Objective. To study the peculiarities of deformation, rotation properties, twisting and untwisting of the left ventricular(LV), evaluation of the function of left atrium in patients with CHF with preserved and reduced ejection fraction of the left ventricular according to Echocardiography technology Non Doppler imaging in two and three-dimensional regimes (2D and 3D Speckle tracking imaging).

Material and methods. The study included 70 patients with chronic heart failure (CHF) with preserved (Group I) and reduced (Group II) ejection fraction (EF) of the left ventricular (LV). In addition to the standard Transthoracic echocardiography, all patients were assessed the deformation of the left ventricle (LV) and left atrium (LA) as well as the rotational properties of the LV using the technology of myocardial image in two and threedimensional regimen.

Results. Studies show that patients CHF deformation of the left ventricular (LV) and left atrium (LA), and the rotational properties, twisting and unwinding of the (LV) according to the two methods were lower than the control group (CG). In both groups there was a reliable increase the size and volume of LA, as well as a decrease the deformation of the LA in it phases and global longitudinal deformation. The values of the global longitudinal deformation of the LA in patients group I and II (-6,68±3.0% and-6,63±3.3%, respectively) were reliably lower compared to CG (-9.3±7.3%) (p <0.001). A good correlation was found between LV deformation and LV EF in patients group I (r = -0.39) ( p <0.001) and in group II (r = 0.35)(p <0.001).

Conclusions. When estimating the deformation of the left ventricular according to the data of two technologies, the threedimensional mode demonstrated lower myocardial deformation in comparison with the three dimensional regime, which may be associated with a fuller assessment of the deformation of the left ventricular myocardium. Also increased global longitudinal deformation of LA can be an early predictor of diagnostics of CHF.

The article presents the results of study dependence of mortality from cardiovascular system diseases on meteorologic factors among population of Baku and Guba. Air temperature and rainfall have been taken as the main meteorological indicator for months. Increased risk of death from cardiovascular diseases in both cities was observed more in the spring-winter months than in the summer, which was associated with a high amount of precipitation at this time of the year and with a lower temperature.

Rosuvastatin is a statin with maximum hypolipidemic effect, to date, which makes it one of the most frequently prescribed lipid-lowering medications. The drug has been widely studied in large international randomized clinical trials and proven to be highly effective. Administration of rosuvastatin at doses of up to 40 mg/day allows to decrease low-density lipoprotein cholesterol (LDL-C) levels by 55-63%, triglyceride levels by 28% and to significantly increase the level of high-density lipoprotein cholesterol by 10-14%. The effectiveness of rosuvastatin for primary prevention of CV complications has been indicated in high and very high risk patients, as well as in intermediate-risk persons and patients with mildly elevated base LDL-C level. The ability of rosuvastatin to suppress the progression of atherosclerosis has been demonstrated by intravascular ultrasound of coronary arteries and by magnetic resonance imaging of carotid arteries. Rosuvastatin is a hydrophilic statin with high hepatoselectivity, low systemic bioavailability (very limited penetration of rosuvastatin into extrahepatic tissues and, hence, lower risk of myotoxicity) and minimal involvement of P450 cytochrome in its metabolism (mostly mediated by 2C9 enzyme), which provides for good tolerability of the drug. High hepatoselectivity and the absence of any significant interaction with cytochrome P450 system mitigate the likelihood of side effects and drug interactions. The above mentioned characteristics of rosuvastatin enable its effective and safe use in treating a wide range of patients.

Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by progressive increase in pulmonary vascular resistance (PVR), higher pulmonary arteries mean pressure (mPAP), decrease in cardiac minute output (CMO) and other hemodynamic, functional and biochemical disorders. Existing PAH therapeutic algorithm, described in the European and Russian clinical guidelines, mainly suggest strategy of sequential combination therapy in the case of inadequate response to initial monotherapy. At this, switching from one PAH-specific drug to another is studied to a lesser extent. At the present similar approach (switching) has already been tested, for example, in switching from one endothelin receptor antagonist (ERA) to another, or from phosphodiesterase type 5 inhibitor (iPDE-5) to soluble guanylate cyclase stimulator (sGC). There are virtually no data about change of monotherapy when drugs target different molecular pathways of vascular tone regulation, in particular, in the pulmonary circulation vessels. This article describes clinical case of female patient with FC III pulmonary arterial hypertension (WHO) switched from therapy by endothelin-1 receptor antagonist (bosentan) to soluble guanylate cyclase stimulator (riociguat). Female, 37 years old, with verified by the right heart catheterization (RHC) diagnosis of idiopathic PAH (iPAH) received PAH-specific monotherapy of bosentan. Due to condition deterioration on the background of bosentan dose increase, medical conference decided to switch this patient to another class of PAH-specific therapy (sGC stimulator riociguat) with consequent follow-up. As a result of such approach positive changes in patient's condition, improvement of hemodynamic parameters, increased tolerance of physical exercise was demonstrated in comparison with previous therapy. This clinical case demonstrates safe and successful transfer from bosentan to riociguat in the patient with idiopathic PAH. Similar tactic for the change of therapy should be studied in further clinical trials.

The literary review reflects the main current data on the problem of surgical treatment of postero-basal left ventricular aneurysms. It is shown that, despite the small percentage of these aneurysms in patients with coronary heart disease (CHD), their importance for surgical treatment is significant, since the effective correction of detected disorders of cardiac structures, myocardium and coronary arteries has not been sufficiently developed to date, and many issues of surgical tactics are contradictory. This applies both to the type of geometric reconstruction of the left ventricle, and the feasibility of mitral regurgitation correction, which due to dysfunction of the papillary muscles is observed in almost all patients with postero-basal aneurysms of the heart. The question of the combined correction of the interventricular septum rupture in patients with postero-basal aneurysms remains complex and unresolved until now. The relevant problem is the choice of surgical tactics of left ventricular reconstruction using two patches in the presence of anteroposterior aneurysms. All of the above reflects the need for further research on the problem of surgical treatment of postero-basal aneurysms of the heart.

The frequent comorbidity of atrial fibrillation (AF) and chronic kidney disease (CKD) in the general population is demonstrated in many epidemiological studies. Most patients with an established diagnosis of AF are recommended to use constant anticoagulant therapy (ACT) to prevent ischemic stroke and thromboembolic complications (TEC). With renal dysfunction, changes in the hemostatic system are observed at all stages of CKD, both related to an increase in prothrombogenic activity as well as to development of coagulopathy, which increases the threat of bleeding. Therefore, in patients with CKD and AF, an important aspect of ACT is the choice of the optimal anticoagulant, that will provide a balance between the risks of stroke and hemorrhagic complications, to which this article is dedicated.