[Prevalence of cardiiovascular risk factors in Russian population of patients with arterial hypertension].

We studied prevalence of arterial hypertension (AH) and its association with major cardiovascular (CV) risk factors among unorganized adult population aged 25-64 years in 10 Russian cities (Volgograd, Voronezh, Ivanovo, Irkutsk, Krasnoyarsk, Orenburg, Vladikavkaz, Samara, Tomsk, Tyumen) with different climatic, geographical, economical and demographical characteristics. This cross-sectional epidemiological study was conducted within the framework of the ESSAY RF-2012 (Epidemiology of Cardiovascular diseases in the Regions of the Russian Federation) project. Epidemiological situation concerning AH was found to be unfavorable. Prevalence of CV risk factors was high especially in young men and postmenopausal women. Major CV risk factors, associated with AH were hypertriglyceridemia, hyperglycemia, and obesity. The obtained results substantiate the expediency of the use of population strategy of AH and CV risk factors prevention in the studied population.

[The role of multispiral computed tomography in assessment of viability of the myocardium and prognostication of left ventricular remodeling in patients with ST-elevation myocardial infarction].

Aim of the study was to assess perfusion defect and viability of the myocardium by the method of multispiral computed tomography (MSCT) in patients with ST-elevation acute myocardial infarction (AMI) and to assess their prognostic role in development of remodeling of the left ventricle (LV). We included into the study 117 patients with AMI. MSCT with intravenous contrast enhancement was carried out on days 3-4 and at 12 months after AMI. In the arterial phase we estimated volume of myocardial perfusion defect, LV end diastolic and end systolic volumes (LVEDV and LVESV), and LV ejection fraction (EF). Three types of myocardial opacification were distinguished on tomograms in delayed phase of MSCT: type I - subendocardial residual defect (RD), type II - transmural RD, type III - transmural delayed hyper enhancement (DE). Patients were divided in 3 groups: (1) with subendocardial RD (n=63), (2) with transmural RD (n=28), (3) with transmural DE (n=26). Development of LV remodeling was registered if at repeat MSCT LVEDV increased more or equal 20% from baseline. In patients with signs of viable myocardium (group 1) volume of perfusion defect was substantially smaller than in patients with nonviable myocardium (groups 2 and 3): 1cm3 (0.4-2.4) vs. 7.3 cm3 (5.3-10.0) and 6.3 cm3 (5.0-15.0), respectively, p<0.001. Compared with groups 2 and 3 patients of group 1 more often were female (p=0.04), had inferior MI (p<0.001), and spontaneous reperfusion (p<0.001). After 12 months LV remodeling was registered in 19.3% of patients, all had signs of nonviable myocardium in more or equal 3 LV segments. In patients with perfusion defect more or equal 10 cm3 probability of development of LV remodeling exceeded 50%. Disturbances of perfusion abnormalities and number of nonviable LV segments were main predictors of LV remodeling.

[Assessment of major artery stiffness: new perspectives of noninvasive diagnosis of coronary atherosclerosis].

AIM: Arterial stiffness is a predictor of atherosclerosis. This study was conducted to develop a method of coronary atherosclerosis severity assessment by means of brachial-ankle pulse wave velocity (baPWV). MATERIAL AND METHODS: We measured baPWV in 119 males (age 51.67 +/- 7.25) who received coronary angiographic examination (CAG). The baPWV was measured by Vasera VS-1000 (Fukuda Denshi). RESULTS: The patients were divided into two groups by severity of stenosis (group 1--less than 50% stenosis, group 2 > 50%). The baPWV value was significantly greater in group 2 (n = 98, baPWV 13.15 +/- 2.14 m/s, p = 0.004) than that in group 1 (n = 21, baPWV 12.13 +/- 1.17 m/s). ROC-curve demonstrated that the best cut-off point of the baPWV for predicting occlusive atherosclerosis was 12.2 m/s. The area under ROC-curve was 0.66 (p = 0.034). An univariate binary logistic regression model demonstrated that only baPWV had a significant odds ratio for coronary stenosis > 50%: 2.68 (95% CI = 1.01-7.15), p = 0.043. Other risk factors were not significantly associated with severity of stenosis. CONCLUSION: The baPWV significantly reflects the severity of stenosis in middle-aged males opening new perspectives of noninvasive detection of coronary artery atherosclerosis in middle-aged males.