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Dispensary observation of patients with coronary artery disease can significantly reduce the likelihood of cardiovascular complications onset. Active outpatient monitoring allows to correct the main risk factors for cardiovascular complications, to estimate the risk of unfavorable cardiovascular events onset and to identificate patients who will get benefit of coronary revascularization. The introduction of a comprehensive assessment of cardiovascular risk and the development of remote monitoring technologies will improve the long-term results of outpatient follow-up of patients with coronary artery disease at high cardiovascular risk.

The article highlights the development of the complex research on using blue spectrum LEDs, taking into account the literature data and the authors' own research. Reaction to light is shown related to stimulating the food activity of aquatic organisms. This is a complex of factors that determine the behavior of aquatic organisms moving towards a light source. Light in the blue segment of spectrum travels the longest distances from the source, so animals and plants have evolved to respond more to the light in this segment. Therefore, using blue LEDs stimu-lates the entire trophic food chain: phytoplankton (phytoplankton growth due to the effective absorption of light energy by chlorophylls a, b and carotenoids in this spectrum) → zooplankton (attracted to the blue light segment due to the reflex about the food presence) → hydrobionts eating zooplankton (attracted to the blue light segment because of the food reflex) → predatory aquatic organisms (also attracted to the blue light segment due to the food reflex). There has been proposed a method of choosing the LED wavelength to optimize the light source subject to the spectral sensitivity of photoreceptors, increasing the LED life with a decreased current, which helps improve the autonomous source life. Based on the nature-like approach and the choice of the light spectrum, using blue LEDs is found reasonable for fishing traditional light-fishing commercial species (saury and squid), as well as other hydrobionts that haven’t been caught using light before (crab, flounder and smelt). This approach allows to use light for catching other aquatic organisms not previously harvested by using light, as well as optimize light sources in fishing traditional commercial species (kilka).

The COVID-19 pandemic triggered a second pandemic, "post-COVID", in people with persistent symptoms after an acute period of coronavirus infection. Most coronavirus patients fully recovered on average within two weeks, but about one in ten people feel long-term symptoms, such as respiratory, cardiovascular, nervous and psychological. Post-COVID symptoms are disparate, various and difficult to interpret. There are no standardized diagnostic methods and generally accepted criteria for verifying post-COVID syndrome now. WHO presented a universal definition of post-COVID syndrome or post-COVID conditions in October 2021. Blood pressure should be observed in post-COVID syndrome due to high prevalence of hypertension in patients with COVID-19. Epidemiology, risk factors and pathophysiology of post-COVID syndrome presents in expert’s consensus of Russian Society of Hypertension. The mechanisms of impairment to the cardiovascular system were analyzed. Particular attention is paid to the clinical features and manifestations of hypertension in post-COVID syndrome, to pathophysiological mechanisms of blood pressure destabilization and further treatment strategy.

Aim To compare variables of transthoracic EchoCG for determining echocardiographic predictors and their prognostic role in the development of persistent paroxysmal ventricular tachyarrhythmias (VT) in patients with ischemic CHF who had been implanted with a cardioverter defibrillator (CD) for primary prevention of sudden cardiac death.Material and methods This single-site prospective study included 176 patients with CHF of ischemic origin aged 58.7±7.4 years with a left ventricular ejection fraction (LV EF) of 30 % [25; 34] % who had been implanted with CD. The follow-up duration was 24 months. The primary endpoint was a newly developed persistent paroxysm of VT (duration ≥30 sec) detected in the “monitored” VT area or a VT paroxysm that required electric treatment. The echocardiographic picture was evaluated by 28 variables. Statistical analysis was performed with the c2, Fisher’s, and Mann—Whitney tests, and the one-factor logistic regression (LR). Prognostic models were developed with a multifactorial LR. The model accuracy was evaluated by 4 metrics: area under the ROC (AUC), sensitivity, specificity, and diagnostic efficacy.Results The primary endpoint was observed in 60 (34 %) patients. Mean time to a persistent VT episode was 19.2±0.8 months (95 % confident interval (CI): 17.5–20.8). Superior-inferior dimensions of the right and left atria (RA and LA, respectively) and the left atrial volume (LAv) were independent predictors for VT. The odds of VT development in patients of the study cohort increased with RAl ≥4.5 cm (odds ratio (OR), 1.6; 95 % CI: 1.4–1.9; р=0.03), LAl ≥5.5 cm (OR, 2.5; 95 % CI: 1.01–6.1; р=0.04), LAv ≥95 ml (OR, 3.2; 95 % CI: 1.3–17.5; р=0.01). A comprehensive analysis of echocardiographic variables proved the prognostic potential of LAv that was linearly associated with the development of VT. The metrics of the best prognostic model were AUC 0.7±0.07 with 95 % CI: 0.54–0.83; specificity, 20.9 %; sensitivity, 95.7 %; and diagnostic efficacy, 47 %.Conclusion This study allowed evaluation of capabilities of transthoracic EchoCG for predicting the probability of VT in patients with CHF of ischemic origin and reduced LV EF. It was shown that linear and volumetric atrial dimensions could be used for stratification of risk of VT and for determining the tactics for primary prevention of sudden cardiac death in this patient category.

Patients with relapsed/refractory multiple myeloma (RRMM) resistant to multiple drug classes remain a high unmet need population. This longitudinal retrospective cohort study assessed real-world treatment patterns and outcomes in adults with RRMM. Patients who had three or more prior lines of therapy including a proteasome inhibitor (PI) and an immunomodulatory agent (double-exposed) were further categorized as refractory to a PI and an immunomodulatory agent (double-class refractory

The article presents the modern strategy of an outpatient cardiovascular care improvement. The modernization of primary health care in outpatient network is based on primary and secondary prevention of cardiovascular diseases including an improvement of outpatient observation, development of an outpatient high-risk offices network, advancement of telemedical consulting, increase of preferential medication provision effectiveness, increase of quality management patients with chronic heart failure and development of vertically integrated medical information system. Improvement of cardiovascular outpatient care will reduce cardiovascular mortality in the whole population.

