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Clinical and functional characteristics of life support systems during and after coronary artery bypass grafting
Aim. To evaluate the clinical and functional characteristics of vital systems during and after coronary artery bypass grafting. Materials and methods. This study included 160 patients who underwent CABG with and without cardiopulmonary bypass at the Samarkand branch of the Republican Specialized Scientific-Practical Medical Center of Cardiology (2020–2026). Patients were divided into two groups: the main group (n=80), where an individualized algorithm using a multifactorial prognostic scale and ulinastatin was applied, and the control group (n=80), where standard management was used. Hemodynamic monitoring included HR, mean arterial pressure, CVP, stroke and cardiac indices, ejection fraction, cardiac output, and SVR across six stages from admission to discharge. Results. The main group showed improved outcomes: reduced myocardial afterload, stabilized HR and pressure, enhanced cardiac performance, and a shift from hypodynamic to eukinetic circulation. Conclusion. In high-risk patients, this approach reduced complication rates and ICU stay. An individualized strategy with ulinastatin ensures a more stable perioperative course and lowers complication risk.
Copyright (c) 2025 J.T. Yusupov, M.M. Matlubov , E.G. Hamdamova (Author) https://creativecommons.org/licenses/by/4.0
Therapeutic approaches to the management of women with gestational hypertension: a cardiologist’s perspective.
The need to expand knowledge about the early stages of gestational therapy for pregnant women with hypertensive disorders is driven by several factors. First, the selection of the optimal antihypertensive therapy regimen is limited by the feasibility of conducting large-scale studies in representative populations due to time constraints and the responsibility for the life of not only the mother but also the child. Second, current recommendations generally recommend initiating therapy by titrating a single drug regardless of blood pressure levels, limiting the use of combination regimens. Third, the identification of specific cardiac risks is limited by the timely implementation of an effective screening strategy.
Copyright (c) 2025 М.А. Садуллоева , Ф.А. Закирова , С.А. Икрамова , Р.Р. Хазраткулов , М.М. Рустамов (Автор) https://creativecommons.org/licenses/by/4.0
Association between disease severity and systemic inflammation in patients with dilated cardiomyopathy
Aim. The aim of this study was to investigate the relationship between clinical-hemodynamic parameters and inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor-α) in patients with dilated cardiomyopathy. Materials and methods. The study included 42 patients (mean age 38.5±1.2 years) with dilated cardiomyopathy and chronic heart failure classified as NYHA functional class II–IV. The patients were divided into two groups: Group I – class II (n=12) and Group II – class III–IV (n=30). Results. As heart failure severity increased (class III–IV), serum levels of C-reactive protein (7.6±1.1 mg/L vs. 4.1±0.6 mg/L, p<0.05), IL-6 (7.5±0.8 pg/mL vs. 4.6±0.2 pg/mL, p<0.01), and TNF- α (8.1±0.9 pg/mL vs. 5.6±0.7 pg/mL, p<0.05) were significantly elevated. These changes were associated with left ventricular dilatation (LVEDD 58±1 mm, p<0.05) and reduced ejection fraction (34.7±1.8%, p<0.05). Conclusion. The findings suggest that inflammatory markers play a crucial role in assessing the severity and prognosis of dilated cardiomyopathy and chronic heart failure.
Copyright (c) 2025 Т.А. Абдуллаев, М.М. Рахматов, Х.А. Гуломов (Автор) https://creativecommons.org/licenses/by/4.0
Improving preventive measures for salt-sensitive arterial hypertension based on clinical characteristics in the Aral Sea region population
Aim. The aim of the work was to improve preventive measures based on the prevalence and clinical characteristics of salt-sensitive arterial hypertension in primary health care facilities among the Aral Sea region population. Materials and methods. The study included 1,021 patients with salt-sensitive arterial hypertension from family clinics affiliated with the Ellikkal’a District Medical Association. All patients underwent clinical and laboratory-instrumental examinations. Results. The results of our study showed that patients with a high salt tolerance had more pronounced clinical features of arterial hypertension than patients with a low salt tolerance. Conclusion. According to the conclusions of our study, periodic assessment of cardiovascular disease risk factors based on the PEN protocol and prevention in primary care settings effectively contribute to the regression of non-communicable diseases and improvement of health indicators in the population of this region.
Copyright (c) 2025 Х.Х. Атаниязов, Х.Г. Фозилов, Г.А. Хамидуллаева, Г.Ж. Абдуллаева (Автор) https://creativecommons.org/licenses/by/4.0
Exercise tolerance and quality of life in patients with chronic heart failure and obesity
Aim. To assess exercise tolerance and quality of life in patients with chronic heart failure (CHF) and obesity depending on the presence of metabolic syndrome (MS). Materials and methods. The study included patients with obesity and CHF (main group) and obese individuals without CHF (control group), stratified by the presence/absence of MS. Treadmill test parameters were evaluated (duration, maximal workload, VO₂, chronotropic index, heart rate increase, peak systolic blood pressure [SBP] and its increment), along with quality of life using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the SF-36 survey. Results. Patients with MS demonstrated significantly lower exercise tolerance: reduced treadmill duration, VO₂, chronotropic index, and heart rate increase, accompanied by a greater increment of SBP. According to MLHFQ, patients with MS reported worse physical and emotional functioning and a higher total score (indicating poorer quality of life). On SF-36, MS was associated with reduced physical functioning and general health. Conclusion. The presence of MS in patients with CHF and obesity is associated with reduced exercise tolerance and impaired quality of life, underscoring the need for comprehensive cardiometabolic rehabilitation aimed at correcting metabolic disturbances and improving functional reserve.
