Aim . To study the relationship between the abundance of the genera in the gut microbiota (GM) and levels of serum biomarkers of chronic systemic inflammation and endotoxemia in patients with HFpEF. Material and methods. The composition of GM among 42 patients with HFpEF (men, 57,1%) was assessed by 16S rRNA sequencing. The median age was 67,0 years, interquartile range [64,0; 71,5] years. Correlation and multivariate regression analysis (with adjustments for sex and age) of relationships between the relative abundance of intestinal bacteria and the concentrations of serum biomarkers including high-sensitivity C-reactive protein (hsCRP), interleukins (IL) 1β and 6, the soluble suppressor of tumorigenicity (sST2), and the level of lipopolysaccharide (LPS) was carried out. Results . According to multivariate regression analysis, the relative abundance of Haemophilus was directly related to the concentration of IL-1β (odds ratio (ОR) 32,37, 95% confidence interval (CI) 2,071237,69, p=0,025), Coriobacteriaceae (unclassified) — with IL-6 (ОR 6,27, (1,42-36,74), p=0,024), Porphyromonadaceae (unclassified) — with sST2 (ОR 5,96, (1,33-34,39), p=0,028), and the relative abundance of the genera Pseudomonas (ОR 7,09, (1,45-42,39), p=0,020), Parasutterella (ОR 4,55, (1,07-22,76), p=0,047) and Clostridiaceae (unclassified) (ОR 4,85, (1,06-24,7), p=0,045) was directly associated with LPS levels. Conclusion. In patients with HFpEF, the relative abundance of some GM genera (e.g., Haemophilus , Coriobacteriaceae (unclassified), Porphyromonadaceae (unclassified), Pseudomonas , Parasutterella , Clostridiaceae (unclassified)) is statistically significantly associated with the concentration of biomarkers of chronic systemic inflammation and endotoxemia.

The guidelines have been developed to standardize and optimize approaches to the follow-up of hypertensive outpatients. They are based on the latest Russian clinical guidelines, standards and procedures for the healthcare provision. Key attention is paid to outpatient follow-up, risk factors, prevention of complications, as well as drug and non-drug treatment.The guidelines present algorithms for outpatient follow-up, methods for blood pressure monitoring, criteria for drug and non-drug therapy prescription, as well as approaches to medical rehabilitation. Particular attention is paid to an individualized approach, adherence to therapy, monitoring the effectiveness of treatment and interdisciplinary interaction.The guidelines are intended for district internists, general practitioners (family doctors), district internists of the shop medical district, as well as for secondary medical personnel working with these doctors, for paramedics of paramedic- obstetric stations (paramedic health centers) in case they are assigned the functions of the attending physician.The guidelines can be used by public health physicians, heads of primary health care facilities and their divisions.

Objective. To characterize and compare myokine profiles in patients with obesity depending on the presence of sarcopenia. Materials and Methods. The study included 77 patients with obesity examined at the National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of Russia from January 2023 to April 2024. Sarcopenia was diagnosed using criteria including handgrip strength, skeletal muscle mass, and physical function assessment. Serum erythroferrone, irisin, myostatin, and interleukin (IL)-6 were assessed using enzyme-linked immunosorbent assay. Results. Thirteen (16.9%) patients demonstrated reduced handgrip strength; 22 participants had decreased appendicular muscle mass to body mass (AMM/BM) ratio. The AMM value correlated with serum concentrations of irisin (ρ=0.297; p<0.009) and erythroferrone (ρ=0.229; p<0.045). Serum concentrations of irisin significantly differed depending on the handgrip strength on the dominant hand (p=0.038), AMM value (p=0.036), and appendicular muscle mass index (ASMI, p=0.007). Serum concentrations of IL-6 were higher in patients with obesity and impaired muscle function (slower 4 m walking speed, p=0.073). Conclusion. In patient with obesity, sarcopenia is associated with myokine profile alterations. This could be due to the disrupted structure, reduced quantity, and disturbed function of muscles in sarcopenia.

