CLINICAL MEDICINE NEWS
Clinical medicine updates: a review of international news
Russ J Cardiol 2013, 6 (104): 5
GLYCOPROTEIN INTEGRIN ALPHA POLYMORPHISM AND ACUTE CEREBROVASCULAR EVENTS IN THE FAMILIES OF PATIENTS WITH ATRIAL FIBRILLATION
Aksyutina N. V.1, Nikulina S. Yu.1, Shulman V. A.1, Nazarov B. V.1, Maksimov B. V.2, Bezruk A.P.1, Balog A.I.3, Poplavskaya E. E.1, Bespalov A. V.1, Kotlovskyi M. Yu.1, Chernova A. A.1
Aim. To assess the associations between the polymorphism of the glycoprotein integrin alpha (Iα) gene and acute cerebrovascular events (ACerVE) in the families of patients with atrial fibrillation (AF).
Material and methods. In total, 43 probands with chronic AF and ACerVE in medical history (25 women and 18 men) and their 54 first, second, and third-degree relatives (37 women and 17 men) were examined. The control group included 188 people free from cardiovascular disease (96 women and 92 men). All participants underwent standard medical examination, lectrocardiography (ECG), echocardiography, and genetic analysis. In addition, the relatives of probands underwent 24-hour Holter ECG monitoring and physical stress test, in order to detect paroxysmal cardiac arrhythmias.
Results. CC genotype of the glycoprotein Iα 807С>Т polymorphism was significantly less prevalent in patients with AF and ACerVE, compared to the control group (23,3% vs. 43,1%; р=0,026; odds ratio (OR) 0,40; 95 confidence interval (CI) 0,19–0,86%). In contrast, СТ genotype of the glycoprotein Iα 807С>Т polymorphism was significantly more prevalent among participants with AF and ACerVE, compared to the controls (62,8% vs. 42,6%; р=0,026). Overall, genotypes with T allele (CT+TT) were significantly more prevalent in AF patients with ACerVE than in controls (76,8% vs. 57,0%; р=0,026; OR 0,40; 95% CI 0,19–0,86%). In three relatives of probands, AF was detected, and two relatives had ACerVE in their medical history. Among the relatives with AF and ACerVE, CT genotype of the glycoprotein Iα 807С>Т polymorphism was also registered.
Conclusion. This study has demonstrated that CT genotype of the glycoprotein Iα 807С>Т polymorphism is associated with ACerVE in the families of AF patients. Individuals with TT genotype of the glycoprotein Iα 807С>Т polymorphism might benefit from the administration of acetylsalicylic acid, while in people with CC and CT genotypes, anticoagulants might be more effective.
Russ J Cardiol 2013, 4 (102): 6-10
Key words: glycoprotein Iα gene, acute cerebrovascular event, atrial fibrillation.
1Prof. V. F. Voyno-Yasenetskyi Krasnoyarsk State Medical University, Krasnoyarsk; 2Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk; 3I. S. Berzon City Clinical Hospital No. 20, Krasnoyarsk, Russia.
PREVENTIVE MYOCARDIAL REVASCULARISATION BEFORE ABDOMINAL AORTIC INTERVENTIONS: LONG-TERM RESULTS
Sumin A. N.1, Korok E. V.1, Panfilov S. D.2, Evdokimov D. O.1, Raikh O. I.1, Kislov E. E.2, Ivanov S. V.1, Barbarash L. S.1
Aim. To assess the effects of preventive myocardial revascularisation on the longterm results of abdominal aortic interventions.
Material and methods. The retrospective analysis of the data from patients examined before planned abdominal aortic interventions was performed. Group I included 86 patients (mean age 59,4±7,7 years) who were operated at the Kemerovo Cardiology Centre clinic. Group II included 32 patients (mean age 53,5±6,2 years) who were operated at the Novokuznetsk City Clinical Hospital No. 29. Before abdominal aortic interventions, the majority of Group I patients underwent coronary angiography (CAG) and, if indicated, preventive myocardial revascularisation. The long-term results were assessed 4–6 years later.
