Kardiologiya最新文献

{"title":"[Differential Diagnosis of Specific Cardiomyopathy in HIV-Adult With Myocardial Perfusion Imaging Via Single Photon Emission Computed Tomography].","authors":"F N Chanakhcian, N I Gulyaev, A V Alekhnovich, M N Vakhromeeva, A S Krylov, D V Puzenko","doi":"10.18087/cardio.2024.12.n2651","DOIUrl":"10.18087/cardio.2024.12.n2651","url":null,"abstract":"<p><p>The article presents a clinical case of secondary cardiomyopathy in an HIV patient with plasmablastic lymphoma due to the combined pathology (HIV infection with ongoing antiretroviral therapy in combination with antitumor therapy), in which the use of multimodal imaging contributed to establishing the correct diagnosis and excluding the unjustified use of invasive methods for diagnosing ischemic heart disease.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"96-100"},"PeriodicalIF":0.5,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin Mediates the Protective Effect against atrial fibrillation/atrial flutter and the Reduction in All-Cause Mortality Risk.","authors":"Xuehong Hu, Chen Tan, Xingpeng Liu, Na Zhang, Fengnan Wang, Zhijuan Wang","doi":"10.18087/cardio.2024.12.n2701","DOIUrl":"10.18087/cardio.2024.12.n2701","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between dapagliflozin and the incidence of atrial fibrillation (AF) and atrial flutter (AFL), along with its impact on all-cause mortality in patients with diabetes mellitus (DM).</p><p><strong>Material and methods: </strong>Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this meta-analysis conducted a comprehensive search across PubMed, Embase, and ClinicalTrials.gov databases up to June 2021. We focused on randomized controlled trials (RCTs) that compared dapagliflozin with a placebo. Trial sequential analysis (TSA) was utilized to assess the reliability of the findings. All statistical analyses were performed using Review Manager software.</p><p><strong>Results: </strong>The final analysis included nine studies, encompassing a total of 30,235 patients. The findings indicated a statistically significant reduction in the incidence of AF / AFL in the dapagliflozin group compared to the placebo group (relative risk (RR) = 0.73, 95 % confidence interval (CI) = 0.59 to 0.89, p=0.002), although this result was not corroborated by TSA. The occurrences of AF and all-cause mortality were also lower in the dapagliflozin group than in the placebo group (RR = 0.71, 95 % CI = 0.57 to 0.89, p=0.003 and RR = 0.90, 95 % CI = 0.82 to 0.98, p=0.02, respectively). However, TSA did not confirm these outcomes.</p><p><strong>Conclusion: </strong>Dapagliflozin appears to offer a significant protective effect against AF / AFL and may reduce the risk of all-cause mortality in patients with DM. However, further research is needed to confirm these findings due to the lack of confirmation by TSA.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"68-76"},"PeriodicalIF":0.5,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Diagnostic Value of ABCDE Stress Echocardiography With Exercise in Patients With Myocardial Infarction.","authors":"T M Timofeeva, A F Safarova, G S Pavlikov, Zh D Kobalava","doi":"10.18087/cardio.2024.12.n2751","DOIUrl":"https://doi.org/10.18087/cardio.2024.12.n2751","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of the clinical and diagnostic role of stepwise stress echocardiography (Stress Echo) with exercise using the ABCDE protocol in patients with myocardial infarction (MI).</p><p><strong>Material and methods: </strong>This single-site study included 75 patients (mean age 61.6±9.8 years; 84% men) after MI. The median time since MI was 1231.0 [381.5; 2698.5] days. All patients underwent Stress Echo using a five-step protocol. Step A identified impaired local contractility, step B identified the sum of B lines, step C identified the left ventricular (LV) contractile reserve, step D identified the coronary reserve in the anterior interventricular branch, and step E identified the heart rate reserve. The Stress Echo result was assessed by scores from 0 (all steps negative) to 5 (all steps positive). The effects of positive steps and the sum of Stress Echo scores on the incidence of the need for repeat revascularization were assessed.