УДК 616.127-005.8-036.11-02:616.988:578.834]-06:(616.379-008.65+616-056.52)]-036-037)

У статті висвітлено клінічний випадок гострого інфаркту міокарда в пацієнта з ожирінням після перенесеного COVID-19 для поліпшення діагностики серцево-судинних ускладнень та вибору оптимального способу профілактики і лікування.
Ключові слова: СOVID-19, гострий інфаркт міокарда, цукровий діабет 2-го типу, ожиріння, серцево-судинні ускладнення.

Abstract. The article highlights a clinical case of an acute myocardial infarction in the patient with obesity after suffering from COVID-19 to improve the diagnosis of cardiovascular complications and choose the optimal method of prevention and treatment.
Keywords: COVID-19, acute myocardial infarction, type 2 diabetes, obesity, cardiovascular complications.

УДК: 616.12-001.8-008.315-08-039.74

Дефібриляція та електрична кардіоверсія відносяться до процедур, які є критично необхідними в практиці лікарів різних спеціальностей, зокрема, які пов’язані з кардіологією та інтенсивною терапією. Ефективне застосування цих методів пов’язане з дотриманням техніки безпеки та алгоритмом проведення реанімаційних заходів.
Ключові слова: дефібриляція, кардіоверсія.

Defibrillation and electrical cardioversion are among the procedures that are critically needed in the practice of doctors of various specialties, in particular, those related to cardiology and intensive care. Effective use of these methods is associated with compliance with safety techniques and the algorithm for resuscitation.
Keywords: defibrillation, cardioversion.

УДК 616.12-008.331.1+616.12-005.4)-085.225.2]-07-084

Aim. Determine the effect of quercetin on predictors of not reaching target blood pressure (BP) levels in patients with arterial hypertension (AH) and coronary heart disease (CHD). Materials and methods. 120 patients with stable coronary heart disease and hypertension of the II stage 2–3 degrees (66
women and 54 men) were examined. The patients were divided into 2 groups: Group I – 58 patients who, in addition to basic therapy (ramipril/amlodipine), received quercetin (Corvitin®), Group II – 62 patients who received only basic antihypertensive therapy. The parameters of daily blood pressure monitoring, blood lipid spectrum, C-reactive protein, the concentration of adhesion molecules (s-VCAM, s-ICAM-1), levels of endothelin-1 (ET-1), IL-1, IL-6, TNF-α were determined. Statistical processing of materials was carried out using the following programs: Minitab 21.0, StatPlus Pro 7.6.5, Wizard Pro, Jamovi, MedCalc. Results. We have established that the risk of not reaching the target level of daily SBP in the group of basic treatment of
hypertension (group II) significantly increases with exceeding the level of LDL >4.0 mmol/l (by 3.6 times), an increase in the level of IL-6 >7 ng/ml (by 10 times), an increase in the level of TNF-α >9 pg/ml (by 7 times), an increase in the level of VCAM >1100 ng/ml (by 2.4 times). In the group of people who additionally took quercetin (group I), with an increase in the level of ET-1 >1.1 pg/ml, the risk of failure to reach the target SBP increases by 2.6 times, in the II group – by 3.5 times toward to daily SBP and 8.6 times – toward to daily DBP. We found out that an increase in the concentration of IL-6 >7 ng/mg significantly increases the risk of arrhythmias by 6 times in group II. Conclusions. When quercetin is used, it is possible to achieve the target values of SBP (daily, daytime, nighttime) and DBP (daily, daytime, nighttime) in a significantly higher proportion of patients compared with those who are prescribed only standard antihypertensive therapy. Quercetin has an endothelial protective effect, as evidenced by a significant decrease in the levels of vascular endothelial adhesion molecules (s-VCAM), type I intercellular adhesion molecules (s-ICAM-1), ET-1, IL-1, IL-6, TNF-α. The additional use of quercetin against the background of standard antihypertensive therapy significantly reduces the risk of failure to achieve the target levels of SBP, DBP and the risk of heart rhythm disturbances even against the background of increased levels of proinflammatory cytokines and markers of endothelial dysfunction.