[Anxiety and Depression in Chronic Heart Failure. What Can a Cardiologist Do?]

AIM: To reveal the probability and duration of the onset of remission of anxiety-depressive symptoms in patients with CHF III-IV receiving optimal medicine treatment (OMT) or (OMT), supplemented with the education program and active outpatient monitoring (OMT + A). MATERIALS AND METHODS: A secondary analysis of the results of RCT CHANCE, which studied the impact of the training program and active outpatient control (further additional exposure (DV) plus optimal medication (OMT) on mortality and cardiovascular hospitalization in patients with CHF III-IV FC. Therapeutic training and outpatient control performed by the cardiologist after discharge from the hospital (weekly in the first month, every 2 weeks for the next 2 months, and then On the basis of the results of the telephone contact, an additional visit could be scheduled, the CHANCE study control group was made up of patients on OMT who were observed as practiced in regular health care setting. Control group had 4 visits to the cardiologist during the 1 year observation. The present analysis included patients on OMT and OMT + DV who had a clinically significant anxiety at the 0 week of the CHANCE program using the Hospital Anxiety and Depression Scale (HADS) (the sum of scores on the anxiety subscale ≥11), depression (the sum of scores on the depression subscale ≥11), or a combination of anxiety and depressive symptoms (scores on anxiety and depression subscales ≥11). Patients who did not pass HADS or SHOCK testing at 0.24 and 48 weeks were excluded from the analyses. A total of 237 patients were included. Severity of HF symptoms were assessed by "Scale of Heart failure Optimizing Clinical Status (SHOCS)" and compared it with the shares of patients who reached remission (HADS scores.

[Role of heart rate in mechanisms of compensation and decompensation in CHF patients with sinus rhythm and atrial fibrillation and methods for safe and efficient control of heart rhythm. Part 2. Atrial fibrillation].

This review focuses on the role of heart rate in patients with a combination of heart failure and atrial fibrillation and on methods for heart rate control in such patients.

[Characteristics and treatment of hospitalized patients with CHF].

The article analyzes some characteristics of hospitalized patients with decompensated chronic heart failure (HF) according to data from Russian and international registries, management of decompensated HF, and tactics for titration of evidence-based disease-modified therapies. The demographic characteristics of the patients from the registers that were used for the research are similar. Yet, the proportion of HF patients with preserved LVEF was greater according to data from several Russian studies. Meanwhile, with the patients that did not receive any loop diuretics and therefore had apparently no congestion signs being excluded from the analysis, the proportion of HF patients with preserved LVEF became similar to that from the international studies. The registers also showed that pulmonary edema and acute left ventricular failure were observed in less than a half of the cases. Nevertheless, patients with mild congestion symptoms still have bad lingering prognosis and require the same amount of medical attention. Up to 40 % of admissions for decompensated CHF resulted from a dietary disorder (excessive sodium consumption), low compliance with therapy and lack of access to primary care providers. Furthermore, the analysis of the outpatient treatment administered prior to the forthcoming hospitalization showed a low prescription rate of evidence-based disease-modifying therapies (ACEi or ARNi, BB, MRA). It is emphasized that in part of patients the administration and/or titration of this therapy can be started during hospitalization. The article also discusses the use of a new class of drugs, angiotensin receptor-neprilysin inhibitors (ARNi), including not only transferring patients from ACEi to ARNi but also the possibility of administering ARNi to stable, hospitalized patients who do not require intravenous diuretics and inotropic drugs.

Echocardiographic assessment of the haemodynamic effect of ethmozine and its diethylamine analogue etacizine in patients with heart failure.

The purpose of the study was to compare the haemodynamic effect of new antiarrhythmic preparations - ethmozine and its diethylamine analogue etacizine in 22 patients with heart failure (HF), stage IIa, of different etiology. The patients were given for one week ethmozine and then again for one week etacizine, during which periods they were followed echocardiographically, with pressure measurement in the pulmonary artery (PAP) and in the right atrium (RAP). Ethmozine in a daily dosis of 600-800 mg did not induce changes in left ventricular dimensions, percentual shortening of the anteroposterior left ventricular dimension (% delta S), in PAP, RAP, arterial pressure and heart rate. With application of etacizine in a dose of 150-200 mg/day, a clinically insignificant decrease was observed in % delta S (by 19.7%; p less than 0.05), which was not accompanied by a more marked augmentation of left ventricular dimensions, PAP, RAP or an intensification of clinical signs of heart failure. In spite of this, on administration of etacizine to patients with HF it is necessary to control haemodynamics, the most suitable method for this being echocardiography.