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Russian Journal Of Cardiology, 2018, 23 (12)

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Address to the readers

Russian Journal of Cardiology 2018; 23(12):5

CLINICAL MEDICINE NEWS

Clinical medicine updates: a review of international news

Russian Journal of Cardiology. 2018;23(12):6

ORIGINAL ARTICLES

THE PREVALENCE OF ELECTROCARDIOGRAPHIC ABNORMALITIES IN THE RUSSIAN POPULATION IN THE EARLY 21ST CENTURY (THE ESSE-RF STUDY)

Muromtseva G. A.1, Vilkov V. G.1, Konstantinov V. V.1 Deev A. D.1, Oshchepkova E. V.2, Rotar O. P.3, Shalnova S. A.1

Abstract

Electrocardiography (ECG) takes the lead in assessing the prevalence of coronary artery disease (CAD) in the population. ECG disorders, grouped in the Major (certain) and Minor (possible) categories, are prognostic markers of a high risk of cardiovascular diseases and sudden cardiac death. Unified assessing methods of ECG disorders prevalence and their associations with socio-demographic parameters have not previously been made in Russia.

Aim. To study the prevalence of ECG parameters of certain and possible coronary artery disease among population of Russia, depending on the socio-demographic characteristics - age, sex, education and place of residence (city or country).

Material and methods. We used 17504 ECGs from representative samples of population (25-64 years old), who participated in the epidemiological study "Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation". The analysis using Minnesota code was carried out among men and women of four age groups, two educational levels, among citizens and countrymen.

Results. The highest prevalence was observed in the "Certain" (5,7%) and "Possible signs of CAD" (7,1%) categories, in the "Certain" (3,8%) and "Possible myocardial ischemia" groups (4,9%), the smallest is in the "Rhythm and conduction disorder" (0,7%) and "STT changes in left ventricular hypertrophy" (0,4%) groups. It was shown that the frequency of ECG disorders increases with age, has an sharp increase after 55 years, regardless of sex. In the age dynamics of categories, STT changes and atrial fibrillation have a decrease of gender differences. All groups of ECG disorders are detected more often among men than women, except for STT changes. With an increase in the level of education, the frequency of ECG pathologies decreases, with the exception of the groups of "major" and "minor Q (QS)", "major rhythm and conduction disorders". The prevalence of most ECG disorders does not depend on the place of residence. However, signs of major myocardial ischemia in men are more common in country than in the city (3,9% vs. 2,7%, p<0,05).

Conclusion. The results confirm the patterns identified earlier. There is a steady association of ECG data with socio-demographic characteristics.

Russian Journal of Cardiology. 2018;23(12):7-17

dx.doi.org/10.15829/1560-4071-2018-12-7-17

Key words: ECG in epidemiological studies, Minnesota code, major (certain) signs of CAD on ECG, minor (possible) signs of CAD on ECG, sex-age associations, gender ratios.

Conflicts of Interest: nothing to declare.

#Participants of the ESSE-RF study, co-authors of the article: Moscow: Balanova Yu. A., Kapustina A. V., Imaeva A. E., Evstifeeva S. E., Suvorova E. I.; Volgograd: Nedogoda S. V., Ledyaeva A. A., Chumachek E. V.; Vologda: Shabunova A. A., Ilyin V. A., Kalashnikov K. N., Kalachikova O. N., Popov A. V.; Voronezh: Chernykh T. M., Bondartsov L. V., Furmenko G. I.; Vladikavkaz: Tolparov G. V., Astakhova Z. T., Boliyeva L. Z., Toguzova Z. A.; Vladivostok: Kulakova N. V., Mokshina M. V., Nevzorova V. A., Rodionova L. V., Shestakova N. V.; Ivanovo: Romanchuk S. V., Belova O. A., Shutemova E. A.; Krasnoyarsk: Greenstein Yu. I., Baikova O. A., Danilova L. K., Evsyukov A. A., Kosinova A. A., Petrova M. M., Ruf R. R., Shabalin V. V., Filonenko I. V.; St. Petersburg: Baranova E. I., Konradi A. O.; Tomsk: Trubacheva I. A., Karpov R. S., Kaveshnikov V. S., Serebryakova V. N.; Tyumen: Efanov A. Yu., Medvedeva I. V., Storozhok M. A., Shalaev S. V.; Kemerovo: Indukayeva Ye. V., Artamonova G. V., Barbarash O. L., Danilchenko Ya. V., Mulerova T. A., Maksimov S. A., Tabakaev M. V.

1National Medical Research Center for Preventive Medicine, Moscow; 2National Medical Research Center for Cardiology, Moscow; 3Almazov National Medical Research Center, Saint-Petersburg, Russia.

Muromtseva G. A. ORCID: 0000-0002-0240-3941, Vilkov V. G. ORCID: 0000-0003-0263-494X, Konstantinov V. V. ORCID: 0000-0002-2590-9144, Deev A. D. ORCID: 0000-0002-7669-9714, Oshchepkova E. V. ORCID: 0000-0003-4534-9890, Rotar O. P. ORCID: 0000-0002-5530-9772, Shalnova S. A. ORCID: 0000-0003-2087-6483.

