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Aim. To evaluate the clinical course and inhospital outcomes of myocardial infarction (MI) in patients receiving continuous direct oral anticoagulant (DOAC) therapy.Material and methods. Data from 390 patients treated for MI were included in the analysis. The mean age was 64.1±12.8 years. The majority were men (61,5%; n=240). All patients underwent standard diagnostic and therapeutic procedures according to clinical guidelines, including coronary angiography and percutaneous coronary intervention when indicated. Clinical, anamnestic and laboratory data (including C-reactive protein level, troponin I, coagulation test) were analysed. The inhospital course of MI, mortality and incidence of complications were evaluated.Results. Patients were divided into two groups according to DOAC therapy received. The main group included 41 patients with constant DOAC intake, while the control group consisted of 349 patients not receiving DOAC. Patients aged 65 years and older accounted for 68,3% (n=28) of the main group (p=0,0033), with a high proportion of cerebral circulation disorders and venous thrombosis (p0,05). Prior DOAC administration had no significant effect on the incidence of gastrointestinal bleeding (odds ratio (OR), 3,96 (95% Confidence Interval (CI) 0,76–20,66)) and mortality (OR 1,47 (95% CI 0,37-5,85)) during hospitalization.Conclusion. Patients with MI who received continuous DOAC therapy had significantly more frequent ST-segment resolution at hospital admission compared with patients who did not receive DOAC. DOAC administration had no significant effect on mortality and incidence of inhospital complications of MI.

Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.

The article discusses the effectiveness and safety of homologous and heterologous revaccination for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in people of different age groups.Aim. The study the severity and duration of immune response in people of different age groups after SARS-CoV-2 revaccination.Material and methods. The study was carried out as part of the prospective registry Saturn, which included persons who received various SARS-CoV-2 revaccination regimens (homoand heterologous) based on the combination of two vaccines: Gam-COVID-Vac and Covivac. Group I (n=106) included persons who received a homologous revaccination with Gam-COVID-Vac, while group II (n=54) — heterologous revaccination with Gam-COVID-Vac and Covivac, group III (n=40) — homologous Covivac revaccination. In addition, all participants in the study were divided into two age categories: ≥60 years (n=33) and

Coronavirus disease 2019 (COVID-19) pandemic was not only a serious challenge for the healthcare system around the world, but also an incentive for intensive research and development for the introduction of innovative technologies and drugs, in particular vaccines against the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The first vaccination campaigns provided significant protection against severe disease course and hospitalization. However, new SARS-COV-2 variants require further comprehensive research and the introduction of booster vaccination. Booster vaccination is the most important tool for immunostimulation and increase of protection duration against the severe disease course. The study of booster vaccines, including BioNTech/Pfizer, Moderna, Oxford AstraZeneca, Sputnik V, Sinopharm и Covaxin vaccines, sheds light on their unique action mechanisms and contribution to long-term immunity. The analysis of clinical data demonstrates their effectiveness and safety. The review summarizes modern knowledge about booster vaccinations against the COVID-19 with focus on action mechanisms and efficiency. In addition, the immune system function in response to COVID-19 is considered, while the role of memory cells, antibody and cellular immunity reactions are emphasized.

