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Contents of Russian Journal of Cardiology 2019 24(4)

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Russian Journal of Cardiology. 201 9;24(4):5

CLINICAL MEDICINE NEWS

Clinical medicine updates: a review of international news

Russian Journal of Cardiology. 201 9;24(4):6

ORIGINAL ARTICLES

INTERNAL OBESITY AS A RISK FACTOR FOR ARTERIAL HYPERTENSION

Druzhilov M. A., Kuznetsova T. Yu.

Abstract

Aim. To assess the role of ultrasound parameters of the extent of abdominal and epicardial visceral adipose tissue (VAT) as prognostic tools for determining the probability of arterial hypertension (AH) development in normotensive patients with obesity.

Material and methods. We studied 526 normotensive (according to the results of daily monitoring of blood pressure (BP)) men (age 45,1±5,0 years) without cardiovascular diseases and type 2 diabetes mellitus, with a SCORE risk <5% and abdominal obesity (waist circumference >94 cm). We analyzed glycemia, lipid spectrum, blood creatinine and urine albumin level. Echocardiography with an assessment of epicardial fat thickness (EFT), triplex scanning of the brachiocephalic arteries, ultrasound assessment of the thickness of abdominal VAT and subcutaneous fat (SCF) were carried out. At the end of the observational phase of the study (duration 46,3±5,1 months), repeated daily monitoring of blood pressure was performed.

Results. Of the 406 available patients, hypertension was detected in 157 (38,7%), including 72 (31,7%) of the initial age group of 35-45 years and 85 (47,5%) of the initial age group 46-55 years. These patients were characterized by initially highervalues of EFT (5,2±0,7 mm vs 4,4±1,0 mm, p<0,001) and the ratio of the thickness of abdominal VAT to the thickness of the SCF (2,9±0,6 vs 2,5±0,6, p<0,001). In the group of individuals with developed AH, the initial incidence of epicardial and abdominal visceral obesity was higher (58,0% vs 23,4%, p<0,001 and 44,6% vs 25,1%, p<0,001, respectively). Ultrasound parameters of abdominal and ectopic (epicardial) VAT were included in mathematical models of the probability of development of AH with a high level of statistical significance and maximum standardized coefficients of regression equations.

Conclusion. Ultrasonic parameters of the severity of abdominal and epicardial VAT can be an additional tools for AH predicting in normotensive people with overweight and obesity.

Russian Journal of Cardiology. 2019;24(4):7–12

dx.doi.org/10.15829/1560-4071-2019-4-7-12

Key words: internal obesity, epicardial fat thickness, arterial hypertension.

Conflicts of interest: nothing to declare.

Petrozavodsk State University, Petrozavodsk, Russia.

Druzhilov M. A. ORCID: 0000-0002-3147-9056, Kuznetsova T. Yu. ORCID: 0000-0002-6654-1382.

Received: 18.03.2019

Revision Received: 02.04.2019

Accepted: 09.04.2019

THE RELATIONSHIP OF EPICARDIAL OBESITY AND LEVELS OF CARDIAC FIBROSIS MARKERS

Gritsenko O. V.1, Chumakova G. A.2,3, Gruzdeva O. V. 2, Shevlyakov I. V.1

Abstract

Lipotoxic myocardial damage with its fibrosis and subsequent formation of heart failure may develop due to epicardial obesity (EO). The possibility of early diagnosis of lipotoxic cardiac fibrosis is not well understood.

Aim. To study the relationship of EO with the level of myocardial fibrosis markers.

Material and methods. The study included 80 men aged 54,3±8,2 with grades I-III obesity. The level of metabolic factors, pro-inflammatory cytokines, adipokines (adiponectin, leptin), soluble leptin receptor and free fatty acids was determined for all patients; the presence of EO was determined by echocardiography with epicardial fat thickness (EFT) ≥7 mm. Coronary artery disease, arterial hypertension, type 2 diabetes mellitus, the presence of left ventricular diastolic dysfunction were the exclusion criteria of the study.

