medi.ru »» Подробно о лекарствах »» Кадиология »» Российский кардиологический журнал
 Информация для профессионалов здравоохранения ! Соглашение об использовании 

MEDI.RU - Подробно о лекарствах
Российский кардиологический журнал »» №2 (100) 2013

CONTENTS
СОДЕРЖАНИЕ

CLINICAL MEDICINE NEWS


Clinical medicine updates: a review of international news
Russ J Cardiol 2013, 2 (100): 5


ORIGINAL ARTICLES

MYOCARDIAL DYSSYNCHRONY, HEART FAILURE AETIOLOGY, AND QRS COMPLEX DURATION IN PATIENTS WITH CLINICALLY MANIFESTED CHRONIC HEART FAILURE

Trukhshina M. A., Sitnikova M. Yu.

Abstract

Aim. To assess the prevalence and clinical value of various types of left ventricular (LV) myocardial dyssynchrony in patients with systolic chronic heart failure (CHF).

Material and methods. In total, 71 patients with Functional Class (FC) II–IV CHF (LV ejection fraction (EF) <35%). The main CHF causes were coronary heart disease, CHD (65%) and non-coronary myocardial pathology (NCMP) which resulted in cardiac dilatation (35%). In 50% of the patients, QRS complex duration was ≤120 ms; in 18% >121 ms and ≤160 ms; and in 30% >161 ms and ≤200 ms. All participants underwent standard examination, echocardiography (EchoCG), and tissue Doppler (TD) ultrasound, in order to assess interventricular (interVD) and intraventricular (intraVD) myocardial dyssynchrony. During the clinical stabilisation period, EchoCG was performed using the Vivid 7 device (GE, Vingmed Dimensions, Norway; 2,5 MHz transducer). Myocardial TD was performed using the method by C. M. Yu.

Results. Various types of myocardial dyssynchrony were observed in 94% of the patients with systolic CHF. In patients with “narrow” QRS, 78% had myocardial dyssynchrony. Dyssynchrony was absent in 5 patients with “wide” QRS (10% of all participants). A combination of interVD and intraVD was registered in 34% of the patients; only interVD in 20%; and only intraVD in 32%.

Conclusion. The prevalence and the pattern of myocardial dyssynchrony were independent of CHF FC and aetiology, being similar in CHD and NCMP patients. Progressing disturbances of intraventricular conductivity, but not CHF FC progression, were associated with increased cardiac chamber dimensions and LV remodelling progression. In patients with QRS >160 ms, LV dimensions and volumes, as well as dyssynchrony parameters, were higher than in patients with “narrow” QRS. The authors believe that the clinical examination of patients with FC II–IV CHF of any aetiology and QRS complex duration >120 ms should include EchoCG and myocardial dyssynchrony assessment.

Russ J Cardiol 2013; 2 (100): 6-11

Key words: heart failure, myocardial dyssynchrony, tissue Doppler.

V. A. Almazov Federal Centre of Heart, Blood, and Endocrinology, St. Petersburg, Russia.


LEFT VENTRICULAR REMODELLING AND DIASTOLIC DYSFUNCTION IN MITRAL VALVE PROLAPSE

Malev E. G.1, Pshepyi A. P.1, Vasina L. V.1, Reeva S. V.1,2, Timofeev E. V.1,2, Korshunova A. L.1,2, Zemtsovskyi E. V.1,2

Abstract

myocardial remodelling and diastolic dysfunction in symptom-free young patients with mitral valve prolapse (MVP), but no arterial hypertension or significant mitral regurgitation.

Material and methods. The study included 78 patients with MVP (mean age 19,7±1,6 years; 72% males). The control group, comparable by age and sex distribution, included 80 healthy people. Longitudinal diastolic strain rate (SRe) was assessed using the speckle tracking method (Vivid 7 Dim, EchoPAC’06, GE). Serum levels of transforming growth factors (TGF) β1 and β2 were measured using ELISA (Bender MedSystems).

