Russian Journal Of Cardiology, 2018, 4 (23)

Russ J Cardiol 2018, 4 (156): 5

CLINICAL MEDICINE NEWS

Clinical medicine updates: a review of international news

Russ J Cardiol 2018, 4 (156): 6

ORIGINAL ARTICLES

PROGNOSTIC SIGNIFICANCE OF ENDOTHELIAL DYSFUNCTION MARKERS IN ARTERIAL HYPERTENSION

Podzolkov V. I., Bragina A. E., Druzhinina N. A.

Abstract

Aim. Assessment of prognostic significance of endothelial dysfunction markers: stable metabolites of nitric oxide (NO_x), von Willebrand factor (vWF), endothelin-1 (E1), homocysteine and tissue plasminogen activator (tPA) in essential hypertension (EAH) patients not taking antihypertension therapy systematically.

Material and methods. Totally, 12 EAH patients investigated (45 males, 79 females) (mean age 51,4±6,5 y. o., mean duration of AH 7,9±7,3 y.). Concentration of NO_x in plasma was measured by spectrophotometry, and of vWF, homocysteine, E1 and tPA — by immune enzyme assay.

Results. By the increase of SCORE risk level, there was significant increase of concentrations of NO_x, E1, homocysteine and vWF in EAH patients (p<0,05), there were no changes in tPA levels (p>0,05). In 8 (8±1,1) years after baseline assessment, 115 patients were assessed second time. Of those 13 (11,3%) had cardiovascular events (CVE) and 5 (4,3%) died. By single factorial regression, the rate of CVE in EAH patients relate to homocystein level (р=0,01), NOx (р=0,001) and vWF (р=0,001). By multifactorial analysis, prognostic statistical significance is found for NO_x (relative risk (RR) =3,8, р=0,006) and vWF (RR =3,5, р=0,005). In ROC-analysis there were found threshold levels of NO_x (>46,6 mcM/L, AUC =0,863) and vWF (>1,68 mg/dL, AUC =0,738), the increase of which is followed by CVE development risk for the levels of NO_x >46,6 mcM/L 3,8 times (sensitivity 81,9% and specificity 65,8%), vWF >1,68 mg/dL — 3,5 times (sensitivity 74,3% and specificity 62,7%). Combination of the parameters point on the risk increase up to 6,5 times (р=0,00007).

Conclusion. NO_x with the threshold of >46,6 mcM/L (RR =3,8) and vWF >1,68 mg/dL (RR =3,5) do show independent prognostic value for 5-year CVE risk assessment in EAH patients that can be applied as an additional method for risk stratification to estimate a group for more aggressive therapy and CVE prevention.

Russ J Cardiol 2018, 4 (156): 7–13

dx.doi.org/10.15829/1560-4071-2018-4-7-13

Key words: endothelial dysfunction, essential hypertension, nitric oxide, von Willebrand factor, SCORE.

I. M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow, Russia.

RETINOL B INDING PROTEIN AS A MARKER OF CARDIOVASCULAR RISK IN ARTERIAL HYPERTENSION AND OBESITY

Vasyuk Yu. A., Sadulaeva I. A., Yushchuk E. N., Trofimenko O. S., Ivanova S. V.

Abstract

Aim. To assess the influence of retinol-binding protein synthetized by adipose tissue, on clinical course and prognosis of arterial hypertension (AH).

Material and methods. Totally, 168 patients included, with AH of 1-3 grade. Study protocol included general clinical investigation (at inclusion, in 1, 4 and 9 months) with analysis of complaints, anamnesis, physical examination, additional laboratory and instrumental methods. In 78 patients among the included, the level of retinolbinding protein RBP4 was measured in blood serum.

Results. Increased level of RBP4 correlated significantly with the age, body mass index, duration of AH, raised level of uric acid, pulse wave velocity signs, endogenic nitrite. Only in the group with raised RBP4 there was stroke anamnesis noted, and obesity of III grade. Dynamics of the level of RBP4 during 9 months treatment, depending on cardiometabolic risk, showed some specifics: at inclusion, in the group with high cardiometabolic risk there was significantly increased RBP4 comparing to the groups of patients with low and moderate cardiometabolic risk.

Conclusion. Increased level of retinol-binding protein is associated with higher cardiometabolic risk and adverse prognosis.

Russ J Cardiol 2018, 4 (156): 14–18

dx.doi.org/10.15829/1560-4071-2018-4-14-18

Key words: arterial hypertension, obesity, retinol-binding protein RBP4, cardiometabolic risk.

