[Characteristics of arterial hypertension clinical course in patients with obesity and anxiety-depressive disorders].

This article covers an important subject clinical course of arterial hypertension in patients with metabolic abnormalities with obesity and anxiety-depressive disorders. Relevance of this topic is defined with high incidence of each aforementioned conditions and their influence on quality of life and social functioning of patients. Review of literature covers subjects of comorbidity and multimorbidity. Relevant data are presented which are focusing on complex management of arterial hypertension co-existing with obesity and anxiety-depressive disorders.

[Possibilities of modern echocardiographic technologies in the early diagnosis of the cardiotoxic effect of chemotherapy drugs anthracycline series in cancer patients].

Chronic heart failure following chemotherapy for cancer is a relevant issue of an adverse cardiovascular prognosis and premature death in cancer patients. This category of patients requires thorough and chronic monitoring of the cardiovascular system, prevention and treatment of cardiovascular complications of chemotherapy, such as IHD, systolic or diastolic myocardial dysfunction, arterial or pulmonary hypertension, pulmonary thromboembolism, pericarditis, stroke, and peripheral vascular disease. However, many aspects of this important interdisciplinary issue presently remain understudied. For instance, it is still impossible to predict long-term consequences of chemotherapy for cancer and development of the associated cardiovascular complications listed above. Baseline evaluation of the risk for cardiovascular complications is a major component in management of such patients. High-risk patients need an individual, detailed schedule of cardiovascular treatment throughout and after the course of chemotherapy. Furthermore, early detection of subclinical myocardial dysfunction is critical for prevention of the most threatening cardiovascular complications of chemotherapy, CHF. Detecting impaired LV EF following chemotherapy is, unfortunately, only a late predictor of irreversible changes, such as toxic cardiomyopathy and clinically pronounced, rapidly progressing CHF. Markers of myocardial injury, high-sensitivity troponins and natriuretic peptides, in combination with up-to-date EchoCG technologies have been recently used. Their use, for instance, for evaluation of LV myocardial global longitudinal strain to detect early, reversible changes in structure and mechanics of the myocardium is promising for ultimate improvement of prediction for such patients.

[Pulmonary arterial hypertension and chronic heart failure as dasatinib cardiotoxicity. A case report].

Modern treatment of patients with oncohematological diseases has allowed to achieve remission or even convalescence in many cases. One of ambitious aims put forward by the hematological society is 100% survival and preservation of quality of life in patients with chronic myeloid leukemia (CML). This hope is related with the emergence of targeted therapy for CML. The second-generation tyrosine kinase inhibitor, dasatinib, which is used for treatment of CML, can occasionally induce severe pulmonary hypertension (PH). We presented here a case report of such cardiotoxicity, which was evident as PH and heart failure in a young female patient with CML treated with dasatinib. Information from published reports about this type of cardiotoxicity is provided. At present time, dasatinib is beginning to be extensively used also in other oncological diseases. For this reason, cardiologists and physicians should be aware of this cardiotoxicity, which can cause heart failure in dasatinib-treated patients.

[Cardiooncology: Current Aspects of Prevention of Anthracycline Toxicity].

Anthracyclines including doxorubicin, epirubicin, daunorubicin, aclarubicin are extensively used as chemotherapeutic agents for treatment of hematological and other malignancies. In cancer therapy anthracyclines are often used in combinations with other chemotherapeutic drugs and agents for molecularly targeted therapy. Anthracyclines are effective and powerful antineoplastic drugs with wide spectrum of application but active use of preparations of this group is limited because of such side effects as cardiotoxicity, myelotoxicity, thromboembolism, alopecia, etc. Cardiotoxicity is the most severe side effect of anthracycline administration. Clinical studies have shown that it is progressive and irreversible. Therefore, early detection and prevention of anthracycline cardiotoxicity has become an important trend in cardiology.

[Azilsartan Medoxomil Capabilities in Arterial Hypertension and Obesity].

Arterial hypertension (AH) is one of the most common cardiovascular disease. Angiotensin II (AT II), the hormone of renin-angiotensin-aldosterone system, realizes its negative effects through AT 1 receptors - application point of angiotensin receptor blockers (ARB). Due to different dissociation AT 1 receptors properties some ARBs are more effective than others. Multiply multicenter randomized and observational studies approve the effectiveness and safety of azilsartan medoxomil in patients with AH 1-2 grade. Several preclinical studies have shown the additional properties of azilsartan, including increase of insulin sensitivity, cardio- and nephron protection in obesity. In our clinical case we showed the positive influence of azilsartan medoxomil on clinic and ambulatory blood pressure, 24-hour aortic stiffness parameters, longitudinal left ventricular strain in patient with AH and obesity.

[Left Atrial Remodeling and Thromboembolic Risk in Patients With Recurrent Atrial Fibrillation].

PURPOSE: To assess the relationship between left ventricular and left atrial (LA) structural and functional characteristics and thromboembolic (TE) risk in patients (pts) with recurrent atrial fibrillation (AF). MATERIAL AND METHODS: Sixty pts (mean age 65 [61; 72] years, 42% men) with nonvalvular paroxysmal and persistent AF during sinus rhythm were divided into three groups based on CHA2DS2-VASc score: 1, 2, and ≥ 3. All pts underwent conventional and speckle tracking echocardiography. Apical four- and two-chamber views images of 6 myocardial segments in the filling phase were obtained to assess global peak left atrial longitudinal strain (PALS) in the reservoir (r) and contractile (c) phase. RESULTS. Patients with paroxysmal AF had significantly higher PALSr compared with patients with persistent AF (15.1 vs 11.2%, p = 0.0002) and PALSc (-15.0 vs -12.0%; p = 0.0002]. In logistic regression analyses, only higher PALSr was significantly associated with lower CHA2DS2-VASc score (OR 0.61; 95% Cl 0.38-0.97; p = 0.03). In order to distinguish patients with moderate and high TE risk we performed ROC curve analysis. Effective PALSr cut-off point was 16.7% with sensitivity of 62.5%, specificity of 39.0% and an area under the curve of 0.85 (95% Cl 0.72-0.98; p = 0.002). CONCLUSIONS: In patients with AF PALSr was independently associated with CHA2DS2-VASc score. Use of a PALSr threshold allows to detect patients with moderate and high TE risk and can be considered in the process of decision making on initiation of anticoagulation treatment in patients with AF and CHA2DS2-VASc score of 1.