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The article describes a clinical case of biventricular arrhythmogenic cardiomyopathy (ACM) presented with myocardial infarction (MI) — like event in a young patient. The patient was hospitalized with suspected acute coronary syndrome and an episode of ventricular tachycardia (VT). Based on increased cardiac troponin, left ventricular systolic dysfunction with wall motion abnormalities, and nonobstructive coronary arteries the initial diagnosis of type 2 MI was made. To verify the etiology behind VT and ventricular structural abnormalities cardiac magnetic resonance imaging (MRI) was performed. Abnormalities of both right and left ventricles demonstrated by MRI and supported by the genetic testing established the diagnosis of biventricular ACM. Since the diagnosis was made, initially diagnosed MI was reassessed in favor of acute myocardial injury as a characteristic of ACM course. ACM should be included into differential diagnosis with MI and acute myocarditis in patients with elevated troponin and nonobstructive coronary arteries.

Infective endocarditis (IE) is a rare disease with a potentially high mortality rate. The patient "portrait" is changing, there is an increase in the proportion of elderly people with concomitant diseases and degenerative defects, prosthetic valves and minimally invasive cardiac operations, implanted intracardiac devices, and hemodialysis. An additional significant negative contribution is made by the transformation of the etiological picture — an increase in the species diversity of pathogens, a decrease in the proportion of streptococci, a steady increase in the staphylococcal and enterococcal etiology of IE. The IE treatment success depends on the competent administration of antibacterial therapy. Clinicians are guided by two main documents: the national clinical guidelines "Infective endocarditis and infection of intracardiac devices" of 2021 and the European clinical guidelines "ESC Guidelines for the management of endocarditis" of 2023. The article summarizes updated data on the optimal prescription of antibacterial therapy, presented in a convenient and understandable format for the practicing physicians. Schemes for prescribing intravenous antibiotic therapy in a hospital are presented not only for traditional pathogens (Staphylococcus sp., Streptococcus sp. and Enterococcus sp.), but also for rare pathogens that cause significant difficulties (pathogens of the HACEK and non-HACEK group, Coxiella burnetii, Bartonella sp., Brucella sp., Tropheryma whipplei, Mycobacterium sp., fungi). Separately, the principles of empirical antibacterial therapy with the most effective treatment regimens not only for left-sided IE, but also for different variants of right-sided IE are presented in detail. New modern possibilities of outpatient oral antibiotic therapy for IE are presented. In conclusion, prospects for the development of conservative IE treatment are proposed.

The assessment of platelet dysfunction is usually used by hematologists to diagnose inherited (such as Bernard-Soulier syndrome, platelet-type-von Willebrand disease, Glanzmann thrombasthenia, etc.), and acquired (symptomatic) platelet disorders (in hemoblastoses, uremia, liver cirrhosis, etc.), as well as to predict the risk of intraoperative bleeding in these groups of patients. Later, laboratory platelet function tests began to be used by cardiologists, first in experimental and clinical studies. In further years, attempts were made to introduce them into clinical practice. Current data show association between platelet hyperreactivity and pathogenesis of cardiovascular events. At the same time, despite the various consensus papers on assessing thrombotic and bleeding risk, monitoring antiplatelet therapy, including those published by Russian experts, in practice there are many subtleties and questions about the practical aspects of using laboratory tests. In addition, the definition of platelet phenotype does not have a clear concept. The review purpose was to describe laboratory methods for assessing the platelet function, to give more information to cardiologists about its practical value and to understand what basic scientists and physicians mean by the term “platelet phenotype”.

Aim. To evaluate the frequency, dynamics, clinical associations and prognostic value of venous congestion at bedside ultrasound using VExUS protocol in patients with decompensated heart failure (HF).Material and methods. This prospective study included 273 patients over 18 years old with NYHA class II-IV decompensated HF. All patients underwent standard clinical and paraclinical analysis, including NT-proBNP determination, transient elastometry and lung ultrasound. To assess venous congestion by bedside ultrasound using the VExUS protocol, the inferior vena cava (IVC) diameter was estimated and the congestion severity was determined on the deviation of Doppler curves of hepatic, portal and renal veins. If the IVC diameter was ≥2 sm, venous congestion was determined. To assess pulmonary congestion, lung ultrasound (LUS) was performed according to the 8-zone protocol, and the sum of B-lines ≥5 was taken as pulmonary congestion. All patients received standard therapy for heart failure. Statistical analysis was performed in SPSS Statistics program, version 26.0.Results. A high detection rate of venous congestion (75,8%) was revealed in patients with decompensated HF on admission at bedside ultrasound examination according to the VExUS protocol: mild – in 35,5%, moderate – in 12,8%, severe – in 27,5% of patients. The detection rate of venous congestion at discharge was 48,7%: mild – in 28,2%, moderate – in 9,5%, and severe – in 11,0% of cases. Pulmonary congestion on admission was detected in 98,9% of cases. Venous congestion was associated with the severity of HF, NT-proBNP level, renal and cardiac dysfunction, liver stiffness and sum of B-lines. The prognostic role of venous congestion according to the VExUS protocol on re-hospitalization for decompensated HF and the combined endpoint (hospitalization for decompensated HF + allcause death) at 12 months was established.Conclusion. The established incidence, associations, and prognostic value of venous congestion in patients with decompensated HF suggest the utility of bedside ultrasound using the VExUS protocol as an available noninvasive method to optimize therapy and risk stratification.

