Relevance. Evaluation of the effectiveness of risk management in persons with high cardiovascular risk is an important element in reducing the death rate of the population from cardiovascular diseases (CVD). Aim. Analysis of the prevalence and level of risk factors control in patients with high CV risk CVD from the Russian centers of the primary care unit of the EUROASPIRE IV study in comparison with the general population of the study. Materials and methods. In this cross-sectional study, 14 European countries, including the Russian Federation, participated. Patients aged 18 to 79 years were included in the study, without clinical manifestations of atherosclerosis, who were prescribed antihypertensive therapy and/or lipid lowering therapy and/or treatment for diabetes between the ages of ≥6 months and <3 years before switching on. The study protocol included analysis of medical records and a visit-interview using a specially designed structured questionnaire on the main aspects of lifestyle (smoking, nutrition, physical activity, psychosocial factors), taking medications and adhering to other recommendations. Anthropometric data, blood pressure, concentration of carbon monoxide (CO) in the exhaled air were also recorded during the interview, and venous blood was taken to determine the levels of lipids, glucose and glycated hemoglobin (HbA_1c). All patients without diabetes in the absence of fasting hyperglycaemia ≥11.1 mmol/l conducted an oral glucose tolerance test. Results. In total, 505 patients with known high CV risk were examined in Russian centers and 405 interviews took place (71.6% of women). The prevalence of smoking in the Russian cohort and in the general population of the study was 17.8 and 16.6%, obesity - 56.6 and 43.5%, diabetes - 18.7 and 27.7%, low physical activity - 53.2 and 68.5%, respectively. Support received by patients with smoking quitting was clearly insufficient and rarely included medical therapy. The frequency of reaching the target level of blood pressure on the background of therapy was 68.1 and 42.8%, respectively, and the target level of LDL-C was 26.2 and 32.7%. HbA_1c <7% was reported in 64.3% of patients with diabetes in the Russian cohort and 58.5% in the study as a whole. The proportion of patients whose diabetes was detected only during the visit-interview was 26.4% and 21.8%, respectively. Conclusion. The different components of cardiovascular prevention in Russia and in the general population of the study had some differences, while in some areas, in particular in the control of blood pressure, Russian patients with BP achieved even better results than in Europe as a whole. On the contrary, the situation in Russian centers was worse with regard to the prevalence of overweight and obesity in patients with BP, control of blood lipid levels, as well as detection rates not previously diagnosed with diabetes.

Aim. To determine efficacy of bisoprolol and sotalol treatments in patients with paroxysmal supraventricular tachycardia (SVT) and essential hypertension (EH) considering effects of these treatments on the regulatory adaptive status (RAS). Materials and methods. RAe study included 49 patients with paroxysmal SVT associated with stage II-III EH randomized to two groups of either bisoprolol (6.9±2.2 mg/day, n=25) or sotalol (162.5±46.2 mg/day, n=24) treatment. Lisinopril (14.5±3.9 and 14.3±4.7 mg/day) and, if indicated, atorvastatin (15.4±3.8 mg/day, n=9 and 16.0±4.8 mg/day, n=10), and acetylsalicylic acid (91.5±14.7 mg/day, n=12 and 94.1±16.5 mg/day, n=14) were administered as a part of combination therapy. Quantitative evaluation of RAS (cardiorespiratory synchronism test), EchoCG, triplex scanning of brachiocephalic arteries, treadmill test, 6-min walk test, 24-h BP and ECG monitoring, and subjective assessment of the quality of life were performed at baseline and after 6 months of therapy. Results. Both regimens of the combination drug therapy comparably improved the structural and functional status of the heart, increased exercise tolerance, effectively suppressed SVT paroxysms, and improved the quality of life. In this process, sotalol reduced RAS to a lesser extent that bisoprolol. Conclusion. In patients with paroxysmal SVT associated with stage II-III EH, the sotalol treatment as a part of the combination therapy may be preferable due to fewer adverse effects on RAS compared to bisoprolol.

