Aim.to evaluate the effectiveness of cardiac contractility modulation (MSS) in patients with chronic heart failure (CHF) and atrial fibrillation (AF).
Materials and methods.The following studies were performed in 40 patients with CHF and AF before implantation of the MSS device and after 2 and 6 months of follow-up: 12-channel ECG, transthoracic EchoCG, 6-minute walk test, determination of the level of Pro-natriuretic N-terminal peptide (NT-proBNP), daily ECG monitoring, and a questionnaire based on the Minnesota quality of life questionnaire for patients with CHF (MHFLQ). All patients received long-term optimal drug therapy for CHF before surgery.
Results.The results obtained indicate a statistically significant positive effect of the use of MSS in patients with CHF and AF on LV FV, the functional class of CHF, and levels of NT-proBNP regardless of the etiology of CHF.
Conclusion.The use of MSS may be promising for the treatment of heart failure in patients with CHF and AF.
In recent decades cardiovascular (CVD) and COPD diseases are widespread around the world, leading to a high prevalence of patients with comorbidity, especially arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) and/or bronchial asthma (BA). The growing number of patients with this comorbidity is due to increased hypertension, COPD, and asthma comorbidities, with the increase of the geriatric population of patients with these pathologies. Epidemiological studies have shown that the deterioration of lung function is as strong a predictor of cardiovascular mortality, as well as major cardiovascular risk factors. However, spirometry in patients with CVD is carried out infrequently. Inadequate spirometric diagnostics of COPD and asthma, especially in patients with cardiovascular disease, affects the clinical course of both diseases, leading to inappropriate treatment and poor prognosis for the patient. The need for extensive screening spirometry in all patients with CVD is not proven. Thera are no spirometry reference values in patients with CVD, which makes it almost impossible to use these parameters in stratification of CV risk. This dictates the need for further research to clarify the relationship between the severity and characteristics of the various CVD and spirometric parameters.
Objective: to examine the characteristics of the regulation mechanisms of the cardiovascular system under the influence of climatic factors of the patients with arterial hypertension (AH) without comorbidity compared to the patients with AH and associated pathology (chronic obstructive pulmonary disease and/or bronchial asthma).Conclusion: during the spring of 2012 – winter of 2013 abnormal summer heat and abnormally low temperatures in winter in the central region of Russian Federation were not observed. Against this background, patients with AH, including with BOD did not have any significant changes of BP and HR in summer compared to those in spring. The increase of the daily average temperature in summer was followed by a significant increase of ventricular extrasystoles. In assessing of the endothelial dysfunction it was proved that it showed a significant deterioration due to hot weather. The best estimation of general health state was noted in winter period according to the VAS. The spirometric parameters of the patients with AH and BOD were significantly better at this time of the year.
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