Vol 8, No 2 (2017)


Comparison of the effect of treatment with the main groups of antihypertensive drugs on the quality of life in patients with stable arterial hypertension

Andreeva G.F., Gorbunov V.M., Molchanova O.V., Deev A.D.


When appointing antihypertensive drugs to patients with stable mild to moderate arterial hypertension (AH) it is necessary to take into account the effect of treatment on the quality of life (QoL) of these patients. The aim of the study was to compare the effect of prolonged use of antihypertensive drugs from the main treatment groups on QoL of patients with stable AH in 5 controlled trials. The results of monotherapy efficacy were assessed by 24-hour blood pressure monitoring and QoL patients were studied before and after long-term monotherapy according to the results of a database analysis of 5 studies performed in our center for the last 4 years. After the period of withdrawal of antihypertensive therapy, patients underwent 24-hour blood pressure monitoring, QoL was evaluated. According to 24-hour blood pressure monitoring, diltiazem had an antihypertensive effect, comparable to the effect of enalapril. Both drugs had no effect on the circadian rhythm of arterial pressure and the outpatient heart rate. Long-term use of none of the antihypertensive drugs (diltiazem, amlodipine, enalapril, metoprolol, telmisartan) did not worsen QoL. The greatest impact on QoL was provided by the group of angiotensin-converting enzyme inhibitors, enalapril, significantly improving QoL.
CardioSomatics. 2017;8(2):5-10
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Psychoemotional status and neuroendocrine changes in patients with hypertension and obesity according to the level of physical activity

Ivanchenko V.S., Gordienko A.I., Matveeva N.V., Gagarina A.A., Ushakov A.V.


Aim. To study psychoemotional status and serum cortisol changes in patients with arterial hypertension (AH) and obesity, depending on the level of physical activity. Material and methods. 76 male patients with AH stage I and II were examined. Group 1 consisted of 36 patients with AH and obesity, group 2 - 40 hypertensive patients without obesity. Serum cortisol level was determined by enzyme-linked immunosorbent assay. To access level of psycho-emotional strain in patients PSM-25 scale was used. The level of reactive and personal anxiety was measured using a Spielberger-Khanin questionnaire. To assess physical activity a brief international physical activity questionnaire (IPAQ) was used. Results. Each group was divided into two subgroups depending on the level of physical activity. According to results of psychological questionnaires physically inactive patients showed significantly higher levels of psychoemotional stress and serum cortisol concentrations as compared to physically active patients. There was an inverse correlation between the level of physical activity with reactive anxiety in group 1 (r=-0.35; p=0.04), and between physical activity with personal anxiety (r=-0.36; p=0.02) and psychoemotional strain in group 2 (r=-0.42; p=0.006). There also was an inverse association between the level of physical activity with systolic (group 1 - r=-0.52; p=0.001; group 2 - r=-0.52; p=0.0006) and diastolic (group 2 - r=-0.45; p=0.004) blood pressure. All groups showed an inverse relationship between physical activity level and serum cortisol concentration that was statistically significant in group 2 (r=-0.36; p=0.04). Conclusion. Our results support the hypothesis that regular physical activity confers resilience by oftimizing physiological and neuroendocrine responses and acts as a buffer against stressors.
CardioSomatics. 2017;8(2):11-15
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Observation of adolescents with high blood pressure, involved in physical activity

Balykova L.A., Ivianskiy S.A., Shirokova A.A., Shchekina N.V., Varlashina K.A.


The article provides a brief overview of the literature data on the prevalence and causes of hypertension in athletes. Different points of view on the effect of regular physical exertion on the level of arterial pressure are considered. In addition, the available diagnostic approaches to the detection of high blood pressure are described. Based on the available data, domestic and foreign experience, oftimal algorithms for diagnosing arterial hypertension in young people involved in sports are presented.
CardioSomatics. 2017;8(2):16-19
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The influence of smoking on the clinical effects of a one-year program of physical rehabilitation of patients of working age who underwent acute myocardial infarction

Bubnova M.G., Aronov D.M., Krasnitskii V.B.


