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Aim: To study the relationship between laboratory markers and echocardiography (EchoCG) parameters in heart failure with preserved ejection fraction (HFpEF) depending on the results of the diastolic stress test (DST)., Material and Methods: The diagnostic algorithm provided by the current guidelines for the assessment of left ventricular (LV) diastolic function was used to select patients. If there were not enough criteria to make a conclusion about increased LV filling pressure (FP) based on standard resting echocardiography data in patients with arterial hypertension and ischemic heart disease, DST was performed to detect HFpEF. 80 patients (50.0% men, mean age 66.3±5.4 years) were included. Group 1 consisted of 41 patients with a positive DST, and group 2 included 39 patients with a negative DST. Concentrations of the markers of immune inflammation, endothelial dysfunction, collagen homeostasis, and myocardial stress were measured., Results: The DST showed significant differences in the E/e' ratio (15.1 [13.4; 15.9] in group 1 and 9.5 [7.9; 10.3] in group 2, respectively, p<0.001) and the diastolic functional reserve index (DFRI) (9.8 [6.8; 14.0] and 21.0 [13.0; 29.0], p < 0.001). Resting EchoCG revealed significant differences in the left atrial reservoir strain (LASr) (22.8 [19.6; 25.6]% and 28.0 [24.8; 30.2]%, p<0.001) and the left atrial stiffness index (LASI) (0.50 [0.40; 0.57] and 0.34 [0.27; 0.41], p<0.001). In patients with HFpEF, the laboratory parameters of collagen regulation had the greatest number of relationships. Correlations were found between the concentrations of matrix metalloproteinase-9 and other biomarkers, including interleukin-10 (IL-10) (r=0.311; p=0.048), myeloperoxidase (r=0.382; p=0.014), N-terminal propeptide of procollagen type I (procollagen I N-terminal propeptide, PINP) (r=0.722; p<0.001) and type III (r=0.591; p<0.001), C-terminal propeptide of procollagen type I (r=0.330; p=0.035), tissue inhibitor of metalloproteinases type 1 (r=0.410; p=0.008), EchoCG parameters, including left atrial volume index (LAVI) (r=0.414; p=0.007) and DFRI (r=0.354; p=0.025). In addition, correlations were found for the concentrations of PINP with IL-10 (r=0.401; p=0.009) and endothelin-1 (r= -0.337; p=0.031); PINP with LAVI (r=0.498; p=0.001) and DFRI (r=0.420; p=0.007)., Conclusion: Patients with HFpEF have a greater number of relationships between markers of collagen homeostasis disorders and EchoCG parameters characterizing an increase in LV FP.

The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) with type 2 diabetes mellitus who underwent COVID-19-associated pneumonia is of great clinical importance for preventing the risk of adverse events. IN the study we used data from 65 patients in the present work. Patients were divided into 2 groups: group 1 included patients with CVD: arterial hypertension (AH) in combination with coronary artery disease (CAD) without DM2 (n=45), group 2 included patients with CVD and DM2 (n=20). Patients were examined at baseline in the infectious disease hospital and 3 months after discharge. During laboratory examination of blood biosamples we evaluated parameters of general blood test; biochemical and immunologicai parameters; elastic properties of the vascular wall. The analyzed leukocyte parameters and their index coefficients - increase in NLR ratio (neutrophils/lymphocytes) and decrease in LYM/CRP ratio (lymphocytes/CRP) were more significantly changed in DM2 group. Patients in both groups had a significant excess of baseline max CRP concentrations with decrease in parameters after 3 months, but with persistent excess values in group 2. Three months after discharge patients with DM2 had levels of hs-CRP, IL-1β and TNFa and NT-proBNP, that exceeded both the reference values and those in group 1, which reflected the presence of more pronounced vascular inflammatory potential for possible adverse events in this group of patients in post-COVID period. The method of multiple regression showed that DM2 is an independent risk factor for increased stiffness of the vascular wall. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and DM2 developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely prevention of unwanted vascular complications., Competing Interests: The authors declare no conflict of interest.