Results. The patients were divided into 2 groups: group I with EO (n=49) and group II without EO (n=31). Group I showed a statistically significant increase in the levels of interleukin-6 (IL-6), C-reactive protein, tumor necrosis factor- α (TNF-α), leptin, a decrease in adiponectin, as well as an increase in all studied myocardial fibrosis markers. In addition, in the group with EO, a positive relationship between the EFT and TNF- α (r=0,29; p=0,041), IL-6 (r=0,28; p=0,049), leptin (r=0,41; p=0,004) and a negative relationship with the level of adiponectin (r=-0,29; p=0,042). We determine a significant effect of the degree of EO on the increase in the level of cardiac fibrosis markers (r=0,28, p=0,049), collagen (r=0,33, p=0,019), transforming growth factor- β (r=0,29, p=0,045).

Conclusion. The results suggest that elevated levels of profibrotic factors in patients with EO may be signs of the presence of preclinical, and therefore, earlier lipotoxic myocardial fibrosis, which was not detected during echocardiographic research in the form of diastolic dysfunction.

Russian Journal of Cardiology. 2019;24(4):13–19

dx.doi.org/10.15829/1560-4071-2019-4-13-19

Key words: obesity, cytokines, adipokines, cardiac fibrosis markers.

Conflicts of interest: nothing to declare.

1Altai Regional Cardiologic Dispensary, Barnaul; 2Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 3Altai State Medical University, Barnaul, Russia.

Gritsenko O. V. ORCID: 0000-0001-5937-4128, Chumakova G. A. ORCID: 0000-0002-2810-6531, Gruzdeva O. V. ORCID: 0000-0002-7780-829X, Shevlyakov I. V. ORCID: 0000-0003-0132-7884.

Received: 15.03.2019

Revision Received: 02.04.2019

Accepted: 09.04.2019

EPICARDIAL FAT THICKNESS AND BIOMARKERS OF INFLAMMATION IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE: CORRELATION WITH THE SEVERITY OF CORONARY ATHEROSCLEROSIS

Koshelskaya O. A.1, Suslova T. E.1, Kologrivova I. V. 1, Margolis N. Yu.2, Zhuravleva O. A.1, Kharitonova O. A. 1, Kravchenko E. S.1, Vinnitskaya I. V.1, Karpov R. S. 1

Abstract

Aim. To study the relationship between the epicardial fat thickness (EFT), biomarkers of inflammation and metabolic dysfunction in patients with coronary artery disease (CAD) and various severity of coronary atherosclerosis.

Material and methods. The study consisted of 89 patients (47 men and 42 women) with stable CAD at the age of 62,2±6,5 years, who assessed the presence and severity of coronary atherosclerosis according to angiography with the calculation of the Gensini Score (GS). We conducted an ultrasonic evaluation of the EFT. We determined the content of glucose, lipid fractions, apoproteins, pro-inflammatory cytokines and adipokines, C-reactive protein by a highly sensitive method (hsCRP).

Results. In the total sample of patients, the median GS index was 13,5 (3,5; 43) points, the median EFT was 4,93 (3,95; 6,0) mm, the median hsCRP was 2,1 (1,02; 3,65) mg/l. There were no correlation relationships between the GS index and the body mass

index, waist circumference, EFT, hsCRP, lipid and carbohydrate metabolism in the general group of patients. In the course of linear regression analysis, an independent contribution of hsCRP >2,1 mg/l to the formation of the first two tertiles of a sample of

GS values was established (0≤ GS ≤28, paired linear regression hsCRP at GS β=0,55, p=0,0221), whereas in patients with GS values from the third tertile (GS >28 points), the growth of this parameter had an independent association with an increase in the

EFT (estimation of the coefficient of paired linear regression of the EFT on GS β=0,56, p=0,0015). The range of hsCRP changes did not affect the value of the β coefficient in paired linear regression models in patients with GS >28 points (n=29) and in the

subgroup of patients with GS >28 and hsCRP >2,1 mg/l (n=18).

