On the basis of a survey of 151 patients, diagnostic criteria for an unfavorable prognosis of mitral valve prolapse were revealed according to echocardiography. Transthoracic and transesophageal echocardiography, daily Holter ECG monitoring were performed. Repeated echocardiography was performed in 12-18 months. Statistical analysis of the material allowed us to identify criteria for poor prognosis of mitral valve prolapse according to echocardiography: severe mitral regurgitation, mitral valve leaflet thickness in diastole 6 mm or more, dilatation of the left ventricular cavity, dilatation of the left atrial cavity, dilatation of the mitral ring.
Arterial hypertension (AH) is one of the most common diseases. Despite numerous studies, many problems related to this pathology remain to be elucidated. The modern classifications of AHare contradictory and true causes of elevated blood pressure (BP) are unknown. There are no methods for diagnostics of early stages of AH nor is there adequateunderstanding of what hypertensive crises are, how they are to be classified and why they develop. Pathomorphosis of AH is practically unexplored. There are no efficient medications and therapies for the radical treatment of AH. The authors propose classification of hypertensive crisis, hypertensive disease, and symptomatic AH. It is recommended to use 24-hour blood pressure monitoring in all AH patients. New approaches to diagnostics of early stages of AH are proposed.
Одной из главных научно-практических школ по подготовке специалистов терапевтического профиля для военноморского флота является кафедра военно-морской терапии Военно-медицинской академии им. С.М. Кирова, которая в 2020 г. отмечает своей 80-летний юбилей. Прародительницей кафедры стала Обуховская городская больница, основанная в 1779 г. в. Санкт-Петербурге. С именем Обуховской больницы связаны многие видные деятели отечественной медицины, ставшие широко известными как в России, так и за ее пределами. В 1931 г. на базе Обуховской больницы был организован 3-й Ленинградский медицинский институт, который в 1940 г. был преобразован в Военно-морскую медицинскую академию. В 1956 г. Военно-морская медицинская академия вошла в состав Военно-медицинской академии им. С.М. Кирова, и кафедра военно-морской и госпитальной терапии заняла в ней одно из ведущих мест в подготовке специалистов терапевтического профиля, многие из которых достигли больших высот в военной и гражданской медицине. В настоящее время кафедра военно-морской терапии продолжает свою успешную лечебную, научную и педагогическую деятельность.
The article presents reviews of modern domestic and foreign scientific publications on the pathogenesis of atrial fibrillation (AF) in patients with arterial hypertension (AH), as well as the issues of blood pressure control in AF. Arterial hypertension (AH) is often accompanied by comorbidity, and, in addition, is the most frequent factor in the development of atrial fibrillation (AF). AF is the most common type of arrhythmia, which increases the risk of thromboembolic complications, heart failure, and leads to an increase in the overall mortality rate. The aim of the work was to study the pathological mechanisms of the formation of AF in hypertension, as well as their mutual impact on the course of diseases, and, in addition, to analyze and compare methods for measuring blood pressure (BP) in AF, used in modern clinical work, to identify the most objective method. A general scientific method was applied: analysis of modern scientifi c domestic and foreign literature on research problems, generalization, comparison, systematization of theoretical data on the experience of application. All reviews were indexed in PubMed, Medline, eLibrary, CyberLeninka, Google Scholar databases. The presented study allow us to conclude that hypertension is both a risk factor for atrial fi brillation and a complication of the course of the disease in patients with atrial fibrillation; the most objective method of measuring blood pressure in AF is oscillometric. The tasks and prospects of future research are identified.
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