A. I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD), Moscow, Russia.

RISK GROUPS FOR PREGNANCY HYPERTENSIVE DISORDERS DEVELOPMENT

Shakhbazova N. A.

Abstract

Aim. Development of clinical, anamnestic, immunological and instrumental prognostic markers of high and low risk of gestational hypertensive disorders.

Material and methods. A range of risk factors was assessed in 220 pregnant women with hypertensive states (main group) and 50 healthy pregnant women (control group). In the pregnant, clinical and anamnestic risk factors of preeclampsia were assessed (age, parity, anamnesis of hypertensive disorders, extragenital diseases, etc.), autoantibodies to 12 antigenes (by ELI-P test),placental growth factor (PGF) and resistance index (RI) in uterus arteries, by Doppler.

Results. During the study, it was found that clinical and anamnestic factors of high risk of pre-eclampsia are: first pregnancy, chronic hypertension, extragenital pathology in woman, anamnesis of pre- and eclampsia, combination of three and more factors. Preclinical immunological predictors of high risk of pre-eclampsia in the 1st trimester are high titre of autoantibodies to S-100, B-2QP, ANCA (range -65 to +94 units), combined raise of three kinds of antibodies, immunity suppression, PGF level in the blood 50-100 pg/mL — for pre-eclampsia, up to 50 pg/mL — for fetal development delay. Doppler markers of high risk of pre-eclampsia: increase of RI up to 0,60 and dicrotic notch in both uterine arteries; RI increase 0,61-0,70 with one dicrotic notch only in one uterine artery; increase of RI more than 0,70 and no dicrotic notch.

Conclusion. The most useful and predictive for pre-eclampsia are clinical and anamnestic, as immunological predictors that are revealed within 15 weeks of pregnancy. Instrumental prognostic markers that are explored after 20 weeks are useful for prognosis prediction on possible pre-eclampsia development and for control of treatment efficacy.

Russ J Cardiol 2018, 4 (156): 19–24

dx.doi.org/10.15829/1560-4071-2018-4-19-24

Key words: pre-eclampsia, risk factors, autoantibodies, placental growth factor, dopplerometry of uterine arteries.

SRI of Obstetrics and Gynecology of the Azerbaidzhan Republic Ministry of Health, Baku, Azerbaidzhan.

SPECIFICS OF ARTERIAL HYPERTENSION DEVELOPMENT IN PENITENTIARY STRESS CIRCUMSTANCES

Dyuzheva E. V.^1,2, Ponomarev S. B.¹

Abstract

Aim. To reveal the specifics of arterial hypertension (AH) development under the circumstances of penitentiary stress.

Material and methods. Totally, 107 patients included, among the persons first time imprisoned, comparable by age and gender — almost healthy young males 25-36 y. o. The relation studied, of psychological test and 24-hour blood pressure (BP) profile and Holter ECG, as heart rate variablity, in three groups of participants formed depending on the duration of imprisonment.

Results. It was found that psychoemotional state during the first month of imprisonment is characterized by a high level of situational, personality anxiety with predominant depressive symptomatic. This is followed by heart conduction and rhythm pathology. With the time of imprisonment, level of anxiety and depression declines. Also, heart rhythm variability analysis shows significant decrease of value of LF (%) and predomination of VLF (%) in the wave spectrum. The parameters of 24-hour BP show a significant increase of BP at later periods of imprisonment. Daytime BP level shows direct relation with the parameter “duration of imprisonment”, and nocurnal BP — with the level of situational anxiety.

Conclusion. Under the circumstances of penitentiary stress, one of the revealed mechanism of AH development is weakening of sympathetic modulation of vegetative innervation of the heart and decline of baroreflectory sensitivity. Increase of the duration of imprisonment and of the level of situational anxiety are the specific factors of penitentiary circumstances that influence AH development in young clinically healthy men.

Russ J Cardiol 2018, 4 (156): 25–31

dx.doi.org/10.15829/1560-4071-2018-4-25-31

Key words: penitentiary stress, arterial hypertension, convicts.

¹SRI of the Federal Penitentiary Service, Moscow; ²Izhevsk State Medical Academy of the Ministry of Health, Izhevsk, Russia.

THE ROLE OF SYSTEMIC INFLAMMATION IN DECREASE OF ELASTICITY OF MAGISTRAL ARTERIES AND IN PROGRESSION OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH SYSTEMIC HYPERTENSION, OBESITY AND TYPE 2 DIABETES

Statsenko M. E., Derevyanchenko M. V.

