The main causes of chronic heart failure (CHF) are hypertension (HTN) and coronary heart disease (CHD). One of the diagnostic methods for heart failure with preserved ejection fraction (HFpEF) can be the HFA-PEFF diagnostic algorithm, according to which diastolic stress test (DST) is indicated for patients with an intermediate probability of heart failure (HF). Objective. The aim of the study was to compare the incidence of HFpEF in patients with HTN with CHD and hypertensive patients without CHD by transthoracic echocardiogram using a DST according to the diagnostic algorithm HFA-PEFF. Design and methods. The study enrolled 45 patients with HTN and symptoms of HF who were divided into two groups according to the presence of CHD: patients with HTN and CHD (group I), patients with HTN without CHD (group II). The major and minor criteria of the HFA-PEFF diagnostic algorithm were evaluated to make the diagnosis of HFpEF. The DST was performed applying a passive leg raising test in patients with an intermediate probability of HFpEF. Results. According to the major and minor criteria of the HFA-PEFF: 7 (21,9 %) patients in group I and 3 (23,1 %) patients in group II did not have HFpEF. The confirmed HFpEF in group I was detected in 2 (6,2 %) patients, and none patients demonstrated confirmed HFpEF in group II. The remaining patients had an intermediate probability of HFpEF. DST with passive leg raising allowed to additionally diagnose HFpEF at an early stage in 6 (26,1 %) patients with HTN and CHD and in 1 (10 %) patient with HTN without CHD. Conclusions. The HFA-PEFF diagnostic algorithm using major and minor criteria allows to make the diagnosis of HFpEF in patients with HTN and symptoms of HF and, according to this algorithm in patients with HTN and CHD was detected more often, compared to patients with HTN without CHD.

Оbjective: in order to evaluate the effects (lipid-lowering, the effect on the endothelial function and oxidative stress) of pitavastatin at a dose of 4 mg in patients with dyslipidemia, arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) at baseline, after 4 weeks and 12 months of treatment. Material and methods: the prospective study included 33 patients (mean age 60 [54;61] years) with AH, COPD and dyslipidemia. Laboratory examination consisted in determining the lipid spectrum, the level of lipid peroxidation products, creatinine, bilirubin, alanine aminotransferase, aspartate aminotransferase. The endothelium’s function was performed by the test with the endothelium-dependent vasodilation. We prescribed Pitavastatin (4 mg, Livazo, Recordati, Ireland) as a lipid-lowering therapy. After 12 months, the atherosclerotic plaques (AP) in the vessel was seen by the ultrasound duplex scanning of carotid arteries. Results: after 4 weeks of treatment with pitavastatin (4 mg), there was a decrease in total cholesterol — 26%, low-density lipoprotein (LDL) — 33%, triglycerides (TG) — 19%, high-density lipoprotein was increased by 18%. There was an improvement in endothelial dysfunction and oxidative stress. There were no side effects in patients. Conclusion: correction of lipid metabolism disorders in AH patients with COPD by prescribing pitavastatin (4 mg) can reduce total cholesterol, LDL and TG, can positively affect endothelial function and lipid peroxidation processes. Therapy with pitavastatin (4 mg) in patients with dyslipidemia, AH and COPD is safe. It is noted the regression of AP after 12 months of regular intake of pitavastatin at a dose of 4 mg.

Analysis of cytokine profile markers in conjunction with the clinical manifestations of coronavirus disease 2019 (COVID-19) can provide valuable information about the pathogenetic manifestations of the disease, and therefore, in the future, determine drugs that affect the cytokine storm and have an anti-inflammatory effect.Aim. To identify correlations between the parameters of the developed cytokine profile and the clinical course in hospitalized patients with COVID-19 of different severity.Material and methods. The study included 70 hospitalized patients with a confirmed diagnosis of COVID-19, with a mean age of 58 [50;69] years, including 40 men (57%) and 30 women (43%). The average lung involvement according to computed tomography (CT) at admission was CT-2 [1;3]. Peripheral venous blood was taken at admission, which averaged 7 [6; 8] days from the symptom onset. Standard biochemical parameters were studied, as well as 47 cytokines and chemokines using the Multiplex system (Merck KGaA, Darmstadt, Germany).Results. Correlations was found between the lung involvement degree and the level of IL-8 (r=0,31, p<0,05), IL-15 (r=0,35, p<0,05), IL-18 (r=0,31, p<0,05), MCP-1 (r=0,36, p<0,05), MIG (r=0,50, p<0,05), TNF-α (r=0,41, p<0,05). An inverse correlation was also found in the level of blood oxygen saturation with the same indicators as follows: IL-8 (r=-0,27, p<0,05), IL-15 (r=-0,34, p<0,05), IL-18 (r=-0,31, p<0,05), MCP-1 (r=-0,40, p<0,05), MIG (r=-0,56, p<0,05), TNF-α (r=-0,45, p<0,05). IL-6 levels were significantly elevated in patients with severe COVID-19 (CT3, CT4), while no increase in IL-6 was observed in patients with moderate disease (CT1, CT2). It is noteworthy that in patients with diabetes, the highest values of IL-12, IL-9 were recorded.Conclusion. Hyperinflammatory syndrome in severe COVID-19 is manifested by high levels of IL-6, MIG, MDC, MCP-1, M-CSF, TNF-α, β, IL-8, IL-18, IL-15. With the CT-1 and CT-2, an increase in only the level of IL-18, IL-8 is noted. The identified patterns prove and make it possible to explain a number of systemic inflammatory changes that occur with COVID-19.