Objectives. The primary objective was to describe antihypertensive and lipid lowering effectiveness of a polypill of amlodipine, atorvastatin, and perindopril at week 12 in patients with arterial hypertension (HTN) and hypercholesterolemia in daily clinical practice. Design and method. The TARGET study (NCT05764317) was a 12-week ambispective observational study. Adult out-patients with HTN and hypercholesterolemia had initiated treatment with the polypill in dosage strengths of 5/10/5 mg; 5/20/5 mg or 5/20/10 mg within 1 month before enrollment. The primary outcome was mean change from baseline in office systolic and diastolic blood pressure (SBP, DBP) and low-density lipoprotein cholesterol (LDL-C) at week 12. Main secondary outcomes were changes of quality of life as assessed by SF-36 questionnaire and adherence to therapy measured by a Russian questionnaire at week 12 compared to baseline. Effectiveness and safety analyses were performed in modified intention-to-treat population. Uni and multivariate regression models were used to define significant predictors for the achievement of target parameters. Results. Four hundred nine outpatients who had already initiated the polypill of amlodipine/atorvastatin/perindopril were included in the study. Very high or extreme cardiovascular (CV) risk initially had 160 (39.1%) of patients, 166 (40.6%) had high CV risk, 71 (17.4%) had moderate and 12 (2.9%) had low CV risk. Mean baseline blood pressure (BP, SD) was 157.3 (15.6)/ 92.3 (9.1) mmHg and mean LDL-C at baseline was 3.7 (1.0) mmol/L. Mean SBP decreased by 32.4 (15.3) mmHg and DBP by 15.0 (10.0) mmHg by week 12 (both р<0.0001). Mean LDL-C value decreased by 1.6 (0.9) mmol/L (р<0.0001). Changes in physical and psychological components of SF-36 were 5.7 (8.2) and 7.7 (9.9) points by week 12 compared to baseline. Proportion of patients with low/moderate adherence decreased from 17.4% (71/409) to 1.5% (6/409) by week 12, whereas a proportion of patients with a high adherence at the end of the observation period increased up to 97.5%. Older age (OR (odds ratio) 0.97, 95% confidence interval (CI) 0.94 to 0.99) and peripheral artery disease (PAD) (OR 0.44, 95% CI 0.22 to 0.91) were significant negative predictors for achieving target BP. Presence of T2D (OR 0.50, 95% CI 0.28 to 0.89) and LDL-C level increase by week 12 compared to baseline (OR 0.28, 95% CI 0.21 to 0.39) were negative predictors for LDL-C target value achievement. One non-serious adverse event (dry cough) and one special situation (insufficient lipid-lowering effectiveness) were reported. Conclusion. Treatment with a polypill amlodipine/atorvastatin/perindopril demonstrated significant BP and lipid-lowering effectiveness and was well tolerated. These changes were accompanied by improvement of adherence to treatment and quality of life.

Research objective: to evaluate global longitudinal strain of the left ventricle in patients with hypertrophic cardiomyopathy (HCM) with different locations of myocardial thickening, with and without concomitant stenotic lesion of the coronary arteries. Materials and methods. Clinical data, echocardiography with speckle tracking echnology, and coronary angiography data from 69 patients with HCM aged 27 to 91 years were analysed. The optimal quantitative threshold for global longitudinal strain was determined by ROC analysis. Results. Echocardiography revealed septal HCM in 26 (37.7%) patients; symmetrical HCM in 18 (26.1%); combined variant in 14 (20.3%); apical variant in 9 (13%); and mid-ventricular variant in 2 (2.9%). Coronary angiography revealed stenotic lesions of the coronary arteries in 32 (46.4%) individuals with HCM. Global longitudinal strain in patients with HCM and concomitant stenotic lesion of the coronary arteries was > −11.2% (AUC 0.839). The degree of reduction in the indicator depended on the location of left ventricular thickening (AUC 0.867÷1). Obesity and reduced left ventricular ejection fraction in HCM reduced global longitudinal strain to > −8.5% (AUC 0.789) and > −7.4% (AUC 0.983), respectively. Conclusion. A decrease in global longitudinal strain of the left ventricle in patients with HCM suggests concomitant stenotic lesion of the coronary arteries: in the septal variant > −12.9%; symmetrical > −11.1%; apical > −10.2%. However, in each individual case, factors affecting global longitudinal strain of the left ventricle regardless of stenotic lesion of the coronary arteries should be taken into account: obesity and decreased left ventricular ejection fraction.