</p><p><strong>Results: </strong>The frequency of positive results was 36% for step A, 18.7% for step B, 80.0% for step C, 53.3% for step D, and 50.7% for step E. In 4 (5.3%) patients, all steps were negative (score 0); in 3 patients (4%), they were positive (score 5). Coronary angiography after Stress Echo during the follow-up period was performed in 26 (34.7%) patients; the need for repeat revascularization was determined in 17 (22.7%) patients. The predictors of the need for repeat revascularization according to a multivariate analysis were positive step A, chest pain pattern, and LV end-diastolic volume at peak exercise (p&lt;0.001). A statistically significant effect of positive step A on survival without a need for repeat revascularization was observed in patients with a history of MI (p=0.020).</p><p><strong>Conclusion: </strong>Among all the parameters of the integrated approach with Stress Echo, the emergence of new areas of impaired LV local contractility in patients after MI remains the main guideline for prescribing an angiographic study and a significant predictor of a need for repeated revascularization. However, the study results suggest that a further investigation of the effect of each positive step and the total ABCDE Stress Echo score on the prognosis for postinfarction cardiovascular complications is promising.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"35-43"},"PeriodicalIF":0.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Decompensated Heart Failure: Structural and Functional Changes in Mitochondria.","authors":"A A Garganeeva, E A Kuzheleva, O V Tukish, K N Vitt, M Yu Kondratiev, E E Syromyatnikova, S L Andreev, Yu A Arsenieva, V A Korepanov, S A Afanasiev","doi":"10.18087/cardio.2024.12.n2737","DOIUrl":"10.18087/cardio.2024.12.n2737","url":null,"abstract":"<p><strong>Aim: </strong>Comparative assessment of structural changes in cardiomyocyte mitochondria of the right atrial appendage and the mitochondrial respiratory function in peripheral blood leukocytes in a cohort of patients after acute decompensated heart failure (ADHF) and with stable chronic heart failure of ischemic etiology with reduced ejection fraction (CHFrEF) or moderately reduced ejection fraction (CHFmrEF) of the left ventricle.</p><p><strong>Material and methods: </strong>The study analyzed 40 micrographs of right atrial appendage cardiomyocytes obtained from 12 patients with CHFrEF and CHFmrEF. The study protocol was registered on ClinicalTrials.gov: NCT05770349. Electron microscopy was performed with a JEM-1400 transmission electron microscope (Subdiffraction Microscopy Collective Use Center at the Electron Microscopy Department of the Belozersky Research Institute of Physico-Chemical Biology, Lomonosov Moscow State University). The total area of interfibrillar mitochondria was calculated as a ratio of the total surface area of mitochondria located between the cardiomyocyte contractile fibers to the total area of the interfibrillar space. The respiratory activity of isolated mitochondria was assessed in oxygenated standard incubation media. Patients were divided into two groups based on the occurrence of an ADHF episode within 12 months before inclusion in the study: Group 1 (n=19), patients without ADHF and Group 2 (n=21), patients with an episode of ADHF.</p><p><strong>Results: </strong>Most of the clinical and anamnestic parameters were comparable between the study groups. Analysis of the mitochondrial respiratory function in peripheral blood leukocytes showed reduced values of the respiratory control level (RCL) in both study groups, 2.14 [2; 2.32] and 2.55 [1.36; 2.84] conv. units. The total area of interfibrillar mitochondria was 41.7 [32; 58]% in the group without ADHF and 33 [21; 46]% in patients with ADHF (p=0.048); significant correlations were found between this parameter and the distance walked in the 6-min walk test (r=0.482; p=0.002) and the peak oxygen consumption during exercise (r=0.395; p=0.012). A ROC analysis was used to determine a threshold value of the total area of interfibrillar mitochondria in patients with ADHF: the cutoff point was 32%.