Received: 20.08.2018

Revision Received: 12.10.2018

Accepted: 19.10.2018

ECHOCARDIOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Akramova E. G.1,2, Feyskhanova L. I.3

Abstract

Aim. To assess echocardiographic data in patients with rheumatoid arthritis (RA).

Material and methods. We included to study 129 women who underwent echocardiography (EchoCG) with Vivid-E9 ultrasound scanner: 55 people with RA and 32 with RA+arterial hypertension (AH). Allowing for the fact that in 36,8% of cases RA was combined with AH, the control group in addition to 14 healthy individuals included 28 people with AH.

Results. The systolic function of the left ventricle (LV), according to the size of the ejection fraction (EF), was preserved. EchoCG diagnosed diastolic dysfunction in 18,2% of patients with RA and 28,1% with RA + AH: usually of a rigid type (16,4% and 18,7%, respectively), less commonly pseudonormal (1,8% and 9,4%, respectively). An association of age and a) wall thickness, LV myocardium mass (r=0,46 and 0,6, respectively; p<0,0001) was found among patients with RA, which is absent in the group with AH; b) data characterizing the state of heart diastolic function (r=0,2÷0,31; p=0,001 and 0,03); c) global deformation (r=0,22; p=0,03). LV hypertrophy was noted in 3,6% of individuals with RA and 34,4% with RA+AH (p=0,02). The global deformation value more than -19,6% was in 34,5% of patients with RA and 59,4% with RA+AH (p=0,03). The global deformation changes were significant only in the presence of LV hypertrophy. Valve leaflet involvement and pathological regurgitation were present in 16,4% of patients with RA and in 31,2% of patients with RA+AH (p<0,05); open foramen ovale was noted in 3,6% and 15,6%, respectively (p<0,05); cardiac dropsy - in 18,2% and 12,5%, respectively.

Conclusion. EchoCG examination in various modes and technologies determined pathological changes, such as LV hypertrophy, valve disorders, mild cardiac dropsy, open foramen ovale, diastolic dysfunction and longitudinal systolic LV dysfunction in 45,4% of patients with RA and 96,9% with RA+AH. The value of the global systolic function can be a significant addition to the formation of cardiac risk groups with early prenosological signs of heart damage.

Russian Journal of Cardiology. 2018;23(12):18-24

dx.doi.org/10.15829/1560-4071-2018-12-18-24

Key words: rheumatoid arthritis, arterial hypertension, echocardiography, left ventricular systolic and diastolic function.

Conflicts of Interest: nothing to declare.

1Central City Clinical Hospital 18, Kazan; 2Kazan State Medical Academy - a branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Health of Russia, Kazan; 3Kazan State Medical University, Kazan, Russia.

Akramova E. G. ORCID: 0000-0002-1900-7726, Feyskhanova L. I. ORCID: 0000-0001-7830-5283.

Received: 14.06.2018

Revision Received: 24.07.2018

Accepted: 18.10.2018

GRACE score in assessing the risk of hospital outcomes in patients with pulmonary embolism

Mullova I. S.1,2, Cherepanova N. A.2, Pavlova T. V.1,2, Khokhlunov S.M.1,2, Gnilomedova D.A.3, Leksina A. A.1, Duplyakov D. V.1,2

Abstract

Aim. To compare the PESI and GRACE scores in assessing the risk of hospital outcomes in patients with pulmonary embolism.

Material and methods. The study included 383 patients with pulmonary embolism (PE), hospitalized during the period of April 4, 2003 on September 18, 2014; 190 (49,6%) are men, the average age is 57,4 years±14,4 years. We considered the patient’s anamnesis, complaints, results of biochemical and instrumental tests, as well as the treatment carried out to the patients.

Results. According to the risk stratification of PESI score, 86 (22,5%) patients had a very low risk of death, 88 (22,9%) had a low risk, 94 (24,5%) had an intermediate risk, 60 (15,%) - high risk and 55 (14,4%) patients have a very high risk. The combination of three ECG signs (SI-QIII, right bundle branch block and T-wave inversion in V1-V3) was significantly more common in patients with a very high PE risk - 14,5% (p=0,025). The most reliable sign of the most echographic (echoCG) criteria was dilatation of right ventricle (RV) (p=0,009) in a group of patients with a very high PE risk. According to the GRACE scale, 112 (29,2%) patients were assigned to the low risk group, and 271 (70,8%) patients - to the high risk group. ECG signs were observed more frequently in the high risk group: SI-QIII, T-wave inversion in III, V1-V3 leads, right bundle branch block (p<0,05). Pulmonary hypertension and RV dilatation according to echoCG prevailed in the high risk group (98,4% and 85,1%, respectively), p<0,05. The minimum value of points on the GRACE score for the deceased patients was 118 points. The GRACE scale showed high predictive ability with a sensitivity of 96% and a specificity of 63% (AUC=0,811, CI 95% 0,0738-0,884). However, the PESI score had a slightly greater predictive value with a sensitivity of 100% and a specificity of 53% (AUC=0,879 compared with AUC=0,811 for the GRACE scale). Analysis of the PESI and GRACE scores showed a moderate correlation between them (r=0,668).

Conclusion. The GRACE score showed a high predictive value for adverse outcomes in PE patients with a sensitivity of 96% and a specificity of 63%. The minimum score on the GRACE score for deceased patients was 118 points.