The article is a continuation of the authors' cycle of works devoted to the development of geoinformation modeling technology for forest ecosystems. The article deals with the formation of an object-oriented catalog of deciduous woody plants growing on the territory of the Lisinsky educational and Experimental Forestry, a branch of S. M. Kirov SPbGLTU. The main purpose of the work is to form a single 3D database of two forest-forming species of hanging birch (Betula Pendula Roth.) and trembling poplar (Populus Tremula L.) to integrate the generated catalog of tree models into the environment of geoinformation modeling of forest ecosystem

Aim. To compare and analyze the results of myocardial revascularization in the Russian Federation (RF) with acute coronary syndrome (ACS) before the onset (2018-2019) and during the novel coronavirus infection (COVID-19) pandemic (2020-2021).Material and methods. The analysis included the number of cases of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation acute coronary syndrome (NSTE-ACS), the number of cases of myocardial revascularization in the above forms of ACS, the number of deaths depending on the form of ACS and the method performed revascularization. The period of time before the start of the coronavirus pandemic corresponded to the annual data received in the Russian Federation for 2018-2019. The period of the coronavirus disease pandemic corresponded to the annual data received in the country for 2020-2021. Absolute, relative, estimated values of patient hospitalization, myocardial revascularization procedures, and mortality in ACS were compared between time periods before and during the COVID-19 pandemic. The data for analysis were obtained from the monitoring of the Ministry of Health of Russia.Results. In 2018 and 2019 in the RF, 531,019 and 501,238 patients were hospitalized with a diagnosis of ACS, and during the pandemic (2020-2021) - 403,931 and 397,930 patients, respectively. Reduction in the number of patients diagnosed with ACS admitted to hospitals in Russia by 22.32% in 2020-2021 years was mainly due to a significant decrease in hospitalizations of patients with a diagnosis of NSTE-ACS (by 29.03%). At the same time, admission to clinics of patients with STEMI decreased only by 6.02%. During the COVID-19 pandemic, mortality increased significantly in PPCI (by 9.6%) and in the general STEMI group (by 12.3%); significantly increased mortality both in the general group (by 48%) and during PCI in patients with NSTE-ACS (by 28.6%); there was an increase in the average annual number of PPCI (by 12.6%), which was accompanied by an increased average annual number of PPCI per 1 million of population (up to 451 per 1 million of population); a slight increase in the average time "symptom-balloon" (by 2 minutes) was recorded; there was an absolute slight decrease and a relative increase in the number of PCIs in NSTE-ACS (by 2.7% and 37.1%, respectively). In 2021, in the Russian Federation, primary PCI was performed in 50.2%, thrombolytic therapy - in 23.1%, and 26.7% of patients remained without reperfusion. Pharmacoinphasive strategy was applied in 60%, and isolated thrombolysis - in 40% of patients.Conclusion. During the COVID-19 pandemic, revascularization in patients with ACS in Russia corresponded to the following trends recorded in the literature: increased hospital mortality in PPCI and in the general STEMI group; hospital mortality both in the general group and during PCI in patients with NSTE-ACS. The indicators of myocardial revascularization in ACS in the RF during the pandemic were fundamentally different from the data of Western countries: there was an increase in the average annual number of PPCI and the average annual number of PPCI per 1 million population; a slight increase in the average symptom-balloon time was recorded; revealed an absolute slight decrease and a relative increase in the number of PCIs in NSTE-ACS.

Aim. To perform a population analysis of Non-High Density Lipoprotein Cholesterol level (non-HDL-c) in Russian population and to evaluate its association with cardiovascular events.Material and Methods. The material consisted of results obtained from 11 regions of the ESSE-RF1 Study and from 4 regions of the ESSE-RF2 Study. Study protocols were identical. The studies were performed in 2012-2014 and 2017, respectively. Endpoints were assessed in 19041 people aged 35-64 years. The median follow-up was 6.5 years in ESSE RF (1) and 3.8 years in ESSE RF(2). Analysis was performed for three lipid variables: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-HDLC in two samples: the general population sample and the same sample without individuals with coronary heart disease (CHD), myocardial infarction (MI) and/or stroke history and not taking statins (the population sample of "without a history of cardiovascular diseases [CVD]". The analysis of nonlinear associations was performed using the generalized additive Cox model. The combined cardiovascular endpoint was represented by cardiovascular death and nonfatal MI and stroke. Traditional and laboratory FRs, socio-demographic parameters were analyzed. The significance level for all tested hypotheses was set to be 0.05.Results. The prevalence of elevated non-HDL-C level (>3.7 mmol/l) was found to be 74.6%. No gender differences were found: there was 74.6% for men and 74.5% for women. Both mean values and prevalence of elevated non-HDL-C were increased with age in women, and its level was slightly decreased in men after 55 years old. Almost all analyzed RFs were significantly associated with elevated non-HDL-C in these two population samples. In both samples elevated total CH and elevated LDL-C were associated with all-cause mortality after correction for all RFs. On the contrary, the non-HDL-C was associated with CVD combined end pints. It has been shown that the risk of these end points increases uniformly with increase in levels of non HDL cholesterol, no nonlinear associations were found.Conclusion. The results of a population-based analysis of non-HDL-C performed in the Russian population for the first time confirmed that elevated non-HDL-C levels contribute significantly to determining the risk of cardiovascular events in the medium term. It can be assumed that the new risk scales (SCORE2 and SCORE OP) proposed by the European Society of Cardiology and the European Society of Preventive Cardiology, which include non-HDL C instead of TC, will allow adequate assessment of 10-year cardiovascular risk for Russians. However, continued monitoring of endpoints in order to obtain stable associations is required.

Aim To study the prevalence of hyperlipidemia in patients with myocardial infarction (MI) in the Russian Federation; to assess the compliance with clinical practice guidelines of the lipid-lowering therapy prescribed upon discharge from the hospital; and to determine the number of patients who are indicated for the combination lipid-lowering therapy to achieve the low-density lipoprotein cholesterol (LDL-C) goal.Material and methods REGION-MI is Russian rEGIstry Of acute myocardial iNfarction, a multicenter, retrospective and prospective observational study. The observation period was divided into 3 stages: observation during the stay in the hospital and at 6 and 12 months after the inclusion in the registry. Plasma total cholesterol (TC) and LDL-C were measured in all patients on admission. Evaluation of the prescribed lipid-lowering therapy included the intensity of the treatment.Results The study included 3 620 patients; 62.4 of them had hyperlipidemia on admission. Mean TC on admission was 5.29 mmol/l and LDl-C level was 3.35 mmol/l. Upon discharge, 95.4% of patients after myocardial infarction continued on or were prescribed statin therapy; ezetimibe was prescribed to 1.22% of patients. Patients with an extremely high level of LDL-C >5 mmol/l accounted for 10.7% of patients with hyperlipidemia. The target level of LDL-C ≤1.4 mmol/l cannot be achieved with the statin and ezetimibe combination therapy in these patients; drugs from the group of PCSK9 inhibitors are indicated for them.Conclusion According to the data of the Russian registry of acute myocardial infarction, REGION-MI, a high incidence of hyperlipidemia is observed in patients with acute MI. Despite multiple studies that have proven the importance of achieving a low LDL-C level and good tolerance and safety of ezetimibe and PCSK9 inhibitors, the prescription frequency of combination therapy remains unreasonably low. Results of a simulation study that was conducted in Sweden and the data of the REGION-MI registry showed that PCSK9 inhibitors as a part of the combination therapy are indicated for many patients. The combination therapy is presently the most powerful type of lipid-lowering treatment that allows, in most cases, achievement of the LDL-C goal.

