[Prevention of ischemic stroke in atrial fibrillation from the point of view of a neurologist. Standards and real clinical practice].

The article outlines aspects of the current state of the problem of the priority choice of an oral anticoagulant for indefinite prevention of stroke and systemic thromboembolism in patients with atrial fibrillation. The advantages of direct oral angicoagulants over warfarin are presented, as well as a comparative analysis of the individual characteristics of the main direct oral angicoagulants from the point of view of personification of preventive therapy in accordance with modern treatment standards. The efficacy and safety of oral anticoagulant therapy has been reviewed in terms of the net clinical benefit.

[The new Epoch of Antithrombotic Therapy in the Long-Term Prevention of a non-Cardioembolic Stroke].

This article presents current opinions on the role of antithrombotic therapy in secondary prevention of cardiovascular diseases (CVD) in patients after noncardioembolic stroke or a transient ischemic attack on the background of sinus rhythm. This review analytically analyses evidence-based data on antithrombotic drugs used for this secondary prevention. Despite the fact that acetylsalicylic acid (ASA) is still a "gold standard" for prevention of noncardioembolic stroke, the search for rational combinations of antithrombotic drugs to increase the effectiveness of preventive treatment is relevant.

[Arterial Hypertension and Optimization of Medication Prevention of Ischemic Stroke].

The article is devoted to the actual problem - the prevention of stroke in patients with arterial hypertension (AH). Mechanisms of cerebral complications of AH, the key areas of prevention of stroke are presented. On the basis of earlier large randomized trials justified the use of fixed combination products (polypills) comprising, along with antihypertensive lipid-lowering drugs, which is the key to improving treatment adherence and effectiveness of pharmacological prevention of stroke.

[Sleep-disordered breathing syndrome in acute ischemic stroke].

Aim: To evaluate the prevalence, structure and risk factors of sleep-disordered breathing in patients with acute ischemic stroke.

Material And Methods: This prospective study included 54 acute ischemic stroke patients aged 66 [57; 72] years, 32 men, 22 women. The diagnosis was confirmed by MRI.

[Prognostic Factors of Cardiovascular Complications After Ischemic Stroke].

We included into prospective cohort observational study 148 patients with ischemic stroke aged 60 [52; 68] years. Duration of a prospective follow-up was 35 [28; 40] months. Cardiovascular events (CVE) registered during follow-up were recurrent stroke, transient ischemic attack, myocardial infarction, unstable angina, congestive heart failure, including acute decompensation of chronic heart failure requiring hospitalization, cardiovascular death.

[Proignostic Factors of Cardiovascular Complications After Ischemic Stroke].

We included into prospective cohort observational study 148 patients with ischemic stroke aged 60 [52; 68] years. Duration of a prospective follow-up was 35 [28; 40] months. Cardiovascular events (CVE) registered during follow-up were recurrent stroke, transient ischemic attack, myocardial infarction, unstable angina, congestive heart failure, including acute decompensation of chronic heart failure requiring hospitalization, cardiovascular death.

[Prognostic factors of recurrent acute cerebrovascular incidents in patients with ischemic stroke].

Objective: To establish prognostic factors of recurrent acute cerebrovascular complications after ischemic stroke.

Material And Methods: A prospective observational study on the 21-22nd day of the acute stage of ischemic stroke included 148 patients, aged 60 [5; 68] years. Following the discharge, a unified telephone survey of patients or their relatives was performed every 3 months.

[Cardiac complications and heart rhythm variability in the late post-stroke period].

The aim of this prospective study was to elucidate the relationship between cardiac complications and heart rhythm variability (HRV) in 90 patients (age median 58 (53;67) years) with the sinus rhythm after ischemic stroke. 24-hr Holter monitoring 21 days after stroke was used for temporal and spectral analysis of HRV. The follow-up period lasted 23 (12; 45) months.

[Cardioneurology: the up-to-date key positions and the future prospects].

The up-to-date key positions and the future prospects of cardioneurology were analyzed. The wide range of questions of cardioneurology was represented and the necessity of the interdisciplinary approach to the diagnostics, treating and prevention of the cerebrovascular diseases were proved. It was pointed that the studied problems are the priority directions in angioneurology and have great social and clinical importance.

[Cardioneurological aspects of antiplatelet therapy in secondary prevention of cardiovascular diseases].

The paper reflects contemporary views of the role of antiplatelet therapy in secondary prevention of cardiovascular diseases in patients with coronary heart disease and ischemic stroke. On the basis of evidence based medicine analytical characteristics of all antiplatelet drugs subjected to clinical trials in the world are presented. Advantages and imperfectness of each agent both as monotherapy and used in combinations are demonstrated.

[Cerebral circulation in chronic hypertensive encephalopathy].

Cerebral blood supply was studied in 123 patients with stage III hypertensive encephalopathy (HE) in the absence of occlusion of main head arteries. Duplex scanning was used to measure blood flow rate in common carotid (CCA), vertebral (VA) and medial cerebral (MCA) arteries. Cortical cerebral blood flow (CBF) was measured by single-photon emission CT using 99mTc- ceretec.

[Comparative clinical and anatomic characteristic of patients with patent foramen ovale in cryptogenic and noncryptogenic stroke].