The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) undergoing COVID-19-associated pneumonia may be of great clinical importance. The study included 116 patients who underwent COVID-19-associated pneumonia. The patients were divided into 2 groups. The first group included 49 patients without CVD, the second group - 67 patients with CVD. A blood sample was performed in all patients at the time of hospitalization and 3 months after discharge from the hospital. The parameters of general blood count, biochemistry, hemostasis, and biomarkers of inflammation were assessed - concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine and IL-6. All patients initially underwent computed tomography of the chest organs. We found that ESR, WBC (leukocytes), NLR (neutrophils/lymphocytes ratio), fibrinogen, LDH (lactate dehydrogenase), LYM/CRP ratio (lymphocytes/CRP) were parameters that significantly distinguished patients in the 1st and 2nd groups. Three months after discharge from the hospital in patients of both groups the increased indicators approached the reference values, however, some parameters such as CRP, ESR, WBC, fibrinogen remained at a higher level in group 2 compared to group 1. Correlation analysis revealed the relationship between parameters of inflammation and hemostasis in the 2nd group of patients, which confirms the presence of latent vascular inflammatory potential in this group. It was revealed that such indicators as lymphocytes, neutrophils, APTT and LDH were associated with the initial volume of lung lesion more than 50%. Increase of these parameters by 1 unit contributes to increase in the volume of lung tissue damage by 6.5%, 6.4%, 11%, and 0.6%, respectively. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely correction of therapy to prevent unwanted vascular complications., Competing Interests: The authors declare no conflict of interest.

The study of the features and dynamics of the erythrocyte parameters of general blood analysis in patients with cardiovascular diseases who underwent SARS-CoV-2 associated pneumonia is of great practical importance. That was a prospective study. The study included 106 patients with SARS-CoV-2-associated pneumonia. All patients were divided into 2 groups. The first group included 51 patients without CVD, the second group included 55 patients with CVD .Patients in both groups underwent laboratory examination of blood samples at the time of hospitalization and 3 months after discharge from the hospital. Parameters of the erythroid series of the general blood test were assessed. Among inflammatory biomarkers, we examined the concentration of C-reactive protein (CRP), high-sensitivity CRP (hs-CRP) and homocysteine. Initially all patients underwent computed tomography of the chest organs. Revealed what indicators of the erythroid series in the groups of patients with and without CVD had significant differences in a number of parameters: ESR; RDW-SD and RDW-CV with significant excess of parameters in group 2. Three months after discharge from the hospital, patients in both groups had a significant increase in HCT, MCV, MCH. There was detected decrease in both groups in MCHC, RDW-CV (p<0.001 for all parameters), ESR level in group 2.At baseline, CRP exceeded reference values in both groups of patients, reaching maximum values in group 2. After 3 months CRP decreased significantly only in group 1. Increased CRP was associated with elevated hs-CRP in 3 months after discharge and elevated homocysteine levels in both groups, indicating the persistence of prolonged inflammatory vascular reaction in patients after SARS-CoV-2 associated pneumonia, more pronounced in group 2 patients. RDW-CV over 13.6 and lymphocytes / CRP less than 0.6 increase the likelihood of having lung tissue damage over 50% by 9.3 and 5.9 times, respectively. Thus, the data obtained confirm that RDW-CV, the coefficient of variation of erythrocyte distribution width, associated with the parameters of inflammatory response and the lymphocytes / CRP is lung volume marker and of COVID-19 severity. Careful consideration of already known laboratory parameters allows us to expand the number of indicators influencing the risk of COVID-19 complications and enable an earlier response to a difficult situation., Competing Interests: The authors declare no conflict of interest.

The study of the parameters of the lipid profile and markers of the inflammatory reaction of the vascular wall in patients with stable angina pectoris in the presence or absence of type 2 diabetes mellitus (T2DM) is of great importance for revealing the gender characteristics of the pathophysiological mechanisms of the development and course of diseases, developing secondary prevention of complications and determining the prognosis. 194 patients with stable angina pectoris (SA), single-vessel coronary artery disease, mean age 60.3 ± 7.8 years were examined. Patients were divided into two groups: group 1 - patients with SA without diabetes 2 (n = 152), group 2 - with SA and diabetes 2 (n = 42). In each group, subgroups of men and women are distinguished. The study of biomarkers was carried out upon admission to the hospital on the background of therapy, taken on an outpatient basis. The study included a complex of parameters of the lipid spectrum, markers of the inflammatory response, endothelial dysfunction, and carbohydrate metabolism parameters. A comparative analysis of biomarkers revealed an excess of reference values of atherogenic lipid fractions in both groups of patients, regardless of patient gender. Moreover, in the first group of patients, in the subgroup of women, a significant excess of the level of TC, PL (a), and ApoA-1 was registered compared with the subgroup of men. In the second group, there were no significant differences in parameters between the male and female subgroups. Evaluation of the parameters of the inflammatory reaction revealed in the subgroup of women with T2DM a steady tendency to exceed the level of hs-CRP, TNF-α, homocysteine compared with both men and women in the SA group without T2DM. The logistic regression revealed the main biochemical markers that affect the aggravation of the course of IHD in women with T2DM: this is a uric acid level of more than 380 mmol / l - OS 11.5 (95% CI 1.71-77.69), TNF-α more 8 pg / ml - OR 7.5 (95% CI 1.07-52.46) and an increase in TG - OR 3.33 (95% CI 1.073-10.335). Thus, women of the 2nd group with the presence of T2DM are characterized by the highest level of atherogenic fractions of lipids, markers of vascular inflammation, glucose and HbA1c, which may indicate the greatest potential for the development of atherothrombotic complications in this subgroup of patients., Competing Interests: The authors declare no conflict of interest.

