To the issue of the use of sodium-lithium countertransport rate in red cell membrane as a prognostic marker of artherial hypertension mordbidity and mortality: an experience of 25-year follow up cohort study

Aim. The article discusses the results of a long-term cohort study devoted to the search for the possible relationship of arterial hypertension morbidity and mortality with the rate of sodium-lithium countertransport (Na+-Li+-СT) in red cell membrane which is a marker of the structural and functional state of the cell membrane. Methods. The study of the functional state of cell membranes by determining the maximal rate of Na+-Li+-CT in red cell membrane with quintiles analysis of the rate of Na+-Li+-CT. Screening clinical examination, including registration of blood pressure (BP), ECG study, the study of eyeground vessels, one- and two-dimensional echocardiography (EchoCG), the study of the lipid spectrum of the blood. Analysis of medical records. Results. Based on the results of long-term follow up of the aging cohort total mortality is not associated with Na+-Li+-СT rate in red cell membrane. At the average age of 50 bimodality is detected in the development of new cases of primary arterial hypertension associated with the values of Na+-Li+-СT rate of the 1st quartile (36-206 micromoles of Li per liter of cells per hour) and 3d quartile (276-347 micromoles of Li per liter of cells per hour). At the average age of cohort of 55.6±6.7 years the distribution of patients with arterial hypertension by quartiles of Na+-Li+-СT rate becomes almost identical with the statistically non-significant prevalence of 4th quartile of Na+-Li+-СT rate. Conclusion. The expected correlation between mortality among persons with hypertension and membrane disorders determined by the high rate of Na+-Li+-СT was not revealed. However, the tendency to the predominance of mortality at high Na+-Li+-СT rate suggests that with a much larger sample size a significant relationship may be confirmed. The necessity of studying the relationship between mortality from arterial hypertension and high rate of Na+-Li+-СT in female cohorts remains actual. Increasing difference of mortality rate among patients with and without arterial hypertension with high rate of Na+-Li+-СT can indicate the relationship between mortality from arterial hypertension and membrane disorders

Risk of long QT syndrome in novel coronavirus COVID-19

The article is devoted to the risk of cardiovascular disease in coronavirus infection. In March 2020, the World Health Organization announced the COVID-19 pandemic. The virus set many tasks for practicing doctors, including the study of its pathogenesis and the creation of a therapy suitable for all patient groups. This paper presents information about cellular entry of the coronavirus, the development of cardiovascular diseases, in particular, the heart, and the latest data on experimental therapy with hydroxychloroquine. Coronavirus has been shown to affect the synthesis of angiotensin 2, which increase the QT interval. At the same time, the combination therapy using chloroquine and azithromycin caused a critical prolongation of the QT interval in some cases. On 4 July 2020, WHO accepted the Solidarity Trial’s International Steering Committee recommendation has stop the trial of these drugs. Cardiologists should review the latest information on the effects of coronavirus on the cardiovascular system and based on this, make recommendations the management and treatment of severe patients

Membrane characteristics and vascular cognitive impairment

Objective: to study the clinical phenomenology of vascular cognitive impairment (VCI) in individuals with different rates of passive transmembrane ion transport.Patients and methods. Cognitive functions were evaluated in 372 patients with different clinical variants of moderate VCI after 1, 5, and 10 years of follow-up. Quantile analysis was used to group  patients into quartiles according to the ranges in the rate of passive  transmembrane ion transport reflecting the genetically determined  properties of cell membranes and identified by the study of Na+–Li+ countertransport (NLC) in the erythrocyte membrane.Results. There was initially a monofunctional non-amnestic type in 11.0% of the patients, a monofunctional amnestic type in 16.1%, a multifunctional non-amnestic type in 34.9%, and a multifunctional amnestic type in 37.9%. At the same type, in the patients with high-speed NLC, the number of amnestic VCI types statistically dominated: 77.1% of the patients belonging to IV quartile. After 1 year and 5 years of follow-up, there was an increase in the number of patients with severe cognitive impairment, reaching the degree of dementia (33.2% of all the examinees following 1 year). The patients with high-speed NLC showed a significant predominance of not only the total number of dementias (86.7% of the patients in IV quartile; p<0.001), but also a more unfavorable mixed (disregulatory + Alzheimer's disease) type of dementia (74.7% of the patients in IV quartile; p<0.001). The dysregulatory type of dementia was more common in patients with low- and moderate-speed NLC. 70% of all dementias formed from the multifunctional amnestic type of mild cognitive impairment (MCI). Different types of MCI were observed to be transformed to the prognostically unfavorable multifunctional amnestic type of MCI. The study conducted 10 years later noted the same trends.Conclusion. The NLC speed has been shown to be associated with the VCI profile, which makes this indicator promising for predicting the course of VCI in the early stage of the disease and for choosing a treatment policy

Skorost' Na/Li-npomueompaHcnopma v eritrotsitakh u bol'nykh sakharnym diabetom tipa 1 i razvitie diabeticheskoy nefropatii

Цель. Определение скорости Na/Li-ПТ в эритроцитах больных СД типа 1 в зависимости от длительности заболевания и стадии ДН и выявление его возможного влияния на развитие нефропатии. Материалы и методы. Обследован 131 больной СД типа 1. Все больные обследовались по программе, которая предусматривает общепринятые клинические и лабораторные методы исследования. Оценивали проницаемость мембран для натрия. Результаты. Исследования показали повышение скорости Na/Li-ПТ у всех больных СД типа 1 по сравнению со здоровыми лицами. Достоверное повышение Na/Li-ПТ по сравнению с нормальным уровнем выявлены у больных с микроальбуминурией и макроальбуминурией. У больных с микроальбуминурией достоверное повышение скорости Na/Li-ПТ появляется только при длительности СД более 10 лет. У больных, у которых макроальбуминурия развилась на ранних стадиях СД (до 10 лет), скорость Na/Li-ПТ достоверно более высокая, чем у больных с макроальбуминурией после 10 лет заболевания. Выводы. С увеличением скорости Na/Li-ПТ риск развития ДН значительно возрастает. Больные с нормальными значениями Na/Li-ПТ в сочетании с другими протективными факторами имеют шанс сохранить нормальную функцию почек достаточно долгое время. Больные с более высокими цифрами Na/Li-ПТ имеют риск развития диабетической нефропатии на ранних сроках течения СД