Russian Journal of Cardiology. 2018;23(12):25-31

dx.doi.org/10.15829/1560-4071-2018-12-25-31

Key words: pulmonary embolism, risk stratification, PESI and GRACE.

Conflicts of Interest: nothing to declare.

1Samara State Medical University, Samara; 2Samara Regional Clinical Cardiology Hospital, Samara; 3Chapaevsk Central City Hospital, Chapaevsk, Russia.

Mullova I. S. ORCID: 0000-0002-9321-6251, Cherepanova N. A. ORCID: 0000-0002-7704-0866, Pavlova T. V. ORCID: 0000-0003-3301-1577, Khokhlunov S. M. ORCID: 0000-0001-6000-6200, Gnilomedova D. A. ORCID: 0000-0001-8460-6058, Leksina A. A. ORCID: 0000-0001-8311-8327, Duplyakov D. V. ORCID: 0000-0002-6453-2976.

Received: 13.06.2018

Revision Received: 24.07.2018

Accepted: 20.09.2018

TREATMENT EFFICACY OF ARRHYTHMIAS AND DILATED CARDIOMYOPATHY SYNDROME OF IMMUNE-INFLAMMATORY NATURE USING PLASMAPHERESIS

Kulikova V. A.1, Nedostup A. V.1, Blagova O. V.1, Zaidenov V. A.2, Kupriyanova A. G.3, Nechaev I. A.1, Ragimov A. A.1

Abstract

Aim. To study the efficacy of plasmapheresis as the main type of pathogenic treatment or in combination with immunosuppressive therapy in patients with dilated cardiomyopathy (DCMP) and arrhythmias of immune-inflammatory nature.

Material and methods. The main group included 20 patients with arrhythmic myocarditis (with premature supraventricular / ventricular contraction >3000/day, n=3/8, atrial fibrillation (AF) n=9) and 14 patients with DCMP syndrome (enddiastolic volume (EDV) left ventricle (LV) 6,3±0,6 cm, ejection fraction (EF) 33,5±8,1%). The inclusion criterion was an increase of at least 2 types of anti-cardiac antibodies titers > twice. Myocarditis is diagnosed using myocardial biopsy, magnetic resonance imaging, multispiral computed tomography, scintigraphy, coronary angiography. We used a course of discrete plasmapheresis. The comparison group included 26 patients with an arrhythmic myocarditis and 19 with DCMP syndrome (EDV 6,6±0,8 cm, EF 32,6±7,3%), which plasmapheresis was not used. Dynamics was assessed at 6 and 12 months.

Results. In groups of patients with arrhythmias and DCMP, a significant decrease in anti-cardiac antibodies titers was observed immediately after plasmapheresis and in control studies (p<0,05). In patients with arrhythmias, a health-promoting effect (a decrease in the number of premature contraction and a frequency of atrial fibrillation >75%) was observed in 65% of the main group and 58% of the comparison group. Predictor of plasmapheresis efficiency was a titer of specific antinuclear factor >1: 40 (sensitivity - 92,3%, specificity - 71,4%, AUC - 0,813, p<0,05). Methylprednisolone was prescribed to 45% of patients in the main group and 73% to patients in the comparison group (p>0,05) at a dose of 8 [4; 16] and 16 [10; 24] mg per day, respectively, p>0,05. In patients with DCMP in the main group, a significant increase in EF (p<0,05) (up to 41,4±8,2% and 46,3±12,7% vs 39,1±13,7% and 37,2±10,7% in the comparison group) and the distance of 6-minute walking test was obtained. A good effect (increase in EF by 10% or more) was noted in 50% of the main group and 32% of the comparison group. The predictor of plasmapheresis efficacy was systolic pressure in the pulmonary artery >28,5 mm Hg. (sensitivity - 100%, specificity - 71,4%, AUC - 0,893, p<0,05). In the main group, methylprednisolone was assigned to 43% of patients, in the comparison group - 89%, p<0,05. The average doses of methylprednisolone in the main group were significantly lower than in the comparison group (8 [8; 17,25] vs 16 [13; 28] mg per day, p<0,05).

Conclusion. Positive clinical response to plasmapheresis was noted in 65% of patients with arrhythmias and in 50% of patients with DCMP of immune-inflammatory nature. In patients with different types of myocarditis, plasmapheresis increases the efficacy of antiarrhythmic and immunosuppressive therapy.

Russian Journal of Cardiology. 2018;23(12):32–43

dx.doi.org/10.15829/1560-4071-2018-12-32-43

Key words: myocarditis, dilated cardiomyopathy, arrhythmias, plasmapheresis, immunosuppressive therapy.

Conflicts of Interest: nothing to declare.

1I. M. Sechenov First Moscow State Medical University, Moscow; 2V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow; 3Y. E. Veltischev The Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russia.

Kulikova V. A. ORCID: 0000-0002-9255-5542, Nedostup A. V. ORCID: 0000-0002-5426-3151, Blagova O. V. ORCID: 0000-0002-5253-793X, Zaidenov V. A. ORCID: 0000-0002-0102-9740, Kupriyanova A. G. ORCID: 0000-0002-1096-5717, Nechaev I. A. ORCID: 0000-0002-3037-3516, Ragimov A. A. ORCID: 0000-0002-4063-1101.

