Cardiorenal syndrome (CRS) covers a spectrum of disorders affecting both the heart and kidneys, in which acute or chronic dysfunction in one organ can cause acute or chronic dysfunction in another organ. The concept of CRS has streamlined the numerous relationships between acute and chronic heart and kidney diseases and united cardiologists and nephrologists in the struggle for the quality and life expectancy of patients. Identification of kidney involvement in the pathological process at the early stages of the cardiovascular continuum, starting with risk factors, will allow for preventive measures that will help improve both cardiovascular and renal outcomes. The above has led to the preparation of these recommendations. The recommendations include modern approaches to the diagnosis, treatment and prevention of all 5 types of CRS in various cardiovascular diseases. The recommendations briefly present the main pathophysiological mechanisms of cattle development and modern classifications. The extremely relevant and, in our opinion, insufficiently covered issues of diagnosis and treatment of contrast-induced nephropathy, renal replacement therapy and its place in the treatment of cattle are highlighted in detail, which, in our opinion, will make the recommendations interesting and useful for a wide range of specialist doctors. The recommendations are intended not only for cardiologists, nephrologists, cardiac and endovascular surgeons, anesthesiologists, intensive care physicians and perfusiologists, but also for general practitioners and internists who are on the first line of the fight against CRS. It is noteworthy that when preparing the recommendations, we used our own experience of the State Institution «Republican Scientific and Practical Center of Cardiology» and the State Institution «Minsk Scientific and Practical Center for Transplant Surgery and Hematology» (Minsk, Republic of Belarus).

Objective: to evaluate the effect of correction of HF therapy based on indicators of multisensory ICD sensors on the clinical course of the disease and the frequency of shocks.

Materials and methods. 111 patients with HF and indications for ICD implantation for the primary prevention of sudden cardiac death were included in the prospective study, then they were divided into two groups: in the studied (n=56) ICD with a multisensory set of sensors; in the comparison group (n=55), standard ICD without sensors. The patients were monitored for 12 months, and the dynamics of quality of life, clinical and laboratory parameters, device monitoring data, discharge episodes, and the number of hospitalizations due to HF decompensation were analyzed.

Results. The patient groups were initially comparable in terms of gender, age, etiology of the disease and severity of the condition. All patients were on optimal medication therapy for HF for more than 3 months. Initially, there were no significant differences in the level of NTpro-BNP and the six-minute walking test distance, and there were no еchocardiography indices in both groups. After 6 months, during device interrogation, diuretic therapy was changed in the study group, taking into account the indicators of multisensory sensors, in the comparison group only based on clinical data. After 12 months, both groups showed positive dynamics in the quality of life index; a significant increase in ejection fraction and NT-proBNP levels in the study group, a significant decrease in the six-minute walking test distance in the comparison group, a comparable number of both adequate and inadequate ICD discharges, and a significantly lower number of hospitalizations for decompensation in the study group.

Conclusion. The use of ICD multisensory monitoring was associated with a statistically significant improvement in the clinical course of HF and the frequency of shocks in patients compared with standard ICD.

Background. Cardiac remodeling is a complex bidirectional process in which structural and functional parameters of the heart deviate from the norm in response to impaired intracardiac hemodynamics following acute myocardial infarction. Reverse left ventricular (LV) remodeling is manifested by improved systolic and diastolic function due to a decrease in cardiac chamber volume.

Objectives. To analyze the dynamics and degree of reverse remodeling of the left ventricle after surgical correction of post-infarction aneurysms of the left ventricle. Based on the results, develop a model for predicting ultrasound parameters in patients in the postoperative period.

Methods. A retrospective analysis of treatment outcomes was conducted for 174 patients who underwent post-infarction aneurysm repair followed by coronary artery bypass grafting (CABG) at the Nizhny Novgorod Research Institute of Cardiology and the Nizhny Novgorod Clinical Hospital named after Academician B.A. Korolev between 2011 and 2022. Patients were divided into two groups. The first group underwent Cooley repair and CABG, while the second group underwent Dor repair and CABG. The patients had various risk factors that influenced the development of LV remodeling processes. Ultrasound imaging was used to obtain data on the LV and other cardiac structures. Artificial intelligence was used to predict the potential extent of cardiac reconstruction.

Results. A significant reduction in ultrasound measurements of LV volume was observed in patients at various postoperative times. The most significant practical outcome of the study was the development of a clinically applicable machine learning model for predicting surgical outcomes. Its high accuracy (confirmed by a low median error) allows the model to be used for preoperative planning to individualize surgical tactics. The model helps determine the "sweet spot" in the extent of resection — one that is sufficient to initiate reverse remodeling but safe from the risk of low-output syndrome. The implementation of such AI-based decision support systems directly contributes to improved surgical safety and patient outcomes.

Conclusion. In cardiac surgery, a key indicator of success is reverse LV remodeling against the background of heart failure remission after surgery. In recent years, assessment of this process has become a cornerstone of clinical practice, as it serves as the main predictor of a favorable long-term prognosis for patients.

Idiopathic pulmonary hypertension (IPAH) nowadays frequently diagnosed in older patients. Consequently, comorbidity increased, complicating patient risk assessment and diagnosis, and influencing therapeutic decisions. This article focuses on comparing clinical, instrumental and demographic parameters, survival rates, and prognosis in patients with “classical” IPAH and those with comorbidities.

Materials and Methods. The study included patients (n=56) with a verified diagnosis of IPAH between 2014 and 2023. All participants were divided into two groups: patients with IPAH without comorbidities (n=26) — Group 1; and patients with IPAH and comorbidities (n=30) — Group 2. The following examinations were performed: 6 minute walk test, echocardiography, right heart catheterization, NTproBNP level assessment, and clinical and biochemical blood tests. Mortality risk assessment was conducted at the time of diagnosis, after 1 year, and after 3 years of therapy using risk stratification scales.

Results. Comorbid patients were older: 46,5 [35,2; 53,0] years vs. 33,0 [28,0; 38,0] years, p=0,001. At time of diagnosis, they had higher body weight and systolic blood pressure values, reflecting the presence of comorbidities. After 36 months, statistically significant differences between the groups were observed in: 6MWT distance (p=0,04); NT-proBNP levels (p=0,014); pulmonary artery systolic pressure ( p=0,014), mean pulmonary artery pressure (p=0,01), mixed venous oxygen saturation (p=0,009), right atrial pressure (p=0,033), pulmonary vascular resistance (p=0,012). Survival rates at 1, 3, and 5 years were 96,1%, 92,3%, and 92,3% respectively in Group 1, . In Group 2, survival rates were 96,7% at 1 year, 86,7% at 3 years, and 73,3% at 5 years (p=0,022).

Conclusion. The increasing proportion of comorbidity patients with IPAH in the population affects the diagnosis and treatment of this patient group, their survival rates, and response to therapy. For a more accurate risk assessment, it is already necessary to include the comorbidity profile in the list of parameters evaluated during risk stratification.

A review of modern Russian and foreign literature on the problem of impaired coronary blood flow reserve as a manifestation of microvascular dysfunction has been conducted. When searching for information on this issue, materials from the following databases were used: RSCI, Best Evidence, Scopus, Elsevier, PubMed, Clinical Evidence, Cochrane Library. Microvascular angina (MVA) is a clinically significant form of ischemic heart disease characterized by myocardial ischemia in the absence of obstructive epicardial coronary artery lesions. This review summarizes key pathophysiological mechanisms contributing to cardiovascular complications in patients with MVA, highlights modern biomarkers and imaging methods used for risk stratification and prognosis, and discusses therapeutic individualization and future directions in clinical monitoring.