Disclaimer The EAC/NSHFMD Guidelines represent the views of the EAC and NSHFMD, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication. The EAC and NSHFMD is not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the EAC/NSHFMD Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EAC/NSHFMD Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic, or therapeutic medical strategies; however, the EAC/NSHFMD Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and, where appropriate and/or necessary, the patient’s caregiver. Nor do the EAC/NSHFMD Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient’s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional’s responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

Members of the Working Group confirmed the lack of financial support/ conflict of interest. In the event of a conflict of interest being reported, the member (s) of the Working Group was (were) excluded from the discussion of sections related to the area of conflict of interest.

E.B. Wataman professor, Dr. of Sci. (Med.) (Moldova); E.K. Kurlyanskaya, Cand. of Sci. (Med.) (Belarus); A.M. Noruzbaeva professor (Kyrgyzstan); V.A. Azizov professor (Azerbaijan); Zelveyan P.A., Dr. of Sci. (Med.) (Armenia)

Objective: To study the role of risk factors for cardiovascular diseases to optimize their pathogenetic diagnosis.

Material and research methods. At the initial stage of clinical trials, all participants (n = 200) were questioned with age-sex characteristics and the main risk factors for cardiovascular diseases (alcohol abuse, smoking, obesity, stress). Biochemical and clinical studies were carried out in two groups of patients, 15 people in each group (the first main group - in addition to bad habits, there is an obesity factor, the second control group - bad habits are detected, but in the absence of obesity) as part of preventive medical examinations.

The results of research. When studying psychosocial risk factors for the development of diseases of the cardiovascular system, a higher prevalence rate was noted for men in depression indicators - 26.3% of cases, and in the group of female patients the results were almost 2.5 times lower and amounted to only 15.0%. in both groups of healthy individuals, a low level of the frequency of occurrence of overweight and obesity was observed, compared with the main group, which were diagnosed in 28.6% of cases in the male half of the subjects, and among the representatives of the opposite sex, the indicator was 24.0%. The proportion of obese women in the main and control groups was higher than men by almost 1.5 times. Against the background of obesity and the presence of signs of non-alcoholic fatty degeneration of the liver, in comparison with patients with normal body weight, certain violations were detected in the form of a higher level in the blood of the liver enzyme ALAT - 35.2 ± 1.57 U / L and 21.3 ± 0 95 U / L, respectively, in the first main group and in the second control group.

Conclusions. Thus, it was found that the cause of cardiovascular diseases, in particular, cardiac automatism disorders, stroke, myocardial infarction due to metabolic and psychoemotional disorders are overweight and obesity, which worsen the prognosis of CVD, creating the prerequisites for the development of complications.

Objective. To determine the effect of bisoprolol or carvedilol therapy on the regulatory-adaptive status (RAS) of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV) the background of hypertensive disease (HD).

Material and methods. The study involved 68 patients with CHF and pEF of the LV, who were randomized into two groups for treatment with bisoprolol (7,3±2,4 mg/day, n=34) and carvedilol (28,4±12,3 mg/day, n=34). As part of the combination therapy, quinapril was prescribed (13,5±2,5 mg/ day, n=34 and 12,6±2,9 mg/day, n=34), and if indicated – atorvastatin (16,3±5,0 mg/day, n=11 and 15,5±5,2 mg/day, n=11) and acetylsalicylic acid in the intestinal soluble shell (93,8±17,7 mg/day, n=8 and 94,4±15,8 mg/day, n=8), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of RAS (by means of a sample of cardiac-respiratory synchronism), treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal fragment of brain natriuretic peptide, echocardioscopy, daily monitoring of blood pressure.

Results. Both regimens of combined drug therapy had comparable cardioprotective, hypotensive and neuromodulating effects, equally increased exercise tolerance. In comparison with bisoprolol, carvedilol differed positive impact on RAS, improved quality of life more.

Conclusion. In patients with CHF and pEF LV in combination therapy, the use of carvedilol, in comparison with bisoprolol, may be preferable due to the positive effect on the RAS.

The purpose of the study: to study the features of the rational use of antihypertensive drugs (AHP) by family doctors on an outpatient basis and their analysis of compliance with current international recommendations.

Materials and methods: According to questionnaires specially developed for studying the pharmacoepidemiology of hypertension, interviews were conducted with family doctors working in health houses located in different regions of the country and the specifics of their appointment of hypertension to patients with hypertension were studied. The duration of medical experience of doctors is on average 22.6 ± 11.0 years.