Results. MVP patients had larger end-systolic and end-diastolic LV dimensions, compared to controls. However, this difference was eliminated after adjustment for body surface area. LV myocardial mass index values were similar in MVP patients and controls (84,2±20,4 g/m 2 and 83,5±15,0 g/m 2, respectively; p=0,80). At the same time, the percentage of participants with concentric LV remodelling (χ 2=5,37; p=0,02) and eccentric LV hypertrophy (χ 2=4,98; p=0,025) was significantly higher in MVP patients, compared to controls. MVP patients also demonstrated a significant SRe reduction in interventricular septum and anterior LV wall. The levels of TGF-β1 (15,2±12,3 ng/ml vs. 9,3±7,7 mg/ml; p=0,004) and TGF-β2 (13,0±1,9 ng/ml vs. 2,5±1,2 mg/ml; p=0,04) were significantly higher in MVP patients than in controls. The levels of TGF-β2 positively correlated with LV myocardial mass index (r=0,42; p=0,001) and SRe (r=0,76; p=0,0001). Multivariate regression analyses confirmed the association between TGF-β2 and SRe (β=1,95; p=0,01).

Conclusion. Diastolic myocardial deformation disturbances, identified using the speckle tracking method, could be due to the increased TGF-β1 signalling and myocardial fibrosis.

Russ J Cardiol 2013; 2 (100): 12-17

Key words: mitral valve prolapse, left ventriculum, diastolic function, remodelling, transforming growth factor-β.

1V. A. Almazov Federal Centre of Heart, Blood, and Endocrinology, 2St. Petersburg State Pediatric Medical University, St. Petersburg, Russia.


CHRONIC MITRAL REGURGITATION IN WOMEN WITH CORONARY HEART DISEASE AND POST-INFARCTION CARDIOSCLEROSIS

Kuznetsov V. A., Yaroslavskaya E. I., Pushkarev G. S., Krinochkin D. V., Zyryanov I. P., Mar’ynskikh L. V.

Abstract

Aim. To identify whether mitral regurgitation (MR) is associated with coronary stenosis localisation in women with coronary heart disease (CHD) and postinfarction cardiosclerosis.

Material and methods. Among 15283 patients included in the “Coronary Angiography Register” © from 1991 to 2012, the women with CHD and postinfarction cardiosclerosis (age 31–72 years) were selected: 94 without MR and 53 with moderate or severe MR.

Results. Patients with MR were significantly older (mean age 57,6±8,5 vs. 52,2±8,5 years; p=0,001), had higher NYHA classes (III–IV) of chronic heart failure, CHF (46,2 vs. 18,5%; p=0,001), and a higher prevalence of repeat myocardial infarction (22,6 vs. 7,1%; p=0,010) than the patients without MR. According to echocardiography data, MR patients demonstrated higher values of left ventricular (LV) asynergy (28,7±14,7 vs. 22,4±12,2%; p=0,016) and linear cardiac dimension indices, including LV indices (30,7±3,0 vs. 27,2±2,7 mm/m 2; p<0,001). This clinical group also shown a reduction in LV contractility (54,7 vs. 17,9%; p<0,001). MR patients were also characterised by multiple localisation of post-infarction cardiosclerosis (33,3 vs. 17,4%; p=0,035). According to coronary angiography data, stenosis of left coronary artery trunk was observed only in women with MR (9,4 vs. 0%; p=0,008). Multivariate analyses demonstrated an independent association between MR, higher NYHA classes, and increased LV dimension indices.

Conclusion. In women with CHD and post-infarction cardiosclerosis, moderate and severe chronic MR was associated with higher NYHA classes of CHF and increased LV dimension indices.

Russ J Cardiol 2013; 2 (100): 18-23

Key words: mitral regurgitation, coronary stenosis, post-infarction cardiosclerosis.

Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tumen Cardiology Centre, Tumen, Russia.


CLINICAL COURSE OF ST ELEVATION MYOCARDIAL INFARCTION AND BLOOD LEPTIN LEVELS

Adamov P. B.1, Lebedeva A. Yu.1, Gordeev I. G.1, Volov N. A.1, Kokorin V. A.1, Levchuk N. N.2, Sofrina S. L.2, Kochmareva E. A.1

Abstract

Recently, researchers have been increasingly interested in the association between the incidence of cardiovascular events (such as myocardial infarction, MI) and leptin – an adipocyte-produced hormone, which normally is involved in the body mass regulation.

Aim. To assess the role of leptin in the clinical course of acute myocardial infarction with ST segment elevation (STEMI) on ECG.

Material and methods. The study included 89 men aged 23–77 years. All patients underwent coronary angiography (CAG) in the first 12 hours of STEMI. Based on the CAG findings, 80 patients underwent percutaneous coronary interventions (PCI). All participants were divided into two groups, based on the plasma levels of leptin. Group 1 (n=42) had elevated leptin levels (>5,63 ng/ml), while Group 2 (n=47) had normal leptin levels (<5,63 ng/ml).

