A significant number of studies on chronic heart failure (CHF) are published worldwide. However, the issue of uniform criteria and approaches to accounting for ambulatory care and mortality associated with this pathology in patient accounting systems has remained resolved, meaning the data and indicators obtained in different regions and countries are not comparable. The aim of the article is to substantiate the need for discussion in the Russian Society of Cardiology on the possibility, principles and methodology of uniform accounting of ambulatory care, hospitalizations and deaths associated with chronic heart failure in healthcare using the classifications of heart failure applied in clinical practice.

Highlights. The results of primary prevention of atrial fibrillation by using antiarrhythmic drug therapy and modulated kinesitherapy in patients with metabolic syndrome with premature atrial complexes are presented.

A significant decrease in the development of the disease was revealed in patients with metabolic syndrome and risk of atrial fibrillation within a year after the examination with the help of pharmacological antiarrhythmic therapy of atrial ectopia and modulated kinesotherapy as primary prevention in comparison with therapy aimed at correcting blood pressure, glucose and blood lipids.

Aim. To assess the possibility of using antiarrhythmic drug therapy (DT) and modulated kinesitherapy (MK)  in patients with metabolic syndrome (MS) and premature atrial complexes (PAC) as the primary prevention of atrial fibrillation (AF).

Methods. 426 MS patients with PAC aged from 58 to 72 years (mean 66.4±0.7 years) were included in the study. All patients had a high probability of developing primary AF within 1 year after the enrollment. Antiarrhythmic DT with class I–III  drugs was used as the primary prophylaxis of AF in 149 (34.97%) patients, MK  – in 121 (28.40%), the correction of blood pressure, glucose and blood lipids – in 156 (36.63%). All patients were followed up for one year and the end point of observation was the maintenance of sinus rhythm or AF registration.

Results. Various clinical forms of AF were recorded in 26.45, 31.54% and 95.51% of patients with MS during primary prevention with the help of pharmacological AAT, UA and correction of its potentially modifiable components (arterial pressure, glucose and blood lipids), respectively, during the year after the examination.

Conclusion. The use of both antiarrhythmic DT of I–III classes, and MК as a primary prophylaxis of AF in patients with MS with PAC and the risk of AF development within one year after the first examination made it possible to reduce the frequency of the arrhythmia by the correction of blood pressure, glucose and blood lipids.

Highlights. The leading factor of ineffective arterial hypertension (AH) control in the population taking medications was the number of metabolic risk factors (RF). In addition, in men, the odds of reaching the blood pressure targets were lower if there was a history of kidney disease and bronchitis, and higher, if statins and hypotensive drugs were taken together, respectively. In women, heart rate equal or higher than 75 beats/min and total carotid atherosclerotic plaque thickness were associated with lower and a visit to a physician in the past year - with higher odds of effective hypertension control, respectively.

Aim. Analysis of factors associated with reaching blood pressure targets in hypertensive population taking medications.

Methods. We examined men and women of 25-64 y.o., randomly drawn from general population, having hypertension and receiving medications. All participants underwent standardized cardiac screening, including a survey on a number of socio-demographic, psychosocial, behavioral variables, traditional and metabolic cardiovascular risk factors, life quality. We measured anthropometric and blood pressure variables, "intima-media" thickness, presence and total thickness of carotid atherosclerotic plaques. Analysis included data from 480 respondents. Parametric and nonparametric statistics were used. To analyze relationships, multivariable logistic regression was used. An error probability <5% was considered statistically significant.

Results. After adjustment for age, wealth level, cardio-vascular deseases and the number of antihypertensive drugs, the following factors increased the chances of effective treatment for hypertension in men - statins, positive answer to the question “Do you feel pain or discomfort?” on the EQ5D scale. Lower odds for detecting target blood pressure levels were associated to the count of metabolic syndrome components according to IDF criteria except arterial hypertension (0-4), kidney disease, previous bronchitis, age. A direct association with the effectiveness of treatment for hypertension in women was shown by a visit to the doctor during the past year, and the opposite - the number of metabolic syndrome components, heart rate ≥75 per minute and the total thickness of carotid atherosclerotic plaques, respectively.

Conclusion. Lack of hypertension control was associated to metabolic risk factors count, age, kidney disease, heart rate ≥75 per minute, previous bronchitis, lack of visit to a doctor over the past year, as well as total thickness of carotid atherosclerotic plaques. The situation can be improved by deliberately losing weight, taking statins by all people at very high and high risk, and seeing a doctor regularly. It is necessary to further study the factors that hinder achievement of blood pressure targets, as well as methods aimed at the prevention and effective correction of metabolic disorders.