High blood pressure (BP) remains the leading risk factor for coronary heart disease, stroke, other cardiovascular diseases, chronic kidney disease, and dementia. Objective. To estimate the frequency of prescribing antihypertensive drugs (AHD) with the allocation of the proportion of fixed combinations (FC) among people aged 25–64 years examined in 16 regions of the Russian Federation as part of the ESSE-RF and ESSE-RF2 studies.Design and methods. The analysis included the results of a survey of representative samples of the population of the Russian Federation in the ESSE-RF studies (2012–2014, men: N = 8376 and women N = 13546 people) and ESSE-RF2 (2017, men: N = 3000 and women N = 3714 people). Each participant signed an informed consent. Arterial hypertension (AH) was defined as systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg and/or if the examined reported taking AHD. Under the lack of control of AH, we understood the proportion of patients (%) with BP levels ≥ 140/90 mm Hg of the total number of patients with AH. Information about the AHD taken was recorded from the words of the patient (trade name of the drug) followed by coding according to the International Nonproprietary Names of Drugs.Results. In the Russian population, there was a decrease in the proportion of uncontrolled BP from 78,5 % (95 % confidence interval (CI) 77,7–79,3) in ESSE-RF to 73,0% (95 % CI 71,3–74,6) in ESSE-RF2. FC intake was detected in 15,6 % (95 % CI 13,8–18,0) of patients treated in the ESSE-RF study, while the proportion of such patients in the ESSE-RF2 decreased to 10,9% (95% CI 9,2–12,8), p < 0,001. The most common FC was the combination of an angiotensin-converting enzyme inhibitors (ACEI) and a diuretic (ESSE-RF: 49,1 % and ESSE-RF2: 45,9 %). In second place in ESSE-RF is a diuretic + angiotensin receptor blockers (25,8 %), in ESSE-RF2 — calcium channel blockers (CCB) + ACEI (22,4%). A more modern combination, namely: the combination of ACEI and CCB, was noted only in 8,7% in ESSE-RF, while in ESSE-RF2 the proportion of this FC increased by 2,5 times.Conclusions. In the population of the Russian Federation, only 10 %-15 % of patients with AH receive FC AHD. An increase in FC intake may contribute to an increase in adherence to therapy, which is extremely important for the Russian population with poor BP control.

Aim. To perform a comparative analysis of indicators of transthoracic echocardiography (TE), to establish echocardiographic predictors and their predictive role in the occurrence of stable ventricular tachyarrhythmia (VT) paroxysms in patients with nonischemic chronic heart failure (HF) and cardioverter-defibrillator (ICD) implanted for primary prevention of sudden cardiac death.Material and Methods. A prospective study was carried out, which included 166 patients with nonischemic HF at the age of 54 (49; 59) years with the left ventricle ejection fraction (LV EF) ≤35% and an ICD implanted. The observation time was 24 months. The primary endpoint was the first-ever stable paroxysm of VT (lasting for ≥30 seconds), detected in the «monitor» zone of VT, or paroxysm of VT, which required ICD therapy. A total of 34 TE indicators were evaluated. Chi-square, Fischer, Manna-Whitney, single-factor logistic regression (LR), and multi-factor LR were used for data processing and analysis and for predictive modelling. Model accuracy was estimated using 4 metrics: ROC curve area (AUC), sensitivity, specificity and diagnostic efficiency.Results. During the two-year observation, 32 patients (19.3%) had a primary endpoint. The average time of occurrence of a stable VT episode was 21.6±0.6 months (95% confidence interval [CI] 20.5-22.8 months). The value of LV end-systolic dimension was the only parameter independently associated with VT (odds ratio 2.8 per unit increase, 95% CI 1.04-7.5; p=0.042). The complex analysis of echocardiographic indicators made it possible to identify 5 factors with the greatest predictive potential, which are linearly and nonlinearly related to occurrence of VT. These included the LV end-diastolic and end-systolic volumes, LV mass, index of relative LV wall thickness, upper-lower size of the right atrium. The metrics of the best predictive model were: AUC – 0.71 0.069 with 95% CI 0.574-0.843; specificity 50%, sensitivity 90.9%; diagnostic efficiency 57.1%.Conclusion. The study made it possible to evaluate the possibilities of the results of TE in predicting the probability of VT occurrence in patients with nonischemic HF and reduced LV EF. Predictive indicators have been identified that can be used to stratify the arrhythmic risk in the exposed cohort of patients.

The article presents the results of the study on the effectiveness of different light sources and their spectrum in commercial catching the aquatic organisms. The proposed method for increasing catch volumes was based on a program of using LEDs with white, green and blue light and monitoring the reaction of the caught aquatic organisms developed by Japanese scientists. In the practice of Russian commercial fishing there are no data found on the response of aquatic organisms to the spectrum and the effectiveness of using white LEDs that were made on the basis of ultraviolet LEDs. There has been given the review of works investigating the reaction to the light spectrum of various hydrobionts living in different ecological niches. It has been found that all hydrobionts under study (herring, pollock, saury, etc.) actively react to the blue spectrum of color, which makes it possible to use blue LEDs as light sources in commercial fishing. Experiments were carried out in Peter the Great Bay (Primorsky Krai, Russia) using a submersible lamp with four blue LEDs. Hydrobionts living in different ecological niches (flounder and Pacific squid) were selected as the objects of study. The flounder has never been fished with light, and Pacific squid is traditionally caught by using light. As a result of experiments, squid catch volumes increased by 32-40%, with additional ship lighting - by 35-42%; flounder catches increased by 167-172% in the evening and up to 211% at night

