Eurasian clinical practice guidelines for dietary management of cardiovascular diseases include actual healthy diet recommendations and modern dietary approaches for prevention and treatment of cardiovascular diseases. Nutritional assessment and interventions based on pathogenesis of atherosclerosis and cardiovascular diseases are presented.

Modern nutritional and dietary recommendations for patients with arterial hypertension, coronary heart disease, chronic heart failure, heart rhythm disorders, dyslipidemia and gout are summarized in present recommendations. Particular attention is paid to the dietary management of cardiovascular patients with obesity and/or diabetes mellitus. This guide would be interesting and intended to a wide range of readers, primarily cardiologists, dietitians and nutritionists, general practitioners, endocrinologists, and medical students.

Aim. To study the features of the early postoperative period in patients with chronic thromboembolic pulmonary hypertension (CTEPH) with surgically significant stenosis of the coronary arteries and to evaluate the impact of cardiac arrhythmias on the hospital period after pulmonary endarterectomy (PEA) in combination with coronary artery bypass grafting (CABG).

Material and methods. The study cohort included 45 patients with CTEPH with surgically significant coronary artery stenosis at the age of 61.4 (55.3-69.5) years. All patients underwent PEA (1st stage) and CABG (2nd stage). The relationship between concomitant rhythm disturbances and various complications in the early postoperative period was assessed using logistic regression analysis.

Results. Initially, in the study cohort, rhythm disturbances were recorded in 33.3% of cases, where atrial fibrillation accounted for a large proportion. Among the early postoperative complications, the leading ones were neurological disorders (28.9%). Hospital mortality was 6.7%. Concomitant rhythm disturbances in the studied patients were associated with the postoperative development of neurological disorders (OR 4.7 (2.5-7.3; p=0.02)), heart failure (OR 2.2 (1.5-6.8); p=0.03)) and acute renal failure (OR 2.4 (1.4-7.9; p=0.01)).

Conclusion. In high-risk cardiac surgical patients with CTEPH and surgically significant coronary artery stenosis, various rhythm disturbances are recorded in 33.3% of cases. In the hospital period after PEA and CABG in the studied patients, neurological disorders accounted for a large proportion of complications among the complications. Hospital mortality was 6.7%. Concomitant rhythm disturbances in patients with CTEPH with surgically significant coronary artery stenosis are associated with a more severe course of the early postoperative period and increase the chances of developing neurological disorders, acute renal failure and acute heart failure.

Aim. To study the effect of endovascular closure of patent foramen ovale (PFO) on the severity of symptoms of migraine attacks in patients with migraine with a history of aura.

Materials and Methods. We analyzed the data of 74 patients with migraine with a history of aura who underwent endovascular closure of the PFO for the period from 2018 to 2022 at the E.I. Chazov National Medical Research Center of Cardiology. All patients underwent examinations that complied with clinical recommendations. The presence of a history of migraine with aura was determined through a patient interview, previous hospital history, and was confirmed by a neurologist. The severity of migraine symptoms was assessed using the MIDAS (Migraine Disability Assessment) scale before occluder implantation and after 36,9 [22,7; 50,8] months the intervention as part of a telephone contact.

Results. 49 patients before the intervention had pain syndrome assessed on the MIDAS scale <11 points, in 25 patients the MIDAS score was ≥11 points. The technical success of the intervention was 100%. In the long–term period, the average MIDAS score in the group of patients with baseline MIDAS <11 was 0.00 [0.00; 5.00] points, and in the group with baseline MIDAS ≥11 was 15.00 [14.00; 15.00] points (p<0,0001). After 36,9 [22,7; 50,8] months occluder implantation, the average MIDAS score decreased by 75.0% in both groups (p<0,0001). The number of patients in the group with an initial MIDAS ≥11 points decreased by 80.0% compared to baseline values (p<0,0001).

Conclusion. Endovascular closure of the PFO in patients with migraine with a history of aura promotes significant regression of the pain syndrome.