A clinical observation of the treatment non-compliance consequences with clinical guidelines and principles of empirical therapy selection in a female patient with intravenous drug abuse, viral hepatitis C and HIV infection, with a history of a COVID-19 and the development of uncontrolled staphylococcal infective endocarditis (IE) of the tricuspid valve, complicated recurrence of early prosthetic IE is presented. Successful treatment was achieved only by a combination of tricuspid valve replacement and the appointment of etiotropic therapy for S. aureus (MSSA). The typical clinical scenario was not accompanied by the choice of adequate empirical antibiotic therapy, despite the high suspicion of association with MSSA, which determined the complicated course of IE. Only the polymerase chain reaction of the heart valve tissue played a key role in the etiological diagnosis. The use of valve tissue polymerase chain reaction in addition to traditional microbiological methods is a valuable diagnostic study.

Delaminating intramyocardial hematoma (DIMH) is a rare and potentially life-threatening complication of acute myocardial infarction. Currently, only isolated reports of cases of myocardial dissection have been published, and until recently, the diagnosis of DIMH was carried out during autopsy or surgery. The article describes echocardiographic criteria and discusses some aspects of the therapy of this pathology. The description of clinical cases of noninvasive diagnosis of DIMH in men aged 60 and 62 years hospitalized with the clinic of decompensation of chronic heart failure is given. This complication in the presented patients was diagnosed using transthoracic echocardiography, thanks to which it was possible to identify the dissection of the myocardium, as well as to trace the dynamics of the organization of an intramyocardial hematoma into a parietal thrombus. Various approaches to patient management are demonstrated: conservative tactics allowed to successfully stabilize the course of chronic heart failure in the first patient, while the condition of the other required the transplantation of a donor heart a few months after discharge from the hospital.

Aim. Assessment of impact of the duration of preoperative antimicrobial therapy (AMT) on the sensitivity of microbiological examination and polymerase chain reaction (PCR) of blood/tissues of resected valves in operated patients with infective endocarditis (IE).Materials and methods. 52 operated patients with active IE were included prospectively (Duke criteria, 2015). All patients underwent microbiological examination of blood before admission to the cardiac surgery hospital, as well as parallel simultaneous microbiological examination and PCR of blood/tissues of excised valves, followed by Sanger sequencing. The duration of preoperative treatment was calculated from the first day of AMT according to IE diagnosis to the day of surgery.Results. The causative agent of IE was established in 84.6% (n=44) patients by means of complex etiological diagnosis. A significant decrease in the sensitivity of microbiological examination of venous blood was revealed when performed in the period before and after hospitalization to a surgical hospital (up 44.2% to 17.3%, p0.05) vs. 75.0% (p0.05) vs 72.4% (p

Aortic valve lesion is a common and may have diverse causes, from degenerative, congenital and infectious diseases to autoimmune conditions. We present a rare case of Takayasu arteritis and severe heart lesion due to the myxomatous degeneration of the aortic and mitral valves associated with development of infective endocarditis (IE) complicated by abscess, fistula, valve perforation and recurrent acute decompensated heart failure in a young female patient. A combined use of histopathological and PCR analyses of valve tissues was critically important for differential diagnosis of the valve lesions, as it made it possible to identify the true cause of the disease. The presence of Takayasu arteritis has played an indirect role by creating conditions for the development of immunosuppression and determining the disease severity and its progression.