Aim. To assess long-term sequelae of COVID-19 in hospitalized patients at 3 to 7 months after discharge.Material and Methods. The whole of 700 patients hospitalized to the temporary COVID-19 treatment center hosted by the FSBI “National Medical Research Center of Cardiology” of the Ministry of Health of Russia from April to June 2020 were invited to participate in a follow-up study. At 3-7 months after the index hospitalization, patients or their proxies were contacted via telephone in order to obtain information on their vital status, cardiovascular and other conditions or their complications, and new hospitalizations. In addition, patients were invited to an outpatient visit under the "COVID-19-follow-up" program, encompassing physical examination and a comprehensive battery of laboratory and instrumental tests, including spirometry, chest computed tomography (CT) and the six minute walk test (6MWT). Further, dyspnea was assessed using the mMRC (Modified Medical Research Council) Dyspnea Scale. Results: We were able to contact 87.4% (612/700) of patients or their proxies. At follow-up, 4.4% (27) patients died, of which 96.3% (26) had cardiovascular diseases (CVD). A total of 213 patients aged 19 to 94 years old (mean age 56.8±12.5, median 57 years [49.0; 64.0]; men, 55.4%) agreed come for an outpatient visit and to participate in the “COVID-19-follow-up” program. Since discharge, 8% (17) of patients required new hospitalizations, and more than a half of these patients (58.8%; 10/17) had CVD-related hospitalizations. A total of 8.4% (18) patients experienced worsening of hypertension, 9 (4.2%) patients had newly diagnosed hypertension, 2 (0.9%) – coronary artery disease patients experienced new/recurrent angina symptoms. 4 (1.9%) patients had newly diagnosed coronary artery disease, and one patient had an ischemic stroke. At the outpatient visit, 114 (53.5%) patients had some symptoms, most frequently, shortness of breath (33%), fatigue (27.4%), chest pain (11.3%), and abnormal heartbeats (8.5%). Based on the mMRC Scale, 59% of patients had dyspnea of varying severity. Most patients had a normal vital capacity (VC), which was moderately reduced in 3.3% and severely reduced in 0.5% of patients. Chest CT scans were obtained in 78 (36.6%) patients, whose worst lung damage scores during hospitalization were CT3 or CT4. One in ten patients (10.8%) with severe lung damage during acute infection had persisting ground glass opacities, 35.9% developed fibrotic changes, 79.6% of patients had linear or fine focal opacities. According to the 6MWT data, 12.3% of patients walked less than 70% of the predicted distance, 67% walked 71 to 99% of the predicted distance, and 20.7% of patients were able to walk 100% of their predicted distance.Conclusion. These data suggest long-term negative sequelae of COVID-19 in more than half of hospitalized patients.

We present ANANASTRA, https://ananastra.autosome.org, a web server for the identification and annotation of regulatory single-nucleotide polymorphisms (SNPs) with allele-specific binding events. ANANASTRA accepts a list of dbSNP IDs or a VCF file and reports allele-specific binding (ASB) sites of particular transcription factors or in specific cell types, highlighting those with ASBs significantly enriched at SNPs in the query list. ANANASTRA is built on top of a systematic analysis of allelic imbalance in ChIP-Seq experiments and performs the ASB enrichment test against background sets of SNPs found in the same source experiments as ASB sites but not displaying significant allelic imbalance. We illustrate ANANASTRA usage with selected case studies and expect that ANANASTRA will help to conduct the follow-up of GWAS in terms of establishing functional hypotheses and designing experimental verification.

Large-scale drug screening is currently the basis for the identification of new chemical entities. This is a rather laborious approach, because a large number of compounds must be tested to cover the chemical space in an unbiased fashion. However, the structures of targetable proteins have become increasingly available. Thus, a new era has arguably been ushered in with the advent of methods, which allow for structure-based docking campaigns (i.e., virtual screens). Solute carriers (SLCs) are among the most promising drug targets. This claim is substantiated by the fact that a large fraction of the 400 solute carrier genes is associated with human diseases. The ability to dock large ligand libraries into selected structures of solute carriers has set the stage for rational drug design. In the present study, we show that these structure-based approaches can be refined by taking into account how solute carriers operate. We specifically address the feasibility of targeting solute carriers with allosteric modulators, because their actions differ fundamentally from those of ligands, which bind to the substrate binding site. For the pertinent analysis we used transition state theory in conjunction with the linear free energy relationship (LFER). These provide the theoretical framework to understand how allosteric modulators affect solute carrier function.

The serotonin transporter (SERT) removes synaptic serotonin and is the target of anti-depressant drugs. SERT adopts three conformations: outward-open, occluded, and inward-open. All known inhibitors target the outward-open state except ibogaine, which has unusual anti-depressant and substance-withdrawal effects, and stabilizes the inward-open conformation. Unfortunately, ibogaine's promiscuity and cardiotoxicity limit the understanding of inward-open state ligands. We docked over 200 million small molecules against the inward-open state of the SERT. Thirty-six top-ranking compounds were synthesized, and thirteen inhibited; further structure-based optimization led to the selection of two potent (low nanomolar) inhibitors. These stabilized an outward-closed state of the SERT with little activity against common off-targets. A cryo-EM structure of one of these bound to the SERT confirmed the predicted geometry. In mouse behavioral assays, both compounds had anxiolytic- and anti-depressant-like activity, with potencies up to 200-fold better than fluoxetine (Prozac), and one substantially reversed morphine withdrawal effects.

The paper scientifically substantiates the use of LED lighting for use in the saury fishery, which uses the calculated spectra of LEDs in the blue spectrum, taking into account the peculiarities of the structure of vision in saury. The proposed lighting systems will reduce the cost of light emission by 7-9 times, and will reduce fuel costs and, accordingly, reduce the carbon component (CO2 emissions) on domestic fishing vessels.

The article is devoted to the analysis of changes in the role of causal and comorbid risk factors for two main types of heart failure with reduced and preserved ejection fraction over the previous 20 years. Within the same time interval, the dynamics of the prevalence and mortality for these clinical variants. Special attention is paid to a possible solution to the issue of the complexity of recording cases of diagnosis and treatment of chronic heart failure in outpatient and hospital practice.Статья посвящена анализу изменений роли причинных и коморбидных факторов риска развития двух основных форм сердечной недостаточности со сниженной и с сохраненной фракцией выброса в предшествующие примерно 20 лет. В рамках этого же временного интервала рассматривается динамика распространенности и смертности. Отдельное внимание уделено возможному варианту решения проблемы сложности учета случаев диагностики и лечения хронической сердечной недостаточности в амбулаторной и госпитальной практике.

