Vol 9, No 4 (2018)


Chronic obstructive pulmonary disease as a predictor of unfavourable prognosis in patients after myocardial revascularization

Bazdyrev E.D., Polikutina O.M., Slepynina Y.S., Garganeeva N.P., Barbarash O.L.


Purpose. We aimed to analyze the results of the annual follow-up of the patients underwent coronary artery bypass grafting (CABG) depending on the presence of concomitant respiratory diseases. Materials and methods. In a year after CABG the prognosis of 646 patients, divided into three groups, was analyzed. A criterion for the formation of the groups was the presence of chronic pulmonary pathology and obstructive ventilatory type of disorders. The first group included 46 (7.1%) patients with coronary artery disease (CAD) and respiratory disease without the signs of obstructive disorder, the second group - 241 (37.3%) patients with CAD and chronic obstructive pulmonary disease (COPD) and the third - 359 (55.6%) patients with isolated CAD. Death, hospitalizations (both for cardiovascular events and respiratory diseases, non-fatal cardiovascular events, exacerbation and complications of COPD, as well as repeated revascularization procedures were evaluated as end points. Results. One year after CABG in patients with COPD the incidence of deaths, hospitalizations for acute cardiovascular events, as well as percutaneous coronary interventions was higher than in patients with isolated CAD. According to the analysis of variance, it was demonstrated that along with age, reduced myocardial systolic function and smoking, both COPD itself and the degree of bronchial obstruction are the potential risk factors for the development of fatal outcome. Conclusion. Comorbid COPD in patients with CAD is the predictor of unfavourable prognosis within a year after CABG.
CardioSomatics. 2018;9(4):5-10
pages 5-10 views

Organizational basis of cardiorehabilitation

Misyura O.F., Shestakov V.N., Zobenko I.A., Karpukhin A.V., Aleksandrov P.V., Goryunova A.A.


Evaluation of long-term experience cardiac rehabilitation in a rehabilitation center "Chyornaya rechka" allowed to formulate general technology rehabilitation of cardiac patients in different categories. The key points of technology at the 2nd stage of rehabilitation are the risk stratification, evaluation classes severity of patients in a rehabilitation center, multidisciplinary rehabilitation. In practice cardiorehabilitation used notion of rehabilitation potential and prognosis of rehabilitation. Suggested modular design personalized rehabilitation programs. The modular structure allows individual programs to achieve optimum results of rehabilitation, facilitating current and final control effectiveness.
CardioSomatics. 2018;9(4):11-16
pages 11-16 views

A patient with arterial hypertension and a very high risk of complications: a role of a triple fixed drug combination

Larina V.N., Orlov D.A., Sidorova V.P.


The article presents a clinical observation of a middle-aged patient with uncontrolled arterial hypertension and a very high cardiovascular risk. Correction of therapy in the form of adding a fixed combination of an angiotensine converting enzyme inhibitor, calcium antagonist and diuretic in maximum doses contributed to a decrease in the levels of office SBP and DBP by 24 and 16%, respectively, SBP and DBP according to daily monitoring of blood pressure - by 16%, SBP time index by 17.1%, DBP - by 37,4% and variability of SBP and DBP by 18 and 30%, respectively, as well as improved adherence to the treatment.
CardioSomatics. 2018;9(4):17-25
pages 17-25 views

Possibilities of interdisciplinary approach to early detection of asymptomatic arterial hypertension

Leshchuk T.Y., Gelberg I.S., Kopuckij A.V.


The latent form - asymptomatic form of arterial hypertension occurs in the general population in 15% to 24% of individuals, is more often associated with men, increased body mass index, smoking, stress, increased systolic blood pressure (BP), hypertrophy and diastolic dysfunction of the left ventricle and is considered the most dangerous a form of the disease that can result in sudden cardiac arrest. Early detection of risk factors for hypertension is of great preventive and economic importance. Objective - to develop a method for early detection of a high risk of developing asymptomatic hypertension with preventive digital X-ray fluorography studies and an interdisciplinary approach. Based on the screening survey conducted in 1411 workers, a method for early detection of high risk factors for asymptomatic hypertension was developed based on statistical significant risk factors. Research was conducted among workers at the workplace of 6 urban enterprises, with the detection of an enlarged left ventricle (ELV) in screening of the subject contingent and measuring BP levels. With elevated BP, 604 (42.8%) workers were identified, and with ELV - 236 (16.7%) cases. The combination of elevated BP and ELV was significantly more frequent (160, 67.8%) than with normal BP (76, 32.2%). Based on the statistical analysis, a logistic regression model with a high residual deviance (about 84%) is constructed, which gives satisfactory forecasts. The diagnostic test of the model, with cutoff threshold equal to pо=0.397, corresponds to: sensitivity - 75.5%, specificity - 64.4%, accuracy - 69.2%. Thus, the use of the screening diagnostic method in the detection of ELV in combination with age in men of 28 years or in women from 39 years of age reveals a high risk of developing asymptomatic forms of hypertension. These patients are taken to the control and sent to the physician by the therapist to perform the pre-examination.
CardioSomatics. 2018;9(4):26-30
pages 26-30 views

Diagnosis and the debatable issues of the treatment of heart failure with preserved ejection fraction

Akhilgova Z.M., Kurkina M.V., Dzhioeva Z.R., Puhaeva A.A., Avtandilov A.G.


Heart failure with preserved fraction (HFpEF) amount for a half of the general heart failure and increasing progressively. In this review we discuss the issues of pathogenesis of HFpEF, illuminated in the recent literature in the last years. Considering the heterogeneity of the pathophysiology of this syndrome and the results of large-scale studies conducted nowadays, it considers the debatable treatment issues of the applying different drugs in the prevention of HFpEF.
CardioSomatics. 2018;9(4):32-37
pages 32-37 views

Clinical case of chronic rheumatic heart disease that was not diagnosed during patient’s lifetime

Tsibulskaya N.Y., Harkov E.I.


The article presents a clinical case of chronic rheumatic heart disease that was not diagnosed during patient’s lifetime because it had been looking like cardiac arrhythmias and heart failure with tricuspid valve disease. It also discusses pathogenetic substrates of chronic rheumatic heart disease and problems in disease diagnostics when it is accompanied by tricuspid valve lesion.
CardioSomatics. 2018;9(4):38-41
pages 38-41 views

A relevance of a differentiated approach to glycemic goals achievement in old patients with type 2 diabetes mellitus and cardiovascular diseases

Safronova T.I.


Today patient’ self-monitoring of blood glucose is considered one of the main components in the management of diabetes mellitus. The article deals with possibilities of modern means for glycemia self-monitoring.
CardioSomatics. 2018;9(4):42-45
pages 42-45 views
pages 46 views

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