Хроническая сердечная недостаточность широко распространена как при сердечной, так и при экстракардиальной пато-логии. Нами проведен ряд исследований, продемонстрировавших высокую эффективность и безопасность применения мельдония у больных с сердечной недостаточностью в условиях коморбидности. Выявлена способность мельдония сни-жать выраженность сердечной недостаточности, улучшать качество жизни пациентов, оказывать благоприятное влияние на липидный и углеводный обмен, функциональное состояние почек у больных с сопутствующим сахарным диабетом. Отмечено позитивное влияние мельдония на вегетативные проявления автономной кардиальной нейропатии и течение диабетической периферической сенсомоторной нейропатии. Кроме того, применение мельдония у больных с артериаль-ной гипертензией оказывает положительное влияние на когнитивный статус. POLETAYEVA, PhD in Medicine, Volgograd State Medical University THE EFFICACY OF MELDONIUM IN PATIENTS WITH CHRONIC HEART FAILURE OF ISCHEMIC ETIOLOGY WITH COMORBIDITIESНeart failure is common both in cardiac and noncardiac disease. We conducted a study that showed high efficacy and safety of meldonium in patients with heart failure and comorbidity. The ability of meldonium reduce the severity of heart failure, improve the quality of life of patients, have a beneficial effect on lipid and carbohydrate metabolism, renal function in patients with concomitant diabetes mellitus. Marked positive impact on meldonium autonomic manifestations of cardiac autonomic neuropathy and for diabetic peripheral sensorimotor neuropathy. In addition, meldonium use in patients with hypertension has a positive effect on cognitive status. Мeldonium reduces the degree of heart failure, improves the quality of life, lipid and carbohydrate metabolism, renal function, manifestation of autonomic cardiac neuropathy and for diabetic peripheral sensorimotor neuropathy in patients with concomitant diabetes mellitus, Application meldonium in patients with hypertension have a positive impact on cognitive status.
Background and aims: to identify heart rate variability (HRV) and blood pressure (BP) in patients with type 1 diabetes depending on the duration of disease and glycemic control.Materials and methods: 43 patients were examined. All patients were divided into 2 groups according to the level of НвА1с: group 1 (n=21) with НвА1с ≤ 7.5% and group 2 (n=22) with НвА1с > of 7.5%. All patients underwent daily monitoring of electrocardiogram Holter and ambulatory BP monitoring within 24 hours in parallel with long term monitoring of blood glucose.Results: Hyppoglycemia is characterized by significant decrease root mean square difference between adjacent RR intervals (RMSSD) (r = −0.531; p = 0.003) and number of consecutive RR intervals, the difference between them is more than 50 ms expressed as a percentage of total number of RR-intervals (pNN50%) (r = the −0.503; p = 0.005) and increase of Low Frequency/High Frequency Ratio (LF/HF) (r = 0552; p = 0.002). Patients with hypoglycemia had significantly higher daily diastolic pressure area index (DPAI24) (p = 0.016), and daily diastolic pressure time index DPTI24 (p = 0.025).Conclusion: our findings demonstrate the need to reduce the frequency of hypoglycemia episodes in patients with T1DM.
The review represents evaluation of the ectopic fatty depots effect on the development of cardiovascular diseases (CVD) in patients with nonalcoholic fatty liver disease (NAFLD). Nowadays, NAFLD is the most common cause of chronic liver disease in most countries of the world. A number of studies have confirmed the important role of NAFLD in the formation and progression of CVD, which is manifested by an increased risk of cardiovascular events in patients with NAFLD according to Framingham Risk Score. The statement that NAFLD should be recognized as an independent risk factor for CVD, in addition to other metabolic disorders, is often confirmed. One of the possible mechanisms of interrelation between NAFLD and CVD is the paracrine activity of visceral adipose tissue; the possibility of local effects of various ectopic depots of visceral fat is being discussed. There is no doubt that epicardial adipose tissue plays an important role in the formation of the hepato-cardiac continuum. Тhere are more and more studies evaluating the effect of other ectopic depots on the development of CVD in patients with NAFLD. The article provides an analysis of publications devoted to the interrelation between fatty ectopic depots and CVD risks in patients with NAFLD. MedLine and PubMed databases in English and Russian languages were used for the search. The review includes articles published from 2000 to 2020.
Purpose: to evaluate the efficacy and safety of the use of rebamipide (Rebamipide-SZ, Severnaya Zvezda NAO) during 8-week therapy in patients with functional dyspepsia (FD) and/or irritable bowel syndrome (IBS). Materials and methods: 60 patients of both sexes aged 18 to 40 years with confirmed FD and/or IBS were examined. All patients received basic therapy for functional gastrointestinal disease. Patients of the main group were additionally prescribed rebamipide 100 mg 3 times a day. All patients were tested according to the 7x7 questionnaire to assess the severity of FD and IBS symptoms; the severity of anxiety and depression symptoms was assessed according to the Hospital Anxiety and Depression Scale (HADS); the level of zonulin in blood was determined by the ELISA method at baseline and after 8 weeks of therapy. Results: in the main group of patients, taking rebamipide led to a more pronounced decrease in the average score on the scales of the 7x7 questionnaire, such as feeling full (0 [0; 0] points vs 1 [1; 1] points, p=0.000), early satiety (0 [0; 0] points vs 0.5 [0; 1] points, p=0.005), bloating (0 [0; 2] points vs 2 [2; 2] points, p=0.001). Only patients of the main group showed a significant decrease in blood zonulin levels both in the FD subgroup (Δ%= -49%) and in the FD+IBS subgroup (Δ%= -20.85%). Conclusions: the use of rebamipide at the dose of 100 mg 3 times a day for 8 weeks as part of the basic therapy of patients with functional dyspepsia and/ord irritable bowel syndrome leads to a statistically significant improvement in the clinical condition of patients and a significant decrease in the level of zonulin in blood serum.
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