Background. The relationship between metabolic risk factors, chronic kidney disease (CKD), metabolic-associated fatty liver disease (MAFLD), and cardiovascular diseases (CVD) is highlighted in the concept of сardiovascular-kidney-liver-metabolic syndrome (CKLMS), which is closely associated with competing risks of adverse outcomes. The impact of the burden of CKLMS remains poorly understood in chronic heart failure (HF) in national cohorts. Objective. To evaluate the frequency of CKLMS components, their combinations, and their impact on the long-term prognosis of patients with HF with mildly reduced ejection fraction (LVEF) (HFmrEF) and post-infarction cardiosclerosis. Design and methods. This was a retrospective analysis of data from a prospective, observational, single-center study involving 160 men (median age 62 years) with post-infarction cardiosclerosis and HFmrEF I (15 %) / II (85 %) NYHA functional class, who had been examined in 2018–2020. All patients received optimal medical therapy for HF and concomitant diseases. Follow-up was conducted through telephone contact / clinic visit at intervals of 6-12 months. The average follow-up period was 5 years (62 [49–64] months). Fatal events were assessed (total mortality, death from CVD and non-cardiovascular causes). Depending on the presence of CKLMS diseases (at the start of observational study), namely: obesity, type 2 diabetes mellitus (T2DM) / impaired glucose tolerance (IGT), CKD, MAFLD patients were divided into phenotypic groups. Results. A high frequency of CKLMS diseases was observed. Arterial hypertension (HTN) and dyslipidemia were detected in 92 % and 100 % of patients, respectively. Obesity/overweight and T2DM/IGT were registered in 43 % / 44 % and 32 % / 3 % of patients, respectively. CKD and MAFLD were diagnosed in every fifth patient. The presence of two or more CKLMS diseases was observed in 33 % of the participants. HTN was registered in 91 % of cases in the absence of the analyzed CKLMS diseases; in 96 % of cases in the presence of one, and in 98 % of cases in the presence of two or more CKLMS diseases. The most common phenotypic group of HFmrEF was represented by a combination of CKD + T2DM/IGT + obesity. The five-year survival rate of patients with HFmrEF was 76 %. The leading causes of death were CVD and cancer. The CKD, LVEF, and N-terminal brain natriuretic propeptide (NT-proBNP) were independent predictors of poor prognosis. The presence of CKD in a patient with HFmrEF was associated with a more than 3-fold increased risk of mortality: OR 3,5; 95 % confidence interval (CI) 1,45–8,40; p = 0,005. The highest five-year mortality was observed in individuals with CKD + T2DM/IGT (obesity in 71 % of cases) and CKD + T2DM/IGT + MAFLD (obesity in 69 % of cases). Conclusions. Patients with HFmrEF and post-infarction cardiosclerosis had a higher frequency of metabolic syndrome components: together with a high occurrence of HTN, at least two CKLMS diseases (obesity, T2DM/IGT, CKD, MAFLD) were detected in every third patient. Phenotypic groups of HFmrEF within CKLMS associated with CKD had the most unfavorable prognosis. The presented data confirm the need for an interdisciplinary approach to the management of patients with HF and the use of a personalized strategy based on pathophysiological phenotypes.
