Vol 2, No 1 (2011)

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.

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.

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.

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.

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.

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.

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.

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.