Abstract

Aim. To evaluate the role of systemic inflammation in decrease of magistral arteries elasticity and progression of endothelial dysfunction in arterial hypertension (AH) patients comorbid with obesity and/or type 2 diabetes (DM2).

Material and methods. Ninety patients with AH stages II-III, 45-65 year old, were selected to 3 groups. Group 1 — patients with “isolated” AH, group 2 — AH with obesity, group 3 — AH and DM2 patients. Standard physical examination was done, vascular stiffness assessment by pulse wave velocity (PWV) measurement of the vessels of muscular (PWVm) and elastic (PWVe) types; the levels were measured of systemic inflammation markers, endothelial dysfunction and fibrosis.

Results. PWVe and PWVe >10 m/s were significantly more common in group 3 patients comparing to group 1 (10,3 [9,5;11,7] vs 9,0 [8,0;11,3] m/s and 70 vs 40%, respectively). Concentration of C-reactive protein (CRP) was significantly higher in AH with DM2 comparing to AH and obesity or only AH (7,92 [4,77;16,15] vs 4,77 [4,53;5,43], 7,92 [4,77;16,15] vs 2,98 [0,65;7,19] mg/L, respectively). Level of endothelin-1 (E1) in blood serum increased significantly in 1 to 3 group, with significant differences in all groups. In AH and DM2 patients, concentration of collagen type 4 in the blood was statistically significantly higher than in AH and

obesity patients and only AH (5,67 [3,58;9,20] vs 2,94 [2,57;8,45], 5,67 [3,58;9,20] vs 2,63 [2,23;7,28] ng/mL). Correlational analysis showed the presence of highly significant correlations in concentrations of CRP and PWVe (r=0,41), level of E1 (0,51), in E1 and duration of DM2 anamnesis (r=0,58), body mass index (r=0,35), smoking (r=0,54), PWVm (r=0,47), PWVe (r=0,47), in concentration of collagen type 4 and duration of DM2 anamnesis (r=0,36), PWVe (r=0,31).

Conclusion. The data obtained witness on the negative influence of systemic inflammation on the elasticity of vascular wall of magistral arteries, and on its importance in progression of endothelial dysfunction in AH patients comorbid with obesity and DM2.

Russ J Cardiol 2018, 4 (156): 32–36

dx.doi.org/10.15829/1560-4071-2018-4-32-36

Key words: arterial hypertension, abdominal obesity, type 2 diabetes, systemic inflammation, endothelial dysfunction, fibrosis markers.

Volgograd State Medical University of the Ministry of Health, Volgograd, Russia.

SPECIFICS OF NEUROHUMORAL ACTIVITY AND CLINICAL PRESENTATION OF MASKED ARTERIAL HYPERTENSION IN YOUNG MALES

Lyamina N. P., Kosareva A. V., Tsareva O. E., Senchikhin V. N., Lipchanskaya T. P., Shkrobova N. V.

Abstract

Aim. To assess the neurohumoral state, specifics of clinical presentation, prevalence and prominence of cardiovascular and behavioral risk factors in males of young age with masked arterial hypertension (MAH).

Material and methods. To the full coverage screening study, 643 participants included, age 18-30 y. o. (mean age 22). Complete clinical and laboratory, instrumental assessments performed, with analysis of neurohumoral activity by the levels of adrenaline, noradrenaline, angiotensin II. All participants were selected to groups: MAH (n=61), manifest AH (n=46), normotonics (n=536). Diagnostics of MAH was done in case of positive test of 30 second respiration pause and 24 hour blood pressure (BP) monitoring.

Results. In males, MAH was found in 9,5% cases, manifest AH in 7,1%, normotonia in 83,4%. In MAH and manifest AH participants the level of adrenaline was higher than in normotonics: 4,55 pM/L [3,53; 5,1], 6,25 pM/L [4,75; 8,65] and 2,1 pM/L

[1,2; 4,5], respectively. Males with MAH had almost 2 times higher level of noradrenaline (19,5 pM/L [18,8; 22,8]) comparing to “normotonics” (8 pM/L [6; 12,1]) and 1,5 times higher than in manifest AH (13,1 pM/L [11,5; 14,4]). Angiotensin II assessment showed that in MAH males it was higher (18,5 pM [15,75; 21,9]), than in normotonics (15,7 pM [13;18,3]), but lower than in manifest AH (20,15 pM [18,9; 21,9]). Food related behavior assessment as of a factor of sodium overconsumption, the higher values were found in MAH patients and in manifest AH (50% and 50%) comparing to normotonics (25%). Early age of smoking beginning found in 28% of MAH males, more prevalent than in normotonics (24%) and manifest AH (15%).

