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Purpose: comparative analysis of clinical, laboratory and angiographic parameters in patients with coronary artery disease, depending on the level of body mass index (BMI).

Material and Methods: 71 patients with coronary artery disease were examined. All underwent general clinical laboratory functional studies and coronary angiography with stenting of the coronary arteries. Depending on the level of BMI, 2 groups of patients were identified: 1 gr. – 36 patients with BMI < 30 kg/m2 and 2 gr. – 35 patients with BMI ³ 30 kg/m².

Results: an increase in BMI was associated with young age and female sex, but fewer acute forms of coronary artery disease. The level of BMI ³ 30 kg/m² was characterized by greater comorbidity, with AH being more frequent among comorbidities; diabetes; diseases of the gastroduodenal zone GDZ (p < 0,05); COPD and past history of Covid-19. In addition, among patients with a BMI ³ 30 kg/m², the incidence of complex ventricular cardiac arrhythmias was 4 times higher than in patients with a BMI < 30 kg/m2. In patients with BMI ³ 30 kg/m², the average amount of medications taken per day was 0,8 less than in the comparison group. The most frequently taken groups of drugs (in addition to BAB and ASA drugs) among patients in group 2 were: calcium antagonists AK; sartans and hypoglycemic drugs, and among patients of group 1 – ACE inhibitors; statins; thienopyridines and antiarrhythmics. 8,5% of the surveyed were NOT adherent to drug treatment, while among patients in group 1 – 13,9% and in group 2 – 2,8% of respondents. An increase in BMI according to ECG data was characterized by an increase in heart rate and a greater predisposition to ventricular arrhythmia, and according to echocardiography, by a thickening of the LV walls and a decrease in its systolic function. Angiographically, higher BMI values were not a criterion for the complexity of vascular lesions. Nevertheless, the length of the atherosclerotic lesion in the respondents in group 2 was greater than in group 1 (p > 0,05). In patients with BMI ³ 30 kg/m², lesions of the distal segments of the main coronary arteries were recorded comparatively more often, with type B stenosis prevailing in the PNA basin (60,0%); in the RCA basin – type A (31,6%) and type B (47,4%) stenoses.

Conclusion: there are still many controversial points in the assessment of the relationship between excess weight and cardiovascular pathology. Nevertheless, the significance of the BMI indicator has its prerogatives in this direction, especially in primary health care at the first contact with a patient.

Aim. To assess the prevalence of the left ventricle involvement and the features of the biventricular phenotype of arrhythmogenic cardiomyopathy in patients with pathogenic mutations in the PKP2 and DSP genes.

Material and methods. Three unrelated probands underwent a comprehensive molecular-genetic, clinical and instrumental examination, which included a 12-lead ECG, 24-hour ECG monitoring, transthoracic echocardiography, and cardiac magnetic resonance imaging with late gadolinium enhancement.

Results. The results of our clinical observations showed that in three studied patients with arrhythmogenic cardiomyopathy left ventricle involvement of various degree was found. The left ventricle damage was characterized by fibrous or fibro-fatty infiltration of the myocardium, as well as regional or global systolic dysfunction of different severity. The patients had pathogenic mutations c.1912C > T (p.Gln638*, rs397517012, rs397517012); c.1237C > T (p.Arg413*, rs372827156) in the PKP2 gene and a new probably pathogenic variant in the form of a c.3494delA deletion in the DSP gene. It was found that the mutation in the DSP gene was associated with a more pronounced systolic dysfunction and a greater percentage of fibrous replacement of the left ventricular myocardium compared with carriers of mutations in the PKP2 gene. All patients had life-threatening ventricular arrhythmias with the need for implantation of a cardioverter-defibrillator.

Conclusion. Our clinical observations have shown that in patients with biventricular arrhythmogenic cardiomyopathy, the detection of a mutation in the DSP gene is associated with a more pronounced systolic dysfunction and a higher percentage of fibrous replacement of the left ventricle myocardium compared with carriers of mutations in the PKP2 gene.

Objective: To compare the effects of atorvastatin monotherapy and the combination of atorvastatin with curcetin (a mixture of the bioflavonoids curcumin and quercetin) on lipid profile and inflammatory biomarkers in patients with unstable angina after COVID-19 (“Long COVID”).

Material. An open simple comparative randomized study was conducted in 186 patients with unstable angina, including 77 (Group I) in whom angina destabilization occurred as a result of COVID-19 during 4-8 weeks prior to inclusion in the study, and 109 patients (Group II) in whom destabilization was not associated with infection.

