Introduction. Vitamin D deficiency may be an independent predictor of coronary heart disease (CHD) and the severity of coronary atherosclerosis. The results of studies of the association of various polymorphisms of the vitamin D receptor (VDR) gene with the risk and severity of CHD are contradictory, which necessitates the study of genetic variants of the VDR gene and the characteristics of the clinical course of CHD in the Russian population.The objective was to determine the distribution of genotypes of TaqI, BsmI and ApaI of polymorphic variants of the VDR gene and the level of vitamin D sufficiency in CHD patients with varying severity of CHD, residents of St. Petersburg.Methods and materials. The study included 407 CHD patients and 318 patients without clinical signs of CHD of comparable age (p>0.05). All CHD patients underwent coronary angiography. Typing of the VDR gene variants was performed by polymerase chain reaction and subsequent restriction analysis. Determination of the level of 25(OH)D blood serum was carried out by enzyme immunoassay.Results. Vitamin D deficiency was detected in 82 % of CHD patients, the content of 25(OH)D in blood serum was lower in CHD patients who had 2 or more myocardial infarctions (MI) than in those who had one MI (p=0.03). Vitamin D deficiency is associated with a 3.6-fold increased risk of multivessel disease (p=0.01). The presence of the aa genotype and the a allele (ApaI), the bb genotype and the b allele of the VDR gene (BsmI) is associated with an increased risk of CHD and the severity of atherosclerotic lesions of the coronary arteries.Conclusion. Vitamin D deficiency is typical for CHD patients and is associated with the severity of coronary atherosclerosis. The presence of aa genotype and a allele (ApaI polymorphism), bb genotype and b allele of the VDR gene (BsmI polymorphism) is associated with an increased risk of CHD and the severity of atherosclerotic lesions of the coronary arteries. TaqI polymorphism of the VDR gene is not associated with the risk of CHD.

Objective. T o evaluate diastolic function of the left ventricle and anthropometric parameters in patients with abdominal obesity (AO). Design and methods . We examined 438 patients aged 30 to 55 years (44,8 ± 0,3 years) with AO (IDF, 2005) and 115 patients (40,3 ± 0,8 years) without AO (comparison group). Two-dimensional transthoracic echocardiography was performed (GE Vivid 7 Dimension) in 2D mode, in M-mode, also Doppler studies were performed using pulsed, continuous-wave, color and tissue regimes of Doppler. Results. Based on echocardiography, 126 patients with AO and arterial hypertension (HTN) (28,8 %) (94 women and 32 men) had type I left ventricular diastolic dysfunction (LVDD). In patients with AO and without HTN, the E/A ratio and the E’ value were lower, and the DT and isovolumic relaxation time (IVRT), the E/E’ and LAVI ratio are higher than the same parameters in the comparison group (p < 0,0001). Only the ratio E/E’ was in accordance with the criteria for type 1 LVDD. We found positive correlations between the body mass index (BMI) and the IVRT (r = 0,3, p = 0,0001), BMI and the E/E’ ratio (r = 0,4, p = 0,0001), BMI and LAVI (r = 0,4, p = 0,0001), between the waist circumference (WC) and the IVRT (r = 0,3, p = 0,001), the WC and the E/E’ (r = 0,3, p = 0,0001), WC and LAVI (r = 0,4, p = 0,0001) in female with AO without HTN. In patients with AO and without HTN, there is a 3,7-fold increase in LVDD risk in case of BMI ≥ 30,0 kg/m 2 (odds ratio: 3,7, 95 % confidence interval: 1,2–9,0, p < 0,0001). Conclusions. The type I LVDD was found in patients with AO and HTN. in patients with AO without concomitant HTN, the risk of LVDD increases by 3,7 times with a threshold of body mass index ≥ 30,0 kg/m 2.