Objective. To determine the risk factors for arrhythmia recurrence after scheduled cardioversion in patients with persistent and long-standing persistent atrial fibrillation (AF) and to assess the impact of circulating biomarkers of fibrosis and inflammation on the risk of arrhythmia recurrence. Design and methods. The study included 122 patients with persistent and long-standing persistent AF who underwent either electrical cardioversion (n = 61) or pharmacologic cardioversion (cavutilide) (n = 61). The study groups were matched in terms of sex, age, and clinical characteristics. Prospective follow-up of patients was carried out for 12 months after cardioversion. Results. The efficacy of electrical cardioversion and pharmacologic cardioversion with cavutilide was comparable (53/61 (86,9 %) vs. 52/61 (85,2 %), p = 0,794). The frequency of AF recurrence within 12 months after cardioversion did not depend on the method of sinus rhythm restoration and was 31/53 (58,5 %) in the electrical cardioversion group and 26/52 (50,0 %) among patients who underwent pharmacologic cardioversion (p = 0,383). Further analysis was conducted in groups of patients with arrhythmia recurrence and those maintaining sinus rhythm for 12 months after cardioversion. The most significant clinical predictors of AF recurrence were metabolic syndrome and congestive heart failure. Analysis of instrumental and laboratory data established that patients with arrhythmia recurrence had more severe atrial dilation, diastolic dysfunction, larger values of epicardial fat thickness, and higher concentrations of blood biomarkers of fibrosis and inflammation. According to multivariate regression analysis of echocardiographic parameters, the most significant predictors of recurrence were the left atrial volume index (LAVI) and epicardial fat thickness. An increase in LAVI greater than 49,5 mL/m² increased the risk of AF recurrence after cardioversion by 2,2 times (relative risk (RR) — 2,215, 95 % confidence interval (CI) 1,396–3,517, p < 0,001), and an epicardial fat thickness greater than 4,55 mm increased the risk of arrhythmia recurrence by 2,4 times (RR — 2,420, 95 % CI 1,570–3,731, p < 0,001). Analysis of laboratory parameters revealed that the concentration of growth differentiation factor 15 (GDF-15) was most strongly associated with the risk of AF recurrence within 12 months after cardioversion (Beta — 0,001, odds ratio — 1,001, 95 % CI 1,001–1,002, p < 0,001). A blood concentration of GDF-15 more than 2432,6 pg/ml increased the risk of arrhythmia recurrence within one year by 2,6 times (RR — 2,593, 95 % CI 1,510–4,451, p < 0,001). Conclusion. The most significant predictors of arrhythmia recurrence within 12 months after cardioversion in patients with persistent and long-standing persistent AF are the following: metabolic syndrome, congestive heart failure, LAVI, epicardial fat thickness, and serum GDF-15 concentration.
Background. Hypertensive kidney disease is one of the long-term complications of poorly controlled arterial hypertension (HTN). This is the second most important cause of the development of chronic kidney disease (CKD) after diabetes mellitus. HTN is one of the key pathogenetic factors contributing to the progressive deterioration of the renal function. Objective. The purpose of this study was to study the overall prevalence of chronic kidney disease in patients with HTN. Design and methods. We performed a retrospective study (analysis of data on outpatient episodes within the period 2021–2024), which included all outpatients older 18 years treated at the Almazov National Research Medical Center with a diagnosis of HTN (essential (primary) hypertension). A total of 4126 patients with HTN were included in the study. According to electronic outpatient records, the main clinical and laboratory parameters were evaluated and CKD was diagnosed. Results. According to the analysis of the CKD prevalence depending on the HTN stage, patients with stage 1 HTN showed no CKD, while it occurred in 39 % (753) of patients with stage 2 HTN (CKD C1 in 48 patients, CKD C2 in 96 patients, CKD C3a in 540 patients, CKD C3b in 69 patients) and in 55 % (862) of patients with stage 3 HTN (CKD C3a in 235 patients, CKD C3b in 286 patients, CKD C4 in 323 patients, CKD C5 in 18 patients). Conclusion. In a large sample of outpatients with HTN we demonstrated a high prevalence of CKD.
Objective . The aim of the study was to determine the combined effect of systolic arterial hypertension (SHTN) and depression as a risk factor for the development of coronary heart disease in men of economically active age (25–64 years) based on a cross-sectional study in an open population. Design and methods . A cross-sectional study was conducted on a representative sample of men aged 25–64 years with a response rate of 85,0 %. Different forms of coronary heart disease were identified using standard epidemiological methods. SHTN was recorded at systolic blood pressure (SBP) ≥ 140 mmHg. The WHO MONICA-psychosocial questionnaire (Depression Scale, MOPSY test) was used to assess depression. Results . Using the equation of the linear function and the application of the logit transformation with the calculation of the cutoff point, the probability of determining coronary heart disease was calculated. For each variable included in the model, the odds ratio Exp(B) was estimated. We found that with a 1-point increase in the BallDepr indicator the risk of developing coronary heart disease increases by 31 %. The presence of SHTN is associated with a 2,2-fold increase in the risk of developing coronary heart disease. Conclusions . The patterns identified during a cross-sectional study of economically active men living in a large city in Western Siberia indicate that the cluster of SHTN and depression presents a risk factor for the development of coronary heart disease.
