Aim.  To compare  the  novel arterial stiffness  index START and  the cardio-ankle vascular index (CAVI) in hypertensive (HTN) patients. Material and methods. A total of 709 people  with HTN aged  24 to 64 years  were  examined by volume sphygmography  using VaSera VS-1000 (Fukuda Denshi, Japan).  CAVI  and  START values obtained retrospectively  from pulse  wave velocity and  blood pressure  were studied using an online calculator.

Results. The median CAVI score was within the normal range (<9,0): 7,5 (6,6; 8,4) on the right and 7,4 (6,5; 8,4) on the left. The median of the START index was 6,25 (5,0; 7,55) on the right and 6,4 (5,1; 7,8) on the left. For young people (21-30 years old), the median START score was 4,47, for the CAVI index — 6,25 (p>0,05). In the older age group (61-70 years), the median START index was 7,27, for the CAVI index — 8,4 (p>0,05).  The growth pattern of the START score with age was higher by 38,5% than the CAVI index by 25,6% (p=0,034). A high degree  of correlation between CAVI and START was noted (r=0,823, p<0,001).  Parameters were associated with age (r=0,412 for CAVI and r=0,355 for START; p<0,001), smoking duration (r=0,390 and r=0,361; p<0,001), glomerular filtration rate (r=-0,317 and r= -0,318; p<0,001), body mass index (r=-0,176 and r=-0,185; p=0,001). For the CAVI index, a relationship was found with the glucose level (r=0,192; p<0,001) and a sedentary  lifestyle (r=-0,157; p=0,04), while for the START index — with the creatinine level (r=0,143; p=0,01).

Conclusion.  Patients  with hypertension  showed  a high correlation between   the  novel  START index  and  the  CAVI   score   (r=0,823, p<0,001).  The indicators  had similar associations  with risk factors, which is important for the  subsequent practical  application of the START index.

Aim. To compare  the epicardial fat thickness  (EFT) in right ventricular anterior wall (RVAW) and left atrial mechanical dispersion  (LAMD) in hypertensive (HTN) patients without arrhythmias and with various types of recurrent atrial fibrillation (AF).

Material and methods. This observational  cross-sectional single-center  study included 383 patients  with HTN, of which 251 did not have AF,  61 patients  had paroxysmal,  and 71 patients  — persistent AF. Echocardiography  performed  against  the  background  of sinus rhythm assessed the EFT in RVAW. In addition, using speckle-tracking echocardiography, the LAMD was determined,  equal to the percentage of the standard  deviation of the time to peak  global longitudinal LA strain in the reservoir phase to duration of cardiac cycle.

Results. In HTN patients without AF, with paroxysmal and persistent AF, the EFT was 6,70 [5,80; 8,00], 8,20 [7,10; 9,93] and 8,70 [7,93; 10,0] mm (р<0,0001), LAMD — 0,72 [0,58; 0,93], 2,87 [2,40; 3,28] and 2,67 [2,11; 3,15]% (p<0,0001), respectively.

Conclusion. In HTN patients with paroxysmal and persistent  AF, the EFT in RVAW and LAMD is significantly greater  than in patients without arrhythmias. In patients with persistent  AF, EFT is greater than in paroxysmal AF, while LAMD practically does not differ.

Aim. To analyze the level of biomarkers of inflammation and endothelial dysfunction in elderly patients with myocardial infarction (MI), hypertension (HTN) and frailty.

Material and methods. Three following clinical groups were formed: patients aged 60-74 years with MI+ grade 1-2 HTN (n=80); patients aged 60-74 with MI+HTN+prefrailty (n=52); patients aged 60-74 years with MI+HTN+frailty (n=114). In patients of all groups 2-4 months after MI, the levels of high-sensitivity C-reactive protein (hsCRP), intercellular adhesion molecule 1 (ICAM-1), nitric oxide (NO) metabolites — nitrates and nitrites, endothelin-1, desquamated endotheliocytes, vascular endothelial growth factor (VEGF) were determined.

Results. Patients with MI+HTN+frailty had a higher hsCRP — 6,4 mg/l compared with patients with MI+HTN+ prefrailty (4,2 mg/l; p<0,01) and patients with MI+HTN (3,2 mg/l; p<0,01). The level of ICAM-1 was 315,6, 242,7, and 213,5 ng/ml, respectively, in these groups (p<0,01). Patients with MI+HTN+prefrailty, MI+HTN+frailty and MI+HTN had following levels of nitrite (NO₂^-) and nitrate (NO₃^-) — 6,7, 5,4, and 7,2 pmol/l (p<0,01). A similar ratio is inherent in NO₃^-. On the contrary, the content of desquamated endotheliocytes and VEGF was significantly higher in patients with MI+HTN+frailty compared with patients with MI+HTN+ prefrailty (p<0,01). The level of endothelin-1 was also significantly higher in patients with MI+HTN+frailty compared with the MI+HTN+prefrailty group: 18,85 vs 13,41 fmol/l (p<0,05).

Conclusion. The levels of inflammation and endothelial dysfunction in patients with MI+HTN are significantly higher than those in patients with MI+HTN+frailty compared with patients with MI+AH+prefrailty and MI+HTN, with the exception of nitric oxide metabolites.

