Despite the achievements of modern cardiology, the cardiovascular morbidity and mortality in most countries of the world remains high, which motivates the wider use of additional (alternative) preventive and therapeutic approaches, one of which is hypoxytherapy. Over several decades of 

using this method, a large amount of data has been accumulated that allows us to state the beneficial effect of various hypoxytherapy regimens on the clinical course of cardiovascular diseases and can potentially improve prognosis of them. The use of hypoxytherapy is associated with an improvement in blood pressure circadian rhythm, flow-dependent vasodilation, an insulin resistance decrease, a vascular wall stiffness redaction, an improvement in blood rheology, endothelial function and nitric oxide system, a decrease of proinflammatory and prothrombotic cytokines levels. A number of modern experts consider hypoxytherapy as an affordable and perspective method of prevention and treatment of cardiovascular disease, effectively supporting traditional non-drug and drug-based approaches. Contemporary data indicate serious future perspectives for an expanded study of the hypoxytherapy possibilities in cardiac patients, including through the State research programmes. This review is devoted to the discussion of the physiological effects of hypoxytherapy, the possibilities of its application in cardiological practice, including with the analysis of own data, as well as precautions during its implementation.

Based on domestic and international literature the review refers to the analysis of the research data on risk factors and biomarkers for the development of adverse cardiovascular events in patients with chronic kidney disease and acute kidney injury. Biomarker studies are important, especially in the early stages of chronic kidney disease, that is, in patients with creatinine clearance above 60 ml/min/1.73 m2, when preventive and therapeutic measures work more effectively. Among the potential predictors of adverse cardiovascular events, the biomarkers related to the following pathological processes (conditions) should be noted: oxidative stress (malondialdehyde, ischemic-modified albumin; superoxide dismutase), inflammation (interleukin-6, interleukin-18), acute kidney injury (kidney injury molecule 1; neutrophil gelatinase-associated lipocalin), cardiospecific biomarkers (highly sensitive troponin) and circulating microribonucleic acids (specific miRNA-133a, miRNA-21), as well as the prospects for further study of some biomarkers in cardionephrology are discussed. A separate emphasis is placed on the need to establish threshold values for various molecules in chronic kidney disease, depending on the degree of decline in kidney function, which will allow these indicators to be effectively used in clinical practice as diagnostic and prognostic biomarkers for cardiovascular diseases, since their usual reference values are used in the general population, will be higher in kidney disease. Currently, only for troponin and natriuretic peptides, certain reference values are established, which are less clear-cut in the population with chronic kidney disease than in the general population, and for all other biomarkers, cut-off values are not yet known.

To date, the problem of preserving symptoms after recovery from a new coronavirus infection is urgent in the world. This condition is called postcovid syndrome. The clinical picture of postcovid syndrome has multiple manifestations: general, respiratory, cardiovascular, gastrointestinal, skin and other symptoms. At the moment, there are no laboratory criteria for the diagnosis of this condition, but the great role of neutrophils in the development of both acute disease and postcovid syndrome has been proven. The formation of neutrophil extracellular traps (not toz) is one of the pathophysiological mechanisms of the course of a new coronavirus infection. In addition, the effect of the ketosis process on the development of complications in the postcovid period has been proven. The article discusses the history of the term, various clinical manifestations of the postcovid period, as well as the role of innate immunity mechanisms at all stages of the course of a new coronavirus infection. 

In contrast to trivial bacterial pneumonia, the diagnosis of septic pulmonary embolism poses a fundamental task for the doctor to search for primary sources of emboli, including right side infective endocarditis, and to change the tactics of managing the patient accordingly. The similarity of the main clinical common and respiratory symptoms of septic pulmonary embolism with symptoms of other inflammatory processes in the lung makes their differential diagnosis difficult without the involvement of additional radiologic investigation methods. The review describes the special features of etiology and pathogenesis, as well as the clinic, complications and principles of diagnosis of septic embolic pneumonia. 

Hypertrophic cardiomyopathy is characterized by genetic and phenotypic heterogeneity which manifests in different variants of localization and extent of myocardial hypertrophy.

Aim: to evaluate specifics of left ventricular hypertrophy, the prevalence and characteristics of clinical and instrumental features of phenotypic variants of hypertrophic cardiomyopathy.