</p><p><strong>Conclusion: </strong>A decrease in the total area of interfibrillar mitochondria of the right atrial appendage cardiomyocytes of less than 32% as measured by electron microscopy is characteristic of patients with a previous episode of ADHF with reduced and moderately reduced left ventricular ejection fraction. The study results confirm the development and persistence of ultrastructural changes in cardiomyocytes after ADHF.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"12-18"},"PeriodicalIF":0.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between the Biomarkers of Collagen Regulation and Echocardiography Parameters in Patients With Heart Failure With Preserved Ejection Fraction.","authors":"N E Shirokov, T N Enina, E V Zueva, E I Yaroslavskaya, D V Krinochkin, N A Musikhina, T I Petelina, L I Gapon","doi":"10.18087/cardio.2024.12.n2706","DOIUrl":"https://doi.org/10.18087/cardio.2024.12.n2706","url":null,"abstract":"<p><strong>Aim: </strong>To study the relationship between laboratory markers and echocardiography (EchoCG) parameters in heart failure with preserved ejection fraction (HFpEF) depending on the results of the diastolic stress test (DST).</p><p><strong>Material and methods: </strong>The diagnostic algorithm provided by the current guidelines for the assessment of left ventricular (LV) diastolic function was used to select patients. If there were not enough criteria to make a conclusion about increased LV filling pressure (FP) based on standard resting echocardiography data in patients with arterial hypertension and ischemic heart disease, DST was performed to detect HFpEF. 80 patients (50.0% men, mean age 66.3±5.4 years) were included. Group 1 consisted of 41 patients with a positive DST, and group 2 included 39 patients with a negative DST. Concentrations of the markers of immune inflammation, endothelial dysfunction, collagen homeostasis, and myocardial stress were measured.</p><p><strong>Results: </strong>The DST showed significant differences in the E/e' ratio (15.1 [13.4; 15.9] in group 1 and 9.5 [7.9; 10.3] in group 2, respectively, p&lt;0.001) and the diastolic functional reserve index (DFRI) (9.8 [6.8; 14.0] and 21.0 [13.0; 29.0], p &lt; 0.001). Resting EchoCG revealed significant differences in the left atrial reservoir strain (LASr) (22.8 [19.6; 25.6]% and 28.0 [24.8; 30.2]%, p&lt;0.001) and the left atrial stiffness index (LASI) (0.50 [0.40; 0.57] and 0.34 [0.27; 0.41], p&lt;0.001). In patients with HFpEF, the laboratory parameters of collagen regulation had the greatest number of relationships. Correlations were found between the concentrations of matrix metalloproteinase-9 and other biomarkers, including interleukin-10 (IL-10) (r=0.311; p=0.048), myeloperoxidase (r=0.382; p=0.014), N-terminal propeptide of procollagen type I (procollagen I N-terminal propeptide, PINP) (r=0.722; p&lt;0.001) and type III (r=0.591; p&lt;0.001), C-terminal propeptide of procollagen type I (r=0.330; p=0.035), tissue inhibitor of metalloproteinases type 1 (r=0.410; p=0.008), EchoCG parameters, including left atrial volume index (LAVI) (r=0.414; p=0.007) and DFRI (r=0.354; p=0.025). In addition, correlations were found for the concentrations of PINP with IL-10 (r=0.401; p=0.009) and endothelin-1 (r= -0.337; p=0.031); PINP with LAVI (r=0.498; p=0.001) and DFRI (r=0.420; p=0.007).</p><p><strong>Conclusion: </strong>Patients with HFpEF have a greater number of relationships between markers of collagen homeostasis disorders and EchoCG parameters characterizing an increase in LV FP.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"51-58"},"PeriodicalIF":0.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Frequency of Occurrence of Cardiovascular Risk Factors and Awareness оf Them Among Young People in Higher Education Institutions.","authors":"A G Plisyuk, Ia A Orlova, E I Zimakova, Yu L Begrambekova, E S Krasilnikova, I S Daudov, S E Evlampiev, O M Nesuk, A G Armaganov, Zh A Akopian, A A Kamalov","doi":"10.18087/cardio.2024.12.n2724","DOIUrl":"https://doi.org/10.18087/cardio.2024.12.n2724","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of risk factors  of cardiovascular disease (CV RF) development and awareness of them among young people studing at University.