Conclusion. The absence of an independent association between EFT and minor or moderate severity of atherosclerotic lesions of the coronary arteries (for GS ≤28 points) in patients with CAD, while an independent marker of GS index increase is higher than 2,1 mg/l. An independent contribution to the formation of a severe coronary atherosclerosis (with a GS value of >28 points) is equally made by thickening of EFT, and a moderately elevated level of hsCRP.

Russian Journal of Cardiology. 2019;24(4):20–26

dx.doi.org/10.15829/1560-4071-2019-4-20-26

Key words: epicardial fat thickness, biomarkers of inflammation, coronary atherosclerosis, Gensini Score.

Conflicts of interest: nothing to declare.

1Research Institute of Cardiology, Tomsk National Research Medical Center, Tomsk; 2National Research Tomsk State University, Tomsk, Russia.

Koshelskaya O. A. ORCID: 0000-0002-6679-1269, Suslova T. E. ORCID: 0000-0001-9645-6720, Kologrivova I. V. ORCID: 0000-0003-4537-0008, Margolis N. Yu. ORCID: 0000-0001-8890-9814, Zhuravleva O. A. ORCID: 0000-0003-0106-6813,

Kharitonova O. A. ORCID: 0000-0002-2818-5882, Kravchenko E. S. ORCID: 0000-0002-1235-9956, Vinnitskaya I. V. ORCID: 0000-0002-6489-0650, Karpov R. S. ORCID: 0000-0002-7011-4316.

Received: 20.02.2019

Revision Received: 18.03.2019

Accepted: 25.03.2019

FEATURES OF HEART REMODELING IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME AND ITS COMORBID ASSOCIATION WITH OBESITY IN THE CONTEXT OF THE SENILISM CONCEPT

Brodovskaya T. O.1, Grishchenko O. O.2, Grishina I. F. 1, Peretolchina T. F.1

Abstract

Aim. To analyze heart remodeling features in with obstructive sleep apnea syndrome and its association with obesity in the context of early cardiac aging.

Material and methods. The study included 101 men, 41 patients with obstructive sleep apnea (OSA), 30 comorbid patients with OSA and obesity, the control group consisted of 30 healthy people. The average passport age of the patients was 40,4±6,7 years. Evaluation of OSA was carried out by cardiorespiratory monitoring, structural and functional features of the heart condition were studied using the echocardiography method, the average biological age was calculated.

Results. Patients of both studied groups were characterized by structural and geometric rearrangement of the left heart chambers, transformation of physiological ellipsoid model into a spherical (left ventricle (LV) sphericity index 0,64±0,07 in the control group, 1,09±0,03 in the OSA group, 1,01±0,03 in the OSA + obesity group, p<0,05), LV hypertrophy (LV myocardial mass index was 78,1±23,9 in the group of healthy individuals, 98,1±11,4 in the OSA group and 116,0±29,4 in the OSA + obesity group, p<0,01). Systolic function in both study groups was preserved however, a tendency to stress of adaptive remodeling mechanisms was revealed. In addition, diastolic dysfunction was detected in both groups, in OSA group was associated with elasticity of the LV wall decrease, and in the OSA + obesity group, both with a violation of elasticity and an increase in the LV wall stiffness. The biological age of patients with OSA is 14% higher than the passport age, and with the association of OSA and obesity, by 39%.

Conclusion. The obtained data prove impact of respiratory sleep disorders at heart remodeling as well as increased biological age. At the same time, the association of OSA with obesity has an additive adverse effect on the remodeling processes and the biological age of patients.

Russian Journal of Cardiology. 2019;24(4):27–34

dx.doi.org/10.15829/1560-4071-2019-4-27-34

Key words: obesity, sleep disorders, apnea, heart remodeling, cardiac age.

Conflicts of interest: nothing to declare.

1Ural State Medical University, Yekaterinburg; 2P.V. Mandryk Central Military Clinical Hospital, Moscow, Russia.

Brodovskaya T. O. ORCID: 0000-0002-2847-4422, Grishchenko O. O. ORCID: 0000-0001-8764-4877, Grishina I. F. ORCID: 0000-0002-9004-3711, Peretolchina T. F. ORCID: 0000-0001-5379-8121.

