Vol 2, No 1 (2011)

Articles
Meditsinskiy aspekt reabilitatsii bol'nykhishemicheskoy bolezn'yu serdtsana sanatornom etape
Shestakov V.N., Zobenko I.A., Misyura O.F., Perepech N.B.
Abstract
Summary. Analysis of the drug therapy in patients with myocardial infarction at sanatorium stage of rehabilitation was performed at Health Medical Center Chernaya Rechka. Within the period from 2003 to 2009 the rate of patients treated with drugs with proven effect on prognosis increased. Frequency of statins prescription increased from 8,3 to 95%. In majority of patients target values of blood pressure and heart rate were reached. Data on postoperative complications in patients after aortocoronary bypass at sanatorium stage of cardiac rehabilitation is presented. Hydrothorax and hydropericardium were revealed in 32 and 21% of all patients respectively, breath dysfunction in 40%, hypochromic anemia in 50, heart rate disorders in 27% of patients. The positive role of complex rehabilitation in decreasing of severity of postoperative complications was confirmed.
CardioSomatics. 2011;2(1):5-8
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Ostryy koronarnyy sindrom: kompleksnyypodkhod v taktike vedeniya patsientov,rol' pervichnoy i vtorichnoy profilaktiki
Skopets I.S., Vezikova N.N., Marusenko I.M., Malygin A.N.
Abstract
Summary. The article analyzes the clinical course, tactics and long-term outcomes in patients with acute coronary syndrome treated at the Regional Vascular Center. An important aspect is not only medication and treatment tool in the acute phase, but also an adequate primary and secondary prevention, which can contribute to improving the quality of life for patients, reducing mortality, economic costs as well as clinical and social consequences of coronary heart disease.
CardioSomatics. 2011;2(1):9-12
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Effektivnost' primeneniya preparata«Magnerot®» pri proyavleniyakh sindromasosudistykh narusheniy i gemorragicheskogosindroma u bol'nykh s idiopaticheskimprolapsom mitral'nogo klapana
Akatova E.V., Nikolin O.P., Martynov A.I.
Abstract
Summary. Aim. To evaluate the efficiency of placebo-controlled magnerot use on vascular and hemorrhagic manifestations in patients with idiopathic mitral valve prolapse (MVP). Subjects and methods. Seventy-four patients (31,7% males and 68,3% women) with idiopathic MVP were examined during a single-blind placebo-controlled study. They were randomized into 2 groups: 1) magnerot (a study group) and 2) placebo (a control group). The mean age of the study group patients was 30,80,4 years. The placebo group was matched by age (mean age 31,10,2) and gender. There was a female preponderance among the examinees in both groups. The study group patients received MagnerotR tablets containing 500 mg of Mg orotate (32,8 Mg of elementary Mg) in a daily dose of 3000 mg (196,8 mg of elementary Mg) for 6 months. All the patients underwent comprehensive examination before and 6 months after the study. Results. A clinical significant reduction in the degree of vascular disorders was noted in 71,3% of the patients with MVP. The incidence of vascular disorders remained virtually unchanged in the study group. Vascular disorders were significantly alleviated after the therapy. If before the therapy, mild, moderate, and severe vascular disorders were diagnosed in 30,2, 55,9, and 13,9% of cases, respectively; whereas after the therapy these were absent in 16,3% of cases; the patients with mild vascular disorders increased by 2,5-fold and their severe form was undetected. The clinical effect of the therapy on the severity of hemorrhagic syndrome was observed in 81,4% of patients (75% males and 89,5% females) and the therapeutic efficiency that very frequently corresponded to clinical improvement was seen in 2,3%. Conclusion. The effect of magnerot therapy is shown to significantly reduce the incidence and degree of vascular disorders and hemorrhagic syndrome and their clinical picture as a whole.
CardioSomatics. 2011;2(1):13-17
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Nekotorye aspekty vosstanovitel'nogolecheniya i pervichnoy reabilitatsii deteys tserebrokardial'nym sindromom
Degtyareva E.A., Zhdanova O.I., Mikheeva A.A., Avakyan A.A.
Abstract
Summary. Efficacy and safety of early use of succinate-emitting parenteral drugs in preterm infants with I-II degree of myocard posthypoxic damage against the background of cerebral ischemia is confirmed on the basis of objective criteria. Scheduled administration of succinate-emitting cardiocytoprotectors to infants with myocard posthypoxic damage offers the possibility of rehabilitation and restoration in earlier time periods.
CardioSomatics. 2011;2(1):18-23
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Energeticheskaya sostavlyayushchaya i ob\"emnyykrovotok gemodinamiki v magistral'nykharteriyakh u bol'nykh khronicheskoy serdechnoynedostatochnost'yu pozhilogo vozrasta
Efremushkin G.G., Filippova T.V., Denisova E.A.
