Russian Journal of Cardiology
ISSN / EISSN : 15604071 / 26187620
Current Publisher: Silicea - Poligraf, LLC (10.15829)
Total articles ≅ 1,248
Latest articles in this journal
Russian Journal of Cardiology, Volume 25, pp 103-110; doi:10.15829/1560-4071-2020-2-3748
Expert Council opinion describes emergency care in a sudden individually significant blood pressure (BP) increase without clinically overt target organ damage. In the new guidelines of the Russian Society of Cardiology, the term “hypertensive urgency” was abolished, and the management of a sudden BP increase was changed. At the same time, a sudden individually significant BP increase may be accompanied by symptoms that reduce patients’ quality of life and ability to work. According to experts, individually significant BP increase accompanied by symptoms requires outpatient treatment using oral rapid-onset drugs with an optimal duration of action, in particular captopril. It has a much evidence-based data on the BP increase use and sublingual administration, and also has a favorable safety profile, which allows prescribing to patients with comorbid diseases. The rationale for the use of angiotensin-converting enzyme inhibitor Capoten (captopril) as a drug for self-management of a sudden individually significant BP increase accompanied by symptoms in hypertension patients is describes.
Russian Journal of Cardiology, Volume 25, pp 1-18; doi:10.15829/1560-4071-2020-s1
СБОРНИК ТЕЗИСОВ19-21 марта, г. Москва
Russian Journal of Cardiology, Volume 25, pp 90-97; doi:10.15829/1560-4071-2020-2-3480
Aim. To assess eft ventricular (LV) contractility dysfunction in patients with chronic lymphocytic leukemia (CLL) receiving chemotherapy with fludarabine, cyclophosphamide, and rituximab (FCR), and to determine the enalapril.effectiveness for their treatment.Material and methods. The study included 49 patients with newly diagnosed Binet stage B CLL in combination with class I-II stable angina, stage 1-2 hypertension and LV ejection fraction (EF) >50%. All subjects did not take angiotensin converting enzyme inhibitors (ACE inhibitors), had no clinical signs of heart failure (HF), and all had indications for FCR combination use before study start. Patients underwent two-dimensional echocardiography initially, before starting chemotherapy (period V1) and after three (84±5 days) (V2) and six (168±7 days) (V3) courses of chemo therapy (enalapril) was added to the treatment regimen in the experimental group.Results. After the third course of chemotherapy, a relative percentage decrease in global longitudinal strain (GLS) was noted in the experimental and control groups — by 16,16±0,80 and 16,2±0,79, respectively (p=0,764). These changes are considered a cardiotoxicity predictor. At the same time, LVEF values remained within the normal range: 63,4% [65; 68] in the experimental group and 63,9% [61,6; 67] in the control group (p=0,960). After the sixth course, LVEF values significantly differed (p=0,002): in the control group, five patients (21%) had cardiotoxicity; in experimental group, there were no patients with cardiotoxicity.Conclusion. A clinically significant decrease in GLS is a marker of subclinical LV contractile dysfunction and is a cardiotoxicity predictor in CLL patients receiving chemotherapy with FCR. The timely addition of enalapril to the treatment regimen can prevent cardiotoxicity in such patients. The need for early assessment of GLS during FCR courses for the detection and prevention of cardiotoxicity has been proved.
Russian Journal of Cardiology, Volume 25, pp 31-40; doi:10.15829/1560-4071-2020-2-3474
Aim. To assess the changes of biochemical markers in hospitalization, the relationship with the severity of myocardial fibrosis and the epicardial adipose tissue (EAT) thickness one year after myocardial infarction (MI).Material and methods. A total of 88 patients (65 men and 23 women) with MI were examined. The percentage of cicatricial changes in the myocardium and the EAT thickness were measured using the magnetic resonance imaging (MRI) one year after MI. In the hospitalization (days 1 and 12) and 1 year after MI, the concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), stimulating growth factor (ST2), interleukin-33 (IL-33) and type I collagen (COL-1). The data were analyzed using descriptive statistics, correlation and ROC analysis, and logistic regression (Statistica 9.0).Results. One year after MI, cicatricial changes were detected in 68 (77%) patients: 27 people had myocardial fibrosis 15%. We established that myocardial fibrosis after MI is associated with unfavorable medical history, a complicated course during in-hospital period and higher concentrations of ST2, NT-proBNP, COL-1 compared with patients without myocardial fibrosis. High levels of ST2, NT-proBNP increase the risk of myocardial fibrosis by 1,2 and 1,8 times after hospitalization, respectively. In patients with myocardial fibrosis >15%, IL-33 level was significantly lower in the 1st day of MI. It was found that the EAT thickness increases with fibrosis of 5-15%. An increase in the left (LV) and right ventricular (RV) EAT thickness by 1,33 times and 1,34 times, respectively, increases the risk of myocardial fibrosis (LV EAT thickness, mm (OR 1,33; 95% CI (1,08-1,4), AUC 0,75; RV EAT thickness, mm (OR 1,34; 95% CI (1,15-1,43), AUC 0,79). In patients with myocardial fibrosis >15%, EAT thickness decreases and correlates with NT-proBNP increase in the acute period and a one year after MI.Conclusion. The development of myocardial fibrosis one year after MI is associated with an increase in ST2, NT-proBNP, COL-1, both in the hospitalization and 1 year after MI. The decrease in IL-33 concentration during hospitalization with MI is accompanied by the development of fibrosis >15% of the myocardium.