Received: 20.01.2019

Revision Received: 08.02.2019

Accepted: 11.04.2019

DILATED CARDIOMYOPATHY: RECONCEPTUALIZATION OF THE PROBLEM

Vaykhanskaya T. G.1, Sivitskaya L. N.2, Kurushko T. V. 1, Levdansky O. D.2, Danilenko N. G.2

Abstract

Dilated cardiomyopathy (DCM) is a complex, etiologically heterogeneous myocardial disease, which is one of the main causes of heart failure and heart transplantation. In 2016, experts from the European working group proposed a new definition of cardiomyopathy, which includes intermediate variants with a change in phenotype in carriers of mutations from subclinical form to the full manifestations of the disease. The classification of DCM was supplemented with intermediate phenotypes with the

inclusion of a hypokinetic form with reduced contractile function without ventricular dilatation and variants with predominant dilation or arrhythmogenicity. Pathological architectonics of DCM consists of many genetic determinants that interact with numerous environmental factors. Clinical manifestations depend not only on the malignancy and penetrance of the gene mutation, but also on a number of other causes — epigenomic factors, age, toxic effects, environmental aggressiveness, pregnancy, and the effects of other acquired diseases. The article summarizes the current epidemiological data and ideas about specific molecular changes with an unfavorable prognosis. For clarity, we present clinical observations of familial DCM with mutations in the RBM20 and LMNA genes.

Russian Journal of Cardiology. 2019;24(4):35–47

dx.doi.org/10.15829/1560-4071-2019-4-35-47

Key words: dilated cardiomyopathy, laminopathy, genetic testing, gene mutations, LMNA, RBM20.

Conflicts of interest: nothing to declare.

1Scientific and Practical Center “Cardiology”, Minsk; 2Institute of Genetics and Cytology, Minsk, Belarus.

Vaykhanskaya T. G. ORCID: 0000-0002-2127-8525, Sivitskaya L. N. ORCID: 0000-0001-6359-4967, Kurushko T. V. ORCID: 0000-0001-5727-3219, Levdansky O. D. ORCID: 0000-0002-3325-0917, Danilenko N. G. ORCID: 0000-0002-3270-3080.

Received: 28.10.2018

Revision Received: 17.12.2018

Accepted: 22.12.2018

OBESITY AND PREGNANCY: CARDIOVASCULAR AND METABOLIC RISKS

Veselovskaya N. G.1,2,3, Chumakova G. A.1,2,3

Abstract

In recent years, obesity has become the leader as a cardiovascular risk factor in various clinical groups, including women of childbearing age. According to epidemiological studies over the past 10 years, obesity in pregnant women is recorded in 15-38% of cases. Obesity is a proven risk factor that complicates pregnancy, childbirth and the postpartum period. The presence of obesity in women before childbirth is a risk factor for infertility, miscarriage in the early period and congenital malformations in the fetus. Overweight and obesity in pregnant women lead to an increase in maternal and perinatal morbidity and mortality. Despite the high prevalence of obesity in pregnant women, the mechanisms for the occurrence of complications, methods of correction and prevention have not been studied enough. Considering the unfavorable prognosis in children of obese mothers, studies are needed to assess the role of internal adipose tissue, adipokines in the formation of insulin resistance, endothelial dysfunction. It is also needed to evaluate effect of systemic inflammation in the risk of developing complications in a pregnant woman and child, as well as programs for primary prevention of obesity in childbearing age.

Russian Journal of Cardiology. 2019;24(4):48–52

dx.doi.org/10.15829/1560-4071-2019-4-48-52

Key words: pregnancy, obesity, cardiovascular risk.

Conflicts of interest: nothing to declare.

1Altai State Medical University, Barnaul; 2Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 3Altai Regional Cardiologic Dispensary, Barnaul, Russia.

Veselovskaya N. G. ORCID: 0000-0001-8654-7020, Chumakova G. A. ORCID: 0000-0002-2810-6531.

