CONFLICT OF INTEREST POLICIES AND DISCLOSURE REQUIREMENTS AMONG EUROPEAN SOCIETY OF CARDIOLOGY NATIONAL CARDIOVASCULAR JOURNALS

Alfonso F., Timmis A., Pinto F. J., Ambrosio G., Ector H., Kulakowski P., Vardas P., on behalf of the Editors’Network European Society of Cardiology Task Force

Abstract

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.

Key Words: Conflict of interest. Disclosure. Editorial ethics. Journals.

 

CLINICAL AND ULTRASOUND PREDICTORS OF HEART FAILURE DEVELOPMENT IN PATIENTS WITH SUBACUTE MYOCARDIAL INFARCTION

Serdyukov D.Yu.¹, Gordienko A.V.¹, Nikiforov V.S.¹, Gulyaev N.I.¹, Rezvantsev M.V.¹, Starienko E.A.²
S.M. Kirov Military Medical Academy¹, St. Petersburg; City Clinical Hospital No. 20², St. Petersburg, Russia.

Abstract

Aim. To identify major clinical and ultrasound predictors of heart failure development in patients with subacute myocardial infarction (MI).
Material and methods. In total, 135 patients with acute and subacute MI were examined. The assessment of pre-existing cardiovascular risk factors and MI clinical course was combined with ultrasound examination of the heart and hepatic vessels.
Results. Chronic heart failure was associated with selected parameters of systolic and diastolic cardiac function, as well as central and hepatic hemodynamics.
Conclusion. In patients with subacute MI, the predictors of congestive heart failure included acute left ventricular failure, pulmonary hypertension, and hepatic venous congestion.

Key words: Myocardial infarction, acute heart failure, hepatic blood flow, chronic heart failure.

 

OBSTRUCTIVE SLEEP APNOEA SYNDROME AND CLINICAL STATUS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND PREEXISTING STABLE ANGINA

Ivanov A. P.^1,2, Klyukvin D. V.³, Rostorotskaya V. V.^1,2, Elgardt I. A.²
Tver Medical Academy¹, Tver; Tver Clinical Cardiology Dispanser², Tver; City Hospital No. 3, Zelenograd³, Russia.

Abstract

Aim. To investigate the effects of obstructive sleep apnoea (OSA) on clinical and functional status of patients with acute myocardial infarction (AMI); to assess the association between pre-existing stable angina and AMI clinical course in the first 3 months.
Material and methods. The study included 68 AMI patients; in 38 participants, OSA was diagnosed based on the electrocardiography and breathing monitoring results. All patients underwent echocardiography and veloergometry.
Results. In OSA patients, AMI risk was higher among young individuals with preexisting diabetes mellitus and arterial hypertension. OSA severity was maximal during the acute phase of AMI. Clinical course of AMI in OSA patients was characterised by disturbed cardiac hemodynamics and progressing myocardial ischemia; during the follow-up period, significant improvement was observed only for the latter. Preexisting stable angina partly counterbalanced negative effects of OSA, being linked to a 1,9-fold reduction in the number of ischemic episodes, and a 2,2-fold decrease in total ischemia duration over 24 hours.
Conclusion. The results obtained should be taken into consideration while treating AMI and preventing its complications.

Key words: Obstructive sleep apnoea, myocardial infarction, pre-existing angina.

 

CARDIO-ANKLE VASCULAR INDEX IN PATIENTS WITH CORONARY HEART DISEASE: ASSOCIATION WITH THE SEVERITY OF CORONARY AND PERIPHERAL ARTERY ATHEROSCLEROSIS

Sumin A. N., Karpovich A. V., Barbarash O. L.
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia.