Materials and methods. The study includes 295 patients with hypertrophic cardiomyopathy aged 18 to 88 years (60.3±13.4 years), 183 men (62 %), and women 112 (38 %). The diagnosis of which was established by 2D echocardiography. The severity, localization and extent of myocardial hypertrophy, the maximum thickness of the hypertrophied segment, left ventricular myocardial mass, left ventricular myocardial mass index, the presence and severity of mid-ventricular and left ventricular outflow tract obstruction were evaluated. Depending on the predominant localization and extent of hypertrophy, patients were divided into 8 groups according to the recommendations for hypertrophic cardiomyopathy of the Ministry of Health of the Russian Federation. The analysis and comparison of the obtained results are carried out.

Results. The average duration of the disease is 10.5±7.52 years. The mean values of the body mass index in patients — 28.2±2.82 kg/m². The phenotype with basal hypertrophy of the septum (n=130, 44.1 %), group 1 was most often noted. In 47 (15.9 %) patients, hypertrophy of the septum of “reverse curve” (2 group) was detected, in 41 (13.9 %) — “neutral septum” (3 group), in 36 (12.2 %) — symmetrical hypertrophy of the left ventricle (8 group), 11 (3.7 %) of patients had combined hypertrophy of the septum and other parts of the left or right ventricle (4 group) and the free left ventricular wall (7 group), in 10 (3.4 %) — middle ventricular hypertrophy of the left ventricle (6 group) and in 9 (3.1 %) — apical hypertrophy (5 group). The highest value of the maximum thickness of the myocardium was noted in patients of the 6th group 19.3 (1920.4 mm). Mid-ventricular obstruction was detected in group 6 (90 %), left ventricular outflow tract obstruction was more often registered in groups 4 and 8 (81.8 % and 77.8 %), and less often in group 5 (22.2 %) (p <0.01). In group 7, there were no cases of rest obstruction of left ventricular outflow tract. The maximum values of myocardial mass and left ventricular myocardial mass index were noted in group 8 — 402 (356-439) g and 195 (173218) g/m², respectively (p <0.01).

Conclusion. Echocardiography is an informative tool for assessing the presence, severity myocardial hypertrophy and determination of the phenotypic variant of hypertrophic cardiomyopathy. Variants of septal hypertrophy are most commonly registered one, among which the most frequent is the phenotype of basal septal hypertrophy. Each phenotype of hypertrophic expression is characterized by its echocardiographic parameters.

195 million women on Earth suffer from chronic kidney disease — some of them are planning to become mothers. Even in absolutely healthy women, pregnancy is fraught with risks. These risks increase when it comes to kidney pathology. It is known that pregnancy in women with kidney diseases, even with preserved renal function, is accompanied by serious problems for both the mother and the fetus. We present a clinical observation of a 23-year-old patient with terminal renal insufficiency who successfully carried out the pregnancy. The patient’s polymorbid condition (chronic kidney disease, ulcerative colitis, anemia, etc.) required complex therapy and an interdisciplinary approach, which was implemented from the first days of the woman’s observation. The highly professional work of a team of specialists (nephrologists, resuscitators, obstetricians-gynecologists, gastroenterologists, infectious disease specialists, functional diagnostics doctors, urologists, etc.) determined the successful outcome of this observation. The article focuses on the factors aggravating this observation, as well as determining, on the contrary, a favorable outcome. 

Лабораторные методы исследования активно применяются клиницистами для уточнения и установления диагноза, но часто возникают случаи, которые сбивают с толку практикующих врачей и заставляют проводить широкий дифференциально диагностический поиск. Выявление тромбоцитопении в общем анализе крови требует тщательного обследования пациента, соотношения результатов анализа с клинико-анамнестическими данными и критического отношения к лабораторным показателям. Одним из ложных диагностических феноменов, затрудняющих правильную интерпретацию снижения числа тромбоцитов, является псевдотромбоцитопения, ассоциированная с применением консерванта этилендиаминтетрауксусной кислоты. В данной статье представлен клинический случай пациентки с ЭДТА-ассоциированной псевдотромбоцитопенией, до выявления которой были проведены полный сбор жалоб и анамнеза, физикальный осмотр, дополнительные методы обследования, изучен обширный дифференциально-диагностический ряд.

One of the causes of transient ischemic attack or ischemic stroke are mass formations in the left heart. One of the predisposing factors for thrombosis is the presence of the Leiden mutation, as the most common form of hereditary thrombophilia in the European population. At the same time, spontaneous dissection of the coronary arteries (SCA) can be one of the reasons of an acute vascular accident. Of particular difficulty is differential diagnosis, which requires additional examination methods (intravascular ultrasound, optical coherence tomography) in addition to coronary angiography. The presented clinical case describes the diagnosis and successful treatment of spontaneous anterior interventricular artery dissection, left ventricular thrombosis, detection of factor V Leiden gene mutation in a young man with a history of transient ischemic attack