The issue of antithrombotic therapy in patients with infective endocarditis has been studied for over 75 years. During that time studying of pathogenesis of the disease and its embolic complications, lead to the introduction of the concept of “immunothrombosis”. That mechanism allows infective agents (mostly bacteria) to be cloaked from the immune system and to multiply freely, leading to growth of vegetation, thus resulting in higher chance of fragmentation. Small-scale experimental and clinical studies on the correction of hemostatic disorders in infective endocarditis, that were performed in 20th century, didn’t show any significant results, that could affect clinical practice. However, reinterpretation of available data on coagulative system will allow to have elements of hemostasis as an application point in treating infective endocarditis. The article will discuss latest insights on the role of hemostasis system in pathophysisology of infective endocarditis, its effects on the development of the embolic complications, perspectives for diagnostics and treatment.

Aim. To study the effects of azilsartan medoxomil/chlorthalidone (AZM/CTD) and losartan/hydrochlorothiazide (LOS/HCT) combinations for NTproBNP levels, 6-minute walk test results, hydration status along with their antihypertensive efficacy according to clinical and 24-hour blood pressure in patients with hypertension and heart failure with preserved ejection fraction (HFpEF).Material and methods. An open randomized study included 56 patients with uncontrolled or untreated hypertension and HFpEF. Patients randomized to receive the AZM/CTD 40/12.5 mg/day (group 1; n=28) or LOS/HCT 100/12.5 (group 2; n=28) within 4 weeks. Patients who did not achieve the target BP

Aim. To describe prognostic meaning of cardiac and other principal clinical manifestations of systemic AL-amyloidosis in their interrelations.Material and methods. It has been made long-time survival analysis of 147 patients with systemic AL-amyloidosis. In the special investigation group (n=58) of AL (n=55) and ATTR (n=3) amyloidotic cardiopathy patients there were evaluated prognostically important structural and functional changes in myocardium with standard and impulse-wave tissue dopplerometric echocardiography in comparison with NTproBNP serum levels.Results. Even though significantly increased nowadays surviving of AL-amylodotic patients (Me=90 months) it has been found that as at previously time orthostatic hypotension and amyloid cardiopathy are being most severe initial syndromes (median 25 months), but after 1 year from diagnosis influence of these syndromes on surviving had decreased and most low surviving was more common in patients with CKD 3-5 (median 28 months). Influence of CKD 3-5 on surviving was associated predominantly with intracardial hemodynamics deterioration. Together with decreased systolic shortening strain rate (48,5%) decreased filtration rate (47,9%) was second of main factors contributing into NTproBNP increasing in effective multiple regression model (R=0,702, F(4,21)=5,095, p=0,005). NTproBNP level in less degree depended on renal clearance.Conclusion. Heart damage is one of the most prognostically unfavorable manifestations of systemic amyloidosis due to a sharp deterioration in the elastic properties of the myocardium, in the process of further development of amyloidosis, the leading factor in progression is the deterioration of the profile of cardiorenal interactions, the marker of which is the level of NTproBNP.

High blood pressure is a risk factor for cardiovascular morbidity and mortality, as well as cognitive decline and loss of autonomy in the elderly and old age. Randomized clinical trials (RCTs) in populations of older patients living at home with low comorbidity and preserved autonomy indicate the benefit of lowering elevated blood pressure in patients over 80 years of age. Older patients with senile asthenia, loss of autonomy and other geriatric problems were excluded from RCTs, and observational studies in these groups of patients indicate an increase in morbidity and mortality with lower blood pressure and antihypertensive therapy. Obviously, in very elderly patients, a universal strategy for the treatment of arterial hypertension cannot be applied due to the significant heterogeneity of their functional status. The geriatric approach to the management of arterial hypertension in older patients involves an assessment of the functional status, the presence of senile asthenia, and the degree of autonomy for the choice of antihypertensive therapy tactics.

Aim. To study the impact of heart rate (HR) reduction with beta-blockers (BB) on left atrial (LA) function in hypertensive patients with paroxysmal or persistent mild symptomatic atrial fibrillation.Material and methods. In this open prospective trial we randomly assigned patients with hypertension, sinus rhythm, elevated heart rate (≥70 bpm), and recurrent atrial fibrillation (EHRA 2A or less) to receive BB with a target HR of less or greater than 70 bpm for at least 4 months. All the patients underwent an echocardiogram [left atrial (LA) function was assessed as emptying fraction]and applanation tonometry at baseline and after 4 months. Primary endpoint was median LA emptying fraction (LAEF) measurement at the end of the study.Results. 47 patients were randomized to group with a target HR of ≤70 bpm and 44 patients to >70 bmp. Among them 44 and 41 patients completed the study. Median follow up was 4.4 months. At the end of the study (4.5 months) median HR was 62 [60; 67] bmp in ≤70 group and 73 [72; 76] bpm in >70 group. Both groups received similar antihypertensive therapy and there were no intergroup differences in systolic and diastolic blood pressure. At the end of the study, patients in ≤70 group had significantly lower LAEF compared with >70 group (37% vs 42%; p=0.01). E’avg was lower and augmentation index was higher in ≤70 group as compared to >70. In regression analysis, after E’avg and augmentation index were included in the model, the association between LAEF and randomization group lost its significance.Conclusion. Beta blockers treatment with strict HR reduction (≤70 bpm) significantly reduced LA function as compared to lenient target HR (>70 bpm).