Abstract

Aim: To investigate the impact of peripheral artery atherosclerosis on the association between cardio-ankle vascular index (CAVI) and coronary atherosclerosis severity in patients with coronary heart disease (CHD).
Material and methods. The study included 182 patients (161 men and 21 women; mean age 58,5±7,5 years), examined before the planned intervention on coronary arteries (CA). Based on the values of ankle-brachial index (ABI), all patients were divided into 5 groups: Group I (n=30) with ABI <0,9; Group II (n=28) with ABI 0,9-0,99; Group III (n=64) with ABI 1,0-1,09; Group IV (n=51) with ABI 1,1-1,3; and Group V (n=9) with ABI >1,3. CAVI was assessed by volume sphygmography method (VaSera VS-1000, Fukuda Denshi, Japan). Coronary angiography was performed with the use of Coroscop and Innova-3100 equipment.
Results. In 31,3% of CHD patients, CAVI values exceeded 9,0, which reflected increased arterial stiffness. ABI values below 0,9, as a marker of peripheral artery atherosclerosis, were observed in 16,5%. In Groups I and II, compared to Groups III, IV, and V, mean CAVI values were non-significantly (p=0,1) lower: 7,7±1,95 and 7,9±1,35 vs. 8,3±1,6, 8,2±1,85, and 8,2±2,1, respectively. The percentage of patients with CAVI >9,0 was higher in Group I than in the other groups (10% vs. 29,4-4,4%; p=0,08). Coronary angiography results were similar in subjects with CAVI values <9,0 vs. >9,0. ABI values were not clearly related to the presence of hemodynamically significant stenosis of two CA, three CA, or left CA trunk.
Conclusion. The prevalence of hemodynamically significant CA stenosis was not associated with the vascular indices of interest. The presence of peripheral artery atherosclerosis influenced the link between vascular stiffness (i.e. CAVI) and the severity of CA atherosclerosis. Therefore, the assessment of clinical and prognostic value of CAVI should take into consideration the severity of peripheral atherosclerosis.

Key words: Cardio-ankle vascular index, coronary atherosclerosis.

 

BLOOD LEVELS OF FATTY ALDEHYDES IN CORONARY HEART DISEASE AND ATHEROSCLEROSIS

Osipenko A. N., Akulich N. V.
A. A. Kuleshov Mogilev State University. Mogilev, Belarus.

Abstract

Aim. To investigate the levels of fatty aldehydes and oxidised fatty acid radicals in erythrocytes and plasma lipids among patients with atherosclerosis and coronary heart disease (CHD).
Material and methods. The study included patients with diagnosed CHD and coronary artery atherosclerosis, as well as healthy volunteers (controls). The levels of fatty aldehydes and oxidised fatty acid radicals were assessed using the capillary gas-liquid chromatography method.
Results. CHD patients demonstrated elevated erythrocyte levels of fatty aldehydes and oxidised fatty radicals, as well as an increased relative content of fatty aldehydes in plasma lipids.
Conclusion. Blood acidosis could play an important role in the elevation of fatty aldehyde levels in erythrocytes among patients with atherosclerosis and myocardial ischemia.

Key words: Fatty aldehydes, fatty acids, plasmalogen phospholipids, atherosclerosis, coronary heart disease.

 

MODULATED KINESIOTHERAPY IN PATIENTS WITH COMPLICATED CORONARY HEART DISEASE

Olesin A. I.¹, Belova A. V.¹, Smolin Z. Yu.²
I.I. Mechnikov North-West State Medical University, Faculty Therapy and Hospital Therapy Department, Therapy Faculty¹; St. Elisabeth’s City Hospital², St. Petersburg, Russia.

Abstract

Aim. To study the effects of modulated kinesiotherapy (MK) on the clinical course of atrial fibrillation (AF) and chronic heart failure (CHF) in patients with coronary heart disease (CHD).
Material and methods. The study included 175 patients, aged 46-65 years, with CHD and/or essential arterial hypertension, persistent AF, and Functional Class (FC) I-II CHF. All participants underwent general clinical examination, 6-minute walk test, and assessment of quality of life (QoL), hemodynamic parameters, atrial late potentials, and P wave dispersion. After selection of anti-recurrent AF therapy, all patients were followed up for one year. After that, MK was administered to 119 individuals (68,0%), while the rest of the subjects continued anti-recurrent AF treatment.
Results. The combination of MK and anti-recurrent AF therapy was associated with improved QoL and left ventricular diastolic function, reduced CHF FC and AF recurrence rates, and decreased left atrium volume and prevalence of atrial late potentials or pathological P wave dispersion values, compared to baseline characteristics.
Conclusion. In patients with CHD, CHF, and persistent AF, the combination of MK and anti-recurrent AF therapy was linked to reduced rates of AF recurrence, as well as to improved CHF FC.