Received: 31.07.2018

Revision Received: 01.10.2018

Accepted: 02.11.2018

PILOT PROJECT "IMPROVEMENT OF MEDICAL CARE FOR PATIENTS WITH CHRONIC HEART FAILURE": RESULTS OF THE FIRST STAGE

Murtazalieva P. M., Karelkina E. V., Shishkova A. A., Zaitsev V. V., Zvartau N. E., Moiseeva O. M.

Abstract

Aim. To assess the real clinical practice data on the management of patients with congestive heart failure in the city emergency hospital conditions for development of key areas to improve medical care for patients with chronic heart failure (CHF).

Material and methods. We analyzed 343 hospitalization cases of patients with decompensation of CHF. On admission, 88% of patients had III-IV class CHF. The quality of medical care was assessed according to criteria approved by the Ministry of Health of Russia and specialists’ society in heart failure.

Results. Along with routine instrumental tests (electrocardiography, chest x-ray), echocardiography was conducted in 64% of patients, and 24-hour Holter monitoring in 3% of patients. Standard laboratory tests in only 15 and 14% of cases included determination of serum potassium and sodium concentrations. The level of lactate dehydrogenase, alkaline phosphatase and γ-glutamyl transpeptidase was estimated in less than 5% of patients. In the hospital, 94% of patients received therapy with β-blockers, 93% - with angiotensin-converting-enzyme inhibitors or angiotensin type II receptor blockers, 74% - with mineralocorticoid receptor antagonists and 88% - with diuretics. However, 48% of patients received parenteral diuretic therapy before discharge from the hospital and were not adapted to receive oral diuretics. The dynamics of weight on the background of diuretic therapy was controlled only in 13% of patients. At the same time, at discharge, the number of patients with III-IV class CHF was 38%.

Conclusion. Despite the positive dynamics during hospitalization, treatment strategy of patients with CHF had some disadvantages. The development of an automated system for receiving, integrating, storing and processing medical information will improve medical care for patients with CHF.

Russian Journal of Cardiology. 2018;23(12): 44-50

dx.doi.org/10.15829/1560-4071-2018-12-44-50

Key words: chronic heart failure, quality of medical care, register.

Funding. The study was supported by a grant from the Russian Science Foundation (17-15-01177).

Conflicts of Interest: nothing to declare.

Almazov National Medical Research Center, St. Petersburg, Russia.

Murtazalieva P. M. ORCID: 0000-0002-8459-7515, Karelkina E. V. ORCID: 0000-0002-3655-9709, Shishkova A. A. ORCID: 0000-0002-0488-9172, Zaitsev V. V. ORCID: 0000-0003-1905-2575, Zvartau N. E. ORCID: 0000-0001-6533-5950, Moiseeva O. M. ORCID: 0000-0002-7817-3847.

Received: 12.11.2018

Revision Received: 23.11.2018

Accepted: 30.11.2018

AN OBSERVATIONAL STUDY TO ASSESS THE OUTCOMES OF TREATMENT OF PATIENTS WITH STABLE ANGINA AFTER PLANNED PERCUTANEOUS CORONARY INTERVENTION: BASELINE PATIENT CHARACTERISTICS

Ratova L. G.1, Parizhskaya E. N.1, Kovaleva K. A.2, Nedoshivin A. O.1, Nemyatykh O. D.2, Pulit V. V.3, Konradi A. O.1,4

Abstract

Aim. To describe the characteristics of patients who were invited in observational, prospective study on a value-based approach to assess the outcomes of treatment of patients with stable coronary artery disease (CAD) by percutaneous coronary intervention (PCI).

Material and methods. We analyzed the baseline characteristics of patients with stable CAD enrolled in a planned PCI with stenting at Almazov National Medical Research Center in 2017. Statistical processing of the results was carried out using Statistica 6.0 (Statsoft Russia) and Microsoft Excel 2017. All registered patients were included in the statistical analysis. Based on the initial clinical characteristics of the patients included in the study, descriptive statistical parameters were calculated. For continuous variables, the mean value and standard deviation were calculated, for the categorical variables - the frequency of characteristic occurrence.

Results. From January 1, 2017 to December 31, 2017, were performed 1740 PCI operations with stenting in 1458 patients aged 63,8±9,6 years (men - 1008 (69,1%)). At the time of admission to the hospital, the body mass index was 29,4±5,2 kg/m2, BP=132,3±15,1/79,6±8,5 mm Hg; HR=69,4±8,3 beats per minute. PCI of one coronary artery was performed in 75,6%, multivascular - in 16,6%, in chronic occlusions - in 4,6% and in bifurcation lesions - in 3,2% of patients, respectively. Type 4a myocardial infarction as a complication of PCI was registered in 2,9% of patients. The average duration of inpatient treatment was 5,5±3,4 days.

Conclusion. Patients with stable CAD who underwent PCI are a representative sample which allows the assessment of treatment outcomes, an objective assessment of the intervention and the calculation of pharmacoeconomic parameters. An observational study will help identifying the factors affecting the efficiency of surgery and getting knowledge of patients’ opinions about this method.