Advances in the diagnosis and treatment of patients with infectious endocarditis are limited by the high frequency of cases with an unknown etiology and imperfection of microbiological (cultural) methods. To overcome these problems new approaches to the identification of infectious endocarditis pathogens were introduced, which allowed achieving certain positive results. However, it should be noted that despite the wide variety of diagnostic tools currently used, there is no ideal method for etiological laboratory diagnosis of infectious endocarditis. The article discusses the features and place of immunochemical, molecular biological (MALDI-TOF MS, real-time PCR, sequencing, in situ fluorescence hybridization, metagenomic methods, etc.), immunohistochemical methods, and their advantages and limitations.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is diagnosed in the absence of anatomically significant stenoses (

Aim. To evaluate gender-related differences of left atrial (LA) phasic function and structural remodeling in conjunction with the parameters of left ventricular (LV) diastolic dysfunction and central aortic pressure in patients with hypertension and recurrent atrial fibrillation (AF).Material and methods. The comparative study included 30 men and 37 women with non-valvular AF, hypertension and LV hypertrophy. Conventional echocardiographic measures were extended with LA measures, including its volume in three phases, LAemptying fraction (LAEF), passive and active ejection fraction. The parameters of central aortic pressure were estimated by applanation tonometry method.Results. No difference was observed between LA and LV structural parameters in men and women. However, in women LAEF (39 [28;50] vs 50 [42;55]%; p=0.02) and E/E’(9.7 [7.8;12] vs 7.1 [5.6;8.6]; p=0.001) were worse than in men. Active LA ejection fraction was higher in women (31 [21;42] vs 24 [19;31]%; p=0.04), whereas passive one – in men (12 [10;14] vs 33 [23;38]%; p

Steady increase in worldwide prevalence of hypertension and hypertension-related cardiovascular morbidity and mortality necessitate new approaches to the management of hypertensive patients. It`s important to recognize that despite several differences the convergence of the 2017 ACC/AHA (US) and 2018 ESC/ESH (European) guidelines is greater now than ever before. The present review focuses on the key similarities and differences of these two documents. Among similarities we analyzed positions regarding the importance of cardiovascular risk evaluation for treatment initiation and choice of optimal treatment strategy: blood pressure (BP) treatment thresholds; drugs of choice for the initiation of antihypertensive therapy and treatment targets in different groups including elderly patients. Among key differences we analyzed sections concerning the classification of BP levels and target BP levels in patients with chronic kidney disease. In conclusion, we may say that in many ways the guidelines are just a different interpretation of the same data. There is no doubt in the importance of lowering high BP and evaluation and correction of high cardiovascular risk. One of the main purposes is to focus attention on younger patients with hypertension.

Aim. To study the effects of sacubitril/valsartan on left ventricular-arterial coupling (LVAC) and arterial stiffness in HFrEF patients.Material and methods. Arterial stiffness by applanation tonometry and LVAC – by two-dimensional echocardiography were evaluated in 18 patients with compensated HFrEF (age 69Ѓ}9 years, 89% male, arterial hypertension – 83%, diabetes – 39%, myocardial infarction – 89%, left ventricular ejection fraction 32Ѓ}4%) initially and after 6 and 12 months of therapy based on sacubitril/valsartan. LVAC was calculated as the Ea (arterial elastance)/ Ees (left ventricular elastance) ratio. Differences were considered statistically significant at p10 m/s). The decrease in PWV (from 11.5Ѓ}2.9 to 10.2Ѓ}2.9 m/s, p

Large randomized clinical trials (RCTs) in patients with non-valvular atrial fibrillation (AF) showed that new direct oral anticoagulants (DOACs) were just as effective at preventing stroke and systemic thromboembolic (STE) complications as warfarin, although DOACs were associated with less risk of intracranial bleeding. There was significant increasing number of publications addressed to use of DOACs in real-world setting in recent years. We discussed some of pros and cons for studies used real-world data in the review. Results of real-world studies provided a generally strong support for conclusions of main RCTs. In comparison of different DOACs against each other apixaban demonstrated lower bleeding risk while patients given rivaroxaban appeared to have higher rate of hemorrhagic events. High adherence to apixaban treatment for AF irrespective to additional value educational program suggested that apixaban treatment is easy to follow and well accepted by patients despite of twice-daily dosing regimen. Healthcare cost analyses demonstrated that patients who were prescribed apixaban had lower stroke/STE-related as well as major bleeding-related medical costs.

