The article presents a systematic review of the literature devoted to the analysis of the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in chronic heart failure with preserved ejection fraction (HFpEF). The research question concerned the possibilities of co-administration of drugs from the groups of sodium-glucose cotransporter-2 inhibitors (iSGLT-2) and GLP-1 RA. The literature was searched in the PubMed system. The final analysis included 11 studies relevant to the topic under study. According to the analysis, GLP-1 RA is an effective treatment for patients with CHF, leading to a reduction in HF symptoms and an improvement in the quality of life of such patients. The issues of simultaneous administration of GLP-1 RA and iSGLT-2 have been studied in sufficient detail in patients with type 2 diabetes mellitus: the effectiveness and safety of such a combination have been demonstrated. In the absence of diabetes in patients with HF, optimization of treatment using the GLP-1 RA class requires additional specially planned studies. The article presents a systematic review of the literature devoted to the analysis of the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in chronic heart failure with preserved ejection fraction (HFpEF). The research question concerned the possibilities of co-administration of drugs from the groups of sodium-glucose cotransporter-2 inhibitors (iSGLT-2) and GLP-1 RA. The literature was searched in the PubMed system. The final analysis included 11 studies relevant to the topic under study. According to the analysis, GLP-1 RA is an effective treatment for patients with CHF, leading to a reduction in HF symptoms and an improvement in the quality of life of such patients. The issues of simultaneous administration of GLP-1 RA and iSGLT-2 have been studied in sufficient detail in patients with type 2 diabetes mellitus: the effectiveness and safety of such a combination have been demonstrated. In the absence of diabetes in patients with HF, optimization of treatment using the GLP-1 RA class requires additional specially planned studies.

Objective: to evaluate the effectiveness of various pharmacological approaches for the primary prevention of left ventricular dysfunction and heart failure induced by anticancer therapy.

Materials and methods: the review was based on an analysis of the PubMed, Embase, Scopus, and Web of Science databases. A systematic literature review was conducted to analyze data on the use of beta-blockers, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, statins, SGLT-2 inhibitors, and mineralocorticoid receptor antagonists. Clinical cases, case series, systematic reviews, meta-analyses, and animal studies were excluded from the results. No time limits were set, and articles published during the lifetime of the databases were analyzed. Studies were included if they reported the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, sodium-glucose cotransporter 2 inhibitors, statins, and mineralocorticosteroid receptor antagonists as primary prevention of left ventricular dysfunction and heart failure in cancer patients.

Results: data on the effectiveness of beta-blockers are contradictory. Angiotensin receptor blockers (in particular, candesartan), angiotensin-converting enzyme inhibitors demonstrate improvement in left ventricular ejection fraction. Statins (atorvastatin and rosuvastatin) have shown effectiveness in primary prevention of cardiotoxicity. SGLT-2 inhibitors have demonstrated promising results in reducing the risk of cardiotoxicity and adverse cardiovascular events. Data on mineralocorticoid receptor antagonists are limited.

Conclusions: beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, and SGLT-2 inhibitors may have a cardioprotective effect in the context of preventing cardiotoxicity caused by anticancer therapy. Additional research is needed to determine the optimal prevention and treatment strategies that take into account individual patient risk factors and the specific therapy being used.

This review is devoted to the modern understanding of the genetic and metabolomic basis of development, features of the course and therapy of chronic obstructive pulmonary disease, one of the leading causes of morbidity and mortality in the world. It analyzes candidate disease genes, results of genome-wide association studies, and metabolomic changes in COPD. It describes methods for metabolomic profiling and integrative approaches to using this data in the diagnosis and treatment of COPD.

According to the World Health Organization, pain remains one of the leading causes for seeking medical care. The modern understanding of pain is grounded in the biopsychosocial model, reflecting its complex and multidimensional nature. In patients with rheumatic diseases, chronic pain represents a multifactorial continuum that often integrates nociceptive, neuropathic, and nociplastic mechanisms. This review analyzes the role of central sensitization (CS) and fibromyalgia (FM) in sustaining chronic pain among patients with rheumatic diseases, summarizing evidence from recent systematic reviews and meta-analyses on the prevalence of FM across rheumatic disorders and its impact on disease activity indices and quality of life. Current therapeutic strategies aimed at modulating CS and FM are discussed, including non-pharmacological interventions, centrally acting pharmacotherapies, and the emerging potential of Janus kinase (JAK) inhibitors, which may modulate both inflammatory and neuroimmune mechanisms of pain.

