Vol 18, No 10 (2016)


Atrial fibrillation management on prehospital and in-hospital phases, based on the principles of evidence-based medicine

Miller O.N., Tarasov A.V., Dik I.S., Belyaeva I.E.


Atrial fibrillation (AF) is the most common type of arrhythmia and is associated with an increased risk of stroke and systemic thromboembolism, heart failure, deterioration in quality of life. The antiarrhythmic drugs (AD) remain the main therapeutic approach in case of AF management, especially on prehospital phase despite the high efficiency of electrical cardioversion (ECV), nowadays. Still, many questions remain unsolved especially the efficacy, tolerability and safety of these drugs, taking into account that AF is not life-threatening. This article, according to the 2014 AHA/ACC/HRS guideline, deals with the modern pharmacological cardioversion of paroxysmal and/or persistent AF, where experts focus on the results of a placebo-controlled studies and meta-analyses using different AD, nowadays. We prove the high efficiency of class IC AD, immediate restoration of sinus rhythm after intravenous and/or oral AD administration, the absence of serious adverse events and the absence of requirement for hospital admission after AD application, and included AD in the recommendations 2014 - class I, level of evidence A, now.
Consilium Medicum. 2016;18(10):8-18
pages 8-18 views

Ventricular arrhythmia accompanied several diseases and syndromes: modern approaches to the treatment and improvement of forecast for life

Bunin Y.A.


The article discusses the current problems of diagnostics, treatment, primary and secondary prevention of death in patients with genetically caused ventricular arrhythmia (VA) associated with a high risk of sudden cardiac death (SCD). We showed the results of basic clinical recommendations and studies concerning the possibility of different antiarrhythmic drugs and implantable cardioverter defibrillators (ICD) in the treatment of VA associated with arrhythmogenic right ventricular cardiomyopathy, short QT syndrome, the Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia and non-compacted myocardial layer. It was shown, that ICD application, in most cases, was the main method of secondary prevention of SCD in this group of patients. In addition, we indicated the number of issues concerning the management of VA patients with several diseases and some syndromes.
Consilium Medicum. 2016;18(10):19-23
pages 19-23 views

Glycemic control as a part of coronary stenosis prevention strategy in type 2 diabetes patients before and after transcutaneous coronary intervention

Salukhov V.V., Kadin S.V., Agliullin A.F.


Diabetes mellitus type 2 (DM 2) is judgefully beleaved to be one of the most sufficient populational risk factors for cardiovascular diseases, and is supposed to be the predictor of unfavorable currence of previously diagnosed coronary heart disease (CAD). Increased cardiovascular hazard in DM 2 is realized due to such coronary atherosclerosis peculiarities as more extensive, multivessel lesion and a bigger stenosis degree. Modern percutaneous coronary intervention (PCI) facilities provide significant survival and quality of life improvement. But there are more frequent target lesion revascularization in DM 2 patients for restenosis. The article covers some questions concerning the influence of glycemic control in DM 2 on different features of CAD progression and in-stent restenosis development in DM 2 patients who underwent PCI. Different aspects of restenosis pathogenesis and prevention are illuminated.
Consilium Medicum. 2016;18(10):24-28
pages 24-28 views

Macronodular bilateral adrenal hyperplasia: diagnose the aberrant receptors and current aspects of treatment

Yukina M.Y., Nuralieva N.F., Beltsevich D.G., Troshina E.A., Platonova N.M.


The investigation strategy for identification the specific expression of aberrant receptors includes ligand-induced tests. The identification of aberrant receptors provides an opportunity for new pharmacological therapeutic strategies. However, the specific aberrant receptors antagonists administration is limited due to the insufficient data on the effectiveness of medication, and side effects of drugs. Currently there is no unified approach of the management of patients with MBAH. Thus, researches, including genomic, directed at improvement of timely diagnostics of disease and development of new therapeutic and potentially preventive measures against MBAH, are topical.
Consilium Medicum. 2016;18(10):29-33
pages 29-33 views

History and prospects of the development of coronary stenting (brief essay)

Analeev A.I., Semitko S.P.


This article is devoted to the history of the development of coronary stenting, review of modern technologies and perspectives for the further development of this technique.
Consilium Medicum. 2016;18(10):34-39
pages 34-39 views

The first case of Absorb bioresorbable vascular scaffold implantation in child with complex congenital heart defect and acute coronary syndrome

Shmatkov M.G., Chernogrivov A.E., Allenov A.A., Morozov Z.A., Bazylev V.V.