Highlights. The article revealed that severe (more than 50%) carotid artery (CA) stenosis was associated with significant slowdown of the information selection processes, and these patients were characterized by older age and tendency to an increase in trait anxiety compared to the patients without CA stenosis.

It was found that the reduced attention and memory was a typical feature of the cognitive status in patients with severe CA stenosis in the early postoperative period of cardiac surgery in comparison with the patients without CA stenosis. At the same time the speed characteristics indicators of the information selection processes in these patients are positively related to state anxiety.

Aim. The cardiac surgery patients were studied in order to analyze the postoperative changes in the efficiency of selection information and memory processes depending on the degree of carotid artery (CA) stenosis (including more than 50%) and the age and the role of the trait anxiety indicator assessed before surgery.

Methods. The prospective study included 229 patients undergoing elected coronary artery bypass grafting (CABG) or CABG and carotid endarterectomy (CEE). Each study participant underwent clinical, instrumental and extended psychometric examination before cardiac surgery and at 7-10 days after surgery. The evaluation of the extracranial vessels state was carried out before surgery using color duplex scanning. Based on the results of assessing the extracranial vessels state, all patients were divided into three groups: no stenosis (n = 124), CA stenosis less than 50% (n = 69) and more than 50% (n = 36).

Results. It was found out that the patients with CA stenoses more than 50% are characterized by a slower reaction under different conditions of visual stimuli selection and by an older age as compared with patients with no stenoses as well as patients with stenoses less than 50%. In the postoperative period of cardiac surgery in comparison with testing before surgery there was an improvement in the information selection stability (an increase in the number of processed symbols per 4 minute of the Bourdon's test (p<0.00006)) and short-term memory (p = 0.03) only in the group of patients without stenoses. The patients with stenoses of less than 50% had an increase the of the information selection stability but the short-term memory decrease (p<0.05) whereas the group with stenoses more than 50% had a decrease in both the stability of information selection and short-term memory (p<0,05). Additional factors of cognitive deficit in CA stenosis patients were trait anxiety associated with memory impairment and a history of stroke that related to a decrease in the effectiveness of a complex visual-motor reaction.

Conclusion. The comprehensive analysis of the cognitive status of cardiac surgery patients with different severity of CA stenosis showed that an increase in the age and stenosis degree is the factor of the reaction time slowdown under different conditions of information selection. To differentiate groups of patients depending on the severity of stenosis in the postoperative period the testing short-term memory and stability of attention is informative. These indicators improve in the group without stenosis but decrease in the group with pronounced stenosis. The trait anxiety and the history of stroke were the additional factors of memory impairment due to CA stenosis.

Highlights. A population-based study of a representative sample of Siberian adolescents revealed for the first time quantitative changes in memory and attention patterns associated with smoking, depending on gender. At the time of the survey of adolescents, the average number of mistakes made in the test with memorization of 10 words was higher in comparison with non-smokers.

Background. The literature data on the association of cognitive impairment with smoking status, which is a conventional risk factor for cardiovascular diseases, in adolescence in an open population remains controversial.

Aim. To examine the effect of smoking on certain cognitive functions indicators in adolescents in the open population of the Novosibirsk region.

Methods. Cognitive functions were studied in 549 adolescents (231 boys (42.1%) and 318 girls (57.9%), mean age - 15.66±0.9 years). The smoking questionnaire in this group was completed by 332 participants. Cognitive functions were assessed using a proofreading test, a Luria test with memorization of 10 words, and a concept exclusion test. Smoking was assessed based on a questionnaire survey. An adolescent, who smoked at least 1 cigarette per week was considered a regular smoker. Descriptive statistics methods and analysis of contingency tables were performed in the statistical package “R” for Windows.

Results. Among adolescents who smoked at the time of the examination (n = 67), the average number of mistakes in the test with memorization of 10 words was higher (2.21±1.04 words), compared with 1.88±1.05 words in the non-smoking group (n = 265). At the same time, there were no statistically significant differences in this cognitive indicator between male smokers and nonsmokers, while differences between female smokers and nonsmokers remained.

Conclusion. In adolescents who smoke, direct memorization of the presented stimulus material is predominantly affected. This is due to the worst assimilation of educational materials by adolescent smokers.

