Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
1.
Kardiologiia ; 61(9): 20-32, 2021 Sep 30.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-34713782

RESUMO

Aim      To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods  The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients' privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).Results The analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion      In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Doenças não Transmissíveis , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pandemias , Sistema de Registros , SARS-CoV-2
2.
Kardiologiia ; 61(6): 35-40, 2021 Jul 01.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-34311686

RESUMO

Aim    To identify clinical and laboratory indexes related with the atherosclerotic plaque (ASP) echogenicity based on results of the analysis of grey-scale median (GSM) in patients aged 40-64 years.Material and methods    The study included patients aged 40-64 years with carotid atherosclerosis. The carotid duplex scanning was performed for all patients. The GSM analysis of obtained images was performed with the Adobe Photoshop CS6 software.Results    Atherosclerotic cardiovascular diseases were found in 31 (21.4 %) patients. Correlation analysis determined inverse interrelationships between GSM and the body weight index (BWI) (r=-0.359; p<0.0001), waist circumference (r=-0.357; p<0.0001), and levels of uric acid (r=-0.244; p=0.021) and glucose (r=-0.205; p=0.032). According to the regression, statistically significant correlations remained between GSM and BWI as well as the waist circumference after the adjustment for sex and age.Conclusion    In patients with carotid atherosclerosis aged 40-64 years, the decrease in ASP GSM was associated with increases in BWI and waist circumference.


Assuntos
Aterosclerose , Doenças das Artérias Carótidas , Estenose das Carótidas , Placa Aterosclerótica , Adulto , Aterosclerose/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Ultrassonografia
4.
Ter Arkh ; 92(9): 108-124, 2020 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-33346439

RESUMO

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.


Assuntos
Asma , COVID-19 , Diabetes Mellitus , Doença Pulmonar Obstrutiva Crônica , Humanos , SARS-CoV-2
5.
Kardiologiia ; 60(7): 103-107, 2020 Aug 11.
Artigo em Russo | MEDLINE | ID: mdl-33155948

RESUMO

The article discusses issues of lipid-lowering therapy in elderly and senile patients. Major statements of actual clinical guidelines are provided. Issues of statin therapy in patients older than 65 and new data on statin safety in such patients are discussed in detail. The authors presented results of clinical studies 2019 on the use of ezetimibe in patients older than 75 as a part of primary and secondary prevention of cardiovascular diseases.


Assuntos
Anticolesterolemiantes , Doenças Cardiovasculares , Inibidores de Hidroximetilglutaril-CoA Redutases , Idoso , Anticolesterolemiantes/efeitos adversos , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/prevenção & controle , Quimioterapia Combinada , Ezetimiba/uso terapêutico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Lipídeos , Prevenção Secundária
6.
Kardiologiia ; 60(6): 1180, 2020 May 25.
Artigo em Russo | MEDLINE | ID: mdl-32720611

RESUMO

This article discusses relevant aspects in the treatment of patients with COVID-19. Up-to-date information about principles for administration of statins, antithrombotics, and antiarrhythmics is presented. The authors addressed in detail specific features of reversing heart rhythm disorders in patients with coronavirus infection and the interaction of antiarrhythmic and antiviral drugs. Recommendations are provided for outpatient and inpatient antithrombotic therapy for patients with COVID-19. Issues of antithrombotic and antiviral drug interaction are discussed.


Assuntos
Anticoagulantes , Cardiologia , Infecções por Coronavirus , Inibidores de Hidroximetilglutaril-CoA Redutases , Pandemias , Pneumonia Viral , Antiarrítmicos/uso terapêutico , Anticoagulantes/uso terapêutico , Betacoronavirus , COVID-19 , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Federação Russa , SARS-CoV-2 , Sociedades Médicas
7.
Kardiologiia ; 60(5): 9-19, 2020 May 04.
Artigo em Russo | MEDLINE | ID: mdl-32515699

RESUMO

The article discusses pathogenesis and treatment of COVID-19. The authors presented state-of-the-art insight into hemostatic disorders in patients with COVID-19 and clinical recommendations on prevention of thrombosis and thromboembolism in patients infected with SARS-CoV-2. The article discussed in detail a new hypothesis proposed by Chinese physicians about a new component in the pathogenesis of COVID-19, namely, about the effect of SARS-CoV-2 virus on the hemoglobin beta-chain and the formation of a complex with porphyrin, which results in displacement of the iron ion. Thus, hemoglobin loses the capability for transporting oxygen, which aggravates hypoxia and worsens the prognosis. The article stated rules of hemotransfusion safety in the conditions of COVID-19 pandemic.