Conclusion. In young males MAH is revealed more often than manifest AH. Development of MAH in young males is related to hypersympathicity with raised catecholamines level, disordered 24 hour rhythm “non-dipper”, disorder of BP variability and higher smoking level, than in normotonics.

Russ J Cardiol 2018, 4 (156): 37–42

dx.doi.org/10.15829/1560-4071-2018-4-37-42

Key words: masked arterial hypertension, younger age, neurohumoral activation, cardiovascular risk factors.

V. I. Razumovsky Saratov State Medical University of the Ministry of Health, Saratov, Russia.

TREATMENT ADHERENCE AND EFFICACY OF ANTIHYPERTENSION TREATMENT IN HYPERTENSIVES IN TYUMENSKAYA OBLAST

Efanov A.Yu.^1,2, Petrov I.М.¹, Petrova Yu. А.³, Vyalkina Yu. А.¹, Pochinok Е. М.¹, Sholomov I. F.¹, Medvedeva I. V.¹, Shalaev S. V.¹

Abstract

Aim. To evaluate the impact of treatment adherence on control of arterial hypertension (AH), and within a prospective study, to find out the predictors of adherence decline.

Material and methods. Randomly, 321 AH patient selected, from the registry of chronic non-communicable diseases on the territory of Tymenskaya Oblast, visited physician office during year 2014. In analysis of outpatient chart, the prevalence of prescription analyzed, of the groups of antihypertension medications (AHM), including combination drugs. In 3 months (±2,1) after office visit, patients were investigated. The following characteristics were assessed: smoking status, alcohol consumption, comorbidities, economical level, employment, depression and anxiety levels, frequency of AHM intake, prevalence to treatment and BP control efficacy. In 12 months (±2,3) patients, during phone interview, answered the questions on adherence to AHM. The factors revealed, increasing the relative risk (RR) of compliance decline. RR calculated with 95% confidence interval (CI).

Results. During a year, decrease of AHM intake found (from 73,2% in 3 months after office visit to 45,2% — in 12 months, р<0,01) and of its efficacy (from 51,9% in 3 months to 41,4% — in 12 months, р<0,01). Compliant to therapy patients reached target levels of BP 3,31 times (2,07-5,31), р<0,01) more often in 3 months after office visit, and 3,39 times (2,09-5,52), р<0,01) — in 12 months. As the predictors of treatment adherence were the following factors: male gender (RR =1,69 (1,06-2,70) p<0,05), age older than 65 (RR =1,72 (1,05-2,81) p<0,05), smoking (RR =1,89 (1,08-3,32) p<0,05), comorbidity 3+ (RR =2,61 (1,48-4,61)

p<0,01), overconsumption of alcohol (RR =1,99 (1,02-3,89) <0,05), raised level of depression (RR =1,65 (1,09-2,69) p<0,05), no tonometer at home (RR =1,85 (1,14-2,99) p<0,05), and recommended number of AHM 3 and more (RR =2,96 (1,11-7,85) p<0,05). Higher adherence factors were female gender (RR =0,59 (0,37-0,95) p<0,05), prescription of fixed AHM combinations (RR =0,51 (0,28-0,923) p<0,05).

Conclusion. During the study, we revealed a “patients portrait”, who are under higher chances of lower AHM adherence, and with the maximum effort is needed to retain on the prescribed treatment.

Russ J Cardiol 2018, 4 (156): 43–48

dx.doi.org/10.15829/1560-4071-2018-4-43-48

Key words: treatment adherence, arterial hypertension, non-compliance predictors, Morisky-Green test, antihypertensive efficacy, compliance.

¹Tyumen State Medical University of the Ministry of Health, Tyumen; ²Scientific-Practitioner Medical Center, Tyumen; ³Tyumen Industrial University, Tyumen, Russia.