We showed the clinical case of emergency coronary angioplasty with Absorb bioresorbable vascular scaffold implantation in child 2 years old with complex congenital heart defect and acute coronary syndrome. The feature of this case was the exclusive rarities in detection of myocardial infarction and percutaneous coronary intervention in children of this age group. In addition, Absorb bioresorbable vascular scaffold implantation was performed for the first time in child 2 years old. In view of uniqueness of this case we believe that our observation was appropriate and payed particular attention to the main approaches of tactics and technical aspects of the intervention.
Consilium Medicum. 2016;18(10):40-42
pages 40-42 views

Beyond the scope of invasive cardiology

Vertkin A.L., Knorring G.Y.


Invasive cardiology has a great opportunity to improve the quality of life and the prognosis of patients with ischaemic heart disease, but with all significance, revascularization procedures are limited in large group of patients. Optimal medical therapy becomes the only alternative option for this group of patients, and for patients who already survived invasive manipulation this procedure can lasting many years. The potassium channels activator Cordinik (nicorandil) has many statistically significant opportunities; the efficacy of this drug has been shown in patients with ischaemic heart disease.
Consilium Medicum. 2016;18(10):43-48
pages 43-48 views

Original and reproduced drugs in cardiology: the problem of interchangeability of bisoprolol

Batishcheva G.A., Mubarakshina O.A., Kurbatova E.I.


The medical practitioner should always choose between the original drugs and the reproduced copies on appointing pharmacotherapy. The issues concerning the interoperability between original and generic drugs, the results of pharmaceutical, pharmacokinetic and therapeutic equivalence studies were extremely important. We showed that, despite the identical international nonproprietary name, the main side effects of the brand name and generics might differ according to the analysis of comparative studies of the original and reproduced bisoprolol. The priority in the treatment of important cardiac diseases should be given to the original drugs, based on the principles of evidence-based medicine.
Consilium Medicum. 2016;18(10):50-54
pages 50-54 views

The arsenal of therapist: torasemide

Kirichenko A.A.


We performed the comparison of the pharmacological characteristics and clinical efficacy between furosemide and torasemide in patients with arterial hypertension, chronic heart failure (CHF), chronic kidney disease and in patients with ascites and cirrhosis. Antidiuretic mechanism of action of torasemide is similar to that of furosemide, but torasemide has a higher bioavailability (>80%) and a longer half-life (3-4 h). The administration of torasemide once a day at doses of 2.5-5 mg reduces diastolic blood pressure to a target BP of less than 90 mm Hg in 70-80% of patients. Antihypertensive efficacy of torasemide is similar to that of thiazides and thiazide-like diuretics. The administration of torasemide once a day at doses of 5 to 20 mg gives the effective diuretic action in patients with CHF. In CHF patients the bioavailability of torasemide is slightly reduced, diuretic action is smooth. Torasemide causes less potassium loss and rebound effect. Total and cardiovascular mortality in patients receiving torasemide is lower (2.2% vs 4.5% of the comparison group); p<0.05. Torasemide pharmacokinetic parameters are not changed in stages III (glomerular filtration rate - GFR 30 - 59 ml/min) and IV (GFR 15-29 ml/min) chronic kidney disease. Torasemide and furosemide therapy is accompanied by a comparable increase of natriuresis and lowering blood pressure in patients with chronic kidney disease.
Consilium Medicum. 2016;18(10):55-60
pages 55-60 views

Clinical aspects of application of candesartan

Rybachkova Y.V.


One of the key systems of the body, affecting the functioning of the heart and blood vessels, - the renin-angiotensin-aldosterone system (RAAS). Amplification RAAS activation plays an important role in the development of cardiovascular diseases. It proved that inhibition of the RAAS activity reduces the incidence of complications of cardiovascular diseases and mortality. Candesartan is a selective blocker of angiotensin II receptor type 1. Distinctive features of its pharmacokinetics and pharmacodynamics are longer duration of antihypertensive action, high selectivity and good bioavailability. In the treatment of hypertension with candesartan is able to effectively prevent the early morning rise in blood pressure. For preparation characterized cerebro and cardioprotective effects, the ability to reduce the risk of new cases of diabetes. The drug is effective in the treatment of nephropathy different genesis, including patients with a severely reduced renal function. The metabolic neutrality, the ability to prevent the development of micro - and macroangiopathy allow us to recommend the angiotensin receptor blocker in the treatment of patients with diabetes mellitus. The favorable pharmacokinetic profile of the candesartan creates performance advantage compared to other drugs of the same group.
Consilium Medicum. 2016;18(10):61-65
pages 61-65 views

Pharmacological validity of amlodipine, lisinopril and rosuvastatin in three-component combination drug products

Giliarevskiy S.R., Golshmid M.V., Kuzmina I.M., Zakharova G.Y., Sinitsina I.I.


