[Detection of risk factors and early manifestations of cardiovascular diseases during ambulatory examination of working age persons].

We have studied prevalence of risk factors (RF) of cardiovascular diseases (CVD) recorded for statistical purposes in subjects of able bodied age during 10 year period of observation in a policlinic as well as prevalence of early and/or oligosymptomatic CVD manifestations in 11762 subjects of working age with RF of CVD development according to results of complex noninvasive examination of cardiovascular system in ambulatory conditions during the period from 2000 to 2009 year. Numbers of men and women were 45.3 and 54.7%, respectively. The program of examination included analysis of ECG, echocardiography (EchoCG), ultrasound examination of brachiocephalic vessels, 24-hour Holter ECG monitoring, exercise test on treadmill. In 2006 and 2007 complex examination was supplemented with 24-hour monitoring of arterial pressure, stress EchoCG, noninvasive arteriography. Complex ambulatory examination of subjects of working age with FR of CVD development with the use of noninvasive methods of functional diagnostics allowed to diagnose in 56% of studied persons various early and/or oligosymptomatic CVD manifestations which often appeared in combination, including ischemic heart disease (in 15%), hypertensive disease- (in 42%), cerebral atherosclerosis - (in 23.5%).

[Stratification of risk of cardiovascular complications in government employees and results of 10-year prospective observation].

We investigated prognostic value of the SCORE scale in working age government employees with 3 or more risk factors (RF) of cardiovascular diseases (CVD) and metabolic syndrome (MS, 2001 criteria) according to results of 10-year prospective observation in a policlinic. The study comprised 268 practically healthy men: 168 patients with 3 or more RF of CVD (mean age 47.76+/-6.9 years) (group 1) and 100 patients with MS (mean age 47.73+/-7.97 years) (group 2). Prospective follow up of group I patients with low or moderate CVD risk calculated with the SCORE scale demonstrated concordance of predicted and actual rates of lethal outcomes. In the group of patients with MS and high CVD risk lowering of number and level of RF took place due to in-depth examination and high compliance to therapy. This resulted in lowering of CVD and postponement rate their later development.

[Risk factors prevalence of subclinical forms of cardiovascular diseases among subjects of working age].

The prevalence of preclinical forms of cardiovascular diseases diagnosed by EchoCG, Holter monitoring, functional test, ultrasound of extracranial arteries was analysed among practically healthy subjects at risk of CHD who underwent primary outpatient examination in 1986-1995 Another 172 persons at high risk of cardiovascular disorders were included in the "vascular run" program for short-term medical examination. It is shown that the frequency of pathological conditions diagnosed by the above methods increases in case of combined arterial hypertension and metabolic disturbances (dyslipidemia, excessive body mass, glucose intolerance). Prospective observations revealed high prognostic value of comprehensive assessment of the cardiovascular system. It is concluded that a program of primary evaluation of the cardiovascular system using functional diagnostic tests for the discovery of preclinical disorders in practically healthy subjects should be developed on an individual basis with regard for risk factors and their magnitude.

[Outpatient diagnostics of the initial stage of essential hypertension].

The informative value of functional diagnostic methods in the revealing of the initial stage of essential hypertension (EH) in patients with high risk of cardiovascular complications (CVC) and type 2 diabetes mellitus (DM2) was studied. The subjects of the study were 186 men considering themselves practically healthy, with high risk of CVC according to SCORE scale. Mean age of the subjects was 47.9 +/- 0.87 years; persons with various metabolic disorders prevailed. The patients were divided into two groups according to body mass index (BMI): group 1 patients (n = 142) had a BMI of > or = 25 kg/m2 (29.16 +/- 0.49); group 2 (n = 46) patients had a BMI of < 25 kg/m2 (22.95 +/- 0.37). The patients underwent clinical and laboratory examination including the measurement of biochemical parameters of lipid, carbohydrate, and purine metabolism. ECG, EchoCG, and 24-hour blood pressure monitoring (BPM) were performed. Office BP levels, 24-hour BMP data, and signs of left ventricular hypertrophy (LVH) according to ECG and EchoCG were evaluated. The study found that in persons with excessive body weight stable 24-hour arterial hypertension with both systolic and diastolic BP increased prevailed, while in subjects with normal body weight systolic arterial hypertension prevailed. The use of milder LVH criteria (left ventricular myocardial mass index > 116 g/m2) increased the number of persons with stage 2 EH. The prevalence of the initial stage of EH according to 24-hour BPM (87.4%) is 2.8 times higher than that according to office BP measurement (31.3%).

[Unsolved questions of infectious endocarditis prophylaxis in outpatients practice]. / Nereshennye voprosy profilaktiki infektsionnogo éndokardita v ambulatornoi praktike.

AIM: To check practical feasibility of recommendations of prevention of infectious endocarditis (IE) and to provide more accurate figures on the occurrence of valvular lesions in working population. MATERIALS AND METHODS: Subacute IE manifestations have been analysed in 10 patients of a general outpatient clinic. Echocardiograms of 6209 patients under 60 years of age were studied retrospectively. RESULTS: In one-third of the patients IE developed in the presence of streptococcal and staphylococcal infection. In all the cases cardiac valve involvement was stated. In 4 cases changes in the valve were not accompanied my impairment of the valvular function. By echocardiography, valvular structure changes without valvular disease were detected 2.3 times more frequently that valvular disease. Difficulties presenting in outpatient IE prophylaxis are outlined. CONCLUSION: Advances in IE prevention will be achieved if echo-CG becomes a mandatory examination in the program of working population check-up, if early diagnosis of streptococcal ENT infection is made, if physicians of different specialties work as a team.