Results. In MI patients, leptin concentration was a predictor of the in-hospital diagnosis of Type 2 diabetes mellitus (DM-2). The plasma leptin concentration in the first 24 hours of MI was associated with the levels of interleukin-1-beta, potassium, creatinine, triglycerides, haemoglobin, body mass index, and left ventricular enddiastolic dimension.

Conclusion. Leptin levels in the acute phase of STEMI could be used for the prediction of MI complications and DM-2.

Russ J Cardiol 2013; 2 (100): 24-30

Key words: leptin, risk factor, predictor, cardiovascular pathology, myocardial infarction, percutaneous coronary interventions, chronic kidney disease, diabetes mellitus.

1N.I. Pirogov Russian National Medical Research University, Moscow; 2O.M. Filatov Moscow City Clinical Hospital No. 15, Moscow, Russia.


SYNTAX SCALE ESTIMATES OF CORONARY STENOSIS SEVERITY AND OUTCOMES OF VARIOUS REVASCULARISATION STRATEGIES IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION AND MULTI-VESSEL CORONARY PATHOLOGY

Tarasov R. S., Ganyukov V. I., Shushpannikov P. A., Krotikov P. A., Barbarash O. L., Barbarash L. S.

Abstract

Aim. To assess 30-day and long-term outcomes of various revascularization strategies in patients with myocardial infarction and ST segment elevation (STEMI) and multi-vessel coronary pathology (MVCP), in regard to the severity of coronary stenosis, as assessed by the SYNTAX scale.

Material and methods. The 30-day and long-term outcomes of various strategies of primary percutaneous coronary intervention (PCI) were assessed in 227 STEMI patients, in regard to the severity of their coronary stenosis (as assessed by the SYNTAX scale). Group 1 included 40 patients who underwent multi-vessel stenting (MVS) as a part of their primary PCI, while Group 2 included 187 patients with indications for staged revascularisation (SR).

Results. At baseline, the MVS and SR subgroups with severe coronary stenosis (SYNTAX score ≥23) were characterised by reduced left ventricular ejection fraction (LVEF), compared to MVS and ER subgroups with SYNTAX score <22 (moderate coronary stenosis): 44,9±9% vs. 54±6,6% (p<0,05) and 49,1±9% vs. 51,3±6,7% (p<0,05), respectively. In the SR group, both the 30-day and 12-month data suggested a significantly higher need for non-target vessel revascularisation (non-TVR), compared to the MVS group: 13,3% vs. 0% and 50,3% vs. 15%, respectively (p<0,05). At 12 months, the incidence of combined end-point (death, myocardial infarction, or target vessel revascularisation, TVR) reached 23%, in contrast to 7,5% in the MVS group (p<0,05). In the SR group, patients with severe coronary stenosis (SYNTAX score ≥23) compared to those with moderate coronary stenosis (SYNTAX score <22), had a significantly higher 12-month risk of death (11,5% vs. 2,75%; p<0,05) or combined end-point (29,5% vs. 18,3%; p<0,05).

Conclusion. In STEMI patients with MVCP, severe coronary stenosis (SYNTAX score ≥23) was associated with selected clinical and angiographic parameters, as well as with a significantly higher 12-month risk of adverse outcomes. The MVS strategy demonstrated satisfactory results throughout the 12-month follow-up period, independently of coronary stenosis severity. In the SR group, patients with SYNTAX score ≥23 had worse outcomes than participants with SYNTAX score <22. The patients with severe coronary stenosis (SYNTAX score ≥23) have worse prognosis and, therefore, might require timely, complete myocardial revascularisation, using MVS or SR strategies.

Russ J Cardiol 2013; 2 (100): 31-37

Key words: myocardial infarction, primary PCI, SYNTAX scale, multi-vessel coronary pathology.

Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia.


POTENTIAL OF CORONARY ANGIOGRAPHY IN THE ASSESSMENT OF CARDIAC COMPLICATION RISK DURING NON-CARDIAC INTERVENTIONS

Sumin A. N., Bezdenezhnykh A. V., Evdokimov D. O., Ivanov S. V., Moiseenkov G. V., Barbarash O. L.

