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Resume. In patients with FC II angina pectoris, a positive high correlation between the number of angina attacks and a high level of anxiety was proved. Features of the effects of ethylmethylhydroxypyridine of succinate on personal anxiety symptoms, the number of angina attacks, the level of blood pressure, as well as the frequency and nature of the heart rhythm, and indicators of variability of heart rhythm were revealed.

Key words: coronary heart disease, angina pectoris, anxiety.

Key words: cardiovascular comorbidity, neuro-, cardioprotection, energy correction, Mexidol.

One of the most common diseases associated with cognitive disorders in elderly patients is chronic heart failure, leading to a cognitive decrease in 25-80% of cases. The review discusses the role of vascular lesions of various calibers and general mechanisms of impaired microcirculation in the development of both cardiac and chronic cerebrovascular insufficiency. It is believed that their understanding can help in the development of more effective approaches in the treatment of cardiovascular and cerebrovascular pathology. Keywords: cognitive disorders, vascular dementia, heart failure, microcirculation disorders, endothelial dysfunction.

Cardiovascular diseases (CCZ) remain the most common among chronic non-infectious diseases. In 2020, approximately 19.1 million deaths around the world were associated with the SVD, and their prevalence with the amendment to age amounted to 7354.1 cases per 100 thousand people. Given the increasing life expectancy and, accordingly, the share of elderly people in the structure of the population, an increase in the prevalence of the CVD is further expected. The functions of the brain and cardiovascular system (CCC) are closely interconnected. So, it is well known that diseases of the brain, such as a stroke, can lead to damage to the myocardium. On the other hand, cognitive functions directly depend on the state of CCC. Therefore, quite often to describe the pathology of the brain in patients with SVD, the term “cerebrovascular diseases” (CVP) is used. CVP combines a group of diseases due to pathological changes in cerebral vessels. The CVP is a manifestation and complication of various SVDs, such as dyslipidemia, arterial hypertension (hypertension), diabetes (diabetes), etc., leading to acute or chronic disturbances in cerebral circulation. Clinically the CVP can manifest by acute cerebrovascular accident in the form of a stroke or transient ischemic attack or have a chronic course, leading to the development of vascular cognitive impairment (KN).

The purpose of the study is to study the influence of Mexidol on the indicators of the lipid spectrum in patients with very high risk of cardiovascular complications (MTR) suffering from type 2 diabetes (SD2).
Material and methods.

Within 3 months, prospective observation of two groups of patients was carried out, the main risk factor for vascular complications in which was SD2. The speed of reaching the target level of blood lipid indicators with standard therapy with statins (1st group) and when supplementing the basic therapy with Mexidol (2nd group) was compared. The determination of lipids in blood serum was carried out by the enzymatic colorimetric method (reagents Boehringer Mannheim, Germany).

Results.

The positive influence of Mexidol, prescribed at the starting stage of statins, on the indicators of lipid spectrum in patients with high and very high risk of MTS, the underlying disease in which was SD2, was noted.

Key words: cardiovascular complications, type 2 diabetes, dyslipidemia, prevention, Mexidol

Place of publication: cardiology and cardiovascular surgery / t. 16, No. 6, 2023

FGAOU in Russian University of Friendship of Peoples named after Patrice Lumumba ", Moscow, Russia

Resume

The purpose of the study. To study the influence of Mexidol in the composition of complex therapy on the perception of life by a patient with heart failure (SN).

Material and methods. An open randomized study included 60 comorbide patients with coronary heart disease (coronary heart disease) and stable chronic heart failure (COL) with cognitive impairment (KN) ≤24 points on the Montreal scale of cognitive function assessment (MOCA). The average age of patients was 73.4 ± 8.6 years, 53% - male, the average fraction of the left ventricle is 43.5 ± 10.6%. 30 patients were included in the standard therapy group with the additional prescription of Mexidol (500 mg intravenously drip 1 time per day for 14 days, then 250 mg 3 times a day 8 weeks) and 30 patients in a standard therapy group. Initially and at the end of the study, an assessment of the perception of life was carried out. The survey included 4 main areas: (1) The relative importance of the goals associated with the disease, (2) problems associated with life with heart failure (CH) and taking medications for CH, (3) decision -making process related to drugs for CH, and (4) awareness and fears for available drugs for SH.
Results. The main problems associated with life with SN and the use of drugs from SN all patients, regardless of the treatment group, initially and after 10 weeks of therapy noted the effectiveness of treatment in a decrease in the symptoms of SN, in a decrease in the number of hospitalizations for SN and mortality. Other problems most urgent for patients were shortness of breath, swelling and fatigue, followed by anxiety about the disease, the need to take a large number of drugs, and the inability to do what they wanted. Lastness, patients were disturbed by depression, the inability to work, the need to help relatives, the cost of drugs and the fight against side effects of drugs. The beneficial influence of Mexidol in complex therapy on the patient’s perception with SN is shown. Improving the cognitive status of the patient, against the background of Mexidol treatment, helps to rethink the main treatment goals for more global - the effectiveness of the drug regarding a decrease in mortality, the number of hospitalizations and symptoms of SN, a decrease in the number of factors limiting the life of edema and breaths, and as a result, an increase in the physical activity of the patient. The only limiting factor is the need for a daily use of a large number of drugs and the desire to reduce their number.
Conclusion. There is a discrepancy between patient priorities and awareness of optimal drug therapy, which proved its effectiveness. Patients are poorly familiar with therapy of CH, and those who are familiar are concerned about her safety and efficiency. Long -term sequential therapy with Mexol with the addition of standard therapy in patients with chronic heart failure of the II - III functional class (according to NYHA classification) with moderate disorders of cognitive status, in addition to a reliable improvement in cognitive status and quality parameters, favorably affects the perception of life with heart failure.