Received: 28.01.2019

Revision Received: 18.02.2019

Accepted: 25.02.2019

POSSIBILITIES OF NON-DRUG CORRECTION OF MENOPAUSAL DISORDERS IN WOMEN WITH METABOLIC SYNDROME: FOCUS ON PROTHROMBOGENIC POTENTIAL OF THE BLOOD AND PRO-INFLAMMATORY STATUS

Berikhanova R. R.1,2, Minenko I. A.2

Abstract

Aim. To study the dynamics of hemostasis, markers of systemic inflammation on the background of non-drug correction of menopausal disorders in women with metabolic syndrome (MS).

Material and methods. Three hundred thirty women 45-50 years old with MS and menopausal disorders are divided into 5 groups. Basic treatment received all women. In the study group and comparison groups, the following were included in the treatment program: physiotherapy exercises, drinking balneotherapy, oral multivitamins and minerals, as well as physical factors in various combinations (vibrotherapy, chromotherapy, melotherapy, aromatherapy, aero ionotherapy). The concentration of fibrinogen, C-reactive protein (CRP), hemostasis parameters were determined in dynamics.

Results. After 6 months of use of all medical complexes with physiotherapy in patients with menopausal syndrome of mild severity, a significant increase in the level of international normalized ratio (INR) was observed from 0,99 to 1,04, fibrinogen level regressed by 14,6-15,4%, CRP by 16,3-20,5% (p<0,05). In patients with climacteric syndrome of moderate severity, the best results were achieved when using the complex with a full set of all the listed factors: an increase in the INR level from 0,97 to 1,01, a decrease in the level of fibrinogen by 14,6%, and the CRP level — by 19,6% (p<0,05).

Conclusion. Polymodal programs, including physiotherapy, improve hemostasis, provide reducing the level of inflammatory markers. In moderate climacteric disorders, the priority is given to the program with simultaneous use of vibrotherapy, chromotherapy, melotherapy, aromatherapy and aeroionotherapy.

Russian Journal of Cardiology. 2019;24(4):53–60

dx.doi.org/10.15829/1560-4071-2019-4-53-60

Key words: menopausal syndrome, metabolic syndrome, hemostasis, physiotherapy, fibrinogen, C-reactive protein.

Conflicts of interest: nothing to declare.

1Central Clinical Hospital of General Aviation, Moscow; 2I. M. Sechenov First Moscow State Medical University Moscow, Russia.

Berikhanova R. R. ORCID: 0000-0002-2193-5468, Minenko I. A. ORCID: 0000-0002-6766-8764.

Received: 27.03.2019

Revision Received: 02.04.2019

Accepted: 09.04.2019

CLINIC AND PHARMACOTHERAPY STRATEGIES AND METHODS FOR THE CORRECTION OF OBESITY AND ASSOCIATED CARDIOVASCULAR RISK

Kuznetsova T. Yu. 1, Druzhilov M. A.1, Chumakova G. A.2,3, Veselovskaya N. D. 2,3,4

Abstract

Today, there is a need to study obesity from the perspective of associated with it cardiovascular risk correcting. Future researches will have to study the pathophysiology of adipose tissue in greater detail, including tissue, cellular and molecular levels, in order to develop the most effective strategies for therapeutic and preventive measures. At the same time, taking into account the basic ideas

about the role of cardiorespiratory fitness in the etiopathogenesis of cardiovascular diseases, the ratio of fat free and fat mass, white and brown adipose tissue, subcutaneous fat and visceral adipose tissue, main directions of these measures becomes obvious. This article discusses strategies for correcting obesity and associated cardiovascular risk as part of primary and secondary prevention of cardiovascular diseases and suggests an algorithm for developing an individual program of preventive measures for an obese patient.

Russian Journal of Cardiology. 2019;24(4):61–67

dx.doi.org/10.15829/1560-4071-2019-4-61-67

Key words: visceral obesity, adipopathy, cardiovascular risk, cardiovascular diseases.

Conflicts of interest: nothing to declare.

1Petrozavodsk State University, Petrozavodsk; 2Altai State Medical University, Barnaul; 3Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 4Altai Regional Cardiologic Dispensary, Barnaul, Russia.

