Pharmacological correction of immune disorders in patients with chronic heart failure and ischemic heart disease

Currently, there are few data on the effect of cardiovascular drugs on the immune status of patients with heart failure (HF). This paper provides information on the impact of ß-adrenergic blocking agent (BAB), angiotensin-converting enzyme inhibitors (ACEI) on the maintenance of markers of immune inflammation in the blood, as well as on inhibition of synthesis of tumor necrosis factor-α (TNF-α) and on blocking of interaction between TNF-α and membrane receptor

Impact of Gut Microbiota on the Risk of Cardiometabolic Diseases Development

Obesity is a multifactorial disease that leads to excessive adipose tissue accumulation, mainly visceral fat. Importance and prevalence of obesity has increased significantly in recent decades all over the world. Until now, the pandemic of obesity has been associated more to lifestyle changes: excessive eating and low physical activity. In recent years, special attention has been paid to studying of composition and functions of intestinal microbiota as major factor in development of obesity and related comorbidities, such as hypertension, cardiac ischemia, heart failure and others. It is proved that gut microbiota affects extraction, accumulation and consumption of energy derived from food, lipid metabolism and immune response. It is also revealed that composition of the microbiota is different in thin and obese people. Thus, study of the relationship between intestinal microbiota composition and risk factors for cardiovascular diseases, in particular obesity, is an actual task. The purpose of this review is analyzing of literature about assessment of relationship between composition and functions of intestinal microbiota in the diagnostics, prevention and treatment of obesity and cardiovascular diseases

XXVII Российский национальный конгресс-онлайн «Человек и лекарство»

.6–9 апреля 2020 г. в Москве состоялся XXVII Российский национальный конгресс-онлайн «Человек и лекарство». В рамках соблюдения введенных законодательных ограничений с целью предупреждения распространения коронавирусной инфекции (2019-nCoV) мероприятие проведено в форме онлайн-конференции в запланированные сроки

Perioperative Management of Patients Receiving Antithrombotic Therapy in Schemes and Algorithms

Currently, antithrombotic therapy is the basis of the pathogenetic treatment of many cardiovascular diseases, such as coronary heart disease, stroke, peripheral vascular disease, as well as mechanical heart valves, heart rhythm disturbances, venous thromboembolism. At the same time, chronic use of antiplatelet and/or anticoagulant drugs is a complicating factor in invasive and surgical procedures, as it increases the risk of bleeding. In this regard, a fundamentally important and complex question arises: how to minimize the risk of periprocedural bleeding without exposing the patient to an increased risk of ischemic and thromboembolic complications? Perioperative management of patients who take antithrombotic drugs for a long time is a complex problem that depends on many factors - the risk of surgery, anesthesia, cardiovascular risks, and the urgency of surgery. Each clinical situation should be assessed individually, collegially, with the participation of surgeons, anesthesiologists, and therapists. The introduction of a checklist into clinical practice for each planned surgical patient will allow us to calculate the individual risk of bleeding and thromboembolic complications, and provide an optimal preventive strategy for perioperative management of the patient. The algorithms and schemes presented in the article for the perioperative management of patients with non-cardiac interventions are aimed at standardizing the management of patients before non-cardiac surgical interventions, which will reduce hemorrhagic risks in the presence of the necessary antithrombotic therapy

Hyperuricemia: Features of the Diet

The association of hyperuricemia (HU) with cardiovascular disease (CVD), diabetes, metabolic syndrome, and kidney disease has been demonstrated in numerous studies. НU is the main pathogenetic factor in the development of gout and is associated with an increase in overall and cardiovascular mortality. НU is included in the list of factors determining cardiovascular risk. According to epidemiological studies, there is a high prevalence of HU in the world and its increase in recent decades. A number of factors have been identified that contribute to the increased risk of НU. Non-modifiable factors include gender, age, genetic factors, and modifiable factors include diet and lifestyle. Nutritional unbalances, increased life expectancy, increased prevalence of obesity, and increased use of drugs (especially diuretics) are seen as contributing factors to the rise in НU. The review was carried out to summarize the available information on the effect of dietary habits, individual foods and nutrients on serum uric acid (SUA) levels and the risk of developing HU. The review presents the results of scientific studies demonstrating the relationship of НU with the consumption of foods rich in purines (offal, red meat, fish, seafood, legumes), alcohol consumption, drinks sweetened with fructose, coffee, dairy products, vegetables and fruits. Diet correction is an important and necessary step in the prevention and treatment of НU. The article reviews the basic principles of dietary management in HU and provides dietary recommendations for patients. For effective prevention and treatment of НU, a mandatory correction of the diet is required

