. Conclusion. When using epidemiological criteria for CAD in the presence of depression, the probability of detecting CAD is higher, both in men and women. At the same time, the highest odds ratios are characteristic for a certain type of CAD, the least — CAD by probable signs.