Kuznetsova T. Yu. ORCID: 0000-0002-6654-1382, Druzhilov M. A. ORCID: 0000-0002-3147-9056, Chumakova G. A. ORCID: 0000-0002-2810-6531, Veselovskaya N. D. ORCID: 0000-0001-8654-7020.

Received: 05.03.2019

Revision Received: 25.03.2019

Accepted: 09.04.2019

CURRENT APPROACHES TO PERIPROCEDURAL ANTICOAGULATION TREATMENT IN PATIENTS UNDERGOING ATRIAL FIBRILLATION ABLATION

Gasymova N. Z.1, Mikhailov E. N.1,2,3

Abstract

Catheter ablation is a standard treatment for patient with symptomatic and drugrefractory atrial fibrillation. As for every invasive approach, ablation is associated with certain risk of complications. About 2-3% of adverse events are related to hemorrhage or thromboembolism. Therefore, periprocedural anticoagulation scheme is of paramount importance to minimize the risk of both types of complications. Here we describe the factors, associated with thromboembolic and bleeding risks, and the evolving approaches for periprocedural anticoagulation treatment. Special attention is paid to uninterrupted oral anticoagulation and potential role of reverse agent in management of procedure-related hemorrhages.

Russian Journal of Cardiology. 2019;24(4):68–77

dx.doi.org/10.15829/1560-4071-2019-4-68-77

Key words: atrial fibrillation, catheter ablation, anticoagulant therapy, warfarin, dabigatran, rivaroxaban, apixaban, hemorrhage, thromboembolism.

Conflicts of interest: Mikhailov E. N. was a member of the expert council, carried out advisory work and lectured for Boehringer Ingelheim. He lectured for Pfizer. The remaining co-authors do not declare a conflict of interest.

1Almazov National Medical Research Centre, St. Petersburg; 2Pavlov First Saint-Petersburg State Medical University, St. Petersburg; 3Saint-Petersburg Electrotechnical University “LETI”, St. Petersburg, Russia.

Gasymova N. Z. ORCID: 0000-0002-3878-8783, Mikhailov E. N. ORCID: 0000-0002-6553-9141.

Received: 26.03.2019

Revision Received: 09.04.2019

Accepted: 16.04.2019

EFFECTS OF BENFOTIAMINE ON THE INSULIN RESISTANCE STATE, SOME PRO- AND ANTI-INFLAMMATORY FACTORS CONTENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CARDIAC AUTONOMIC NEUROPATHY

Sergienko V. A.1, Sergienko A. A.1, Segin V. B. 2, Ajmi S.1, Sergienko L. M.1

Abstract

Aim. The aim of the study was to analyze the effect of benfotiamine (BFT) on the insulin resistance state, the content of some pro- and anti-inflammatory factors in patients with type 2 diabetes mellitus (T2DM) and advanced stage of cardiac autonomic neuropathy (CAN).

Material and methods. 40 patients with T2DM and advanced stage of CAN, aged between 50-59 yrs with disease term 1-6 yrs and average glycated hemoglobin A 1c (HbA1c) 7,16%±0,19% were examined. Patients were divided into 2 groups. The patients from first group received standard hypoglycemic treatment (n=19, control) for three mo. To patients from the second (n=21, treatment group) was prescribed 300 mg/q.d. of the BFT in addition for three mo. The levels of blood glucose, HbA1c, immunoreactive insulin (IRI), high sensitivity C-reactive protein (hs-CRP), leptin, tumor necrosis factor-alpha (TNF-alpha),

interleukins (IL)-6, IL-8 and IL-10 were determined. The Homeostasis Model Assessment (HOMA) insulin resistance (IR) index (HOMA-IR) parameters, TNFalpha/IL-10 ratio were calculated.

Results. Treatment with BFT led to significant decrease in the concentration of IRI [ Δ=-12,74%±1,42% (p<0,05)]; hs-CRP (Δ=-13,62%±1,96% (p<0,05)), TNF-alpha ( Δ=-10,24%±1,54% (p<0,05)) and IL-6 (Δ=-15,41%±2,03% (p<0,05)) compared to the control group. At the same time, prescription of BFT does not affect the concentration of glucose, leptin, IL-8, IL-10; HOMA-IR and TNF-alpha/IL-10 ratio parameters (p>0,05).