</p><p><strong>Material and methods: </strong>Сross-sectional study study included 1182 young men and women studying at Lomonosov Moscow State University (age 18-44 years), with no history of chronic non-infectious diseases, who underwent a screening  in April-June 2022. All participants filled out the standard \"Questionnaire for citizens under the age of 65 years to identify chronic non-communicable diseases, risk factors for their development, and the use of narcotic drugs and psychotropic substances without prescription\", a specially designed questionnaire on socio-demographic characteristics and risk factors for CVD development, and a questionnaire on nighttime sleep status. Results. In young men, the most common FRs were low fruit and vegetable intake (46.8%). Sleep disturbances were reported by 28.8% of men and 34.5% of women. Low physical activity was present in 1 in 5 young people. Obesity was found in 5.0% of the study participants. Young women in general showed greater awareness of CV RF. The most frequent factor mentioned in the questionnaire was smoking. More than 60% of respondents mentioned low physical activity and  nutritional factors , while obesity and overweight were mentioned by only 16% of respondents.More CV RFs were named by natural science students, and more smokers were identified among them.</p><p><strong>Conclusion: </strong>The obtained data allow us to speak about the high prevalence of behavioral CV RFs  and insufficient awareness of their adverse health effects in young people, even with a high level of education. The effectiveness of preventive measures can be largely determined by their precise targeting. Raising awareness of the need for greater consumption of fruits and vegetables, sleep norms, the dangers of arterial hypertension, hypodynamia and obesity, in our opinion, is an important component of preventive work among students in universities.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 12","pages":"19-26"},"PeriodicalIF":0.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Incidence and Prognostic Value of Readmissions in Patients With Heart Failure: Data From a Large Cohort Study of Real Clinical Practice in St. Petersburg.","authors":"A E Soloveva, T V Gorbacheva, A E Solovev, S V Villevalde, N E Zvartau, E V Shlyakhto","doi":"10.18087/cardio.2024.11.n2781","DOIUrl":"https://doi.org/10.18087/cardio.2024.11.n2781","url":null,"abstract":"<p><p>Aim    To evaluate the cumulative incidence and prognostic value of rehospitalizations in patients with heart failure (HF) within one year after discharge.Material and methods    The data of patients with HF hospitalized for the first time (code I50.x in the diagnosis) for the period from January 01, 2022 through February 13, 2024 were selected from the St. Petersburg Chronic Heart Failure Registry. Age and gender characteristics, comorbidities, risk of rehospitalization and death after discharge from the hospital depending on the number of rehospitalizations were analyzed. Descriptive statistics methods, Kaplan-Meier survival analysis, and the Fine and Gray competing risks model were used. P&lt;0.001 was considered significant.Results    The study included 43,143 patients with HF who were hospitalized for the first time. During a median observation time of 242 days, 6,395 (14.8%) patients were readmitted, most often once (78.4%). A greater number of rehospitalizations was typical for men, patients with HF of ischemic genesis, atrial fibrillation, diabetes mellitus, obstructive pulmonary diseases, and a history of COVID-19. The cumulative incidence of rehospitalizations for HF during 1, 3, 6, and 12 months was 3.2%, 7.0%, 10.8%, and 17.2%, respectively, taking into account the competing risk of death. With an increasing number of hospitalizations, the median time to the next hospitalization decreased, and the risk of readmission increased (p&lt;0.001). The probability of death within a year of the index hospitalization was 14.9% (95% confidence interval [CI]: 14.5%-15.3%). The all-cause death rate was 30, 44, and 54 cases per 100 patient-years for patients with one, two, and at least three readmissions vs. 19 cases per 100 patient-years for those without readmissions. Readmitted patients were characterized by an increased risk of death: the adjusted hazard ratios of death in patients with one, two, and at least three readmissions were 1.47 (95% CI: 1.36-1.59), 1.97 (95% CI: 1.69-2.30), and 2.24 (95% CI: 1.81-2.78), respectively.Conclusion    In patients hospitalized with HF for the first time, the cumulative one-year HF readmission rate adjusted for the competing risk of death was 17.2%. Increased readmission rates were independently associated with increased odds of readmission and death.