Aim. To study the anti-inflammatory effects of intensive lipid-lowering therapy and genetic predictors of its effectiveness in patients with very high cardiovascular risk.Material and methods. 58 patients with a history of cardiovascular disease and low-density lipoprotein cholesterol (LDL-C)>1.8 mmol/l or non-highdensity lipoprotein cholesterol (non-HDL-C)>2.6 mmol/l (mean age 61.9±8.6 (M±SD) years, 62.1% of men) were included into the study. Polymorphism Phe189Ser of the CYP3A4 (gene encoding cytochrome P4503A4, CYP3A4*17, rs4987161) and APOA1 (gene encoding apolipoprotein A): -75G/A in the promoter region (rs670) and +83C/T in the 5'-untranslated region (rs5069) was determined in all patients. Inflammatory status (high-sensitivity C-reactive protein (hsCRP), monocyte chemoattractant protein (MCP-1) and soluble vascular adhesion molecule (sVCAM-1)) was assessed initially and after 4 weeks of treatment with atorvastatin 80 mg/day. The results were considered statistically significant at p

Today there is enough data on gender differences in regard to epidemiology, pathogenesis and prognostic value of atrial fibrillation (AF). Left atrial structural and functional changes associated with development and persistence of AF can be more significant for women than for men. Explanation for it can be provided by a higher prevalence of left ventricular diastolic dysfunction in women, which is strongly related with central aortic pressures. Many studies have shown gender differences of central pulse wave contour; however further investigations of their prognostic power and relationship with left atrial remodeling are needed. According to current guidelines for AF management rhythm control is not a superior treatment strategy compared with heart rate control. The subanalysis of RACE study showed that rhythm control in female patients with AF increased significantly the risk of composite endpoints including cardiovascular mortality, heart failure, thromboembolic events, bleedings, severe side effects of antiarrhythmic drugs and the need for a pacemaker implantation. It seems that in some cases rate control approach may be preferable in female patients with recurrent AF. The current management of AF is still suboptimal and one of the ways to increase effectiveness should take into consideration the gender differences of left atrial, left ventricular and arterial interaction. More relevant randomized studies will be required to confirm this hypothesis.

Aim. To study the effect of sacubitril/valsartan compared with valsartan on natriuresis, diuresis, blood pressure (BP) and the level of biomarkers in hypertensive patients.Material and methods. Hypertensive patients (n=16) received sacubitril/valsartan 400 mg QD or valsartan 320 mg QD for 7 days in a double-blind,-randomized, cross-over study. The change in 24-hour diuresis and natriuresis, fractional urinary sodium excretion, and BP level have been studied, as-well as soluble biomarkers: cyclic guanosine monophosphate (cGMP), plasma brain natriuretic peptide (BNP), mid-regional precursor of the atrial natriuretic-peptide (MR-proANP) and the N-terminal precursor of the brain natriuretic peptide (NT-proBNP).Results. The trend toward higher levels of 24-hour natriuresis on Day 1 (21%, p=0.068) was found in the sacubitril/valsartan group compared to-valsartan one. Fractional sodium excretion was significantly higher in the sacubitril/valsartan group on Day 1 after 6 hours (50%, p=0.004) and subsequent-samples up to 12 hours; the maximum effect was achieved 2-4 hours after taking the medication (mean value 2.08, p=0.005). Sacubitril/valsartan-therapy compared with valsartan therapy was associated with a significant increase in 24-hour diuresis on Day 1 (41%, p

The heart is related with vascular system anatomically and functionally. Structural and functional changes in the arterial bed increase afterload on the left ventricle (LV), and can change its function, leading to the restructuring of the LV adaptation. Systolic blood pressure (SBP) in the aorta, directly reflecting the load on the LV, differs significantly from the SBP in the brachial artery due to delaying the occurrence of a reflected wave in the aorta. Left ventricular-arterial interaction is a concept that helps to understand the various options for the «optimal» functioning of the cardiovascular system, the effects of changes in the arterial bed to heart function. Methods of analysis of left ventricular-arterial interaction, clinical consequences of the breach and the effects of antihypertensive therapy are presented in the review; the results of the authors own studies are also presented.

