RÉSUMÉ
Based on a clinical case report, the article shows the individual selection of effective therapy for a patient with arterial hypertension and dyslipidemia. Taking into account the risk factors for cardiovascular diseases, Equamer® was selected as a fixed combination of amlodipine + lisinopril + rosuvastatin capsules 10 mg+20 mg+10 mg (Gedeon Richter Plc, Budapest, Hungary). In the patient with hypertension, ischemic heart disease was verified, and stenting of the anterior descending artery was performed. According to the clinical guidelines, when arterial hypertension is associated with ischemic heart disease, the drug therapy of choice should be a combination of dihydropyridine slow calcium channel blockers with an angiotensin-converting enzyme inhibitor. The fixed triple combination of amlodipine, lisinopril, and rosuvastatin is one of the most appropriate in this clinical situation; this combination targets the two major risk factors for cardiovascular diseases, arterial hypertension and dyslipidemia.
Sujet(s)
Amlodipine , Association médicamenteuse , Dyslipidémies , Hypertension artérielle , Humains , Amlodipine/administration et posologie , Antihypertenseurs/usage thérapeutique , Inhibiteurs des canaux calciques/usage thérapeutique , Dyslipidémies/traitement médicamenteux , Dyslipidémies/complications , Hypertension artérielle/traitement médicamenteux , Lisinopril/administration et posologie , Lisinopril/usage thérapeutique , Rosuvastatine de calcium/administration et posologie , Rosuvastatine de calcium/usage thérapeutique , Résultat thérapeutiqueRÉSUMÉ
Aim To evaluate the incidence of iron deficiency (ID) in men and women with chronic heart failure (CHF) and to compare clinical and functional indexes in patient with and without ID depending on the gender.Material and methods An additional analysis of the study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)" was performed. The study included 498 (198 women, 300 men) patients with CHF, in whom, in addition to iron metabolism, the quality of life and exercise tolerance (ET) were studied. 97 % of patients were enrolled during their stay in a hospital. ID was defined in consistency with the European Society of Cardiology (ESC) Guidelines. Also, and additional analysis was performed according to ID criteria validated by the morphological picture of the bone marrow.Results ID was detected in 174 (87.9 %) women and 239 (79.8 %) men (p=0.028) according to the ESC criteria, and in 154 (77.8 %) women and 217 (72.3 %) men (p=0.208) according to the criteria validated by the morphological picture of the bone marrow. Men with ID were older and had more severe CHF. They more frequently had HF functional class (FC) III and IV (63.4 % vs. 43.3 % in men without ID); higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower ET. HF FC IIIâincreased the probability of ID presence 3.4 times (p=0.02) and the probability of HF FC IVâ13.7 times (p=0.003). This clinical picture was characteristic of men when either method of determining ID was used. In women, ID was not associated with more severe CHF.Conclusion Based on the presented analysis, it is possible to characterize the male and female ID phenotypes. The male ID phenotype is associated with more severe CHF, low ET, and poor quality of life. In females of the study cohort, ID was not associated with either the severity of CHF or with ET.
Sujet(s)
Défaillance cardiaque , Carences en fer , Humains , Femelle , Mâle , Qualité de vie , Prévalence , Défaillance cardiaque/complications , Défaillance cardiaque/diagnostic , Défaillance cardiaque/épidémiologie , Maladie chronique , PhénotypeRÉSUMÉ
Aim To study the role of growth differentiation factor 15 (GDF-15) in the long-term prognosis for patients after uncomplicated myocardial infarction (MI).Material and methods This study included 118 MI patients aged <70 years with and without ST-segment elevation on electrocardiogram (ECG). All patients underwent an examination that included ECG, echocardiography, Holter ECG monitoring, routine laboratory tests, and tests for plasma N-terminal pro-brain natriuretic peptide (NT-proBNT) and GDF-15. GDF-15 was measured by ELISA. The dynamics of patients was evaluated by interviews at 1, 3, 6, and 12 months. The endpoints were cardiovascular death and hospitalization for recurrent MI and/or unstable angina. Results Median concentration of GDF-15 in MI patients was 2.07 (1.55; 2.73) ng/ml. No significant dependence was found between GDF-15 concentration and age and gender, MI localization, smoking, body weight index, total cholesterol, and low-density lipoprotein cholesterol. During 12-month follow-up, 22.8â% of patients were hospitalized for unstable angina or recurrent MI. In 89.6â% of all cases of recurrent events, GDF-15 was ≥2.07 ng/ml. For patients with GDF-15 in the upper quartile, the time dependence of recurrent MI was logarithmic. High concentrations of NT-proBNP in MI patients were also associated with increased risk of cardiovascular death and recurrent cardiovascular events [RR, 3.3 (95â% CI, 1.87-5.96), Ñ=0.046].Conclusion A combination of GDF-15 and NT-proBNP at high concentrations significantly reflects an adverse prognosis for patients with uncomplicated MI within 12 months [RR, 5.4 (95â% CI, 3.4-8.5), Ñ=0.004].