Copyright (c) 2025 Н.Ф. Ташкенбаева (Автор) https://creativecommons.org/licenses/by/4.0
Adherence to drug therapy in patients after acute myocardial infarction: a systematic review of the literature
Aim. To systematically analyze current approaches to assessing and improving medication adherence in patients after acute myocardial infarction during outpatient follow-up, with a particular focus on factors influencing treatment adherence and the role of a multidisciplinary approach. Materials and Methods. A systematic review of the literature on medication adherence after acute myocardial infarction was conducted. Data from large international studies were analyzed, including a meta-analysis of 10 studies involving 106,002 patients, the 2023 American Heart Association scientific statement, the 2023 ESC and 2025 ACC/AHA guidelines, and current cardiac rehabilitation programs. Results. A meta-analysis showed that good adherence to drug therapy is associated with reduced all-cause mortality (odds ratio 0.56; 95% CI: 0.45-0.69), cardiovascular mortality (OR 0.66; 95% CI: 0.51-0.87), and hospitalization rates (OR 0.61; 95% CI: 0.45-0.82). Non-adherence to therapy occurs in 30% of patients after myocardial infarction. Shared decision making, structured cardiac rehabilitation programs, and the involvement of multidisciplinary teams significantly improve long-term treatment adherence. Conclusion. Adherence to drug therapy is a key factor in improving the prognosis of patients after acute myocardial infarction. A multidisciplinary approach, including shared decision making, patient education, pharmaceutical counseling, and the use of digital technologies, demonstrates the greatest effectiveness in improving adherence.
Copyright (c) 2025 Д.Д. Сохибов , Р.Х. Тригулова , Н.С. Мирахмедова (Автор) https://creativecommons.org/licenses/by/4.0
Clinical portrait of a patient who suffered a myocardial infarction and acute cerebrovascular accident, according to outpatient registry data
Purpose: to determine the clinical and epidemiological characteristics and laboratory and instrumental research indicators, the profile of cardiovascular risk factors in patients who have suffered myocardial infarction and stroke, and to establish their adherence to treatment before and after the reference event over a 12-year observation period. Materials and methods. An analysis of data from 410 patients who presented to an outpatient clinic between January 1, 2019, and December 31, 2022, with confirmed acute (recurrent) myocardial infarction and/or stroke was conducted. Statistical software packages (SPSS, SAS, STATISTIKA 10, Stata) and programming languages ​​(R, Python) were used. Results. Lipid metabolism disorders were detected in 36.8% (n=151). Hypolipidemic therapy was prescribed in 21.7% (n=89) of patients, and in the stroke group - 7.9% (n=18). In patients who had a history of MI and stroke, it was 45% (n=9). Among patients with MI (MI group), lipid-lowering therapy was prescribed in 38.5% (n=6). 2.4% (n=10) of excess weight decreased, 1.9% (n=8) of those who quit smoking, 3.4% (n=14) of those who achieved target lipidogram values, 0.2% (n=1) of those who adjusted their diet, and 0.2% (n=1) of those who improved physical activity. The highest level of compliance with recommended measures was observed in relation to the treatment of arterial hypertension - 88.5% (n=363). Conclusion. In patients who have had myocardial infarction and stroke, the following clinical, epidemiological and laboratory characteristics have been identified, as well as the prevalence of cardiovascular risk factors: smoking, alcohol abuse, arterial hypertension, dyslipidemia, obesity and diabetes mellitus.
Copyright (c) 2025 Н.Ф. Побиванцева , Н.Б. Конончук , О.В. Микульская , Е.А. Григоренко , Н.П. Митьковская (Автор) https://creativecommons.org/licenses/by/4.0
Prevalence of atherosclerotic lesions of the brachiocephalicarteries and their association with cardiovascular risk factors: a cross-sectional study in uzbekistan
Aim. To assess the prevalence of atherosclerotic lesions of the brachiocephalic arteries (BCA), their association with cardiovascular risk factors, and cardiovascular risk according to the SCORE scale in the population of Uzbekistan. Materials and methods. A cross-sectional study (conducted in 2025 using 2022 data) included 6,425 patients (47.6% men, 52.4% women; mean age 54.0 ± 23.1 years) at the Republican Specialized Scientific and Practical Medical Center of Cardiology, Uzbekistan. Carotid and brachiocephalic ultrasound was performed using a short protocol assessing stenosis in four segments [1]. The following parameters were analyzed: age, total cholesterol (TC), arterial hypertension (AH), smoking, systolic and diastolic blood pressure (SBP, DBP). Cardiovascular risk was determined using the SCORE system [2]. Statistical analysis was performed using SPSS 26. Results. BCA lesions were detected in 54.8% of patients. Age correlated with the presence of lesions (Spearman’s ρ = 0.219, p < 0.01), while TC did not (ρ = 0.032, p = 0.207). Men over 50 years had more extensive lesions (7.9% with four affected segments) compared to women (2.6%). According to the SCORE scale, men and patients over 50 years had a moderate to high cardiovascular risk (4–8%). Conclusion. Age is the key risk factor for atherosclerosis of the brachiocephalic arteries. The high prevalence of arterial hypertension emphasizes the need for preventive measures in Uzbekistan.