Aim. To evaluate the potential of using factors associated with type 2 myocardial infarction (MI) for its early diagnosis.

Material and methods. This prospective study included 204 patients diagnosed with acute coronary syndrome (ACS). At the time of admission, each patient underwent standard examinations for ACS patients. The 1-year stage consisted of telephone survey of patients on the course of long-term postinfarction period. There were following endpoints: death, recurrent coronary events and hospitalization.

Result. Patients with type 2 MI accounted for 10,8% (n=22) of the entire analyzed sample. A model for prehospital diagnosis of probable type 2 MI has been developed. The model included clinical and history data that allow to suggest the type 2 MI course without invasive and laboratory studies. The model included signs (body mass index ≥35, kg/m², atrial fibrillation+Killip I, hemoglobin <110 g/l within 1 year before MI, chronic obstructive pulmonary disease), the most common in type 2 MI patients according to own data and previous studies.

Conclusion. A model of prehospital clinical assessment of MI risk has been developed for making a preliminary diagnosis and forming different patient streams at the admission stage for the final verification of the diagnosis.

Aim. To investigate the relationship between echocardiographic parameters and laboratory immune inflammation signs in patients after coronavirus disease 2019 (COVID-19) pneumonia depending on the left ventricular (LV) involvement according to speckle tracking echocardiography (STE).

Material and methods. The study included 216 patients (men, 51,1%, mean age, 50,1±11,1 years). The examination was carried out in patients 3 months after COVID-19 pneumonia. Patients were divided in 3 groups: group I (n=41) — diffuse decrease (≥4 segments the same LV level) of longitudinal strain (LS) according to STE; group II (n=67) — patients with regional decrease (LS reduction ≥3 segments corresponding to systems of the anterior, circumflex or right coronary arteries); group III — patients without visual left ventricle involvement (n=108).

Results. There were no significant differences in LV ejection fraction — 68,9±4,1% in group I, 68,5±4,4% in group II and 68,6±4,3 in group III (p=0,934). A decrease in the global longitudinal left ventricle strain was detected significantly more often in groups I and II compared with group III (-17,8±2,0, -18,5±2,0 and -20,8±1,8%, respectively; p<0,001). At the same time, LS depression of LV basal level (-14,9±1,5, -16,8±1,2% and -19,1±1,7%; p<0,001), as well as a decrease in LS of LV inferior-posterior segments in group with diffuse involvement was detected significantly more often than in groups II and III. In addition, we revealed a significant difference in interleukin-6 concentration — 3,1 [2,5;4,0], 3,1 [2,4;3,8] and 2,5 [3,8;1,7] pg/ml, (p=0,033), C-reactive protein — 4,0 [2,2;7,9], 5,7 [3,2;7,9] and 2,4 [1,1;4,7] mg/l, (p<0,001), tumor necrosis factor-a — 5,9±1,9, 6,2±1,9 and 5,2±2,0 pg/ml, (p=0,004) and ferritin — 130,7 [56,5;220,0], 92,2 [26,0;129,4] and 51,0 [23,2;158,9] pg/l, respectively (p=0,025).

Conclusion. A relationship was found between diffuse and regional left ventricular involvement according to STE and signs of immune inflammation in patients 3 months after COVID-19 pneumonia.

Aim. To study the effect of inhalation therapy with an active hydrogen (AH) on the protein composition of exhaled breath condensate (EBC) in patients with post-COVID syndrome (PCS).

Material and methods. This randomized controlled parallel prospective study included 60 patients after coronavirus disease 2019 (COVID-19) with PCS during the recovery period and clinical manifestations of chronic fatigue syndrome who received standard therapy according to the protocol for managing patients with chronic fatigue syndrome (CFS). The patients were divided into 2 groups: group 1 (main) — 30 people who received standard therapy and AH inhalations (SUISONIA, Japan) for 10 days, and group 2 (control) — 30 medical workers who received only standard therapy. Patients in both groups were comparable in sex and mean age. All participants in the study were sampled with EBC on days 1 and 10. Samples were subjected to tryptic digestion and high-performance liquid chromatography combined with tandem mass spectrometry analysis using a nanoflow chromatograph (Dionex 3000) in tandem with a high-resolution time-of-flight mass spectrometer (timsTOF Pro).

Results. A total of 478 proteins and 1350 peptides were identified using high resolution mass spectrometry. The number of proteins in samples after AH therapy, on average, is 12% more than before treatment. An analysis of the distribution of proteins in different groups of patients showed that only half of these proteins (112) are common for all groups of samples and are detected in EBC before, after, and regardless of hydrogen therapy. In addition to the qualitative difference in the EBC protein compositions in different groups, quantitative changes in the concentration of 36 proteins (mainly structural and protective) were also revealed, which together made it possible to reliably distinguish between subgroups before and after treatment. It is worth noting that among these proteins there are participants of blood coagulation (а-1-antitrypsin), chemokine- and cytokine-mediated inflammation, and a number of signaling pathways (cytoplasmic actin 2), response to oxidative stress (thioredoxin), glycolysis (glyceraldehyde-3- phosphate dehydrogenase), etc.