Abstract
Summary. Background. There is no clear understanding of the value of minute volume of blood in distinct phases of blood flow and the total of its value in some of the main arteries. Energy component of the different phases of blood flow and pulse wave (PW) in elderly patients with chronic heart failure (CHF) remains poorly understood. Purpose. To study the redistribution of the blood flow volume and its energy component in the main arteries in aged patients with CHF. Materials and methods. In total 56 (48,2%) patients with CHF of I-II degree, of which 5 (8,9%) women aged between 63 and 87 (on average 76,60,9) years were included into the study. Patients were examined with the use of doppler scanning of the common carotid (CCA), brachial (BA) and femoral (FA) arteries, in which the diameter of the arteries, volumetric blood flow rate (Q, cm3/s), minute volume of blood (cm3/min), specific kinetic energy (hV, sm2/s2) blood flow and PW were determined. Results. In alderly patients with CHF Q (cm3/s), and minute blood volume (m3/min) in the CCA, and the PA are already in CHF of I degree much higher than their values in healthy subjects and further increased in CHF of II degree in all phases of blood flow. In BA these indices remained within the values of those in healthy individuals. Total minute volume of blood in 3 pairs of studied arteries in patients with CHF of I degree increased compared with healthy in 1,5 times and in patients with CHF of II degree in 2,1 times. In CHF blood volume in the CCA in the phase of rapid was increased, but hV of blood flow is not increased. In the CCA hV PW decreased more than 2 times in comparison with healthy people. Thus, hV of blood moving through the main vessels positively associated with the minute volume of blood and hV PW with extension velocity of the latter. Therefore in the CCA as the minute blood volume increases at the same time the energy component of Q, cm3/s and PW decrease that apparently reduces the possibility of damaging effect of an increased blood volume on the brain vessels.
CardioSomatics. 2011;2(1):23-28
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Kompleksnaya terapiya pri aterogennoydislipidemii i nealkogol'noy zhirovoybolezni pecheni
Cherkashova E.A., Zvenigorodskaya L.A., Samsonova N.G., Nilova T.V., Sil'vestrova S.Y., Khomeriki S.G.
Abstract
Summary. Non-alcoholic fatty liver disease (NAFLD) is one of the major components of the metabolic syndrome. NAFLD is now recognized as one of the major cardiovascular risk factors since cholesterol synthesis takes place in the liver. In this connection, to choose hypolipidemic therapy that has well-known hepatotoxic effects is an intricate problem. Of great importance in the pathogenesis of NAFLD is the impaired colonic microflora and hence elevated levels of microbial waste products (short-chain fatty acids, endotoxin, nitric oxide), which should be also kept in mind when treating atherogenic dyslipidemia. Statin + probiotic combination therapy used in patients with NAFLD and atherogenic dyslipidemia is more effective than monotherapy in reducing the levels of cholesterol and intestinal microflora metabolism products.
CardioSomatics. 2011;2(1):29-36
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Vliyanie lipektomii peredney stenkizhivota na techenie metabolicheskogosindroma
Volokh M.A., Khalimov Y.S., Shapovalov V.M., Gubochkin N.G.
Abstract
Summary. Objective: to study the influence of surgical correction of abdominal obesity in patients with type 2 diabetes mellitus on clinical course of metabolic syndrome (MS). Design and methods: 181obesity and type 2 diabetes mellitus patients were studied. All patients were divided into two groups. First group consisted of 109 patients, who underwent lipoaspiration or abdominoplasty with subsequent medication. Second group - 72 patients suffering from abdominal obesity and type 2 diabetes mellitus, were treated conservatively without surgery. MS was diagnosed by six criteria in 90 (82,5%) first group patients and in 57 (79,1%) second group patients. 19 (17,5%) patients in the first group and 15 (20,9%) - in the second had five diagnostic MS criteria. Results. The study of patients serum lipid structure shows different results depending on the treatment technique. Anterior abdominal wall lipectomy leads to much faster and significant improvement in main lipidogram features, especially triglyceride and low-density lipoprotein concentration, which are the most important markers of MS progression. Unlike patients with obesity and type 2 diabetes mellitus treated conservatively with medication, surgically treated patients show fast and resistant improvement in cardonhydrate metabolism compensation markers, which are decrease of serum fasting glucose and glycated hemoglobin levels. Arterial hypertension stage II and III in the first group patients developed significantly less in 5 years after surgery (р<0,05), and arterial hypertension stagу I - significantly more. Conclusion. Surgical correction of abdominal obesity has improves clinical course of metabolic syndrome due to normalizing carbonhydrate and lipid metabolism. This positive influence are more evident in stage 1 or 2 obesity patients. Anterior abdominal wall lipectomy decelerates the arterial hypertension progression.
CardioSomatics. 2011;2(1):37-41
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Rol' polimorfizma gena konneksina 40v geneze nasledstvennogo sindroma slabostisinusovogo uzla
Nikulina S.Y., Chernova A.A., Shul'man V.A., Kukushkina T.S., Voevoda M.I., Maksimov V.N.
Abstract
Summary. In this study for the first time on clinical-genetic material an association of the hereditary sick sinus syndrome (SSS) with the connexin 40 gene polymorphism was found. For the first time it was revealed that the heterozygous variant of connexin 40 gene genotype was significantly more common in patients with SSS and their healthy relatives in comparison with subjects of the control group.