Copyright (c) 2025 Ф.М. Бекметова , М.Н. Хотамова , С.Я. Абдуллаева , Ш.А. Оринбаев (Автор) https://creativecommons.org/licenses/by/4.0
Effectiveness and prevention of complications of the use of a new generation biodegradable framework - magmaris in acute myocardial infarction
Aim. To evaluate the immediate clinical and angiographic success in patients with NSTEMI, who underwent percutaneous coronary intervention (PCI) with the installation of a new generation of resorbable scaffolds “Magmaris”. Materials and methods. Material and methods: clinical data of 64 patients with an acute form of coronary artery disease (49 men and 15 women) who were fitted with a biodegradable Magmaris frame were used. Anamnestic, general clinical, laboratory and coronary angiographic data were obtained from patients with acute forms of coronary artery disease who underwent percutaneous coronary intervention (PCI) with the installation of a Magmaris BVS frame as endovascular treatment. Results. Implantation of bioresorbable scaffolds "Magmaris" in patients with coronary artery disease was characterized by immediate good angiographic success in 100% of cases and clinical success in 95.8% of cases. Patients with low LVEF were characterized by a higher SYNTAX score (p <0.001), a greater number of multivessel lesions (p> 0.05), the involvement of a larger number of coronary basins (p> 0.05), and a greater number of stenotic segments per patient (p> 0.05) and, accordingly, a longer atherosclerotic lesion. This was confirmed by an inverse correlation (which did not reach the level of reliability), which may have been due to the small size of the sample under study. The presence of CKD, according to angiographic characteristics, was associated with a greater number of multivessel and complex (type "C" according to the ACC / ANA classification) lesions, a greater number of stenotic segments and, accordingly, the implantation of more devices, while the immediate angiographic success of the PCI procedure was 100%, but clinical success was 5.9% lower, than in patients without CKD. Comorbidity with type 2 diabetes, according to angiographic characteristics, was accompanied by a relatively longer and more severe type (type "C") of atherosclerotic lesions of the coronary arteries, despite the relatively lower incidence of multivessel lesions and a smaller number of stenotic segments. The presence of type 2 diabetes did not in any way affect the angiographic success of the PCI procedure (which was 100%), but worsened the clinical success by 11.1%. Conclusion. The primary results of evaluating the use of the bioresorbable scaffold "Magmaris" in our country turned out to be very encouraging. However, it is necessary to conduct further more in-depth studies in this direction, in particular, to study the issues of the influence of various risk factors or pathological conditions on angiographic characteristics and assess the safety and effectiveness of using the polymer scaffold "Magmaris".
Copyright (c) 2025 С.Ш. Холикулов, Н.П. Юлдошев, Aziz Eshpulatov (Автор) https://creativecommons.org/licenses/by/4.0
Influence of combined pathogenetic treatment on the dynamics of epicardial fat thickness in patients with cad and metabolic syndrome
Aim. To evaluate the influence of combined hypolipidemic therapy (statins in combination with ezetimibe and fenofibrate) and sodium-glucose cotransporter 2 inhibitors on epicardial fat thickness in patients with coronary heart disease and metabolic syndrome. Materials and methods: The study included 49 patients with coronary heart disease and metabolic syndrome who underwent treatment at the Republican Specialized Scientific and Practical Medical Center of Cardiology. The patients were divided into 2 groups: 1) intensive statin therapy in combination with ezetimibe, 2) with the addition of fenofibrate and SGLT2 inhibitors. All patients underwent biochemical tests and imaging marker assessments, followed by comparison of the dynamics within and between groups. Results. When comparing two groups receiving different types of therapy, both groups demonstrated a significant decrease in lipid parameters: LDL-C p<0.001, TC p<0.001, TG p<0.001. Additionally, the group treated with fenofibrate and SGLT2 inhibitors showed a more significant reduction in epicardial fat (11.4 mm in the first group and 10.4 mm in the second group, p<0.05). Conclusion: Pathogenetic therapy with the inclusion of fenofibrate and SGLT2 inhibitors more effectively reduces the level of EFT, as well as TG, VLDL-C, and the TG/HDL index.
sodium glucose co-transporter 2 inhibitors
Copyright (c) 2025 A.R. Kim, A.B. Shek, R.B. Alieva (Author) https://creativecommons.org/licenses/by/4.0
Sudden cardiac death in regularly training young athletes: risk factors and prevention
Sudden cardiac death (SCD) in young athletes engaged in regular intensive training represents a rare but highly significant clinical and social problem. Although the incidence is low, SCD typically occurs unexpectedly during physical exertion or shortly thereafter, often as the first manifestation of previously undiagnosed cardiovascular disease. The main etiological factors include hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, myocarditis, dilated cardiomyopathy, and primary electrical disorders such as long QT syndrome. Risk stratification is based on a comprehensive approach that involves clinical history, physical examination, resting and exercise electrocardiography (ECG), echocardiography, and, in selected cases, genetic testing. Recent consensus statements highlight the importance of improving ECG interpretation criteria to reduce false-positive results in athletes. Preventive strategies include pre-participation cardiovascular screening, continuous follow-up of high-risk groups, and timely intervention in suspected cases. Equally important are emergency measures, including cardiopulmonary resuscitation and rapid use of automated external defibrillators, which significantly improve survival outcomes. Awareness of potential risk factors, combined with optimized screening protocols and personalized decision-making, may reduce the incidence of SCD in the athletic population.