Abstract

Aim. To study the prevalence of coronary atherosclerosis in patients referred to planned non-cardiac interventions of intermediate and high risk.

Material and methods. This retrospective analysis included 397 medical histories of patients who underwent planned interventions on aorta, carotid arteries, and peripheral arteries, PA (341 men and 56 women; mean age 60,0±13,0 years). Carotid endarterectomy (CEA) was performed in 161 patients (40,6%); PA intervention in 160 (40,3%); and abdominal aortic reconstruction in 76 (19,1%). Comparisons were performed by coronary angiography (CAG) results and immediate intervention results.

Results. According to the CAG data, coronary artery (CA) stenosis ≥70% was registered in 291 patients (73,3%). Significant CA stenosis was more common in patients referred to PA reconstruction, compared to patients referred to abdominal aortic reconstruction (p=0,005). However, three-vessel stenosis was observed in 11,9% and 22,4%, respectively (p for trend 0,003). The prevalence of left CA trunk stenosis and/or three-vessel stenosis was similar across all groups. Preventive myocardial revascularisation was performed significantly more often in patients referred to aortic intervention, compared to patients referred to CEA (p=0,005). Postintervention complications (predominantly local ones) were registered in 9,6% of the patients. Neurological complications were more common after CEA. Two CEA patients (1,3%) died of periprocedural myocardial infarction. Only one high-risk patient died (0,4%). No marked between-group difference in the risk of death was observed.

Conclusion. In patients referred to non-cardiac interventions of intermediate and high risk, a hemodynamically significant stenosis of one main CA was registered in 30,5%, of two CA in 26,6%, and of three CA in 16,5%. A combination of left CA trunk stenosis and/or three-vessel stenosis was registered in 24,1%. Routine CAG provides an opportunity to select the patients with the high risk of cardiac complications during non-cardiac interventions, who might need preventive myocardial revascularisation.

Russ J Cardiol 2013; 2 (100): 38-44

Key words: non-cardiac interventions, coronary angiography, periprocedural complications.

Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia.


GALECTIN-3 AS A MARKER AND MEDIATOR OF ENDOGENOUS INFLAMMATION AND NITROSYLATION OXIDATIVE STRESS IN PATIENTS WITH CHRONIC HEART FAILURE

Shchukin Yu.B., Berezin I. I., Medvedeva E. A., Seleznev E. I., Dyachkov V. A., Slatova L. N.

Abstract

Aim. To investigate the association between plasma levels of galectin-3 and parameters of endogenous inflammation and nitrosylation oxidative stress (NOS) in patients with decompensated chronic heart failure (CHF).

Material and methods. In total, 197 CHF patients with myocardial infarction in medical history were divided into 3 groups: Group 1 (n=56) with Functional Class (FC) II CHF IIA; Group 2 (n=72) with FC III CHF IIA; and Group 3 (n=69) with FC IV CHF IIB. The control group (CG) included 39 healthy individuals. Plasma levels of galectin-3, 3-nitrotyrosine, low-density lipoprotein (LDL) oxidation, EC-SOD activity, interleukin-6, and high-sensitivity C-reactive protein (hsCRP) were measured.

Results. In Groups 1, 2, and 3, plasma levels of galectin-3 were significantly higher than in CG: by 39% (p<0,05), 164% (p<0,001), and 428% (p<0,001), respectively. The activity of NOS increased in parallel with CHF FC: by 24% (p<0,05) in Group 1, by 81% (p<0,01) in Group 2, and by 152% (p<0,001) in Group 3. There was a strong positive correlation between galectin-3 and 3-nitrotyrosin and between galectin-3 and LDL oxidation across all three groups. The activity of endogenous inflammation also increased in parallel with CHF FC. A strong positive correlation between galectin-3 and hsCRP, as well as between galectin-3 and interleukin-6, was also observed.

Conclusion. Galectin-3 levels correlate with CHF severity and are associated with the key parameters of NOS and endogenous inflammation. Therefore, galectin-3 could be regarded as a marker and mediator of these pathological processes.

Russ J Cardiol 2013; 2 (100): 45-49

Key words: chronic heart failure, galectin-3, inflammation, nitrosylation oxidative stress.

Samara State Medical Academy, Samara.


STRATEGY OF SELECTING THE SCALES OF RISK, PROGNOSIS, AND DISEASE SEVERITY IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

Arutyunov A. G.