Russian Journal of Cardiology. 2018;23(12): 52-56

dx.doi.org/10.15829/1560-4071-2018-12-52-56

Key words: coronary artery disease, stable angina, percutaenous coronarography intervention, patient-oriented approach.

Conflicts of Interest: nothing to declare.

Funding. The study is supported by a grant from the Russian Science Foundation (17-15-01177).

1Almazov National Medical Research Center, St. Petersburg; 2St. Petersburg State Chemical Pharmaceutical Academy, St. Petersburg; 3Company "SP.ARM", St. Petersburg; 4Institute of Translational Medicine, ITMO University, St. Petersburg, Russia.

Ratova L. G. ORCID: 0000-0002-3109-034X, Parizhskaya E. N. ORCID: 0000-0003-3863-8547, Kovaleva K. A. ORCID: 0000-0002-6647-2479, Nedoshivin A. O. ORCID: 0000-0001-8892-6411, Nemyatykh O. D. ORCID: 0000-0001-5933-2120, Pulit V. V. ORCID: 0000-0002-5814-5750, Konradi A. O. ORCID: 0000-0001-8169-7812.

Received: 19.11.2018

Revision Received: 23.11.2018

Accepted: 30.11.2018

CLINIC AND PHARMACOTHERAPY

EFFECTIVE BLOOD PRESSURE REDUCTION: RESULTS OF THE REGIONAL PROGRAM "DOVERIE"

Dobryninа N. V., Yakushin S. S.

Abstract

In clinical practice, quite often the practitioner faces difficulties in correcting arterial pressure in patients with arterial hypertension. Patients mostly for various reasons prefer to be treated with generic drugs, sometimes to the detriment of the effectiveness of treatment. The regional study conducted by us clearly showed the presence of additional possibilities of the original drug Prestans (Servier, France) in reducing blood pressure compared to equivalent dosages of generic fixed combinations.

Russian Journal of Cardiology. 2018;23(12):57–63

dx.doi.org/10.15829/1560-4071-2018-12-57-63

Key words: аrterial hypertension, epidemiology, combination therapy, the original drug, generics.

Conflicts of Interest: nothing to declare.

Ryazan State Medical University named after academician I. P. Pavlov, Ryazan, Russia.

Dobryninа N. V. ORCID: 0000-0023-2200-1592, ResearcherID: U-9725-2018, Yakushin S. S. ORCID: 0000-0002-1394-3791, ResearcherID: A-9290-2017.

Received: 19.10.2018

Revision Received: 06.11.2018

Accepted: 13.11.2018

SUPPORTING A PRACTITIONER

ALGORITHM OF ECHOCARDIOGRAPHY IN PREGNANT WOMEN

Gorokhova S. G.1, Morozova T. E.2, Arakelyants A. A.2, Barabanova E. A.2, Dyakonova E. G.2

Abstract

Pregnancy is a physiological condition that takes a defined period of time in a woman’s life. For nine months, the mother’s heart works under conditions of daily additional load, which is necessary to ensure placental blood flow. In this regard, structural and functional adaptation of the heart develops in a healthy woman with a normal pregnancy. A pregnant woman with some heart diseases is less likely to adapt. That leads to greater susceptibility to stress resulting in pathological changes of pregnancy. In addition, each pregnancy may develop new heart diseases, which in some cases may be relatively innocent, but in others - fatal. In this regard echocardiography (EchoCG) is a necessary procedure for assessing a woman’s health status that needs before bearing a fetus, during and after pregnancy.

Russian Journal of Cardiology. 2018;23(12):75–82

dx.doi.org/10.15829/1560-4071-2018-12-75-82

Key words: pregnancy, echocardiography, congenital heart disorders, acquired valve disease, peripartum cardiomyopathy, predictors of cardiovascular risk.

Conflicts of Interest: nothing to declare.

1Russian Medical Academy of Continuing Professional Education, Moscow; 2I. M. Sechenov First Moscow State Medical University, Moscow, Russia.

Gorokhova S. G. ORCID: 0000-0001-7087-8140, Morozova T. E. ORCID: 0000-0002-3748-8180, Arakelyants A. A. ORCID: 0000-0002-1243-2471, Barabanova E. A. ORCID: 0000-0002-2095-8879, Dyakonova E. G. ORCID: 0000-0002-8575-3444.

Received: 16.08.2018

Revision Received: 29.09.2018

Accepted: 13.10.2018

INFORMED CONSENT TO THE RECEIPT AND USE OF HUMAN CELLULAR MATERIAL: JURISTIC AND ETHICAL REGULATION

Stambolsky D. V., Bryzgalina E. V., Efimenko A. Yu., Alasania K. Yu., Shkomova E. M., Gavrilenko S. M., Varkhotov T. A., Matskeplishvili S. T.

Abstract

Further progress in medicine is closely related to the clinical introduction of regenerative technologies, including cell therapy. Presented article covers the ethical and legal status of obtaining an informed consent from donors of cell material. The manuscript defines specific functions of such informed consent related to the features of research object and possibilities of its further use. The recommended content of the informed consent from cell material donors is determined in the context of global trends as well as guidelines for obtaining the consent. Existing difficulties and contradictions while developing an informed consent are presented.