The development of combined drugs, including antihypertensive and hypolipidemic components, represents the important stage in the clinical pharmacology funds for the treatment and prevention of cardiovascular disease complications. This approach allows significantly increase the degree of adherence of patients to treatment. The interactions between the drug components should be minimal or absent to improve the efficacy and safety of combined drug application. The article shows the significant data concerning the pharmacological validity of the combined application of dihydropyridine calcium channel blockers, amlodipine, angiotensin-converting enzyme inhibitors lisinopril and rosuvastatin; the most widely used drugs - statins.
Consilium Medicum. 2016;18(10):66-70
pages 66-70 views

Calcium channel blockers in cardioprotection and nephroprotection: with a focus on lercanidipine

Evdokimova A.G., Ryzhova Y.V., Tebloev K.I., Shuyskaya O.A.


We show the literature review concerning the use of calcium channel blockers (CCB) in patients with arterial hypertension from the standpoint of cardioprotection and nephroprotection positions. The article deals with the classification and pharmacological characteristics of CCB. Special attention is paid to the third-generation dihydropyridine CCB, in particular, lercanidipine.
Consilium Medicum. 2016;18(10):71-75
pages 71-75 views

Angiotensin II receptor antagonist - candesartan in the arsenal of therapist

Kirichenko A.A.


The article deals with the comparison of pharmacological characteristics and the clinical efficacy of angiotensin II receptor blockers in patients with arterial hypertension, chronic heart failure (CHF) and chronic kidney disease. High binding affinity to the angiotensin type 1 receptors, slow dissociation and repeated fixation of candesartan provide the expressed and prolonged duration of the antihypertensive and organoprotective actions. Therapeutic efficacy of candesartan is equivalent to that of other major classes of antihypertensive agents. The application of candesartan is highly effective in CHF associated with left ventricular systolic dysfunction. In the group of patients with preserved left ventricular function, candesartan efficacy is statistically significant. We show the decrease of risk of the developing atrial fibrillation in the course of candesartan treatment in hypertension patients with CHF.
Consilium Medicum. 2016;18(10):76-81
pages 76-81 views

The optimal approach to the treatment of autonomic disorders in cardiology practice

Troshina D.V., Volel B.A., Kopylov F.Y.


This article discusses the clinical variants of dysfunction of the autonomic nervous system, common in the practice of cardiologists. Analyzes heterogeneity of autonomic disorders in a cardiac pathology: vegetative crises and dystonia (cardioneurosis). We also discuss modern approaches to the treatment of autonomic disorders in cardiology, their advantages and disadvantages with the withdrawal of the possible presence of optimal treatment strategy.
Consilium Medicum. 2016;18(10):82-86
pages 82-86 views

Hemoptysis: differential diagnostic aspects in cardiology practice

Trukhan D.I., Viktorova I.A., Viktorov S.I.


The article describes the main diseases of the cardiovascular and respiratory systems in which there is clinical symptom of hemoptysis.
Consilium Medicum. 2016;18(10):87-93
pages 87-93 views

The case of coronary artery disease and chronic glomerulonephritis of young woman

Seliverstova D.V., Evsina O.V., Aleevskaya A.M.


Nowadays the numbers of cardiovascular system diseases have been in high level and the kidney’s diseases are spread widely too. In this case a lot of patients have development of cardiorenal syndrome. It is a pathophysiological heart and kidneys disorder, wherein acute or chronic dysfunctions the one of these organs lead to acute or chronic dysfunctions the other. The cardiorenal syndrome is the most common among the elderlies, because it is a developing a long time. There are a few type of the syndrome. In this article we consider the least examined occurrence of cardiorenal syndrome in the 4 type, wich led to Q-myocardial infarction in young woman.
Consilium Medicum. 2016;18(10):94-97
pages 94-97 views

Psychological characteristics of patients with stress-induced arterial hypertension: emotion dysregulation is the central component in the pathogenesis

Pervichko E.I., Ostroumova O.D., Zinchenko Y.P.


The article deals with the role of emotion dysregulation in the pathogenesis of hypertension. We discussed in detail various strategies to regulate emotions. We showed the data of the experiment on modelling the emotional load and revealed that the "stressful" situations in patients with so-called "hypertension at the workplace" differ from healthy individuals and patients with the "classic" arterial hypertension in a variety of psychological and physiological characteristics. We showed that patients with "hypertension at the workplace" repressed emotions and the emotion regulation strategies were ineffective in overcoming psychic tension and created the conditions for chronization of high BP and could be considered as the central parts of pathogenesis of arterial hypertension.
Consilium Medicum. 2016;18(10):98-105
pages 98-105 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies