Biomedical subjects

B A Sidorenko

Publications and source records attributed to B A Sidorenko.

At least 19 recordsLinked to original sources

PubMed2006

[Noninvasive diagnosis of the state of lower extremities arterial vascular bed in patients with diabetes of type 2].

Complex noninvasive investigation of arterial vascular bed and microcirculation of lower extremities was carried out in 87 patients with diabetes and 47 patients with atherosclerosis obliterans of lower extremities without diabetes. Color duplex scanning allowed to detect occlusive-stenotic and nonocclusive changes of arterial vascular bed in patients with type 2 diabetes. Calcinated atherosclerotic plaques in patients with type 2 diabetes more often localize in superficial femoral, popliteal arteries and arteries of the calf. Such plaques are twice as frequent among patients with atherosclerosis obliterans with diabetes compared with those without diabetes. Laser Doppler flowmetry with test of reactive postocclusion hyperemia and positional test in patients with atherosclerosis obliterans and type 2 diabetes allows to reveal more pronounced disturbances of microcirculation compared with patients without diabetes. In patients with type 2 diabetes with hemodynamically insignificant stenoses of arteries of lower extremities laser doppler flowmetry and transcutaneous measurement of oxygen tension in skin of a foot reveal disturbances of microcirculation.

Adult↗

PubMed2006

[Brain natriuretic peptide as marker and factor of prognosis in chronic heart failure].

The role of natriuretic peptides in pathogenesis of chronic heart failure (CHF) is reviewed. Main attention is given to significance of measurement of brain natriuretic peptide in the following clinical situations related to CHF: diagnosis of CHF, screening of patients with symptomless left ventricular dysfunction, differential diagnosis of edematous syndrome, indications to therapy and monitoring of its effectiveness, assessment of long term prognosis of patients with CHF. Possibilities of curative use of natriuretic peptides and inhibitors of vasopeptidases are also discussed.

Biomarkers↗

PubMed2006

[Restenosis after bare-metal stents implantation in small coronary arteries.].

Potential of bare uncoated metal stents in prevention of restenosis in coronary arteries with diameter of 2.2-3.0 mm in comparison with balloon angioplasty (BA) was studied in 426 patients with ischemic heart disease (mean age 58+/-11 years, 16% women, 8% with diabetes, total cholesterol 211+/-44 mg/dl, all received aspirin and clopidogrel). BA was carried out in 214 patients (mean artery diameter 2.45+/-0.25 mm) and coronary stenting (CS) - in 212 patients (mean artery diameter 2.43+/-0.27 mm). Immediate success rate was 85.5 and 96.2% in BA and CS groups, respectively (p<0.001). When complementary methods of revascularization were taken into account success rate of the whole intervention was 100% in both groups. Inhospital cardiovascular complications developed in 3.7 and 2.8% of patients in BA and CS groups, respectively (p=ns). During 6 months of follow-up rates of target vessel restenosis and repeat percutaneous interventions were 24.3 and 15.6% (p=0.034) while total rate of complications related to target vessel was 36.9 and 26.9% in BA and CS groups, respectively (p=0.035). Thus CS compared with BA in patients with low risk of restenosis development in small coronary arteria provides better immediate, inhospital and remote results.

Angioplasty, Balloon, Coronary↗

PubMed2006

[Polymorphism of genes of factors of hemostasis in patients with early development of ischemic heart disease.].

The review is devoted to analysis of data, related to contribution of genetic peculiarities of the hemostasis system to early development of ischemic heart disease (IHD). Information is presented on polymorphisms of tissue factor, coagulation factors VII, V, prothrombin, thrombomodulin, fibrinogen, thrombin activated fibrinolysis inhibitor, tissue plasminogen activator inhibitor, platelet membrane glycoproteines Ia, Iba, IIIa in patients with early development of IHD. Contradictoriness of existing data on effects of genetic heterogeneity of factors of hemostasis on risk of development of IHD at young age and necessity of further investigations in this area are underlined.

Coronary Artery Disease↗

PubMed2006

[Pulmonary hypertension and right ventricular failure. Part I. Classification, anatomy, patophysiology.].

In a series of articles authors discuss the literature data concerning epidemiology of pulmonary hypertension, its modern classification, peculiarities of pathogenesis and treatment in various diseases. In first communication they examine questions of terminology and classification of pulmonary hypertension and also discuss peculiarities of anatomy, physiology and pathophysiology of pulmonary circulation and right ventricle of the heart.