The serotonin transporter (SERT/SLC6A4) is arguably the most extensively studied solute carrier (SLC). During its eponymous action – that is, the retrieval of serotonin from the extracellular space – SERT undergoes a conformational cycle. Typical inhibitors (antidepressant drugs and cocaine), partial and full substrates (amphetamines and their derivatives), and atypical inhibitors (ibogaine analogues) bind preferentially to different states in this cycle. This results in competitive or non-competitive transport inhibition. Here, we explored the action of N-formyl-1,3-bis (3,4-methylenedioxyphenyl)-prop-2-yl-amine (ECSI#6) on SERT: inhibition of serotonin uptake by ECSI#6 was enhanced with increasing serotonin concentration. Conversely, the KM for serotonin was lowered by augmenting ECSI#6. ECSI#6 bound with low affinity to the outward-facing state of SERT but with increased affinity to a potassium-bound state. Electrophysiological recordings showed that ECSI#6 preferentially interacted with the inward-facing state. Kinetic modeling recapitulated the experimental data and verified that uncompetitive inhibition arose from preferential binding of ECSI#6 to the K+-bound, inward-facing conformation of SERT. This binding mode predicted a pharmacochaperoning action of ECSI#6, which was confirmed by examining its effect on the folding-deficient mutant SERT-PG601,602AA: preincubation of HEK293 cells with ECSI#6 restored export of SERT-PG601,602AA from the endoplasmic reticulum and substrate transport. Similarly, in transgenic flies, the administration of ECSI#6 promoted the delivery of SERT-PG601,602AA to the presynaptic specialization of serotonergic neurons. To the best of our knowledge, ECSI#6 is the first example of an uncompetitive SLC inhibitor. Pharmacochaperones endowed with the binding mode of ECSI#6 are attractive, because they can rescue misfolded transporters at concentrations, which cause modest transport inhibition.

Modern high-throughput sequencing assays efficiently capture not only gene expression and different levels of gene regulation but also a multitude of genome variants. Focused analysis of alternative alleles of variable sites at homologous chromosomes of the human genome reveals allele-specific gene expression and allele-specific gene regulation by assessing allelic imbalance of read counts at individual sites. Here we formally describe an advanced statistical framework for detecting the allelic imbalance in allelic read counts at single-nucleotide variants detected in diverse omics studies (ChIP-Seq, ATAC-Seq, DNase-Seq, CAGE-Seq, and others). MIXALIME accounts for copy-number variants and aneuploidy, reference read mapping bias, and provides several scoring models to balance between sensitivity and specificity when scoring data with varying levels of experimental noise-caused overdispersion.

Aim. Assess the structure of comorbid conditions, cardiovascular pharmacotherapy and outcomes in patients with atrial fibrillation (AF) and concomitant coronary artery disease (CAD) included in the outpatient and hospital RECVASA registries.Materials and methods. 3169 patients with AF were enrolled in outpatient RECVASA (Ryazan), RECVASA AF-Yaroslavl registries and hospital RECVASA AF (Moscow, Kursk, Tula). 2497 (78.8%) registries of patients with AF had CAD and 703 (28.2%) of them had a previous myocardial infarction (MI).Results. There were 2,497 patients with a combination of AF and CAD (age was 72.2±9.9 years; 43.1% of men; CHA2DS2-VASc – 4.57±1.61 points; HAS-BLED – 1.60±0,75 points), and the group with AF without CAD included 672 patients (age was 66.0±12.3 years; 43.2% of men; CHA2DS2-VASc – 3.26±1.67 points; HAS-BLED – 1,11±0.74 points). Patients with CAD were on average 6.2 years older and had a higher risk of thromboembolic and hemorrhagic complications (pConclusion. 78.8% of patients from AF registries in 5 regions of Russia were diagnosed with CAD, of which 28.2% had previously suffered myocardial infarction. Patients with a combination of AF and CAD more often than in the absence of CAD had hypertension, chronic heart failure, diabetes, chronic kidney disease and anemia. Patients with the previous MI had higher incidence of diabetes than those without the previous MI. The frequency of proper cardiovascular pharmacotherapy was insufficient, and to a greater extent in the presence of CAD and the previous MI than in their absence. All-cause mortality was recorded in patients with a combination of AF and CAD more often than in the absence of CAD. All-cause mortality and the incidence of nonfatal myocardial infarction were higher in patients with AF and the previous MI than in those without the previous MI. The presence of CAD and, in particular, the previous MI, was significantly associated with a higher risk of death, as well as a higher risk of developing a combined cardiovascular endpoint.

BACKGROUND: Atopic dermatitis is considered a childhood illness, and the direct and indirect health care burden of atopic dermatitis in adults is not fully understood. OBJECTIVE: To measure the dir...

Andrey Deryabin, MSc Social Psychology, Research Fellow, Center for Socialization and Personalization of Children’s Education, Federal Institute for the Development of Education, Russian Presidential Academy of National Economy and Public Administration (RANEPA); Teaching Assistant, Department of Sociology and Mass Communication, Novosibirsk State Technical University. Address: Bld. 1, 9 Chernyakhovskogo Str., 125319 Moscow, Russian Federation. E-mail: deryabin-aa@ranepa.ru (corresponding author) Ilya Boytsov, PhD student, Department of Applied Economics, Faculty of Economic Sciences, National Research University Higher School of Economics. Address:11 Pokrovsky Blvd, 109028 Moscow, Russian Federation. E-mail: iboytsov@hse.ru Aleksandr Popov, Doctor of Sciences in Philosophy, Associate Professor, Head of the Open Education Research Sector, Center for Socialization and Personalization of Children’s Education, Federal Institute for the Development of Education, Russian Presidential Academy of National Economy and Public Administration (RANEPA); Head of the Laboratory for Competency-Based Approach in Teaching, Institute of System Projects, Moscow City University; Professor, Department of Sociology and Mass Communication, Novosibirsk State Technical University. Address: Bld. 1, 9 Chernyakhovskogo Str., 125319 Moscow, Russian Federation. E-mail: popov-aa@ranepa.ru Pavel Rabinovich, Candidate of Sciences in Engineering, Associate Professor, Director of the Center for Project and Digital Development in Education, Institute for Social Sciences, Russian Presidential Academy of National Economy and Public Administration (RANEPA). Address: Bld. 2, 82 Vernadskogo Ave, 119602 Moscow, Russian Federation. E-mail: pavel@rabinovitch.ru Kirill Zavedensky, Deputy Director of the Center for Project and Digital Development in Education, Institute for Social Sciences, Russian Presidential Academy of National Economy and Public Administration (RANEPA). Address: Bld. 2, 82 Vernadskogo Ave, 119602 Moscow, Russian Federation. E-mail: kirillzav3@gmail.com This study investigates into Russian school principals’ beliefs about the requirements that digital transformation of schools imposes on students, parents, educators and administrators. Answers to an open-ended questionnaire obtained from 7,189 schools representing all administrative districts of the Russian Federation were analyzed using natural language processing technology. Responses were categorized according to the European Framework for the Digital Competence of Educators (DigCompEdu). In general, responses reflect the use of information technology by the relevant groups of participants in the educational process, educators assigning the greatest significance to selection and distribution of educational content, students to information search and communication, parents to communication, control and safety, and administrators to digital interactions. However, the spectrum of digital competences attributed by respondents to every group of participants in the educational process is rather narrow. Low occurrence of most DigCompEdu framework categories in questionnaire responses allows to conclude that school principals have a poor understanding of many important dimensions of digital competences.

