Репозиторий Университета

© 2018 Stolichnaya Izdatelskaya Kompaniya. Aim. To study the changes in the stiffness of the arterial wall, vasomotor function of the endothelium, and appearance of new cases of atrial fibrillation (AF) in patients with arterial hypertension with long-term treatment with lisinopril. Material and method. 66 hypertensive patients with cardiac sinus rhythm at the age of 48-64 years (mean age 58.4±4.2 years) were included into the study. They were randomized into 2 groups: patients of group 1 (n=35) were prescribed lisinopril or a combination of lisinopril with hydrochlorothiazide over the 5-year follow-up; patients of group 2 (control) did not receive angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. The follow-up duration was from September 2010 until June 2016. It included telephone calls once every 3 months and annual clinical, instrumental and laboratory examination. The new-onset AF was identified by the 24-hour Holter ECG monitoring results and by patient symptom diaries. Results. New-onset AF was registered in 2 patients (6%) in the lisinopril group and in 4 patients (13%) from the control group (p=0.001) over the 5-year follow-up. Lisinopril significantly reduced AF incidence in hypertensive patients. The patients on lisinopril were found to have no significant changes in the left ventricular mass index and left atrial size according to echocardiography done after the 5-year follow-up whereas in the patients of control group both parameters increased significantly. Lisinopril contributed to the maintenance of endothelial vasodilator function and prevented increase in arterial wall stiffness. Conclusion. Long term lisinopril treatment was found to significantly reduce the AF incidence in hypertensive patients over the 5-year follow-up. Lisinopril demonstrated organoprotective properties throughout the cardiovascular disease continuum and can be recommended for primary prevention of arrhythmia in hypertensive patients..

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article covers the development of the problem of sudden cardiac death prevention with the implantable cardioverterdefibrillators from the moment of creation of these devices to our days. The current concept of primary prevention of sudden cardiac death, based on the severity of manifestation of heart failure and left ventricular dysfunction, is not effective enough. Its practical application is difficult because it requires mass application of implantable defibrillators, with low predictive accuracy of these criteria in terms of development of lifethreatening arrhythmias. The development of methods for visualizing the myocardium, allowing to assess the severity of myocardial fibrosis, as well as the possibilities of medical genetics, at the present stage, allows us to clarify indications for implantation of cardioverterdefibrillators and thereby significantly improve the concept of preventing sudden cardiac death with these instruments.

© 2018 Media Sphera Publishing Group. All rights reserved. The relevance of the investigation is due to the need to optimize the system for the primary prevention of drug addiction and use because of its insufficient efficiency in the Russian Federation. This problem is manifested in the low awareness of the population, primarily young people, about the negative consequences of the use of narcotic drugs and psychotropic substances and about the high associated risk of their involvement in the use of narcotics, including new types of psychotropic substances (synthetic narcotics). In this connection, the aim of our investigation was to develop a method for determining the potential efficiency of measures for the primary prevention of drug addiction and use, by applying mathematical modeling. The Kermak - McKendrick epidemic model of the susceptible infected removed (SIR) - like type was used as a basis to build a drug use spread model that represented as transition of groups of individuals from one state to another in relation to drug use. This gave rise to a simulation model estimating the magnitude of a drug use reduction in the risk group in relation to the initial one if varying effective preventive measures were implemented. The drug abuse scenario in case of effective measures was analyzed. Enhancing the effectiveness of measures for primary prevention of drug addiction was shown to lead to a stronger rather than linear decline in the size of a group at risk for drug and in the number of drug users. This model may be used to prepare programs, strategies for the primary prevention of drug addiction to evaluate their potential effectiveness.