Aim. To establish factors associated with carotid plaques (CP) in a male population aged 25–44 years. Material and methods. The analysis included data of 309 men 25–44 years old from a representative sample of the general unorganized population aged 25–64 years, formed according to the cluster principle (Kish method) in the framework of the multicenter epidemiological study ESSE-RF. All participants signed a voluntary informed consent to participate in the study and underwent cardiological screening and CP detection using a high-class ultrasound system. The analysis included information on socio-demographic, behavioral, and conventional risk factors (RFs) for cardiovascular diseases (CVD), obtained according to the unified protocol of the ESSSE-RF study. Descriptive statistics, stepwise multivariate logistic regression, and χ2 -discretization were used. Results. The CP prevalence was 7.4 %, varying from 6.3 % at the age of 30–34 years to 17.9 % at the age of 40–44 years, respectively. Significant determinants of early carotid atherosclerosis were age (OR = 1.20; 95 % CI 1.08–1.34; p = 0.001), low density lipoproteins (LDL-C) ≥ 4.7 mmol/L (OR = 9.82; 95 % CI 3.09–31.2, p < 0.001), waist circumference > 94 cm (OR = 0.16; 95 % CI 0.04–0.58, p = 0.005), and living in a private household (OR = 4.75; 95 % CI 1.38–16.3, p = 0.014). An independent association was obtained when using blood total cholesterol (TC) ≥ 7.1 mmol/L instead of LDL-C: OR = 11.2; 95 % CI 2.70–46.3, p = 0.001. Conclusions. Excessive high levels of atherogenic lipoproteins play a key role in genesis of early atherosclerosis in men, therefore screening for TC in this group is a priority. Total cholesterol was sufficient indicator of early atherosclerosis presence, although in this role it was slightly less effective than LDL-C. We revealed inverse association between early atherosclerosis and abdominal obesity and the direct one with living in a private housing. Further study of these factors could contribute to the development of personalized approaches to prevention of early carotid atherosclerosis in population. 

Left atrial appendage occlusion is a non-pharmacological method for preventing thromboembolic complications in patients with atrial fibrillation. Due to the high prevalence of atrial fibrillation worldwide and in the Russian Federation, the number of patients requiring prevention of its thromboembolic complications with anticoagulant therapy is constantly increasing. However, because of certain limitations in its use, the development of new types of left atrial appendage occluders, particularly domestically produced ones, as an alternative to drug-based anticoagulation and their implementation in clinical practice is an extremely actual issue. Objective. To test a new left atrial appendage occluder model and demonstrate its advantages over the existing old-type model. Material and methods. Two experiments were conducted: 1) implantation of a prototype occluder into a silicone model of the left atrium; 2) implantation of a prototype occluder in the left atrial appendage of a porcine heart. Conclusions. A new model of left atrial appendage occluder was tested. Experiments on silicone models and fresh porcine hearts showed that the new model is not inferior to the existing ones, and no significant disadvantages of the new model were identified.