Healthy Eating in Population Models of Nutrition: Asian Diet Style Summary

The population of Japan and Okinawa is known for the longest life expectancy, which many researchers rightly associate with the nature of nutrition existing in these territories. The Japanese diet and Okinawan diet, along with other traditional diets, are real examples of historically established sustainable patterns of healthy eating. Asian eating styles have marked differences from European eating patterns, not only in differences in food sources, but also in eating habits. The article presents the historical, climatic and cultural features of these diets; the issues of food composition, energy and nutritional value of these models of nutrition are considered in detail with an analysis of the differences existing between them; highlights the benefits of products grown mainly in Japan, which are ration-forming for the population of this country; as well as the results of scientific studies on the protective effect of the Japanese and Okinawan diets on human health and disease prevention

Aspects of transthoracic echocardiography protocol in obese patients

Often, transthoracic echocardiography in obese patients reveals normal indicators of intracardiac hemodynamics and heart geometry. Can the clinician determine the risk of cardiovascular events and proper management in such patients based on the data obtained? Do many overweight patients really have no cardiac abnormalities, or they simply could not be detected? New capabilities of transthoracic echocardiography make it possible to detect abnormalities in the early stages of the disease, even in the absence of clinical manifestations. Thus, the inclusion of additional parameters in the standard protocol of echocardiography in obese patients will most accurately determine the management tactics and prognosis, thereby reducing the risk of unfavorable outcomes

Prognostic Significance of the Integral Index of the Alcohol Situation in Assessing Regional Differences in Mortality from Cardiovascular Diseases in the Russian Federation

Aim. To evaluate the stability of the integral index of the alcohol situation in the regions of the Russian and its prognostic significance regarding adult mortality from diseases of the circulatory system.Material and methods. The dynamics of standardized mortality rate for cardiovascular diseases (CVD) and TM in 2012 and 2018 in regions of Russia with safe and unsafe alcohol situations was analyzed. The average group mortality rate were evaluated, as well as the average rate of dynamics of the indicator reduction for the period from 2012 to 2018.Results. In 2012, differences in the rates of total mortality, as well as mortality from CSD, IHD, and CVD in regions with different levels of alcohol wellbeing were significant with a significance level of p <0.05. In 2018, intergroup differences in mortality from CSD and IHD were unreliable. Differences in average mortality rates from other causes significantly differed with a significance level of p <0.05. Total mortality and mortality from CVD, including individual forms, decreased in all regions, regardless of the level of alcohol well-being. The average rate of decline in mortality in the group of regions with an unfavorable situation was lower than the same indicator in regions with a favorable situation, with the exception of mortality from CVD. The most pronounced were differences between regions in the rate of decline in mortality from MI (p <0.05). For the remaining causes of death, the differences were not significant.Conclusion. The hypothesis of a significant contribution of the alcohol factor to cardiovascular mortality is confirmed. In the groups of regions that differ in the integral index of the alcohol situation, significant differences were noted in the indicators of both total mortality and mortality from the main groups of cardiovascular diseases. These differences persist over time, which confirms the hypothesis that the proposed integral indicator can be used for a long-term forecast of the influence of the alcohol situation on public indicators

Perivascular adipose tissue in the pathogenesis of cardiovascular disease

Perivascular adipose tissue (PVAT) is an active regulator of vascular homeostasis. In physiological conditions, it maintains normal function of vessels, releasing antiatherogenic, anti-inflammatory and vasodilating biologically active substances. Dysfunctional PVAT secretes pro-inflammatory cytokines and adipokines, which play an important role in the development of cardiovascular diseases. This review considers the PVAT function in health and disease, its contribution to the pathogenesis of atherosclerosis, hypertension, aortic aneurysm and vasculitis. In addition, novel methods of non-invasive PVAT assessment and potential strategies for targeted treatment of cardiovascular diseases are presented

Practical aspects of managing patients with cardiogenic shock

Cardiogenic shock is the leading cause of death among patients with acute coronary syndrome. This pathology is characterized by high rates of inhospital and annual mortality. In Russian literature, data on the prevalence, diagnosis and treatment of patients with cardiogenic shock are limited. Therefore, the main aim of this publication is to increase the awareness of specialists about modern approaches to the diagnosis and treatment of this condition. This review discusses in detail the main causes of cardiogenic shock, aspects of pathophysiology, modern classification, diagnosis, and algorithms for pharmacological and non-drug therapy in patients with cardiogenic shock