Results: The main drugs in the prescription structure were ACE inhibitors (19.7%), beta-blockers (19.6%), calcium antagonists (19.1%, diuretics (18.9%) ARBs (12.8%). central action drugs – 8.5%, alpha-adrenergic blockers – 1.4%. ACE inhibitor administration structure: enalapril – 33.8%, lisinopril – 26.3%, captopril – 23.3%, perindopril – 10.1 %, ramipril – 4.7%, the rest - 1.3% Of the beta-blockers: atenolol – 35.7%, bisoprolol – 34.7%, propranolol -15.7%, metoprolol - 8.0%, nebivolol – 4.3% and carvedilol 1.7%. The structure of the appointment of calcium antagonists: amlodipine – 38,3%, nifedipine – 29.6%, verapamil 16.8%, nifedipine SR and verapamil SR 5.7% each, diltheazem 2.1%, the share of all the others no more than 1.8%. Diuretic structure: hydrochlorothiazide – 36.0 %, furosemide – 28.8%, spironolactone – 18.6%, indapamide – 13.5%, torasemide – 2.1%, acetazolamide – 0.9%. The main proportion of ARB was losartan (84.0%) valsartan (8.7%), candesartan (4.2%), all the rest – 3.1%. 38.1% of family doctors still prescribe a centrally acting drug – clofellin, an imidazoline receptor agonist moxonidine (physiotens) is prescribed by family doctors very rarely (1.8%).

73.2% of respondents seek to reduce blood pressure to 140/90 mm Hg. Art., and the rest are limited to lowering blood pressure to a «working» level. 33.7% of family doctors start hypertension with monotherapy with the selection of an effective dose of one drug. 40.6% of doctors prefer free combination of AHP, 54.7% consider fixed combinations to be convenient, the rest are low-dose combinations.

Conclusion: Our study confirms the need for further improvement of the rational use of AHP by family doctors

Aim. The aim of our study was to assess the prevalence of contrast-induced nephropathy (CIN) in patients with chronic coronary artery disease (CAD) and its 1-year prognostic significance.

Materials and methods. 462 patients with chronic CAD and indications to the interventions with intraarterial contrast media administration were included in the study. We conducted a prospective open cohort study (ClinicalTrials.gov NCT04014153). The primary endpoint was the development of CIN. The secondary endpoints were total mortality, cardiovascular mortality, myocardial infarction, stroke, gastrointestinal bleeding, acute decompensation of heart failure, coronary artery bypass grafting, repeat percutaneous coronary intervention.

Results. 28 patients (6%) developed CIN. The rate of CIN in female patients was twice higher, than in males (9,29% vs. 4,66%). There was a trend towards less cases of CIN in patients without obesity (5,88% vs. 6,22%). CIN developed more frequently in patients with anemia (8,9% и 5,7%, р=0,3649, ОR 1,633,95% CI 0,6507-4,239). There was a trend to higher incidence of CIN in people with hyperuricemia (8% vs. 5,95%, р=0,6575, ОR 1,375,95% CI 0,3055-5,808). The rate of CIN in patients with diabetes mellitus was 2% higher, then without one. People, who suffered from myocardial infarction after 1 year of follow up, had the highest rate of CIN (26,7%), as well as patients with other major cardiovascular complications (18,1%). The rate of repeat percutaneous coronary interventions was 9,5%, the rate of acute decompensation of heart failure was 7%.

Conclusion. The prevalence of CIN in patients with chronic CAD was 6%. After 1 year of follow up the rate of CIN was higher in patients who had myocardial infarction, repeat percutaneous coronary interventions and acute decompensation of heart failure.

The features of the clinical course of non-compaction cardiomyopathy, its prognosis and even its diagnosis are still the subject of discussion. The variety of phenotypes of this disease and genetic heterogeneity dictates the need for detailed clinical and molecular genetic examination of patients with this pathology. The article presents a clinical observation of a patient with a dilated phenotype of left ventricular non-compaction, progression of chronic heart failure, as well as the presence of ventricular rhythm and conduction disorders that required the implantation of cardiac resynchronization therapydefibrillator (CRT-D). The patient was found to have a missense mutation c. 1892A>G (p.Tyr631Cys, rs1060501183) in PKP2 gene in a heterozygous state. The issues of differential diagnostics with arrhythmogenic right ventricular cardiomyopathy and treatment strategies for the disease were discussed.

Schedule of scientific activities.