[Diagnosis and treatment of cognitive impairment in patients with chronic cerebral ischemia: the results of observational Russian program DIAMANT]. / Diagnostika i lechenie kognitivnykh narushenii u patsientov s khronicheskoi ishemiei golovnogo mozga: rezul'taty Vserossiiskoi neinterventsionnoi nabliudatel'noi programmy DIAMANT.

AIM: To investigate the efficacy of divaza in outpatients with cognitive disorders and chronic brain ischemia (CBI). MATERIAL AND METHODS: The non-interventional observational program included the data of 2583 outpatients with CBI from 30 cities (8 federal okrugs of the Russian Federation) who were on outpatient neurological treatment and received divaza in a dose of 2 tablets three times a day from Oct 2016 to Jan 2017. Cognitive functions were evaluated using the MoCA scale before and after 3 months of treatment. RESULTS AND CONCLUSION: Cognitive disorders were identified in 90.7% of patients (<26 MoCA scores). After treatment, the mean MoCA score increased from 19.58±5.13 to 23.99±4.21 (p<0.0001), the number of patients with normal cognitive functions rate (≥26 scores) increased from 9.3 to 41.3%, the number of patients with marked cognitive impairment decreased. The drug was well-tolerated by old and very old patients, adverse events were observed rarely (0.6% of cases). The majority of doctors (88.4%) noticed the effect of divaza as significant improvement or improvement, and 89.6% of patients valued the effect to be excellent or good. The use of divaza, the drug with endothelioprotective and nootropic effects, is pathogenetically justified and promising in patients with cognitive disorders of vascular etiology.

[Effects of long-term therapy with angiotensin-converting enzyme inhibitor and carvedilol on the heart remodeling process after non-Q-wave myocardial infarction].

This 2-year comparative study of EchoCG data dynamics included 230 CHD patients after primary non-Q-wave myocardial infarction of whom 76 were treated with A CE inhibitor perindopril throughout the study period (group 1) and 72 with perindopril and carvedilol (non-selective alpha-1, beta-1,2 adrenergic receptor blocker) (group 2). The control group was comprised of 82 patients that could not use either medicine for a variety of reasons. These patients developed signs of post-infarction left ventricular remodeling (enhanced MS and LVMM index, left ventricular spherization, cavity enlargement, systolic and diastolic LF dysfunction). Combined therapy arrested the remodeling process within 12 months after onset, reduced systolic MS, and promoted the tendency toward restoration of the LV geometric shape, size, diastolic and systolic function.

[The specific features of left cardiac cavity remodeling in patients with chronic obstructive pulmonary disease and chronic cor pulmonale].

AIM: To study left ventricular structural and functional changes in patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP) at different stages of a cardiac remodeling process. SUBJECTS AND METHODS: Echocardiography was used to examine 98 patients with COPD complicated by the development of CCP in a number of cases. The significant signs of CCP were absent in 19 patients; the signs of compensated and decompensated CCP in 41 and 38 patients, respectively. RESULTS: In the patients with COPD, the formation of CCP during remodeling of the heart involves its left cavities whose changes lie in the occurrence of left ventricular (LV) diastolic dysfunction, mainly of the restrictive type, in ventricular spherization, higher myocardial systolic tension, in tendencies towards increases in LV mass index, left atrial sizes, and in the indices reflecting LV systolic dysfunction. The LV diastolic dysfunction correlates with the degree of right ventricular hypertrophy and dilatation and the presence of complete right bundle-branch block. CONCLUSION: Progressive worsening of diagnostic filling of the left ventricle and its systolic function is an additional factor aggravating hemodynamic disorders in patients with COPD and CCP, which should be kept in mind on choosing an appropriate therapy for patients with CCP.