OBJECTIVE To evaluate serum galectin 3 and to determine the potential clinical value of this parameter in patients with atrial fibrillation - AF (paroxysmal and persistent) and metabolic syndrome (MS). DESIGN AND METHODS We examined 100 patients with MS (50 with paroxysmal or persistent AF and 50 without arrhythmia) and 50 healthy persons. Serum galectin 3 measured by ELISA method, ECHO cardiography was performed to all examined persons. RESULTS Galectin 3 in patients with MS and AF was higher, than in patients with MS without arrhythmia and much more higher than galectin 3 in healthy persons 0,72 (0,44;1,36), 0,44 (0,42;1,22) and 0,32 (0,28;0,42) ng/ml (<0,01). In patients with persistent AF levels of galectin 3 is higher than in patients with paroxysmal AF. Positive correlation between the levels of galectin 3 and duration arrhythmia was revealed (r=0,301; p<0,01). Higher level of galectin 3 was revealed in patients with frequent paroxysms of AF and ineffective antiarrhythmic therapy. CONCLUSION Marker of myocardial fibrosis serum galectin 3 in patients with atrial fibrillation and metabolic syndrome is higher than in patients with the metabolic syndrome, without this arrhythmia and higher than in healthy controls. In patients with persistent AF level of galectin 3 was higher than in patients with paroxysmal AF.

The aim of this study is determination of predictors of efficiency of radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) and metabolic syndrome (MS). Material and methods. 98 patients with AF (78 patients with AF and MS (IDF, 2005) and 20 patients without MS) have been examined. Comparison groups included 50 patients with MS without arrhythmia and 50 practically healthy subjects. RFA was performed with Carto 3 navigation system. Follow-up period after RFA was 12 months. Epicardial fat thickness (EFT) was measured with help of echo-cardiography. Results: patients with AF relapse had more MS components than those with effective procedure (3.21±1.18 and 1.73±1.14, accordingly, p<0.001). Initially, EFT of patients with AF relapse after RFA was larger that in patients without arrhythmia after exposure. EFT in patients with AF more than3.5 mmincreases probability of arrhythmia relapse in 1.87 times (OR: 1.87, 95 % CI 1.03 — 3.41, р = 0.04). Conclusion: determination of EFT with echo-cardiogaphy can be used in estimation of AF relapse risk after RFA.

The aim of this study is determination of predictors of efficiency of radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) and metabolic syndrome (MS). Material and methods. 98 patients with AF (78 patients with AF and MS (IDF, 2005) and 20 patients without MS) have been examined. Comparison groups included 50 patients with MS without arrhythmia and 50 practically healthy subjects. RFA was performed with Carto 3 navigation system. Follow-up period after RFA was 12 months. Epicardial fat thickness (EFT) was measured with help of echo-cardiography. Results: patients with AF relapse had more MS components than those with effective procedure (3.21±1.18 and 1.73±1.14, accordingly, p<0.001). Initially, EFT of patients with AF relapse after RFA was larger that in patients without arrhythmia after exposure. EFT in patients with AF more than3.5 mmincreases probability of arrhythmia relapse in 1.87 times (OR: 1.87, 95 % CI 1.03 — 3.41, р = 0.04). Conclusion: determination of EFT with echo-cardiogaphy can be used in estimation of AF relapse risk after RFA.

fibrillation (AF) and to reveal the significance of this marker of fibrosis in MS. Design and methods. We examined 100 patients with MS (50 with paroxysmal or persistent AF and 50 without arrhythmia) and 50 healthy persons. Serum galectin 3 was measured by ELISA method, all examined subjects underwent echocardiography. Results. Galectin 3 was higher in patients with MS and AF compared to patients with MS without arrhythmia and much higher than in healthy persons [0,72 (0,44; 1,36); 0,44 (0,42; 1,22 and 0,32 (0,28; 0,42) ng/ml, р < 0,05; р < 0,001 and р < 0,001, respectively]. Galectin 3 in patients with 5 components of MS was higher, than in patients with 4 and 3 components of MS [2,01 (0,52; 4,59); 0,54 (0,44; 1,37) and 0,42 (0,32; 0,42) ng/ml, р < 0,05; р < 0/001 and р < 0,001, respectively]. Correlations between galectin 3 and waist circumference, blood pressure, left and right atrium volume, triglyceride level were found (r = 0,57; r = 0,51; r = 0,45; r = 0,40; r = 0,41; р < 0,001). Conclusion. Galectin 3, a marker of fibrosis in patients with MS and atrial fibrillation was higher than in patients with MS without arrhythmia and significantly higher than in healthy persons.