Abstract

The assessment of the current disease severity in patients with the syndrome of acute decompensation of chronic heart failure (acute decompensated heart failure, ADHF) and the prediction of the risk of adverse events or in-hospital death remains one of the most important problems of current clinical practice. The need to consider the current disease severity while selecting the therapeutic strategy justifies the search for the most convenient and user-friendly risk scales.

Aim. To identify the optimal risk scale for the use in patients with ADHF syndrome. The paper focusses on the key risk scales which assess the severity, prognosis, and death risk in this clinical group. The emphasis is on the instruments which can be easily used in the routine clinical practice and which do not require additional examination.

Material and methods. The data on ADHF patients came from the City Clinical Hospital No. 4 Register. This epidemiological study included both retrospective analysis of the patients hospitalised earlier and the analysis of the data from currently hospitalised ADHF patients. Over 12 months, 1034 patients were included in the study: 662 retrospective cases and 372 currently hospitalised patients (54% women and 46% men; age 58–80 years). The following risk scales were used: Russian “Shocks”, US classification (“warm and dry”), Killip and Kimball (1967), Forrester and Stevenson (1977), Seattle HF Model, and EFFECT.

Results. Among the analysed risk scales, the most accurate prognosis was observed for the EFFECT scale, particularly for the estimation of the 30 and 360-day risk of death. The predicted 30-day number of deaths was 153, compared to the observed number of 148 (p=0,01). For the 360-day risk, the respective numbers were 352 and 337 (p=0,01).

Conclusion. Based on the results obtained, all examined scales can be classified into two types: Type I – for the assessment of the current disease severity (with the “warm and dry” classification as the most informative and use-friendly scale); and Type II – for the prediction of life expectancy and death risk at Day 30 and Day 360 (with EFFECT scale as the best-performing instrument).

Russ J Cardiol 2013; 2 (100): 50-55

Key words: acute decompensated heart failure syndrome, risk scales, chronic heart failure decompensation.

N. I. Pirogov Russian National Medical Research University, Moscow.


CLINIC AND PHARMACOTHERAPY

RELIABILITY AND SAFETY OF LONG-TERM DABIGATRAN USE IN PATIENTS WITH ATRIAL FIBRILLATION

Serdechnaya E. V.1, Yurieva S. V.1, Tatarskyi B. A.2

The paper presents the data on effectiveness and safety of long-term dabigatran use for the prevention of thromboembolic complications in patients with atrial fibrillation (AF). The criteria for selecting an optimal dose of dabigatran are discussed. The authors summarise the results of the current international and Russian clinical guidelines on dabigatran use in AF patients.

Russ J Cardiol 2013; 2 (100): 56-60

Key words: atrial fibrillation, thromboembolic complications, stroke, haemorrhage, oral anticoagulants, dabigatran.

1Northern State Medical University, Arkhangelsk; 2V.A. Almazov Federal Centre of Heart, Blood, and Endocrinology, St. Petersburg, Russia.


SYMPATHETIC ACTIVITY AND ARTERIAL HYPERTENSION: POTENTIAL FOR CORRECTION

Shayduk O. Yu., Taratukhin E. O.

The paper is focussed on the role of increased sympathetic activation in the pathogenesis of arterial hypertension (AH), its exacerbations (hypertensive crises), and complications. One of the effective methods of interrupting pathogenetic “vicious circles” in AH is the blockage of peripheral alpha-adrenoreceptors. One of the medications of choice for urgent treatment of hypertensive crises, as well as for long-term ambulatory treatment, is urapidil – a peripheral sympatholytic with characteristics of a central serotonin receptor agonist.

Russ J Cardiol 2013; 2 (100): 61-64

Key words: catecholamines, urapidil, adrenoreceptors, sleep apnoea.

Hospital Therapy Department No. 1, Therapy Faculty, N. I. Pirogov National Medical Research University, Moscow, Russia.


CHALLENGES IN HYPOTENSIVE THERAPY: THE ROLE OF CALCIUM ANTAGONISTS

Taratukhin E. O., Teplova N. V.

The paper addresses the role of calcium channel blockers (CCB) in the treatment of patients with arterial hypertension and concomitant pathology. The authors present the findings of the recent studies on CCB effects on renal function, bronchial function, and systemic inflammation. This additional information on comorbidities is essential for the doctors’ choice of optimal individualized therapy.