Objective. To analyse the clinical features of posterior reversible encephalopathy syndrome. Design and methods. We carried out analysis and systematisation of national and international literature on the pathogenesis, clinical manifestations and treatment of posterior reversible encephalopathy. Results. The main risk factors, etiology and differential diagnosis of this syndrome are considered. A clinical case of posterior reversible encephalopathy manifested in a patient with hypertension is presented. Conclusions. Due to its rare occurrence, the information on the pathogenesis, clinical manifestations, differential diagnosis and treatment of posterior reversible encephalopathy remains scarce. Advancements in diagnostic methods, in particular magnetic resonance imaging, contribute to better detection and differentiation of this disease. Spontaneous regression of clinical manifestations of the disease is often observed, but irreversible cases can occur.
Objective. The aim of the study was to identify clinical, demographic, laboratory and instrumental predictors of the functional outcome of primary intracerebral hemorrhage (ICH) after 90 days among the parameters available within the first hour after the patient's admission to the hospital. Design and methods. A retrospective analysis of the medical records of all patients with primary ICH admitted to the primary vascular department of the Dyurtyulinskaya Central District Hospital of the Republic of Bashkortostan from 2015 to 2021 was performed. Clinical, demographic data and the results of standard laboratory and instrumental examinations were recorded, as well as functional outcomes after 90 days according to the modified Rankin scale (mRs). Results. Data from 120 patients were analyzed. The following predictors of unfavorable functional outcome (mRs 3 points or more) of primary ICH after 90 days were identified: high blood sodium level (p = 0,014), stroke severity according to the NIHSS scale (p = 0,0001), longer QT interval duration (p = 0,05). Conclusion. Thus, early predictors of unfavorable functional outcome of primary ICH after 90 days, along with the initial severity of neurological deficit, were electrolytes level, as well as signs of myocardial repolarization disorders. These results allow for an early (at admission to the hospital) identification of the risk group for the unfavorable functional outcome, as well as for the optimal management of patients with primary ICH due to early correction of the identified factors.
This article analyzes the cardiological aspects of the etiology of cryptogenic stroke, including ESUS (embolic stroke of undetermined source). Special attention is paid to the pathophysiological mechanisms and risk factors for the development of cardioembolism in the absence of instrumentally confirmed atrial fibrillation. Several key areas are considered in detail: atrial cardiopathy as a complex of structural and functional changes in the left atrium, a subclinical form of atrial fibrillation and aorto-arterial embolism caused by non-stenosing atherosclerotic plaques, intracranial atherosclerosis and atheromatosis of the aortic arch. A comprehensive analysis of modern diagnostic biomarkers is presented, including instrumental (P-wave terminal force in lead V1 — PTFV1, supraventricular arrhythmias, indicators of structural changes in the left atrium) and laboratory ones (N-terminal pro-B-type natriuretic peptide, troponin, D-dimer), which identify the hidden embologenic substrate. New diagnostic approaches are highlighted, including advanced electrocardiographic monitoring protocols, echocardiographic techniques, and advanced vascular imaging techniques. The need for a comprehensive early diagnostic protocol implemented as part of a personalized approach is emphasized.
