Uskach T.M.,Moscow State University |
Kochetov A.G.,Moscow State University |
Tereschenko S.N.,Russian Cardiology Scientific and Production Center
Cardiovascular Therapy and Prevention (Russian Federation) | Year: 2012
Currently, beta-adrenoblockers (β-AB) are regarded as one of the major medication classes in the treatment of patients with chronic heart failure (CHF). In several international studies, β-AB therapy of CHF patients was associated with reduced levels of haemoglobin (Hb) and development of new anaemia cases. Anaemia is known as an adverse prognostic factor in CHF Aim. To study the effects of β-AB therapy on the anaemia clinical course among CHF patients. Material and methods. The study included 90 ambulatory patients with Functional Class (FC) II-IV CHF and anaemia. The participants were divided into 3 equally sized groups (n=30 per group) and treated with carvedilol, metoprolol, or nebivolol for 6 months. Results. By the end of the follow-up, baseline Hb levels increased in the nebivolol group (p=0,028), and were also significantly higher than in the other two groups. In the carvedilol group, the levels of haematocrit (Ht) and glomerular filtration rate (GFR) significantly decreased (p=0,017 and 0,06, respectively). In the metoprolol group, no substantial changes of laboratory parameters were observed. The maximal reduction in baseline CHF FC was registered in the patients receiving nebivolol (p=0,037). A significant improvement in myocardial contractility, based on the echocardiography data, was registered in the carvedilol and nebivolol groups. Conclusion. Nebivolol therapy was associated with a significantly more pronounced reduction in pro-BNP levels, compared to carvedilol or metoprolol treatment (p<0,001). The nebivolol group also demonstrated the most pronounced improvement in quality of life of CHF patients (p<0,001). These findings suggest that nebivolol could be recommended as a medication of choice in patients with CHF and anaemia.
Kuzmin V.S.,Russian Cardiology Scientific and Production Center |
Rosenshtraukh L.V.,Russian Cardiology Scientific and Production Center
Kardiologiya | Year: 2010
In this review we discuss mechanisms of antiarrhythmic and adverse proarrhythmic action of class III drugs. Special attention is given to ionic currents and channels which determine specific features of their effects (1 Kr' 1Ka' 1Kur). We consider general patterns of changes of bioelectrical activity in atria and ventricles leading to development of arrhythmias or stabilization of rhythm. We also discuss value of QT-interval as predictor of torsade de pointes. Perspectives and limitations of development of novel class III antiarrhythmic drugs are discussed as well. We present consideration of efficacy and mechanisms of action of such compounds as dronedarone and vernacalant suggested for termination of atrial fibrillation and maintenance of sinus rhythm. Special attention is given to RG-2 - a novel compound with class III activity.
Dergilev K.V.,Russian Cardiology Scientific and Production Center |
Rubina K.A.,Russian Cardiology Scientific and Production Center |
Parfenova E.V.,Russian Cardiology Scientific and Production Center
Kardiologiya | Year: 2011
The search for sources of stem/progenitor cells the use of which has a potential to affect course of ischemic heart disease and chronic heart failure is conducted nowadays in many countries. Resident cardiac stem cells (CSC) were revealed during recent years on the basis of expression of c-kit, sca-1, MDR1, and islet-1 markers. In vitro experiments demonstrated possibility of their differentiation into cardiomyocytes, smooth muscle cell and endothelial cells. Introduction of CSC in injured myocardium in animals facilitated its partial repair and short term improvement of cardiac function. This holds promise for the use of these cells in the future. In the review we have attempted to summarize literature data on resident CSC and their application for the treatment of heart diseases. Key words: cardiac stem cells; c-kit cells; sca-1 cells; side population cells; islet-1 cells; cardiospheres.
Shakhmatova O.O.,Russian Cardiology Scientific and Production Center |
Komarov A.L.,Russian Cardiology Scientific and Production Center |
Panchenko E.P.,Russian Cardiology Scientific and Production Center
Kardiologiya | Year: 2010
Classical risk factors of development of cardiovascular diseases does not allow to detect all persons needing active prevention. Because of this reason great attention is given to novel biomarkers one of which is homocysteine. Most widely-spread causes of elevation of homocysteine level are such factors as deficit of folic acid and B6 and B12 vitamins, as well as genetic peculiarities. Main damaging effect of homocysteine is activation of atherothrombosis. Therapy with folic acid causes significant lowering of homocysteine level. Effect of therapy with vitamins on the risk of development of cardiovascular diseases has been assessed both in observational epidemiological studies and large prospective randomized trials. Their results are controversial. The present review is devoted to the analysis of these trials.
Khayutini V.M.,Russian Cardiology Scientific and Production Center |
Lukoshkova E.V.,Russian Cardiology Scientific and Production Center |
Ermishkin V.V.,Russian Cardiology Scientific and Production Center |
Sonina R.S.,Russian Cardiology Scientific and Production Center
Kardiologiya | Year: 2010
History of development of the method of measurement of duration of the preelection (DPE) period - characteristic of left ventricular (LV) contractility is presented. On the basis of physiological prerequisites a novel computerized method of DPE measurement in each consecutive cardiocycle has been created. Distinct features of this method are: 1) principle of measurement - tetrapolar impedancemetry, with signal electrodes located along projection of the ascending aorta, one in the center of presternum, second - 5 cm caudally; 2) starting point for DPE counting - the point on ascending portion of R-wave of electrocardiogram at which the first derivative of ECG signal reaches maximum, stopping point - the point of maximum of the second derivative of the primary impedance signal on the ascending front of its pulse wave. The method has been tested on healthy people for 10 functional tests. The results are presented characterizing dynamic peculiarities of changes of LV contractility during veloergometer exercise test with staderly increasing work load and reflecting development of positive inotropic action of sympathetic nervous system. Special characteristics of this action: small concealed period, preservation of achieved elevated level during lowering of work load (before its switching off) and subsequent slow (compared with chronotropic effect) diminution, as well as turning on at low loads.