Purpose. Study of the clinical effectiveness of a long-term (one-year) physical rehabilitation program with the inclusion of physical training (PT) in the III (polyclinic) stage of cardiac rehabilitation in patients with ischemic heart disease of working age who underwent acute myocardial infarction (AMI), depending on the status of smoking. Materials and methods. The study included men (n = 241, mean age 51.3 ± 2.2 years) who underwent AMI (no earlier than 3 weeks from the event). Patients were randomized into 2 groups: the main ("O") - 126 people and the control ("K") - 115 participants. All patients received standard medication. In the "O" group, PT was used in the medium intensity regime (50-60% of the fulfilled capacity with a load sample) 3 times a week for one year. Each of the groups was divided into two subgroups, depending on the status of smoking. Effectiveness of the effect was assessed by clinical data and results of instrumental-laboratory analysis. Results. After a yearly PT, a significant increase in physical performance was observed in smokers (n=41) and nonsmokers (n=41) and nonsmokers (n=85) after IMI: an increase in the duration of the load (by 30.3%, p<0.001 and 28.4%, p<0.001) and its power (by 31.2%, p<0.001 and 30.8%, p<0.001) against the backdrop of an increase (by 3.8%, p<0.01) in the economics of physical work, but only for smokers. In the absence of PT, only in nonsmokers (n=72) after AMI, there was an increase in the duration of the load (by 10.1%, p<0.01) and its power (by 11.1%, p<0.05), but to a lesser extent than non-smoking trained patients. In smoking patients (n=43), in the absence of PT, there was no change in the Fed indicators, on the contrary, there was a decrease in the cost-effectiveness of the work performed (by 13.3%, p<0.05). The level of daily motor activity increased only against the background of PT among smokers by 22.2% (p<0.001) and non-smokers by 19.4% (p<0.01). This was combined with a decrease in heart size and increased contractility of the left ventricular myocardium in smokers and non-smokers, but more pronounced positive changes in the background of PT were seen in non-smoking patients. There was no positive dynamics of echocardiographic parameters in the absence of PT, although a slight increase (by 1.9%, p<0.05) of the left ventricular ejection fraction was observed in nonsmokers. Only in the background of PT, smoking and non-smoking patients (equally) had a decrease in the levels of atherogenic lipids and an increase in the concentration of high-density lipoprotein cholesterol by 18.2% (p<0.05) and 20% (p<0.05), respectively. In smoking patients without PT, on the contrary, there was an increase (by 12.5%, p<0.05) of the level of triglycerides. PT had anti-ischemic effects, manifested in a reduction in angina attacks and the need for nitroglycerin consumftion in smokers and non-smokers, in contrast to untrained patients. After the year of PT, the development of all cases of cardiovascular complications significantly decreased in the subgroup of smokers by 44.8% (p<0.05) and the non-smoking group by 50.9% (p<0.05), and the number of days of temporary incapacity for work Per patient decreased by 2 days for smokers and 2.6 days for non-smokers. The conclusion. Long-term (annual) PT of medium intensity at the third outpatient stage of cardiac rehabilitation in both smokers and non-smokers who underwent AMI provides a stable course of the disease, reduces the likelihood of developing cardiovascular complications, improves the patient's quality of life and is safe in the vast majority. At the same time, smoking should be considered as a factor that reduces the rehabilitation potential of the patient who has undergone AMI and prevents better results in cardiac rehabilitation.
CardioSomatics. 2017;8(2):20-29
pages 20-29 views

Non-invasive stimulation of angiogenesis with shock-wave therapy in patients with coronary artery disease (literature review). Part 2

Matskeplishvili S.T., Borbodoeva B.M.


The article presents a review of published data regarding the most important problem in cardiology - treatment of patients with coronary artery disease and left ventricular dysfunction and improvement of quality of life in this group. The review covers the contemporary management of coronary artery disease, new approaches to the treatment of coronary artery disease in patients without possibility of myocardial revascularization or having undergone revascularization. The safety and effectiveness of shock-wave therapy in this group of patients is presented.
CardioSomatics. 2017;8(2):30-34
pages 30-34 views

Ivabradinum supplements the clinical efficacy of percutaneous coronary intervention in patients with coronary heart disease with stable angina

Aronov D.M., Bubnova M.G.


The review is devoted to the role of ivabradinum in the procedure of percutaneous coronary intervention (PCI) in patients with ischemic heart disease with stable angina. It is reported that reperfusion of the myocardium with PCI, even in combination with modern drug therapy, does not have a complete clinical effect. The authors substantiate the possibility of completing the clinical effect of PCI in such patients by prescribing ivabradinum. The drug reduces the heart rate more than with medication without it.
CardioSomatics. 2017;8(2):35-43
pages 35-43 views

Risk factors of subclinical atherosclerosis of obesity women

Shenkova N.N., Chumakova G.A., Veselovskaya N.G., Osipova E.S., Ott A.V.


Research objective: study the metabolic risk factors (RF) of subclinical atherosclerosis of obese women. Material and methods. 89 women have been included in research, 50.6±6.6 years old with abdominal obesity and waist circumference >80 cm without coronary heart disease and atherosclerosis of other localisation. According to the results of the ultrasound study of brachiocephalic arteries (BCA), two groups were formed for comparison: Group 1 (n=60) without atherosclerosis BCA, Group 2 (n=29) with atherosclerosis BCA. Definitions of classical and additional metabolic RF, of adipokines of visceral adipose tissue (VAT) and ghrelin were spent to the surveyed patients. The thickness of epicardial fat (tEF) was defined at transthoracic echocardiography. Results. In the group 2 there were the highest indexes of: LDL 3.7 (2.9; 4.6) mmol/L, Apo B 1.32±0.29 g/L, CRP 2.8±0.96 mg/l, leftin 20.0 (16.4; 23.1) ng/ml, tEF 7 (6; 8) mm; lower indexes of Apo A1 1.16±0.31 g/l and ghrelin 40.7 (39.1; 42.8) pg/dl. Conclusion. The signs of subclinical atherosclerosis of the carotid arteries of obese women were associated with higher amount of VAT (tEF), inflammatory activity of plasma (CRP) and neurohumoral disorders (leftin, ghrelin).
CardioSomatics. 2017;8(2):44-50
pages 44-50 views

Treatment of atherogenic dyslipidemia: modern principles and new possibilities

Bubnova M.G.