The aim of this study was to search for significant associations between quality of life and psychological status indicators and the 1-year prognosis of patients with myocardial infarction (MI) and other determinants. Material and methods. The study included 150 patients with non-fatal MI. Psychological status and quality of life indicators, behavioral and socioeconomic factors were assessed. Medical records were collected at discharge. The incidence of a composite cardiovascular outcome was recorded after one year. Using statistical analysis, a search was conducted for significant associative relationships between various variables in the study (methods of logistic linear and binary regression). Results. Subclinical and clinical manifestations of anxiety (frequency 4.7 %) were significantly associated with the lack of higher education odds ratio (OR) – 11.3 (95 % confidence interval (CI) 1.2; 109.6), coronary artery bypass grafting (CABG) after MI – OR 22.9 (95 % CI 1.6; 337.5), low EQ-5D utility index – OR 1.9 (95 % CI 1.6; 2.4); while depression (frequency 6.7 %) was associated with acute stress before MI – OR 5.6 (95 % CI 1.3; 23.2), and the development of a one-year composite cardiovascular outcome – OR 4.5 (95 % CI 1.2; 17.6). According to the quality of life assessment after MI, moderate and severe problems with mobility were identified in 6.7 % of patients, daily activities in 2.0 %, pain in 10.7 %, anxiety/depression in 6.7 %, and there were no problems with self-care. The patients’ health status according to the EQ-VAS scale was 75 (65; 85) points, and the calculated EQ-5D utility index was 1 (1; 1). Low health status score (frequency 41.3 %) was significantly associated with alcohol consumption – OR 2.3 (95 % CI 1.0; 4.9), acute stress before MI – OR 2.3 (95 % CI 1.1; 4.9), low level of physical activity – OR 2.8 (95 % CI 1.0; 7.8)), non-prescription of mineralocorticoid receptor antagonists – OR 2.8 (95 % CI 1.3; 5.9), development of the one-year composite cardiovascular outcome – OR 3.2 (95 % CI 1.2; 8.1); a low EQ-5D score (frequency 16.7 %) was associated with CABG after MI – OR 21.3 (95 % CI 2.2; 211.2) and the development of a one-year composite cardiovascular outcome – OR 3.4 (95 % CI 1.2; 9.1). In patients with MI, quantitative changes in the levels of psychological status indicators (depression, anxiety) and key quality of life parameters (health status according to the EQ-VAS scale and the summary weighted utility index EQ-5D) were not only interrelated with each other at the time of MI, but were also determined by factors preceding MI (social – income, family status, behavioral – acute stress); clinical features associated with MI (patient age at the time of the event, non-use of statins before MI, history of multifocal atherosclerosis, completeness of coronary revascularization in MI or CABG), and also reflected in the 1-year prognosis (development of a composite cardiovascular outcome). Conclusions. In patients with MI, significant associations were confirmed between quality of life and psychological status indicators and one-year prognosis, as well as social, behavioral, and clinical determinants.

Lipoprotein(a) (Lp(a)) is a significant independent cardiovascular risk factor (CVR) associated with the development of atherosclerotic cardiovascular disease (CVD), heart failure, atrial fibrillation, and increased overall and cardiovascular mortality. The aim of the study: to assess the incidence of elevated Lp(a) levels (> 75 nmol/L) in patients with very high CVR, as well as to analyze differences in clinical and laboratory characteristics and drug therapy between groups with normal and elevated Lp(a). Material and methods. A retrospective analysis of outpatient records of patients with very high CVR (n = 76, 63.2 % men, median age 61.0 [51.0; 70.0] years) who visited the Lipid Center of the Research Institute of Therapeutic, Preventive and Microbiological Medicine, a branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, from July 2025 to April 2026. All patients included in the study underwent clinical laboratory testing. Results. In the analyzed group of patients with very high CVR, the incidence of elevated Lp(a) ≥ 75 nmol/L was 38.2 %, and ≥ 125 nmol/L – 31.6 % of patients. In the group with elevated Lp(a) levels, patients were younger (55.0 [47.0; 68.5] and 64.0 [53.0; 71.0] years, p = 0.019), had earlier onset of CVD (53.5 [49.5; 60.5] and 62.0 [51.0; 66.0] years, p = 0.022), and were more likely to have a family history of CVD (89.7 % and 46.8 %, p = 0.012). In the group with elevated Lp(a) levels, higher TC (4.9 [3.4; 6.2] mmol/L vs. 4.3 [3.6; 5.9] mmol/L, p = 0.765) and LDL-C (2.6 [1.6; 3.9] mmol/L vs. 2.0 [1.5; 4.0] mmol/L) values were observed, but without reaching statistical significance (p = 0.460). The proportion of patients who achieved the target LDL-C level was low and did not differ between the groups. In patients who did not achieve the target LDL-C level, the median Lp(a) was higher (45.0 [20.0; 190.5] nmol/L) compared to patients who achieved the target LDL-C level (20.0 [20.0; 225.0] nmol/L), but the difference did not reach statistical significance (p = 0.533). Conclusions. The incidence of elevated Lp(a) levels (>75 nmol/L) in patients with very high CVD was 38.2 %. Patients with elevated Lp(a) levels are characterized by earlier onset of CVD, a positive family history, and insufficient efficacy of standard lipid-lowering therapy in reducing LDL-C.