Conclusion. Obtained data may indicate a decrease in the activity of the proinflammatory link of the immune response and allow us to consider BFT as a promising pharmacological agent in the complex treatment of the advanced stage of CAN.

Russian Journal of Cardiology. 2019;24 (4):78–82

dx.doi.org/10.15829/1560-4071-2019-4-78-82

Key words: benfotiamine, type 2 diabetes mellitus, cardiac autonomic neuropathy, insulin resistance, pro- and anti-inflammatory factors.

Conflicts of Interest: the research was carried out within the frame of the scientific work of Lviv National Medical University named after Danylo Halytsky (№ 0111U000131).

1Danylo Halytsky Lviv National Medical University, Lviv; 2Lviv Regional State Clinical Medical and Diagnostic Endocrinology Center, Lviv, Ukraine.

Sergienko V. A. ORCID: 0000-0002-6414-0956, Sergienko A. A. ORCID: 0000-0001-7519-2279, Segin V. B. ORCID: 0000-0003-3871-2196, Ajmi S. ORCID: 0000-0001-8284-102X, Sergienko L. M. ORCID: 0000-0001-9873-9847.

Received: 27.09.2018

Revision Received: 29.11.2018

Accepted: 07.12.2018

EXPERT CONSENSUS

PRE-DIABETES AS AN INTERDISCIPLINARY PROBLEM: DEFINITION, RISKS, APPROACHES TO THE DIAGNOSTICS AND PREVENTION OF TYPE 2 DIABETES AND CARDIOVASCULAR COMPLICATIONS

Committee of experts: Barbarash O. L.1,8, Voyevoda M. I. 2, Galstyan G. R.3, Shestakova M. V.3, Boytsov S. A. 4, Aleksandrova O. Yu.5, Bryzgalina S M.6, Druk I. V. 7, Karetnikova V. N.1,8, Kashtalap V. V.1,8, Kvitkova L. V. 8, Korennova O. Yu.7, Ogarkov M. Yu.1,6, Plotnikova E. Yu. 8, Tsygankova O. V.9, Svarovskaya A. V.10, Chumakova G. A. 1,11

Russian Journal of Cardiology. 2019;24(4):83–91

dx.doi.org/10.15829/1560-4071-2019-4-83-91

Key words: prediabetes, type 2 diabetes, metformin, cardiovascular diseases.

Conflicts of interest: nothing to declare.

1Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 2Federal Research Center for Basic and Translational Medicine, Novosibirsk; 3National Medical Research Center of Endocrinology, Moscow; 4National Medical Research Center of Cardiology, Moscow; 5M. F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow; 6Novokuznetsk State Institute of Postgraduate Medical Education, Novokuznetsk; 7Omsk State Medical University, Omsk; 8Kemerovo State Medical University, Kemerovo; 9Novosibirsk State Medical University, Novosibirsk; 10Tomsk National Medical Research Center, Tomsk; 11Altai State Medical University, Barnaul, Russia.

Barbarash O. L. ORCID: 0000-0002-4642-3610, Voyevoda M. I. ORCID: 0000-0001-9425-413X, Galstyan G. R. ORCID: 0000-0001-6581-4521, Shestakova M. V. ORCID: 0000-0002-5057-127X, Boytsov S. A. ORCID: 0000-0001-6998-8406, Aleksandrova O. Yu. ORCID: 0000-0002-7246-4109, Bryzgalina S M. ORCID: 0000-0002-5550-4113, Druk I. V. ORCID: 0000-0001-8317-7765, Karetnikova V. N. ORCID: 0000-0002-9801-9839, Kashtalap V. V. ORCID: 0000-0003-3729-616X, Kvitkova L. V. ORCID: 0000-0002-0536-2970, Korennova O. Yu. ORCID: 0000-0001-8047-5521, Ogarkov M. Yu. ORCID: 0000-0002-7252-4845, Plotnikova E. Yu. ORCID: 0000-0002-6150-180, Tsygankova O. V. ORCID: 0000-0003-0207-7063, Svarovskaya A. V. ORCID: 0000-0001-7834-2359, Chumakova G. A. ORCID: 0000-0002-2810-6531.