Conclusion. The use of hydrogen therapy can contribute to the switching of a number of physiological processes, which may affect the success of recovery in PCS patients. In particular, the obtained results indicate the activation of aerobic synthesis of adenosine triphosphate in mitochondria by hydrogen therapy, which correlates well with the decrease in the blood lactate level detected by laboratory studies. At the same time, this therapy can inhibit pro-inflammatory activity, negatively affecting the coagulation and signaling pathways of integrins and apoptosis, and, in addition, activate protective pathways, tricarboxylic acid cycle, FAS signaling, and purine metabolism, which may be essential for effective recovery after COVID-19.

The article presents a case report of the Chatterjee phenomenon after implantation of a pacemaker in a patient with heart failure with preserved ejection fraction. During hospitalization in a specialized cardiology hospital, the patient's electrocardiogram (ECG) showed atrial fibrillation (AF) with a ventricular rate of 49 bpm, ST segment depression of 1 mm in I, II, V4-V6 leads. Taking into account the data of 24-hour ECG monitoring (pauses up to 5,2 seconds with AF) and Stokes-Adams syndrome equivalents, a decision was made to implant a single-chamber pacemaker. Immediately after the pacemaker implantation, AF was registered on the ECG with a pacemaker VVI mode of 60 pulses/min. On the second day after intervention, the pacemaker was reprogrammed in the form of reducing the minimum pacing rate from 60 to 45 pulses/min. On the third day after pacemaker implantation, altered terminal ventricular complex part was detected in the form of negative T waves in I, II, III, aVF, V2-V6 leads, as well as ST segment depression in V3-V6 to 1,5 mm. Differential diagnosis of the identified abnormalities with other clinical conditions accompanied by impaired repolarization processes according to ECG data was carried out. In dynamics, normalization of the ECG picture after 2,5 months was demonstrated.

Cardiovascular pathology occupies a leading place among all causes of death and permanent disability of the population. In recent years, there has been an increase in the number of cardiovascular comorbidity cases, which leads to a significant deterioration in the quality of life, difficulties in the selection of therapy and a worse prognosis. Cardiorheumatology is an actual and actively discussed direction in this area. One of the most common rheumatic pathologies is osteoarthritis. Researchers identify a number of factors aggravating the course of cardiovascular pathology in the presence of osteoarthritis: regular intake of non-steroidal antiinflammatory drugs, chronic pain syndrome, decreased mobility. The review provides current data on the problem under discussion, in particular, the current understanding of pathogenetic relationships. The issues of safety of non-steroidal anti-inflammatory drugs in cardiovascular patients are highlighted. The potential of using modern immunological cytokines in this group of patients are described using the example of galectin-3 as a marker of prognosis.

According to modern literature data, the role of human immunodeficiency virus (HIV) infection has been proven as an independent risk factor (RF) for atherosclerosis and cardiovascular diseases (CVDs), including coronary artery disease, heart failure, and sudden cardiac death. The role of antiretroviral therapy (ART) in the occurrence of CVD remains debatable. On the one hand, ART is a mandatory component in CVD prevention, since there are numerous confirmations of the association of high viral load and noncompensated immune status with an increased risk of CVD. On the other hand, the use of certain classes of ART agents is associated with the development of dyslipidemia, insulin resistance, and type 2 diabetes, which are risk factors for CVD. In this regard, the current HIV treatment protocols require an assessment of CVD risk factors to select the optimal ART regimen. It must be remembered that when using generally accepted algorithms and scales for assessing the risk of CVD, the real risk may remain underestimated in HIV-infected patients. This literature review presents a patient data management algorithm developed by the American Heart Association and describes statin therapy in patients with HIV infection.

Sedentary behavior (SB) and low (insufficient) physical activity (LPA) are two complementary negative factors affecting cardiovascular health. Most of the current studies are devoted to the study of SB and physical activity (PA) of different intensity separately, while their combined effect has not been studied enough. The purpose was to analyze the literature on the assessment of combined SB+PA effect of different intensity on the general and cardiovascular health of a person. When preparing the review, a search was made for publications in the MedLine, Cochrane, Scopus databases, as well as electronic resources e-library, CyberLeninka and libraries of physical culture and sports universities in Russia for 2002-2022.

Issues related to various SB+PA combinations and their effects on general and cardiovascular health are considered and discussed. The facts of the favorable effect of switching sedentary behavior on the same time moderate-intensity PA are presented. The presented data indicate the need for further study, taking into account the mutual substitution of SB and FA of different intensity.

Methodological guidelines have been developed for inpatient internists, general practitioners, paramedics providing healthcare care in accordance with the professional standard "internist", "general practitioner". The guidelines are based on consensus papers, accumulated clinical and scientific experience. The methodology for organizing and conducting an ultrasound-assisted assessment of visceral adipose tissue is described in detail. Algorithms for diagnosing visceral obesity are presented to help the practitioner. Particular attention is paid to visceral fat assessment using ultrasound-assisted examination. These guidelines will be of interest to doctors, heads of healthcare facilities, as well as students of medical universities.