Vol 6, No 4 (2015)

Журнал «КардиоСоматика» является печатным органом ООО «Российское общество кардиосоматической реабилитации и вторичной профилактики» (РосОКР).В отличие от всех существующих специализированных обществ по реабилитации пациентов с сердечно-сосудистыми заболеваниями РосОКР ставит перед собой задачу возрождения в России не только современной и эффективной реабилитации кардиальных больных, но и разработки программ реабилитации лиц с сопутствующими соматическими заболеваниями, которым, как правило, отказывается в реабилитации. Все эти сложные вопросы можно активно обсуждать на страницах журнала «КардиоСоматика».

The information content of SCORE model in the evaluation of the total ten-year cardiovascular risk in an isolated sample of 207 males without clinical manifestations of atherosclerosis was investigated. It was revealed that the most of the observations from persons who had attained over a 10-year period of the combined end point, the model qualified incorrectly, which didn’t meet the requirements of individual risk assessment in a limited sample group of males. It is shown that the inclusion of subclinical atherosclerosis markers in SCORE model can significantly improve its sensitivity. At the same time, a group of poor prognosis gets a significant number of observations for individuals free of cardiovascular events due to the high probability of false positive response.

Conducted a study to determine the effectiveness of blood pressure (BP) control in patients after renal transplantation using a two renin-angiotensin aldosterone system (RAAS) blockade. Within 6 months after kidney transplantation is observed syndrome uncontrolled blood pressure (BP) in 51.6% patients; 13 transplant patients (69.2% men and 30.8% women; mean age 34.7±11.8 years) had chronic glomerulonephritis (100% of cases) as the main cause of end-stage chronic kidney disease. Patients received a dose of aliskiren 150-300 mg in combination with a sartans and calcium antagonist after signing informed consent. Within 2 months of treatment there was a significant deterioration in graft function in achieving optimal BP<130/80 mm Hg. The study showed a significant decrease glomerular filtration rate, uptrend resistance index arc and central vessels of the transplanted kidney, increasing proteinuria. The 2-3 therapy aliskiren and angiotensin receptor blockers was safe in terms of effect on the mineral, carbohydrate, protein exchanges.

Aim. To assess the afficiency of using different shcemes of the antiarrythmic therapy (AAT) after the surgical treatment of the atrial fibrillation (AF).Material and methods. This retrospective study included 279 patients: 141 (49%) females and 168 (51%) males, aged 59±7.9 years who had got Сox-Maze IV procedure at Federal cardiovascular center (Penza). 27 patient (9.7%) had the paroxysmal AF, 252 (90.3%) - the persistent one. The AF’s duration was 36 months (from 1 to 180). The size of the left atrium was average 52.4±8.4 mm (from 40 to 82 mm). The medium functional class (FC) of heart failure (HF) (NYHA) was 2.8±0.4: II FC-63 (22.6%), III FC - 213 (76.3%), IV FC - 3 (1.1%). There were 3 groups of patients:1 group had 57 patients who had got amiodaron over 6 months; 2 group - 126 patients who had got b-blocker (b-B) (bisoprolol) long monotherapy; 3 group - 96 patients who had got amiodaron during 3-6 months then had got bisoprolol long therapy. All patiens got Cox-Maze IV procedure.Results. Remote results assessed after 6 months-3 years period after the operation. In all groups the number of patients with I and II FC HF increased; there was significant difference at 2 group (p1-2=0.01; p2-3=0.01; p1- 3=0.73). And there were more patients with sinus rhythm at 2 group than at 3 group significantly. The freedom from AF at 1 group was 77%±0.89, at 2 group - 68%±0.98, at 3 group - 85%±0.95 with the significant difference between 2 and 3 groups (р1-2=0.61; p1-3=0.13; p2-3=0.01).Conclusions. AAT by amiodaron during 3-6 months and then by beta-blocker (bisoprolol) longly after Cox-Maze IV procedure allows to keep sinus rhythm to 85% patiens at the distant period of time and comparing with the b-blocker-monotherapy allows to keep sinus rhythm more effectively. The difference of efficiency by long amiodaron-monotherapy and amiodaron-therapy during 3-6 months is not got statistical significant after Cox-Maze IV procedure.

The myocardial remodeling of athletes heart is an essential process that occurs in sport exercises. However, depending on the type of load, remodeling can be of different type. An endurance load leading to eccentric cardiac remodeling, whereas power loads cause a concentric transformation of heart. Even in a same sport particular types of load can be different. This causes lead to difficulties in the differential diagnosis of physiological and pathological remodeling. Furthermore, it is believed that there must be sufficient time remodeling. We described the clinical observation, in which the athlete in the same sport, by changing the particularly of the training loads, there is objectively determined transformation of the myocardium in a relatively short period of time.