Correction of autonomous nervous status by VNS attenuated HR and improved functional state of the heart in CAD patients. Cardiotropic effect of VNS was the most pronounced in patients with preserved endogenous stress-limiting systems associated with hsp60 and/or hsp70.

Aim.To investigate the difference in characteristics of patients admitted to the Tomsk National Research Medical Center with a diagnosis of heart failure (HF) in 2002 and 2016.Methods. Medical charts of all patients hospitalised in a single centre, with a diagnosis of HF, were included. Two three‑month periods were compared from January 2002 (n=210) and January 2016 (n=378).Results.Fewer patients with HF had symptoms or required diuretics in 2016 (63 % vs 98,6 %, p<0.001). During this period the percentage of patients with HFpEF increased from 58.6 % to 74.1 % (p=0.001) whereas those with HFrEF remained similar (19.5 % vs 14.0 %, p=0.1) and those with HFmrEF declined (21.9 % vs 11,9 %, p=0.007). In patients with HFrEF the prescription of ACEi / ARB remained similar (80.4 vs 88 %, p=0.3), beta‑blockers increased from 68 to 85 % (p=0.03) and aldosterone antagonists from 9.7 to 49 % (p<0.001).Conclusion.Prescription rates for prognostic medications in HFrEF improved in 2016. The substantial percentage of patients diagnosed with HFpEF without symptoms or diuretic raises the question of whether a diagnosis of HF was appropriate in some cases.

Aim. Identification of clinical, anamnestic, etiological, echocardiographic features of chronic heartfailure with an intermediate ejection fraction of the left ventricle among patients hospitalized in the cardiology hospital. Material and methods. Analyzed 423 hospitalization. The diagnosis of CHF was present 378patients (89,6%), the median age was 62 [56; 69]. All patients underwent six-minute walk test, followed by determination of the functional class of heart failure, ultrasound of the heart. Results. In the group of patients Cnppv met significantly less complaints of shortness of breath and weakness, in comparison with patients suffering from Snfu and Ssfv (p<0.05). The severity of violations of the functional state ofpatients with CHF was progressively increased by reducing the levels of LVEF less than 40%. The vast majority of the reason for the development of CHF was a combination of coronary heart disease and arterial hypertension found in 82% of cases in the total cohort. In isolation, these diseases were the cause of heart failure in 3% (coronary heart disease) and 3.4% (arterial hypertension) patients. Conclusion. The incidence of heart failure with an intermediate ejection fraction of the left ventricle among patients with CHF, hospitalized in the cardiology hospital, was 12%. Patients Cnppv had removed the clinical symptoms, despite significant pathological changes in echocardiographic parameters. In addition, the development of Snpf in 93% of cases on a background of myocardial infarction significantly aggravates the prognosis of life ofpatients suffering this pathology.

Aim. To study how to change the portrait of the patient with acute myocardial infarction (AMI) for a 30-year period in the global aging of the population, and conduct a comparative assessment of the main epidemiological indicators of AMI over the period of time. Material and methods. The study included patients with AMI registered in the database «Register of acute myocardial infarction» in 1986 (593 cases) and 2015 (729 cases), respectively. Statistical processing of the results was performed using the statistical program Statistica V10.0. Results. Over a 30-year period, the proportion of elderly patients increased by 13.4% (p<0.001). Among men younger than 60 years decreased morbidity, mortality, and hospital mortality from AMI. In persons 60 years and older reduced the incidence of first AMI, however, the incidence of re-AMI and morbidity and mortality has not decreased. Often the AMI was to develop on the background of comorbidities (p<0.001). A marked increase in the number of atypical forms of the disease from 11.6% in 1986 to 33.2% in 2015 (p<0.001), mostly among patients of older age groups. Elderly patients are often hospitalized in non-core hospitals (7.7% in 1986 compared to 13.6% - in 2015; p<0.001). There was an increased incidence of acute left ventricular failure, cardiogenic shock, arrhythmias (p<0.001). Conclusions. Thus, the significant increase ofpatients' age at the time of development of AMI in 2015, compared with 1986, is a reflection of the process of demographic aging of the population, and inevitably leads to the accumulation of comorbid pathology, weighting demographic status of patients, the clinical picture of the disease and causes to significant difficulty in providing effective specialized medical care to patients.

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High mortality from cardiovascular diseases (CVD) requires improved approaches to the treatment of this socially significant pathology. Wide implementation of surgical myocardial revascularization makes it possible to improve significantly both life quality and expectancy in patients with coronary heart disease. The aim of this work was to analyze the literature on the impact of preoperative, operative and postoperative factors on the long-term prognosis after coronary artery bypass grafting (CABG). The review refers to both recent and earlier informative works. The target groups for this article are therapists, cardiologists, rehabilitologists, who work with patients in the short and long term after CABG. Data of Russian and foreign literature show that the long-term prognosis after CABG is largely determined by preoperative factors, in particular – age, set of cardiovascular risk factors (RF) and comorbidity, specifically – severity of coronary and systemic atherosclerosis, incident cardiovascular complications, structural and functional state of the heart. In the aggregate these factors reflect the cumulative effect and further potential of actual cardiovascular RFs, affect longterm risk of adverse events, and determine the therapeutic targets of secondary prevention. Priority of arterial conduits and completeness of revascularization are the main operative factors that determine the course of the long-term period after CABG. Among the postoperative factors, the efficiency of secondary CVD prevention is of paramount importance, in particular – achievement of target RF levels, compensation of cardiac and extracardiac pathology, adherence to the long-term medical therapy, known to improve outcomes based on specific comorbidity. Efficiency of secondary CVD prevention largely depends on patient's health attitudes, the key influence on which beyond attending physician can be provided by participation in rehabilitation programs, teaching patients the meaning and essentials of lifestyle modification and cardiovascular RFs’ control.