Objective: To study the role of therapeutic exercises (TE) in the correction of blood pressure, stiffness of the vascular wall and disorders of bone mineral metabolism in postmenopausal hypertensive patients., Material and Methods: The study included 78 patients (mean age was 53.32±7.61 years). All patients are divided into 3 groups. The first control group is 20 women without arterial hypertension and menopause. The second group consisted of 27 patients with arterial hypertension (AH) and post-menopause who were not undergone the TE complex and the 3 rd group - 31 women with AH and post-menopause who were undergone TE complex. Patients of all groups were examined in dynamics: at the starting point of the study and 12 months later, out-patient monitoring of blood pressure; sphygmography; densitometry and test for blood serum biochemistry parameters, including sex hormones, vitamin D., Results: In the course of the study, blood pressure, vascular wall stiffness and disorder of bone mineral density were revealed significantly higher in the group 3 with significantly reduced levels of sex hormones. Multidirectional correlation relationships between the studied parameters are revealed. Treatment combined with therapeutic exercises led to permanent improvement tendency in studied parameters like blood pressure, pulse wave velocity, metabolic disorders and T-criterion., Conclusion: The result of the study indicates that the exercise therapy complex used in the form of regular classes, according to the scheme proposed by the exercise therapy doctor, can be recommended for implementation in clinical practice with the aim of comprehensively affecting the patient's body and developing personalized treatment tactics for postmenopausal women with hypertension.

In recent years, accumulated numerous data on the pathogenetic links of the formation of arterial hypertension. A number of studies have shown that vitamin D deficiency, associated with age, changes in sex hormonal status, increased tone of the reninangiotensin-aldosterone system, endothelial dysfunction, and calcium metabolism, can be one of the mechanisms of development and progression of arterial hypertension. The purpose of the review was to summarize the results of the original domestic and foreign studies, prospective observations and meta-analyzes on the relationship between vitamin D deficiency and arterial hypertension., Competing Interests: The authors declare no conflict of interest.

Recently, they increasingly began to pay attention to the role of a nonspecific immune-inflammatory vascular response as a link in general pathogenetic mechanisms with a change in the elastic properties of arteries and phenomena of destructive bone changes, which at the subclinical level is of great importance for the prevention of the development of socially significant diseases. A total of 104 patients were examined (mean age 57.45 years), which were divided into three groups. The first group included 39 healthy women, the second group included 30 patients with hypertension and osteopenia, and the third group included 35 women with hypertension and osteoporosis. The analysis of markers of the immune inflammatory response, endothelial dysfunction, hormonal and mineral-vitamin status parameters was conducted against the background of the study of parameters of daily monitoring of arterial pressure, study of parameters of vascular wall stiffness and densitometry to clarify the predictors of cardiovascular and degenerative bone changes in postmenopausal women. A significant increase in the concentration of HF-CRP, the level of homocystemine, IL-8, parathyroid hormone, against the background of a significant decrease in the level of estrogen, progesterone, testosterone, with a persistent tendency to increase in total cholesterol, atherogenic lipid fractions, myeloperoxidase, endothelin-1 and decrease was recorded calcitonin, total and ionized calcium, with a significantly minimal value of vitamin D in the 3rd group of patients. The risks of development and progression of bone destructive changes were calculated using the logistic regression method for the group of AH with osteopenia and osteoporosis. Thus, for patients with hypertension and osteopenia, a significantly significant parameter associated with the risk of developing osteoporosis was an indicator of the velocity of the pulse wave, an increase in the level of which exceeds 12.05 m/s is associated with an increased risk of developing osteoporosis by 3.8 times. Increased levels of pro-inflammatory parameters, IL-6 and 8, TNF-α, HB-SRB, parathyroid hormone and reduced levels of progesterone and IL10, took the most active part in aggravating the degree of available bone tissue destruction. Timely specialized multidirectional study of biochemical and instrumental parameters (in particular, the study of the speed of the pulse wave and densitometry) can be the basis for the development of personalized prevention and treatment tactics for women in order to prevent socially dangerous cardiovascular and bone complications., Competing Interests: The authors declare no conflict of interest.