Currently, among all types of orofacial pain, the least studied is persistent idiopathic facial pain (PIFP), also known by the old name atypical facial pain. There are few studies on this topic, which is why this type of prosopalgia continues to be a diagnosis of exclusion, and the frequency of misdiagnosis is extremely high. A search was conducted for literary sources in the databases PubMed, Web of Science, Scopus, and eLibrary to select articles published from 1924 to 2025 using the keywords “persistent idiopathic facial pain” and “atypical facial pain”. The review examines the prevalence, views on etiopathogenesis, clinical manifestations, diagnosis and treatment of PILB.

Objective: to study a relationship between coronary heart disease (CHD) and lung cancer is the subject of numerous studies, since both diseases have common risk factors (smoking, age, genetics, environmental factors, obesity, diabetes, physical inactivity, stress) and pathogenetic mechanisms (chronic inflammation, oxidative stress and endothelial dysfunction).

Materials and methods: the study period covers the time period from January 1, 2015 to June 1, 2024. Patients who underwent planned myocardial revascularization at the Research Institute — Regional Clinical Hospital No. 1 n. a. Prof. S.V. Ochapovsky, Krasnodar (chief physician — Corresponding Member of the Russian Academy of Sciences V.A. Porkhanov) were analyzed. A lung tumor was diagnosed in 165 patients in the preoperative period, which required surgical removal followed by histological verification. Lung cancer was verified in 89 patients (group A) and benign lung neoplasm was diagnosed in 76 patients (group B).

Results: there were no significant differences in gender, age and anamnestic data between patients with and without lung cancer. In patients with lung cancer, the anatomical severity of coronary heart disease calculated by the SYNTAX scale (SX) was higher than in patients without cancer (median: 12.00, interquartile range: 4.55–21.01 vs. median: 9.00, interquartile range: 3.00–14.28, p = 0.036). SX was defined as high (SXhigh) with a value of >16, low (SXlow) ≤16. Neutrophilto-lymphocyte ratio (NLR) was determined in all patients and was defined as high (NLR-high) if the value was >2.23 and low (NLR-low) if the value was ≤2.23. Among all patients, patients with lung cancer had a higher frequency of SXhigh compared with patients without cancer (35.96% vs. 19.73, p=0.021). Moreover, among patients with NLR-high, patients with lung cancer had a higher frequency of SXhigh than patients without cancer (50.82% vs. 25.0%, p=0.044), but among patients with lung cancer, the percentage of SXhigh was not significantly higher than in patients without cancer among patients with NLR-low (21.43% vs. 19.64%, p=0.850). Multivariate logistic regression analysis showed that SXhigh was associated with an increased risk of lung cancer with an odds ratio of 1.834 (95% CI: 1.063–3.162, p=0.029).

Conclusions: it was demonstrated that the anatomical severity of CAD was associated with lung cancer, but the association of the two diseases was significant among patients with high inflammation than among patients with low inflammation. The results indicated that inflammation may play an important role in the association between CAD and lung cancer.

Objective: to study the features of arterial hypertension in patients with pathology of the venous system.

Materials and methods: the study consisted of 2 stages. Stage 1 included 410 patients with arterial hypertension. The presence of signs of connective tissue dysplasia was initially identified, and the patients’ height and weight were measured to calculate their body mass index (BMI, kg/m2). Using ultrasound diagnostics, the patients’ renal venous blood flow, heart and kidney conditions were examined, and the levels of creatinine, glucose, uric acid, and serum lipid profiles were measured. In the presence of renal venous blood flow disorders in the examined patient, in addition to standard antihypertensive therapy, diosmin was prescribed at a dose of 600.0 mg once a day for 1 month, twice a year every 6 months, followed by dynamic monitoring of blood pressure and creatinine control status for 2 years. Based on the data obtained, the patients were divided into two groups: group 1 (n=291) (patients with AH+bilateral renal venous blood flow disorders) and group 2 (n=119) (patients with AH+normal.