Copyright (c) 2025 E. Турсунов, Р. Д. Курбанов, Н.У. Закиров, Н.З. Сроджидинова, А. С. Расулов (Автор) https://creativecommons.org/licenses/by/4.0
Universality of SPC (Single-Pill Combination) A New Approach to the Treatment of Cardiovascular Diseases: From Guidelines to Real-World Clinical Practice
In the modern ESH (2023) and ESC (2024) guidelines on arterial hypertension (AH), the following key provisions for the use of combination therapies from the start of treatment have been clearly formulated for the first time: the use of single-pill combinations (SPCs) should be preferred at any stage of treatment, i.e., at the initiation of therapy with a combination of two drugs and at any other stage of treatment (Class I recommendation, Level of Evidence B). These statements have also been incorporated into the 2024 clinical guidelines on AH in adults by the Russian Cardiological Society (RCS) and the 2025 National Clinical Protocol on AH by the Ministry of Health of the Republic of Uzbekistan. This article presents a new approach to the treatment of cardiovascular diseases using universal SPCs in real-world clinical practice
Copyright (c) 2025 H. G. Fozilov, G. A. Khamidullayeva, G. J. Abdullayeva, G. U. Mullabayeva, N.R. Salimova, K. Y. Filipyak (Author) https://creativecommons.org/licenses/by/4.0
Improvement of percutaneous coronary intervention in patients with ischemic cardiomyopathy: a systematic literature review
Aim. To evaluate the effectiveness of percutaneous coronary intervention (PCI) in patients with ischemic cardiomyopathy and identify opportunities for its improvement, as well as to conduct a comparative analysis with coronary artery bypass grafting (CABG). Materials and methods. A systematic search of medical literature published from 2017 to 2025 was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases. 110 sources from high-impact factor journals were analyzed, including key randomized controlled trials (STICH, REVIVED-BCIS2), meta-analyses, and systematic reviews on ischemic cardiomyopathy and revascularization methods. Results. Ischemic cardiomyopathy is the leading global cause of heart failure, in the treatment of which revascularization plays an important role alongside quadruple pharmacotherapy. PCI demonstrates superior stroke risk reduction compared to CABG, while CABG excels in reducing repeat revascularization needs and improving long-term survival. In patients achieving complete revascularization, mortality risk decreased by 34% and repeat revascularization risk by 33%. Conclusion. When choosing between PCI and CABG in patients with ischemic cardiomyopathy, patient clinical characteristics, coronary anatomy, and comorbidities must be considered. The degree of revascularization and myocardial viability are important factors determining clinical outcomes.
Copyright (c) 2025 Х.Г. Фозилов, А.М. Абдукамилов (Автор) https://creativecommons.org/licenses/by/4.0
Systematic Review of Different Reperfusion Therapy Methods in Patients with ST-Elevation Acute Coronary Syndrome: Literature Review
Aim. Systematic analysis and comparison of different reperfusion therapy methods in patients with ST-elevation acute coronary syndrome (STEMI), including primary percutaneous coronary intervention (pPCI) and thrombolytic therapy (TLT), with emphasis on time factor and COVID-19 pandemic impact. Materials and methods. A systematic review of prospective randomized and observational studies comparing pPCI and TLT effectiveness in STEMI patients was conducted. Data from major international trials including DANAMI-2 (1572 patients), PRAGUE-2, STAT, GISSI, ISACS-STEMI COVID-19, meta-analyses of 23 studies, and modern global longitudinal strain assessment methods were analyzed. Results. Meta-analysis of 23 randomized studies showed statistically significant pPCI advantages over TLT: 30-day mortality 8.0% vs 13.7% (p=0.0003), recurrent infarction 3.8% vs 7.0% (p<0.05), revascularization need 5.7% vs 25.2% (p<0.001). "Golden hour" concept was confirmed. COVID-19 pandemic led to 19-30.5% reduction in STEMI presentations and worse prognosis. Conclusion. pPCI demonstrates statistically significant advantages over TLT, however method selection should consider time factor and technical availability. Modern global longitudinal strain assessment methods improve prognostic accuracy.
Copyright (c) 2025 H.G. Fozilov, B.R. Atamuratov (Author) https://creativecommons.org/licenses/by/4.0
The impact of ulinastatin in complex therapy on the incidence of early postoperative complications after coronary artery bypass grafting
Aim. To evaluate the effectiveness of ulinastatin as part of complex therapy in reducing the incidence of early postoperative complications in patients with multivessel coronary artery disease after CABG. Materials and methods. The study included 160 patients treated in the cardiac surgery intensive care unit. They were divided into a main group (80 patients, who underwent risk prediction using a multifactorial scale and received ulinastatin) and a control group (80 patients, who received standard treatment). Research methods comprised clinical observation, application of the prognostic risk assessment scale, laboratory determination of inflammatory markers, and statistical analysis using Student’s t-test, the Mann–Whitney test, and Pearson’s correlation. Results. In the main group, the incidence of hyperthermia and pneumonia was 50% and 10%, compared with 100% and 12.5% in the control group. ARDS and multiple organ failure were three times less frequent (1.25% vs. 3.75%), mediastinitis occurred in 1.25% vs. 3.75%, and postoperative wound infection in 3.75% vs. 6.25%. No lethal outcomes were recorded in the main group, whereas mortality in the control group reached 2.5%. Conclusion. The combined use of a multifactorial risk prediction scale and ulinastatin reduces the severity of systemic inflammatory response, lowers the frequency of early complications, and prevents mortality after CABG.
Copyright (c) 2025 Ж.Т. Юсупов , М.М. Матлубов , Р.С. Кушназаров (Автор) https://creativecommons.org/licenses/by/4.0
Heart remodeling in the obstructive form of hypertrophic cardiomyopathy, efficacy of Morrow septal myectomy
Obstructive hypertrophic cardiomyopathy (OHCMP) is a disease characterized by cardiac remodeling due to genetic factors. OHCMP can cause the development of dynamic obstruction in the outflow tract of the left ventricle, diastolic dysfunction, mitral regurgitation, myocardial ischemia, and cardiac arrhythmias. Clinically, patients are manifested by symptoms of heart failure. OHCMP is the most common cause of sudden cardiac death, especially in young people and among athletes. According to the results of epidemiological observations conducted in the USA and European countries, sudden cardiac death in athletes under 35 years of age is associated with OHCMP in 30–40% of cases. Today, despite the availability of modern non-invasive methods of treating the disease, the effectiveness of the surgical method prevails. The article analyzes the data presented in the literature on the features of cardiac remodeling in this disease, the results of clinical studies conducted in this area, and the effectiveness of treatment methods
Copyright (c) 2025 N. Rasulova, T.A. Abdullaev, A.A. Khakimov (Author) https://creativecommons.org/licenses/by/4.0
Early biomarkers of endothelial dysfunction: clinical implications for the diagnosis and management of cardiovascular disease
This review synthesizes current evidence on early biomarkers of endothelial dysfunction (ED) in cardiovascular disease (CVD), emphasizing their role in diagnosis, prognosis, and management. ED, characterized by reduced nitric oxide bioavailability and increased inflammation, serves as a reversible precursor to atherosclerosis, thrombosis, and events like myocardial infarction. Established biomarkers, including adhesion molecules, cytokines, and inflammatory markers, reflect endothelial activation and predict CVD risk, with recent studies confirming their utility in hypertension. Emerging focus on L-arginine derivatives, particularly asymmetric dimethylarginine (ADMA), highlights its specificity as an endogenous nitric oxide synthase inhibitor, associated with vascular impairment in hypertension, diabetes, and CVD. Clinical trials, such as the AtheroGene and Framingham Offspring studies, demonstrate ADMA’s prognostic value for major adverse events. Future directions advocate integrating ADMA into multi-biomarker panels with AI and omics for personalized medicine, addressing gaps in standardization and early detection. Non-invasive techniques like flow-mediated dilation and ultrasound-derived markers complement biomarkers for subclinical CVD assessment. Overall, biomarker-driven strategies promise enhanced CVD prevention and tailored therapies.