Russ J Cardiol 2013; 2 (100): 65-68

Key words: calcium channel blockers, inflammation, COPD, nephropathy, lercanidipine.

Hospital Therapy Department No. 1, Therapy Faculty, N. I. Pirogov National Medical Research University, Moscow, Russia.


ASPIRIN EFFECTIVENESS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND CORONARY HEART DISEASE WHO RECEIVE NON-STEROIDAL ANTI-INFLAMMATORY DRUGS

Kropotina T. V.1, Morova N. A.2

Abstract

Aim. To study coagulation and vascular-platelet haemostasis in patients with rheumatoid arthritis (RA) and coronary heart disease (CHD), who receive various non-steroidal anti-inflammatory drugs (NSAID) in combination with low doses of aspirin.

Material and methods. The study included 79 patients (59 women and 20 men; mean age 61,0 years; mean disease duration 8,5 years) with confirmed RA diagnosis. All participants received disease-modifying anti-inflammatory therapy and NSAID, as well as standard pharmacological CHD therapy. The parameters of coagulation and vascular-platelet haemostasis were compared by the type of administered NSAID (diclofenac, tenoxicam, nimesulide, or meloxicam). In total, 40 patients with increased platelet aggregation but no previous antiaggregant therapy were administered aspirin (100 mg/day). Platelet aggregation was re-assessed at Day 7–8 of aspirin therapy. The control group included 25 untreated healthy men (mean age 55 years).

Results. Activated coagulation haemostasis was observed in 58,2% of patients with RA and CHD, as manifested in increased levels of fibrinogen, soluble fibrin monomer complexes (SFMC), factor XII-dependent fibrinolysis, and von Willebrand factor, compared to controls. The therapy with most NSAID was linked to similar changes in coagulation haemostasis. The patients receiving diclofenac, nimesulide, and meloxicam demonstrated an activation of vascular-platelet haemostasis, as manifested in a significant increase of spontaneous platelet aggregation and ADP-induced platelet aggregation, compared to controls. Among patients receiving tenoxicam, there was a tendency towards a reduction in ADP-induced platelet aggregation (aspirin-like effect). Among patients already receiving diclofenac, nimesulide, or meloxicam, aspirin administration typically resulted in reduced platelet aggregation. In total, 42,4% of the patients did not respond to aspirin therapy.

Conclusion. Patients with RA and CHD who receive NSAID are also in need of antiaggregant therapy. The latter should be administered under control of vascularplatelet haemostasis, as in a substantial proportion of these patients (42,4%), aspirin effectiveness is not adequate.

Russ J Cardiol 2013; 2 (100): 69-74

Key words: rheumatoid arthritis, CHD, NSAID, platelet aggregation.

1Omsk Region Clinical Hospital; 2Omsk State Medical Academy, Omsk, Russia.


CLINICAL CASE OF LONG-TERM TREATMENT OF OSLER-WEBER-RENDU DISEASE IN A 83-YEAR-OLD PATIENT

Arutyunov G. P., Bylova N. A., Lapochkina S. E.

Russ J Cardiol 2013; 2 (100): 78-79

N.I. Pirogov State National Medical University, Moscow, Russia.


ACUTE CEREBROVASCULAR ACCIDENT IN A PATIENT WITH BRACHIOCEPHALIC VESSEL ABNORMALITIES AND TYPE III (HYPERMOBILITY) EHLERS-DANLOS SYNDROME

Viktorova I. A.1, Kiseleva D. S.1, Sokolova V. A.2, Konshu N. V.1

Russ J Cardiol 2013; 2 (100): 80-82

1Omsk State Medical Academy; 2Western Siberian Medical Centre, Federal Medico-Biological Agency. Omsk, Russia.


LITERATURE REVIEWS

VASCULAR PATHOLOGY IN HEREDITARY CONNECTIVE TISSUE DISORDERS

Perekalskaya M. A.1, Volkova I. I.2, Ostanina Yu. O.1, Luksha E. B.3

The large group of hereditary connective tissue disorders includes several hundreds of genetically heterogeneous diseases with systemic connective tissue pathology. The clinical manifestations of the latter are determined by mutation types. Some syndromes are well-known and extensively described (such as Marfan syndrome and Ehlers-Danlos syndrome), while the others have been described only recently and are less known. The clinical presentation of these syndromes typically includes vascular pathology, particularly aortic and arterial disorders, which are the focus of the present review.