Despite advances in diagnosis and treatment, heart failure (HF) still remains one of the unsolved problems of modern cardiology. The appearance and progression of HF is preceded by the development of maladaptive myocardial remodeling. In this regard, the search for new molecules for therapeutic action aimed at preventing myocardial remodeling is of undoubted interest. In this context, the galaninergic system seems to be a promising target. To date, evidence has been accumulated that activation of the galaninergic system leads to an increase in cardiomyocyte protection in the early stages after myocardial injury. It has been shown that galaninergic cascades can influence myocardial remodeling, including cell death, cardiomyocyte hypertrophy, and fibrosis. Various experimental models of heart damage showed that under stress conditions and the action of galanin and its derivatives, carbohydrate metabolism in cardiomyocytes improved, oxidative stress decreased due to antioxidant effect, and hyperproduction of reactive oxygen species by mitochondria decreased. Data were also obtained that galaninergic cascades prevent cardiomycyte hypertrophy by suppressing the expression of some fetal genes. This review article describes the currently studied cellular and molecular effects of galanin on the cardiovascular system, as well as data on the role of the galaninergic system in the pathogenesis of myocardial remodeling.

Aim. To study the relationship of gut microbiota (GM) composition with clinical and paraclinical characteristics of patients with coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF). Material and methods . The study included 64 patients (men, 71,9%) with CAD, 33 (men, 87,9%) with HFrEF and 38 (men, 63,2%) with various cardiovascular risk factors (control group). GM composition was assessed using real-time polymerase chain reaction and next- generation sequencing. To identify correlations of GM composition with clinical and paraclinical characteristics, the Spearman rank correlation coefficient (ρ) was calculated. Generalized linear models (QuasiPoisson, overdispersion) with covariates (age, body mass index) were used to compare groups by phylotype. Results. The relative abundance of Bacillota phylotypes is significantly higher in patients with CAD and HFrEF compared to controls (p<0,001). The Bacillota/Bacteroidota dysbiosis ratio was also significantly higher in patients with CAD and HFrEF than in the control group (p<0,001). According to correlation analysis, the relative representation of methanogenic archaea Methanomassiliicoccaceae, Methanomethylophilaceae (ρ=0,49, p<0,0003) directly correlated with ventricular arrhythmias in patients with HFrEF. Conclusion. Patients with CAD and HFrEF differ significantly from the control group in GM composition at the phylotype level. In the study groups, Bacillota/Bacteroidota dysbiosis ratio was also significantly higher than in the control group. The relative abundance of the archaea Methanomassiliicoccaceae and Methanomethylophilaceae is associated with episodes of ventricular tachycardia/ventricular fibrillation.

The steady increase in the prevalence of carbohydrate metabolism disorders worldwide, with the vast majority of type 2 diabetes (T2D), specifies the need to improve disease prevention measures. A special niche in the preventive continuum is occupied by early carbohydrate metabolism disorders, the treatment of which makes a significant contribution to T2D prevention. The absence of a characteristic clinical performance, inadequate apprehensive attitude of healthcare professionals contributes to unnoticed development of carbohydrate metabolism disorders, while progressive disorders lead to micro-, macrovascular complications and the manifestation of T2D. On September 16, 2024, under the chairmanship of Academician of the Russian Academy of Sciences O. M. Drapkina and under the aegis of the Russian Society for the Prevention of Noncommunicable Diseases, the Expert Council was held on Organizational and Applied Aspects of Follow-up Monitoring of Patients with Prediabetes by a General Practitioner. The meeting was attended by the main external experts in internal medicine of regional health protection executive authorities, leading experts of the National Medical Research Center for Therapy and Preventive Medicine and regional branches of the Russian Society for the Prevention of Noncommunicable Diseases, who presented current related problems and proposals for their solution. The Expert Council resolution is presented in this article.