Copyright (c) 2025 N.M. Nurillayeva, N.Z. Srozhidinova, M.A. Makhkamova, L. Khafizova (Author) https://creativecommons.org/licenses/by/4.0
The impact of revascularizatıon vıa stenting on left ventricular ejection fraction ın patients with myocardial infarction
Aim. To evaluate the one-year dynamic effect of complete or incomplete revascularization on left ventricular ejection fraction (LVEF) in patients with a history of myocardial infarction (MI) who have preserved or mildly reduced LVEF. Materials and methods. The study included 270 patients with a history of MI. All patients underwent transthoracic echocardiography and coronary angiography (CAG) based on clinical examination findings. Depending on the number of affected atherosclerotic coronary vessels and the extent of stenting performed, patients were divided into three groups: Complete revascularization (CR) (n=115), Incomplete revascularization (IR) (n=94), and No revascularization (NR) (n=61). After the procedure, all patients were discharged with standard treatment. After one year, follow-up echocardiographic assessment of LVEF was performed. Results. In the CR group, LVEF increased significantly from 54.0 [47.0; 59.7] to 55.7 [46.9; 61.4] (p = 0.017). In the IR group, LVEF increased from 53.9 [43.7; 56.4] to 55.7 [46.9; 61.4], but the change was not statistically significant (p = 0.458). In the NR group, LVEF decreased from 50.7 [45.0; 56.3] to 48.2 [41.8; 54.3] (p = 0.011). No statistically significant differences were observed between groups in terms of diastolic function parameters of the left ventricle. Conclusion. In post-infarction patients, complete anatomical revascularization of affected coronary arteries via stenting has a significantly positive impact on the improvement of LVEF.
Copyright (c) 2025 E.Y. Tursunov, R.D. Kurbanov, N.U. Zakirov (Author) https://creativecommons.org/licenses/by/4.0
Application of the Ross operation in children with congenital aortic valve pathology
Aim. To evaluate the clinical effectiveness and safety of the Ross procedure in children with congenital aortic valve disease. The main aim of the study was to determine the physiological and hemodynamic advantages of the Ross operation compared to conventional valve replacement techniques. Materials and methods. A total of 14 pediatric patients who underwent the Ross procedure at the Medion Innovation Center between 2022 and 2025 were analyzed. The primary diagnoses were aortic stenosis (n = 9) and aortic insufficiency (n = 5). In all cases, the full-root replacement technique was applied. Postoperative echocardiographic parameters, including transvalvular pressure gradient and degree of regurgitation, were assessed. Results. A significant improvement in postoperative hemodynamic parameters was observed in all patients. The mean aortic pressure gradient decreased from 45 ± 12 mm Hg to 8 ± 3 mm Hg, and no clinically significant regurgitation was detected. No early postoperative complications or autograft dysfunction were reported during the follow-up period. Conclusion. The Ross procedure is an effective and safe surgical method for treating congenital aortic valve pathology in children. It restores near-physiological hemodynamics, improves long-term outcomes, and reduces the need for reoperation. The results support broader implementation of the Ross procedure in pediatric cardiac surgery practice.
Copyright (c) 2025 Yu.S. Sinelnikov, A.R. Kayumov, Sh.Sh. Adilov, N.A. Zoirova, E.M. Ligin (Author https://creativecommons.org/licenses/by/4.0
The Role of Adipose Tissue Depots in the Pathogenesis of Coronary Artery Disease: Beyond Body Mass Index
In recent years, researchers have focused on the role of various adipose tissue depots in the development of coronary artery disease (CAD), extending beyond traditional obesity assessments based on body mass index (BMI). Visceral adipose tissue, epicardial fat, fatty liver disease (currently termed metabolic dysfunction-associated steatotic liver disease), and perivascular adipose tissue actively participate in CAD pathogenesis through mechanisms of systemic inflammation, oxidative stress, endothelial dysfunction, and atherosclerosis. Visceral fat, characterized by high metabolic activity, secretes proinflammatory cytokines that promote insulin resistance and atherosclerosis. Epicardial fat surrounding the coronary arteries exerts local effects by releasing adipokines that may accelerate the progression of atherosclerotic plaques. Fatty liver disease is associated with dyslipidemia and enhanced systemic inflammation, increasing cardiovascular risk. Perivascular adipose tissue regulates vascular tone and inflammation, and its dysfunction contributes to arterial stiffness and hypertension. The relevance of studying these adipose depots lies in the need to identify new biomarkers and targets for personalized prevention and treatment of CAD. Traditional obesity assessment methods such as BMI, fail to reflect adipose tissue distribution and metabolic activity, underscoring the importance of more detailed investigation into the role of various fat depots in cardiovascular pathology.