Received: 13.03.2019

Revision Received: 03.04.2019

Accepted: 09.04.2019

LITERATURE REVIEWS

THE ROLE OF IMMUNE CELLS IN THE DEVELOPMENT OF ADIPOSE TISSUE DYSFUNCTION IN CARDIOVASCULAR DISEASES

Uchasova E. G. 1, Gruzdeva O. V.1,2, Dyleva Yu. A.1, Belik E. V. 1, Barbarash O. L.1,2

Abstract

Adipose tissue dysfunction characterized by a loss of homeostatic functions. It is observed in patients with obesity, insulin resistance and diabetes. In case of violation of the physiological properties in adipose tissue, an increased production of cytokines and chemokines occurs with the infiltration of tissue by immune cells. In turn, immune cells also produce cytokines, metalloproteinases, reactive oxygen species and chemokines, which are involved in tissue remodeling, cellular signal transduction and immunity regulation. The presence of inflammatory cells in adipose tissue affects organs and tissues. So in the blood vessels, inflammation of perivascular adipose tissue leads to vascular remodeling, superoxide production, endothelial dysfunction with loss of the bioavailability of nitric oxide, contributing to the development of various vascular diseases. In adipose tissue dysfunction,

adipokines are also produced, such as leptin, resistin, and visfatin. These substances contribute to metabolic dysfunction, alter systemic homeostasis, sympathetic outflow, glucose regulation, and insulin sensitivity. Thus, the study of the mechanisms of interaction between immune cells and adipose tissue is promising and may be an important therapeutic target.

Russian Journal of Cardiology. 2019;24(4):92–98

dx.doi.org/10.15829/1560-4071-2019-4-92-98

Key words: macrophages, immune cells, adipose tissue, adipokines, cardiovascular diseases.

Conflicts of interest: nothing to declare.

1Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 2Kemerovo State Medical University, Kemerovo, Russia.

Uchasova E. G. ORCID: 0000-0003-4321-8977, Gruzdeva O. V. ORCID: 0000-0002-7780-829X, Dyleva Yu. A. ORCID: 0000-0002-6890-3287, Belik E. V. ORCID: 0000-0003-3996-3325, Barbarash O. L. ORCID: 0000-0002-4642-3610.

Received: 22.11.2018

Revision Received: 02.02.2019

Accepted: 11.02.2019

GENDER DIFFERENCES OF CARDIOVASCULAR RISK

Shapovalova E. B., Maksimov S. A., Artamonova G. V.

Abstract

Despite the many unresolved issues on gender characteristics of cardiovascular health, accumulated data allows to generalize global, national, ethnic, and social patterns. There are small deal of domestic studies that not always presented at a high evidentiary level. Meanwhile, in foreign literature, the study of gender characteristics is given an important place. The purpose of this review is to highlight the gender characteristics of the prevalence of the main cardiovascular risk factors according to literature data. The article shows the gender trends in the prevalence of the main determinants of cardiovascular health. It can be assumed that the cardiovascular continuum has a gender orientation and is triggered by men and women with “its own” cardiovascular risk factors. The development of this direction will help to form a gender-based prevention and treatment strategy to predict and limit adverse outcomes in a particular region of the country.

Russian Journal of Cardiology. 2019;24(4):99–104

dx.doi.org/10.15829/1560-4071-2019-4-99-104

Key words: cardiovascular diseases, gender differences, gender risk factors, gender-oriented cardiovascular continuum.

Conflicts of interest: nothing to declare.

Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.

Shapovalova E. B. ORCID: 0000-0002-4497-0661, Maksimov S. A. ORCID: 0000-0003-0545-2586, Artamonova G. V. ORCID: 0000-0003-2279-3307.

Received: 17.09.2018

Revision Received: 11.11.2018

Accepted: 09.01.2019

6 мая 2019 г.
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