The study of the causes of the development of vascular coronary complications after angioplasty with stenting using the evaluation of biochemical parameters in the dynamic observation of patients with IHD with significant coronary stenosis determines the relevance of the study. To analyze the parameters of lipid spectrum and markers of vascular inflammatory reaction in patients with IHD, in groups with stable angina and episode of unstable angina after angioplasty with stenting, to trace the dynamics of biochemical parameters and to reveal the predictors of undesirable coronary events. Patients with IHD with significant coronary stenosis of the arteries (SCS, n = 95) after coronary angiography at the point of maximum increase in the level of markers of the inflammatory reaction (3 months after angioplasty) are divided into 2 groups - patients with persistent stable angina pectoris (SA, n = 77) until the end of the study and patients with developed postvascularization episode of unstable angina (UA, n = 18). The dynamics of observation of biochemical parameters recorded the absence of normalization of the atherogenic spectrum of the lipid profile and the prolonged nature of the vascular inflammatory response to the end point of observation after angioplasty.The method of binary logistic regression revealed that in the general group of patients with IHD, an increase in the level of low density lipoprotein cholesterol by 1 mmol / L significantly increases the probability of significant coronary stenosis in men and raises the risk of UA after angioplasty by 7.38 times. It was found that patients with UA at the initial stage have a significantly higher risk of coronary blood flow instability in the post-vascularization period due to an elevated level of homocysteine. A set of biochemical markers for predicting the significance of coronary stenosis and development of undesirable vascular coronary events after angioplasty in patients with IHD has been identified: male sex, elevated LDL cholesterol and hyperhomocysteinemia., Competing Interests: The authors declare no conflict of interest.

Aim: To evaluate the degree of carotid artery (CA) atherosclerotic lesion and lipid metabolic disturbances in patients with hypertension and in those with hypertension concurrent with coronary heart disease (CHD) in the indigenous and non-indigenous population living in the Yamal-Nenets Autonomic District., Subjects and Methods: Two hundred men and women aged 21 to 55 years (mean age 48.2 ± 0.7 years), who resided in the Far North, were examined. The patients were divided into 4 gender-and age-matched groups of 50 persons in each: 1) natives; 2) newcomers with hypertension only; 3) natives with CHD and hypertension; 4) non-natives with the above conditions. To study CA involvement, all the patients underwent duplex scanning of the brachiocephalic arteries at the extracranial level and blood lipid analysis in an outpatient setting (Salekhard)., Results: In all the patients, common CA intima-media thickness was significantly greater than the upper limit of the normal range defined in the Guidelines, this indicator proved to be highest in the groups of indigenous people (p<0.001). The latter with CHD and hypertension more commonly tended to have atherosclerotic lesion in the left CA (p=0.06) than the non-indigenous people whereas the number of stenosis in other CAs was similar. In the natives versus the newcomers with CHD and hypertension, the atherogenic blood lipid composition was due to the higher levels of total cholesterol and low-density lipoproteins. In the non- indigenous patients with CHD and hypertension, the atherogenicity of the blood lipid composition was characterized by the higher levels of triglycerides (p=0.04) and very low-density lipoproteins (p=0.02) with the lower concentrations of high-density lipoproteins as compared to those in the natives with CHD and hypertension.

Objective: To study special characteristics of the course of arterial hypertension (AH) among native and nonnative population of Yamalo-Nenets autonomous district., Material and Methods: We examined 100 residents of Far North with AH (men and women aged 21-55, mean age 44.08 ± 1.15 years). All patients were divided into 2 equal groups by 50 subjects: group I consisted of representatives of native and group II--nonnative population. Examination was carried out in outpatient clinic in Salekhard and included 24-hour ambulatory blood pressure monitoring (ABPM), registration of heart rate variability, duplex scanning of brachiocephalic arteries, and assessment of blood lipid profile. The groups were matched by age, gender and disease duration., Results: Analysis of heart rate variability detected significant degree of strain of regulatory systems in most patients of both groups. According to results of ABPM "non-dipper" patients prevailed in group I compared to group II (p = 0.01). Common carotid artery intima-media complex was significantly greater compared to normal value in all patients; it was thicker in group I (p < 0.03), but number of carotid artery stenoses was similar in both groups. No dyslipoproteinemia was detected., Conclusion: Compared with group of representatives of nonnative (adopted) population group of native subjects with AH was characterized by greater carotid intima media thickness and prevalence of "non-dipper" patients.

