The Siberian Medical Journal最新文献

{"title":"Prevalence of arterial hypertension and other risk factors for cardiovascular diseases in Siberia","authors":"Л. Барбараш, Д. П. Цыганкова, Г. В. Артамонова, O. Barbarash, D. Tsygankova, G. V. Artamonova","doi":"10.29001/2073-8552-2019-34-3-60-65","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-60-65","url":null,"abstract":"Hypertension is of interest for many Siberian researchers. Given the climatic, geographical, socio-economic, and ethnic characteristics of the population living in Siberia, addressing this problem has been one of the main goals of large epidemiological studies for several decades. This article discusses the main results of the epidemiological studies conducted in the Siberian Federal District on the prevalence of hypertension and its risk factors.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130952660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension in elderly and senile patients: clinical characteristics and treatment quality (according to the national register of arterial hypertension)","authors":"A. Aksenova, E. Oshchepkova, A. Orlovsky, I. Chazova","doi":"10.29001/2073-8552-2019-34-3-73-86","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-73-86","url":null,"abstract":"Introduction. The importance of studying treatment in older hypertensive patients is underlined by the tendency to aging of the population as a whole. During recent years, the approach to therapy of older patients changed. The guidelines on management of arterial hypertension recommend lower target blood pressure values and earlier start of the treatment.Aim. To study the quality of arterial hypertension treatment and clinical characteristics in older patients (≥65 years).Material and Methods. The Russian national registry of hypertension was conducted in 22 regions of the Russian Federation since 2012. It included 53 city primary health care centers and five cardiology clinics. The data were analyzed in two groups comprised of 65 to 79-year-old individuals and patients older than 80 years. Data on physical, instrumental, and laboratory examinations, as well as data regarding antihypertensive and lipid-lowering therapy and comorbidities, were analyzed.Results: Patients aged 65 to 79 years and those older than 80 years had coronary artery disease (42.7% and 55.5%), chronic heart failure (CHF) (46.8% and 55.7%), history of Q-wave myocardial infarction (MI) (6.4% and 5.9%), stroke (5.5% and 5.7%), atrial fibrillation/flutter (3.7% and 6.5%), chronic kidney disease (CKD) stage 3–5 (36.6% and 48.4%), and diabetes mellitus (19.4% and 13.4%). Following the guidelines on management of arterial hypertension 2013, the target values of systolic blood pressure were achieved in 30% of patients; target values of diastolic blood pressure were reached in 60% of patients. Decreases in systolic blood pressure lower than <120 mmHg and in diastolic blood pressure lower than 70 mmHg were found in 3% of patients. In accordance with Guidelines 2018, target values of systolic blood pressure were achieved in 21–24% of patients; target values of diastolic blood pressure were achieved in 12–13% patients. Ambulatory 24-h blood pressure monitoring was performed only in 2.8% of 65–79-year-old patients and in 1.9% of patients older than 80 years. Data on antihypertensive therapy were absent in 13% of medical records of patients who had indications for it. Medical records of 20% of patients with history of Q-wave MI, CHF, diabetes mellitus, and CKD did not contain data on administration of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Administration of beta-blockers and mineralocorticoid receptor antagonists in patients with hypertension and chronic heart failure was insufficient. Achievement of target cholesterol levels was insufficient in both age groups. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121442110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac pathology in patients with resistant hypertension","authors":"Ф. Мордовин, Т. М. Рипп, V. Mordovin, T. Ripp, E. Sitkova","doi":"10.29001/2073-8552-2019-34-3-53-59","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-53-59","url":null,"abstract":"Patients with resistant arterial hypertension have a high prevalence of cardiac pathology. In particular, left ventricular hypertrophy and reduced coronary reserve play independent role in determining the risk of cardiovascular complications. Diagnostic approaches to their detection are currently represented by a wide range of highly informative studies using modern ultrasound equipment, magnetic resonance imaging, computed tomography scanner, and gamma camera. The active study of the involvement of the cascade of pathophysiological mechanisms in the development of cardiac changes in hypertension allows not only to identify the factors associated with the severity of the lesion, but also to find new application points for the cardioprotection and to reduce cardiovascular risk. Along with the pharmacological capabilities, the renal denervation method is currently under active study. Despite high variability of the results and their poor predictability, a number of studies show the efficiency of this method in correcting the structural and functional changes in the heart, which is of important prognostic value for resistant hypertension.