The effectiveness of humoral and cell-mediated immunity as a result of primary vaccination for Severe Acute Respiratory Syndrome- related CoronaVirus 2 (SARS-CoV-2), as well as the effectiveness of revaccination, is an important research problem. Studying and selecting optimal revaccination regimens will allow for long-term protection against coronavirus disease 2019 (COVID-19).Aim. To study the severity of humoral and cell-mediated immune response in various (homo- and heterologous) SARS-CoV-2 revaccination regimens as part of a prospective observational study 18 and 24 months after primary vaccination.Material and methods. The study was carried out within the prospective registry SATURN, which included individuals who received various SARS-CoV-2 revaccination (homo- and heterologous regimens) based on a combination of two following vaccines: Gam- COVID-Vac and CoviVac. Depending on the chosen regimen, 3 following groups were formed: group I (n=106) — participants with a homologous Gam- COVID-Vac regimen at each stage of vaccination and revaccination; group II (n=54) — participants with a heterologous regimen of sequential administration of Gam- COVID-Vac and CoviVac at the stage of vaccination and revaccination; group III (n=40) — participants with a homologous CoviVac regimen at the stage of vaccination and revaccination. At the first visit, all participants underwent a medical history collection, examination, and identification of potential contraindications to vaccination. At each subsequent visit, the level of anti- SARS-CoV-2 S-glycoprotein IgG antibodies was additionally determined. At visits 1, 3 and 5, the activity of specifically sensitized T-lymphocytes to the surface and nuclear antigen of SARS-CoV-2 was assessed. The IgG concentration was analyzed using the Abbott Architect SARS-CoV-2 IgG reagent kit, while T-cell immunity was assessed using the T-Spot.COVID test system (Oxford Immunotec). Visit 1 corresponded to the 1st stage of primary vaccination, visit 2 — 2nd stage of primary vaccination, visit 3 (12 months after visit 1) — 1st stage of revaccination, visit 3 (21 days after visit 3) — 2nd stage of revaccination, visit 5 –18 months after primary vaccination, visit 6 — 24 months after primary vaccination.Results. The average level of anti- SARS-CoV-2 S-glycoprotein IgG antibodies in group I at visit 3 was 520 [478; 540] BAU/ml, in group II — 499 [199,5; 540] BAU/ml and in group III — 456 [389; 509,5] BAU/ml. The values were comparable to those obtained at visit 6. However, in group II, IgG level at visit 5 was significantly higher compared to visit 6 (p=0,001). The greatest decrease by visit 5 in the number of active T cells responding to SARS-CoV-2 Spike stimulation was recorded in group III (5,00 [0,50; 11,50] vs 1,00 [0,00; 5,50]; relative changes -80,0%; p=0,067). Also, among patients in group III, there was a significant decrease in the number of active T cells responding to stimulation with SARS-CoV-2 nucleocapsid (10,00 [3,00; 22,50] vs 1,00 [0,00; 11,50]; relative changes -90,0%; p=0,0160). Participants in groups I and II demonstrated stable results on visit 5, relative to visit 3. In all studied groups, no significant relationship was found between IgG levels to SARS-CoV-2 S-glycopeptide and the number of active T cells. Strong positive relationships were found between the level of active T cells responding to SARS-CoV-2 spike stimulation and the level of active T cells responding to SARS-CoV-2 nucleocapsid stimulation: group I (ρ=0,807; p

Aim. To determine sex differences in the structural and functional state of skin microcirculation in individuals with newly diagnosed hypertension.Material and methods. The study included 124 men and 42 women of working age with low or moderate cardiovascular risk and newly diagnosed hypertension. Skin microcirculation was examined on the left upper limb simultaneously by three methods: 1) video capillaroscopy; 2) laser Doppler flowmetry; 3) photoplethysmography.Results. According to video capillaroscopy, in men compared to women, the functional and structural capillary density is lower — 79 vs 89 cap/mm2 (p

Aim. To study the functional state of the terminal arteries and arterioles of the skin using photoplethysmography (PPG) in men with hypertension (HTN) of low and moderate cardiovascular risk (CVR) and to identify morphofunctional diagnostic criteria associated with HTN.Material and methods. A total of 118 healthy men (30-60 years old) underwent clinical and biochemical blood tests, PPG, ultrasound of cardiac and main arteries, 24-hour blood pressure monitoring. According to 24-hour blood pressure monitoring, two groups were formed: the control group — 59 normotensive men, HTN group — 59 men with HTN.Results. According to the PPG data, men with HN had higher normalized augmentation index (Alp75) (3,8 and -5,25%; (p