Sujet(s)
Facteur-15 de croissance et de différenciation , Infarctus du myocarde , Humains , Infarctus du myocarde/diagnostic , Pronostic , Angor instable/diagnostic , Cholestérol LDLRÉSUMÉ
Aim To evaluate the prevalence of iron deficiency (ID) in Russian patients with heart failure (HF).Material and methods Iron metabolism variables were studied in 498 (198 women, 300 men) patients with HF. Data were evaluated at admission for HF (97â%) or during an outpatient visit (3â%). ID was determined according to the European Society of Cardiology Guidelines.Results 83.1â% of patients had ID; only 43.5â% of patients with ID had anemia. Patients with ID were older: 70.0 [63.0;79.0] vs. 66.0 years [57.0;75.2] (p=0.009). The number of patients with ID increased in parallel with the increase in HF functional class (FC). Among patients with ID, fewer people were past or current alcohol users (p=0.002), and a greater number of patients had atrial fibrillation (60.1 vs. 45.2â%, p=0.016). A multiple logistic regression showed that more severe HF (HF FC) was associated with a higher incidence of ID detection, whereas past alcohol use was associated with less pronounced ID. An increase in N-terminal pro-brain natriuretic peptide (NT-proBNP) by 100âpg/ml was associated with an increased likelihood of ID (odds ratio, 1.006, 95â% confidence interval: 1.002-1.011, p=0.0152).Conclusion The incidence rate of HF patients is high in the Russian Federation (83.1â%). Only 43.5â% of these patients had anemia. The prevalence of ID in the study population increased with increases in HF FC and NT-proBNP.
Sujet(s)
Fibrillation auriculaire , Défaillance cardiaque , Carences en fer , Sujet âgé , Fibrillation auriculaire/complications , Marqueurs biologiques , Études transversales , Femelle , Défaillance cardiaque/complications , Hospitalisation , Humains , Mâle , Adulte d'âge moyen , Peptide natriurétique cérébral , Fragments peptidiquesRÉSUMÉ
The article presents a clinical case of isolated, severe right ventricular heart failure in the absence of cardiac magnetic resonance imaging confirmation of myocardial injury.
Sujet(s)
Défaillance cardiaque , Ventricules cardiaques , Coeur , Défaillance cardiaque/diagnostic , Défaillance cardiaque/étiologie , Ventricules cardiaques/imagerie diagnostique , Humains , Imagerie par résonance magnétiqueRÉSUMÉ
A clinical case of acute coronary syndrome in a patient with multiple myeloma with a primary lesion of the thoracic spine is presented. The diagnosis of myeloma was difficult due to the similarity of the pain syndrome in these diseases. Repeated episodes of acute coronary syndrome occurred after courses of chemotherapy.
Sujet(s)
Syndrome coronarien aigu , Myélome multiple , Infarctus du myocarde , Humains , Myélome multiple/complications , Myélome multiple/diagnostic , Myélome multiple/traitement médicamenteux , Infarctus du myocarde/diagnostic , Infarctus du myocarde/étiologieRÉSUMÉ
Aim To reveal relationships between growth differentiation factor-15 (GDF-15) and laboratory and instrumental indexes in patients with myocardial infarction in acute phase.Material and methods The study included 118 patients younger than 70 years with ST-segment elevation or non-ST segment elevation myocardial infarction (MI). For these patients, GDF-15 was measured by enzyme immunoassay within 48 h of MI clinical onset along with a routine examination. Statistical significance of differences in qualitative variables was assessed by the Student's t-test for normal distribution and by the nonparametric Mann-Whitney U-test; significance of differences in quantitative variables was assessed by the Pearson's chi-squared test. The presence of a relationship between quantitative variables was assessed with the Pearson's correlation coefficient and the Spearman's rank correlation coefficient.Results For patients with MI, mean GDF-15 concentration was 2.25±1.0 ng/ml. Moderate correlations were found for GDF-15 and levels of natriuretic peptide (r=0.36, p<0.01), white blood cells (r=0.32, p<0.01), and ejection fraction (Simpson rule) (r=-0.32, p<0.01); weak correlations were found with levels of troponin I (r=0.21, p=0.02) and urea (r=0.20, p=0.04), and interventricular septal thickness by echocardiography (r= -0.26, p<0.01). GDF-15 was higher in patients with ST-segment elevation MI (2.36±1.02 vs 1.99±0.96, p<0.05) and in the presence of hypo- or akinetic areas (2.35±1.05 vs 1.85±0.70, p<0.05). No dependence of GDF-15 on the presence of traditional cardiovascular risk factors was observed.Conclusion GDF-15 correlates with major markers of myocardial injury; its level is higher in patients with ST-segment elevation MI regardless of the infarct location.