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"238 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123039518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the I/D polymorphism of angiotensinconverting enzyme gene with the development of essential hypertension","authors":"O. Pavlova, S. Ogurtsova, M. Liventseva, T. H. Lakotko, I. Korobko, V. Shyshko, A. Mrochek","doi":"10.29001/2073-8552-2019-34-3-87-96","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-87-96","url":null,"abstract":"Objective. To determine the impact of the I/D polymorphism of the angiotensin-converting enzyme (ACE) gene on the development of essential hypertension, taking into account gender differences.Material and Methods. Clinical data were assessed and a molecular genetic study was performed in 602 people including 401 patients with essential hypertension and 201 individuals of the control group, representing the Belarusian ethnic group. Genotyping was performed using the method of polymerase chain reaction and restriction fragment length polymorphism.Results. The distribution of genotypes of the I/D polymorphism of the ACE gene did not differ between patients with hypertension and normotensive individuals: II, ID, and DD genotypes were detected in 100 (24.9%), 192 (47.9%), and 109 (27.2%) patients and in 52 (25.9%), 108 (53.7%), and 41 (20.4%) people of the comparison group, respectively. Differences were found between the distribution of DD genotype in men with hypertension and in the control group, where the frequencies were 28.4% and 17.3% (p  =  0.04), respectively, in contrast to no differences in women: 25.8% and 23.3% (p  =  0.64), respectively. Carrying the DD genotype in men compared with the ID and DD genotypes (recessive model) of the I/D polymorphism of the ACE gene increased the probability of developing essential hypertension by 1.9 times (OR   =   1.89; 95% CI  =  1.04-3.44). The analysis of the prevalence of risk factors depending on the I/D polymorphism of the ACE gene showed that male patients with the DD genotype more often had burdened heredity in regard to the development of premature cardiovascular diseases (23 patients (37.7%)) compared with the individuals with II and ID genotypes: 13 (21.7%) and 14 (14.9%) patients, respectively (χ2  =  1.16; p  =   0.005), and mainly through the paternal line.Conclusions. Development of essential hypertension is associated with the carriership of the mutant DD genotype of I/D polymorphism of the ACE gene in men. ","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123756297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of coronary stent type on the long-term results of coronary artery bypass surgery after stenting clinically related artery in acute coronary syndrome in patients with multivessel coronary artery disease","authors":"A. Bocharov, L. V. Popov","doi":"10.29001/2073-8552-2019-34-3-144-152","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-144-152","url":null,"abstract":"Justification. The results of endovascular revascularization are largely determined by the type of stents used. The use of baremetal coronary stents significantly worsens the long-term results of endovascular treatment of coronary artery disease. Given the widespread use of bare-metal coronary stents in the Russian Federation for the treatment of coronary artery disease and acute coronary syndrome, in particular, the issue of the impact of the above-mentioned endovascular interventions on the long-term results of coronary artery bypass grafting (CABG) performed after endovascular revascularization of the clinically related artery in patients with acute coronary syndrome and multivessel lesions does not lose relevance.Aim. To compare the long-term results of the staged strategies of revascularization of the coronary bed: CABG performed after stenting the clinically related artery with third-generation biodegradable polymer-based sirolimus-eluting stents for acute coronary syndrome and CABG performed after stenting the clinically related artery with bare-metal coronary stents for acute coronary syndrome.Material and Methods. The analysis used