Postprandial hypotension (PPH) is an important but underrecognized condition resulting from an inadequate compensatory cardiovascular response to meal-induced visceral blood pooling. PPG is recognized as an important clinical problem because it has a high prevalence in the older age group and is associated with the development of cardiovascular complications and geriatric syndromes. Possible pathophysiological mechanisms of PPG: increased visceral blood flow; weakening of baroreflex function due to disorders associated with age or autonomic dysfunction; inappropriate activation of sympathetic nerves; dysregulation of vasoactive intestinal peptides; insulin-mediated vasodilation. Ask about symptoms of postprandial hypotension and a decrease in systolic blood pressure (BP) of ≥20 mm Hg. Art. 15-60 minutes after eating is of paramount importance for making a diagnosis of PPG. One of the main strategies for preventing PPG is to reduce gastric distension (small meals and more frequent meals), resting on your back after eating, and drinking enough water. Walking after eating also appears to help restore blood pressure after eating. Caution should be exercised when prescribing protein supplements in the elderly, modifying the diet by replacing high-nutrient sweeteners with low-calorie sweeteners (d-xylose, xylitol, erythritol, maltose, maltodextrin, and tagatose). Metformin or acarbose modulates the cardiovascular response in patients with diabetes mellitus and reduces postprandial hypotension. Thus, PPG is a fairly common and clinically significant phenomenon in elderly patients. Increasing the awareness of doctors about pathophysiology and methods of diagnosis and prevention will improve the efficiency and safety of managing geriatric patients.

In most cases, portal vein thrombosis progresses without treatment; spontaneous recanalization of portal vein develops in 42 % of patients with liver cirrhosis. Effective treatment strategies include administration of anticoagulants, interventional procedures such as transjugular intrahepatic porto-systemic shunt or endovascular fibrinolysis. Anticoagulant therapy has certain difficulties in patients with liver cirrhosis due to the complex profile of hemostasis, a tendency to both hemorrhages and hypercoagulation. In addition to traditional anticoagulants (heparin preparations, fondaparinux, vitamin K antagonists), direct oral anticoagulants have been widely used in recent years for portal vein thrombosis. Previously, portal vein thrombosis was considered a contraindication to performing transjugular intrahepatic porto-systemic shunt, currently the method is often used to restore portal blood flow through the shunt and prevent repeated thrombosis. Endovascular fibrinolysis is still an option for specialized centers for «difficult» patients. In cases of increased risk of venous thromboembolism, patients with liver cirrhosis are recommended to be prevented with low-molecular-weight heparin or direct oral anticoagulants, but further studies should clarify their effectiveness in this aspect. The review highlights data on the features of therapy, primary and secondary prevention of portal vein thrombosis in patients with liver cirrhosis. Despite the existing clinical recommendations for management of patients with cirrhotic portal vein thrombosis, the choice of a particular strategy primarily depends on an individualized assessment of risks and benefits of each treatment method.

Many researchers have noted the problem of adherence to drug treatment in patients with cardiovascular diseases (CVD). Mobile health (mHealth) technologies can have a significant positive impact on changing patient behavior, preventing and preventing exacerbations (recurrences) of cardiovascular diseases (CVD). To put this approach into practice, first of all, it is necessary to find out the possibilities of using mHealth for patients with CVD.
Aim. To study the acceptance of medical applications by patients with CVD, and also to assess patients’ attitudes towards personal responsibility for maintaining their health in the context of using mHealth.
Materials and Methods. Partial least squares structural equation modeling in the Smart-PLS environment was used to implement the UTAUT model (the unified theory of acceptance and use of technology), which included 10 constructs: Use of Applications, Intention to Use, Performance Expectancy, Social Influence, Facilitating Conditions, Attitude towards the use of Applications, Anxiety, Patient’s Role, Role of Prevention and Value of Information. The study included 437 patients with CVD who had experience using medical applications: female (253) and males (184), average age 47.95±5.22 years.
Results. Constructs Performance Expectancy, Social Influence, Facilitating Conditions, and Value of Information had a direct positive effect on construct Intention to use of health Applications and explained 59,3 % of the variance this construct. The positive influence of the construct Intention to use of Applications and Attitude towards the use of Applications explained 61,2 % of the variance in the construct Use of Applications. The construct Anxiety indirectly, through Attitude towards the use of Applications, had a negative impact on the construct Use of Applications. 41,4 % of the variance of construct the Value of Information, that is, an understanding of the need for medical literacy, was determined by the Social Influence construct, as well as an understanding of the role of personal responsibility for health and CVD prevention.
Conclusion. Patients with CVD understand the importance of personal participation in maintaining their health and are ready to use mHealth to prevent the disease and develop behavior aimed at reducing modifiable risk factors for CVD. One of the barriers to mHealth adoption may be patients’ fear of using medical applications on their own. Acceptance of mHealth technologies by patients with CVD to improve the effectiveness of treatment will be possible if there are appropriate technical conditions and social support that creates a trusting, professional, understandable and attractive image of mHealth.