Assuntos
Gasometria , Transfusão de Sangue , Infecções por Coronavirus/fisiopatologia , Hemostasia , Pneumonia Viral/fisiopatologia , Betacoronavirus , COVID-19 , Hemoglobinas , Humanos , Hipóxia , Ferro , Pandemias , Porfirinas , SARS-CoV-2
8.
Kardiologiia ; 59(10): 88-96, 2019 Oct 15.
Artigo em Russo | MEDLINE | ID: mdl-31615391

RESUMO

In 2017 the Endocrine Society issued the Scientific Statement "Screening for Endocrine Hypertension" This document was developed by experts from different medical institutions of USA, Europe and Australia. Herein we present the main provisions of this Statement in the form of brief algorithm for the clinicians' actions for timely detection of secondary endocrine hypertension and rational referral of the patient for confirmational testing.The full text of the Scientific Statement in English is contained in the article. Young WF Jr., Calhoun DA, Lenders JW, Stowasser M, Textor SC. Screening for Endocrine Hypertension: An Endocrine Society Scientific Statement. Endocrine Reviews. 2017; 38 (2):103-122.URL: https://academic.oup.com/edrv/article/38/2/103/3104343.


Assuntos
Doenças do Sistema Endócrino , Hipertensão , Doenças do Sistema Endócrino/complicações , Doenças do Sistema Endócrino/diagnóstico , Europa (Continente) , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia
9.
Kardiologiia ; 59(5S): 47-57, 2019 Jun 20.
Artigo em Russo | MEDLINE | ID: mdl-31221075

RESUMO

This Conclusion of the Board of experts is devoted to the analysis of the evidence base, the position in modern clinical guidelines, the efficacy and safety analysis as well as the options of combined therapy with statins and ezetimibe (Otrio, JSC "AKRIKHIN") in various categories of patients in routine clinical practice in theRussian Federation. Cardiovascular diseases (CVD) continue to lead in the structure of morbidity and mortality inRussia. Hypercholesterolemia is one of the main modifiable risk factors for CVD. Administration of HMGCo-A-reductase inhibitors (statins) remains the basis for the prevention and treatment of the main complications of atherosclerosis, but the achievement of target levels of LDL-C on of statin monotherapy in Russian practice among different categories of risk does not exceed 50%. Proportion of patients (up to 12%) does not tolerate statin therapy, which requires the search for alternative therapies. To optimize the control of the level of LDL-C, combination therapy with statins and ezetimibe is used. Ezetimibe is an effective lipid-lowering drug, an inhibitor of intestinal absorption of cholesterol, which was investigated in many international and Russian studies, the results of which have demonstrated good tolerability, safety and efficacy (reduction of LDL-C levels by 18% in monotherapy). It was noted that the combined therapy with low/medium doses of statins and ezetimibe effectively reduces the level of LDL-C by 44-53%, which is comparable to the effect of high doses of statins and reduces CV risk in patients with CKD and ACS. Otrio (INN Ezetimib) tablets 10 mg ( JSC "AKRIKHIN",Russia) has demonstrated bioequivalence to the original drug Ezetrol tablets 10 mg (Schering-plough Labo N. V,Belgium). Broad use of a new generic product Otrio in combination with different statins will significantly increase the frequency of achievement of target lipid levels in patients with high and very high CV risk, including patients with chronic renal failure, type 2 diabetes and in patients with high hypercholesterolemia (LDL-C > 5 mmol/l) and, ultimately, reduce the burden of CV disease and mortality in Russia.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Anticolesterolemiantes , LDL-Colesterol , Quimioterapia Combinada , Ezetimiba , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases , Metabolismo dos Lipídeos , Fatores de Risco , Federação Russa
10.
Kardiologiia ; 59(5): 45-52, 2019 May 25.
Artigo em Russo | MEDLINE | ID: mdl-31131767

RESUMO

AIM: to assess possibility of the use of carotid wall shear rate (WSR) as a marker of systemic atherosclerosis and atherosclerotic cardiovascular disease (ASCVD). MATERIALS AND METHODS: We included into this study 200 patients with different cardiovascular risk (142 patients already had one or more ASCVD). All patients underwent ultrasound scanning of carotid and lower limb arteries with measurement of the ankle-brachial index. Carotid WSR was determined during ultrasonic scanning of carotid arteries in accordance with the Hagen-Poiseuille law. RESULTS: Mean WSR value in this cohort of patients was 434±139 s-1. Based on the results of the ROCanalysis, it was found that WSR below the threshold value of 300 s-1 allowed to predict the presence of ASCVD with sensitivity of 97.1 % and specificity of 84.6 %. WSR <300 s-1 was associated with relative risk (RR) of ASCVD presence 11.2 (95 % CI 1.26-99.3, p=0.03), adjusted for factors such as sex, age, smoking, obesity, hypertension, estimated glomerular filtration rate (eGFR), low density lipoprotein cholesterol, and high sensitivity C-reactive protein, carotid intima-media thickness. The model which included carotid WSR, as well as factors such as the presence of type 2 diabetes, obesity, sex, age, eGFR, allowed to diagnose combined atherosclerotic lesions of peripheral arteries with a sensitivity of 73.1 % and a specificity of 90.3 %. CONCLUSION: Evaluation of the carotid WSR allows to diagnose with satisfactory sensitivity and specificity the presence of combined atherosclerosis of peripheral arteries and ASCVD.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Doenças das Artérias Carótidas , Diabetes Mellitus Tipo 2 , Artérias Carótidas , Espessura Intima-Media Carotídea , Humanos , Fatores de Risco
11.
Kardiologiia ; 59(12S): 12-17, 2019 Dec 10.
Artigo em Russo | MEDLINE | ID: mdl-31995721

RESUMO

The article discusses in detail the question of the additional positive effects of ezetimibe in addition to direct hypolipidemic action. The data of experimental and clinical studies in which the effect of ezetimibe on carbohydrate metabolism, inflammation, endothelial dysfunction, and liver is studied. The article also discusses the results of clinical studies that examined the effect of ezetimibe on atherosclerotic plaque.


Assuntos
Ezetimiba/uso terapêutico , Placa Aterosclerótica , Anticolesterolemiantes , Humanos , Inflamação
13.
Ter Arkh ; 91(10): 54-62, 2019 Oct 15.
Artigo em Russo | MEDLINE | ID: mdl-32598632

RESUMO

AIM: To study the features of atherosclerosis of peripheral arteries in patients with coronary artery disease (CAD) depending on the presence of type 2 diabetes mellitus (T2DM) and to identify factors associated with multifocal atherosclerosis. MATERIALS AND METHODS: The study included 140 patients (77 men and 63 women) with CAD (mean age 62.0 (56.0-66.0) years). The first group included 70 people with CAD and T2DM, and the second group included 70 patients with CAD without T2DM. All patients underwent duplex scanning of the carotid and lower limb arteries (LLA). Local vascular stiffness of the common carotid artery (CCA) was assessed by ultrasound scanning. The Peterson elasticity modulus, distensibility and strain of the CCA were determined. The ankle - brachial index (ABI) was measured by the Doppler method. RESULTS AND DISCUSSION: In the group of patients with T2D, there were statistically more patients with atherosclerotic plaques in both carotid arteries and LLA. Also among patients with T2DM the severity of stenosis of carotid arteries and LLA at all levels was significantly greater. Local carotid stiffness was higher in the first group of patients. The proportion of individuals with reduced ABI.


Assuntos
Aterosclerose , Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2 , Idoso , Índice Tornozelo-Braço , Artérias Carótidas , Artéria Carótida Primitiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
14.
Eksp Klin Gastroenterol ; (11): 19-24, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25842658

RESUMO

Paper describes clinical and immunological study about the relationship between chronic diseases of the digestive system and atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age. There were revealed the structural and clinical features of the gastrointestinal tract diseases, depending on the extent of atherosclerosis in the basin of the abdominal aorta. Evaluation of the immune status included the determination of lymphocyte subpopulation composition, the functional state of neutrophils and cytokine levels. It is found that the progression of atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age with chronic diseases of the digestive system was accompanied by the activation of pro-inflammatory mechanisms of the immune system and the accompanying intensification of oxidative stress.


Assuntos
Aterosclerose/imunologia , Aterosclerose/patologia , Doenças do Sistema Digestório/imunologia , Doenças do Sistema Digestório/patologia , Idoso , Aorta Abdominal/microbiologia , Aorta Abdominal/patologia , Aterosclerose/complicações , Linfócitos B/imunologia , Doença Crônica , Citocinas/imunologia , Doenças do Sistema Digestório/complicações , Endoscopia Gastrointestinal , Feminino , Humanos , Ativação Linfocitária/imunologia , Masculino , Linfócitos T/imunologia , Ultrassonografia Doppler
16.
Klin Lab Diagn ; (1): 42-4, 2013 Jan.
Artigo em Russo | MEDLINE | ID: mdl-23807995

RESUMO

The sample for examination included 52 patients with chronic cardiac failure and 26 patients with anemia amongst. The expected increase of production of prohepsidin against the background of increased serum concentrations of anti-inflammatory cytokines was not detected. The tendency to decrease level of prohepsidin alongside with decrease of content of serum iron and ferritin in blood serum testified depletion of iron resources in organism.


Assuntos
Anemia Ferropriva/sangue , Peptídeos Catiônicos Antimicrobianos/sangue , Insuficiência Cardíaca/sangue , Ferro/sangue , Precursores de Proteínas/sangue , Idoso , Anemia Ferropriva/complicações , Anemia Ferropriva/diagnóstico , Doença Crônica , Feminino , Ferritinas/sangue , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Hepcidinas , Humanos , Masculino , Pessoa de Meia-Idade , Transferrina/análise
17.
Klin Med (Mosk) ; 91(8): 40-4, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24437184

RESUMO

This paper summarizes results of a long-term prospective study of the patients with hypertrophic cardiomyopathy (GCMP) divided into two groups, one with progressive disease (42%) the other with its stable course (58%). The progress of GCMP was not associated with thickening of the left ventricle. Predictors of the progress included manifest and extensive asymmetry of myocardial hypertrophy. Dilatation cardiomyopathy developed in 5.5% of the cases of nonobstructive GCMP. Therapy had no significant effect on clinical manifestations of GCMP.


Assuntos
Cardiomiopatia Hipertrófica/fisiopatologia , Ecocardiografia Doppler/métodos , Ventrículos do Coração/diagnóstico por imagem , Volume Sistólico , Função Ventricular Esquerda/fisiologia , Adulto , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Progressão da Doença , Feminino , Seguimentos , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Tempo
18.
Klin Med (Mosk) ; 89(2): 35-40, 2011.
Artigo em Russo | MEDLINE | ID: mdl-21574440

RESUMO

We studied the character of cardiovascular and metabolic disorders in diabetic patients depending on the severity of depression. It was shown that depressive symptoms in excess of 10 scores by the Beck scale are predictors of atherogenous dyslipidemic disorders, atherosclerotic changes in peripheral vessels and cardiac valves, myocardial remodeling, and asymptomatic diastolic dysfunction. Also, DM-associated depression proved to reflect resistance to orthostatic hypotension. Results of the study suggest the necessity of dynamic evaluation of the affective status of DM patients based on subjective depression scales that could be used by a therapist or endocrinologist without special preliminary training.


Assuntos
Aterosclerose/etiologia , Depressão/complicações , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Dislipidemias/etiologia , Aterosclerose/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
19.
Klin Med (Mosk) ; 87(3): 31-4, 2009.
Artigo em Russo | MEDLINE | ID: mdl-19469252

RESUMO

The aim of this work was to elucidate the relationship between the serum erythropoietin level, the degree of heart involvement in patients with chronic cardiac failure (CCF), characteristics of peripheral red blood cells and iron metabolism. A total of 77 patients with ischemic CCF were enrolled in the study. The control group comprised 13 subjects free from cardiovascular disorders. The analyses encompassed peripheral blood, serum iron, iron-binding capacity of serum, creatinine clearance, erythropoietin and TNF-alpha levels, echoCG data. The patients with CCF were divided into three groups based on the level of erythropoietin. Statistical analysis revealed the relationship between anemia, structural-functional changes in myocardium and erythropoietin production. Anemia appeared to be an additional stimulus for biosynthesis of erythropoietin in these patients.


Assuntos
Anemia/tratamento farmacológico , Eritropoetina/farmacocinética , Insuficiência Cardíaca/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/etiologia , Biópsia , Relação Dose-Resposta a Droga , Ecocardiografia , Eritropoetina/administração & dosagem , Feminino , Seguimentos , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Humanos , Ferro/sangue , Masculino , Miocárdio/patologia , Estudos Retrospectivos , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangue
20.
Klin Med (Mosk) ; 81(8): 26-8, 2003.
Artigo em Russo | MEDLINE | ID: mdl-14520940

RESUMO

Content of circulating products of lipid peroxidation (LPO), alpha-tocopherol (AT) and ceruloplasmin (CP), was studied in patients with hypertrophic and dilated cardiomyopathies (HTCMP and DCMP). The data obtained correlates with severity of chronic cardiac failure (CCF) and exercise tolerance of the patients. It is shown that the rise in LPO products level and simultaneous lowering of AT concentration in HTCMP and DCMP depend on the functional class of chronic cardiac failure by NYHA (1964). Content of lipoperoxides, AT and CP in the serum reflect the HTCMP patients' tolerance to exercise. Laboratory estimation of the levels of LPO products, AT and CP in patients with cardiomyopathies can substantially objectivize and supplement both clinical and functional-diagnostic assessment of CCF severity.


Assuntos
Antioxidantes , Ceruloplasmina/metabolismo , Insuficiência Cardíaca/sangue , alfa-Tocoferol/sangue , Adulto , Antioxidantes/metabolismo , Cardiomiopatia Dilatada/sangue , Cardiomiopatia Dilatada/fisiopatologia , Cardiomiopatia Hipertrófica/sangue , Cardiomiopatia Hipertrófica/fisiopatologia , Doença Crônica , Tolerância ao Exercício/fisiologia , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Peroxidação de Lipídeos , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...