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 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.
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.
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.
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.
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.
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.
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