Developed on the instructions of the Russian Health Ministry, approved by the Society of Emergency Cardiology and the leading committee of Cardiology National clinical guidelines on diagnosis and treatment of hypertrophic cardiomyopathy working group: Chair of working group - prof. Ageev Ph.T. (Moscow), deputy chair of working group - MD Gabrusenko S.A. (Moscow), MD Postnov A.Y. (Moscow), RAS Academician Akchurin R.S. (Moscow), PhD Smirnova M.D. (Moscow) The Expert Committee: prof. Karpov R.S. (Tomsk), prof. Shaposhnik I.I. (Chelyabinsk), prof. LopatinYu.M. (Volgograd), prof. Barbarash O.L. (Kemerovo), prof. Galyavich A.S. (Kazan)

Actuality. Condition of hepatopathy being quite common in patients with dilated cardiomyopathy has a special, pathognomonic value at right ventricular cardiomyopathy, as hepatic congestion develops already in the early stages of the disease. Its development was greatly exacerbates the underlying disease, increases symptoms and worsens the general state of patients. The aim. Explore the features of deviations in the biochemical analysis, and the relationship between impaired liver function and the type of damage to the heart in various forms of cardiomyopathy Materials and methods. The study included 52 patients with CHF II-IV of NYHA classes, due to idiopathic dilated ( DCM ) and right ventricular (RV DCM ) dilated cardiomyopathies. All patients were assessed a clinical status, transthoracic echocardiography and blood biochemical investigation. Results. It has been shown that RVDCM in 2 times more common in women, is characterized by more frequent occurrence of signs of hepatopathy (81,8 % vs. 43,3 %), in the form of increased levels of bilirubin (mainly due to indirect fractions 14,82 ± 16,21mkmol / l vs. 6,76 ± 3,51 mkmol / l), transaminases ( 36,3 % and 30 %) and the relative hypoalbumin (2,9 ± 0,6 g / dl vs. 3,16 ± 0,48 g / dl ), hypocholesterolemia in this group of patients.

Aim. To study features of coronary arteries atherosclerotic lesions in unstable angina (UA) patients depending on distribution of APO С-III gene polymorphism and type of dislipidemia. Material and methods. There were examined 141 patients of Uzbek nationality with UA class IIB (Braunwald E. et al., 1989). The control group consisted of 50 healthy persons. DNA allocation made from blood by means of a set «Diatom™ DNA Prep 200» under the standard report of firm of the manufacturer (laboratory Isogene Russia). For carrying out PCR of amplification used a set (laboratory SibEnzyme, Russia). The sequence primers was used, according to recommendations Ahmad Reza Bandegi et al, 2011. Results. At the comparative analysis the distribution of S2 alleles SstI polymorphism of gene АРО C-III among the patients with UA in comparison with healthy persons, has been found a more prevalence of S2allelecarriers (HR 2,58, 95% CI 1,2-5,7, Р<0,05). In patients with carriage of S2 alleles it was observed raised triglycerides level (P <0,05) and high frequency of three-vessel coronary arteries lesion (HR 2,17, 95% CI 1,1-4,4, Р<0,05). At the comparative analysis in a subgroup of patients with triglycerides above a distribution median (>230 mg/dl) also prevailed S2 alleles carriers (HR 2,31, 95% CI 1,1-4,7, p <0,05) and occurrence of three-vessel coronary arteries lesion (HR 2,51, 95% CI 1,2-5,1, Р=0,003), whereas in a subgroup with triglycerides level <230 mg/dl have appeared more patients with one-vessellesion (HR 2,52, 95% CI 1,1-5,9, Р<0,05). Conclusion. Presence of three-vessel coronary arteries lesion among unstable angina patientsassociated with S2 alleles SstI polymorphism of gene АРО C-III carriage and hypertriglyceridemia.

Purpose: studying influence chronobiological factors on frequency of occurrence ACS/ AMI Material and methods: Epidemiological features of AMI and ACS were studied among the constant population of one of districts of Tashkent. The research was carried during one year (from 1.07.2009 to 30.06.2010). Results: the register were included 683 patients with AMI/ACS., of them men - 67,9 % and women - 32,1 %. According to our data January and December appeared to be the less favourable months, and Mаy and June were the most favourable. The analysis of the incidence rate of ACS/AMI with regards to seasons of year showed, that the greatest quantity of patients as well as of lethal outcomes (23,0 % and 33,9 %, respectively) at the prehospital stage was noted on the autumn-winter period. Lethal outcomes at a pre-hospital stage on time of days were registered in night (0.00 till 5.59 o'clock) and morning (6.00 till 11.59 o'clock) hours (29,6 % and 27,1 % accordingly) is slightly more often. Conclusion. Thus, our researches have confirmed a universal tendency that episodes ACS/AMI on time of days meet in the morning is more often, and night time of days is interfaced to higher probability lethality at a pre-hospital stage.

Objectives. To estimate immediate and long term results of the minimally invasive coronary surgery (MICS) at the multiple lesions of the coronary arteries depending on completeness of the achieved myocardium revascularization for optimization of the surgical treatment of the patients with coronary heart disease (CHD). Materials and methods. From 2011 up to 2013 at the cardiac surgery department of ME “Vitebsk regional clinical hospital” 151 patients with the CHD underwent minimally invasive myocardium revascularization (MIMR) at the multiple lesions of coronary arteries. MIMR strategy was directed to avoid artificial cardiopulmonary bypass with cardioplegia and manipulations on the ascending aorta, usage of the left minithoracotomy access and tendency to perform complete or functionally reasonable arterial myocardium revascularization. 84 patients underwent complete MIMR, 67 patients - functionally reasonable incomplete MIMR. Results. Immediate results of the MIMR were found satisfactory (complete angina retrogression and absence of the major cardiovascular complications) in 99,3% patients and were compared in groups of patients who underwent complete (98,8%) or functionally reasonable (100%) MIMR (р>0,05). Operation time was longer and emergency conversion to the assist extracorporeal circulation (AECC) was more frequent in the complete MIMR group of patients in comparison with functionally reasonable MIMR group (р<0,05). Statistically significant difference in adverse event rate during and after surgery was not found in current groups of patients (р>0,05). There were no major differences in the frequency of the recrudescent angina and major cardiovascular complications (combined adverse patient outcome) between complete and functionally reasonable MIMR groups of patients during long-term follow-up - 2,41% and 5,97% respectively (р>0,05). Conclusion: MICS with aortic no-touch technique can be applied for majority of multivessel CHD patients as a complete, functionally reasonable or hybrid revascularization with or without AECC, saving the effectiveness and clinical effect duration of the coronary procedures.