In the interests of practical healthcare, routine classifications should be modified as rarely as possible. At the same time changes should be discarded only on sufficient grounds, for example, when there are no obvious advantages of a new classification over the existing ones or they can no longer be modified by introducing fundamental changes and amendments. In this regard, the evolution of approaches to the classification of chronic heart failure (CHF) is prominent. It becomes particularly relevant due to the fact that currently experts of the Russian Society of Cardiology (RSC) are actively discussing a new draft classification of CHF. The authors of the lecture gave a brief historical insight and reviewed the main classifications of CHF used in North America, Europe, and Russia. The new classification of CHF proposed by RSC experts, which is actually a modified classification of North American colleagues, does not have obvious advantages over the currently used CHF classification in Russia (since 2002). The latter is based on the classification by Vasilenko – Strazhesko which is familiar to domestic internists, since it has become an indispensable part of their clinical practice and has stood the test of time. In addition, its underlying principles provide the potential for its flexible modification.

Clinical examples for variants of cardiovascular complications of a new coronavirus infection (COVID-19) are presented when they are visualized by means of magnetic resonance imaging (MRI) of the heart and chest organs with paramagnetic contrast enhancement and synchronization with ECG and respiration signal. The syndromes of post-COVID focal infarct injury and diffuse inflammatory lesion are identified. The picture of MRI visualization of coronary atherosclerotic plaque is presented. The results of quantitative processing of cardiac MRI in these two different syndromes of post-COVID cardiological complications are presented. The presented clinical examples indicate the need for cardiac MRI to monitor patients and assess the long-term cardiovascular effects of COVID-19.

AIM To comparatively estimate the time course of changes in key metabolic parameters and quality of life (QL) in patients with coronary heart disease during 4-week therapy with atenolol and amlodipine. SUBJECTS AND METHODS The 4-week randomized open-label trial included 60 patients with functional classes II-III stable angina pectoris on exertion associated with metabolic syndrome (all male patients aged 29 to 62 years (mean age 48.1 +/- 0.9 years)). Along with the traditional studies accepted in specialized cardiology practice, QL was assessed using the EORTC QLO CORE 30 questionnaire prior to treatment and on the last day of the trial. RESULTS Four-week therapy with the individually adjusted dosages of atenolol (68.7 +/- 4.17 mg/day) or amlodipine (5.5 +/- 0.34 mg/ day) ensured comparable positive changes in the subjective assessment of QL. CONCLUSION The positive changes in exercise tolerance that was considered to be an objective indicator for physical improvement in the treatment with amlodipine were more pronounced than those in that with atenolol. Therapy with amlodipine caused no change in blood lipid parameters while that with atenolol was associated with a 9.7% increase in blood triglyceride concentrations.

Enalapril (average dose 7,0+/-0.8 mg) was given for 12 weeks to 15 patients with preserved left ventricular (LV) systolic function who had survived large focal myocardial infarction small i, Ukrainian6 months before that. The use of enalapril was associated with 49% lessening of severity of clinical signs of heart failure (p<0.001) and 47% increase of tolerance to physical exercise. It also provided dose dependent 17.8% reduction of LV myocardial mass (p<0.05), normalization of initially "hypertrophic" type of transmitral flow, 21% lowering of LV end diastolic pressure (p<0.05) without effect on LV volume, geometry, global and local systolic function.