Introduction. Despite significant advances in modern medicine, the prevalence   of cardiovascular disease (CVD) remains high. Studying current trends in the prevalence of major CVD risk factors (RF) in different occupational groups is of particular interest Aim: to assess current trends in the prevalence of major CVD RFs based on a comparative analysis of baseline and follow-up studies in an organized population of white-collar workers. Material and research methods. A follow-up preventive study was conducted among employees of one of the research institutes in Baku 15 years after the baseline survey. The follow-up study included 136 participants (92 women and 44 men), and the baseline study included 196 participants (111 women and 85 men). A set of standard epidemiological methods used in cardiology was applied. Results. The follow-up study demonstrated a tendency toward a higher prevalence of arterial hypertension (35.9-26.1% and 47.7-36.9%; p>0,05) and diabetes mellitus (9.8-4.5% and 13.6-8.4%; p>0,05) in both women and men compared with the baseline survey; however, these differences were not statistically significant (p>0.05). At the same time, a tendency toward a lower prevalence of overweight, low physical activity, smoking, excessive salt intake and alcohol consumption was observed, more pronounced among men. Among men, the prevalence of low physical activity (11.4% vs. 38.1%; p<0.01), smoking (13.6% vs. 41.7%; p<0.01) and excessive salt intake (4.5% vs. 16.7%; p<0.05) was significantly lower in the follow-up study; no cases of excessive alcohol consumption were recorded. The proportion of men without CVD risk factors increased more than twofold compared with the baseline study (11.4% and 4.8%; p>0,05). Conclusion. The findings confirm the need for regular monitoring and multicomponent correction of CVD risk factors and support the development of gender-oriented prevention programs.

Introduction. The diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) remains a challenging task. Despite the revised 2010 criteria of the ITF Task Force, most patients still face difficulties in establishing this diagnosis. Objective. To assess the clinical and genetic characteristics of patients with a preliminary diagnosis of “ARVC,” with a focus on the final diagnosis established after re-evaluation at the Republican Scientific and Practical Center of Cardiology (RSPC “Cardiology”). Material and methods. Twenty-eight patients (53.6% male, median age 35 [24; 43] years) with a preliminary diagnosis of ARVC referred to the RSPC “Cardiology” were examined. The clinical and instrumental evaluation included 12-lead ECG, 24-hour Holter monitoring, transthoracic echocardiography (TTE), and cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE). The ARVC diagnosis was based on the 2010 ITF criteria and classified into definite, borderline, and possible categories. Genetic testing for mutations in genes associated with cardiomyopathies and inherited rhythm disorders was performed using next-generation sequencing (NGS). Results. Among the 28 patients with a preliminary diagnosis of ARVC, only 7 (25%) were diagnosed with definite ARVC according to the 2010 ITF criteria and confirmed by genotyping (mutations in the PKP2 and DSG genes in 5 patients, mutation in the non-desmosomal TMEM43 gene in 1 patient, and mutations in ILK and RBM20 genes in 1 patient). Eight (28.6%) patients were diagnosed with borderline ARVC, and 4 (14.3%) with possible ARVC. In 9 (32.1%) patients, the diagnosis of ARVC was ruled out due to misinterpretation of cardiac MRI. Genotyping revealed no ARVC-associated mutations in the borderline, possible, or excluded groups. A total of 7 (25%) patients received an ICD; of these, 6 were deemed appropriate, while 1 was considered inappropriate due to an unconfirmed ARVC diagnosis. Conclusions. A misdiagnosis of ARVC was found in 32.1% of patients suspected of having the condition. The most common reason for false suspicion was misinterpretation of cardiac MRI results, particularly regional dyskinesia/akinesia of the right ventricular wall due to factors such as pericardial constriction, right ventricular diverticulum, pectus excavatum, right ventricular enlargement in athletes, or frequent arrhythmias causing artifacts. Genotyping proved helpful in timely confirmation of the ARVC diagnosis in this patient cohort.