Results. In Group I, CAG was performed in 77 (89%) patients, and preventive myocardial revascularisation was performed in 23 (27%) patients. Among Group I patients, fatality was 1,2% (n=1) in the long-term post-intervention period, with the level of total mortality of 3,5%. In Group II patients, the respective figures were 31,2% (n=10) and 34,4% (p<0,001). In univariate analyses, the main predictor of total morality was the absence of preventive myocardial revascularisation (odds ratio, OR, 14,49; 95% confidence interval (CI) 3,65–57,49; p<0,001). Clinical manifestations of angina (p=0,063) and myocardial infarction in medical history (p=0,105) failed to demonstrate statistical significance as mortality predictors. The factors associated with a reduction in the risk of fatal outcomes were β-blocker therapy (OR 0,06; 95% CI 0,01–0,31; p<0,001) and ACE inhibitor therapy (OR 0,35; 95% CI 0,11–1,10; p=0,070).
Conclusion. Preventive myocardial revascularisation significantly improved the longterm survival after abdominal aortic interventions. In logistic regression analyses, the absence of preventive myocardial revascularisation was associated with reduced long-term survival after abdominal aortic interventions, while β-blocker therapy was linked to improved long-term survival.
Russ J Cardiol 2013, 6 (104): 11-16
Key words: coronary angiography, abdominal aortic interventions, preventive revascularisation, survival.
1Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; 2Novokuznetsk City Clinical Hospital No. 29, Novokuznetsk, Russia.
ENDOTHELIAL DYSFUNCTION MARKERS IN PATIENTS WITH NON-ST ELEVATION ACUTE CORONARY SYNDROME AND MULTIFOCAL ATHEROSCLEROSIS
Berns S. A.1, Schmidt E. A.1, Yukhno E. S.2, Kiprina E. S.1, Barbarash O. L.1
Aim. To investigate the association between endothelial dysfunction markers and multifocal atherosclerosis in non-ST elevation acute coronary syndrome (NSTE- ACS).
Material and methods. The study included 82 patients with NSTE-ACS, who underwent coronary angiography, colour duplex ultrasound of brachiocephalic arteries (BCA) and lower extremity arteries (LEA), and a complex assessment of endothelial function during their hospitalisation. Vasodilating endothelial function was assessed by endothelium-dependent vasodilatation (EDVD) in a reactive hyperemia test. Vasoconstrictory and adhesive endothelial function was assessed by the blood levels of endothlin-1, sP-selectin, and sE-selectin in a solid-phase enzyme immunoassay. Statistical analyses were performed using the STATISTICA 6.0 software package.
Results. Isolated coronary artery (CA) atherosclerosis was registered in 46,3% of the patients, while isolated BCA atherosclerosis was observed in 9,7%, and the combination of CA and peripheral artery atherosclerosis was registered in 19,5%. No cases of isolated LEA atherosclerosis were observed. According to the visualisation results, 24,3% of the patients had no signs of atherosclerotic stenosis (>30%) in any vascular basin. The highest levels of endothelin-1 were registered in patients with isolated BCA atherosclerosis and with the combination of peripheral and CA atherosclerosis. No significant differences were observed between the groups by the blood levels of sP-selectin and sE-selectin; moreover, these levels were within the reference range. All groups demonstrated similar levels of vasodilating endothelial function.
Conclusion. In NSTE-ACS patients, vasoconstrictory endothelial function was clearly associated with the atherosclerosis parameters. At the same time, there was no link between the atherosclerosis severity and localisation and the parameters of vasodilating and adhesive endothelial function. Endothelin-1, as a vasoconstriction marker, was most informative in patients with peripheral and multifocal atherosclerosis.
Russ J Cardiol 2013, 6 (104): 17-22
Key words: non-ST elevation acute coronary syndrome, endothelial dysfunction.
1Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, 2Kemerovo Cardiology Dispanser, Kemerovo, Russia.
METABOLIC PLATELET STATUS IN PATIENTS WITH STABLE ANGINA
Grinstein I. Yu.1, Savchenko A. A.1,2, Savchenko E. A.1, Kosinova A. A.1, Grinstein Yu.I.1
Aim. To study the activity of NAD- and NADP-dependent platelet dehydrogenases in patients with various functional classes of angina.