In order to study anatomical and functional characteristics of patent foramen ovale (PFO) in patients with cryptogenic stroke and with other stroke subtypes we examined 56 stroke patients (male--35, female--21, age 46.7 +/- 16.5 years) with PFO and ischemic stroke.

[Pathogenetic significance of patent foramen ovale in patients with the determined cause of ischemic insult].

The prevalence of open oval window (OOW) in patients with different types of ischemic insult and the possibility of independent pathogenetic contribution of OOW to brain injury were evaluated by examining 85 patients (mean age 53 +/- 14 yr) with cardioembolic (CES), lacunar (LS), and other subtypes of ischemic insult. CT and MRT of the head, duplex scanning of head arteries, contrast transcranial monitoring middle cerebral arteries, standard and contrast transthoracic and transoesophageal echocardiography revealed OOW in 40% of the patients. It had small anatomic and functional size and a tunnel-like shape.

[Paradoxical embolism in patients with ischemic stroke].

The present study included 84 patients with ischemic stroke of known and unknown etiology. The risk of paradoxical embolism (PE) was evaluated using contrast transthoracic echocardiography, contrast transcranial Doppler monitoring, and transoesophagal echocardiography. The majority 64%) of the patients with strokes of known etiology were found to be predisposed to PE because they had the patent interatrial foramen (PIF) and pulmonary shunt (51 and 13 respectively).

[Cerebral hemodynamics and endothelium function in patients with cerebrovascular pathology treated by teveten].

Teveten (eprosartan mesilate) was used as a monotherapy or in combination with hypotiazide (12,5 mg/day) in dosage 600 mg once a day for treatment of 20 patients with cerebrovascular pathology (chronic cerebrovascular insufficiency, consequences of brain ischemica in the presence of arterial hypertension stage I-II, or higher borderline levels of normal blood pressure (BP). Treatment duration was 12 weeks, 24-h monitoring of BP was made some indices of cerebral blood flow, hemodynamics and peripheral vessels reaction were registered. Modulating antihypertensive effect of Teveten was found, statistically significant reduction of systolic BP did not result in worsening of cerebral hemodynamics.

[Cerebral perfusion in patients with arterial hypertension and chronic forms of brain vascular pathology].

Aim: To examine cerebral perfusion in patients with dyscirculatory encephalopathy and residual disorders of cerebral circulation in arterial hypertension.

Material And Methods: Duplex scanning of extra- and intracranial arteries, computed tomography of the head were performed in 26 hypertensive patients with chronic vascular pathology of the brain. Cerebral perfusion was studied by the evidence obtained at single-photon emission computed tomography.

[Echocardiographic changes associated with risk of developing embolic complications in patients with ischemic stroke].

Aim: To study echocardiographic parameters associated with embolic complications in patients with cardioembolic and other pathogenetic subtypes of ischemic stroke.

Material And Methods: 330 patients with ischemic stroke (IS) were examined. Transthoracal echocardiography was made in all the patients, transesophageal echocardiography was performed in 53 (16.

[Comparative assessment of persistent and paroxysmal atrial fibrillation as causes of cardiocerebral embolism].

In 66 patients with embolic stroke of cardiac origin (33 with persistent and 33 with paroxysmal atrial fibrillation) transthoracic and transesophageal (21 patients, 31.2%) echocardiography was used for detection of atrial thrombosis. Lone atrial fibrillation was significantly more frequent among patients with paroxysmal atrial fibrillation.

[Pathogenetic assessment of cardiac arrhythmia and myocardial ischemia in hemodynamic stroke].

330 patients with ischemic stroke entered the trial. They were divided into two groups: 72 (21.8%) patients with hemodynamic stroke (group 1) and the rest 258 (78.

[Perpetual cardiac fibrillation and predictors of sudden cardiac arrhythmic death in patients with ischemic stroke].

Aim: To study predictors of sudden cardiac arrhythmic death in patients with perpetual cardiac fibrillation (PCF) and ischemic stroke.

Material And Methods: 230 patients with ischemic stroke were examined. 22 (9.

[Cardiac arrhythmia in cardiac embolism].

To study cardiac arrhythmia in patients with cardiocerebral embolism, we examined 330 patients with ischemic stroke using ECG and Holter monitoring. 33 patients were control. Group 1 consisted of 104(31.

[Echocardiographic alteration in patients with hemodynamic stroke].

Echocardiography was made in 330 patients with ischemic stroke. Group 1 consisted of 72(21.8%) patients with hemodynamic stroke, the rest 258(78.

[Cardiac pathology in various in various pathogenetic subtypes of ischemic stroke].

Heart pathology was studied in various pathogenetic subtypes of ischemic stroke. A total of 330 stroke patients were divided into 4 groups. Group 1 consisted of 104 (31.

[Reactivity of cerebral vessels in patients with circulatory encephalopathy, arterial hypertension and cerebral hypoperfusion risk].

Aim: To study cerebral vasomotor reactivity (CVR) in patients with chronic cerebrovascular disturbances caused by arterial hypertension (AH) and to determine criteria of cerebral hypoperfusion risk during antihypertensive therapy.

Material And Methods: 80 patients with chronic cerebrovascular disturbances because of AH and 15 normotensive subjects without any neurological pathology (control group) were examined using CT of the brain, duplex scanning of extra- and intracranial arteries, echocardiography. CVR was assessed with transcranial dollperography of the blood flow velocity in both middle cerebral arteries before and after nitroglycerine provoked test.