Aim. To study clinical and anamnestic data, as well as inhospital outcomes in patients with ST elevation myocardial infarction (STEMI) with prior coronavirus disease 2019 (COVID-19) compared with previously uninfected STEMI patients.Material and methods. This prospective study included 181 patients treated for STEMI. The patients were divided into 2 groups, depending on the anti-SARS-CoV-2 IgG titer as follows: the main group included 62 seropositive patients, while the control group — 119 seronegative patients without prior COVID-19. Anamnesis, clinical and paraclinical examination, including electrocardiography, echocardiography, coronary angiography, were performed. Mortality and incidence of STEMI complications at the hospital stage were analyzed.Results. The mean age of the patients was 62,6±12,3 years. The vast majority were men (69,1% (n=125)). The median time from the onset of COVID-19 manifestations to STEMI was 60,00 [45,00; 83,00] days. According to, the patients of both groups were comparable the severity of circulatory failure (p>0,05). Coronary angiography found that in patients of the main group, Thrombolysis In Myocardial Infarction (TIMI) score of 0-1 in the infarct-related artery was recorded much less frequently (62,9% (n=39) vs, 77,3% (n=92), p=0,0397). Patients of the main group demonstrated a lower concentration of leukocytes (9,30*109/l [7,80; 11,40] vs 10,70*109/l [8,40; 14,00], p=0,0065), higher levels of C-reactive protein (21,5 mg/L [9,1; 55,8] vs 10,2 mg/L [5,1; 20,5], p=0,0002) and troponin I (9,6 ng/mL [2,2; 26,0] vs 7,6 ng/mL [2,2; 11,5], p=0,0486). Lethal outcome was recorded in 6,5% (n=4) of cases in the main group and 8,4% (n=10) in the control group (p=0,6409). Both groups were comparable in terms of the incidence of complications (recurrent myocardial infarction, ventricular fibrillation, complete atrioventricular block, stroke, gastrointestinal bleeding) during hospitalization (p>0,05).Conclusion. Patients with STEMI after COVID-19, despite a more burdened history and higher levels of C-reactive protein and troponin I, compared with STEMI patients without COVID-19, did not differ significantly in clinical status, morbidity, and inhospital mortality.

Aim. To provide data on the diagnostic and prognostic value of questionnaire survey for post-COVID-19 syndrome during screening and regular medical check-ups of employees, as well as preventive medical examinations.Material and methods. This single-center cross-sectional comparative study involved 1120 people (92,1% of the general population — all employees of the organization), including 195 men (67,3% of the general population) and 925 women (79,5% of the general population). All participants filled out the post-COVID-19 syndrome (PS) detection questionnaire, the Hospital Anxiety and Depression Scale and the QAA-25p Adherence Assessment Questionnaire. Potential adherence to treatment was calculated using the SCOPA software. Statistical processing was performed using tools adapted for medical and biomedical research (Python language; Sklearn, NumPy, Pandas libraries) and Statistica 6.13 (StatSoft Inc., USA).Results. As a result, 47% of respondents noted at least one symptom that reduces the quality of life and/or performance efficacy. In all subsamples, women reported symptoms more frequently than men. The most informative indicators associated with post-COVID-19 syndrome are age (Mann-Whitney U test, p=0,042), number of PS symptoms (Mann-Whitney U test, p=0,001), severity of PS symptom (Mann-Whitney U test, p= 0,004) and adherence to health care (Kruskal-Wallis H test, p=0,021). An increased level of anxiety is associated with all the analyzed symptoms, depression level with 6 symptoms, age with 5 symptoms, insufficient compliance with 3 symptoms.Conclusion. PS questionnaire should be included in a comprehensive survey program of persons undergoing medical examinations. It is necessary to develop algorithms for the treatment and diagnosis of patients that take into account the number and severity of individual symptoms separately for men and women with consideration to their COVID-19 epidemiological status, as well as age and markers of anxiety, depression, and adherence to treatment.

During the spread of an increasing number of new variants of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), it is extremely important not only to assess the immunogenicity and efficacy, butalso the safety of various combinations of vaccines. Excessive immune response and associated signs and symptoms may occur with varying frequency as expected from the use of vaccines.Aim. To compare the reactogenicity of various (heterologous and homologous) vaccination regimens in a prospective observational study.Material and methods. In individuals aged ≥18 years, in the absence of contraindications to vaccination, two types of vaccines were used at primary vaccination and revaccination: Gam-COVID-Vac and CoviVac: group I (n=97) — Gam-COVID-Vac at each stage of primary and booster vaccination ; group II (n=7) — Gam-COVID-Vck at each stage of primary vaccination, CoviVac at each stage of revaccination; group III (n=42) — CoviVac at each stage of primary vaccination, Gam-COVID-Vac at each stage of revaccination; group IV (n=38) — CoviVac at each stage of primary and secondary vaccination. In all participants, the dynamics of IgG to SARS-CoV-2 spike glycoprotein receptor-binding domain and T-cell immunity to SARS-CoV-2 were determined over time. To control the plasma hemostasis, the method of dynamic thrombophotometry was used. Local and systemic adverse events were assessed.Results. The number of vaccinated individuals with a rise in body temperature above 370 C after the 1st stage of revaccination was significantly (p