Results: in patients with hypertension, bilateral renal venous blood flow disorders were 2.4 times more common than normal renal blood flow (p0.001) and were more often associated with such manifestations of DST as mitral valve prolapse (11.9 times, p0.001), nephroptosis (24.8 times, p0.001), varicose veins extremities (23.3 times, p0.001), hemorrhoids (10.6% vs 0%, p0.001), chronic venous insufficiency (26.5% vs 0%, p0.001), varicocele (6.0 times, p=0.05). In addition, when comparing the body mass index between the groups, significant differences were obtained: the proportion of people with a BMI of 18.6–24.9 was 8 times higher among group 1 patients (43.3% vs 5.3%, p 0.001). In patients with hypertension and bilateral renal venous blood flow disorders, it was found that 30% of the examined patients had signs of varicose veins of the lower extremities, as well as chronic venous insufficiency, which were familial in nature (these conditions were found in parents, grandparents). In addition, patients with hypertension and bilateral renal venous blood flow disorder in 100% of cases noted a crisis course of hypertension associated with alcohol consumption (including low-alcohol drinks), as well as episodes of physical inactivity. The additional administration of diosmin to standard antihypertensive therapy in patients with hypertension and bilateral renal venous blood flow disorder made it possible to slow down the progression of a decrease in glomerular filtration rate.

Conclusion: thus, it can be concluded that the presence in patients with hypertension of conditions such as mitral valve prolapse, nephroptosis, varicose veins of the lower extremities, varicose veins of the spermatic cord and distal rectum, chronic venous insufficiency, as well as BMI values corresponding to the norm, may be a predictor of the presence of impaired renal venous blood flow. Patients with arterial hypertension and impaired renal venous blood flow have characteristic features of the clinical course of hypertension (family history of venous pathology), lifestyle stratification (alcohol consumption, physical inactivity), provoking a crisis course. Additional administration of drugs to antihypertensive therapy in this category of patients that affect the state of the venous system pathogenetically rationally and may slow down the rate of decrease in glomerular filtration rate.

Objective: to assess the relationship between oxytocin levels in biological fluids and cognitive function indicators before and after coronary artery bypass grafting. To evaluate the effectiveness of postoperative cognitive rehabilitation using computer programs that stimulate cognitive function.

Materials and methods: the study included 47 men hospitalized for elective coronary artery bypass grafting under cardiopulmonary bypass. Cognitive function was assessed preoperatively and on the 10th postoperative day using the MMSE, FAB, Schulte tests, and the 10-word memory test. Biological fluid samples were collected to determine oxytocin levels using enzyme-linked immunosorbent assay. During the hospitalization period, patients received medication therapy and underwent cognitive rehabilitation using computer programs that stimulate cognitive function.

Results: following surgery, positive changes in cognitive abilities were recorded in several tests, including the one-hour drawing task and the three-part ten-word recall test, compared to preoperative results. Meanwhile, in a number of other tests, such as the MMSE, FAB, and Schulte test, results remained consistent with preoperative results, indicating stability of cognitive function. Plasma- and salivary-bound oxytocin concentrations significantly decreased on the second day after surgery, but a characteristic increase was noted by the tenth day. The study found a significant correlation between cognitive function and oxytocin levels in both plasma and salivary samples.

Conclusion: the study demonstrated the effectiveness of postoperative cognitive rehabilitation using computerized stimulation programs. Oxytocin may be considered as a biomarker for vascular cognitive impairment.

Objective: to determine predictors of atrial fibrillation (AF) development in the long-term period in patients who had suffered from COVID-19.

Materials and methods: the prospective study included 112 patients with no significant history of cardiovascular disease who were hospitalized with moderate to severe COVID-19. Upon admission, all patients underwent a general clinical examination, as well as determination of the concentration of NT-proBNP and the level of highly sensitive troponin T (HCTT). The patients were monitored for 366 [365; 380] days after discharge from the COVID-hospital.

Results: the patients were divided into 2 groups: group 1 consisted of 103 (92%) patients who did not have AF and group 2 included 9 (8%) patients who were diagnosed with AF paroxysm for the first time in the long-term follow-up period;. According to the results of the multifactorial analysis, statistically significant predictors associated with the development of AF after COVID-19 were: age 60 years, male gender, risk on the SCORE-2 scale, smoking index 20 pack/year, GFR value <70 ml/min/1.73 m2 and the sum of the points of the psychological component of health according to the SF questionnaire-36 less than 75.

Conclusion: traditional cardiovascular risk factors (old age, male gender, smoking, GFR), as well as a reduced psychological status during hospitalization have a significant impact on the development of AF in the long-term period in patients who have undergone COVID-19.

