Vol 17, No 12 (2015)

22-25 сентября в Москве состоялся Российский национальный конгресс кардиологов. Обширная программа национального конгресса предлагала широкий выбор мероприятий: заседания, круглые столы, научные сессии, симпозиумы, на которых обсуждались научные и практические вопросы кардиологии, предлагались меры как по снижению смертности от ССЗ, так и их профилактике. Печень играет центральную роль в транспорте как экзогенного ХС, так и эндогенных ЛП». При нарушении процессов транспорта ХС в периферические ткани и обратного его захвата в печень наблюдается развитие гиперхолестеринемии и как следствие - атеросклероза. Рассмотреть влияние процессов, происходящих в печени, на состояние сердечно-сосудистой системы О.М.Драпкина предложила на модели неалкогольной жировой болезни печени (НАЖБП).

На конкретных клинических примерах О.Н.Миллер продемонстрировала типичные ошибки, возникающие в повседневной практике при выборе антиаритмического препарата (ААП).

Hypertension remains the cornerstone of the cardiovascular continuum. An increasing number of patients receiving combination antihypertensive therapy to achieve target blood pressure, expanding indications for combination therapy at the onset of treatment. Constantly growing market of fixed combinations (FC) of antihypertensive drugs. The article gives an overview of the FC, registered in the Russian Federation, discussed the clinical situation for the purpose of the pre-emptive or other FC. A more detailed analysis of FC, including angiotensin receptor blocker II, and diuretics, in particular, discusses the benefits of FC, including angiotensin receptor blocker II azilsartan and thiazide diuretic chlorthalidone.

This literature review examines the available evidence base and recommendations for the use of basic antiplatelet agents used in clinical practice. Data on the current understanding on the use of acetylsalicylic acid (ASA) for primary prevention of cardiovascular events is reviewed. We discuss the step-wise approach to the individual assessment of benefits from the use of ASA in primary prevention, proposed by the Working Group on Thrombosis of the European Society of Cardiology.

In the recent past, cardiac manifestations of gastroesophageal reflux disease (GERD), including chest pain and heart rhythm disturbances was the subject of many publications. However, the classification of GERD, adopted at the World Congress of Gastroenterology in Montreal in 2005, refers chest pain to typical (not extra-esophageal) manifestations of the disease. Cases of cardiac arrhythmia are not considered as a syndrome associated with GERD.The probable causes of chest pain (CP) in GERD include esophageal smooth muscle spasm in response to irritation by refluctate its mucosa, visceral hypersensitivity and ischemic pain associated with atherosclerotic vascular disease process. In the latter case the CP is not a direct consequence of GERD. However, this pathology has common risk factors with coronary artery disease (CAD), which results in their comorbidity (prevalence of GERD is higher among patients with CAD than in the general population). Furthermore, there is data that irritation of esophageal mucosa by refluctate is able to cause reflex spasm of the coronary arteries, which is accompanied by ischemic manifestations on the electrocardiogram and the typical clinical symptoms of angina. ThatЂs why distinguishing ischemic and esophageal kinds of pain may be difficult.Gastroesophageal reflux is able to be a trigger of cardiac rhythm and conduction disturbances. Among mechanisms may be imbalance of autonomic influences on the heart, including viscero-visceral reflexes caused by irritation of the esophagus and mediated via the vagus nerve; inflammatory process, which is able to spread from the esophageal wall to the adjacent left atrium wall; and the mechanical compression of the anterior left atrium wall by food passing through the esophagus.Thus, the modern classification of GERD does not assume the presence of cardiac syndrome among extra-esophageal manifestations of the disease. Ischemic pain and cardiac arrhythmias associated with GERD should be considered from the standpoint of comorbidity.

Tuberculosis of the spine is 50-60% of cases of all forms of osteoarticular tuberculosis. The leading role in the diagnosis of destructive bone changes in tuberculous lesions of the spine is played by ray examination methods. Due to the fact that each of these methods has its advantages and disadvantages it requires a clear approach in the diagnosis of tuberculous lesions of the spine. It should be noted that at the moment in the presence of a large hardware base requires a comprehensive clinical and diagnostic approach, which would allow a rational design algorithm of examination of patients with suspected tuberculous lesion of the spine, improve the quality of diagnosis and optimized treatment strategy.

In a multicenter observational programs RESOURCE were included 324 (181 female and 143 male) patients with overactive bladder due to neurologic disease. The average age of patients was 59.4±0.7 years (23 to 94). The purpose of research was to evaluate the efficacy and safety of high doses of trospium chloride in patients with overactive bladder due to neurologic disease. According to the study it was found that 11 patients stopped treatment because of severe side effects, 8 preferred dose of trospium chloride 15 mg/day, 25 - 30 mg/day, 155 - 45 mg/day, 115 - 60 mg/day, 7 - 75 mg/day, 2 - 90 mg/day and 1 - 120 mg/day. There was no direct proportional relationship between increasing doses of trospium chloride, and improving symptoms of urgent and frequent urination. Thus, an individual approach in dose selection trospium chloride in patients with neurogenic overactive bladder can be quite effective and safe measure to achieve optimal clinical outcome with a good safety profile.

Systemic sclerosis (SSc) is a rare autoimmune connective tissue disease characterized by thickening of the skin and multiple organ involvement. Gastroesophageal reflux disease (GERD) is a common disease manifestation of SSc, as well as interstitial lung disease (ILD), the latter is the main cause of SSc related mortality. Several studies broached the issue of a potential association of GERD with SSc-ILD and indicated that microaspiration of gastric acid may cause inflammation consecutively leading to lung fibrosis. The aim of this review is to recapitulate current evidence for a link between GERD and ILD in SSc patients and emphasize the necessity of early diagnosis and treatment in order to hopefully slow down the progression of mortality driving SSc-ILD.