Material and methods. The study included 91 men with Functional Class II–IV angina, aged 45–72 years. In all participants, the bioluminescent method was used to measure the activity of the following enzymes: glucose-6-phosphate dehydrogenase (G6PD), glycerol-3-phosphate dehydrogenase (GPDH), NADPmalate dehydrogenase (NADP-MDH), NAD- and NADH-dependent lactate dehydrogenase reaction (LDH and NADH-LDH, respectively), NAD- and NADHdependent malate dehydrogenase reaction (MDH and NADH-MDH, respectively), NADP- and NADPH-dependent glutamate dehydrogenase (NADP-GDH and NADPH-GDH, respectively), NAD- and NADH-dependent glutamate dehydrogenase (NAD-GDH and NADH-GDH, respectively), NAD- and NADP-dependent isocitrate dehydrogenase (NAD-IDH and NADP-IDH, respectively), and glutathione reductase (GR).
Results. The metabolic platelet status was associated with the functional class of angina. In patients with Functional Class II angina, minimal platelet changes, linked to the inhibition of plastic processes, were observed. Patients with Functional Class III angina demonstrated an inhibition of lipid metabolism and an increase in glycolytic activity. In Functional Class IV angina, the metabolic disturbances were most pronounced and manifested in inhibited plastic processes and lipid catabolism, together with activated anaerobic reactions.
Conclusion. In stable angina patients, the changes in intracellular metabolic activity of platelets mirror the increase in the functional class of angina. Modification of platelet metabolism could be one of the methods of decreasing the receptor and, therefore, aggregation platelet activity.
Russ J Cardiol 2013, 6 (104): 23-27
Key words: angina, platelets, NAD- ad NADP-dependent dehydrogenases, intracellular metabolism.
1Professor V. F. Voino-Yasenetskyi Krasnoyarsk State Medical University; 2Research Institute of Far North Medical Problems, Siberian Branch, Russian Academy of Medical Sciences, Krasnoyarsk, Russia.
A NON-INVASIVE MARKER OF INSULIN RESISTANCE IN PATIENTS WITH OBESITY
Veselovskaya N. G.1,3, Chumakova G. A.1,2, Ott A. V.3, Gritsenko O. V.1,2
Insulin resistance (IR) and hormone activity of visceral fat are the main pathogenetic mechanisms which link obesity and cardiovascular complications. Until recently, the association between epicardial adiposity and IR has been understudied.
Aim. To investigate the association between the thickness of epicardial fat tissue (tEFT) and IR and to determine the predictive value and threshold levels of tEFT for the diagnostics of IR.
Material and methods. The study included 186 men (mean age 54,4±9,1 years) with the mean body mass index of 34,23±3,97 kg/m². IR was assessed by the levels of insulin and HOMA-IR index. The echocardiography measurement of tEFT (mm behind the free right ventricular wall) was performed in a systole, in a parasternal position on the long and short left ventricular axis.
Results. Mean tEFT levels in the IR-positive group were significantly higher (7,0 (7,0;9,0)) than in the IR-negative group (5 (4,0;6,0); p<0,001). In the logistic regression analyses, the proportion of accurate predictions was 91%, and the Somers’ D-value was 0,837. The optimal cut-off for tEFT, as a non-invasive IR marker, was ≥7 mm (sensitivity 91,5% and specificity 90,6%).
Conclusion. The tEFT parameter could be used as a non-invasive marker of IR, which might facilitate the identification of obese patients with high levels of cardiovascular risk and the early start of preventive interventions.
Russ J Cardiol 2013, 6 (104): 28-32
Key words: insulin resistance, metabolic syndrome, epicardial adiposity.
1Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; 2Altay State Medical University, Barnaul; 3Altay Region Cardiology Dispanser, Barnaul, Russia.
LUNG DIFFUSION CAPACITY AND NON-SPECIFIC INFLAMMATION MARKERS IN PATIENTS WITH CORONARY HEART DISEASE AND DIABETES MELLITUS
Bazdyrev E. D., Bayrakova Yu.V., Polikutina O. M., Bezdenezhnykh N. A., Slepynina Yu.S., Barbarash O. L.