Objective: to assess the relationship between treatment adherence and psychoemotional status (PES) in outpatients with hypertension (AH).

Materials and methods: 114 outpatients of both sexes with AH were examined, median age 64.00 (57.00–73.00) years. Respondents completed an online quantitative assessment of adherence to treatment (KOП-25) questionnaire with the automatic calculation of 4 adherence indicators to lifestyle modification (LSM), to medical support (MS), to drug therapy (DT), total adherence to treatment (TAT). Adherence was assessed as low at < 50%, middle 50–75%, and high >75%. To diagnose the patient's PES, the questionnaire “Hospital Scale of Anxiety and Depression (HADS)”, the method of assessing anxiety of C.D. Spielberger, Y.L. Khanin.

Results: in patients with AH, the indicators of adherence to LSM, MS, DT, TAT 64,06±17,36; 73,00 (63,25–80,00); 69,53±16,12; 68,55±15,86%, respectively. Low adherence to LSM (in 21.9%) and high adherence to DT (in 40.4% of patients) were more common. On the HADS scale, 86.8/71.1% had no anxiety/depression, 8.8/19.3% had subclinical levels, and 4.4/9.6% had clinically significant levels, respectively. Reactive anxiety (RA) of low level was diagnosed in 36.8%, moderate in 48.2% and pronounced in 14.9%. In the absence of anxiety, lower adherence to LSM and MS was detected in 16.2% and 6.1%, with subclinical anxiety in 80% and 30% of patients, respectively. When analyzing the dependence of adherence to LSM, MS, DT and TAT on the presence/absence of depression in patients with AH, no significant differences were found. With an increase in RA, the number of patients with a low level of adherence increased and the number of patients with a high level of adherence to LSM, MS, DT and TAT decreased. More than half of patients with low RA experienced a high level of adherence to MS, DT, and TAT.

Conclusion: the majority of ambulatory patients with AH had an average level of virility to LSM, MS, DT, TAT. Low adherence to LSM and high adherence to DT were more common. Subclinical/clinical anxiety and depression were reported in 13.2% and 28.9% of ambulatory patients with AH, respectively. Almost 2/3 of patients with AH had moderate and high RA, indicating a stay in a stressful situation. Lack of anxiety in patients with AH was statistically significantly associated with increased adherence to LSM and MS, but was not associated with adherence to DT and TAT.

Objective: integration into outpatient practice of monitoring cardiovascular adaptation in patients with hypertension using simple computational cardiac indices.

Material and methods: in 79 patients with hypertension (43 men and 36 women) aged 18 to 59 years, in addition to physical examination, anthropometry, and bioimpedance analysis, clinical and instrumental parameters were determined to calculate such primary cardiovascular parameters as systolic blood pressure (SBP) and diastolic blood pressure (DBP), mean hemodynamic blood pressure (MGP), stroke index (SI), cardiac index (CI), stroke blood volume (SBV), minute blood volume (MBV). As integral indicators of the state the cardiovascular system, considered peripheral vascular resistivity (PVS), the integral index of the equilibrium of the cardiac and vascular components (IIECVC) and the adaptive potential (AP) were considered.

Results: in 69.6% of patients, hypertension was uncontrolled. The presence of a high level of visceral fat (VF≥9 conventional units) in patients with AH compared to their normal values was accompanied by higher values of SBP and DBP; at the same time, the statistically significant correlation of the level of VF with the values of SBP, DBP, MGP and PVS was direct, and with SBV, SI, IIECVC, AP was inverse; in patients younger than 44 years, in contrast to those in the age range from 44 to 59 years, the increase in VF was not accompanied by an increase in SI and PVS. None of the patients with hypertension had a satisfactory level of adaptation (AP≤2,1 conventional units). In patients with unsatisfactory adaptation, in contrast to patients with strain of adaptation mechanisms, higher (p<0,05) values of SBP, MGP, HR, SBV, MBV, as well as direct correlations of AP with IIECVC and inverse correlations of AP with PVS and PVS with IIECVC, which reflected pressor vascular activity and increased load on the heart with a decrease in its pumping function, were found.

Conclusion: Depending on the AP subclass, integration into clinical practice of such simple integral cardiovascular parameters as PVS, which reflects vascular resistance, and PVS, indicating the balance of the cardiac and vascular components, makes it possible to assess the degree of cardiac adaptation, the pumping function of the heart, and the degree of vascular resistance to assess the effectiveness of treatment and prevention of AH complications without the need to resort to additional expensive diagnostic methods.