Along with efficacy and safety, it is extremely important to study the severity of humoral and cellular immunity during not only vaccination, but also revaccination against the Severe Acute Respiratory Syndromerelated CoronaVirus 2 (SARS-CoV-2).Aim. To compare the immunogenicity (humoral and cellular immunity) of various (heterologous and homologous) revaccination regimens against coronavirus disease 2019 (COVID-19) in a prospective observational study.Material and methods. In individuals aged ≥18 years, in the absence of contraindications to vaccination, two following types of vaccines were used for primary vaccination and revaccination: Gam-COVIDVac and CoviVac. Group I patients received Gam-COVID-Vac at each stage of primary and secondary vaccination; patients of group II — Gam-COVID-Vac at each stage of primary vaccination, CoviVac at each stage of re-vaccination; patients of group III — CoviVac at each stage of primary vaccination and Gam-COVID-Vac at each stage of revaccination; patients of group IV — CoviVac at each stage of primary and secondary vaccination. All participants (at each stage of vaccination, revaccination and 12 months after the primary vaccination) were determined the level of IgG to the receptor-binding domain of SARS-CoV-2 spike (S) protein and T-cell immunity to SARSCoV-2.Results. The maximum level of IgG at the second stage of revaccination was observed in groups I and III. In addition, in groups I, III and IV, a significant (p8). At the same time, the level of active T cells responding to SARS-CoV-2 nucleocapsid Ag stimulation by Visit 4 (stage II of revaccination) was noted in groups II (14,5) and IV (12).Conclusion. The use of the Gam-COVID-Vac vaccine as a booster dose in both homologous and heterologous vaccination regimens against the SARS-CoV-2 virus is most effective for stimulation and humoral and T-cell post-vaccination response.

The paper provides a brief overview of the modern possibilities of using a smartphone as a diagnostic device of a wide profile. In some cases, additional specialized attachments are required. In others, the diagnostic algorithm uses only standard cameras, a microphone and various built-in smartphone sensors. The development of the smartphone integration into the healthcare system is modern, relevant and very promising, given the widespread use of smartphones among the global population.

The coronavirus disease 2019 (COVID-19) pandemic remains one of the most urgent problems for healthcare professionals due to the variety of non-pulmonary manifestations. Along with the respiratory syndrome in a significant proportion of patients, the disease course is accompanied by pronounced systemic inflammatory response and hemostasis changes. This is associated with a high risk of complications, especially in patients with concomitant cardiovascular pathology. The aim of the study was to analyze and systematize the literature data on the pathogenesis, clinical course, and outcomes of myocardial infarction (MI) in patients with COVID-19. For review, publications indexed in the PubMed, Google Scholar, Web of Science, and Cyberleninka databases were used. The search depth was 2 years, starting from 2020. The review is based on summarized data from the most relevant clinical studies, reports and systematic reviews. The literature analysis made it possible to conclude that the published data on MI in patients with COVID-19 are currently contradictory. Multiple thrombosis, sepsis, macrophage activation, increasing hypoxemia, imbalance between myocardial oxygen supply and demand in patients with severe COVID-19 have led to a high incidence of type 1 and type 2 MI. It should be especially noted that in a number of cases, MI with COVID-19 occurs in patients with intact coronary arteries, and its course is associated with a high incidence of complications, which, in turn, leads to a significant increase in short- and mid-term mortality.