The main stages of the creative path of the scientist with a world-famous, professor, the Honored Worker of Science of the Russian Federation, Academician of the Russian Academy of Sciences Alexey Petrovich Golikov are presented in the article.

Aim To study the practice of drug treatment of ischemic heart disease (IHD) and the consistency of this practice with the established guidelines.Material and methods Results of the Russian part of the EUROASPIRE V study were compared with the general European population of the study. At ≥6 mos. and Results Upon discharge from the hospital, patients of the Russian cohort and of the entire study population were prescribed acetylsalicylic acid or other antiplatelet drugs (99.2% and 94.1%, respectively); beta-blockers (87.2 and 81.6%, respectively); angiotensin-converting enzyme (ACE) inhibitors (69.9% and 61.1%, respectively); sartans (16.5% and 14.2 %, respectively); calcium channel blockers (19.3 and 19.4 %, respectively); nitrates (8.0% and 22.5 %, respectively); diuretics (31.1 and 32.5 %, respectively); statins (98.0% and 85.0 %, respectively); and anticoagulants (6.6 and 8.3 %, respectively). For the long-term treatment, patients of the Russian cohort and of the entire study population took antiplatelets (94.7 % and 92.5 %, respectively); beta-blockers (83.2% and 81.0 %, respectively); ACE inhibitors (60.2% and 57.3 %, respectively); sartans (19.3% and 18.4 %, respectively); calcium antagonists (21.1% and 23.0 %, respectively); nitrates (9.0% and 18.2 %, respectively); diuretics (31.8% and 33.3 %, respectively); statins (88.2% and 80.8 %, respectively); and anticoagulants (8.8% and 8.2 %, respectively). High intensity hypolipidemic therapy was prescribed to 54.0 % of patients in Russian centers and 60.3 % of patients in the entire study. Both Russian and international patients evaluated their compliance with the prescribed medication as high.Conclusion According to results of the EUROASPIRE V study as compared to earlier studies, the practice of drug therapy in Russian patients with IHD has significantly approached European indexes. Further optimization is possible by a more extensive use of high intense hypolipidemic treatment and antidiabetic drugs with a documented positive effect on prognosis of cardiovascular diseases.

Aim To study features of diagnosis and treatment of acute myocardial infarction (AMI) in Russian hospitals, results of the treatment, and early and late outcomes (6 and 12 months after AMI diagnosis); to evaluate the consistence of the treatment with clinical guidelines; and to evaluate patients’ compliance with the treatment.Material and methods The program was designed for 3 years, including 24 months for recruitment of patients to the study. The study will include 10, 000 patients hospitalized with a confirmed diagnosis (I21 according to ICD-10) of ST segment elevation acute myocardial infarction (MI) (STEMI) or non-ST segment elevation MI (NSTEMI) based on criteria of the European Society of Cardiology Guidelines on Forth Universal Definition of Myocardial Infarction (2018). The follow-up period was divided into three stages: observation during the stay in the hospital and at 6 and 12 months following inclusion into the registry. The primary endpoint included cardiac death, nonfatal MI during the hospitalization and after one-year follow-up. Secondary endpoints were 6-months and one-year incidence of repeated MI, heart failure, ischemic stroke, clinically significant hemorrhage, unscheduled revascularization after discharge from the hospital, and the proportion of patients who continue on statins, antiplatelet drugs, and drugs of other groups for 6 months and 1 year.Results The inclusion of patients into the registry started in 2020 and will continue for 24 months. By the time of the article publication (June, 2021), more than 2,000 patients will be included.Conclusion REGION-MI (Russian rEGIstry Of acute myocardial iNfarction) is a multicenter, retrospective and prospective observational cohort study that excludes any interference with the clinical practice. Results of the registry will help to analyze a real picture of medical care provided to patients with myocardial infarction and to schedule ways to improve the situation.

The paper considers the problems arising in the trawl fishery for Pacific squid and suggests ways to solve them. The necessity of using flexible spacers (GRU) for horizontal opening of trawls when working on difficult soils and for stable output of the trawl system to the surface is shown. The ease of control of the trawl system with the GRU is shown in contrast to the trawl systems with boards. To ensure a large horizontal opening of the trawl and reduce drag, it was proposed to use multi-wall trawls. According to calculations, the proposed trawl systems will reduce fuel costs by 1.7-2 times and, accordingly, will reduce the carbon component (CO2 emissions).

Introduction Real-world disease management of atopic dermatitis (AD) is hampered by a lack of consistency between providers that treat AD regarding assessment of severity, disease activity, and quality of life. Variability and inconsistency in documentation makes it difficult to understand the impact of AD. This study summarizes AD-related symptoms and concerns captured in unstructured qualitative provider notes by healthcare providers during visits with patients with AD. Methods Provider notes were obtained for patients with AD (n = 133,025) from a USA-based ambulatory electronic health records system. The sample included both children (n = 69,551) and adults at least 18 years of age (n = 63,474) receiving treatment from a variety of specialties including primary care, dermatology, and allergy/immunology. Key skin-related words were identified from a review of a sample of notes and natural language processing (NLP) was applied to determine the frequency of the keywords and bigram patterns. Results Provider notes largely focused on symptoms (primarily itch) and symptom relief rather than the impact of AD on work or lifestyle. Despite the known relationship between itch and skin pain, neuralgia was not widely documented. Compared to primary care providers, dermatologists’ and allergist/immunologists’ notes had more documentation of symptom-related issues. Personal and work/life burden issues were not widely documented regardless of specialty. Conclusion The topics documented in case notes by healthcare providers about their patients with AD focus largely on symptoms and, to a lesser extent, treatment, but do not reflect the burden of AD on patients’ lives. This finding highlights a potential care gap that warrants further investigation.