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 11","pages":"96-105"},"PeriodicalIF":0.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Remodeling Predictors in Chronic Heart Failure of Ischemic Etiology.","authors":"A A Ageev, M V Kozhevnikova, D A Tyurina, E O Korobkova, T O Kondratieva, K M Shestakova, N E Moskaleva, P A Markin, N V Khabarova, S A Appolonova, Yu N Belenkov","doi":"10.18087/cardio.2024.11.n2794","DOIUrl":"https://doi.org/10.18087/cardio.2024.11.n2794","url":null,"abstract":"<p><p>Aim      To identify metabolomic and structure and function markers of remote left ventricular (LV) remodeling in patients with chronic heart failure (CHF) of ischemic etiology and LV ejection fraction (EF) &lt;50%.Material and methods  This prospective study included 56 patients with 3-4 NYHA functional class CHF of ischemic etiology (mean age, 66±7 years) and 50 patients with ischemic heart disease (IHD) without signs of CHF (69 [64; 73.7] years). Concentration of 19 amino acids, 11 products of kynurenine catabolism of tryptophan, 30 acylcarnitines with different chain lengths were measured in all participants. The metabolites that showed statistical differences between the comparison groups were then used for the analysis. Echocardiography was used to assess LV cavity remodeling at the time of the CHF patient inclusion in the study and after 6 months of follow-up. Predictors of long-term LV cavity remodeling were assessed for this cohort taking into account statistically significant echocardiographic parameters and metabolites.Results Patients with CHF of ischemic etiology, predominantly (81%) had pathological calculated types of LV remodeling (concentric and eccentric hypertrophy, 46 and 35%, respectively). However, this classification had limitations in describing this cohort. In addition, in this group, the concentrations of alanine, proline, asparagine, glycine, arginine, histidine, lysine, valine, indolyl-3-acetic acid, indolyl-3-propionic acid, C16-1-OH, and C16-OH were significantly (p&lt;0.05) lower, and the concentrations of most medium- and long-chain acylcarnitines were higher than in patients with IHD without signs of CHF. The long-term (6 months) reverse remodeling of the LV cavity in CHF of ischemic etiology was influenced by changes in the interventricular septum thickness (hazard ratio, HR, 19.07; 95% confidence interval, CI, 1.76-206.8; p=0.006) and concentrations of anthranilic acid (HR 19.8; 95% CI 1.01-387.8; p=0.019) and asparagine (HR 8.76; 95% CI 1.07-71.4; p=0.031).Conclusion      The presence of an interventricular septum thickness of more than 13.5 mm, anthranilic acid concentrations of higher than 0.235 μM/l, or an asparagine concentration of less than 135.2 μM/l in patients with CHF of ischemic etiology after 6 months of follow-up affects their achievement of LV cavity reverse remodeling.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 11","pages":"106-116"},"PeriodicalIF":0.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Iron Deficiency, Anemia and Combination of Iron Deficiency With Anemia With Severity of Manifestations of Chronic Heart Failure. Additional Analysis of the Study \"Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)\".","authors":"V Yu Mareev, Zh D Kobalava, Yu V Mareev, Yu L Begrambekova, L V Karapetyan, S A Galochkin, E R Kazakhmedov, A A Lapshin, A A Garganeeva, E A Kuzheleva, A A Efremushkina, E V Kiseleva, O L Barbarash, T B Pecherina, A S Galyavich, Z M Galeeva, L V Baleeva, N A Koziolova, A S Veklich, D V Duplyakov, M N Maksimova, S S Yakushin, E A Smirnova, E V Sedykh, I I Shaposhnik, N A Makarova, A A Zemlyanukhina, V V Skibitskiy, A V Fendrikova, A V Skibitskiy, N A Spiropulos, E M Seredenina, Ya A Orlova, K A Eruslanova, Yu V Kotovskaya, O N Тkacheva, M A Fedin","doi":"10.18087/cardio.2024.11.n2786","DOIUrl":"10.18087/cardio.2024.11.n2786","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Aim      To evaluate the role of iron deficiency (ID) identified by various criteria, anemia, and the combination of ID and anemia in determining the severity of the clinical course of chronic