the data of two-year follow-up of patients who underwent two-stage revascularization: at the first stage, patients received stenting of the clinically related artery for acute coronary syndrome and, at the second stage, they received coronary artery bypass grafting no later than 90 days from the date of stenting. The study included 218 patients with multivessel lesions of the coronary bed, admitted with clinical manifestation of acute coronary syndrome. The long-term follow-up period was 24 months. The following end points were analyzed: cardiovascular mortality, myocardial infarction, re-revascularization, and combined MACCE end point (cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, and re-revascularization). The observation was carried out at the hospital stage and, then, on an outpatient basis once every three months.Results. There were no significant differences between the groups. The frequency of repeated revascularization, including repeated revascularization of the stented artery, and recurrence of angina were significantly higher in the group with baremetal coronary stents. There were no significant differences between the groups in regard to cardiovascular mortality, nonfatal myocardial infarction and acute cerebrovascular accidents. The frequency of MACCE events was significantly higher in the group of bare-metal coronary stents, mainly due to the frequency of repeated revascularizations.Conclusion. Coronary artery bypass grafting performed in the early period after stenting of the clinically related artery using bare-metal coronary stents in patients with acute coronary syndrome and multivessel lesions was associated with a significantly larger number of repeated coronary revascularizations and higher rate of recurrent angina compared to a similar strategy, but with","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127602869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of inflammation in the development of metabolic disorders in patients with arterial hypertension","authors":"L. Zhuravlyova, M. V. Kulikova","doi":"10.29001/2073-8552-2019-34-3-45-52","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-3-45-52","url":null,"abstract":"In recent years, the comorbid course of cardiovascular diseases, primarily arterial hypertension with impaired carbohydrate tolerance or type 2 diabetes mellitus, is becoming increasingly important in the developed countries of the world. In this regard, the need for a more detailed study of the general mechanisms of the development of arterial hypertension, pre-diabetes, and type 2 diabetes mellitus, namely inflammation, is increasing. There are many studies that investigate the role of inflammation in hypertension and associated glucometabolic disorders, but the exact mechanisms by which activated immune cells lead to the development and maintenance of these conditions remain to be seen. Obtaining new data in this area may contribute to a deeper understanding of cardiometabolic disorder pathogenesis. It may allow to predict the progression of these disorders at the early stages and to develop effective preventive and therapeutic tactics for their correction.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133818242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEATURES OF THE ORGANIZATION OF CLINICAL TRIALS OF NARCOTIC DRUGS IN RUSSIA","authors":"G. Gildeeva, E. A. Ezhova, D. V. Butuzova, N. L. Mishchenko, V. Yurkov, A. V. Teteneva, T. S. Ageeva","doi":"10.29001/2073-8552-2019-34-2-152-158","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-2-152-158","url":null,"abstract":"The problem of ensuring the necessary level of availability of narcotic drugs (NLP) in the Russian Federation, especially in the framework of palliative medical care for oncological patients is the area of special and constant attention of the Government and civil society. Recently, a number of necessary changes of the legislation aimed at simplifying the procedures for prescribing and issuing NLP have been introduced, and the possibility of optimizing the rules for their storage and accounting as well as improving the methods for calculating the needs for such drugs are being actively discussed.As part of the import substitution program in Russia, the new dosage forms for NLP are under development. Such process is accompanied by clinical studies with a number of features that take into account the specific chemical composition of finished products.