Sujet(s)
Infarctus du myocarde , Infarctus du myocarde avec sus-décalage du segment ST , Marqueurs biologiques , Facteur-15 de croissance et de différenciation , Humains , Infarctus du myocarde/diagnostic , Infarctus du myocarde avec sus-décalage du segment ST/diagnostic , Troponine IRÉSUMÉ
In this article we present brief overview of the subject of amyloidosis and involvement of the cardiovascular system, the criteria for diagnosis, principles of treatment, and the clinical case of cardiac amyloidosis.
Sujet(s)
Amyloïdose , Cardiomyopathies , HumainsRÉSUMÉ
Nowadays full-genome sequencing allows achieving revolutionary progress in the modern medicine. As the result of a huge work on the study of the human genome and based on the results obtained, one can conclude that the single nucleotide polymorphisms are the reasons of the vast majority of non-communicable diseases as well as the diseases other than injuries and poisoning, i.e. the diseases where the cause is not obvious. To clarify the role of single nucleotide polymorphism in the occurrence of atrophic gastritis, it is required to perform full-genome sequencing and human genome scanning with a simultaneous mass serological screening of atrophic gastritis. As a result, it will be possible to establish which single nucleotide polymorphism is responsible for mild, moderate, and severe mucosal atrophy in the antrum and the body of the stomach. Serological screening of mild, moderate, and severe mucosal atrophy in the antrum and the body of the stomach can be made using GastroPanel.
Sujet(s)
Gastrite atrophique/génétique , Étude d'association pangénomique , Infections à Helicobacter/génétique , Helicobacter pylori/immunologie , Atrophie , Muqueuse gastrique , Gastrite , HumainsRÉSUMÉ
AIM: To evaluate the efficacy and safety of a fixed-dose combination of the angiotensin-converting enzyme inhibitor lisinopril 10 mg and the calcium antagonist amlodipine 5 mg (ekvator) in conjunction with rosuvastatin (mertenil). SUBJECTS AND METHODS: The investigation enrolled 50 patients (mean age 57.9 years) with essential hypertension. All the patients received the fixed-dose antihypertensive combination. Stable Functional Class I or II exertional angina was in 46% of the patients. The remaining 54% were found to have brachiocephalic atherosclerosis. All the patients had dyslipidemia and were given rosuvastatin. RESULTS: The mean systolic blood pressure (SBP) initially reached 164.26 mm Hg. During the whole follow-up, the reduction in mean SBP generally accounted for 22.6% (p = 0.000). At the study inclusion, the mean diastolic blood pressure (DBP) reached 99.38 mm Hg. The total decline in mean DBP was 19.3% (p = 0.000). The mean level of total cholesterol (TC) decreased significantly by 32.1% (p = 0.000); that of triglycerides (TG) also fell significantly by 31.8% (p = 0.04); that of high-density lipoproteins increased insignificantly by 11.1% (p = 0.599); that of low-density lipoproteins (LDL) dropped significantly by 47.5% (p = 0.000). CONCLUSION: Being safe, the fixed-dose lisinopril and amlodipine combination is effective in lowering blood pressure in patients with hypertensive disease (HD) concurrent with coronary heart disease (CHD) or atherosclerotic changes in the carotid artery. The use of rosuvastatin in patients with HD concurrent with CHD during 2 months causes positive changes in the blood lipid composition as a significant reduction in the-levels of (TC), LDL, and TG.