Aim. To determine correlations of AH-associated interleukins (IL-18, IL-6) with sodium consumption in AH patients with and without DM. Materials and methods. The study included AH patients with and without DM (n=63) who were managed at the Municipal Clinic #64, Moscow Department of Health Care, Branch 1. Plasma levels of IL-6 and IL-18 were measured using ELISA kits (Bender Med-Systems). Salt consumption was determined using a Charlton: SaltScreener questionnaire. Statistical analyses were performed using the Statistica 10.0 software. Results. Four groups were formed: Group 1, grade 2 AH and DM (n=19); Group 2, grade 2 AH and no DM (n=4); Group 3, grade 3 AH and no DM (n=28); and Group 4, grade 3 AH and DM (n=12). Group 2 was small and was excluded from further analysis due to impossibility of statistical treatment. All patients consumed more than 6 g of salt per day (approximately 10 g). Analysis of intergroup differences in selected parameters showed differences between groups in levels of cholesterol, triglycerides, LDL, and GFR. The following correlations were identified in the groups: Group 1, positive correlation of IL-18 with sodium consumption (r=0.65) and CRP level (r=0.52) and of IL-6 with LDL level (r=0.48); Group 3, positive correlation of IL-18 with IL-6 (r=0.66) and of IL-6 with CRP (r=0.52); Group 4, positive correlation of IL-18 with GFR (r=0.82) and of IL-6 with waist circumference (WC) (r=0.84) and IL-6 (r=0.73). Conclusion. Patients consuming more than 6 g ofsalt daily (approximately 10 g) with AH and DM had more pronounced inflammation, which promoted progression of kidney disease.

Background. Aortic stenosis (AS) is the most common valve defect in developed countries; its prevalence increases with age of the population. He most frequent cause for isolated AS in adults is calcification ofnormal tricuspid or congenital bicuspid aortic valve (AV). ’Ete only effective treatment ofAS is aortic valve replacement (AVR). Major negative prognostic factors include low LV ejection fraction (EF), age older than 70, female gender, and comorbidities such as renal dysfunction, chronic obstructive pulmonary disease, and neural disorders. Aim. To study negative prognostic factors influencing outcomes of treatment for AS and to determine possibilities for managing AS patients taking into account these factors. Materials and methods. 120 medical records of patients who had undergone AVR for isolated AS (76 women and 44 men aged 45 to 81) were studied retrospectively, and 50 patients were examined in a late post-AV period (26 women aged 67.5 (65.0-72.0) at the time of surgery, 24 men aged 63.0 (57.0-68.0) at the time of surgery), and 84 unoperated patients (51 women and 33 men). Results. Perioperative death rate was 8.76%, 11 of 120 patients, 3 men (6.8% of operated men) and 8 women (10.5% of all operated women). ’Eie deceased patients aged 70 or older whereas perioperative death rate of patients younger than 70 was zero (Pχ²=0.004). Despite a relatively high perioperative risk, late survival of patients older than 70 who had undergone AVR was substantially and statistically significantly higher than that of unoperated AS patients. In elderly patients who died during the perioperative period of AVR, the history of valve defect was longer, and a part of the patients who did not survive AVR could have been operated at age younger than 70. Unoperated AS patients with a small LV cavity, severe LV hypertrophy, and LV EF >70% were suggested to be isolated into a special group of risk with a special strategy for cardiosurgical treatment.

The article discusses the issue of searching for optimum oral anticoagulants to prevent thrombosis and embolism induced by heart disease both in patients with atrial fibrillation and sinus rhythm. A complex bidirectional relationship between atrial fibrillation and coronary atherosclerosis is considered along with possible mechanisms for development of myocardial infarction in patients with atrial fibrillation. The authors provided evidence-based data which can be used in selecting an anticoagulant for prevention of heart disease induced thrombosis and embolism taking into account both the efficacy and safety established in randomized clinical studies.

This review focuses on peculiarities of therapy for heart rhythm disorders in patients with CHF. Efficacy and safety of anti-arrhythmic drugs and a high incidence of pro-arrhythmic effects are discussed. It is shown that the underlying disease and severity of structural damage to the heart are of critical significance. Treatment of ventricular arrhythmias and atrial fibrillation are discussed.

The article presents a case report of metastatic heart damage which developed in association with urothelial bladder carcinoma in a 79-year old female patient. Various masses may be found in the heart. In tumors, a secondary damage to the heart is observed much more frequently than a primary damage; however, metastasis of bladder carcinoma to the heart is extremely rare. 0f interest is the fact of metastatic damage to all layers of the heart, including the endocardium, pericardium, and myocardium.