Key words: Coronary heart disease, atrial fibrillation, chronic heart failure, modulated kinesiotherapy.

 

BIOMARKERS ROLE IN THE DEVELOPMENT OF SINUS NODE DYSFUNCTION

Vasilets L. M., Tuev A. V., Khlynova O. V., Vustina V. V., Ratanova E. A.
Academician E. A. Wagner Perm State Medical Academy, Hospital Therapy Department No. 1, Perm, Russia.

Abstract

Aim. In patients with different types of sinus node dysfunction (SND), to study inflammation marker levels and assess their value as predictors of SND development.
Material and methods. The study included 83 individuals: 63 patients with SND (the main group) and 20 controls. The main group was divided into three subgroups: Subgroup 1, with vegetative SND (VSND); Subgroup 2, with Type I and II sick sinus syndrome (SSS); and Subgroup 3, with tachy-brady syndrome, or Type III SSS. In all participants, the measurement of serum levels of inflammation markers, cardiac electrophysiological testing, and long-term electrocardiography monitoring were performed. The inflammation markers of interest included tumour necrosis factor alpha (THF-α), interleukin (IL) 6, IL-4, C-reactive protein (CRP), and fibrinogen.
Results. Compared to controls, SND patients were characterised by increased levels of TNF-α and IL-6. TNF-α concentration was linked to SND type, with the highest levels observed in patients with tachy-brady syndrome. Elevated levels of inflammation markers independently predicted SND development. In particular, VSND risk was 2,5 times higher in patients with IL-6 concentration >3 pg/ml. SSS risk doubled when the levels of IL-6 increased from 2,5 pg/ml to 4 pg/ml. TNF-α levels >16 pg/ml were associated with a 1,5-fold increase in the risk of Type I-II SSS transformation into tachy-brady syndrome.
Conclusion. Increased expression of inflammation cytokines in SND patients could be directly linked to pathogenetic mechanisms of this arrhythmic syndrome.

Key words: Sinus node dysfunction, C-reactive protein, fibrinogen, tumour necrosis factor alpha, interleukin-4, interleukin-6.

 

ELECTROCARDIOGRAPHY PATTERNS OF TILT-INDUCED CARDIOINHIBITORY SYNCOPE IN CHILDREN AND ADOLESCENTS

Pogodina A. V., Dolgikh V. V., Valyavskaya O. V.
Research Centre of Family Health and Human Reproduction Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russia

Abstract

Aim. To study electrocardiographic patterns of tilt-induced cardioinhibitory (CI) reactions in children and adolescents.
Material and methods. The study included 16 children and adolescents (10 boys), aged 8-18 years, with recurrent syncope in anamnesis and CI syncope mechanisms confirmed by the tilt table test (TTT) results. Medication-free TTT was performed according to the Westminster protocol, with continuous electrocardiography; all records were processed manually. The following electrocardiogram (ECG) records (3 minutes each) were analysed: before the table tilt; in the head-up position; before the syncope; during the syncope; and during the recovery phase.
Results. In children and adolescents with CI syncope, the baseline ECG demonstrated increased parasympathetic influence on heart rate (HR) regulation. Early orthostasis was characterised by increased HR (+35,8±11,5%). During the increase in orthostatic stress and before the syncope development, HR additionally and significantly increased (p=0,001 vs. early orthostasis). Syncope development was associated with HR reduction and subsequent cardioinhibition, either acute, or after a short period of disturbed sinoatrial and/or atrioventricular conductivity. The recovery phase was characterised by a significant HR reduction, compared to the baseline (p=0,0006), and frequent vagal-associated arrhythmias.
Conclusion. ECG patterns of CI syncope in children and adolescents demonstrate increased sympathetic influences on HR regulation, followed by acute parasympathetic activation. The degree of vagal activation defines ECG patterns during syncope development and recovery phase.

Key words: Syncope, tilt-test, electrocardiogram.