Highlights. For the first time, mapping models of morbidity and mortality from the blood circulation system diseases for assessing the performance of the health protection system in federal districts of the Russian Federation were proposed. The method makes it possible to identify low-quality health systems, and outsider regions, where it is necessary to develop measures in order to identify modifiable and non-modifiable risk factors and improve the performance of health care system both in federal districts and in the Russian Federation as a whole.

Aim. To develop mapping models of morbidity and mortality from the blood circulation system diseases (BCSD) and to propose indices for assessing the performance of the health care system in different federal districts of Russia over a 10-year period (from 2010 to 2019).

Methods. Reporting forms of federal statistical observation in the field of public health were used.

Results. The incidence of BCSD among the population of the Russian Federation has been steadily increasing over the past two decades, increasing 2.047-fold from 2000 to 2019, while the mortality rate of the Russian population decreased 2.073-fold over the same period. Mapping models of morbidity and mortality from BCSD have been developed and indices for assessing the performance of the health protection system in different federal districts of Russia over a 10-year period (from 2010 to 2019) have been proposed.

Conclusion. The mapping of low and ultra-low incidence rates of BCSD combined with high and ultra-high mortality rates from BSC among the population of the federal districts indicates low detection rates and low performance of the primary health care system in detecting BSC among the population assigned to receive primary health care according to the territorial principle. The correlation of indicators of general morbidity and mortality from HIPC in relation to health care resources allows timely assessment and finding resources in those areas that contribute to the maximum efficiency of medical organizations at minimum cost.

Highlights. Patient education program developed for patients with prosthetic heart valves, which includes information on the anticoagulant therapy, prevention of prosthetic valve endocarditis, and physical and psychological rehabilitation, helps to improve adherence to treatment and quality of life immediately upon completion of training (6 months). The quality of life and adherence to treatment were higher at 10-year follow-up in patients undergoing full course of training, in inpatient and outpatient settings, compared with patients undergoing training in inpatient setting only.

Aim. To evaluate the efficacy of the training program for patients with prosthetic heart valves in improving treatment adherence and quality of life at 10-year follow-up.

Methods. Patient education program entitled “School for patients with prosthetic heart valves” was developed and implemented at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo) in 2010. The program provides knowledge and training regarding anticoagulant therapy, prevention of prosthetic valve endocarditis, physical and psychological rehabilitation. The training group consisted of 92 patients who completed a full course of training (6 months). The control group included 56 patients who completed training in inpatient setting only. Long-term efficacy of the developed education program was assessed at 10-year follow-up via evaluation of the indicators of adherence to treatment (questionnaire for determining the integral indicator of adherence to treatment (IIAT)) and the quality of life (using Short-Form 36-item questionnaire (SF-36)).

Results. Initially, data analysis showed no statistically significant differences between the groups in the quality of life and adherence to treatment. Six months later the IIAT score in the training group (full course of training) was 9.15±1.16, in controls the score was 6.20±1.05 (р = 0.0001). Highest IIAT scores in the training group remained similar (8.10±1.20 points) at 10-year follow-up, in the control group it was lower - 5.19±1.09 (р = 0.0001). After 6 months, physical component summary score increased by 24% over baseline in controls (р = 0.0001) and by 25% in the training group (р = 0.0001). After 6-month follow-up, there was an improvement in the psychological component summary score by 14.5% (р = 0.0001) in the control group and by 42.8% in the training group (р = 0.0001). 10 years after completion of training, physical component and mental component summary scores were higher in patients undergoing full training course - 8.3% (р = 0.0001) and 14.3% (р = 0.0001), respectively.

Conclusion. Patient education program “School for patients with prosthetic heart valves” via full course of training increases levels of adherence to treatment and quality of life mainly due to improvement of psychological component summary score in the early period (6 months) and at 10-year follow-up.

Highlights. The article presents relevant literary data on the epidemiology, main causes, approaches to the diagnostics and treatment of type 2 myocardial infarction patients. The authors emphasize an unfavorable prognosis in these patients due to comorbidity that leads to development of myocardial infarction. They highlight the need to improve and unify approaches to identifying this phenomenon, as well as the necessity to conduct observational and randomized studies to evaluate approaches to the treatment of type 2 myocardial infarction patients.

Abstract. The article summarizes the available data from clinical trials and current guidelines, approaches to the definition and type 2 myocardial infarction (MI) differential diagnosis in clinical practice. The attention is focused on the fundamental difference between type 1 and type 2 MI and the need to consider the comorbidities for the identification of etiological factors type 2 MI development. The lack of evidencebased medical data regarding the prognosis and effective treatment of patients with type 2 MI is emphasized. Nevertheless, such patients are characterized with high rates of overall and cardiovascular mortality in hospital and long-term disease course, as well as a high rate of readmission. Thus, there is the need for multicenter observational studies of type 2 MI patients and the development of algorithms for treatment and rehabilitation of this category of patients.