Heart Failure↗

PubMed2006

[Pulmonary hypertension and right ventricular failure. Part III. Patients with congenital heart disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification, peculiarities of its pathogenesis and treatment in various diseases and conditions. In the third lecture they consider peculiarities of pathogenesis of pulmonary hypertension and right ventricular failure in patients with congenital heart defects, and present literature data on drug treatment and other curative interventions in pulmonary hypertension in patients with Eisenmenger syndrome.

Heart Defects, Congenital↗

PubMed2006

[Contemporary approaches to the treatment of chronic heart failure in adults (after materials of recommendations of American College of Cardiology and American Heart Association, 2005)].

Detailed and critical analysis of a novel version of the "Updated Guideline for the Diagnosis and Management of Chronic Heart Failure (CHF) in the Adult" prepared by experts of American College of Cardiology and American Heart Association is given. The novel version contains somewhat modified recommendations on the management of patients with CHF. In particular this relates to the place of various classes of drugs in the treatment of CHF due to systolic left ventricular dysfunction. For the first time recommendations on the treatment of patients with CHF and normal left ventricular ejection fraction are presented in detail. Among statements of the updated guideline the following are considered controversial or deserving special discussion. Perindopril is mentioned among recommended ACE inhibitors despite the fact that it has never been studied in long term trials. Results of SENIORS trial are ignored and nebivolol is not included in the number of beta-blockers with proven efficacy. Despite multiple proofs of beneficial effects of aldosterone receptor blockers on clinical course of CHF wide use of spironolactone and eplerenone is not recommended because of multiple communications about life threatening hyperkalemia. Inherent dangers of digoxin therapy are disregarded and the use of cardiac glycosides in patients with sinus rhythm is not prohibited.

Aged↗

PubMed2006

[Causes and outcomes of coronary arteries perforations].

Coronary artery perforation is a rare but serious complication of percutaneous coronary interventions. Aim of this study--to assess inhospital and long term outcomes in patients in whom perforation occurred during coronary intervention and elucidation of predictors of coronary artery perforation. Between May 1997 and October 2002 perforations were formed in the course of percutaneous interventions in 127 patients what amounted 1.08% of 11,793 patients, subjected to coronary interventions, and 0.77% of 16,494 treated coronary segments. Causes of perforations were complex stenoses, chronic occlusions, calcified lesions, small predicted and minimal vessel lumen, high percent stenosis, use of excimer laser or thromboextrator. Rates of arterial perforations and subsequent adverse events including cardiac tamponade and urgent coronary artery bypass surgery as well as mortality had been declining throughout observation period.

Angioplasty, Balloon, Coronary↗

PubMed2006

[Effect of twelve-month combined therapy with perindopril and indapamide on the level of blood pressure and left ventricular hypertrophy in patients with hypertensive disease].

Left ventricular hypertrophy (LVH) in patients with hypertensive disease is associated with unfavorable prognosis. Long term and effective antihypertensive therapy is capable to cause reverse development of LVH. We included in this study 72 patients (27 men, 45 women, age from 34 to 72 years) with untreated 1st and 2nd degree arterial hypertension (systolic blood pressure 140-179 mm Hg and/or diastolic blood pressure 99-109 mm Hg) and echocardiographical signs of LVH (left ventricular myocardial mass index >120 g/m2 in men and >100 g/m2 in women). After that the patients were randomized into 2 groups: the study group (39 patients, mean age 53.0+/-11.6 years) received combination of perindopril and indapamide in initial dose of 2 mg/0.625 mg, and comparison group (33 patients, mean age 54.4+/-8.2 years) received monotherapy with enalapril (10 mg). Once daily dosing of the preparation provided high level of compliance of patients with treatment. During 12-month therapy with combination of perindopril and indapamide target blood pressure (<140/90) was achieved in 74.4% of patients, during monotherapy with enalapril--in 27.3% of patients. Significant decrease of left ventricular myocardial mass index (LVMMI) with combination therapy was observed by 6th month of treatment (from 260 to 234 g), with monotherapy within same period of time--from 267 to 260 g. As a result of 12 months therapy of patients with I-II degree of hypertension with perindopril and indapamide LVMMI decreased by 17.5% while monotherapy with enalapril was associated with 5.6% decrease of LVMMI. Lowering of LVMMI occurred mainly at the account of decrease of left ventricular wall thickness.