Objective. To determine the predictors of the development of cognitive impairment in patients with hypertension (HTN) with long-term post-COVID syndrome. Design and methods. A single-stage screening clinical study was conducted. Over a period of 3 years, 205 patients (23,4 %) with long-term post-COVID syndrome according to the NICE criteria were recruited among eligible 878 patients with HTN. The patients were divided taking into account the presence of cognitive impairment using the SEMOGRAPH information system: the first group included 80 patients (39,0 %) with cognitive impairment, the second group included 125 patients (61,0 %) without cognitive impairment. Results. The predictors of the development of cognitive impairment in patients with long-term post-COVID syndrome and their cut-off points were chosen using ROC curve: for body mass index values, a cut-off point of 28,36 kg/m 2 was set, > 26,0 mm/h — for erythrocyte sedimentation rate, < 126,0 g/l — for hemoglobin level, > 3,9 mg/l — for C-reactive protein serum concentration, > 101,9 pg/ml — for serum N-terminal fragment of brain natriuretic propeptide, > 171,1 μg/l — for ferritin, > 0,016 pg/ml — for serum tumor necrosis factor alpha, > 28,8 pg/ml — for serum caspase-6. In HTN patients with long-term post-COVID syndrome after hospitalization due to COVID-19-related pneumonia, the relative risk of cognitive impairment is increased by 2,8 times (95 % confidence interval (95 % CI) 1,63–4,92); the risk of concentration problems — by 8,1 times (95 % CI 4,84–13,99); “brain fog” symptom — by 2,5 times (95 % CI 1,75–3,50), abnormal blood pressure (BP) circadian profile “Non-dipper / Night-peaker systolic BP” — by 1,9 times (95 % CI 1,37–2,68); “Over-dipper systolic BP” — by 18,8 times (95 % CI 2,67–390,89); masked nocturnal hypertension — by 5,1 times (95 % CI 1,61–18,13). Conclusion. More severe forms of COVID-19, long-term post-COVID syndrome manifested by symptoms such as “brain fog”, impaired concentration, as well as abnormal patterns of circadian BP rhythm, obesity, ferrokinetic disorders, the development of myocardial stress, the presence of low-intensity non-specific inflammation, and signs of apoptosis were predictors of the development of cognitive impairment in COVID-19 survivors with HTN.
Preeclampsia is one of the most significant medical and social problems of modern obstetrics. This complication of pregnancy not only threatens the life of the mother and fetus during pregnancy, but also serves as a predictor of severe cerebrovascular and cardiovascular complications in the long term. Preeclampsia causes both acute and chronic cerebrovascular diseases, which are caused by increased permeability of the blood-brain barrier, impaired cerebral autoregulation, hypercoagulation and inflammation. This literature review analyzes papers published from January 2010 to June 2025 and cited by PubMed, Scopus, MEDLINE, and eLibrary. The features of regulation of cerebral blood flow during normal pregnancy and preeclampsia are described. Cerebrovascular complications of preeclampsia during pregnancy include posterior reversible encephalopathy syndrome, reversible cerebral vasoconstriction syndrome, hemorrhagic and ischemic stroke, and cerebral venous sinus thrombosis. In the long-term postpartum period, women with a history of preeclampsia have an increased risk of neurocognitive disorders, including impaired executive function and memory. There are also significant psychosocial consequences, i.e. decrease in the quality of life and social functioning, increased levels of anxiety, depression, which reduces adaptation to stressful situations of everyday life. Chronic dysfunction of the blood-brain barrier can cause not only functional neurovascular disorders, but also morphological changes. In the long term, preeclampsia is associated with an increased risk of vascular dementia, Alzheimer's disease, and stroke. Offspring born to mothers with preeclampsia have an increased risk of neurological diseases, including cognitive impairment, attention deficit hyperactivity disorder, autism spectrum disorders, depressive disorders, epilepsy, and cerebral palsy.