Key words: heart failure, cognitive status, quality of life, Mexidol, perception of life.

Information about the authors:
Tolkacheva V.V. -https://orcid.org/0000-0001-6847-8797
Karapetyan L.V. -https://orcid.org/0000-0002-6697-2393
Khutsishvili N.I. -https://orcid.org/0009-0009-2669-8092
Galochkin S.A. -https://orcid.org/0000-0001-7370-8606
Kazamedov E.R. -https://orcid.org/0000-0002-6274-8933
Kobalava Zh.D. -https://orcid.org/0000-0002-5873-1768
Author responsible for correspondence: Tolkacheva V.V. -E-mail: tolkacheva-vv@rudn.ru

How to quote:
Tolkacheva V.V., Karapetyan L.V., Khutsishvili N.I., Galochkin S.A., Kazakhmadov E.R., Kobalava Zh.D. The influence of Mexidol in the composition of complex therapy on the perception of life by a patient with heart failure, cardiology and cardiovascular surgery. 2023; 16 (6): 642–651. https://doi.org/10.17116/kardio202316061642

Place of publication:
cardiology and cardiovascular surgery, 2023, T. 16, No. 4

Summary:
Purpose of the study. Assessment of the effect of Mexidol, as part of the complex therapy of heart failure for 10 weeks on cognitive status, quality parameters, asthenic syndrome and anxiety level in patients with XN II-III functional class (according to NYHA classification). Material and methods. An open randomized study included 60 comorbide patients with coronary heart disease (coronary heart disease) and stable chronic heart failure (COL) with cognitive disorders (KN) ≤24 points on the Montreal scale for evaluating cognitive functions (MOCA). The average age of patients was 73.4 ± 8.6 years, 53% - male, the average release fraction of 43.5 ± 10.6%. 30 patients were included in the standard therapy group with the additional purpose of Mexidol (500 mg intravenously dropped 1 time per day for 14 days, then 250 mg 3 times a day 8 weeks) and 30 patients in a standard therapy group. Initially and at the end of the study, an assessment of the effect of therapy on the cognitive status of patients on the Montreal scale of assessment of cognitive functions (Mosa), anxiety level on the Bek scale, the degree of severity and the dynamics of asthenic syndrome on the subjective scale of astheny assessment (MFI-20), and health profiles according to the questionnaire was carried out EQ-5D-5L and quality parameters based on the results of the Essence on the Minnesotsky (MlHFQ), Kansas (Kansas City CardiOMYOPATHY QUESTIONNAIRA, KCCQ) and the SF36 questionnaire “Evaluation of the quality of life”. Results. In patients who received Mexidol, in addition to standard therapy, a reliable improvement of cognitive function by 21%was revealed, a decrease in anxiety-by 38%and the severity of asthenic syndrome-by 12%, improve the overall health of the EQ-5D-5L questionnaire-by 25%by 25% , as well as the qualities of life according to the Minnesotsky questionnaire - by 48%, according to the Kansas questionnaire - by 39%. Conclusion. Mexidol, when adding to standard therapy of patients with XN II-III, functional class, reliably improves cognitive status, quality parameters, reduces the severity of asthenic syndrome and anxiety level. Key words: heart failure, cognitive status, quality of life, Mexidol.