Objective: to develop and validate a calculator program for assessing the risk of acute decompensation of heart failure in outpatients with heart failure with reduced left ventricular ejection fraction (HFrEF). Material and methods. A single-center randomized clinical retrospective-prospective study included 652 patients with HFrEF followed at a Heart Failure Center, aged 62.5 (61; 68.5) years; 545 (83.6 %) were men. Of these, 106 patients were selected by simple random sampling to form the validation group. In this group, monthly telephone interviews were conducted by a paramedic from the chronic heart failure center using a structured questionnaire focused on symptoms of fluid retention. The data were entered into a computer-based calculator program, which generated recommendations (emergency hospitalization, unscheduled cardiology visit, or continued follow-up) displayed on the monitor. Validation was performed by retrospectively comparing the calculator’s recommendations with actual adverse events over one year of follow-up. Cases of emergency hospitalization and unscheduled medical visits were recorded. Results. For identifying indications for unscheduled visits, the calculator showed a sensitivity of 85.5 %, specificity of 99.5 %, and area under the ROC curve (AUC) of 0.925. For identifying indications for any medical contact, sensitivity was 73.5 %, specificity 99.7 %, and AUC 0.866. Overall performance for determining the need for any medical contact was: sensitivity 73.5 %, specificity 99.7 %, AUC 0.866. Conclusions. The developed calculator program effectively identifies cases requiring medical attention in various forms, and its recommendations for unscheduled visits or emergency hospitalization are justified in the vast majority of cases.

Aim. To evaluate the associations between visceral adipose tissue (VAT) leptin and peptide hormones and metabolic disorders in abdominal obesity (AO). Material and methods. The study included 101 individuals aged 25–65 years. Patients completed questionnaires, underwent anthropometric measurements, triple blood pressure measurement, as well as fasting venous blood sampling and VAT biopsy collection during elective surgery. Blood lipid profile parameters and glucose levels were determined using enzymatic methods. Homogenates were prepared from the VAT biopsies. Amylin, C-peptide, glucagon, pancreatic polypeptide (PP), ghrelin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), secretin, and leptin levels in blood and adipose tissue homogenates were measured using multiplex assay. Sex hormone levels in blood (estradiol in women, testosterone in men) were measured in all patients using ELISA kits. Results. A direct correlation was established between blood amylin levels and its content in VAT, as well as between serum and VAT leptin levels. A direct association was revealed between VAT leptin content and metabolic indices (TyG and LAP), as well as body mass index (BMI) and waist circumference (WC). VAT leptin content was directly associated with WC, BMI, and AO after adjustment for sex, age, glucose, and triglyceride levels, which persisted in females. The odds of having a LAP index ≥ 32 increased by 2.2 % per 1 ng/g increase in adipose tissue leptin content. Conclusions. Leptin content was directly associated with anthropometric indicators of obesity (WC, BMI), and this pattern persisted in females. The odds of having a LAP index ≥ 32 increased by 2.2 % per 1 ng/g increase in adipose tissue leptin content.

The high prevalence of low physical activity (PA) and increased screen time (ST) is one of the main modifiable risk factors for the development of cardiovascular diseases associated with atherosclerosis. Low PA and the high ST in association with atherogenic blood lipids are of particular interest. So the aim of the study was to investigate blood lipid profile parameters at different levels of PA and ST in adolescence. Material and methods. Four cross-sectional population studies (2009, 2014, 2019, 2024) of adolescents aged 14–18 were conducted. 2,638 adolescents were examined. PA was assessed according with categories, weekly hours, the International Physical Activity Questionnaire (iPAQ) and WHO criteria, but ST – based on weekly hours spent sitting or lying in front of a computer or TV screen, and in 2024, also using a Smartphone. Blood for biochemical tests was collected after a 12-hour fast using enzymatic methods. Total cholesterol, HDL cholesterol, and TG tests were performed. Statistical analysis was performed using SPSS v. 13.0. Results. A high prevalence of low PA was observed across all studied criteria (from 38.6 % to 52 % in boys and from 63 % to 75 % in girls, p < 0.05). The prevalence of PA decreased over the 15 years. 75 % adolescents had high level of ST. ST structure changed significantly during this period: TV viewing decreased ten times , computer ST increased until 2019 by 1.5 times for boys and 2 times for girls (p < 0.001). After that it decreased significantly between 2019 and 2024 may be due to Smartphone ST registration. Associations of blood lipid parameters (TG and HDL-C), the atherogenic index and low PA including high ST had been found. PA criteria based on the number of hours per week showed more informative than other criteria. iPAQ criteria was insensitive in our study. Conclusions. High prevalence of low PA and high ST were identified. ST structure has changed significantly. Associations of some blood lipid parameters and low PA including high ST were demonstrated.