heart failure (CHF) in a retrospective analysis of data from 498 patients who participated in the ID-CHF-RF Russian multicenter program.Material and methods  ID was diagnosed by the following three criteria established by the European Society of Cardiology (ESC) and the Russian Society of Cardiology (RSC): 1) ferritin concentration &lt;100 μg/l or ferritin concentration 100-299 μg/l in combination with a decreased transferrin saturation (TS) &lt;20%; 2) ID criteria that showed a high sensitivity and specificity when compared with bone marrow morphology (BMM): TS ≤19.8% or serum iron (SI) ≤13 μmol/l; and 3) a composite index including a ferritin concentration &lt;100 μg/l in combination with TS &lt;20% and SI ≤13 μmol/l. The presence of anemia was defined as a hemoglobin concentration of less than 12.0 g/dl in women and less than 13.0 g/dl in men according to the criteria of the World Health Organization.Results Concomitant anemia was detected in 40.3% of patients with CHF; in 85.1% of cases, anemia was combined with the SI concentration below normal. CHF patients with concomitant anemia were significantly older and had low levels of not only red blood cells and hemoglobin but also all parameters of iron metabolism, i.e., SI, ferritin concentration, and TS. The mean deviation of the red blood cell size, that characterizes the degree of anisocytosis, was significantly increased in patients with anemia, especially with a low SI. These patients had a higher CHF functional class, elevated levels of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) and walked a shorter distance in the 6-minute walk test, which reflects significantly more severe manifestations of CHF with concomitant anemia, particularly in combination with a low SI. The incidence of ID was 83.1% (including 23.3% in combination with anemia) according to the ESC/RSC criteria; 74.5% (including 43.3% with anemia) according to the BMM criteria; and 51.6% (including 51.7% with anemia) according to the composite index, which seems to be stricter compared to the first two criteria. Regardless of the assessment method (by total weighted average data), in ID combined with anemia, not only the hemoglobin concentration was significantly reduced but all three analyzed parameters of iron metabolism were also significantly reduced (SI 9.0 μmol/l vs. 10.4 μmol/l; ferritin 41 μg/l vs. 59 μg/l; TS 8.5% vs. 12.9%) compared to ID without anemia, respectively. The CHF severity and the NT-proBNP concentration were also maximum for the combination of ID and anemia, in contrast to ID without anemia, regardless of the ID criterion used. A more accurate comparison of the methods for determining ID in CHF in the context of their prognostic value will be obtained by analyzing the data of a two-year foll","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 11","pages":"62-75"},"PeriodicalIF":0.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Role of the Left Atrium in the Pathogenesis of Heart Failure With Preserved Ejection Fraction].","authors":"A G Ovchinnikov, A V Potekhina, A Yu Filatova, O N Svirida, M Kh Shogenova, M S Sobolevskaya, F T Ageev","doi":"10.18087/cardio.2024.11.n2799","DOIUrl":"https://doi.org/10.18087/cardio.2024.11.n2799","url":null,"abstract":"<p><p>Left atrial dysfunction (left atrial myopathy) is not only a consequence of impaired left ventricular diastolic function but also plays a central role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF). Left atrial myopathy in HFpEF is associated with a more severe course of heart failure and an unfavorable prognosis, and the choice of treatment largely depends on its severity. Echocardiography allows an accurate assessment of the left atrial condition, while the parameters of left atrial myocardial strain are sensitive to early functional disorders to help diagnosing HFpEF and determining the prognosis. This article discusses the participation of the left atrium in the left ventricular filling, its status at different stages of left ventricular diastolic dysfunction, the major mechanisms of atrial myopathy in HFpEF, and therapeutic approaches to its restriction and reversion.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 11","pages":"132-147"},"PeriodicalIF":0.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}