CLINIC AND PHARMACOTHERAPY

OPTIMAL ORGANOPROTECTION, CONTROL OF B LOOD PRESSURE AND METABOLIC DISORDER WITH THE FIXED COMBINATION OF LISINOPRIL, AMLODIPINE AND ROSUVASTATIN IN SYSTEMIC HYPERTENSION

Nedogoda S. V., Chumachek E. V., Ledyaeva A. A., Tsoma V. V., Salasyuk A. S., Smirnova V. O., Hripaeva V. Yu., Palashkin R. V., Popova E. A.

Abstract

Aim. Evaluation of the ability of the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer) in achievement of additional angioprotection in patients with systemic arterial hypertension (AH) and high pulse wave velocity (PWV), regardless

of previous antihypertensive therapy (AHT).

Material and methods. To the open multicenter observational study 24 weeks duration, 60 patients included, taking double AHT during 6 months. All participants underwent ambulatory 24 hour blood pressure (BP) monitoring, applanation tonometry (augmentation index and central BP), pulse wave velocity assessment, laboratory tests (lipids, fasting glucose, insulin resistance index (HOMA), leptin, high sensitive C-reactive protein (hsCRP) before and after transition to the fixed combination of lisinopril, amlodipine and rosuvastatin (Equamer).

Results. By the data from office BP measurement, after transition of patients from the double combinations to fixed combination of lisinopril, amlodipine and rosuvastatin, there was additional decrease of systolic BP (SBP) by 14,3% and diastolic BP (DBP) by 18,5%. By the data from ABPM, decrease of SBP was 16,1%, and DBP — 21,8%. Combination of lisinopril, amlodipine and rosuvastatin decreased PWV by 14,4%, augmentation index by 14,5%, central SBP by 8,1% (p<0,01 for all comparisons with baseline). Fixed combination of lisinopril, amlodipine and rosuvastatin made it to decrease low density lipoproteides by 44%, triglycerides by 36,1% and increase of high density lipoproteides by 10,3% (p<0,01 for all with baseline). Usage of combination of lisinopril, amlodipine and rosuvastatin showed significant decrease of insulin resistance, hsCRP and leptin levels.

Conclusion. Fixed combination of lisinopril, amlodipine and rosuvastatin makes it to better control BP, improve vascular elasticity parameters (augmentation index, PWV, central BP) and facilitates the improvement of lipid and glucose metabolism, decrease of inflammation, leptin resistance in patients taking at baseline double antihypertensive therapy.

Russ J Cardiol 2018, 4 (156): 49–55

dx.doi.org/10.15829/1560-4071-2018-4-49-55

Key words: arterial hypertension, pulse wave velocity, central arterial pressure, augmentation index, leptin, inflammation, combination antihypertension therapy, lisinopril, amlodipine, rosuvastatin.

Volgograd State Medical University of the Ministry of Health, Volgograd, Russia.

COMPARISON OF INFLUENCE OF VARIOUS REGIMENS OF DRUG INTAKE ON 24 HOUR B LOOD PRESSURE, CENTRAL AORTIC PRESSURE AND VASCULAR WALL STIFFNESS IN SYSTEMIC HYPERTENSION PATIENTS WITH ISCHEMIC STROKE

Skibitsky V. V., Fendrikova A. V., Opolskaya S. V.

Abstract

Aim. To assess and compare the efficacy of combination antihypertension drugs influence with various dosage regimens during 24 hour, on the parameters of daily blood pressure (BP) profile, central aortic pressure (CAP) and vessel wall stiffness in arterial hypertension (AH) patients with ischemic stroke (IS).

Material and methods. To the study, 177 AH patients included, with IS within last 4 weeks. All patients were randomized to 3 groups depending on the regimen of antihypertensive drugs combination intake during 24 hours. At baseline and in 12 months of therapy all patients underwent 24 hour BP monitoring (ABPM), CAP measurement and vessel wall stiffness evaluation.

Results. In 8 weeks of antihypertension therapy, target pressure level achievement was significantly more common in b. i.d. valsartan (group 3) comparing to once daily in the morning (group 1) or evening (group 2) (p<0,05). In all groups there were

statistically significant positive changes in ABPM, CAP and stiffness. Also, in the group 2 there was significantly (p<0,05) more prominent decrease of the main ABPM, CAP and stiffness parameters than in the group 1. Valsartan b. i.d. led to significantly more prominent (p<0,05) improvement of the main ABPM, CAP and stiffness parameters improvement comparing to both variants of its once daily regimens. In 12 months of chronopharmacotherapy, in all groups, there was significant (p<0,05) increase of “dipper” 24 hour BP profile patients. Differences of the groups of “dippers” and “non-dippers” by the 12th month of treatment were significant for 3rd and 1st (p=0,0004), 3rd and 2nd (p=0,04) groups with the benefit for group 3.