Aim. To investigate the prevalence of cardiorenal interactions, predictors of development, variants of clinical course, and outcomes of acute kidney injury (AKI) in patients with acute decompensation of chronic heart failure (ADCHF).Material and methods. Patients (n=278) with clinical manifestations of ADCHF were included into the study. All patients underwent clinical, laboratory and instrumental investigation. Renal function was assessed using the CKD-EPI formula to calculate glomerular filtration rate (GFR). Hydration was assessed using the bioimpedance analyzer ABC-01 "Medass" (Russia). Chronic kidney disease (CKD) and AKI were diagnosed according to the criteria of the latest Russian and international guidelines. Six phenotypes of AKI were identified: outpatient and hospital acquired, transient and persistent, de novo, and on the background of CKD.Results. CKD was detected in 125 (45%) patients. AKI developed in 121 (43.5%) patients, and in 52.9% of cases was nosocomial, in 53.7% transient and in 52.1% of cases occurred in patients without history of CKD. The risk of in-hospital mortality compared with patients without AKI significantly increased only in patients with nosocomial AKI (14.1 and 3.8%, p

Aim. To study the therapeutic equivalence of original and generic fosinopril in patients with arterial hypertension (HT) of 1-2 degrees, and to evaluate the cost effectiveness of original drug substitution with generic. Material and methods. Patients (n=36) with HT of 1-2 degree aged 41-82 years and disease duration up 3 to 22 years included in an open, crossover , randomized trial. All patients had two courses of treatment: with generic (Fosicard) and the original drug (Monopril); sequence of courses was determined by randomization. Wash-out period (10-14 days) preceded each course. Treatment duration was 6 weeks; drugs were administered QD; initial dose - 10 mg/day. Blood pressure (BP) and heart rate (HR) were evaluated at the end of the wash-out period, and in 2, 4 and 6 weeks of therapy. In case of ineffective BP control (>140/90 mm Hg) hydrochlorothiazide 12.5 mg was added initially and dose fosinopril was increased up to 20 mg/day next. Results. Patients in groups were comparable by basic clinical parameters. Both fosinopril based drugs have comparable antihypertensive effect. Differences between their effect on systolic and diastolic BP as well as HR at all steps of treatment were not significant. The individual analysis revealed a tendency to more pronounced Monopril antihypertensive effect compared with Fosicard, but the differences were not significant. An average dose of Monopril was 11.8±3.9 mg/day , and Fosicard — 13.2±4.7 mg/day (p=0.13); the rate of monotherapy with both drugs of fosinopril at dose of 10 mg/day was similar (in 41% and 44% of patients, respectively); the rate of combined therapies with various composition differed insignificantly. Reduction in BP

Aim. To study the characteristics of renin profile and parameters of central pulse wave and arterial stiffness in patients with previously untreated arterial hypertension (HT). Material and methods. Patients (n=83; 39 males (47%); age 57.3±7.6 years) with untreated uncomplicated 1-2 degree HT without associated clinical conditions and diabetes, with glomerular filtration rate>60 ml/min/1.73m2 were enrolled into the study. Plasma renin activity (PRA), plasma renin level and angiotensin II level were evaluated. The analysis of the central pulse wave, and pulse wave velocity (PWV) measurements were performed.Results. The incidence of volume-dependent HT (PRA Conclusion. The presence of volume-dependent HT is associated with older age, higher level of systolic BP and increase in arterial stiffness independent of age and BP.

Aim. To study the characteristics of renin profile and parameters of central pulse wave and arterial stiffness in patients with previously untreated arterial hypertension (HT). Material and methods. Patients (n=83; 39 males (47%); age 57.3±7.6 years) with untreated uncomplicated 1-2 degree HT without associated clinical conditions and diabetes, with glomerular filtration rate>60 ml/min/1.73m2 were enrolled into the study. Plasma renin activity (PRA), plasma renin level and angiotensin II level were evaluated. The analysis of the central pulse wave, and pulse wave velocity (PWV) measurements were performed.Results. The incidence of volume-dependent HT (PRA

ESC Guidelines for the diagnosis and treatment of heart failure: what is new?

ESC Guidelines for the diagnosis and treatment of heart failure: what is new?