 

METABOLIC SYNDROME PREVALENCE IN RUSSIAN CITIES

Rotar O. P.¹, Libis R. A.², Isaeva E. N.², Erina A. M.^1,4, Shavshin D. A.³, Moguchaya E. V.¹, Kolesova E. P.¹, Boyarinova M. A.¹, Moroshkina N. V.¹, Yakovleva O. I.¹, Solntsev V. N.¹, Konradi A. O.¹, Shlyakhto E. V.¹
V. A. Almazov Federal Centre of Heart, Blood, and Endocrinology¹, St. Petersburg; Orenburg State Medical Academy², Orenburg; Kaliningrad Region Clinical Hospital³, Kaliningrad; City Clinical Hospital of Emergency Care⁴, Kursk, Russia.

Abstract

Aim. Metabolic syndrome (MS) is a combination of the key cardiovascular risk factors, namely obesity, carbohydrate metabolism disturbances, arterial hypertension (AH), and dyslipidemia. MS prevalence varies, depending on the MS definition used. The aim of this study was to assess the prevalence of MS and its components in large Russian cities (St. Petersburg, Kursk, Orenburg, and Kaliningrad), using international MS criteria.
Material and methods. In total, 1046 individuals were screened in 4 cities: 309 in St. Petersburg, 170 in Kursk, 279 in Orenburg, and 288 in Kaliningrad. All participants underwent a questionnaire survey on demographics, risk factors, lifestyle, family history, comorbidities and treatment. Blood pressure measurement (3 measurements on the right arm) and nthropometry were also performed. Lipid profile and fasting glucose levels were measured with the use of Hitachi-902 analyser (Roche Diagnostics). MS was diagnosed based on the criteria by ATP III (2001–2005), IDF (2005), and JIS (2009).
Results. High prevalence of MS was observed regardless of the criteria used; the highest prevalence was registered for the JIS-2009 criteria. For all MS criteria, no significant difference in MS prevalence was registered across the cities, or between men and women in each city. The majority of the patients (over 80%, regardless of the criteria used) had at least one MS component, with the highest prevalence observed in Kursk (94% for IDF-2005 and JIS-2009 criteria).
Conclusion. In each region, the prevalence of MS was high, which might be related to high levels of cardiovascular morbidity and mortality in Russia. The IDF-2005 criteria agreed with the JIS-2009 ones to a greater extent than with the ATP III definition. However, prospective studies are needed to establish the national normal values of waist circumference, for reliable diagnostics of abdominal obesity in the Russian population.

Key words: Metabolic syndrome, arterial hypertension, obesity, dyslipidemia, cardiovascular disease, waist circumference.

 

ENDOCRINE ASPECTS OF AMIODARONE THERAPY IN CLINICAL PRACTICE (FOLLOW-UP AND TREATMENT ALGORITHM FOR PATIENTS WITH THYROID DYSFUNCTION).

Sviridenko N.Yu.¹, Platonova N. M.¹, Molashenko N. V.¹, Golitsyn S. P.², Bakalov S. A.², Serdyuk S. E.³
Endocrinology Research Centre, Moscow, Russia¹, A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex, Moscow, Russia², State Research Centre for Preventive Medicine³, Moscow, Russia.

Abstract

This review discusses the effects of amiodarone on thyroid function and summarises the results of international studies and the evidence obtained by the researchers from the A.L. Myasnikov Research Institute of Clinical Cardiology and Endocrinology Research Centre. The guidelines on thyroid dysfunction diagnostics and therapy, as well as the follow-up of amiodarone-treated patients, are presented.

Key words: Amiodarone, thyroid gland, thyrotoxicosis, hypothyreosis.

 

MAGNESIUM MEDICATION USE IN CARDIOLOGY PRACTICE

Mamedov M. N.
State Research Centre for Preventive Medicine. Moscow, Russia.

Abstract

This review focuses on the mechanisms of action and clinical effectiveness of Magnerot, or magnesium orotate, which is widely used in cardiac patients. Organic salt of magnesium orotate increases magnesium assimilability, improves vasodilatation and myorelaxation, and demonstrates antiarrhythmic and anti-ischemic effects. In cardiology practice, the scope of Magnerot use is relatively wide, from angina to heart failure treatment.