Results: In group I, the level of hsC-reactive protein [5,4 (2,06-7,4) g/l and IL-6 8,6 (5,4-10,3) pg/ml] was higher (P < 0,05) than in group II patients [3,8 (1,2-4,0) g/l and 6,9 (2,2-10,2) pg/ml], respectively. In subgroup I of patients after COVID-19, atorvastatin monotherapy (n = 43) did not have a significant effect after two months of treatment, while in subgroup II the combined use of atorvastatin with curcetin (n = 34) for 2 months reduced the level of hsCRP by 49,0% (P < 0,05) and Il-6 by 40,0% (P < 0,05).

Conclusion. In patients with unstable angina after COVID-19, combination treatment with atorvastatin and curcetin reduced concentrations of inflammatory biomarkers compared with atorvastatin monotherapy.

Aim: to evaluate demographic and disease characteristics in pulmonary arterial hypertension (PAH) patients, for which selexipag is prescribed as PAH-specific treatment.

Materials and methods: the study enrolls 73 patients with PAH, where there were 49 patients with idiopathic PAH and 24 patients with associated conditions. These patients were diagnosed in department of pulmonary hypertension and heart disease of the National Medical Research Centre of cardiology named after academician E.I. Chazov of Ministry of Health. Clinical, functional and hemodynamic characteristics of PAH patients were examined. The diagnosis was confirmed according to Eurasian (2019) and Russian (2020) guidelines for the diagnosis and treatment of pulmonary hypertension.

Results: At selexipag initiation, median of patient`s age was 43 years, 86,3% were female. Etiological analysis revealed idiopathic PAH in 49 (67,1%) patients, 24 (32,9%) had associated conditions: 14 (19,2%) had connective tissue disease‒associated PAH, 6 (8,2%) had PAH after correction of the initial heart defect, 4 (5,5%) had HIV-associated PAH. The median 6-minute walking distance (6MWD) was 370 (300,0-443,75) m, which was corresponding to WHO functional class III, the median Borg dyspnea index was 5 (3,0-6,0). 7 (9,6%) patients did not undergo 6MWD due to severity of their condition. According to right heart catheterization data the median mean pulmonary arterial pressure was 58,5 (48,25-65,0) mmHg, the median right atrium pressure was 7,5 (5,0-10,0) mmHg, the median venous oxygen saturation 58,5% (56,0-66,0), the median cardiac index was 2,0 (1,6-2,5) liter/min/ m2, the median pulmonary vascular resistance was 15,0 (10,3-19,1) Wood units. At selexipag initiation, according to Eurasian (2019) and Russian (2020) guidelines 1 (1,3%) was at low risk, 21 (28,8%) were at intermediate risk and 51 (69,9%) were at high risk of 1-year mortality. Due to risk status, selexipag was initiated in double (50,7%) and triple (49,3%) PAH-specific therapy.

Conclusions: At selexipag initiation, PAH-patients typically have WHO FC III and are at high risk, despite receiving PAH-specific treatment. Selexipag was prescribed as part of a combination regimen in most patients.

A large amount of genetic information is localized in microRNAs which are a class of non-coding RNAs formed from longer RNA precursors, usually having a length of 19-24 nucleotides and a specific hairpin structure. Although microRNA studies have been started relatively recently, there is no doubt that they play an important role in regulating gene expression at the post-transcriptional level in embryonic development, and are also involved in maintaining the normal functions of adult cells. For the first time, microRNA was discovered in the study of free-living nematodes Caenorhabditis elegans and then a new mechanism for suppressing expression using antisense RNA was discovered. MicroRNA may be part of protein-coding transcripts or may be located in the intergenic genome regions. Changes in the functional activity and number of microRNAs can lead to diseases such as oncological, cardiovascular, gynecological, and neurological. MicroRNA is also involved in the process of neurodegeneration and the development of mental diseases. Since part of the microRNA is specific to certain tissues and/or stages of development of the organism, microRNA molecules can be considered as a promising diagnostic tool. Among the advantages of these biomarkers are the possibility of detecting pathology in the latent stage, the low invasiveness of studies and resistance to destructive factors. At the same time, microRNAs can be detected in various biological fluids: blood serum, urine, seminal fluid, saliva, breast milk. Currently, the possibilities of using microRNAs in targeted therapy are widely discussed in connection with the possibility of regulating the expression of genes with undesirable properties or overexpression of microRNA inhibitors to prevent the negative effects of microRNAs that cause the development of the disease. The first part of the review discusses the historical aspect of the study of microRNAs, their mechanism of formation, the features of circulating microRNAs and the possible therapeutic effect of exogenous microRNAs coming from food on the human body.

On December 5, 2022, Ravshanbek Davletovich Kurbanov celebrated his 75th birthday: the chairman of the Association of Cardiologists of Uzbekistan, director of the Republican Specialized Center for Cardiology, chief cardiologist of the Ministry of Health of the Republic of Uzbekistan, academician of the Academy of Sciences of the Republic of Uzbekistan, professor, doctor of medical sciences, laureate of the State Prize of the 1st degree, Hero of Uzbekistan.