To evaluate plasma concentration of apelin and its correlation with structural and functional heart parameters in patients with abdominal obesity. 93 patients with abdominal obesity (criteria IDF, 2005) and 21 healthy people at the ages from 25 to 57 years old were investigated. Weight, height, waist circumference, and plasma apelin concentration were measured. Dimensions and volume of the cardiac chambers, systolic and diastolic functions of the ventricles were measured with echocardiographic method. Plasma apelin concentration was higher in patients with abdominal obesity as compared to healthy people (0.70 (0.55 - 0.94) ng/ml and 0.55 (0.42 - 0.72) ng/ml, respectively; p = 0.04). There is significant negative correlation between apelin level and longitudinal size of the left ventricle (r=-0.307; p = 0.003); index of the left atrial volume (r=-0.201; p = 0.05); longitudinal size of the left atrium (r=-0.248; p = 0.02); right atrium volume (r=-0.261; p = 0.01); right atrium area (r=-0,251; p = 0,02); basal size of the right ventricle (r=-0,202; p = 0,05); longitudinal size of the right ventricle (r=-0.234; p = 0.02). Plasma apelin concentration was higher in patients with abdominal obesity as compared to healthy people. There were revealed significant negative correlation between apelin level and longitudinal size of left ventricle, index of left atrial volume, longitudinal size of left atrium, right atrium volume, right atrium area, basal size of right ventricle, and longitudinal size of right ventricle.

Objective. To evaluate the epicardial fat thickness (EFT) in patients with metabolic syndrome (MS), including paroxysmal and persistent atrial fibrillation (AF). To relate EFT to the fibroid heart marker, i.e. galectin 3. Materials and methods. We examined 100 patients with MS (50 with AF), and 50 healthy persons made the control group. Serum galectin 3 was measured by ELISA method. The EFT was measured with echocardiography. Results. EFT in patients with MS was twofold higher than in healthy persons. EFT in patients with MS and AF didn't differ significantly from that in patients with MS without AF. Positive correlation between the levels of EFT and galectin 3 in serum was revealed. Serum galectin 3 and EFT were associated with atrial fibrillation in patients with MS (OR:1,27, 95% CI 1,02-1,58 and OR:1,73, 95% CI 1,37-2,19, correspondingly).Conclusion. Definition of EFT at echocardiography can be used in the assessment of risk AF in patients with MS.

Objective . To evaluate the incidence and causes of atrial fi brillation in hospitalized patients of therapeutic profi le and to compare the dynamics of these parameters over past 25 years. Design and methods. We analyzed 14595 medical histories of the faculty therapy clinic of Pavlov St Petersburg State Medical University for the periods from 1985 to 1990 years and from 2005 to 2010 years. Results. The incidence of atrial fi brillation increased by 1,7 times over the past 25 years. There is a signifi cant increase in the number of patients with atrial fi brillation in combination with co-morbidities: obesity — 1,9 times, essential hypertension — 1,8 times, and type 2 diabetes mellitus — 3-fold increase. The incidence of valvular heart diseases in patients with atrial fi brillation decreased by 1,9 times from 1985 to 2010 year. Statistical signifi cance of differences was assessed by Fisher’s exact test (p < 0,0001). Conclusion. The number of hospitalized patients with atrial fi brillation signifi cantly increased over the past 25 years. The number of patients with nonvalvular atrial fi brillation signifi cantly increased from 1985 to 2010 year and the number of patients with rheumatic valvular heart disease with atrial fi brillation decreased.

Objective. To evaluate the incidence and causes of atrial fi brillation in hospitalized patients of therapeutic profi le and to compare the dynamics of these parameters over past 25 years.Design and methods.We analyzed 14595 medical histories of the faculty therapy clinic of Pavlov St Petersburg State Medical University for the periods from 1985 to 1990 years and from 2005 to 2010 years.Results.The incidence of atrial fi brillation increased by 1,7 times over the past 25 years. There is a signifi cant increase in the number of patients with atrial fi brillation in combination with co-morbidities: obesity — 1,9 times, essential hypertension — 1,8 times, and type 2 diabetes mellitus — 3-fold increase. The incidence of valvular heart diseases in patients with atrial fi brillation decreased by 1,9 times from 1985 to 2010 year. Statistical signifi cance of differences was assessed by Fisher’s exact test (p < 0,0001).Conclusion.The number of hospitalized patients with atrial fi brillation signifi cantly increased over the past 25 years. The number of patients with nonvalvular atrial fi brillation signifi cantly increased from 1985 to 2010 year and the number of patients with rheumatic valvular heart disease with atrial fi brillation decreased.