Objective. To investigate the associations of polymorphic variants rs662799 of the APOA5 gene with the development of acute cerebrovascular accident in patients with cardiovascular pathology. Design and methods. The main group of our study included 260 patients with acute cerebrovascular accident on the background of cardiovascular diseases and 272 volunteers without cardiovascular diseases (control group). The age range of patients with acute cerebrovascular accident was from 32 to 69 years [57,0 (51,0–62,0) years], and the age range of the control group was from 37 to 68 years [55,0 (51,0–62,0) years]. There were 157 men (age 56,5 (51,0–62,0 years) and 103 women (age 57,0 (51,0–62,0) years) in the main group. The control group included 170 men (age 55,0 (51,0–62,0) years) and 102 women (age 55,0 (51,0–62,0) years). All patients with acute cerebrovascular accident underwent the following examinations: collection of complaints and medical history, clinical examination, brain computed tomography, electrocardiography, echocardiography, and ultrasound doppler. The control group represents a population sample of residents of Novosibirsk who were examined as part of the international HAPIEE project in Novosibirsk. The results of the molecular genetic analysis were obtained from 254 patients in the main group and 272 patients in the control group. Statistical analysis was carried out using the SPSS v. 23. Results. The heterozygous AG genotype and the G allele of the APOA5 gene were more prevalent in the stroke cohort compared to control group. Among patients with acute cerebrovascular accident, a statistically significant decrease in the number of carriers of the common AA genotype and the A allele of the APOA5 gene was confirmed compared to the control group. Conclusion. The results of our study proved associations of single-nucleotide polymorphism rs662799 (A > G) with the development of acute cerebrovascular accident. The AG genotype and the G allele of the APOA5 gene showed significant associations with acute cerebrovascular accident in the main group of patients, in the subgroup of men and in the subgroup of patients with hypertension.
Peripheral blood microvesicles in patients with ischemic stroke are being profoundly investigated. Most works indicate an increase in the level of circulating microvesicles during different periods of stroke. The available data suggest that the level of microvesicles is a potential biomarker of the atherothrombotic subtype of ischemic stroke. Stroke severity, brain lesion volume, and outcome correlate with the level of microvesicles in peripheral blood. In the long term, the detection of microvesicles will help identify patients at high risk of stroke. Further work should determine the diagnostic and prognostic role of different microvesicle phenotypes in relation to stroke outcomes. Microvesicles should be also evaluated as targets for the treatment and prevention of stroke.
Background. Cognitive impairment in acute ischemic stroke has a negative impact on patients’ adaptability and quality life. They can result from acute ischemic brain damage affecting areas responsible for cognitive functions, or they can precede stroke. In the latter case, chronic cerebrovascular pathology and neurodegenerative process are the most common clinical variants. Their combination is considered within the concept of mixed cognitive impairment. In routine practice, magnetic resonance imaging (MRI) plays an important role, and visual semi-quantitative MR scales have been developed for the assessment of brain damage. Objective. To assess changes in white and gray matter in patients with lacunar and cardioembolic stroke using visual MR scales and to compare these data with the results of neuropsychological examination. Design and methods . We included 42 patients with cardioembolic and 52 patients with lacunar stroke and assessed changes in white and gray matter using 6 visual MR scales. A comprehensive neuropsychological examination was also performed. A correlation analysis was applied to assess the associations between the results of MR scales and impaired cognitive functions. Results. Patients with both lacunar and cardioembolic stroke subtypes, were characterized by a moderate degree of white matter damage. At the same time, patients with cardioembolic stroke tend to have more severe changes. In lacunar stroke, minor and moderate changes in gray predominate, while cardioembolic stroke is characterized by moderate and severe atrophy, which is reflected by the Koedam scales (0,000004) and atrophy of medial temporal lobe (0,000002). However, the results of the global cortical atrophy scale did not differ in these groups (0,902). Neuropsychological examination demonstrated that mild (44,2 % and 16,7 %, respectively) and moderate (46,2 % and 59,5 %, respectively) cognitive impairment predominates in both lacunar and cardioembolic stroke, and dementia is less common. Correlation analysis showed reliable links between structural brain damage and clinical features of cognitive impairment. Conclusion. Cardioembolic and lacunar strokes are characterized by moderate diffuse damage of white matter. The Wahlund and Scheltens scales are the most efficient for their detection. The greatest of degree gray matter damage was recorded in frontal lobes, in mediobasal regions of temporal lobes and parietal lobes in cardioembolic stroke and infratentorially and in basal ganglia in lacunar stroke. Both stroke subtypes are characterized by mild and moderate cognitive disorders, and dementia is registered only in isolated cases. The development of cognitive impairment correlates with topography and degree of white and gray matter damage.