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129827245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORONARY ATHEROSCLEROSIS AND CARDIAC ARRHYTHMIAS","authors":"E. Yaroslavskaya, K. Aksenova","doi":"10.29001/2073-8552-2019-34-2-21-25","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-2-21-25","url":null,"abstract":"Cardiac arrhythmias are associated with deterioration in patient’s quality of life, thromboembolic complications, and sudden cardiac death. Coronary atherosclerosis is often the cause of cardiac arrhythmias. Myocardial hypoxia and remodeling lead to impaired formation and conduction of the impulse and the development of ectopic rhythm. The article reviews the main pathogenetic mechanisms for various types of cardiac arrhythmias in patients with atherosclerotic coronary lesions.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"33 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124342529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAPABILITIES OF 123I-MIBG SCINTIGRAPHY AND GATED BLOOD-POOL SPECT IN PREDICTING THE RESULTS OF CARDIAC RESYNCHRONIZATION THERAPY","authors":"A. Mishkina, K. Zavadovsky, V. Saushkin, D. Lebedev, Yuriy B. Lishmanov, Sergey V. Popov","doi":"10.29001/2073-8552-2019-34-2-63-70","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-2-63-70","url":null,"abstract":"Purpose.To assess the diagnostic value of scintigraphy parameters of sympathetic activity and mechanical dyssynchrony of the heart for prediction of the results of cardiac resynchronization therapy (CRT).Material and Methods.The study included 28 patients with functional class III (NYHA) chronic heart failure referred for CRT. Before operation, a set of scintigraphic studies was performed to evaluate mechanical dyssynchrony, the state of cardiac sympathetic innervation, and perfusion. Clinical status, volume indices, and contractility of both cardiac ventricles were evaluated 6 months after CRT. After that, all patients were divided into 2 groups: group 1 included CRT responders (n=15); group 2 comprised non-responders (n=13).Results. Significant differences between groups were found in the following baseline parameters: early heart-to-mediastinum ratio (H/M) (2.42 and 1.87; p<0.05), delayed H/M (1.89 and 1.78; p<0.05), left ventricular (LV) end-diastolic volume (EDV) (271 mL and 299 mL; p<0.05); LV end-systolic volume (ESV) (206 mL and 227 mL; p<0.05), and interventricular dyssynchrony (109 ms and 62 ms; p<0.05). Responders showed a strong correlation between delayed H/M and LV dyssynchrony (–0.795, p<0.05). According to logistic regression analysis, delayed H/M (OR=4.25; 95% CI 1.4–12.92; p<0.5) and interventricular dyssynchrony (OR=1.01; 95% CI 1.003–1.03; p<0.5) were statistically significant determinants of the response to CRT.Conclusion. 123I-MIBG myocardial scintigraphy can be used to predict the effectiveness of CRT. Delayed H/M ratio and interventricular dyssynchrony are the independent predictors of response to CRT.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124375767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EPIDEMIOLOGICAL ASPECTS OF THE PREVALENCE OF CORONARY HEART DISEASE IN AN OPEN URBAN POPULATION: GENDER DIFFERENCES","authors":"M. Kayumova, E. Gakova, O. Senatorova","doi":"10.29001/2073-8552-2019-34-2-146-151","DOIUrl":"https://doi.org/10.29001/2073-8552-2019-34-2-146-151","url":null,"abstract":"The aim. To determine gender differences in the prevalence of coronary heart disease in an open urban population.Material and Methods. For a one-stage epidemiological study in an open urban population, a representative sample of 25–64-year-old residents was formed from the electoral lists of the Central Administrative District of Tyumen (n=2000) using a “random” mathematical method. The response rates of the study were 85.0% among men and 70.3% among women. The conclusion about the presence of coronary artery disease was carried out according to strictly standardized epidemiological methods. Definite CHD (strict criteria) and possible CHD (lax criteria) were distinguished based on the extended criteria.Results. The prevalence rates of CHD in the open 25–64-year-old population were 12.4% in men and 10.0% in women. According to strict epidemiological criteria, the prevalence of painless ischemic heart disease prevailed in men; the prevalence of angina pectoris prevailed in women (predominantly at a young age). According to non-strict criteria, possible myocardial ischemia prevailed in men and women.Conclusion. The results can serve as a scientific basis for primary prevention of coronary artery disease and also necessitate identification of the gender differences in the study of the profile of conventional and non-conventional risk factors and their relationships with the prevalence of CHD in an open population of the urbanized Siberian city.","PeriodicalId":153905,"journal":{"name":"The Siberian Medical Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123893336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}