Objective: to study the vitamin D (25(OH)D) status in various regions of the Russian Federation (RF), and to determine the relation between age, levels of 25(OH)D and parathyroid hormone (PTH).
Methods: The vitamin D status was investigated in residents of various regions of the Russian Federation (Northwestern Federal District, Central Federal District, Southern Federal District and Far Eastern Federal District) between 2012 and 2017. In this cross-sectional study 115694 anonymous samples were analyzed. All samples were provided by an independent commercial laboratory. Serum levels of vitamin D (25(OH)D) were measured using chemiluminescent assay.
Results: The prevalence of low levels of 25(OH)D was widespread in the Russian Federation: deficiency (0,05). The median level of vitamin D was higher in the summertime than in the winter months (25,3 ng/ml [18,3; 33,5] vs 24 ng/ml [16,7; 32,5], p=0,006). Levels of 25(OH)D30 ng/ml) was low, which was comparable to the age group over 80 years (22,6 % and 18 %, respectively, p=0,1). A negative inverse correlation between vitamin D and PTH levels was confirmed (r=-0,11, p=0,002). There was a weak positive correlation between the age of participants and PTH levels (r=0,18, p=0,000).
Conclusion: The obtained data indicate the high prevalence of 25(OH)D deficiency among all age groups in the Russian Federation. Vitamin D levels were statistically differed depending on age and season. Geographic factors did not have a significant impact on vitamin D status in different regions of the Russian Federation. The highest prevalence of severe D deficiency was observed in age group younger 20 years and over 80 years. A weak positive correlation was established between age and PTH levels. Considering the high frequency of low vitamin D concentrations in the elderly age group, this condition rеrequires adequate correction and further follow-up in order to prevent the negative effects of vitamin D deficiency on bones.

Purpose: To develop and validate a tool to assess salt intake in the adult population of the Russian Federation.
Material and Methods: Respondents filled out food diaries, where the type of food intake, its volume, and the fact of additional salting of the dish were taken into account. R language, version 4.2.1, RStudio development environment (packages ggplot2, ggpubr, dplyr, tidyverse, gtsummary, rstatix) were used for statistical processing of the obtained data.
Results: A total of 271 respondents were included in the study, with a median age of 52 [20; 70] years. It was found that the main factors for high sodium intake were pre-salting, consumption of salty foods, lower intake in confectionery, low salt intake was characterized by higher consumption of dairy products. Cohen’s consistency test was κ = 0.48 95 % CI (0.08; 0.08), Cronbach’s alpha values α = 0.8. At a threshold score of ≥12 points on the questionnaire, the questionnaire had a sensitivity of 85 % compared with the median score from the 3-day food diary data. At a threshold score < 12 points, the questionnaire has a specificity of 74 % compared with the median score from a 3-day food diary.
Conclusion: The SOLE questionnaire can be used to determine the estimated level of salt intake by the population, but for wider application in the territory of the Russian Federation additional validation by regions is required.

