Disclaimer. The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication. The EAC is not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the EAC 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 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 Guide-lines 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 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.

   In December, 2021 at the IXth All-Russian Congress «Pulmonary Hypertension 2021» the first Eurasian guidelines for the diagnosis and treatment of pulmonary hypertension associated with congenital heart disease in adults were approved. The expert group discussed many contentious issues, including the need for diagnostic tests for vasoreactivity. Invasive registration of the reaction of the pulmonary vessels to vasodilators – a vasoreactivity testing – in idiopathic, hereditary and drug- and toxin-induced pulmonary arterial hypertension (PAH) is used to determine indications for calcium antagonist therapy, in PAH associated with uncorrected congenital heart disease (CHD) in children – to determine the indications for surgical treatment. The use of a vasoreactivity testing to assess the operability of adult patients with congenital heart disease is inappropriate. An overview of the performance technique, specific pulmonary vasodilators and criteria for evaluating the test for vasoreactivity in various subgroups of PH associated with CHD is given.

   This work is devoted to a literature review of published articles, where studies are focused on studying the frequency, structure of complications of cardiovascular diseases in patients with COVID-19, that occurred in vivo and post-mortem: myocarditis, myocardial damage, AMI, and other thrombotic events. Some studies also provide comparative data on COVID-19+ and COVID-19- patients, complication patterns, and mortality rates. The results of the studied materials shows that, the frequency of cardiac complications and the number of deaths are significantly more common in patients with concomitant diseases such as arterial hypertension, diabetes mellitus, obesity, CKD, arrhythmias. Patients over 60 years of age are at increased risk of a severe course of the disease, this is due to the fact that these individuals have concomitant chronic diseases that are decompensated due to an acute infectious process, reducing the adaptive capabilities of the organism, and lead to a deterioration in survival rates.

   The aim is to study the effect of microvascular reperfusion injury (RI) of myocardium on structural and functional changes of heart in patients with acute coronary syndrome with ST segment elevation (STE-ACS) and endovascular revascularization.
   Materials and Methods. The study included 146 patients with STE-ACS (mean age 54 ± 10 years, 89 % men). Depending on the presence of microvascular RI, according to CMR, performed on 5 ± 3 days after myocardial infarction, patients were divided into groups: the first group included 73 patients (50 %) with microvasculature lesions, the second group consisted of 73 patients (50 %) without microvasculature lesions. All patients underwent endovascular myocardial revascularization within 12 hours of symptoms onset. The assessment of structural and functional parameters of heart was performed by CMR with contrast enhancement on 5 ± 3, 30 and 90 days, by echocardiography on 1-2 days, 1, 6 and 12 months after myocardial infarction.
   Results. In our study microvascular RI was accompanied by a significant size of infarction, a high transmurality index (TI), a large size of edema and a low myocardial salvage index, was associated with LV dilatation, a decrease in  global and local myocardial contractility during the 12 months post-infarction period (p < 0.05). The risk of developing pathological remodeling of left ventricle with microvascular RI size >1.2 % of LV mass is OR=6.25, 95 % CI 2.25–17.35 (p < 0.001), myonecrosis size on day 5 ± 3 of MI >11.7 % of LV mass (OR=10.1, 95 % CI 4.72–21.69, p < 0.001), TI > 64.3 (OR=5.63, 95 % CI 2.37–13.39, p < 0.001), edema size >24.7 % of LV mass (OR = 2.33, 95 % CI 1.09–4.97, p < 0.02).
   Conclusion. Microvascular RI of myocardium is associated with pathological remodeling of the left ventricle.

   Aim. The aim of our study was to assess the frequency of contrast-induced acute kidney injury (CI-AKI) in patients undergoing computed tomography (CT) with intravenous contrast media and to evaluate the effects of statins in the prevention of CI-AKI.
   Materials and methods. 181 patients undergoing CT with intravenous contrast media administration were included in prospective observational study (ClinicalTrials.gov ID NCT04666389). The primary endpoint was CI-AKI according to KDIGO criteria (the 25 % rise (or 0,5 mg/dl) of serum creatinine from baseline assessed 48–72 hours after administration of contrast media). There were 120 patients in the group with high dose of statins administration and 60 patients without statin treatment. The most frequent cardiovascular disease was hypertension in both groups — 93 % and 85 % respectively.
   Results. CI-AKI was diagnosed in 12 (6,7 %) patients — 9 patients in the no statins group and 3 patients in the statins group. The high dose statin administration statistically significant had less frequency of CI-AKI (p = 0,003) compare with no statins group (OR = 0,144, 95 %CI: 0,037–0,554).
   Conclusion. Statin pretreatment is effective at preventing CI-AKI and should be considered in high-risk patients.

   The purpose. Assessment of the presence of the cardiovascular risk factors, associated clinical conditions, the degree of target organ damage in patients with arterial hypertension depending on the new coronavirus infection.
   Material and methods. In a retrospective cohort study 284 patients with arterial hypertension were identified, 162 of them had a novel coronavirus infection and 122 patients didn’t have a history of a new coronavirus infection. Patients who had a new coronavirus infection were divided into groups depending on the disease. Inclusion criteria were the presence of arterial hypertension in history and taking antihypertensive therapy.
   Results. Patients with hypertension who’ve had a new coronavirus infection are more likely to have risk factors such as smoking, overweight, early menopause as opposed to patients with hypertension without indication of past COVID-19. Comparing patients with increased severity of the novel coronavirus infection elevated uric acid levels and hypercholesterolemia were associated with more severe COVID-19 (p < 0.05). Patients with chronic kidney disease, cerebrovascular disease, detection of atherosclerotic lesions of the brachiocephalic arteries and diabetes mellitus have an increased probability of deaths occur from the novel coronavirus infection (p < 0.05). There was no significant difference between the compared groups of coronary heart disease, atrial fibrillation, chronic heart failure and also the daily blood pressure profile and a severe course of COVID-19.
   Сonclusion. The presence of diabetes mellitus, cerebrovascular disease, chronic kidney disease, detection of atherosclerotic lesions of the brachiocephalic arteries, and also hyperuricemia or hypercholesterolemia in patients with hypertension revealed a risk of severe coronavirus infection.