Conclusion. Two times a day or only evening intake of valsartan with thiazide like diuretic in the morning facilitated more significant improvement of the main parameters of ABPM, CAP and vascular wall rigidity comparing to just morning intake. B.i.d. valsartan regimen led to significantly (p<0,05) more commonly reached target BP level, improved normalization of 24 hour BP in most of patients, led to more significant improvement of the main ABPM, CAP and vascular stiffness parameters comparing to once daily morning or evening regimen.

Russ J Cardiol 2018, 4 (156): 56–66

dx.doi.org/10.15829/1560-4071-2018-4-56-66

Key words: arterial hypertension, chronopharmacotherapy, 24 hour blood pressure monitoring, central aortic pressure, vascular wall stiffness, ischemic stroke.

Kuban State Medical University of the Ministry of Health, Krasnodar, Russia.

ADDITIONAL ANGIOPROTECTION AND METABOLIC DISORDERS CORRECTION IN TREATMENT OF ARTERIAL HYPERTENSION PATIENTS REACHED TARGET B LOOD PRESSURE LEVELS, WITH FIXED COMBINATION OF PERINDOPRIL AND INDAPAMIDE

Nedogoda S. V., Ledyaeva A. A., Chumachek E. V., Tsoma V. V., Salasyuk A. S., Smirnova V. O., Khripaeva V. Yu., Palashkin R. V., Popova E. A.

Abstract

Aim. Evaluation of the ability of fixed combination of perindopril and indapamide (Noliprel Bi Forte) to achieve additional angioprotection in patients with arterial hypertension already reached target blood pressure (BP) at previous antihypertension

therapy with losartan and hydrochlorothiazide (HCT).

Material and methods. To open observational study, lasting 12 weeks, 25 patients included, those who had been taking losartan+HCT 100/12,5 mg.

Results. During the study, all patients underwent 24 hour BP monitoring, applanation tonometry (augmentation index assessment and of central BP), measurement of pulse wave velocity (PWV), laboratory tests (lipids, fasting glucose, HOMA index, homocystein, leptin, adiponectin, high-sensitive C-reactive protein (hsCRP), vascular age assessment). After shifting the therapy with losartan and HCT to combination perindopril and indapamide, BP decreased additionally by 3,9%, and diastolic BP — 5,4% (p<0,05). There was decrease of augmentation index by 9,4% and vascular age by 6,0% (p<0,05). There was also decrease of leptin level by 14,5%, hsCRP by 11,0%, and increase of adiponectin by 9,9% (p<0,05).

Conclusion. The fixed combination perindopril and indapamide does have advantages for losartan and HCT combination in BP control, vascular elasticity improvement, and facilitates the decrease of body mass index, insulin resistance and non-infectious inflammation.

Russ J Cardiol 2018, 4 (156): 67–74

dx.doi.org/10.15829/1560-4071-2018-4-67-74

Key words: arterial hypertension, pulse wave velocity, central BP, augmentation index, combination antihypertension therapy, perindopril, indapamide, adipokines.

Volgograd State Medical University of the Ministry of Health, Volgograd, Russia.

COMPARISON OF THE ORIGINAL (PLAVIX) AND GENERIC (CLAPITAX) CLOPIDOGREL ON PLATELET AGGREGATION: OBSERVATIONAL STUDY

Skotnikov А. S.^1,2, Sizova Zh. М.¹, Baglikov А. N.³, Rozhnova О. G.², Novitsky N. I.³

Abstract

Aim. To compare antiplatelet activeness of the original clopidogrel and its generic, and to evaluate the routine practice of antiplatelet drugs intake by clinically stable patients aiming prevention of atherothrombosis.

Material and methods. Total number of patients that have been taking clopidogrel: 186, of those at outpatient stage 54 on original clopidogrel, the rest 132 on generic. Adenosindiphosphate-induced activeness was measured in two groups (n=57) taking consequently Plavix and Clapitax before replacement of the drug and 14 days after.

Results. At interchange of the drug in group 1 (Clapitax to Plavix) and group 2 (Plavix to Clapitax) the grade of achieved effect remained, and in group 2 it showed additional non-significant decrease. Adverse events related to antiplatelet therapy were not registered. At in-patient stage, 117 patients had an interchange of the drug (incl. several times) of original clopidogrel to its various generics (n=65), and vice versa (n=52), that was related to a range of routine reasons, of those patient and relatives preferences, specifics of drug supply in a clinic.

