No 14 (2011)

Atrial fibrillation (AF) and arterial hypertension (AH) are two most common, often combined pathologies of the cardiovascular system. The incidence of these diseases increases with age; they lead to numerous complications and high mortality. Although the relationship between these pathologies is not fully investigated, the treatment of AH is not a new approach to the correction of AF. Aggressive treatment of AH can prevent the structural changes of the myocardium, reduce the incidence of thromboembolic complications, and slow or prevent the occurrence of AF in patients with this type of atrial tachyarrhythmias. Specific drug therapy plays an important role in primary and secondary prevention of AF and its complications.

The article reviews current treatment options for various versions of edema, especially in chronic heart failure and chronic kidney disease. One of the most effective approaches to stimulate diuresis in patients with edematous syndrome is the use of loop diuretics, of which the most interesting is torasemid (Diuver). Its principal advantages are presence of additional properties of aldosterone antagonists and positive impact on long-term prognosis of patients. The use of such drugs (currently available torasemide) will certainly facilitate the management of patients with chronic heart failure, chronic kidney disease, as well as most other variants of the edematous syndrome.

The article presents the results of clinical studies that have examined the possibility of additional effect of antihyperlipidemic agents (statins, polyunsaturated fatty acids) on the prognosis in patients with chronic heart failure (CHF). The role of ω-3 polyunsaturated fatty acids in the prevention of cardiovascular complications, including ventricular arrhythmias and sudden death in patients with heart failure and coronary heart disease is demonstrated.

The article presents the results of study of combination therapy with citicoline and Actovegin among 74 patients with brain concussion for 2 to 15 days after trauma. Of these, 54 patients received conventional therapy, and 20 patients, received Actovegin (400 mg 3 times daily) and citicoline (200 mg 2 times a day) within 3 months in addition to conventional therapy. The study found that the use of citicoline and Actovegin leads to a more complete regression of neurodynamic disorders, increase speech activity, and restoration of associative interactions in the cerebral hemispheres. In addition, significantly greater improvement in subjective measures (general health, performance capability, fatigue) was observed. Therapy with Actovegin and citicoline provides decrease of severity of cognitive impairment in acute mild traumatic brain injury. This clinical effect of the drugs contributes improvement of quality of life of patients.

The article presents the results of a 15-year follow-up in 31 patients with mitral valve prolapse, who have regularly received Magnerot at a dose 1500 mg/day during 3 months, 2 times a year. The features of the dynamics of the clinical picture in conjunction with the phenotypic severity of connective tissue dysplasia, changes in the electrocardiogram, structure of heart valves, and vegetative homeostasis are identified. The changes of level of the daily profile of blood pressure, tones of sympathetic and parasympathetic nervous systems are considered. According to a retrospective analysis, the treatment led to significant improvement of clinical and instrumental parameters in all patients studied. As a result of regular use of magnesium orotate, clear improvement in quality of life in patients with mitral valve prolapse was observed.