Vol 9, No 1 (2018)


The relationship between the SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting

Bazylev V.V., Nemchenko E.V., Slastin Y.S., Karnakhin V.A., Pavlov A.A.


The goal is to reveal the relationship between the score SYNTAX score and the development of postoperative atrial fibrillation (AF). Materials and methods. Retrospective study included 156 patients (mean age 59±7 years) undergoing an isolated coronary bypass (CB). Exclusion criteria were: AF in the anamnesis, lesions of the valvular heart apparatus, diameter of the left atrium more than 50 mm, repeated surgical interventions on the heart. SYNTAX score, clinical, laboratory and echocardiographic parameters were evaluated. Results. The average score of the SYNTAX score was 26.7; postoperative AF was detected in 23 (14.7%) patients. Statistically significant differences were revealed during the time of mechanical ventilation (10.6±5.9 in comparison with 21.6±33.5, p=0.001) and SYNTAX score (25.7±8.7 vs 32.7±11.4, p=0.001). SYNTAX score and time of artificial ventilation are independent predictors of postoperative AF. Conclusion: a high score SYNTAX score is associated with a more frequent postoperative rhythm disturbance in the type of AF in patients undergoing an isolated CB.
CardioSomatics. 2018;9(1):5-9
pages 5-9 views

Regulatory adaptive status in determining the effectiveness of treatment with bisoprololum and nebivololum in patients with paroxysmal atrial fibrillation and hypertension

Eremina M.A., Tregubov V.G., Pokrovskiy V.M.


Increase in mortality from cardiovascular causes, systemic thromboembolism, congestive heart failure, increased frequency of hospitalization and deterioration in quality of life is associated with atrial fibrillation (AF). Essential hypertension (EH) is the most common cause of AF. To prevent recurrence of AF in patients with hypertension b-blockers (b-AB) can be used. Taking into account the possible effect of multidirectional b-AB on the functional condition of the body, in order to determine the effectiveness of therapy, it is advisable to apply a quantitative assessment of the regulatory-adaptive status (RAS). Goal - compare the effectiveness of bisoprololum and nebivololum in patients with paroxysmal AF and EH, given their impact on the RAS. Materials and methods. 50 patients with AF against the background of EH of stages II-III were randomized into two groups for treatment with bisoprololum (5.4±1.8 mg/day, n=25) or nebivololum (5.6±1.6 mg/day, n=25). As part of combination therapy, patients were administered lisinoprilum (14.2±3.8 and 14.3±3.7 mg/day), when required also atorvastatinum (19.1±3.7 and 18.8±4.4 mg/day), acetylsalicylic acid (90.0±4.6 and 91.2±4.1 mg/day), respectively. Initially and in 6 months, the following was done: quantitative assessment of the RAS (cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, daily monitoring of blood pressure and electrocardiogram, subjective assessment of the quality of life. Results. Both drug regimens comparably suppressed arrhythmia, controlled hypertension, improved the structural and functional condition of the heart. The use of nebivololum positively affected the RAS, to a greater extent increased exercise capacity and improved the quality of life. Conclusion. In patients with paroxysmal AF against the background of EH of stages II-III, the use of nebivololum as part of combination therapy may be preferable to bisoprololum due to its positive impact on the RAS.
CardioSomatics. 2018;9(1):10-16
pages 10-16 views

Clinical efficacy of pitavastatin

Aronov D.M., Bubnova M.G.


In the review article, anti-hyperlipidemic effects of a new synthetic statin, pitavastatin, are compared with similar effects of other statins. Attention is drawn to the ability of the drug to significantly increase the concentration of high-density lipoprotein cholesterol (by 19.3%!). A number of important, including previously unknown, pleiotropic effects of the drug are considered.
CardioSomatics. 2018;9(1):17-25
pages 17-25 views

Predictive value of copeptin in the development of severe heart failure in patients with acute coronary syndrome without ST-segment elevation

Zhukova A.V., Arabidze G.G.


The authors present data on the role of new biochemical marker copeptin as the C-end part of the pro-vasopressin, in assessing the risk of severe heart failure in short observation period (30 days) in patients with acute coronary syndrome (ACS) without ST-segment elevation the first 3:00 from the manifestation of pain combined with the definition of the levels of troponin T. Materials and methods. Prospective single center study included 128 patients (including 52 persons with acute myocardial infarction (AMI) diagnosis, 58 persons with unstable angina pectoris and 18 people with unconfirmed coronary event) with suspected ACS without ST-segment elevation with risk factors for coronary heart disease, selected according to criteria of inclusion/exclusion, received information on the study and gave their written consent to participate. Within the framework of the study, levels of troponin T and copeptin were determined for every patient at the admission, a diagnostic test of troponin T was repeated in 12-72 hours. During hospitalization, all patients were subjected to medical diagnostic examination, laboratory diagnosis, drug therapy, prescribed by standards of care, including medical history and analysis of the medical records, registration of ECG, echocardiography, quantitative determination of troponin T, assessment of left ventricular failure on a scale Killip and level of copeptin. Results. The level of copeptin during the early 3 hours since the manifestation of pain identified a direct correlation (r=0.76) between the values of the Copeptin upon receipt and the exacerbation of severity of congestive heart failure (HF) Killip classification established in patients with AMI in the period of hospital treatment and 30-day observation period. The level of copeptin during the early 3 hours since the manifestation of pain was 2.99 ng/ml (95% confidence interval - CI 1.89-4.09) for patients with HF class Killip 3 and 5.57 ng/ml (95% CI 5.08-6.06) for patients with HF class Killip 4 respectively. The level of copeptin ≥2.95 ng/ml significantly increase the risk of severe HF in 11 times - relative risk 11.4 (5.64-22.9, p<0.0001) compared with patients who have level of copeptin below the diagnostic slice - relative risk 0.15 (0.04-0.56), with negative prognostic value of 98% (95% CI 93.00-99.45), specificity 92.45% (95% CI 85.81-96.13, precision 91.67% (95% CI 84.99-95.53) and sensitivity 85.71% (95% CI 60.06-95.99). Conclusions. The level of copeptin ≥2.95 ng/ml, which is defined the first 3:00 from the manifestation of pain syndrome is an important prognostic marker for risk of severe congestive heart failure and an independent prognostic factor in outcome in patients with ACS without ST-segment elevation.
CardioSomatics. 2018;9(1):26-31
pages 26-31 views