Idiopathic pulmonary hypertension (IPAH) is a rare severe disease with a poor prognosis. Assessing quality of life (QoL) using questionnaires can significantly complement clinical, laboratory and instrumental data. Aim. To assess QoL using various questionnaires in patients with a newly and previously diagnosed IPAH. Materials and methods. 73 patients with IPAH were included in the study, all patients filled out Qol questionnaires: universal (SF-36, EQ-5D-3L) and special for patients with pulmonary hypertension (CAMPHOR, PAH-SYMPACT, EmPHasis-10). Two groups were formed, comparable by age and gender: group 1-42 patients with newly diagnosed IPAH; group 2-31 patients with a previously diagnosed IPAH. Results. Significant differences in SF-36 were found in the scale of Mental Health (52 [40; 64] % in the first group and 60 [52; 80] % in the second, p=0,02) and Mental component summary (40,8 [34,3; 49,3] % and 49,1 [41,0; 55,9] %, respectively, p=0,03). According to the EQ-5D-3L results, differences were found in the Visual Analogue Scale (VAS) and EQ-5D Index: higher values were found in the second group (the median VAS score was 50 [40; 60] % in the first group and 60 [50; 70] % in the second, p=0,006, EQ-5D Index – 0,60 [0,30; 0,71] and 0,66 [0,57; 0,76], respectively, p=0,05). No significant differences were found in the results of CAMPHOR, PAH-SYMPACT, and EmPHasis-10 in two groups. Conclusions. Pathogenetic therapy promotes improvement of functional status of patients with IPAH. Low emotional status indicators in patients with a prevalent disease indicates the need to develop a system of psychological assistance for IPAH patients.

Chronic heart failure (CHF) is a severe clinical syndrome, which can develop in patients with various heart diseases. Tactics of management of patients with CHF depends on cause of development of this syndrome, therefore exact diagnosis is especially important. Echocardiography (EchoCG) is the main method in algorithm of examination with any cardiological examination, but neither EchoCG, nor other traditional cardiological methods of examination in all clinical situations can reveal cause of development of CHF, therefore search for new diagnostic strategies is important. Objective of the work: to show possibilities of magnetic resonance tomography of heart in examination of patients with chronic heart failure on example of own clinical observations. Materials and methods. Analyzed heart studies performed on patients with chronic heart failure from March 2024 to December 2025. An analysis of the literature devoted to the diagnosis of chronic heart failure was conducted, and the search was carried out using the Google Scholar, Scopus, PubMed, and Web of Science databases. All clinical cases presented in the article were performed by the authors of the article. Results. Along with traditional methods of cardio-visualization (EchoCG, scintigraphy of myocardium), MRI with contrast agent is included in diagnostic algorithm of examination of patients with chronic heart failure, especially in complex situations. The article presents standard protocols of MRI for analysis of structural and functional changes of myocardium, contraindications to performance of MRI. On clinical observations possibilities of MRI are demonstrated in clarification of etiology of chronic heart failure in patients with reduced ejection fraction and preserved ejection fraction of left ventricle. Presented clinical cases of use of MRI for differential diagnosis of various causes of hypertrophy of myocardium of LV in patients with CHF, differential diagnosis of ischemic and non-ischemic lesion of myocardium. Conclusion. In the work are demonstrated the possibilities magnetic resonance tomography is highly informative method of diagnosis in patients with chronic heart failure, both in patients with reduced ejection fraction and in absence of its reduction.

Progressive Duchenne muscular dystrophy is a common X-linked recessive myopathy caused by a mutations in the gene encoding dystrophin. Duchenne muscular dystrophy is characterized by damage to the heart muscle with conduction and rhythm disturbances, and the development of dilated cardiomyopathy, which may be asymptomatic. The development of heart failure determines the unfavorable prognosis of patients with Duchenne muscular dystrophy. Insufficient awareness of physicians about the characteristics of heart damage in Duchenne muscular dystrophy creates the prerequisites for describing interesting clinical observations. The article presents a clinical observation of the development of dilated cardiomyopathy and heart failure with a low left ventricular ejection fraction in a 19-year-old male patient with Duchenne muscular dystrophy. The dynamics of Duchenne muscular dystrophy progression from the moment of diagnosis to the development of decompensated heart failure are described. The article presents clinical course data, laboratory parameters, electrocardiography and echocardiography data in dynamics. The article presents diagnostic criteria for Duchenne muscular dystrophy, prospects for therapy aimed at correcting the genetic defect by replacing, modifying or reparating the dystrophin gene. The presented case demonstrates the need for a personalized multidisciplinary approach to a patient with Duchenne muscular dystrophy, with the participation of an orthopedic surgeon, pulmonologist, cardiologist, endocrinologist, and ophthalmologist.

Introduction. In world practice, the common femoral artery is considered the traditional access for endovascular treatment of brachiocephalic arteries. Case report. The possibility of radial access for endovascular treatment of common carotid artery «in-stent restenosis» in a patient with occlusion of infrarenal abdominal aorta and the only functioning internal carotid artery on the ipsilateral side was demonstrated. Conclusion. This experience of correcting the common carotid artery lesion using radial access is only a single clinical observation and cannot be interpreted as a universal algorithm.