The ongoing pandemic of coronavirus disease 2019 makes it important to study the immunogenicity, the duration of immune response, and the safety of existing vaccines.Aim. As part of a prospective observational study, to assess associations between levels of anti-Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) S protein IgG antibodies and thrombodynamics parameters in individuals vaccinated with Gam-COVID-Vac and CoviVac vaccines.Material and methods. The study included 137 people who completed the first 3 visits: 30 people received the Gam-COVID-Vac, 107 people — CoviVac. The study participants underwent venous blood sampling before the introduction of the 1st and 2nd vaccine doses, as well as 42 days after the administration of 1st dose in order to quantify the level of IgG antibodies. At each visit, plasma hemostasis parameters were analyzed using a thrombodynamics test.Results. During the follow-up period, there was a clear increase in the level of anti-SARS-CoV-2 S protein IgG antibodies in both groups. At the same time, this increase over time was significantly greater in Gam-COVID-Vac group. There was no correlation detected between thrombodynamics test results and the levels of anti-SARS-CoV-2 S protein IgG antibodies.Conclusion. The data obtained demonstrate the ability of both vaccines to stimulate the production of anti-SARS-CoV-2 antibodies. However, immune response to Gam-COVID-Vac is much higher. The lack of correlation between thrombodynamics and the level of specific antibodies suggests that vaccination for COVID-19 with Gam-COVIDVac and CoviVac does not cause changes in plasma hemostasis and does not increase the risk of thrombosis.

In the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is extremely important to study immunogenicity and immune response duration in different vaccines.Aim. As part of a prospective observational study, to study the levels of anti-SARS-CoV-2 S-protein IgG antibodies in individuals vaccinated with the Gam-COVID-Vac and CoviVac vaccines.Material and methods. The data of 93 people who completed the first 3 visits were analyzed, 23 of whom were vaccinated with the Gam-COVID-Vac vaccine and 70 people — with the CoviVac vaccine. We collected blood before the injection of vaccine doses I and II, as well as 42 days after the injection of dose I in order to quantitatively determine IgG levels. The level of anti-SARS-CoV-2 S-protein IgG antibodies was determined using the SARS-CoV-2 IgG ELISA-BEST reagent kit on the InfiniteF50 TECAN system.Results. A significant increase in anti-SARS-CoV-2 S-protein IgG antibodies was observed in those vaccinated with Gam-COVID-Vac. In the group of CoviVac vaccine, an increase in the level anti-SARS-CoV-2 S-protein IgG antibodies in absolute values was recorded, however, this increase did not reach statistical significance.Conclusion. The data obtained show that the level of anti-SARS-CoV-2 S-protein antibodies 42 days after Gam-COVID-Vac vaccination is significantly higher than after CoviVac vaccination. However, an increase in the level of IgG in both groups indicates the ability of both vaccines to stimulate the production of anti-SARS-CoV antibodies.

Aim. To study sex characteristics of cutaneous microvascular structure and function in a cohort of healthy working-age people without cardiovascular diseases.Material and methods. The study included 35 healthy men (42±4 years) and 34 women (41 ±5 years). The cardiovascular system was assessed in all patients. The microcirculatory bed of the skin was investigated by the following non-invasive methods: 1) computerized video capillaroscopy; 2) laser Doppler flowmetry; 3) photoplethysmography.Results. According to computerized video capillaroscopy in men, compared with women, there was a smaller number of both functioning capillaries (78 vs 86 capillaries/mm2, respectively (p

Hypertension remains a pandemic of the 21st century, being a major factor of premature death. The introduction of imaging methods into clinical practice revealed a high prevalence of target organ damage mediated by hypertension. One of the systemic target organs in hypertension is endothelium. Its damage plays an important role in the initiation of the cardiovascular disease continuum. On the other hand, structure and function defects of the endothelium is considered as a possible reason for the increase in blood pressure. This literature review systematizes data on a causal relationship between hypertension and endothelial dysfunction, and discusses the direction of further study of vascular endothelium function.

Aim. To study clinical, medical history and paraclinical characteristics of patients with non-ST elevation myocardial infarction (NSTEMI) after coronavirus disease 2019 (COVID-19).Material and methods. The study included 209 patients with NSTEMI who were admitted to the Demikhov City Clinical Hospital (Moscow). The patients were divided into 2 groups: the experimental one (n=104) — those after COVID-19, the control one (n=105) — those without history of COVID-19. All patients underwent routine diagnostic investigations in accordance with current standards and clinical guidelines.Results. The mean age of patients in the experimental group was 61,8±12,2 years, while in the control one — 69,0±13,0 years (p