Aim: This study aimed to assess physician preferences for later lines (third to fifth) of therapy in patients with relapsed/refractory multiple myeloma (RRMM) in the USA. Materials & methods: Factors relevant to physicians' treatment preferences for RRMM were identified from a literature search and refined in a qualitative phase. Preferences were quantitatively assessed using a discrete choice experiment. Physicians (n = 227) made choices regarding treatment scenarios for RRMM. Results: Efficacy had the highest mean relative importance, with overall survival valued as most important when making treatment decisions for patients with RRMM. Reduced incidences of keratopathy and thrombocytopenia had similar relative importance in later-line treatment. Conclusion: Greater understanding of physicians' criteria for clinical decision-making may help inform wider adoption of new treatments.

Aim To study specific features of the parenteral anticoagulant therapy for acute myocardial infarction (MI) in the Russian Federation and to evaluate the consistency of the prescribed parenteral anticoagulant therapy with the effective clinical guidelines.Material and methods REGION-MI, the Russian rEGIstry for acute myOcardial iNfarction, is a multicenter observational study. This registry includes all patients admitted to hospitals with a documented diagnosis of ST-elevation acute MI (STEMI) and non-ST-elevation acute MI (NSTEMI) based on the criteria of the Forth Universal Definition of MI of the European Society of Cardiology. Risk of bleeding was assessed with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) scale, and risk of major bleeding in patients with NSTEMI was additionally assessed with the CRUSADE scale.Results From November 01, 2020 through April 03, 2022, 5025 patients were included into the REGION-MI registry. At primary vascular departments, 70.5% of patients were administered unfractionated heparin (NFH); at regional vascular centers, 37.1 % of patients were administered NFH, 29.6 % enoxaparin, 20,2% NFH in combination with enoxaparin, 6.8 % fondaparinux, 4.2 % NFH in combination with fondaparinux, and 1.9 % nadroparin. At the prehospital stage, NFH was used as an anticoagulant support for the thrombolytic therapy (TLT) in 84% of patients, and low-molecular heparins (LMH) were used in 16 %. At the hospital stage, UFH was administered to 64.4 % of patients, and enoxaparin was administered to 23.9 % of patients. Among the patients who had undergone primary percutaneous coronary intervention (PCI), 40 % received NFH, 25 % enoxaparin, 22 % NFH in combination with enoxaparin, 7 % fondaparinux, and 4 % NFH in combination with fondaparinux. In conservative and invasive tactics of therapy for NSTEMI, NFH was also administered more frequently (43 and 43 %, respectively), followed by (according to frequency of administration) enoxaparin (36 and 34 %, respectively), NFH in combination with enoxaparin (10 and 16 %, respectively), fondaparinux (7 and 6 %, respectively), and NFH in combination with fondaparinux (3 and 1 %, respectively).Conclusion According to the Russian registry of acute MI, REGION-MI, with all strategies for the treatment of MI, parenteral anticoagulants are not prescribed in full consistency with clinical guidelines. The most frequently used parenteral anticoagulant is NFH. Despite the high efficacy and safety of fondaparinux, the frequency of its administration remains unjustifiably low not only in the Russian Federation but also in other countries. The same can be said about the administration of enoxaparin to patients who had received TLT. Attention should be paid to physicians’ awareness of recent clinical guidelines, to minimize the prehospital treatment with parenteral anticoagulants, to limit this treatment to the TLT support, and to provide continuity between all stages of medical care.

SUMMARYThe serotonin transporter (SERT) removes synaptic serotonin and is the target of anti-depressant drugs. SERT adopts three conformations: outward-open, occluded, and inward-open. All known inhibitors target the outward-open state except ibogaine, which has an unusual anti-depressant profile and stabilizes the inward-open conformation. Unfortunately, ibogaine is promiscuous and cardiotoxic, limiting understanding of inward-open state ligands. We computationally docked over 200 million small molecules against the ibogaine stabilized inward-open state of SERT. Thirty-six top-ranking compounds were synthesized and thirteen inhibited with potencies ranging from 29 to 5000 nM. Structure-based optimization led to two novel inhibitors with Ki values down to 3 nM. The new molecules stabilized an outward-closed state of the transporter and had little activity against off-targets. A cryo-EM structure of one of these bound to SERT confirmed the predicted geometry. In mouse behavioral assays, both had anxiolytic and anti-depressant activity, with potencies up to 200 better than fluoxetine.

Background: While disease-modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF (>40%). Sacubitril/valsartan has been compared with a renin-angiotensin-aldosterone–system inhibitor alone in 2 similarly designed clinical trials of patients with reduced and preserved LVEF, permitting examination of its effects across the full spectrum of LVEF. Methods: We combined data from PARADIGM-HF (LVEF eligibility≤40%; n=8399) and PARAGON-HF (LVEF eligibility≥45%; n=4796) in a prespecified pooled analysis. We divided randomized patients into LVEF categories: ≤22.5% (n=1269), >22.5% to 32.5% (n=3987), >32.5% to 42.5% (n=3143), > 42.5% to 52.5% (n=1427), > 52.5% to 62.5% (n=2166), and >62.5% (n=1202). We assessed time to first cardiovascular death and HF hospitalization, its components, and total heart failure hospitlizations, all-cause mortality, and noncardiovascular mortality. Incidence rates and treatment effects were examined across categories of LVEF. Results: Among 13 195 randomized patients, we observed lower rates of cardiovascular death and HF hospitalization, but similar rates of noncardiovascular death, among patients in the highest versus the lowest groups. Overall sacubitril/valsartan was superior to renin-angiotensin-aldosterone–system inhibition for first cardiovascular death or heart failure hospitalization (Hazard Ratio [HR] 0.84 [95% CI, 0.78–0.90]), cardiovascular death (HR 0.84 [95% CI, 0.76–0.92]), heart failure hospitalization (HR 0.84 [95% CI, 0.77–0.91]), and all-cause mortality (HR 0.88 [95% CI, 0.81–0.96]). The effect of sacubitril/valsartan was modified by LVEF (treatment-by-continuous LVEF interaction P =0.02), and benefit appeared to be present for individuals with EF primarily below the normal range, although the treatment benefit for cardiovascular death diminished at a lower ejection fraction. We observed effect modification by LVEF on the efficacy of sacubitril/valsartan in both men and women with respect to composite total HF hospitalizations and cardiovascular death, although women derived benefit to higher ejection fractions. Conclusions: The therapeutic effects of sacubitril/valsartan, compared with a renin-angiotensin-aldosterone–system inhibitor alone, vary by LVEF with treatment benefits, particularly for heart failure hospitalization, that appear to extend to patients with heart failure and mildly reduced ejection fraction. These therapeutic benefits appeared to extend to a higher LVEF range in women compared with men. Clinical Trial Registration: https://www.clinicaltrials.gov . Unique identifiers: NCT01920711 (PARAGON-HF), NCT01035255 (PARADIGM-HF).