Aim. To assess the differences in the lung diffusion capacity and non-specific inflammation markers among patients with coronary heart disease (CHD) and the combination of CHD and Type 2 diabetes mellitus (DM-2).
Material and methods. The study included 70 CHD patients: with DM-2 (n=40; 57,1%) and without DM-2 (n=30; 42,9%). Lung diffusion capacity (DIco) was assessed with the single-breath method and subsequent correction by haemoglobin levels (DIco cor). The levels of the following non-specific inflammation markers were also assessed: IL-1β, IL-12, TNF-α, IFN-γ, MMP-9, and CRP.
Results. In all participants, DIco levels were within the reference range. However, in patients with CHD and DM-2, they were significantly lower (–6,3%). Moreover, in DM-2 patients, the levels of inflammation markers, such as CRP (p=0,006), MMP-9 (p<0,001), and TNF-α (p=0,01), were significantly higher than in non-diabetic CHD patients. A reduction in DIco levels correlated with an increase in the activity of nonspecific systemic inflammation, assessed by the levels of CRP (r=–0,39; p=0,020), MMP-9 (r=–0,66; p=0,013), TNF-α (r=–0,72; p=0,02); with decompensated carbohydrate (for HbA1 and DIco cor, r=–0,32; p=0,043) and lipid metabolism (for total cholesterol and DI cor, r=–0,29; p=0,025; for low-density lipoprotein cholesterol and DIco cor, r=–0,45; p=0,003; for triglycerides and DIco cor, r=–0,43; p=0,021); and with the duration of DM-2 (r=–0,65; p=0,014).
Conclusion. In patients with CHD and DM-2, respiratory dysfunction, manifested in decreased levels of DIco cor, is associated with increased levels of inflammation markers (CRP, MMP-9, and TFN-α). The decrease in DIco cor is linked to increased activity of non-specific systemic inflammation (assessed by the levels of CRP, MMP-9, and TFN-α), decompensated carbohydrate and lipid metabolism, and a longer duration of DM-2.
Russ J Cardiol 2013, 6 (104): 33-38
Key words: lung diffusion capacity, diabetes mellitus, coronary heart disease.
Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia.
THYROID STATUS COMPENSATION AND CARDIOVASCULAR PARAMETERS IN PATIENTS WITH PRIMARY HYPOTHYREOSIS
Mazur E. S., Kileynikov D. V., Mazur V. V., Semenychev D. G.
Aim. To investigate the effects of primary hypothyreosis (PHT) compensation on cardiac remodelling, aortic elasticity, and vasomotor endothelial function.
Material and methods. In total, 28 women with PHT were examined (age 42–78 years; median age 59,5 years). All patients underwent echocardiography and the assessment of aortic elasticity and vasomotor endothelial function using the method by Cleremajer et al. (1992). The examination took place twice, during the PHT decompensation and its compensation due to the treatment with levothyroxine sodium (on average, 3 months after the beginning of the therapy).
Results. The PHT compensation was associated with a reduction in the levels of thyrotrophic hormone from 18,8 (95% confidence interval 10,7–27,0) to 2,6 (2,1–3,1) mIU/l (p<0,001) and an elevation in the levels of free thyroxin from 10,8 (9,2–12,44) to 13,7 (12,7–14,7) pmol/l (p<0,005). Left ventricular myocardial mass decreased from 192,4 (182,0–202,8) to 171,4 (160,9–181,9) g. The proportion of patients with left ventricular diastolic dysfunction decreased from 92,9 (77,4–98,0) to 71,4 (54,7–88,2)% (p<0,05), while the proportion of patients with right ventricular diastolic dysfunction decreased from 82,1 (64,4–92,1) to 25,0 (9,0–41,0)% (p<0,001). Aortic wall thickness reduced from 5,26 (4,90–5,62) to 4,53 (4,28–4,78) mm, aortic elasticity index increased from 2,26 (1,60–2,92) to 5,26 (4,36–6,15) mm 2/mm Hg, and pulse wave velocity decreased from 12,8 (11,4–14,3) to 8,42 (6,59–10,3) m/s. Relative increase in brachial artery diameter in the reactive hyperemia test, as a marker of vasomotor endothelial function, changed from 2,91 (1,69–4,14) to 9,13 (7,84–10,4)% (all p-values <0,001).