Acute coronary syndrome (ACS) is caused by an acute mismatch between myocardial oxygen demand and its supply. This mechanism is largely associated with the progression of coronary atherosclerosis in combination with an inflammatory response, hypoxemia, and blood procoagulation. Patients with the coronavirus disease 2019 (COVID-19), aggravated by cardiovascular diseases and comorbidities, are at high risk of ACS.Aim. To analyze the publications, which reflects the development of ACS in patients with COVID-19, its pathogenesis, and clinical course. Material and methods. Literature data were searched using Google Scholar, PubMed, ScienceDirect, and Cyberleninka services. The analysis included data from clinical guidelines on COVID-19, data from clinical studies, reports, and systematic reviews.Results. This literature review summarizes and systematizes the data presented in modern publications, highlights the aspects of the clinical course and pathogenetic mechanisms underlying ACS in patients with COVID-19.Conclusion. The pathogenesis of COVID-19 is inextricably associated with the widespread cytopathic effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), uncontrolled immune response that causes systemic inflammation, as well as the coagulation system activation. In patients with COVID-19, along with the atherosclerosis, these mechanisms significantly increase the risk of ACS and can worsen its in-hospital course.

The growing population of elderly people is the main «antithrombotic drugs consumer» because there is higher prevalence of thromboembolic diseases (acute coronary syndrome, venous thromboembolism, atrial fibrillation) among them than among younger people. Elderly people have high risks of both thromboembolic and bleeding complications associated with antithrombotic drugs using. Antithrombotic drug choice is based on individual careful estimation of the «risk/benefit» ratio. Sometimes real clinical practice gives us problems and questions, having no answers in any guidelines. Such a difficult clinical case of elderly patient management is presented in this article.

The results of prospective randomized clinical trials planned to assess the efficacy of using statins in high doses before percutaneous coronary interventions (PCI) are presented in the review. The effect of this approach on the severity of myocardial damage and clinical outcomes in planned PCI in patients with stable ischemic heart disease (IHD) and early PCI in acute coronary syndrome (ACS) without stable ST-segment elevation was found. The results of the trials planned to study the incidence of contrast-induced nephropathy as well as data from meta-analyzes of conducted clinical trials are demonstrated.According to the accumulated facts, taking high doses of statins before PCI can contribute to reduce myocardial damage with a decrease in the risk of periprocedural myocardial infarction. This effect was demonstrated in the planned coronary stenting in patients with stable IHD and in PCI in the first days of treatment of ACS without the stable ST-segment elevation. It was found both in patients who had not previously taken statins and in patients permanently treated with statins. The additional expected benefit of using a high dose of statins prior to PCI is the prevention of contrast-induced nephropathy. However, due to the limited evidence base, there is no consensus on the advisability of such an approach in current clinical guidelines.

Aim. As the endothelial glycocalix (EG) — gel-like layer on the surface of endothelium, participates in normal endothelial functioning maintenance, search for markers that characterize its condition, is of high scientific interest. Aim of the study — to evaluate clinical and diagnostic opportunities for novel EG marker, related to thickness and plasticity of EG, represented as perfused boundary region (PBR, μm) of erythrocytes.Material and methods. Totally, 208 patients included (123 men, 85 women) at the age 40-65 y.o., with various level of cardiovascular risk by SCORE, and coronary heart disease (CHD). EG of microvessels was charterized via PBR, that was measured with dark field capillaroscope with diod light of green spectrum.Results. With the values of PBR >2 μm there is worsening of morphofunctional state of arteries of different localizations, and microcirculatory vessels, level of apolipoprotein A1 decreases, as structure protein of high density lipoproteins, and prevalence of carotid atherosclerosis increases two times, of CHD — 2,5 times (p2 μm, is associated with worsening of microcirculatory vessel condition, and of large arteries, prevalence of stenosing atherosclerosis of carotid arteries and CHD, that points on its properties of surrogate marker of endothelial dysfunction and further opportunities for its implementation with diagnostical aims.

Endothelium glycocalyx (EG) is a highly organized protecting complex of the vessels. Damage of EG is one of the first pathogenetic mechanisms of a range of pathologies onset, and primarily cardiovascular diseases. Current paper focuses on the structure, functioning of EG normally and in pathology, and on the possibility to apply EG as potential vascular biomarker, target for therapy.