Adult↗

PubMed2006

[Antiatherogenic effects of angiotensin converting enzyme inhibitors from positions (point of view) of evidence based medicine. Part I].

In a series of two articles the authors present data from controlled trials in which cardio-, cerebro-, and vasoprotective effects of angiotensin converting enzyme inhibitors (ACEI) were assessed. The first communication deals with results of randomized studies in most of which no objective proof of antiischemic (antianginal) effects of ACEI was obtained. In seven placebo controlled studies effects of ACEI were evaluated by means of quantitative angiography (or intravascular ultrasound) and in none of them favorable effect of long-term therapy with ACEI on progression of coronary atherosclerosis and restenosis rate after balloon coronary angioplasty was revealed. Retardation of progression of carotid artery atherosclerosis under influence of ACEI was noted in 2 of 4 trials. But diagnostic value of noninvasive methods which were used in these trials is considerably lower than that of angiography or intravascular ultrasound.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2006

[Pulmonary hypertension and right ventricular failure. Part II. Patients with left ventricular involvement].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, modern classification; peculiarities of its pathogenesis and treatment in various diseases and conditions. In the second part they consider peculiarities of pathogenesis of pulmonary hypertension and right ventricular failure in patients with predominant involvement of left cardiac chambers. Effects of various classes of drugs used in the treatment of left ventricular heart failure including their influence on pulmonary circulation and functional state of the right ventricle are also discussed.

Comorbidity↗

PubMed2006

[Pulmonary hypertension and right ventricular failure. Part IV. Chronic lung disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification; peculiarities of its pathogenesis and treatment in various diseases and conditions. In the forth lecture they present literature data on prevalence of chronic cor pulmonale among patients with congestive heart failure and its value for prognosis. The authors consider peculiarities of pathogenesis of pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) and interstitial lung diseases. Attention is paid to the fact that chronic cor pulmonale develops mainly in bronchitic type of COPD and rarely is met in patients with emphysematous type of COPD. Pathogenetic mechanisms of right ventricular failure in COPD and the role of interaction of hemodynamic, renal, and neuro-humoral factors in pathogenesis of edematous syndrome in patients with chronic cor pulmonal are presented. The article also contains discussion of possibilities and limitations of clinical and instrumental diagnostics of pulmonary hypertension and right ventricular failure in patients with COPD.

Disease Progression↗

PubMed2006

[Angiotensin converting enzyme inhibitors in acute period of myocardial infarction: the place of zofenopril].

Acute myocardial infarction (MI) is one of main predecessors of chronic heart failure (CHF), for the treatment of which angiotensin converting enzyme inhibitors (ACEI) are recommended at present. It seems logical to prescribe ACEI in early period of MI in order to prevent development of CHF in postinfarction period. For assessment of benefit and risk related to prescription of ACEI early after onset of acute MI multiple placebo controlled trials have been carried out. Data obtained in these trials evidence for inexpediency of wide use of ACEI in acute period of MI. Several categories of patients with acute MI with stable hemodynamics have been established in whom benefit of early prescription of ACEI noticeably outweighs possible risk. Those are patients with clinical manifestations of CHF or echocardiographical signs of systolic left ventricular dysfunction as well as patients with high risk of development of CHF in postinfarction period. The latter group comprises patients with transmural MI of the anterior left ventricular wall in whom thrombolytic therapy either have not been carried out or have been ineffective, patients with diabetes mellitus or hypertension in anamnesis. In all other cases prescription of ACEI in early period of acute MI might be dangerous because hypotension induced by them can worsen blood flow and aggravate ischemic injury of the myocardium and increase dimensions of MI.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2006

[Pulmonary hypertension and right ventricular failure. Part V. Therapy in the patients with chronic obstructive pulmonary disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification; peculiarities of its pathogenesis and treatment in various diseases and conditions. In the fifth lecture they present literature data on nondrug interventions and drug therapy of patients with chronic obstructive pulmonary disease (COPD), complicated with development of chronic cor pulmonale. Contemporary views of the role of oxygen therapy and bronchodilators of various type in treatment of COPD are discussed in detail. Beneficial effect of dihydropyridine calcium antagonists on pulmonary circulation in patients with COPD, possibilities and limitations of their long term use in treatment of pulmonary arterial hypertension including that in patients with COPD are considered. The authors also consider in detail beneficial and harmful properties of drugs, which may be used in treatment of patients with COPD, in particular of digoxin, diuretics, spironolactone, angiotensin converting enzyme inhibitors. Discussion of indications to phlebotomy in patients with COPD and chronic cor pulmonale is presented as well.