CardioSomatics. 2011;2(1):41-43
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Preduprezhdenie serdechno-sosudistykhoslozhneniy u patsientov s faktorami riskas pozitsii dokazatel'noy meditsiny
Bubnova M.G.
Abstract
Summary. This review embraces the modern principles of cardiovascular disease prevention (CVD) as well as two important approaches to their prevention: non-drug treatments (correction of risk factors related to lifestyle) and drug treatments. Clinical effects and indications for use of such drug groups as antiplatelet agents, lipid-lowering drugs, angiotensin-converting enzyme are marked. The article focuses on the treatment characteristics of patients with multiple coronary risk factors. The results of clinical study on the antihypertensive effectiveness of Lisinopril in patients with high-risk of hypertension and multiple risk factors are presented.
CardioSomatics. 2011;2(1):44-51
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Predoperatsionnaya terapiya statinamiu patsientov s ishemicheskoy bolezn'yu serdtsa
Barbarash O.L., Bayrakova Y.V., Kurguzova E.M.
Abstract
Summary. The need for statins in patients with acute and chronic forms of coronary heart disease is now beyond doubt. However, there is still a view that from the perspective of safety it is necessary to cancel statins before a surgery and reinstitute them after a surgery. This review examines the feasibility and safety of preoperative statin therapy in patients with ischemic heart diseases before planned coronary bypass surgery.
CardioSomatics. 2011;2(1):51-54
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Osobennosti kardioprotektivnogo deystviyazofenoprila vo vtorichnoy profilaktikeserdechno-sosudistykh zabolevaniy
Vaulin N.A.
Abstract
Summary. Zofenopril is one of the most recent ACE inhibitors; it shows a high lipophilicity. This property determines its high and rapid absorption, a considerable proportion of excretion with bile and improved tissue permeability associated with the prolonged effect of tissue ACE inhibition. This property must underlie some effects of zofenopril, which are absent in other drugs of this class. Thus, the combination of lipophilicity and antioxidant activity ensures the optimal antihypertensive efficacy along with antiatherogenic activity. These two latter properties most probably make a major contribution to a reduction in death rates after myocardial infarction, as conclusively demonstrated in a series of SMILE clinical trials. The above properties of zofenopril support once again the idea that not all ACE inhibitors are equally effective in the treatment of arterial hypertension and in secondary prevention after myocardial infarction.
CardioSomatics. 2011;2(1):55-63
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Perspektivy klinicheskogo primeneniyanovoy fiksirovannoy kombinatsii -preparata Ko-Eksforzh v lecheniiarterial'noy gipertonii
Bubnova M.G.
Abstract
Summary. This review is concerned with improving of blood pressure (BP) control in patients with arterial hypertension (AH). The reasons for the low treatment compliance and combined antihypertensive therapy benefits are analyzed. Data for futility of an extended use of antihypertensive drugs (AHD) fixed combinations are given. Studies demonstrating high efficacy and safety of a new triple fixed combination of amlodipine, valsartan and hydrochlorothiazide (HCT) are presented as well. Patients with hypertension, which should more actively use this combination of drugs, are signified.
CardioSomatics. 2011;2(1):64-71
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Astenicheskiy sindrom v kardiologicheskoypraktike
Kopylov F.Y., Nikitina Y.M., Makukh E.A.
Abstract
Summary. Asthenic syndrome often occurs in the cardiologist daily practice. Fatigue can develop not only against the background of various cardiovascular diseases, but also be a symptom of mental disorder, which should be considered in the diagnosis and treatment. Treatment of asthenic syndrome based on both the application of various non-drug approaches and the use of pharmacotherapy.
CardioSomatics. 2011;2(1):71-75
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Sushchestvuyut li perspektivy primeneniyapetlevykh diuretikov dlya lecheniyaarterial'noy gipertenzii?
Fomin V.V.
Abstract
Summary. The paper discusses the indications for use of loop diuretics to treat essential hypertension and the current limits in terms of their introduction into the practice of routine antihypertensive therapy. By using torasemide as an example, the author demonstrates prospects for using loop diuretics for the treatment of essential hypertension.
CardioSomatics. 2011;2(1):76-80
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Khronicheskoe legochnoe serdtse:klassifikatsiya, klinika, diagnostika,lechenie. Chast' I
Polyakova O.V., Arabidze G.G.
Abstract
Summary. In the first part of this review both domestic and foreign data from clinical and experimental researches relating to modern views on the definition, classification, clinical and morphological picture, as well as approaches to the treatment of chronic pulmonary heart (CPH) are presented. The CPH classification in stages and functional classes depending on the level of pulmonary failure, arterial oxygen saturation, right ventricular hypertrophy and heart failure are given. Modern methods of diagnosing CPH are introduced as well.
CardioSomatics. 2011;2(1):81-86
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Zaklyuchenie ekspertov Vserossiyskogonauchnogo obshchestva kardiologov (VNOK),Natsional'nogo Obshchestva po izucheniyuateroskleroza (NOA), Rossiyskogo obshchestvakardiosomaticheskoy reabilitatsiii vtorichnoy profilaktiki (RosOKR)po optimizatsii terapii statinamiv klinicheskoy praktike
- -.
Abstract
CardioSomatics. 2011;2(1):86-92
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