Russian Journal of Cardiology. 2018;23(12):84–90

dx.doi.org/10.15829/1560-4071-2018-12-84-90

Key words: informed consent, donor, biomedicine, bioethics, biotechnologies, bioindustry.

Conflicts of Interest: nothing to declare.

Funding. This study was supported by a grant from the Russian Science Foundation (14-50-00029).

Lomonosov Moscow State University, Moscow, Russia.

Stambolsky D. V. ORCID: 0000-0001-6983-9697, Bryzgalina E. V. ORCID: 0000-0002-5103-9488, Efimenko A. Yu. ORCID: 0000-0002-0696-1369, Alasania K. Yu. ORCID: 0000-0002-7452-8882, Shkomova E. M. ORCID: 0000-0003-3581-8681, Gavrilenko S. M. ORCID: 0000-0001-9444-5358, Varkhotov T. A. ORCID: 0000-0003-3363-7596, Matskeplishvili S. T. ORCID: 0000-0002-5670-167X.

Received: 16.08.2018

Revision Received: 29.09.2018

Accepted: 13.10.2018

PERSPECTIVE TECHNOLOGIES FOR SCREENING HEART RHYTHM DISTURBANCES: FOCUS ON MOBILE ECG DEVICES

Berdnikov S. V.1, Berdnikova O. A.2

Abstract

Now diagnostics of a paroxysmal form of atrial fibrillation remains an important problem. The real prevalence of atrial fibrillation can be strongly underestimated, including due to its ≪silent≫ character. The existing technologies for atrial fibrillation screening including Holter-monitoring have no high sensitivity, difficult and also cannot be widely used in population. In this regard the special relevance by the mobile medical technologies which are not demanding a visit to the doctor is acquired. In this article the overview of modern technologies of screening disturbances of a heart rhythm by means of registration of the single-channel ECG by the smartphone and its subsequent analysis by means of modern mathematical algorithms is provided.

Russian Journal of Cardiology. 2018;23(12):92–97

dx.doi.org/10.15829/1560-4071-2018-12-92-97

Key words: atrial fibrillation, ECG, mobile technologies, screening, smartphone.

Conflicts of Interest: nothing to declare.

1European medical center, Moscow, Russia; 2Center of ambulatory dialysis 50, Moscow region, Russia.

Berdnikov S. V. ORCID: 0000-0003-0942-4187, Berdnikova O. A. ORCID: 0000-0002-7490-8308.

Received: 02.06.2018

Revision Received: 23.07.2018

Accepted: 30.07.2018

DIAGNOSTIC METHODS

PREDICTIVE VALIDITY OF THE MODEL FOR CALCULATING OF ECHOCARDIOGRAPHIC PARAMETERS IN HEALTHY PATIENTS

Sokolov A. A., Soldatenko M. V., Smorgon A. V.

Abstract

Aim. Development of a model for calculating of predicted values of key echocardiography (EchoCG) parameters in patients of different ages and staturelweight values.

Material and methods. The study included 10604 apparently healthy patients aged from 1 day to 65 years; 5726 (54%) of them are female. In addition to the general clinical study, all patients underwent EchoCG with the measurement of standard indicators as recommended by the American Society of Echocardiography. We measured body surface area (BSA) and selected a regression model, which most adequately links the values of the EchoCG parameters and staturel-weight values.

Results. All EchoCG parameters showed a significant correlation with BSA. The patients were divided into four groups to receive more homogeneous cohorts. We have identified newborns and adults. A group of children was additionally divided according to BSA, by less than 0,3 m2 and more than 0,3 m2. The calculated regression equations were reliable in both cases - before and after separation. Comparison of dispersion excesses showed a better dependence among the separated groups. The separation also significantly increased the prediction accuracy.

Conclusion. The proposed mathematical models relevantly predict the normal values of variables. The method is well suited for calculating the Z-index of main EchoCG parameters.

Russian Journal of Cardiology. 2018;23(12):98–102

dx.doi.org/10.15829/1560-4071-2018-12-98-102

Key words: echocardiography, allometry, normalization, Z-index.

Conflicts of Interest: nothing to declare.

Tomsk National Research Medical Center of RAS, Tomsk, Russia.

Sokolov A. A. ORCID: 0000-0003-0513-9012, Soldatenko M. V. ORCID: 0000-0002-9886-0695, Smorgon A. V. ORCID: 0000-0002-6531-7223.

Received: 09.04.2018

Revision Received: 27.04.2018

Accepted: 11.05.2018

EXPERT CONSENSUS

LIPID-LOWERING TREATMENT IN THE IMPROVEMENT OF OUTCOMES IN PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR DISEASE AND DIABETES MELLITUS: THE ROLE OF PCSK9 INHIBITORS

Galstyan G. R.1, Galyavich A. S.2, Grineva E. N.3, Gurevich V. S.4,5, Ezhov M. V.6, Kalashnikov V. Yu.1, Karpov Yu. A.6, Mkrtumyan A. M.7, Nedogoda S. V.8, Smolenskaya O. G.9, Shlyakhto E. V.3, Yakovlev A. N.3

Abstract

The resolution of Russian scientific expert council was adopted on September 28, 2018, Moscow.