Highlights. The data regarding the relationship between obstructive sleep apnea syndrome and atrial fibrillation were analyzed.

Abstract. The review article presents current data on the relationship between obstructive sleep apnea syndrome and atrial fibrillation. The spread of these pathological processes increases with age and is associated with a significant risk of cardiovascular complications. In this regard, this review seems to be quite relevant. Possible pathophysiological mechanisms influencing the relationship between obstructive sleep apnea syndrome and atrial fibrillation are discussed. The role of CPAP therapy - Continuous Positive Airway Pressure in the prevention and treatment of atrial fibrillation is highlighted.

Highlights. The article analyzes the current evidence base for anticoagulant and antiplatelet therapy in patients with atrial fibrillation undergoing percutaneous coronary interventions, and future perspectives of such therapy.

Abstract. A number of patients undergoing percutaneous coronary intervention may require intensification of antithrombotic therapy. These include patients with atrial fibrillation. The difficulty of treatment of this group of patients consists in the achievement of a certain level of hypocoagulation, which will be sufficient for the prevention of acute ischemic events, mainly associated with the implanted coronary stent, but will not lead to the clinically relevant bleeding. Achieving this balance requires a careful and personalized approach to prescribing a variety of combination (antiplatelet and anticoagulant) therapy regimens. The article provides an overview of modern antithrombotic therapy regimens in this group of patients, their evidence base and promising directions for improving such therapy.

Each year about 400 000 people in Russia get strokes. Whereas an acute treatment takes place in specialized intensive care units in hospitals, follow-up is handed over to general (rarely – private) practitioner. The majority of stroke survivors show low adherence to follow-up resulting in repeated hospitalizations and growth of multi-morbidity burden. With COVID-19 pandemic negatively affecting availability of medical services and increasing health risks for stroke survivors, a physician-patient relation becomes the means of persuading patients to healthpromoting behaviour.

Highlights. The review summarizes the latest achievements in the field of remote patient monitoring, highlights the main advantages and limitations of modern methods of remote monitoring and rehabilitation of patients with cardiovascular diseases.

Abstract. Devices for remote health monitoring and rehabilitation that use modern telemedicine technologies are becoming more and more widespread in cardiovascular disease management. Modern technologies are affordable and reliable assistants for healthcare professionals, they assist in monitoring patients “at home”, early detection of adverse events, and timely notification of the need for medical help. The review summarizes the latest achievements in the field of remote patient monitoring for ambulatory management, diagnostics, dynamic monitoring, and cardiac rehabilitation of patients with cardiovascular diseases. The main advantages and limitations of remote patient monitoring technologies are presented, and methods for the implementation of these technologies are discussed.

Highlights. The review synthesizes the results of clinical studies on the use of sartans. This topic is highly relevant due to the antihypertensive, metabolic and organ-protective effect of sartans, which can positively affect the course of coronary atherosclerosis.

Abstract. Angiotensin II receptor blockers (sartans) are widely used to treat cardiovascular diseases. This class of drugs has antihypertensive and metabolic effects and organ-protective capabilities. Currently, sartans are of high interest due to their pleiotropic effect: improved lipid metabolism, antidiabetogenic action, nephroprotection, and, as a result, reduced total cardiovascular risk. The article presents an overview of clinical data on the use of sartans in patients with ischemic heart disease, the mechanisms of organ-protective effects and prospects of using this class of drugs for total cardiovascular risk reduction. The following data sources were used: e-Library, ClinicalTrials.gov, PubMed, trialbulletin.com, smartpatients.com, BioPortfolio.com.

Highlights. The described clinical case of surgical treatment of congenital anomaly of the aortic arch is of high interest to specialists due to the relatively late manifestation of symptoms, low incidence of the anomaly, prior surgical treatment of congenital heart disease in medical history, and characteristics of surgical intervention.

Background. The described clinical case reports successful treatment of vascular ring formed by right aortic arch with aberrant left subclavian artery. The described clinical case of surgical treatment of congenital anomaly of the aortic arch is of high interest to specialists due to the relatively late manifestation of symptoms, low incidence of the anomaly in the population, prior surgical treatment of congenital heart disease in medical history, and the outcome of surgical treatment - newly formed left aortic arch.