Russ J Cardiol 2013; 2 (100): 83-88

Key words: connective tissue, hereditary disorders, vascular pathology.

1Novosibirsk State Medical University; 2Academician E. N. Meshalkin Research Institute of Circulation Pathology; 3State Novosibirsk Region Clinical and Diagnostic Centre, Novosibirsk, Russia.


CLINICAL DIAGNOSTICS OF FIBRILLINOPATHIES (TYPE 1)

Trisvetova E. L.

Diagnostic criteria are presented for the syndromes related to mutations of fibrillin gene type 1 (such as Marfan syndrome, ectopia lentis, MASS phenotype, mitral valve prolapse syndrome, stiff skin syndrome, Shprintzen-Goldberg syndrome) and for the acromelic group of dysplasias (such as geleophysic dysplasia, Weill-Marchesani syndrome, and acromicria).

Russ J Cardiol 2013; 2 (100): 89-93

Key words: fibrillinopathies, Marfan syndrome, diagnostic criteria.

Belorussia State Medical University, Minsk, Belorussia.


DIFFICULT CHOICE: ANGIOTENSIN RECEPTOR ANTAGONISTS

Taratukhin E. O.

The paper is focussed on the therapeutic choice of angiotensin receptor antagonists (ARA). The author presents the data on the comparison between different sartans and their benefits which are not explained by the blood pressure reduction. The findings from large multi-centre studies (EUTOPIA, DOHSAM, and OLIVUS-Ex) are also discussed. The evidence presented justifies specific ARA choices, despite the fact that at a first glance, this medication class appears homogeneous.

Russ J Cardiol 2013; 2 (100): 94-97

Key words: atherosclerosis, inflammation, nephroprotection, diabetes mellitus, olmesartan, coronary flow reserve.

Hospital Therapy Department No. 1, Therapy Faculty, N. I. Pirogov National Medical Research University, Moscow, Russia.


CLINICAL IMPLICATIONS OF OSTEOPOROSIS IN CHRONIC HEART FAILURE

Larina V. N.1, Bart B. Ya.1, Raspopova T. N.2

The paper focusses on the problem of impaired bone metabolism in patients with chronic heart failure. The authors discuss the importance of this problem, prevalence of osteoporosis, pathophysiological mechanisms of bone metabolism impairment, and common risk factors of heart failure and osteoporosis. The therapeutic strategy in patients with heart failure and osteoporosis is described.

Russ J Cardiol 2013; 2 (100): 98-104

Key words: chronic heart failure, osteoporosis, risk factors.

1N.I. Pirogov Russian National Medical Research University, Moscow; 2Diagnostic and Clinical Centre No. 1, Moscow City Healthcare Department, Moscow, Russia.


COMBINATION OF CORONARY HEART DISEASE, CHRONIC HEART FAILURE, AND ANAEMIC SYNDROME: CLINICAL FEATURES AND PROGNOSTIC IMPACT OF ANAEMIA TREATMENT

Kalyuta T. Yu., Shvarts Yu.G., Sokolov I. M.

Practitioners are often faced with a combination of coronary heart disease (CHD), chronic heart failure (CHF), and anaemic syndrome. These patients are typically characterised by a worse prognosis of acute and chronic CHD, as well as by a rapid progression of CHF and chronic renal failure (CKF). This review is focussed on the epidemiology of anaemia in CHD and CHF patients; the aetiology and pathogenesis of anaemia in CHD and CHF; and the changes of cardiovascular parameters in patients with anaemic syndrome. Despite the abundance of studies on CHD and CHF clinical course and prognosis in anaemic syndrome, very little is known about the effects of anaemia treatment on the clinical course and prognosis of CHD. The review presents the external evidence and original results on the prognosis of acute and chronic CHD in anaemic patients. A modern view on anaemia treatment in various CHD forms is also presented.

Russ J Cardiol 2013; 2 (100): 105-111

Key words: coronary heart disease, heart failure, anaemic syndrome, haemoglobin.

V. I. Razumovskyi Saratov State Medical University, Saratov.


INFORMATION

The First World Educational Forum "Russian Heart Days". Post-release
Russ J Cardiol 2013; 2 (100): 112

 Информация для профессионалов здравоохранения ! Соглашение об использовании 
medi.ru »» Подробно о лекарствах »» Кадиология »» Российский кардиологический журнал