Conclusion. PHT compensation is associated with reduced left ventricular myocardial mass, improved left and right ventricular function, increased aortic elasticity, and improved vasomotor endothelial function.
Russ J Cardiol 2013, 6 (104): 39-42
Key words: primary hypothyreosis, cardiac remodelling, aortic elasticity, endothelial dysfunction.
Tver State Medical Academy, Tver, Russia.
АSSOCIATION BETWEEN OXIDATIVE-ANTIOXIDANT MODIFICATIONS OF LOW-DENSITY LIPOPROTEINS AND CORONARY HEART DISEASE IN A MALE POPULATION OF NOVOSIBIRSK
Ragino Yu.I., Krivchun A. S., Polonskaya Ya.V., Sherbakova L. V., Sadovskyi E. V., Voevoda M. I.
Aim. To investigate the association between potentially atherogenic oxidativeantioxidant modifications of low-density lipoproteins (LDL) and coronary heart disease (CHD) in a male population.
Material and methods. A population-based survey included 1024 male residents of Novosibirsk City, aged 47–73 years. The participants underwent a questionnaire survey, a standard cardiologic survey, anthropometry, blood pressure measurement, and electrocardiography. “Definite CHD” (Functional Class II–IV stable effort angina) was registered in 223 men (21,8%), according to validated epidemiologic, clinical, and functional criteria. Blood biochemistry analyses focused on the levels of total cholesterol (TCH), triglycerides (TG), high-density lipoprotein cholesterol (HDL–CH), high-sensitivity C-reactive protein (hsCRP), glucose, baseline levels of lipid peroxidation (LPO) products and fat-soluble antioxidants (alpha-tocopherol, retinol, beta-carotene, and xanthines) in LDL, LDL oxidation resistance in vitro, and an concentration of autoantibodies to oxidised LDL (oxLDL).
Results. There were positive correlations and independent associations between the oxidative LDL modifications, in particular between reduced LDL oxidation resistance and CHD. On the other hand, there were negative correlations between the antioxidant LDL modifications (such as reduced alpha-tocopherol levels in LDL) and CHD. The prevalence of CHD was higher in participants with baseline levels of LPO products in LDL >0,8 nM MDA/mg LDL protein and with reduced LDL oxidation resistance (baseline levels >5,4 nM MDA/mg LDL protein vs. levels >13,2 nM MDA/mg LDL protein at later stages of LDL oxidation). However, the prevalence of CHD was lower in individuals with LDL levels of alpha-tocopherol >1,06 mg/mg LDL protein.
Conclusion. These findings agree with the previously obtained data on the key role of oxidative LDL modifications in the pathogenesis of atherosclerosis and CHD.
Russ J Cardiol 2013, 6 (104): 43-47
Key words: population study, coronary heart disease, low-density lipoproteins, oxidation resistance, antioxidants.
Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia.
FIVE-YEAR DYNAMICS OF CIRCADIAN BLOOD PRESSURE PROFILE IN FAR NORTH WORKERS WITH ARTERIAL HYPERTENSION
Zapesochnaya I. L., Avtandilov A. G.
Aim. In a prospective study, to assess the dynamics of circadian profiles of blood pressure (BP) in Far North workers with arterial hypertension (AH) and different shift working patterns.
Material and methods. In the first phase of the study (2003–2005), 95 patients with Stage 1–2 AH were examined. Group I included 53 patients who worked only day shifts; Group II included 42 patients who worked alternating day and night shifts. In the second phase (2007–2011), both groups were examined, including 24-hour BP monitoring, and two subgoups (treated vs. untreated AH) were defined.
Results. In Far North workers with AH, there was a negative dynamics in circadian BP profile, particularly among night shift workers. AH patients require antihypertensive combination therapy irrespective of their shift working patterns.