The work aimed at studying atherosclerotic lesions in brachiocephalic arteries and lipid spectrum in coronary heart disease (CHD) and arterial hypertension (AH) in indigenous and alien population of Yamalo-Nenetsky Autonomous District. It included 200 patients with CHD and AH (men and women aged 21-55 years, mean 48.2 +/- 07 yr). They were allocated to indigenous and alien groups (100 persons each). The patients matched for age and sex were examined by duplex scanning based at an outpatient facility (Salekhard). The indigenous population showed more pronounced thickening of the intima-media complex (IMC) of the common carotid artery (p = 0.001) and more frequent lesions of the main head arteries with stenosis of different severity (especially in internal carotid arteries). Total cholesterol, LDLP and atherogenicity index were similar in both groups and higher than normal. Indigenous subjects had less atherogenic structure of the lipid spectrum due to lower TG and VLDLP but higher HDLP levels.

Aim: To investigate the specific features of a 24-hour blood pressure (BP) profile and heart rate variability (HRV) in the indigenous peoples (Nenets, Khanty, Selcups, and Komis) and newcomers with chronic coronary heart disease (CHD) and hypertension, who lived in the Yamal-Nenets Autonomic District., Subjects and Methods: Two hundred male and females patients aged 21 to 55 years (mean age 48.2 +/- 0.7 years) with chronic CHD and hypertension, who resided in the Far North, were examined. All the patients were divided into 4 groups: (1) 50 aboriginal patients with hypertension only; (2) 50 newcomers with hypertension only; 3) 50 natives with chronic CHD and hypertension; (4) 50 non-natives with the above conditions. The groups were matched for gender, age, and the duration of hypertension and CHD. To study the nature of changes in the 24-hour BP profile, all the patients underwent 24-hour ambulatory BP monitoring (ABPM) and HRV examination., Results: The HRV analysis revealed that all the groups had increases in sympathetic autonomic nervous system (ANS) activity (88% in Group 1; 96% in Group 2; 94% in Group 3, and 92% in Group 4) and decreases in parasympathetic ANS activity (76% in Group 1; 74% in Group 2; 78% in Group 3; and 72% in Group 4), which was suggestive of neurocardiopathy. Analyzing the data of 24-hour ABPM showed that among the natives, there were more patients with increased systolic and diastolic BP (SBP and DBP) variability and higher nocturnal SBP time index (TI). These groups also showed a preponderance of patients with abnormal 24-hour BP profiles as compared to the groups of newcomers (p = 0.034). Among the latter, there were more patients with higher SBP and DBP variability and increased daytime DBP TI and also more patients with a normal nocturnal BP reduction (p = 0.012)., Conclusion: The group of indigenous populations displayed a predominance of non-dippers and night-pickers and higher nocturnal SBP and DBP whereas the group of non-indigenous ones exhibited a preponderance of dippers and higher daytime SBP and DBP variability.

Aim: To investigate the effects of ivabradine in combination with perindopril on cerebral blood flow and endothelial functional activity., Subjects and Methods: Sixty-four patients with coronary heart disease (CHD) and arterial hypertension (AH) were examined. Group 1 (n = 38) patients took ivabradine in combination with perindopril and Group 2 (n = 26) received metoprolol. At baseline and 8 weeks after therapy, 24-hour blood pressure (BP) monitoring and electrocardiography were done, cerebral blood flow was estimated by Doppler ultrasound, reactive hyperemia and nitroglycerin tests were performed, and plasma nitrite levels were determined., Results: With a comparable decrease in BP and heart rate in the internal carotid artery basin in both groups over time, there was a fall in peak systolic blood flow velocity; Group 1 showed a reduction in pulsatility index (PI) and systolic/diastolic ratio (ISP). After 8 weeks, there was an increase in endothelium-independent vasodilation and baseline blood flow velocity in the brachial artery in Group 1 and a rise in endothelium-dependent vasodilation in Group 2; in both groups, reactive hyperemia were higher in the brachial artery basin. No changes in nitrite levels were recorded during therapy. There was an inverse correlation between PG and PI in Group 1 and between PG and ISP in Group 2., Conclusion: By unidirectionally affecting the vasomotor function of the endothelium, ivabradine in combination with perindopril versus metoprolol has a more favorable effect on circulatory resistance and blood flow velocity in the brachiocephalic arteries of patients with CHD and AH.