Objective: to establish the changes of thyroid gland in patients with rheumatoid arthritis (RA) in the presence of subclinical hypothyroid dysfunction (hypoSTD).

Materials and methods: 457 patients with RA were examined. 68 people (14.6%) were identified, including 63 women (13.5%), with hypoSTD. All female patients with RA and hypoSTD were assigned to Group I. Group II (comparison group) included 44 women with RA without hypoSTD.

Results: the thyroid gland (TG) volume in patients of group I averaged The volume of the thyroid gland (TG) in patients of group I averaged 11.15 cm³ (ml) (LQ — 9.5; UQ — 13.2) and was significantly lower than the values in group II —14.06 cm³ (LQ — 13.3; UQ — 16.2) (U=780, p<0.05). With an increase in RA activity, the TG volume decreased in both groups. However, in patients of group II, this decrease was of a tendency nature (p >0.05), whereas in group I, the differences between the values in patients with low and high activity acquired statistical significance (U =763; p<0,05). Moreover, the volumetric TG indices in individuals of group I with a high degree of RA activity were significantly lower than in group II. Depending on the duration of RA, a decrease in the volumetric TG indices was noted. However, in patients of group I, the decrease in thyroid volume from 14,6 cm³ with RA duration of up to 6 years to 8,9 cm³ with duration >10,5 years was statistically significant (p <0,05), whereas in patients of group II these changes were of a tendency nature (p >0,05). Moreover, the thyroid volume in patients of group I was smaller than in patients of group II with a significant difference in patients with RA duration from 6.5 to 10 years (p <0,05). A study of the relationship between individual parameters of RA patients and hypothyroidism showed that the development of hypothyroidism in RA patients is influenced by the duration of arthritis (kKW = 8,86, p = 0,003), the presence and age of menopause (kKW = 4,23, p = 0,039; kKW = 6,36; p = 0,012, respectively), thyroid volume (kKW = 8.0, p = 0.0046), as well as seropositivity (the presence of rheumatoid factor) (kKW = 13,1, p<0,001).

Conclusion: the study showed an inverse relationship between the volume of the TG and the activity and duration of RA, which, given the high connection with seropositivity, may indicate a single autoimmune nature of systemic inflammation, manifested by both RA and hypothyroidism, or the comorbidity of these diseases, which requires mandatory and dynamic monitoring of the thyroid gland in patients with RA.

The analysis of this clinical case is aimed at understanding the contribution of metabolic diseases to the development and further course of acute myocardial infarction. Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) have been proven to be closely linked to cardiovascular disease, especially coronary heart disease. Hepatic steatosis associated with metabolic dysfunction is a growing public health problem. Metabolic dysfunction and associated insulin resistance are associated with an increased risk of endothelial dysfunction and systemic inflammatory response. This complex pathophysiology accelerates atherogenic dyslipidemia, atherogenesis, diastolic dysfunction, and cardiac arrhythmias. An in-depth study of the problems of unified pathogenetic mechanisms in comorbid patients will allow timely prevention of the development of acute events in the course of chronic non-communicable diseases.

Nephropathy is a term used to describe damage or dysfunction of the kidneys, which can ultimately lead to renal failure. At the same time, secondary nephropathies are often encountered in clinical practice, which are not independent kidney diseases, but are complications of the underlying disease. Myeloma nephropathy, which is a serious complication of multiple myeloma, is an example of secondary kidney damage. Often, this pathology is diagnosed when late irreversible complications appear, as a result of which the percentage of treatment effectiveness decreases due to the development of chronic renal failure. In order to optimize the detection of renal disorders and timely initiation of necessary treatment, we present an analysis of a clinical case of a patient suffering from this disease.

Granulomatous diseases are a heterogeneous group of diseases of various etiologies, manifested by a variety of clinical syndromes and variants of tissue changes, heterogeneous sensitivity to therapy and the predominance of a common dominant histological feature — the presence of granulomas that determine the clinical and morphological essence of each disease. Sarcoidosis occupies a special place among granulomatous diseases, as one of the most common and clinically significant pathologies of this group. A clinical case of a rare comorbidity, sarcoid reaction and prostate cancer, in a 61-year-old man, confirmed by examination of biopsy material, is presented.