metabolic dysfunction-associated steatotic liver disease
Copyright (c) 2025 Doctor of Biological Sciences Yusupalieva, R. N.B. N. Aliyeva, S. N.S. N. Akhmedova, A. N.B. N. Doubt (Author) https://creativecommons.org/licenses/by/4.0
The Effect of Posterior Pericardiotomy on the Risk of Supraventricular Arrhythmias after Off-Pump Coronary Artery Bypass Grafting (OPCABG)
Aim. To evaluate the effectiveness of posterior pericardiotomy in reducing the risk of postoperative supraventricular arrhythmias in patients who underwent off-pump coronary artery bypass grafting. Materials and methods. This study was conducted at the Republican Specialized Scientific and Practical Medical Center of Cardiology. The study included 220 patients with coronary artery disease who had indications for surgical intervention. The average age of the patients was 58,6±7,2years, including 31 women and 189 men. The patients were randomly divided into 2 groups. 110 patients in the first group underwent posterior pericardiotomy, and 110 patients in the second group did not undergo this procedure. All patients underwent Holter ECG monitoring (HMECG) 5 days and 24 hours before the surgery. Results. According to the monitoring results, 48 patients developed POAF after off-pump coronary artery bypass grafting, which accounted for 21.8% of the total number of patients. Analysis of clinical and anamnestic parameters showed the following. The groups did not differ significantly in age and gender (Table 1). Arterial hypertension was more common in the group with POAF - 95.1% compared to 44.3% in the group without POAF (X2 = 29.9; p < 0.001). Also, patients in the main group were more likely to be obese than in the group without POAF (X2 = 7.1; p = 0.008). Diabetes mellitus (DM) was also significantly more common in patients with POAF - 68.5% compared to 30.5% (X2 = 17; p < 0.001). Conclusion. According to our results, 21.8% of patients after off-pump CABG had POAF. The main reasons for this were the patient’s age, left atrial dilation, comorbidities, and myocardial fibrosis. It can be concluded that posterior pericardiotomy significantly reduces the incidence of supraventricular arrhythmias. It also reduces the incidence of cardiac tamponade, thromboembolic complications, and the length of stay in the intensive care unit and rehabilitation unit, which saves hospital resources.
off-pump coronary artery bypass grafting (OPCABG)
postoperative atrial fibrillation (POAF)
Holter monitoring electrocardiography (HM ECG)
Copyright (c) 2025 О.О. Джаббаров, Г.У. Муллабаева, И.М. Шарипов, Х.Г. Фозилов (Автор) https://creativecommons.org/licenses/by/4.0
The effect of antihypertensive drugs on cognitive functions
According to the World Health Organization data, 1.13 billion people worldwide suffer from arterial hypertension, with only 21% under proper control. Dementia currently negatively affects the quality of life of 55 million people worldwide, with one new case recorded every 3.2 seconds. Analyzing the effects of antihypertensive medications on cognitive function and evaluating protective mechanisms against dementia development is currently considered one of the urgent issues. There is reliable evidence that the effects of antihypertensive medications on cognitive function are related not only to blood pressure reduction but also to independent neuroprotective mechanisms. Angiotensin receptor blockers reduce dementia risk by 12-26% compared to other antihypertensive medications. Calcium channel blockers demonstrate 17% greater neuroprotective effects compared to other drug classes. ARBs and calcium channel blockers possess the best neuroprotective properties and are considered preferable for cognitive function protection. These effects occur independently of blood pressure reduction mechanisms.
Copyright (c) 2025 М.И. Атоева, Г.Ж. Абдуллаева, Х.Ф. Юсупова, И.В. Ибрагимова (Автор) https://creativecommons.org/licenses/by/4.0
Predictors of sudden cardiac death and the impact of coronary artery bypass grafting on their development
Sudden Cardiac Death (SCD) is one of the most severe and life-threatening manifestations of cardiovascular diseases and is among the leading causes of mortality worldwide. The primary pathogenic factors contributing to the development of this condition include ischemic heart disease (IHD), ventricular arrhythmias, reduced left ventricular ejection fraction (LVEF), and the formation of scar tissue in the myocardium. The mechanism underlying SCD is complex, involving a combination of myocardial ischemia, electrical instability, and morphological changes, all of which contribute to the onset of malignant arrhythmias. Coronary artery bypass grafting (CABG) is an effective revascularization technique in patients with ischemic heart disease. It not only alleviates symptoms but also significantly improves long-term prognosis by enhancing cardiac function. Studies have shown that CABG, particularly in patients with reduced LVEF, decreases overall mortality and the risk of developing SCD. In conclusion, CABG plays an important role in the prevention of SCD, but it is not a standalone solution. A thorough analysis of the underlying risk factors, early identification of high-risk patients, and the development of individualized, comprehensive preventive and therapeutic strategies represent the most effective approach in reducing SCD incidence.
Copyright (c) 2025 А.Ш. Расулов, Р.Д. Курбанов, Г.У. Муллабаева, Э.Я. Турсунов, А.Г. Кеворков, К.Ш. Сайфиддин Ходжи (Автор) https://creativecommons.org/licenses/by/4.0
The importance of lipoprotein(a) in the development of cardiovascular diseases
Aim. To study the impact of lipoprotein (a) levels on major cardiovascular events. Materials and methods. We examined the impact of lipoprotein(a) levels on major cardiovascular events based on a review of articles on this topic. Results. Based on a review of articles on this topic, it can be said that Lp(a) is a highly atherothrombogenic lipoprotein associated with atherosclerotic cardiovascular diseases and their complications, in particular, ischemic heart disease and aortic valve stenosis. Conclusion. Lipoprotein (a) levels may serve as a criterion for determining residual risk during hypolipidemic therapy.