The purpose of the study is to assess the impact of the main risk factors (RF) of chronic non-communicable diseases on the severity of the postCOVID-19 syndrome (PCS) in COVID-19 convalescents.
Materials and methods: 270 persons (48.1 % of them men, mean age 53.2±13.2 years) were included in the one-time observational study and are COVID-19 convalescents. The patients were divided into three groups according to the severity of the PCS. Group 1 included 79 people with no PCS, group 2 included 97 patients with light PCS, group 3 included 94 patients with moderate PCS. All patients were given standard general clinical and laboratory examination, anthropometry, echocardiography, and anamnesis data were evaluated. Persons without PCS were younger than patients with PCS (р=0,003). In patients with PCS compared to persons who did not develop PCS, statistically signifi cantly higher levels of glucose and IgG in the blood serum, systolic blood pressure and diastolic blood pressure, body mass index (BMI) waist circumference (WC) and indexes: triglyceride-glucose index (TyG /WC), TyG /BMI, lipid accumulation product (LAP), visceral adiposity index (VAI), number of obese patients and persons with diastolic left ventricular dysfunction. Patients with moderate PCS were more likely to have cardiovascular disease before developing a new coronavirus infection.
Results: The forced expiratory volume in 1 s (FEV1), forced vital lung capacity (FVC) scores were lower for mild to moderate PCS compared to persons without PCS. There is a direct relationship between the presence of PCS and glucose level (r =3,138, p=0,000), diastolic left ventricular dysfunction (r =2,876, p=0,008) in the general group. In women, this association was detected only with the presence of diastolic left ventricular dysfunction (r=4,457, p=0,008). In men with glucose (r =4,343, р=0,000), WC (r =1,068, р=0,060) и diastolic left ventricular dysfunction (r =3,377, р=0,033). The chance of having a moderate PCS in men and women was associated with glucose level (r =1.537, p=0.001), VAI (r =1.256, p=0.005), САД (r =0.977, p=0.027), CVD before COVID-19 (r=0.460.036). In the group of men this association was preserved only with the level of glucose (r =2,357, p=0,004), the index VAI (r =1,430, p=0,020) and the presence of preceding CVD (r =0,160, p=0,014).
Conclusion: the presence of PCS in convalescents COVID-19 independently of other factors is due to the level of glucose and the presence of diastolic left ventricular dysfunction. PCS of moderate severity is associated with an increase in glucose, systolic blood pressure, VAI index, and the presence of CVD prior to COVID disease, with PCS of moderate severity more associated with cardio-metabolic risk factors in men.

The diversity of clinical forms of amyloidosis is related to differences in amyloidogenic precursor proteins. Cardiac involvement is characteristic of AL- and ATTR-amyloidosis, with cardiac involvement developing in the vast majority of patients with AL-amyloidosis and in 50-60 % of patients with ATTR-amyloidosis. ATTR- (transthyretin) amyloidosis is one of the types of systemic amyloidosis, the precursor protein of which is transthyretin in the presence of mutations in its molecule (familial forms) or age-related disorders of its tetrameric secretion. Until recently, it was believed that transthyretin amyloidosis did not occur in Russia. However, the introduction of molecular genetic diagnostic methods for transthyretin mutations has demonstrated the occurrence of ATTR amyloidosis in Russia with a frequency close to the European average for non-endemic areas. The article presents the case report of systemic amyloidosis in a middle-aged woman. The disease presented at the age of 54 years with carpal tunnel syndrome. Subsequently, chronic heart failure refractory to treatment became the dominant manifestation of the disease. Heterogeneity of structure and significant myocardial thickening with preserved ejection fraction detected in dynamics in combination with new symptoms (diarrhea, orthostatic arterial hypotension, periorbital purpura, proteinuria) were considered as an infiltrative heart lesion within the framework of systemic amyloidosis. The result was a fatal asystole. Autopsy findings confirmed the diagnosis of systemic amyloidosis. The article discusses the issues of differential diagnosis of AL- and ATTR- amyloidosis based on the analysis of anamnestic and clinical data. The onset of the disease with carpal tunnel syndrome, the progressive distal neuropathy combined with autonomic dysfunction, the dominant cardiac involvement, the absence of renal amyloidosis according to autopsy data, and the duration of the disease from the time of clinical manifestation to death of 43 months are more indicative of ATTR amyloidosis. The article also discusses modern approaches to diagnostics of amyloid heart lesion in clinical practice, points out the difficulties arising in this case, emphasizes the importance of early diagnosis of cardiac amyloidosis, which allows to realize the possibilities of modern methods of amyloidosis treatment.