Russ J Cardiol 2013, 6 (104): 48-53
Key words: arterial hypertension, Far North, night shifts, circadian blood pressure profile.
Russian Medical Academy of Post-diploma Education, Moscow, Russia.
CLINIC AND PHARMACOTHERAPY
TRIMETAZIDINE MB ROLE IN THE OPTIMISATION OF THE ACUTE CORONARY SYNDROME TREATMENT: EFFECTS ON ENDOTHELIAL DYSFUNCTION AND SYSTEMIC INFLAMMATION
Davydov S. I., Titova V. V., Gordeeva M. A., Tarasov A. A., Babaeva A. R.
Aim. To study the effects of trimetazidine MB therapy on the clinical manifestations and markers of endothelial dysfunction and systemic inflammation in patients with acute coronary syndrome (ACS).
Material and methods. This open, comparative, randomised parallel-group study included 60 patients with a verified ACS diagnosis (34 men and 26 women, aged 40–84 years). All participants were randomised into two treatment groups: the main group receiving trimetazidine MB (Preductal MB) 35 mg twice a day, and the control group receiving standard therapy but not trimetazidine MB. The examination included electrocardiography (ECG), echocardiography, 24-hour ECG monitoring, and chest X-ray.
Results. After 3 months of the treatment, the main group demonstrated a significant reduction in the incidence and duration of anginal attacks (–58% and –42%, respectively), as well as in the weekly nitrate intake (–66%). There was a nonsignificant (possibly, due a relatively small sample size) tendency towards a reduction in the severity of anginal attacks (–36%). The control group demonstrated a less prominent dynamics of clinical parameters: the incidence of anginal attacks decreased by 21%, the weekly nitrate intake by 20%, and the duration and severity of anginal attacks only by 6%.
Conclusion. The combination of trimetazidine MB with the standard ACS therapy improves the treatment effectiveness, in terms of the anginal syndrome manifestations and endothelial function stabilisation, as suggested by a significant reduction in von Willebrand factor and endothelin levels, compared to the control group.
Russ J Cardiol 2013, 6 (104): 54-61
Key words: endothelial dysfunction, systemic inflammation, coronary heart disease, angina, anginal attack, trimetazidine MB (Preductal MB).
Volgograd State Medical University, Volgograd, Russia.
ANTIISCHEMIC AND ANTIARRHYTHMIC EFFECTS OF SIMVASTATIN IN PATIENTS WITH DIASTOLIC HEART FAILURE
Pinchuk T. V.1, Fedulaev Yu.N.1, Khayretdinova G. A.2
Aim. To assess the dynamics of antiischemic and antiarrhythmic effects of the 6-month simvastatin therapy (20 mg/d) in patients with ischemic chronic heart failure (CHF), arterial hypertension, and preserved left ventricular (LV) ejection fraction.
Material and methods. The study included 125 patients with diastolic dysfunction (impaired relaxation and pseudonormalisation): 66 patients receiving standard CHF treatment and simvastatin (the main group), plus 59 patients receiving only standard CHF treatment (the control group). Within the main group, antiischemic and antiarrhythmic effects of simvastatin were compared by the type of diastolic LV dysfunction. At baseline and after 6 months of the treatment, all participants underwent 24-hour electrocardiography monitoring.
Results. According to the analyses of qualitative and quantitative parameters of transient myocardial ischemia, the main group demonstrated a reduction in the ischemia duration (–32,7%; p<0,001), the ST segment displacement area (–35,7%; p<0,001), and the number of ischemic episodes (–30,3%; p<0,001). Within the main group, a significant dynamics of these parameters was observed only among patients with impaired relaxation (–44,5%, —43,9%, and –36,2%, respectively; p<0,001). QTDc significantly decreased in the main group (–17,9%; p<0,05), with a non-significant tendency towards reduction in the control group (–13,3%; p>0,05). In patients with Type I and Type II diastolic heart failure (DHF), the QTDc reduction was similar (p<0,05). The number of supraventricular and ventricular extrasystoles significantly decreased in the main group (–24,5% and –27,9%, respectively; p<0,05), exclusively among patients with Type I DHF, in contrast to the control group. Pathologic values of heart rate turbulence (HRT) were observed in one-third of the patients from both groups. The simvastatin therapy was associated with a significant decrease (–20%) in the number of patients with pathologic HRT values, irrespectively of the DHF type. The TWA index significantly decreased only in the main group (–25,9%; p<0.05), with no marked difference by the DHF type. In the main group, parasympathetic parameters of heart rate variability significantly increased, while in the control group, these parameters significantly decreased.