Russian Journal of Cardiology. 2018;23(12):103–106

dx.doi.org/10.15829/1560-4071-2018-12-103-106

Key words: PCSK9 inhibitors, diabetes mellitus, atherosclerotic cardiovascular diseases, low-density lipoprotein cholesterol.

Conflicts of Interest: nothing to declare.

1National Medical Research Center for Endocrinology, Moscow; 2Kazan State Medical University, Kazan; 3Almazov National Medical Research Center, St. Petersburg; 4St. Petersburg State University, St. Petersburg; 5I. I. Mechnikov North-Western State Medical University, St. Petersburg; 6National Medical Research Center of Cardiology of the Ministry of Health, Moscow; 7A. I. Evdokimov Moscow State University of Medicine, Moscow; 8Volgograd State Medical University, Volgograd; 9Ural State Medical University, Ekaterinburg, Russia.

Galstyan G. R. ORCID: 0000-0001-6581-4521, Galyavich A. S. ORCID: 0000-0002-4510-6197, Grineva E. N. ORCID: 0000-0003-0042-76808, Gurevich V. S. ORCID: 0000-0002-6815-444X, Ezhov M. V. ORCID: 0000-0002-1518-6552, Kalashnikov V. Yu. ORCID: 0000-0001-5573-0754, Karpov Yu. A. ORCID: 0000-0003-1480-0458, Mkrtumyan A. M. ORCID: 0000-0003-1316-5245, Nedogoda S. V. ORCID: 0000-0001-5981-1754, Smolenskaya O. G. ORCID: 0000-0002-0705-6651, Shlyakhto E. V. ORCID: 0000-0003-2929-0980, Yakovlev A. N. ORCID: 0000-0001-5656-3978.

Received: 01.10.2018

Revision Received: 15.10.2018

Accepted: 29.10.2018

LITERATURE REVIEWS

NEPHROPROTECTIVE STRATEGY IN THE TREATMENT OF HYPERTENSION AS A MODERN GENERAL MEDICAL PROBLEM

Podzolkov V. I., Bragina A. E., Ishina T. I., Bragina G. I., Vasilyeva L. V.

Abstract

The current population is characterized by a high prevalence of risk factors for the development of chronic kidney disease: hypertension, diabetes, obesity, metabolic syndrome, physical inactivity, smoking. The development of severe complications and a close connection with potentially fatal cardiovascular disorders make this disease a socially and economically significant problem. Treatment of chronic kidney disease in advanced stages belong to nephrologist duties. However, the success of preventive interventions depends on the time of their onset, which makes it relevant to identify the disease. The use of nephroprotective approaches by physicians of different specialties (general practitioners, cardiologists, gerontologists, nephrologists, endocrinologists) can significantly improve the prognosis of both those at risk of developing renal dysfunction and the existing disease. The review presents data on the clinical and laboratory efficacy of angiotensin-renin blocker use, as well as the combination of angiotensin II receptor blockers with calcium antagonists. Using the combination of the angiotensin II receptor blocker irbesartan and amlodipine as an example, we demonstrated the possibilities of nephroprotective therapy in patients with renal dysfunction.

Russian Journal of Cardiology. 2018;23(12): 107-118

dx.doi.org/10.15829/1560-4071-2018-12-107-118

Key words: : arterial hypertension, chronic kidney disease, nephroprotection, fixed combinations, amlodipine, angiotensin receptor blockers.

Conflicts of Interest: nothing to declare.

I. M. Sechenov First Moscow State Medical University, Moscow, Russia.

Podzolkov V. I. ORCID: 0000-0002-0758-5609, Bragina A. E. ORCID: 0000-0002-2699-1610, Ishina T. I. ORCID: 0000-0001-7720-0770, Bragina G. I. ORCID: 0000-0002-0558-7096, Vasilyeva L. V. ORCID: 0000-0001-5730-7837.

Received: 18.09.2018

Revision Received: 12.11.2018

Accepted: 19.11.2018

THE COMBINATION OF ATRIAL FIBRILLATION AND OBSTRUCTIVE SLEEP APNEA - IS THERE A CONNECTION?

Arutyunyan G. G., Agaltsov M. V., Davtyan K. V., Drapkina O. M.

Abstract

The review discusses the issue of the mutual influence of combination of atrial fibrillation (AF) and obstructive sleep apnea (OSA). In individuals with a combination of these pathologies, OSA can influence the easier realization of AF. The presence of respiratory disturbances in sleep reduces the effectiveness of all types of AF treatment (antiarrhythmic, surgical, electrical cardioversion). It is shown, that the treatment of OSA by the method of non-invasive ventilation support (CPAP-therapy) improves the results of catheter treatment of AF in the early postoperative period.

Russian Journal of Cardiology. 2018;23(12):119–124

dx.doi.org/10.15829/1560-4071-2018-12-119-124

Key words: atrial fibrillation, obstructive sleep apnea, catheter treatment of AF, CPAP-therapy.

Conflicts of Interest: nothing to declare.

National Medical Research Center for Preventive Medicine, Moscow, Russia.

Arutyunyan G. G. ORCID: 0000-0002-3442-3613, Agaltsov M. V. ORCID: 0000-0002-4982-628X, Davtyan K. V. ORCID: 0000-0003-3788-3997, Drapkina O. M. ORCID: 0000-0002-4453-8430.