Conclusion. The found equal residual reactivity of the platelets after Clapitax and Plavix intake in two groups witness on therapeutical equivalence of the drugs.

Russ J Cardiol 2018, 4 (156): 75–81

dx.doi.org/10.15829/1560-4071-2018-4-75-81

Key words: antiplatelets, therapeutical equivalence, clopidogrel, Clapitax, Plavix.

¹I.M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow; ²Scientific-Research Center of Comorbid Pathology “Rational Medicine”, Moscow; ³Kaluzhskaya Oblast City Clinical Hospital № 2 “Pine Grove”, Kaluga,

Russia.

TAURIN INFLUENCE ON CLINICAL COURSE OF STABLE ANGINA IN POSTINFARCTION CARDIOSCLEROSIS PATIENTS

Vasilieva I. S., Rezvan V. V.

Abstract

Aim. Study of efficacy and safety of taurin in management of stable angina patients with postinfarction cardiosclerosis.

Material and methods. Totally, 95 postinfarction cardiosclerosis patients included, with stable angina of II and III functional class. The patients that were included, had refused revascularization. To the main group, 48 were included with added taurin

(Dibicor, “PIK-Pharma”, Russia, 750 mg daily), and to comparison group — 47 patients that were taking standard treatment and placebo. Treatment duration 3 months.

Results. Clinical efficacy of taurin in postinfarction cardiosclerosis and stable angina is confirmed by significant improvement of the following parameters: subjective state (decreased fatigue, less complaints on palpitation, less severity of dyspnea and rarer angina attacks), of the life quality parameters by Seattle questionnaire; echocardiographic parameters, normalized cardiac rhythm. Postive changes achieved on the basis therapy with taurin, remained for 3 months after drug discontinuation.

Conclusion. Positive influence of taurin on clinical and instrumental parameters of patients make it to recommend its prescription for stable angina treatment in postinfarction cardiosclerosis patients.

Russ J Cardiol 2018, 4 (156): 82–88

dx.doi.org/10.15829/1560-4071-2018-4-82-88

Key words: stable angina, postinfarction cardiosclerosis, taurin, life quality, exercise tolerance, cardiac dysrhythmias.

I. M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow, Russia.

OPINION ON A PROBLEM

LIRAGLUTIDE PLEIOTROPIC EFFECT IN CARDIOVASCULAR RISK REDUCTION IN TYPE 2 DIABETES — A MANDATE FOR CARDIOLOGIST AND INTERNIST

Nedogoda S. V.

Abstract

The data from a range of large trials (LEADER, EMPA-REG, CANVAS) show evidently the practical use of the modern glucose lowering drugs usage for successful management of cardiovascular risk in type 2 diabetes (DM2) patients. The article is focused on analysis and review of possible mechanisms and benefits of cardiovascular risk reduction in DM2 with prescription of the antagonist of glucagonlike peptide 1 — liraglutide (Victoza®).

Russ J Cardiol 2018, 4 (156): 89–92

dx.doi.org/10.15829/1560-4071-2018-4-89-92

Key words: diabetes, cardiovascular risk, liraglutide, glucagon-like peptide 1, adipokines.

Volgograd State Medical University of the Ministry of Health, Volgograd, Russia.

EXPERIMENTAL STUDY

THE ROLE OF GROWTH DIFFERENTIATION FACTOR 11 (GDF11) IN REGULATION OF LIPID METABOLISM AND CARDIOHEMODYNAMIC FUNCTIONS IN ESSENTIAL HYPERTENSION PATIENTS IN MODERATE EFFORT EXERCISES

Guseva Е. S.^1,2, Davydov S. О.^1,2, Kuznik B. I.^1,2, Smolyakov Yu. N.¹, Stepanov А. V.^1,2, Fine I. V.³, Magen E.⁴

Abstract

Aim. To reveal the role of a “youth protein” GDF11 in regulation of lipid metabolism and cardiovascular system work in essential hypertension (EH) in women taking antihypertension medications and regularly involved in moderate physical exercises (kinesitherapy).

Material and methods. In all participants, the level of GDF11 was measured by immune enzyme assay, and levels of lipids; registration was done of blood pressure, echocardiography and circulation condition with a novel sensor of dynamic light scattering (mDLS).