Conclusion. Simvastatin therapy was associated with a significant improvement of the key qualitative and quantitative parameters of transient myocardial ischemia, as well as with a marked antiarrhythmic effect.
Russ J Cardiol 2013, 6 (104): 62-67
Key words: diastolic left ventricular dysfunction, simvastatin, chronic heart failure, myocardial ischemia, antiarrhythmic effect.
1N.I. Pirogov Russian National Medical Research University, Moscow; 2Center for Innovative Technologies in Sports and National Team Training, Moscow, Russia.
SALT CONSUMPTION. КIDNEYS AS THE TARGET ORGAN. РART IV
Poteshkina N. G.
The paper is focused in the salt consumption effects on renal system during the development and progression of arterial hypertension. The factors facilitating the transformation of normal hemodynamic profile into the hypertensive one are discussed. The author presents the results of experimental and clinical studies which confirm negative effects of excessive salt consumption on the morphology and function of kidneys as the key organ regulating blood pressure levels. These effects are due to both hemodynamic and non-hemodynamic mechanisms of the salt sensitivity phenomenon. The evidence of the low-salt diet effectiveness in the prevention of kidney pathology, as the target organ damage in arterial hypertension, is presented.
Key words: arterial hypertension, salt consumption, renal system, target organ.
Russ J Cardiol 2013, 5 (103): 68-75
N. I. Pirogov Russian National Medical Research University, Moscow, Russia.
PROBLEMS IN PHARMACOTHERAPY OF RESISTANT ARTERIAL HYPERTENSION
Teplova N.V., Taratukhin E.O.
The paper focuses on the problems in the treatment of patients with resistant arterial hypertension. The relevant recommendations from the European guidelines are presented. Angiotensin receptor antagonists are considered as a group of antihypertensive agents with additional benefits and good tolerability. The evidence on antihypertensive combination therapy is also presented.
Russ J Cardiol 2013, 6 (104):76-79
Key words: resistant arterial hypertension, combination therapy, diuretics, calcium antagonists, olmesartan.
Hospital Therapy Department No. 1, Therapy Faculty, N.I. Pirogov Russian National Medical Research University, Moscow, Russia.
VIKTOR A. LUSOV: DOCTOR, SCIENTIST, LEADER, AND TEACHER
Gordeev I. G., Shaidyuk O. Yu., Luchinkina E. E., Taratukhin E. O.
The paper is focused on the importance of Viktor A. Lusov, as well as the department he had been heading for many years, for the Russian cardiology. The biographical information and the data on Professor Lusov’s students and colleagues are presented. The authors emphasise the important role of the clinical school maintained by Viktor A. Lusov — a talented doctor, scientist, leader, and teacher.
Based on the materials of the History Session, the Russian National Cardiology Congress
Russ J Cardiol 2013, 6 (104): 80-84
Key words: cardiology, thrombolysis, myocardial infarction, department, hospital therapy.
Hospital Therapy Department No. 1, Internal Medicine Faculty, N. I. Pirogov Russian National Medical Research University, Moscow, Russia.
ATHEROSCLEROSIS 2013: CONTROVERSIAL ASPECTS OF LIPID-LOWERING THERAPY IN THE CARDIOLOGIC PRACTICE
Russ J Cardiol 2013, 6 (104): 85-90
Sergey S. Yakushin
Russ J Cardiol 2013, 6 (104): 91
Vladimir L. Gabinskiy
Russ J Cardiol 2013, 6 (104): 91
Russian Journal of Cardiology: contents for 2013
Russ J Cardiol 2013, 6 (104): 92-96