Aim To evaluate the clinical picture and factors associated with unfavorable outcomes in admitted patients with COVID-19.Material and methods This study included all patients admitted to the COVID Center of the National Research Center of Cardiology of the Russian Ministry of Health Care from May 1 through May 31, 2020. Clinical demographic, laboratory, and instrumental indexes and associated factors were studied with one-way and multivariate logistic regression analysis.Results This study included 402 patients aged 18 to 95 years (mean age, 62.9±14.6 years); 43.0 % of them were older than 65 years. COVID-19 was frequently associated with chronic comorbidities, including arterial hypertension (74.4 %), obesity (41.6 %), history of ischemic heart disease (12.9 %), atrial fibrillation (18.9 %), type 2 diabetes mellitus (DM) (13.0 %), and oncological diseases (9.2 %). 13.0 % of patients were smokers; less than 10% had chronic lung diseases. 3.9% of patients had a combination of COVID-19 and acute coronary pathology, including acute myocardial infarction (MI) in 3.2 % (13) and unstable angina in 0.7 % (3). The most frequent clinical manifestation of COVID-19 were four symptoms: cough (81.1 %), weakness (80.3 %), shortness of breath (71.6 %), and fever (62.7 %). 46.5% of patients had shortage of breath and chest pain/compression, 40.3% had headache, 31.1% had myalgia, 28.8% had anosmia, and 25.5% had ageusia. Arterial oxygen saturation was 55 years, NEWS scale score >4.0, oxygen saturation 5.4 mmol/l, hs-CRP >25.7 mg/l, and creatinine clearance Conclusion This study established factors associated with unfavorable outcomes in admitted patients with COVID-19. This will allow identifying in advance patients with a high risk of complications that require increased attention to take more active diagnostic and therapeutic measures at prehospital and hospital stages.

Background Cardiac rhythm and conduction disorders are common in patients with epilepsy and are presumably one of the leading causes of sudden unexpected death. There are only a few published reports on ictal cardiac arrhythmias detected by continuous monitoring, and the majority had a small sample size. Objective The aim of this study was to evaluate the frequency and type of cardiac arrhythmias recorded by an implantable loop recorder in patients with drug-resistant epilepsy. Methods We implanted a subcutaneous loop recorder to 193 patients with drug-resistant epilepsy. Automatic triggers to initiate cardiac rhythm recording were cardiac pauses of >3 seconds and any episodes of bradycardia (≤45 beats/min) or tachycardia (≥150 beats/min). Patients/relatives were instructed to begin peri-ictal rhythm recording by using an external activator device. The follow-up duration was 36 months, with scheduled follow-up visits every 3 months. Results A total of 6494 electrocardiogram traces were recorded during the median follow-up of 36 months (interquartile range 3–36 months). Ictal heart rhythm and rate changes were detected in 143 patients (74%). The most common finding was ictal sinus tachycardia (66.8%). Sinus bradycardia was observed in 13 patients (6.7%). Three patients had clinically relevant cardiac pauses of >6 seconds, requiring permanent pacemaker implantation. Five patients (2.6%) died suddenly. Conclusion Ictal heart rhythm and rate changes occur in most of the patients with drug-resistant epilepsy. Clinically relevant cardiac events, related to ictal and postictal periods, are rare. No potentially malignant arrhythmias were detected in patients who died suddenly during the preceding follow-up period.

Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.

BACKGROUND: Seasonal influenza vaccination is recommended for patients with cardiovascular diseases. Low vaccination coverage among these patients is due to insufficient knowledge about vaccine efficiency and its regular annual use. This work aimed to study the repeated 6-month changes in hemagglutinin antibody titers (AT) for 3 years in patients with cardiac pathology in a comparative study of influenza preventive vaccination. MATERIALS AND METHODS: Analysis of ATs obtained based on the hemagglutination-inhibition test (HAI) was performed in 235 of 817 participants in a prospective follow-up. Blood sampling was performed at baseline, before the vaccination, and 6 months after, and at the same term in unvaccinated patients in the 2012–2013 and 2014–2015 seasons, respectively. The seropositive and seronegative responses to vaccination or acute respiratory or influenza infection were used, according to the reference values of seroconversion and seroprotection and the fact of seroconversion. Multiple regression analysis with a logarithmic scale was used to assess the vaccine effectiveness indices. RESULTS : With vaccination coverage of at least 40% against seasonal influenza within 3 years, the trends of a decrease in seropositive and an increase in seronegative responses in the vaccination group and its reverse nature in the comparison group were determined by traditional analysis. Using logarithmic calculation, an increase in HAI AT seroconversion was revealed over a 3-year follow-up period. It was characterized by a homogeneous serological response at annual vaccination and heterogeneous with a higher serological response in cases without vaccination (p = 0.002 for H1N1 and p = 0.005 for H3N2, respectively). This trend can be determined by a higher and more stable prevaccination level of HAI AT than the same residual level of AT among unvaccinated patients. CONCLUSION : During long-term cardiac studies, the logarithmic calculation in interpreting the results of HAI AT overcomes the limitations of the traditional analysis of assessing the efficiency of the annual influenza vaccine. Further serological programs are required to better understand the role of routine seasonal influenza vaccination in preventing morbidity and mortality of patients with cardiovascular diseases.