Copyright (c) 2025 Р.Е. Жемуратова , А.Б. Шек (Автор) https://creativecommons.org/licenses/by/4.0
Short and Medium-term Efficacy and Safety of “Sinotech+” (Uzbekistan) Stent in Primary Stenting for Patients with Acute Coronary Syndrome with ST-Segment Elevation
Aim. To evaluate the efficacy and safety of the Uzbekistan-manufactured “Sinotech+” stent during primary percutaneous coronary intervention (pPCI) in patients presenting with ST-elevation acute coronary syndrome (STEMI). Materials and methods. The study was conducted at the X-ray Endovascular Treatment Department of Cardiovascular Diseases at the RSSPMCC. Between January and June 2025, all 31 patients diagnosed with STEMI underwent pPCI procedures. "Sinotech+" stents were implanted in 17 patients (54.8%), while "Resolute Integrity" stents were implanted in 14 patients (45.2%). Patients who received "Sinotech+" stent implantation were analyzed. Results. Coronary lesion distribution was as follows: single-vessel disease in 5 patients (29.4%), two- vessel disease in 7 patients (41.2%), and multi-vessel disease in 5 patients (29.4%). Pre-procedural coronary flow assessment using the TIMI (Thrombolysis in Myocardial Infarction) perfusion scale revealed TIMI-0 flow in 9 patients (53%) and TIMI-1 flow in 8 patients (47%). Following pPCI, TIMI-3 flow was achieved in 14 patients (82.4%), while TIMI-2 flow was achieved in the remaining 3 patients (17.6%). These results demonstrated 100% technical success (stent deployment and vessel opening) and 82.4% angiographic success (achieving TIMI-3 flow), indicating high clinical efficacy of primary PCI using “Sinotech+” stents. Conclusion. The Uzbekistan-manufactured “Sinotech+” stent demonstrated high efficacy and safety in patients presenting with STEMI. No complications (thrombosis, restenosis, recurrent myocardial infarction, repeat revascularization) were observed during clinical follow-up.
Copyright (c) 2025 Х .Фозилов, Б. Атамуратов, Б. Юлдашов (Автор) https://creativecommons.org/licenses/by/4.0
Speckle-tracking echocardiography in assessing staged cardiac remodeling in ischemic heart failure
Aim. To assess the features of global staged remodeling of the heart chambers in patients with ischemic chronic heart failure, depending on the degree of left ventricular ejection fraction (LVEF) reduction, using two-dimensional echocardiography with myocardial deformation analysis. Materials and methods. The study included 96 patients with a confirmed diagnosis of CHF according to current criteria. Patients were divided into three groups based on LVEF: Group I – LVEF >50% (n=46, preserved systolic function); Group II – LVEF 40-49% (n=24, mildly reduced systolic function); Group III – LVEF <40% (n=26, significantly reduced systolic function). Global longitudinal strain (GLS) of the LV was significantly lower in patients with reduced ejection fraction. Results. In the group with LVEF >50%, the mean GLS was 17.0 ± 2.8%, while in those with LVEF 40–49% and <40%, values decreased to 12.6 ± 2.1% and 9.4 ± 2.2%, respectively (p < 0.001). A similar trend was observed for GLS measured in 4-, 2-, and 3-chamber views. These findings indicate high sensitivity of GLS to impaired myocardial contractility and confirm its clinical significance in assessing LV functional status.The assessment of LA function using 2D speckle-tracking echocardiography in the reservoir, conduit, and contractile phases also revealed a significant decrease in absolute parameters: LASr (reservoir phase) - 35.5 ± 8.3% (LVEF >50%) →17.8 ± 11.2% (LVEF <40%), *p* < 0.001; LASct (conduit phase) - 17.6 ± 5.4% → 8.8 ± 6.5%, *p*< 0.001; LAScd (contractile phase) - 18.7 ± 5.9% → 8.7 ± 4.6%, *p* < 0.001. In patients with LVEF>50%, RV longitudinal strain parameters were highest (RVFWLS - 21.3 ± 4.0%; RV GLS - 18.1 ± 3.2%), while in LVEF 40–49%, they decreased (19.9 ± 2.8% and 16.0 ± 2.7%, respectively), and in LVEF <40%, the most pronounced decline was observed (RVFWLS: 14.0 ± 4.1%; RV GLS: 10.5 ± 3.1%), with significant intergroup differences (p=0.001). Conclusion. Patients with ischemic CHF exhibit progressive remodeling of all heart chambers (LV, LA, and RV), with worsening functional impairment as LVEF declines. LV global longitudinal strain (GLS), as well as LA (LASr, LASct, LAScd) and RV (RVFWLS, RV GLS) deformation parameters, demonstrate high sensitivity to hemodynamic changes and may serve as early markers of CHF progression. Speckle-tracking echocardiography is an informative non-invasive method for assessing subclinical myocardial dysfunction and may be useful for risk stratification and therapy monitoring in patients with varying degrees of CHF severity.
Copyright (c) 2025 Ф.М. Бекметова , Х.Г. Фозилов , Р.Ш. Бекбулатова , Ш.У. Хошимов , Ш.А. Оринбаев (Автор) https://creativecommons.org/licenses/by/4.0
Benefits and risks of implementing the Neuromed AI medical decision support system in the cardiology service of the Republic of Uzbekistan.