Russian Journal of Cardiology, Volume 25, pp 19-24; doi:10.15829/1560-4071-2020-2-3416
Aim. To create a prediction score for assessing the mortality risk 6 months after hospitalization with acute coronary syndrome (ACS).Material and methods. Based on the results of ACS RECORD-3 register (Russia), we determined independent mortality predictors 6 months after ACS by performing multivariate regression analysis in patients discharged alive from the hospital with known outcomes.Results. The following predictors were obtained during the analysis: non-prescription of aspirin at discharge (odds ratio (OR) 5,8; 95% confidence interval (CI) 2,315,0; pConclusion. The novel RECORD-6 risk score is an accurate and simple prediction tool for assessing the mortality risk 6 months after discharge from the hospital. The prediction accuracy of the RECORD-6 risk score is not lower the GRACE risk score.
Russian Journal of Cardiology, Volume 25, pp 100-102; doi:10.15829/1560-4071-2020-2-3459
Клинический случай инфекционного эндокардита, вызванного золотистым стафилококком, повлекший за собой осложнения в виде мультифокальных повреждений головного мозга эмболической этиологии.
Russian Journal of Cardiology, Volume 25, pp 60-67; doi:10.15829/1560-4071-2020-2-3713
Aim. To study the cardiac remodeling in heart failure (HF) patients with atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD).Material and methods. The study included 120 patients who were divided into 4 groups: the experimental group — patients with HF, AF and COPD (n=29), group 1 — patients with COPD, without cardiovascular disease (n=28), group 2 — patients with HF and COPD, without AF (n=30), group 3 — patients with HF and AF, without COPD (n=33). All patients underwent echocardiography using the MyLab70 Ultrasound System (Esaote, Italy).Results. In comparison with patients of group 3, patients of the experimental group had lower left and right atrial volumes (p=0,001 and p=0,004, respectively), higher right ventricular (RV) wall thickness (pConclusion. The results of the study revealed features of cardiac remodeling pathogenesis in HF patients with AF and COPD. Comparative analysis of the results made it possible to indicate different mechanisms underlying AF, to assess the effects of both AF and chronic airway obstruction on the cardiac structure and function in patients with HF and combination of these pathologies.
Russian Journal of Cardiology, Volume 25, pp 113-118; doi:10.15829/1560-4071-2020-2-3720
Inflammatory mediators play an important role in the pathogenesis of acute coronary syndrome (ACS). The results of experimental and randomized clinical trials on the role of various inflammation inhibitors in the treatment of coronary artery disease (CAD), in particular CANTOS and COLCOT, mark a new stage that can significantly change the clinical course and outcomes of the disease. We analyze our own experience in studying this problem. There are much prospects for the use of immunomodulatory and anti-inflammatory drugs reducing the residual inflammatory risk, but additional studies are needed to determine their role in the treatment of CAD.
Russian Journal of Cardiology, Volume 25, pp 111-112; doi:10.15829/1560-4071-2020-2-3727
The article discusses the creation of a new classification for coronary artery disease. The classification of acute and chronic forms of coronary artery disease is proposed as one of the variants.
Russian Journal of Cardiology, Volume 25, pp 74-80; doi:10.15829/1560-4071-2020-2-3649
Non-invasive cardiovascular imaging plays an important role in examination of patients with chronic coronary syndrome. Positron emission tomography (PET) has the highest diagnostic accuracy and prognostic significance due to the ability to assess myocardial blood flow (MBF) and coronary flow reserve (CFR). These physiological processes provide myocardial oxygen demand, both at rest and stress, as well as maintaining sufficient myocardial circulation during coronary artery constriction. At the same time, the high cost and low availability of assessing MBF and CFR by PET do not allow widespread use of this approach in clinical practice. The use of modern gamma cameras with cadmium zinc telluride detectors can be an alternative to PET. The aim of the review is to present fundamental information about MBF and CFR, as well as about the possibilities of using scintigraphy for determination of these parameters and their clinical significance.