[Subclinical markers of liver damage in patients with arterial hypertension and obesity].

AIM: To investigate the possibility of preclinical detection of liver damage in patients with hypertension and obesity. MATERIALS AND METHODS: The study included 168 patients with hypertension aged 30 to 60 years. All patients underwent general clinical and laboratory-instrumental examination, including ultrasound of the abdominal organs with Doppler assessment of blood flow and determination of markers such as ALT, AST, TG, lipid profile indicators at inclusion, after a month, three months and nine months. RESULTS: Depending on the presence of obesity, all patients with hypertension were divided into two groups. Obese patients had a statistically significant increase in office blood pressure, FSI, the ratio of TG and LDL-C to HDL-C, a more significant higher average levels of glucose, TG and ALT levels, as well as impaired hepatic blood flow according to ultrasound. CONCLUSION: Indicators of FSI, ALT/AST ratio, ratio of TG and LDL-С to HDL-C as well as assessment of hepatic blood flow indicators can be used for early diagnosis of nonalcoholic fatty liver disease, as they predict liver steatosis.

[Prevalence and prognostic value of gastroenterological manifestations of COVID-19: data from the Russian University Clinic].

AIM: Assessment of the prevalence and prognostic value of gastroenterological manifestations in patients with COVID-19. MATERIALS AND METHODS: A single-center retrospective cohort study was carried out. Only cases with laboratory confirmed detection of SARS-CoV-2 virus RNA using polymerase chain reaction in oro-/nasopharyngeal smear samples were subject to analysis. Patients with documented (according to anamnestic data and/or according to examination data during hospitalization) organic pathology of the gastrointestinal tract (GIT) and/or hepatobiliary system, malignant neoplasms of any localization, as well as pregnant patients were excluded from the general register of retrospective data. The final cohort was divided into two groups depending on the presence of gastrointestinal symptoms: COVID-19 with gastrointestinal symptoms (cases) and COVID-19 without gastrointestinal symptoms (control). RESULTS: The final sample consisted of 3764 patients, including 2108 (56%) women and 1656 (44%) men. The average age of the subjects included in the analysis was 58.0 years (95% confidence interval CI 48.663.0). In the study cohort, gastroenterological manifestations (alone or in combination) were recorded in 885 (23.51%) patients. Calculation of the odds ratio (OR) of unfavorable and lethal outcomes between the analyzed groups showed that the presence of gastroenterological symptoms significantly increases the chances of lethal outcome in a cohort of elderly and senile patients (OR 1.6817, 95% CI 1.03352.7364; p=0.0364), determines a higher risk of hospitalization or transfer to the intensive care unit (OR 1.2959, 95% CI 1.05471.5922; p=0.0136), development of acute respiratory distress syndrome (OR 1.5952, 95% CI 1.31641.9329; p0.0001), as well as the need for mechanical ventilation (OR 1.2849, 95% CI 1.0771.5329; p=0.0054). CONCLUSION: The present study has demonstrated that gastroenterological symptoms are detected in about one in four patients infected with the SARS-CoV-2 virus and multiply the risk of adverse and life-threatening complications of COVID-19.

[Serum brain natriuretic peptide and its role in acute coronary syndrome with different types of mitochondrial dysfunction].

The level of serum brain natriuretic peptide (BNP) was measured in 236 patients with acute coronary syndrome. Some of them presented with mitochondrial dysfunction. None showed diagnostically significant BNP levels within 12 hours after admittance, but patients with unstable angina and BNP level below 80 pg/ml had the lowest risk of serious cardiovascular diseases. Marked mitochondrial dysfunction was associated with maximum BNP levels 12 hr and 14 days after hospitalization and mild dysfunction with minimal BNP concentration.

[Efficacy of shock-wave therapy in the treatment of chronic ischemic heart failure].

INTRODUCTION: Shock-wave therapy (SWT) has proved its efficacy and safety in a number of studies in stable effort angina. METHODS: Twenty-four patients (20 men, 4 women; mean age 63.3 +/- 6.1 years) with chronic heart failure (CHF) of ischemic origin (>6 months after AMI) and left ventricular (LV) ejection fraction (EF) <40% received SWT in addition to their stable treatment. SWT was performed in 9 sessions with 100 shocks per spot in viable segments detected by low dose dobutamine stress echocardiography. Patients were examined at baseline and at 3 and 6 months after SWT. Troponin T level was measured after each week of treatment. RESULTS: Class of CHF significantly decrease from 2.2 +/- 0.8 to 1.7 +/- 0.7 at 3 and at 6 months after SWT (p<0.01). Six-minute walk test improved from 414 +/- 141 to 509 +/- 141 and 538 +/- 116 m (p<0.01) at 3 and 6 months, respectively. Significant augmentation of LVEF at rest was noted at 3 and 6 months after SWT (from 32.2 +/- 6.0 to 34.8 +/- 9.6 and 37.7 +/- 9.5, respectively p=0.03). Troponin T was negative in all cases. Significant increase of LV longitudinal deformation was registered at 6 months (from -8.84 +/- 0.38 to -9.72 +/- -0.44%, p<0.01) what evidenced for improvement of LV contractility. The latter was a result of restored hibernating segments function (longitudinal deformation of these segments rose from initial -7.52 +/- -0.5 to -9.18 +/- 0.53 and -9.63 +/- 0.59% at 3 and 6 months after SWT, respectively, p<0.01). CONCLUSIONS: In patients with CHF SWT caused significant clinical improvement as well as increases in LV EF and distance walked during 6-min walk test. These results justify conduct of a placebo controlled study.