Received: 03.06.2018

Revision Received: 22.10.2018

Accepted: 29.10.2018

MYOCARDIAL PERFUSION SCINTIGRAPHY IN THE DIAGNOSTICS OF TAKOTSUBO SYNDROME

Abdrakhmanova A. I.1,2, Saifullina G. B.2, Amirov N. B.3,4

Abstract

We analyzed the publications about single-photon emission computed tomography in the diagnostics of takotsubo syndrome; the dynamics of testing data are presented on a clinical example. Single-photon emission computed tomography can be used to evaluate perfusion parameters for exclusion of myocardial infarction in uncertain cases. In segments with impaired contractile function, it is possible to detect normal or reduced perfusion. During the acute phase there is a reduced accumulation of radiopharmaceuticals in myocardial segments with impaired function, which coincides with the regional distribution of neuronal activity. Pathological changes may persist for several months, and use of scintigraphy with a radiopharmaceutical may help in cases when the diagnosis was not well-timed established. The method of myocardial scintigraphy in ECG-synchronized tomography allows to simultaneously assess the perfusion and the function of the left ventricle and differentiate such disorder as takotsubo syndrome.

Russian Journal of Cardiology. . 2018;23(12):125–130

dx.doi.org/10.15829/1560-4071-2018-12-125-130

Key words: takotsubo syndrome, perfusion scintigraphy, diagnosis.

Conflicts of Interest: nothing to declare.

1 Kazan (Volga region) Federal University, Kazan; 2Interregional Clinical Diagnostic Center, Kazan; 3Kazan State Medical University, Kazan; 4Interior Ministry Hospital of Republic of Tatarstan, Kazan, Russia.

Abdrakhmanova A. I. ORCID: 0000-0003-0769-3682, Saifullina G. B. ORCID: 0000-0002-1259-0285, Amirov N. B. ORCID: 0000-0003-0009-9103.

Received: 04.07.2018

Revision Received: 27.08.2018

Accepted: 11.11.2018

CLINICAL GUIDELINES

RUSSIAN SOCIETY OF CARDIOLOGY POSITION PAPER ON 2018 GUIDELINES OF THE EUROPEAN SOCIETY OF CARDIOLOGY/EUROPEAN SOCIETY OF ARTERIAL HYPERTENSION FOR THE MANAGEMENT OF ARTERIAL HYPERTENSION

Working group: Kobalava Zh. D., Konradi A. O., Nedogoda S. V.
Committee of experts: Arutyunov G. P., Baranova E. I., Barbarash O. L., Villevalde S. V., Galyavich A. S., Glezer M. G., Drapkina O. M., Kotovskaya Yu. V., Libis R. A., Lopatin Yu. M., Nedoshivin A. O., Ostroumova O. D., Ratova L. G., Tkacheva O. N., Chazova I. E., Chesnikova A. I., Chumakova G. A.

Russian Journal of Cardiology. 2018;23(12): 131-142

dx.doi.org/10.15829/1560-4071-2018-12-131-142

Conflicts of Interest: nothing to declare.

Kobalava Zh. D. ORCID: 0000-0002-5873-1768, Konradi A. O. ORCID: 0000-0001-8169-7812, Nedogoda S. V. ORCID: 0000-0001-5981-1754. Arutyunov G. P. ORCID: 0000-0002-6645-2515, Baranova E. I. ORCID: 0000-0002-8788-0076, Barbarash O. L. ORCID: 0000-0002-4642-3610, Villevalde S. V. ORCID: 0000-0001-7652-2962, Galyavich A. S. ORCID: 0000-0002-4510-6197, Glezer M. G. ORCID: 0000-0002-0995-1924, Drapkina O. M. ORCID: 0000-0002-4453-8430, Kotovskaya Yu. V. ORCID: 0000-0002-1628-5093, Libis R. A. ORCID: 0000-0003-0130-990X, Lopatin Yu. M. ORCID: no, Nedoshivin A. O. ORCID: 0000-0001-8892-6411, Ostroumova O. D. ORCID: 0000-0002-0795-8225, Ratova L. G. ORCID: 0000-0002-3109-034X, Tkacheva O. N. ORCID: 0000-0002-4193-688X, Chazova I. E. ORCID: 0000-0002-9822-4357, Chesnikova A. I. ORCID: 0000-0002-9323-592X, Chumakova G. A. ORCID: 0000-0002-2810-6531.

Received: 19.11.2018

Revision Received: 23.11.2018

Accepted: 30.11.2018

2018 ESC/ESH GUIDELINES FOR THE MANAGEMENT OF ARTERIAL HYPERTENSION

The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)

Russian Journal of Cardiology. 2018;23(12):143–228

dx.doi.org/10.15829/1560-4071-2018-12-143-228

Key words: guidelines, hypertension, blood pressure, blood pressure measurement, blood pressure treatment thresholds and targets, hypertension-mediated organ damage, lifestyle interventions, drug therapy, combination therapy, device therapy, secondary hypertension.

INFORMATION

Russian Journal of Cardiology: contents for 2018

Russian Journal of Cardiology. 2018;23(12): 229-238

28 декабря 2018 г.
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