Results. In women with AH taking antihypertension medications, the level of GDF11 was lower more than 3 times. In EH patients the deviations found, in a shear flow velocity with significant increase of rapid velocity processes. Correlations found for GDF11 level with the age, blood pressure, condition of the heart work, hemodynamical and oscillatory indexes. In the EH group patients regularly doing exercises (kinesitherapy), the level of GDF11, blood pressure, lipid profile and all parameters of heart work and hemodynamics are close to normal.

Conclusion. The “youth protein” CDF11 is a factor of prevention of AH. Kinesitherapy in EH patients normalizes GDF11, lipid profile, and significantly increases the work of cardiovascular system.

Russ J Cardiol 2018, 4 (156): 93–98

dx.doi.org/10.15829/1560-4071-2018-4-93-98

Key words: essential hypertension, GDF11, moderate exertion, kinesitherapy, blood pressure, cardiodynamics, hemodynamics.

¹Chita State Medical Academy, Chita, Russia; ²Innovation Clinic “Health Academy”, Chita, Russia; ³Elfi-Tech Ltd, Rehovot, Israel; ⁴Medicine C Department, Barzilai Medical Center, Ben Gurion University of Negev, Ashkelon, Israel.

CLINICAL CASES

FAMILY CASE OF MITRAL VALVE PROLAPSE — IMPACT OF INCREASED LEVEL OF TRANSFORMING GROWTH FACTOR β

Omelchenko M. Yu., Malev E. G., Mitrofanova L. B., Vasina L. V., Zemtsovsky E. V., Nedoshivin A. O.

Russ J Cardiol 2018, 4 (156): 99–101

dx.doi.org/10.15829/1560-4071-2018-4-99-101

Key words: mitral valve prolapse, transforming growth factor β.

National Almazov Medical Research Center of the Ministry of Health, Saint-Petersburg, Russia.

MALIGNANT HYPERTENSION WITH PREDOMINANT KIDNEY DAMAGE

Lapochkina N. D.¹, Mamedguseyinova S. S.¹, Korsakova L. V.², Vechorko V. I.², Otarova S. М.¹, Gordeev I. G.¹

Abstract

The article is on a clinical case of malignant arterial hypertension in predominant kidney damage in a young man with disease anamnesis lasting 17 years. Recent data on the disorder provided, aspects of its management complexity that do make to regard the problem far from solution.

Russ J Cardiol 2018, 4 (156): 102–105

dx.doi.org/10.15829/1560-4071-2018-4-102-105

Key words: malignant arterial hypertension, antihypertension therapy, chronic renal failure, hemodialysis.

¹N. I. Pirogov Russian National Research Medical University (RNRMU), Moscow; ²O. M. Filatov City Clinical Hospital № 15, Moscow, Russia.

HYBRID SURGICAL RECONSTRUCTION OF AORTA DISSECTION MANIFESTED DURING PREGNANCY

Kozlov B. N., Panfilov D. S., Pryakhin A. S., Shipulin V. M.

Abstract

In the article, a brief review provided of various perspectives on the tactics of surgery in thoracic aorta dissection in pregnant and parturient women. Clinical case presented of successful surgery of dissection type A (Stanford) in the puerperant, with good short and middle term results. The aim of clinical case demonstration is to rise awareness on the risks of aorta dissection in pregnant and puerperant women. It also witness for radicality of the “frozen elephant trunk” technology.

Russ J Cardiol 2018, 4 (156): 106–110

dx.doi.org/10.15829/1560-4071-2018-4-106-110

Key words: aorta dissection, pregnant, parturient, surgical treatment, frozen elephant trunk.

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

LITERATURE REVIEW

CATESTATIN AS A NOVEL MARKER OF CARDIOVASCULAR RISK IN SYSTEMIC HYPERTENSION

Gubareva E. Yu., Kryukov N. N., Gubareva I. V.

Abstract

Review of the key studies on antihypertensive, vasodilatatory, angiogenic and antiapoptotic action of catestatin — a peptide resulting from endogenic protease interaction with chromogranin А. Plasma levels of catestatin correlate negatively with the hypertension phenotype. Pathogenetic role is discussed for catestatin in development of essential hypertension and its possible influence as a marker of cardiovascular risk stratification.

Russ J Cardiol 2018, 4 (156): 111–116

dx.doi.org/10.15829/1560-4071-2018-4-111-116

Key words: catestatin, essential hypertension, cardiovascular risk.

Samara State Medical University of the Ministry of Health, Samara, Russia.

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