Antihypertensive Agents↗

PubMed2006

[Non-compact left ventricular myocardium: current state of the problem].

Non-compaction of the left ventricle or spongy myocardium is a rare congenital cardiomyopathy which is characterized by impaired endomyocardial morphogenesis, hypertrophy of left ventricular myocardium with prominent trabeculation, and deep inter-trabecular recesses. According to WHO classification (1995) this disease belongs to unclassified cardiomyopathies. Main clinical signs of ventricular non-compaction are heart failure, ventricular arrhythmias, systemic and pulmonary embolism. Echocardiography which is a basic method of diagnosis can reveal double layer structure of thickened left ventricular wall and multiple prominent trabeculation with wide inter-trabecular spaces. Predominant localizations of pathological process are region of cardiac apex, inferior and lateral left ventricular walls. Treatment of patients with ventricular non-compaction concentrates on elimination of its main clinical symptoms.

Cardiomyopathies↗

PubMed2006

[Torasemide--new generation loop diuretic: clinical pharmacology and therapeutic application].

Peculiarities of clinical pharmacology of new generation loop diuretic torasemide and its possible place in the treatment of arterial hypertension, chronic heart failure (CHF) and liver cirrhosis are considered. Main advantage of torasemide over loop diuretics of furosemide and bumetamide type is that in addiction to powerful diuretic and natriuretic actions it produces potassium sparing effect that is explainded by ability its of to tosasimide to block aldosterone receptors in renal tubules. Moreover torasemide exerts longer action than furosemide and bumetamide what allows to take it once a day. In low doses torasemide produces pronounced antihypertensive effect without augmentation of excretion of potassium and water with urine. Because of this it can be used as antihypertensive drug for monotherapy or in combination with other drugs. Contrary to thiazide and loop diuretics prescription of subdiuretic doses of torasemide usually does not require control of potassium content in the blood or addition of potassium preparations. In higher doses (10 mg/day or more) torasemide acts as typical loop diuretic and can be used in the treatment of CHF and liver cirrhosis with ascites. Due to potassium sparing action it more rarely than furosemide and bumetamide causes hypokalemia. Comparative studies have shown than in CHF torasemide exerts more favorable effect on clinical signs of disease and functional status of patients than furosemide. Total mortality, cardiovascular mortality and requirements in hospitalization of patients receiving torasemide is substantially less than of patients receiving furosemide.

Heart Failure↗

PubMed2006

[Obstructive sleep apnea syndrome and heart rhythm disturbances].

Review of terminology, predisposing factors, clinical signs and complications of the obstructive sleep apnea syndrome is presented. Main emphasis is made on heart rhythm disturbances in this disease. Possible causes of cardiac arrhythmias, special characteristics of their course in patients with severe concomitant pathology, methods of diagnosis and treatment, including the use of noninvasive positive pressure ventilation are discussed.

Arrhythmias, Cardiac↗

PubMed2005

[Angiotensin converting enzyme, NO-synthase, and endothelin-1 genes and left ventricular hypertrophy in natives of Yakutia with hypertensive disease].

Association of polymorphic markers G7831A of ACE gene, Lys198Asn of endothelin-1 (EDN1) gene, and 4a/4b of NOS3 gene with characteristics of structure and function of the left ventricle was studied in 70 (31 men and 39 women) natives of Yakutia with hypertension. Mean age of patients was 48.3+/-0.74 years, duration of hypertension -- 12.4+/-0.99 years; 60 (85.7%), 7 (10%) and 3 (4.3%) patients had III, II and I degree of hypertension, respectively. Polymerase chain reaction was used for identification of alleles of polymorphic markers G7831A of ACE gene, Lys198Asn of EDN1 gene, and 4a/4b of NOS3 gene. Polymorphic marker G7831A of ACE gene was not associated with severity of hypertrophy of left ventricular myocardium as well as with state of systolic and diastolic left ventricular function. Patients with allele Asn of EDN1 gene in the genotype had significantly lower value of peak A integral of trans-mitral blood flow. Patients with allele 4a of NOS3 gene had thicker left ventricular walls, greater left ventricular myocardial mass and mass index.

Adult↗