Place of publication:
cardiology and cardiovascular surgery, 2022, T. 15, No. 6

Summary:
The development of preventive measures to reduce the risk of developing cognitive deficiency is named after the main priorities of medicine. Cardiovascular diseases and cognitive disorders, on the one hand, have similar risk factors, such as obesity, smoking, dyslipidemia, insufficient physical activity, low level of education, and, on the other hand, the presence of atrial fibrillation (FP), arterial hypertension (hypertension (hypertension ), heart failure (CH), chronic kidney disease, diabetes contributes to the progression of cognitive impairment. In the era of patient-oriented medicine, choosing the optimal treatment regimen of hypertension, FP, SN, it is necessary to take into account the potential possibilities of certain regimes of therapy in the prevention of cognitive impairment. This article is devoted to the review of existing therapeutic strategies to prevent the development of cognitive deficiency in patients with a cardiological profile. Keywords: cognitive disorders, dementia, arterial hypertension, atrial fibrillation, heart failure, Mexidol.

Place of publication:
cardiology and cardiovascular surgery, 2020, T. 13, No. 5

Summary:
Purpose of the study. To study the effects of Mexidol on the level of n-cowline sodium sodium hormone (NT-PROBNP), the severity of oxidative stress, inflammatory reaction and endothelial dysfunction in patients with II-II-III functional class (FC) in the classification of NYHA during consistent intravenous and oral introduction Mexidol for 13 weeks against the background of standard basic therapy. Material and methods. The study included 44 patients with chemical and heart failure of the II -III functional class according to NYHA, a release fraction of less than 50%. The average age was 65.5 ± 11.8 years, 75% were male patients. 21 patients were included in the basic therapy group with the additional purpose of Mexidol (1000 mg intravenously dropped 1 time per day for 7 days, then 250 mg 3 times a day 12 weeks) and 23 patients in the basic therapy group. 34 patients completely completed the study. 10 patients were made in the form of a phone call in connection with an epidemic environment. Initially, on the 7th day and at the 13th week, an assessment of the level of the N-Container's sodium sodium hormone (NT-PROBNP), oxidative stress (the amount of low-minor dyalldehyde (MDA) and the activity of superoxidsmutase (SOD)), an assessment of the level of n-cow cerebral hormone was held. an inflammatory reaction (level of C-reactive protein (CRB), factor of necrosis of tumors α (FNOα)), as well as the content of homocysteine ​​and level of cystatin C. Results. In patients who received Mexidol in addition to basic therapy, a reliably more pronounced decrease in the level of NT-PROBNP, a decrease in the concentration of MDA, a decrease in the level of SRB and FNOα and an increase in the activity of SOD on the 7th day, and after 13 weeks of therapy compared to the group that received therapy was revealed Only basic therapy. Conclusion. When adding to the basic therapy of patients with chemical and heart failure II-III, the NT-PROBNP level has a reliable antioxidant activity, reduces the severity of the inflammatory reaction, slows down the increase in homocysteine, and does not affect the kidney function (cystatin C). Keywords: chronic brain ischemia, heart failure, oxidative stress, antioxidants, N-connection propeptide of cerebral hormone (NT-PROBNP), mild dialdehyde, superoxidsmutase, SRB, ethylmethylhydroxypirinidine sequicine, mexed.

Place of publication:
Journal of Neurology and Psychiatry, 9, 2018

Summary:
The article presents a review of domestic and foreign literature on the influence of arterial hypertension (AH) on the risk of cognitive impairment. The data of major studies are considered, indicating the relationship of blood pressure and risk of developing vascular dementia and Alzheimer's disease in elderly and senile people, as well as the role of antihypertensive therapy. Evidence of the negative impact of the presence of hypertension in the middle age on the state of cognitive functions in the elderly is presented. The importance of interdisciplinary approach to the treatment of cognitive impairment with cardiologists and/or therapists together with neurologists, as well as comprehensive treatment regimens, including correction of risk factors and neuroprotective therapy, is emphasized. Keywords: arterial hypertension, cognitive disorders, vascular dementia, Alzheimer disease, antihypertensive therapy.

Place of publication:
cardio, issue No. 11 (25), 2017

Summary:
cardiovascular diseases (SSZ) are a global problem for all of mankind. With the growth of socio-economic well-being in developed countries since the middle of the last century, heart disease and blood vessels have become the main cause of disability and mortality. In the structure of the fatal outcomes of Russians from blood circulation diseases, coronary heart disease (coronary heart disease) is only slightly inferior to the vascular pathology of the brain, including stroke.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, No. 1, 2013

Summary:
an assessment of the quality of life and anxiety was carried out in 130 patients with coronary heart disease and stable angina pectoris of the II functional class (FC) in the conditions of the City Clinical Hospital No. 4 BuzOO. Clinical and functional indicators in patients with stable angina pectoris, the effect of the disease on their quality of life were studied. The clinical efficiency of the drug 2-ETIL-6-methyl-3-hydroxypyridine serpicinate (Mexidol) in the complex treatment of patients with stable angina pectoris II FC is evaluated. A differentiated approach to pharmacotherapy has been developed taking into account the level of personality alarm in patients with angina pectoris II FC.