The review presents the main provisions of the current recommendations of the European and American communities on the diagnosis and treatment of atherogenic dyslipidemia. Evidence of the importance of reducing the level of low-density lipoprotein cholesterol as a key factor in the development of cardiovascular diseases caused by atherosclerosis and the primary goal of lipid lowering therapy are given. Unresolved problems of statin therapy are indicated. A characteristic of a new class of lipid-lowering drugs is the inhibitors of the subtilisin/kexin type 9 proprotein convertase (PCSK9). The results of the first large studies with the PCSK9 inhibitor evoloucumab were discussed, which allowed to formulate the main indications for the prescriftion of this group of drugs in clinical practice.
CardioSomatics. 2017;8(2):51-58
pages 51-58 views

Morphofunctional state of the brain in chronic heart failure

Akimova N.S., Sokolov I.M., Martynovich T.V., Shvarts Y.G.


The aim of the study was to examine the dependence of functional and morphological changes in the brain and factors of the severity of chronic heart failure. Materials and methods: 54 patients with chronic heart failure of ischemic genesis, I-IV functional class were cognitive tests, echocardiography, nuclear magnetic resonance imaging of the brain. Results. With an increase in the functional class of chronic heart failure, the worst results of Veksler-5 and 7 cognitive subtests are noted, a smaller thickness of gray matter of parietal lobes, lower diffusion coefficients of water molecules in the white matter of the parietal and occipital lobes, and a smaller thickness of the middle legs of the cerebellum. Comparative analysis of the central nervous system state indices in patients with chronic heart failure with different fraction of left ventricular ejection did not show significant differences. The conclusion. The established results confirm the significance of the functional class of chronic heart failure as a marker of cognitive dysfunction and pathological changes in both gray and white matter of the brain, whereas the size of the left ventricular ejection fraction is obviously less useful in this respect.
CardioSomatics. 2017;8(2):59-62
pages 59-62 views

Effect of exercises on the patients receiving hemodialysis

Frolov A.V.


This article gives an overview of the scientific evidence on the impact of physical activity on various parameters of the health of people with end-stage renal disease. With examples of clinical observations, interrelations are established between nutritional status, menstrual disorders, osteopenia, erectile dysfunction and the impact on them of methods of physical rehabilitation.
CardioSomatics. 2017;8(2):63-69
pages 63-69 views

Predicting the development of cardiac arrhythmias and cardiac conduction disorders in patients

Nicoulina S.Y., Chernova A.A., Tretyakova S.S., Plita E.V.


The article is devoted to descriftion of the new method for diagnostics and predicting of the development of risk for development of cardiac arrhythmias and cardiac conduction disorders in patients by using of the computer system. For oftimization of the diagnostic and prevention of these pathologies in different health facilities (outpatient clinics, in-patient clinics)was developed a technology for the estimation of genetic risk and predicting in families by analysis of clinical, instrumental and genetic data. The process is automated by using the analytical software complex (computer system). The basis for the technology is the results of our multiyear researches to identify associations between the genetic polymorphisms and different cardiac conduction disorders. The article presents the possibilities of using the developed technology in clinical practice, the basic principles of work with the computer system.
CardioSomatics. 2017;8(2):70-73
pages 70-73 views

Acute coronary syndrome: treatment strategies (part 1)

Perepech N.B.


Two cases of medical care for patients with acute coronary syndrome are discussed, in which conservative and invasive treatment strategies were applied. The clinical aspects of thrombolytic therapy and percutaneous coronary interventions, the use of antiplatelet agents and anticoagulants for the prevention of atherothrombotic events after the restoration of blood flow through the infarct-responsible coronary artery are considered.
CardioSomatics. 2017;8(2):74-80
pages 74-80 views

Results of XII Russian Scientific and Practical Conference of the Russian Society of Cardiosomal Rehabilitation and Secondary Prevention with International Participation "Rehabilitation and secondary prevention in cardiology"

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Традиционная объединенная XII Российская научно-практическая конференция Российского общества кардиосоматической реабилитации и вторичной профилактики (РосОКР) с международным участием «Реабилитация и вторичная профилактика в кардиологии» с большим успехом прошла 20-21 апреля 2017 г. в Центральном доме ученых Российской академии наук г. Москвы. Конференция была организована РосОКР при участии Российского кардиологического общества, Российского научного медицинского общества терапевтов, Союза реабилитологов России, ФГБУ «Государственный научно-исследовательский центр профилактической медицины» Минздрава России.
CardioSomatics. 2017;8(2):81-82
pages 81-82 views

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