Key words: Magnerot, coronary heart disease, heart failure.

 

WHEN “BRUGADA HEART” STOPS BEATING

Andjelic Sladjana
Emergency Medical Service Belgrade, Serbia.

Abstract

The typical Brugada patient is young, otherwise healthy male with normal general medical and cardiovascular physical findings. A present a case of successful resuscitation following “Brugada heart” arrest, where diagnosis of type 2 Brugada syndrome was made after cardiopulmonary resuscitation (CPR).

Key words: “Brugada heart”; cardiac arrest; cardiopulmonary resuscitation

 

CARDIAC RESYNCHRONISATION THERAPY: SELECTED PATHOPHYSIOLOGICAL ASPECTS OF DYSSYNCHRONY AND HEMODYNAMIC DISTURBANCES

Kiyutina M. V.^1,3, Gordeev I. G.¹, Samoylenko I. V.², Samoylenko V. I.²
N. I. Pirogov Russian Medical University, Therapy Faculty, Hospital Therapy Department No. 1¹, Moscow; City Clinical Hospital No. 4, Cardiosurgery Department², Moscow; O. M. Filatov City Clinical Hospital No. 15³, Moscow, Russia.

Abstract

Management of chronic heart failure (CHF) remains one of the most important problems in modern cardiology. Despite the recent pharmacotherapy successes, substantial numbers of CHF patients remain resistant to pharmaceutical treatment. Over the last decade, a new CHF management method, based on cardiostimulation technologies, has become widely used. The implantation of three-chamber cardiac pacemakers provides an opportunity to perform cardiac resynchronisation therapy. This method targets dyssynchrony of myocardial excitation, as a pathogenetic component of CHF. This review describes the main components of dyssynchrony pathogenesis and pathophysiological mechanisms of its correction via biventricular stimulation.

Key words: Chronic heart failure, cardiac resynchronisation therapy, dyssynchrony.

 

METABOLIC EFFECTS OF STATINS AND CLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS

Yakovenko E. I.¹, Mamedov M. N.²
Polyclinic No. 96¹, North-West Administrative District, Moscow; State Research Centre for Preventive Medicine², Moscow, Russia.

Abstract

Thus review presents the modern concept of atherosclerosis and its main pathophysiological mechanisms, such as lipid peroxidation and inflammation. The authors describe the underlying mechanisms of the statins’ influence on clinical manifestations of atherosclerosis, which are related to lipid-lowering, pleiotropic, and metabolic effects of statins. Complex metabolic influences of statins are also discussed, including their effects on insulin resistance, glycemia, lipid profile (triglycerides and high-density lipoprotein cholesterol), uric acid, and markers of inflammation and lipid peroxidation. Finally, the impact of statin therapy on major cardiovascular risk factors, such as arterial hypertension and obesity, is debated.

Key words: Atherosclerosis, statins, metabolic effects.

 

PATHOGENETIC FACTORS OF CORONARY HEART DISEASE AND HELICOBACTER PYLORI INFECTION

Pavlov O. N.
Yaroslavl Station Clinical Hospital, Russian Railways, Yaroslavl, Russia.

Abstract

This literature review describes pathogenetic stages of chronic inflammation, as a factor associated with the development of atherosclerosis complications and coronary heart disease (CHD) progression. The author presents the evidence confirming atherogenic effects of Helicobacter pylori infection on the clinical course of CHD.

Key words: Coronary heart disease, atherosclerosis, inflammation, infection.

 

PREVENTION OF CARDIOVASCULAR COMPLICATIONS IN DIABETES MELLITUS: THE ROLE OF ASPIRIN

Strizhakov L. A.
I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Abstract

The review presents modern national and international evidence on aspirin therapy in patients with diabetes mellitus. The results of multi-centre studies which investigated aspirin effects on cardiovascular complication risk among diabetic patients are analysed. The modern guidelines on aspirin therapy in diabetes mellitus are discussed.

Key words: diabetes mellitus, aspirin, cardiovascular complications.