Features of structural and functional changes in the cardiovascular system and their correction in patients with chronic heart failure in combination with cardiopulmonary pathology

Evdokimov V.V., Kovalenko E.V., Evdokimova A.G., Komissarova T.A., Tebloev K.I., Voronina G.V.


The article discusses the treatment for combined pathology of cardiovascular and respiratory systems, contains the results of authors own study on structural and functional changes in the myocardium of the left and right parts of the heartin patients with chronic heart failure and concomitant chronic obstructive pulmonary disease and results of their correction with the use of nebivolol and enalaprilor losartan in the complex therapy.
CardioSomatics. 2018;9(1):32-39
pages 32-39 views

Systemic inflammation as a risk factor for cardiovascular disease: review of the literature

Marusenko I.M., Polskaya I.I.


The review shows the problem of systemic inflammation as a key factor influencing the cardiovascular morbidity and mortality in patients with autoimmune rheumatic diseases. Represented literature data on the role of inflammation in the pathophysiology of cardiovascular disease in rheumatoid arthritis, its impact on the accelerated development of atherosclerosis. A separate section is devoted to the problem of lipid paradox. Review shows data on the influence of the traditional basic anti-inflammatory drugs and genetically engineered biological agents on the risk of cardiovascular disease in rheumatoid arthritis. Also, EULAR recommendations for assessing the risk of cardiovascular disease in rheumatoid arthritis.
CardioSomatics. 2018;9(1):40-46
pages 40-46 views

The role of non-alcoholic fatty liver disease in the development of cardiovascular diseases

Eganyan R.A.


The review describes the pathogenetic mechanisms of the relationship between cardiovascular disease and non-alcoholic fatty liver disease (NAFLD), which is the rationale for selecting therapeutic targets for intervention. The role of insulin resistance, oxidative stress, inflammation, dyslipidemia, intestinal microflora, heredity in the pathological relationship between NAFLD and cardiometabolic disorders are discussed. Present-day data of domestic and foreign scientists on prevalence, etiology, pathogenesis, clinical picture and treatment of this comorbid state are presented. Information is given on the development of subclinical and clinical atherosclerosis, as well as the concept of the hepatocardial continuum. In the treatment of NAFLD, the main role is given to the elimination or correction of etiopathogenetic factors of the development of the disease, excessive body weight, obesity, insulin resistance, hyperglycemia, hyperlipidemia. Particular attention is paid to the issues of dietetic complex intervention and the influence of various nutrition components on the state of the cardiovascular system and the liver.
CardioSomatics. 2018;9(1):47-53
pages 47-53 views

Clinical case: the experience of using acetylsalicylic acid, fosinopril and diltiazem in the therapy of a patient with cardiovascular pathology

Zadionchenko V.S., Shekhyan G.G., Yalymov A.A., Shchikota A.M., Terpigorev S.A., Kabanova T.G., Nikishenkov A.M.


The article briefly describes the inhibitor of angiotensin converting enzyme (ACEI) - fosinopril, calcium channel blocker - diltiazem and antiplatelet agent- acetylsalicylic acid (ASA). The mechanism of their action and possible side effects are given. The authors of the article described in detail the antihypertensive drug from the group ACEI - fosinopril, antiplatelet agent - ASA and non-hydropyridine calcium channel blocker - diltiazem. The results of multicenter randomized trials of ASA, fosinopril in patients with arterial hypertension, ischemic heart disease, nephropathy and heart failure are presented. The article presents a clinical example that demonstrates the selection of the optimal drugs for the treatment of the combined pathology of the heart and kidneys, and also provides an evidence base for the efficacy and safety of fosinopril and ASA preparations. Presented drugs (ASA, fosinopril, diltiazem) are highly effective in all categories of patients with CVD and can be recommended for wider clinical use.
CardioSomatics. 2018;9(1):54-60
pages 54-60 views

Major aspects for constant self-monitoring of the level of glycemia in patients with diabetes

Petunina N.A., Goncharova E.V., Panasenko O.I.


The article is devoted to the role of self-monitoring of the level of glycemia in achieving the goals of treatment in patients with diabetes mellitus. The dependence between the compensation of carbohydrate metabolism and the level of motivation of the trained patient for the control of glycemia is shown, the necessity of regular self-monitoring of glycemia by the patient is grounded. The main methods and means used for self-monitoring of glycemia are given and their characteristics are given. The importance of teaching patients to self-control methods as a measure of preventing the occurrence of complications of diabetes mellitus is substantiated. Comparative data on the prevalence of complications in patients, both not using self-monitoring, and conducting it, are given. Teaching patients proper glycemic control with portable glucometers is an important and indispensable component of diabetes therapy.
CardioSomatics. 2018;9(1):61-66
pages 61-66 views

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