Aim ― Meta-analysis of clinical trials comparing the efficacy of medical therapy (MT) and surgical treatment, including cardiac resynchronization therapy with and without cardioversion-defibrillation (CRT and CRT-D), circulatory support system (CSS) and heart transplantation (HT), in terms of decreasing overall mortality in patients with severe chronic heart failure (CHF). Material and Methods ― Meta-analysis included 39 clinical trials with a total number of 30,257 patients. Search was performed in MEDLINE, Medscape, Pubmed databases and on web resources, dedicated to clinical trials (National Institutes of Health, Clinical Center, ClinicalStudyResults.org, ClinicalTrials.gov). Results ― There was no significant overall mortality reduction in patients receiving MT when compared to control group: OR=0.97 (95% CI: 0.85-1.10), p=0.211. Treatment with CRT and CRT-D, as well as CSS implantation and HT reduced overall mortality: OR=0.67 (95% CI: 0.57–0.79), p < 0.001 for CRT/CRT-D and OR=0.46 (95% CI: 0.24–0.86), p = 0.018 for CSS/HT. Conclusion ― Superiority of surgical treatment over traditional MT in terms of overall mortality was observed in patients with severe CHF.
Olanna T. Kotsoeva Comparison of impact of medical therapy and surgical treatment on overall mortality in patients with severe chronic heart failure: a meta-analysis // Russian Open Medical Journal, Vol. 5, Issue 3, 2016, pp. 0-0

There was studied the relationship between polymorphic variants of APOC3 (rs2854117), PON1 (rs854560, rs662), AGT (rs4762, rs699) and AGTR1 (rs5186) genes with the results of cognitive tests in patients with chronic heart failure (СHF) of ischemic genesis and healthy persons. The general group included 50 patients with CHF of II-IV functional classes, the control group - 50 healthy volunteers. Cognitive functions were estimated by 5th and 7th subtests of Wexler and Burdon's test. There was revealed statistically significant correlation between the polymorphism of APOC3, PON1, AGT, AGTR1 genes and the results of cognitive tests in patients with CHF and healthy persons. These data suggest that the polymorphism of the studied genes may be important in the genetic susceptibility to the formation and progression of cognitive disorders.
Tatyana V. Martynovich, Natalya S. Akimova, Edward A. Fedotov, Yuri G. Schwartz Polymorphism of genes associated with increased cardiovascular risk and cognitive function in patients with chronic heart failure and in healthy persons: the pilot study // Russian Open Medical Journal, Vol. 4, Issue 1, 2015, pp. 0-0

Background. Low-frequency (LF) oscillations in heart rate (HR) are largely an index of baroreflex gain. Controlled 0.1 Hz breathing maybe used as input stimuli for study of this resonance phenomenon in LF oscillations in HR. The aim of this study was the investigation of the dynamic characteristics of LF oscillations in the heart rate (HR) of chronic heart failure (CHF) patients during bicycle exercise (BE) tests, under 0.1 Hz controlled breathing. Methods. Forty five male patients aged 50±3 years with left ventricle ejection fraction (EF) <50% and 35 male patients aged 52±6 years with EF>50% participated in the study. BE tests were performed for all participants. Five-minute recording of R-R intervals was performed first in sedentary posture and in 25 W load stage of BE test. The frequency estimates of heart rate variability in LF spectrum bands were obtained. Results. Under the load rising till 25 W in CHF patients with EF<50%, consequent depression of LF band power was observed 2-3 times in comparison with the relaxed condition. There was no similar significant expressed dynamic in the group with EF>50%. Conclusions. The stability of LF oscillations in HR to low-intensity loads depends from the severity of myocardial contractility damage. The power dynamic of 0.1 Hz component of the heart rate variability spectrum may be considered an independent index of dynamic stability of the heart autonomic control in CHF patients.
Health Science Journal 2013; 7(1): 90-98.

