[The agreed experts' position of the Eurasian Association of Therapists on tactics of management of patients with comorbid pathology infected with SARS-Cov-2].

The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.

[The influence of beta-adrenoblocking therapy on the markers of systemic inflammation in patients with acute coronary syndrome].

The study was designed to estimate activity of a series of anti-inflammatory markers (C-reactive protein (CRP), ceruloplasmin, haptoglobulin, interleukin (IL)-4, and IL-8) in the acute phase of acute coronary syndrome (ACS) and effect of beta-adrenoblocking therapy on their activity. The patients were divided into 2 groups: one was treated with beta-blocker metoprolol tartrate as a main component of ACS pharmacotherapy (n = 30), the other included the patients with absolute contraindications to bena-adrenoblockers (n = 15). Otherwise, patients of both groups received standard antianginal therapy including nitrates, anticoagulants, ACE inhibitors, and statins. The frequency of prescription of these drugs and coronary angioplasty was comparable in both groups. It was shown that patients with ACS have elevated levels of CRP, haptoglobulin and prooxidant marker ceruloplasmin.

[The effects of trimetazidine on left ventricular function and physical exercise tolerance in patients with ischemic cardiomyopathy].

Trimetazidine is a new metabolic antiischemic agent, which increases the tolerance of cardiomyocytes to ischemia. The aim of the study was to evaluate the effect of additional trimatazidine therapy in patients with ischemic cardiomyopathy (ICMP) in comparison with standard therapy of cardiac insufficiency. According to the results of the study, trimetazidine improves the clinical status, functional class of cardiac insufficiency, left ventricular ejection fraction, in ICMP patients. Trimetazidine increases physical exercise tolerance according to the results of six-minute walking test. Thus, the optimization of myocardial energetic metabolism may be a promising perspective in the treatment of coronary heart disease with systolic dysfunction.

[Myocardial remodeling in chronic renal failure patients on hemodialysis].

Pathologic myocardial changes in is one of the main causes of death in patients with terminal chronic renal failure (CRF). The authors studied structural and functional condition of the myocardium and the effect of various CRF factors on cardiovascular complications. The study demonstrates positive correlation between systolic arterial pressure (AP) and left ventricular (LV) remodeling, as well as between the degree of anemia and LV remodeling in patients with CRF on program hemodialysis. Concentric LV hypertrophy (LVH) was revealed in 24 (65%) patients, eccentric LVH--in 7 (19%) patients. The results show that eccentric LVH with reduced ejection fraction in CRF patients on hemodialysis is associated with high systolic and pulse pressure.

[A comparative study of anapriline and carvedilol effectiveness in patients with thyrotoxicosis in pre- and postoperative periods]. / Sravnitel'naia otsenka éffektivnosti anaprilina i karvedilola u bol'nykh tireotoksikozom v pred- i posleoperatsionnom periodakh.

Thyrotoxicosis often affects cardiovascular system. Structural-functional condition of the myocardium is essential in the outcome of surgical intervention on the thyroid in thyrotoxicosis and indicates effectiveness of the treatment. A comparative trial studied the effects of beta-blockers (anaprilin and carvedilol) on preoperative condition of left-ventricular (LV) myocardium and late after subtotal resection of the thyroid gland. 27 thyrotoxicosis patients with myocardial remodeling in the form of concentric LV hypertrophy entered the trial. Though in preoperative preparation anapriline is recommended, in postoperative period it is better to use carvedilol as it has a good effect on reverse development of myocardial remodeling and hemodynamics in view of its balanced beta- and alpha-adrenoblocking action.

[Dobutamine stress echocardiography in prediction of dilated cardiomyopathy in patients with allergic myocarditis]. / Dobutamin-stress-ékhokardiografiia v otsenke prognoza razvitiia diliatatsionnoi kardiomiopatii u bol'nykh allergicheskim miokarditom.

Total contractility reserve (TCR) and role of TCR in prediction of dilated cardiomyopathy (DCM) were evaluated in patients with infectious allergic myocarditis (IAM) by means of stress-echocardiography with dobutamine. Systolic function of the left ventricle (LV) appeared activated in different degree in relatively equal baseline low levels of LV contractility. IAM patients with reduced reserve of TCR are characterized by low increment of LV contractility under stress test and frequent onset of DCM. The increment of ejection fraction in low-dose dobutamine stress echocardiography was found informative in prediction of DCM development, highly sensitive and specific.

[Comparative characteristics of left ventricular remodeling in dilatation cardiomyopathy and ischemic disease]. / Sravnitelnaia kharakteristika remodelirovaniia levogo zheludochka pri dilatatsionnoi kardiomiopatii i ishemicheskoi bolezni serdtsa.

Left ventricular remodelling plays an important pathogenetic role in progressive circulatory insufficiency both in dilated cardiomyopathy (DCMP) and in ischemic heart disease with postinfarction cardiosclerosis. In terminal cardiac failure structural changes (changed geometry of the left ventricle, in particular) become stereotypic. The dobutamin test in DCMP reveals low functional reserve of the total and segmentary contractility compared to ischemic cardiomyopathy. This may help in echocardiographic diagnostic difficulties.

[Systolic and diastolic left ventricular function in patients with dilated cardiomyopathy]. / Otsenka sistolicheskoi i diastolicheskoi funktsii levogo zheludochka u bol'nykh diliatatsionnoi kardiomiopatiei.

Echocardiographic investigation of the defects in left ventricular systolic and diastolic functions was made in patients at different stages of dilated cardiomyopathy (DC). The established clinico-echocardiographic parallels demonstrate that noticeable dilation of the left ventricle appears as early as initial DC when systolic function is still unchanged. Early DC stages are characterized by left ventricular dysfunction presenting as enhanced blood filling in atrial systole. Progression of circulatory insufficiency brought about the "pseudonormal" pattern with intensive blood flow in early diastole.

[Effect of the long-term atenolol therapy on the structural and functional parameters of the left ventricle in patients with dilated cardiomyopathy]. / Vliianie dlitel'noi terapii atenololom na strukturno-funktsional'nye pokazateli levogo zheludochka u bol'nykh dilatatsionnoi kardiomiopatiei.

The effect of long-term atenolol therapy on the structural and functional parameters of the left-ventricular (LV) myocardium was studied in patients with dilatational cardiomyopathy by means of echocardiography. Six-months treatment with atenolol improved the clinical status and reduced the degree of LV dilatation in patients with circulatory insufficiency of functional classes I and II. The contractility parameters (ejection fraction and delta S) increased in patients of all functional classes but more markedly in those of functional classes I and II. The effect of atenolol on the transmitral diastolic flow in patients with the initial stages of chronic circulatory insufficiency was characterized by the absence of changes in the flow rate during the period of rapid filling and a significant lowering of the atrial peak, which corresponded to improvement in the patients' status.