Aim: Clinical testing of the NeuromedAI Cardio intelligent system, designed to automate routine tasks of cardiologists and improve the quality of medical care; Materials and methods. The study used the NeuromedAI Cardio intelligent system and a questionnaire, including 28 questions aimed at expert assessment of the potential benefits of the system for doctors. The questionnaire helped to define the main requirements for the system, as well as formulate recommendations for improving the model. In particular, areas were identified for enriching the training dataset and further training the model in order to improve the accuracy of responses; Results. As part of a pilot study of the Neuromed system conducted in 2024, an anonymous survey of 21 cardiologists was organized. The average experience of the participants was 17 ± 11.1 years. Analysis of the questionnaires showed that during interaction with the system, specialists asked a total of 400 questions, which reflects a high level of interest in the technology and its active testing in the professional environment; Conclusion. Based on the obtained results, it is planned to develop recommendations for adapting the system for implementation in the practice of primary health care in the Republic of Uzbekistan. It is expected that the adapted system will improve the accuracy of diagnosis and the effectiveness of treatment at the primary level, which will be reflected in the improvement of key indicators of public health and will receive positive feedback from health workers.
Copyright (c) 2025 Х.Г. Фозилов, Р.Х. Тригулова (Автор) https://creativecommons.org/licenses/by/4.0
An integrated approach to determining the risk of developing preeclampsia in pregnant women with hypertensive conditions
Aim. Hypertensive disorders complicate one in ten pregnancies, which necessitates the development of new standards for determining the risk of preeclampsia and heart failure in pregnant women. To determine early clinical markers in pregnant women with gestational arterial hypertension (GAH) as sensitive diagnostic criteria for the development of hypertensive complications. Materials and methods. The study included 91 pregnant women of the 2nd-3rd trimesters, divided into groups: healthy pregnant women (n=44) and with GAH (n=47) according to the ESC Guidelines 2018. Physical examination, blood pressure measurement, BMI calculation, detailed blood tests including lipidogram, coagulogram, determination of prolactin and NT-proBNP, echocardiography, vascular stress test to assess endothelial function were performed. Results. Pregnant women with GAH were found to have morphofunctional changes in the heart, early signs of endothelial dysfunction, lipid and carbohydrate metabolism disorders. Microalbuminuria demonstrated high diagnostic value for detecting early renal dysfunction. The prognostic significance of prolactin and NT-proBNP levels was established. Conclusion. Comprehensive early monitoring of clinical and biochemical parameters of pregnant women with GAG is necessary for timely detection of preeclampsia predictors. The results contribute to the improvement of diagnostic and preventive standards for the management of this cohort of patients.
Copyright (c) 2025 M. Садуллоева, Ф.А. Закирова , М.У. Турсунова , А.А. Абдухакимов , С.А. Икрамова , В.Х. Джураева (Автор) https://creativecommons.org/licenses/by/4.0
Gender-specific features of dilated cardiomyopathy in the uzbek population
Dilated cardiomyopathy (DCM) is one of the most common non-ischemic myocardial disease characterized by systolic dysfunction and cardiac chamber dilation. Gender-specific features of DCM progression and prognosis remain understudied. Aim. To evaluate gender-specific characteristics of medical history, clinical presentation, and functional parameters in patients with DCM in the Uzbek population. Materials and methods. A retrospective analysis included 269 DCM patients (180 men, 89 women) treated at the Republican Specialized Scientific-Practical Medical Center of Cardiology from 2010 to 2017. Data on age at diagnosis, disease duration, hospitalizations, NYHA class, hemodynamics, and six-minute walking test were assessed. Statistical analysis involved t-test and χ2 test (p < 0.05). Results. Women were younger at diagnosis (33.7 vs. 41.3 years; p < 0.001), had shorter disease duration (p = 0.041), and were hospitalized more frequently (75% vs. 65%; p = 0.041). No significant differences were found in NYHA class, blood pressure, or respiratory parameters. Men demonstrated better physical endurance (p = 0.191). Conclusion. Significant gender differences were identified, underscoring the need for personalized management of DCM patients.
Copyright (c) 2025 Т.A. Абдуллаев , И.А. Цой , Х.А. Гуломов , С.Т. Мирзарахимова , О.К. Худойберганов , М.М. Рахматов (Автор) https://creativecommons.org/licenses/by/4.0
Epidemiology and Cardiovascular Risk Assessment in Patients with Carotid Artery Atherosclerosis in the Republic of Uzbekistan: A Cross-Sectional Population-Based Study
Aim. Atherosclerosis of the carotid artery basin is a key pathogenic factor in ischemic stroke. In the context of a lack of local epidemiological data, studying the prevalence of lesions and associated risk factors in the Republic of Uzbekistan is of particular importance. The aim of the study was to assess the prevalence of atherosclerotic lesions in the carotid arteries, identify associated risk factors, and perform cardiovascular risk stratification using the SCORE scale among the adult population of Uzbekistan, taking into account gender, age, and regional characteristics. Materials and Methods. A population-based cross-sectional study was conducted at the Republican Specialized Scientific and Practical Medical Center of Cardiology (Tashkent). The analysis included data from 6,425 adult patients who underwent ultrasound duplex scanning of the carotid arteries. Demographic indicators, blood pressure levels, lipid profile, smoking status, presence of arterial hypertension (AH), and 10-year cardiovascular risk according to the SCORE scale were assessed. For statistical analysis, univariate and multivariate logistic regression models were used. Results. Atherosclerotic lesions of the carotid arteries were significantly more frequently detected in men over 50 years of age (p<0.05). The strongest correlation was found with arterial hypertension (r=0.85; p<0.001). Smoking and elevated systolic blood pressure showed a moderate association with plaque presence (p<0.01). Mean SCORE values in certain regions (Samarkand and Navoi regions) reached Conclusion. These findings emphasize the need to implement targeted preventive programs aimed at controlling hypertension and reducing smoking prevalence in high-risk groups.
Copyright (c) 2025 F. N.M. N. Bekmetova, H. N.G. N. Fozilov, S. N.Ya. n. Abdullayeva, M. N.N. Khotamova, A. N.Sh.n. Almanova, S. N.N. Donierov (Author) https://creativecommons.org/licenses/by/4.0