Vol 18, No 10 (2016)

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.

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.

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.

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.

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.

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.

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.

The article describes the main diseases of the cardiovascular and respiratory systems in which there is clinical symptom of hemoptysis.

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.