Objective. To evaluate the effect of escitalopram on heart rate (HR) in patients with anxiety disorder. Design and methods. A retrospective study included 38 patients (24 women, 14 men) with anxiety disorder (Hospital anxiety and depression scale, HADS anxiety subscale ≥ 8 score) treated with escitalopram for at least 6 months. Patients receiving beta-blockers, with arrhythmias, or severe comorbidities were excluded. HR was measured at rest using the ri-fox N pulse oximeter before and 1 month after initiating therapy. Statistical analysis was performed using paired t-test and ANOVA (R, version 4.3.2). Results. Baseline HR was 88 ± 10; 91 ± 12, and 82 ± 9 beats/min in women aged 23–60 years (n = 16), women aged 60–78 years (n = 8), and men aged 26–56 years (n=14), respectively. After 1 month of therapy, HR decreased to 69 ± 8; 73 ± 9, and 68 ± 7 beats/min, respectively (p < 0,001). HR reduction was observed in 73,7 % of patients; 21,1 % maintained HR > 80 beats/ min. No significant differences were found by age (p = 0,15) or sex (p = 0,11). Conclusion. Escitalopram reduces HR, mitigating tachycardia associated with anxiety disorder, but monitoring is required due to variable treatment responses.
Background. Individuals with hypertension tend to have higher liver function test (LFT) levels and an increased risk of hypertension when abnormal LFT levels are present. The dysfunction of the liver is identified as a significant contributor to the development of hypertension. Objective. The article specifically focuses on review of various LFT markers such as albumin, alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), serum bilirubin, lactate dehydrogenase, prothrombin time (PT) and their role in hypertension. Results. The increase in albumin concentration from approximately 40 to 50 g/l within the physiological range correlated with a rise in systolic blood pressure ranging from 5 to 11 mmHg in males and from 6 to 17 mmHg in females. Also, there is a negative correlation between serum ALP and indices of artery anatomy and function in hypertensive African men. Moreover, an inverse correlation between elevated ALT levels and hypertension in Chinese adults, suggesting that elevated ALT may precede the onset of hypertension. The overall prevalence of elevated ALT and AST among freshmen was 6,8 % and 2,3 %, respectively, suggesting a strong correlation between ALT levels and hypertension in both males and females. Another study indicated that higher GGT levels were associated with an increased risk of hypertension. In men with pre-hypertension, but not in normotensive individuals, serum bilirubin levels negatively correlated with arterial stiffness. No significant relationship between arterial stiffness and bilirubin levels was observed in women. An increase in serum LDH level is linked to the severity of pregnancy-induced hypertension and complications for both mother and fetus. Systolic blood pressure and diastolic blood pressure showed a positive correlation with activated partial thromboplastin time (APPT) in hypertensive patients. These findings suggest that PT and APTT measurements could be used as indicators to assess hemostatic abnormalities in individuals with hypertension and guide antihypertensive medication. The exact mechanisms by which the liver function panel influences hypertension were not reported.
Objective. To compare the efficacy of pharmacological cardioversion with cavutilide and electrical cardioversion in patients with persistent and long-standing persistent atrial fibrillation (AF), and to identify predictors of early arrhythmia recurrence.Design and methods. The study included 104 patients with persistent or long-standing persistent atrial fibrillation who underwent pharmacological (cavutilide) or electrical cardioversion. Prospective follow-up was conducted for 1 week.Results. The groups of patients undergoing electrical or pharmacological cardioversion were comparable by baseline clinical and echocardiographic parameters. The efficacy of pharmacological cardioversion with cavutilide was comparable to that of electrical cardioversion (50/59 (84,7 %) vs. 41/45 (91,1 %), p = 0,331). Predictors of failure to restore sinus rhythm included: duration of the current episode of persistent AF and prior cardioversion. The rate of early arrhythmia recurrence in the pharmacological and electrical cardioversion groups was comparable (17/50 (34 %) vs. 11/41 (26,8 %), p = 0,461). Patients with early AF recurrence demonstrated more pronounced enlargement of the left and right atria. The most significant predictor of early AF recurrence was a higher left atrial volume index (LAVI), with a ROC analysis-derived threshold value of 50,5 mL/m², associated with the 2,34‑fold increase in the risk of arrhythmia recurrence.Conclusion. The efficacy of pharmacological cardioversion with cavutilide is comparable to that of electrical cardioversion. Predictors of failure to restore sinus rhythm include the duration of the current AF episode and prior cardioversion. Left atrial volume index exceeding 50,5 mL/m² is associated with the 2,34‑fold increase in the risk of arrhythmia recurrence within 1 week after cardioversion.
Background. Endothelial dysfunction is considered one of the possible pathophysiologic mechanisms of decreased exercise tolerance in patients after COVID‑19.Objective. To evaluate the structural and functional vascular changes and exercise tolerance in patients at the long-term follow-up after hospitalization for COVID‑19.Design and methods. Patients older than 18 years of age from the epidemiological ESSE-RF study were examined: COVID‑19 group (n = 31) — patients hospitalized due to COVID‑19; control group (n = 31) — patients not hospitalized due to COVID‑19. Endothelial state was assessed by levels of von Willebrand factor (vWF), interleukin 6 (IL‑6), and trimethylamine-N-oxide (TMAO); arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) and by cardio-ankle vascular index (CAVI); exercise tolerance was evaluated by cardiopulmonary exercise testing (CPET).Results. The patients were examined at 570 ± 179 days after hospitalization for COVID‑19. There were no differences in vascular parameters between the COVID‑19 group and the control group (p > 0,05): vWF — 2,2 (0,5; 2,7) vs. 2,3 (1,0; 2,9) U/mL, IL‑6–1,5 (1,0; 3,1) vs. 1,6 (1,0; 3,5) pg/mL, TMAO — 1023,9 (712,7; 1284,7) vs. 896,9 (731,0; 1061,1) pg/mL, cfPWV — 8,4 (7,1; 9,5) vs. 8,2±1,1 m/s, CAVI — 8,0 ± 1,1 vs. 8,2 ± 1,1; as for the results of the CPET: VO2peak — 86,0 (81,0; 92,7) % predicted vs. 86,0 (81,0; 91,5) % predicted, VE/VCO2peak — 28,7 ± 4,5 vs. 27,6 ± 4,8, breathing reserve — 54,7 ± 10,0 % vs. 58,3 ± 8,1 %.Conclusion. Patients in the long-term period after hospitalization for COVID‑19 show no structural and functional changes or exercise tolerance issues in CPET compared with patients who were not hospitalized for COVID‑19.
The anniversary article presents the life and creative path of the outstanding Russian Soviet scientist, physician and teacher Georgy Fedorovich Lang (1875-1948), one of the founders of Russian cardiology. The scientific achievements of the scientist are shown, a special place among which is the creation of the concept of hypertensive disease, a disease of the neurohumoral apparatus regulating blood circulation, caused by mental trauma and overstrain of the central nervous system.
The article is dedicated to the 150th anniversary of the birth of the valid member of the Academy of Medical Sciences of the USSR Georgy Fedorovich Lang - an outstanding scientist and practicing physician, one of the founders of Russian cardiology. The article outlines the biography of Georgy Fedorovich and reflects the main scientific achievements of this scientist and his students. The article provides detailed information about G. F. Lang’s research in the field of heart and vascular pathologies, in particular, about his work on the study of high blood pressure. G. F. Lang created the neurogenic theory of arterial hypertension and identified a special nosological form - hypertensive disease, synonymic to essential hypertension. The treatment approach in patients with essential hypertension recommended by G. F. Lang is presented.
This study examines the scientific contributions of Georgy F. Lang and his relevance to understanding cardiometabolic disorders in survivors of the Leningrad Siege and their offspring. The article provides an overview of key findings from longitudinal studies of Siege survivors conducted by Russian and European research groups. Current investigations focus on elucidating transgenerational inheritance mechanisms through analysis of a two-generation cohort in the survivors’ descendants. The comprehensive study is presently aimed to evaluate structural and functional characteristics of the cardio-vascular-renal-hepatic-metabolic continuum in first and second generation descendants of Siege survivors, in comparison to a population-based sample of St Petersburg residents. Contemporary researchers continue developing Lang’s theoretical framework by employing modern methodologies to establish evidence-based preventive strategies aimed at mitigating the negative health impacts of traumatic experiences across generations.