Aim. In a prospective study to determine whether implantation of a left ventricular lead (LVL) into the zone of late electrical activation of left ventricle (LV) determined by noninvasive electrophysiological mapping before implantation increases the number of responders to cardiac resynchronization therapy (CRT) compared to standard approach. To evaluate the dependence of the response to CRT on the position of the stimulating pole of the LVL in relation to the zone of late activation during the native rhythm.

Methods. The study included two groups of patients with indications for CRT of I and II a class according to the European Society of Cardiology recommendations on pacing and resynchronization therapy in 2021. In the main group (n=60) noninvasive electrophysiological mapping (NEM) was performed before implantation in order to determine the zone of late electrical activation of the LV. Patients in the control group (n=60) underwent standard implantation without NEM procedure. The response to CRT in both groups was compared. The influence of the distance from the stimulating pole of LVL to the late zone of LV activation at the initial rhythm (distance LVL-late zone) on the formation of response to CRT was analyzed.

Results. Analysis of conjugation of response to CRT depending on the group demonstrated statistically significant differences between the number of responders/ non-responders to CRT in the main and control groups (51/9 vs. 38/22, respectively, p<0.01). Analysis of the dependence of the response to CRT on the LVL-late zone distance in both groups revealed a statistically significant influence of this indicator: Pearson Chi-square Criterion = 50.27, p<0.01. According to the logistic regression equation, a significant increase in the probability of no response to CRT from 0 points to 1 point occurred in the range of LVL-late zone distance values of 46-57 mm. The probability of response was minimal in case the value exceeded 57 mm.

Conclusions. Targeted implantation of LVL into the late zone determined by NEM significantly increases the probability of response to CRT. When the distance from the stimulating pole of LVL to the late zone is ˃57 mm, the probability of a response to CRT is minimal.

The incidence and prevalence of amyloid cardiomyopathy (AC) has been increasing in recent years, and this diagnosis is often detected at the final stage. This determines late prescription of specific therapy and worsening prognosis of patients. Unfortunately, doctors are not sufficiently informed about the pathogenesis of AC and diagnostic methods. This circumstance leads to prolongation of time from the manifestation of the disease to the diagnosis. Despite the presence of a large number of AC masks, a number of specific clinical diagnostic markers called «red flags» helps to suspect AC. In addition, the development of diagnostic algorithms using non-invasive imaging methods can help not only in diagnosing AC at an early stage of the disease, but also in determining the type of amyloidosis, that determines the success of timely administration of disease-modifying therapy. The aim of this review is to analyze the possibility of using MRI criteria to attempt non-invasive typing of amyloidosis and to differentiate ATTR and AL AС.

Cardiovascular disease continues to be the leading cause of death in both developed and developing countries. Low-dose acetylsalicylic acid is used worldwide for primary and secondary prevention of cardiovascular events on a long-term basis to reduce mortality and lethality. At the same time, the incidence of gastrointestinal bleeding associated with acetylsalicylic acid intake is steadily increasing. The presented case report illustrates the development of gastrointestinal bleeding against the background of dual antiplatelet therapy in a patient with coronary heart disease with a history of ulcers. A 65-year-old patient with an aggravated coronary history was routinely hospitalized in the cardiology department. On admission to the hospital, taking into account the increasing complaints of crushing pain behind the sternum, acute coronary syndrome was excluded in the patient, esophagogastroduodenoscopy was performed, which revealed a subcardia callous ulcer. On the same day, there was a negative trend in clinical manifestations in the form of syncope, hypotension up to 70/50 mmHg, vomiting «coffee grounds». According to the data of repeated emergency esophagogastroduodenoscopy a superficial ulcerous defect in the subcardia area with bleeding vessel in the bottom was revealed and combined endoscopic hemostasis was performed. Further examination of the patient revealed Helicobacter pylori infection, which in combination with other risk factors influenced the occurrence of this complication. First-line anti-ulcer eradication therapy was prescribed. The patient subjectively evaluated his condition as satisfactory and was discharged with recommendations for outpatient treatment. The purpose of this case report is to emphasize the importance of timely detection and treatment of gastrointestinal diseases in high-risk patients. This may allow for timely prevention of bleeding in patients with high-risk coronary heart disease in the future, taking into account a personalized approach.