The aberrant right subclavian artery or the so-called arteria lusoria, although it is the most common anomaly of the aortic arch (0.19–4.1 %), is extremely rare in patients with malignant neoplasms. Preoperative detection of this pathology is extremely important in the treatment of patients with esophageal, lung and thyroid diseases, and mediastinal organs, which minimizes the risk of massive arterial bleeding, ischemia of the right upper limb, and damage to the right non-reversible lower laryngeal nerve. We wanted to present a literature review and 3 clinical cases of this pathology. 

Adipokines and inflammatory cytokines play a key role in the regulation of metabolic, inflammatory, and cardiovascular processes. Their involvement in the pathogenesis of arterial hypertension (AH) opens up new opportunities for understanding the mechanisms of disease development and developing personalized approaches to its prevention and treatment. These molecules are of particular importance in young patients aged 25–45 years, in whom AH may be latent and require more sensitive biomarkers for diagnosis and prognosis. The aim of the study was to analyze current data on the role of adipokines and cytokines in the pathophysiology of AH, with an emphasis on their diagnostic and prognostic value. Material and methods. The analysis used the results of preclinical and clinical studies published between 1986 and 2026. The review included data from PubMed and Google Scholar, taking into account the age range of 18–45 years. Results. Proinflammatory adipokines such as visfatin, resistin, PAI-1, lipocalin-2, as well as cytokines TNF-α and IL-6, demonstrate a close relationship with the development of hypertension, especially in the presence of obesity and metabolic syndrome. Conclusions. Adipokines and inflammatory cytokines represent an important group of biomarkers that can improve early diagnosis, risk stratification and prediction of therapy effectiveness in patients with hypertension. The presented data emphasize the need for further prospective studies to clarify the mechanisms of action of these molecules and their clinical significance, especially in the young population.

Calcific aortic valve stenosis and atherosclerotic coronary artery disease not only share common risk factors but also exert synergistic effects on the left ventricular (LV) myocardium. Hemodynamically significant coronary artery disease is detected in 60–70 % of patients with severe aortic stenosis, and concomitant LV hypertrophy, by increasing myocardial susceptibility to ischemia, accelerates the development of subendocardial replacement fibrosis—an independent predictor of adverse prognosis after valve replacement. This review presents an analysis of current evidence on structural and functional LV remodeling in patients with severe aortic stenosis following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Data on the population prevalence of aortic stenosis are systematized, and the mechanisms of myocardial morphofunctional remodeling are detailed, with a central focus on myocyte hypertrophy, interstitial fibrosis, and neurohormonal dysregulation. The dynamics of LV reverse structural remodeling achieved with the two alternative strategies for correcting aortic stenosis are examined using echocardiography and cardiac magnetic resonance imaging. It is shown that TAVI is associated with earlier and more pronounced reverse remodeling within the first 6 months after the intervention, whereas SAVR is characterized by gradual yet sustained improvement in LV morphofunctional parameters. The molecular basis of cardiomyocyte hypertrophy regression and interstitial fibrosis reversal is analyzed in detail, and the correlation between cardiac structural remodeling and clinical outcomes and long-term prognosis is discussed. The review also systematizes findings obtained by national research groups investigating this problem. In parallel, predictors capable of limiting or, conversely, potentiating the completeness of reverse myocardial structural recovery are analyzed. Future research horizons are outlined, with particular emphasis placed on the implementation of proteomic and genomic techniques, which pave the way toward personalized selection of the valve replacement strategy.

Developed by the European Society of Cardiology Working Group on Myocarditis and Pericarditis, endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC) and the European Association for Cardio‑Thoracic Surgery (EACTS). Published: European Heart Journal, 22 October 2025.