Research objective is to determine the influence of adaptation method to periodic pressure chamber hypoxia on dynamics of systolic and diastolic functions of myocardium in patients with early stages of chronic heart failure. Materials and Methods: 100 men with post-infarction cardiosclerosis at the age of 40-65 years with I and IIA stages and l-ll functional classes (NYHA) of chronic heart failure have been examined. Results: Positive dynamics of systolic and diastolic cardiac functions and other parameters of echocardioscopy under the influence of the hypoxic therapy in comparison with classical physical rehabilitation have been obtained. Furthermore, a more significant effect has been observed in patients with CHF IIA. Conclusion: Improvement in the geometry of the heart has proved that adaptation method to periodic pressure chamber hypoxia could be recommended for rehabilitation of patients with heart failure of early stages.
Dmitrieva М.К. Adaptation to periodic pressure chamber hypoxia and its influence on systolic and diastolic functions in chronic heart failure // Saratov Journal of Medical Scientific Research, Vol. 8, Issue 2, 2012, pp. 247-251

Aim: to evaluate arterial wall rigidity, clinical condition and prognosis in active and standard therapy of patients with chronic heart failure (CHF). Materials and methods. A total of 211 patients with CHF experienced Q-wave myocardial infarction was enrolled in the study. At admission to the hospital all patients were randomized into two groups. Patients of the first group (n=106) were managed actively after discharge from the hospital, patients of the second group (n=105) were managed conventionally after discharge from the hospital. Patients were observed for three years. Re-sults. Over three year-investigation actively managed patients demonstrated significant (p<0,05) decrease in systolic and diastolic blood pressure, heart rate, blood serum levels of total cholesterol, N-terminal cerebral natriuretic peptide, increase of 6-minute walk-test, left ventricle ejection fraction reduction and decrease in number hospitalization of patients with CHF as compared to those who were conventionally managed. At patients of II group pulse wave speed in aorta (PWVA) since the first year, an index of augmentation of brachial artery and systolic pressure in aorta in three years of supervision above (p<0,05) in comparison with patients of group I. Conclusion. One of deterioration factors of systolic functions of the left ventricle and the prognosis in patients with CHF of group of standard therapy was progressing of arterial wall rigidity pathology
Rebrov A.P., Kosheleva N.A. Arterial wall rigidity in active and standard therapy of patients with chronic heart failure (three-year investigation) // Saratov Journal of Medical Scientific Research, Vol. 8, Issue 1, 2012, pp. 67-72

Aim: to estimate prognostic value of indicators of heart rhythm variability (HRV) in patients with chronic heart failure (CHF) within three years. Materials and methods: A total of 110 patients aged 55,2±6,5 years with CHF experienced Q-wave myocardial infarction were enrolled in the study. Analysis of HRV measures was obtained by means of 5 minutes records of standing at rest. Results: Within three years of supervision of patients 50 cases of cardiovascular complications were developed: 22 cases presented CHF regeneration, 13 patients suffered recurrent myocardial infarctions, lethal outcome was observed in 15 cases. It was established that at level of low-frequency spectrum HRV less than 5,2 In ms2 decompensations CHF (p=0,048) and lethal outcome (p=0,02) were determined than at bigger value of this indicator. Independent predictors of lethal outcome in patients with CHF within three years included the left ventricle ejection fraction, uric acid, N-terminal fragment of cerebral natriuretic peptide and low-frequency spectrum HRV. Conclusions: The developed algorithm of estimation of individual risk of lethal outcome development in CHF patients within three years, will allow to improve tactics and prognosis in this category of patients
Kosheleva N.A. Prognostic value of heart rhythm variability in patients with chronic heart failure (three-year investigation) // Saratov Journal of Medical Scientific Research, Vol. 7, Issue 4, 2011, pp. 845-850

The aim of the given study was to define antithrombogenic and vasodilative vascular wall activity in patients with disturbed function of left ventricle (LV), developed after Q-myocardial infarction; and to specify its role in chronic heart failure (CHF) prognosis. 40 patients after Q-myocardial infarction were examined; compare five group consisted of 20 patients. Antithrombogenic (anticoagulant and fibrinolytic) and vasomotor activity of vascular wall were determined. It was revealed that disturbance of systolic function of left ventricle in patients with CHF is accompanied by decrease of antithrombogenic and vasodilative vascular wall activity. Patients with IV functional class of CHF having long term CHF and blood release value consisted < 33%; during six months of monitoring the number of repeated unfavourable cardiovascular events was essentially increased.
N.A Kosheleva, A.P Rebrov ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH DISTURBED MYOCARDIAL CONTRACTIVE ACTIVITY OF THE LEFT VENTRICLE IN CHRONIC HEART FAILURE PROGNOSIS // Saratov Journal of Medical Scientific Research, Vol. 4, Issue 2, 2008, pp. 76-81