The article is dedicated to the 150th anniversary of the birth of the valid member of the Academy of Medical Sciences of the USSR Georgy Fedorovich Lang - an outstanding scientist and practicing physician, one of the founders of Russian cardiology. The article outlines the biography of Georgy Fedorovich and reflects the main scientific achievements of this scientist and his students. The article provides detailed information about G. F. Lang’s research in the field of heart and vascular pathologies, in particular, about his work on the study of high blood pressure. G. F. Lang created the neurogenic theory of arterial hypertension and identified a special nosological form - hypertensive disease, synonymic to essential hypertension. The treatment approach in patients with essential hypertension recommended by G. F. Lang is presented.

Introduction. Childhood obesity is a vindicated risk factor both for early and late cardiovascular outcomes. Hypertension is one of the most significant comorbidities accompanying obesity. The risk of developing hypertension in obese patients is influenced by a variety of factors. There is a lack of knowledge in hypertension risk associated with puberty evaluation in obese adolescent boys.

Objective. The study was aimed to evaluate the risk of hypertension as a common comorbidity in obese adolescent boys regarding puberty.

Design and methods. The study involved 147 boys with obesity (code E66.0, ICD-10) aged 14-17 years old. Routine clinical examination was performed according to national standards. Family history and medical history data was collected. Anthropometrics were performed including weight and height measurement, body mass index calculation and evaluation using WHO tables and z-score. Laboratory study included blood testosterone levels determination. Instrumental study included 24-hour blood pressure monitoring. Hypertension diagnosis was defined using common criteria. Statistical analysis included use of descriptive and analytical methods.

Results. Odds ratio for having hypertension during obesity are associated with higher z-BMI score, Tanner puberty score and blood testosterone level.

Conclusions. We concluded that morbid obese boys in late adolescent age, having higher Tanner puberty score, higher zBMI score and higher blood testosterone show highest odds for having hypertension.

The anniversary article presents the life and creative path of the outstanding Russian Soviet scientist, physician and teacher Georgy Fedorovich Lang (1875-1948), one of the founders of Russian cardiology. The scientific achievements of the scientist are shown, a special place among which is the creation of the concept of hypertensive disease, a disease of the neurohumoral apparatus regulating blood circulation, caused by mental trauma and overstrain of the central nervous system.

This study examines the scientific contributions of Georgy F. Lang and his relevance to understanding cardiometabolic disorders in survivors of the Leningrad Siege and their offspring. The article provides an overview of key findings from longitudinal studies of Siege survivors conducted by Russian and European research groups. Current investigations focus on elucidating transgenerational inheritance mechanisms through analysis of a two-generation cohort in the survivors’ descendants. The comprehensive study is presently aimed to evaluate structural and functional characteristics of the cardio-vascular-renal-hepatic-metabolic continuum in first and second generation descendants of Siege survivors, in comparison to a population-based sample of St Petersburg residents. Contemporary researchers continue developing Lang’s theoretical framework by employing modern methodologies to establish evidence-based preventive strategies aimed at mitigating the negative health impacts of traumatic experiences across generations.

Objective. To compare the efficacy of pharmacological cardioversion with cavutilide and electrical cardioversion in patients with persistent and long-standing persistent atrial fibrillation (AF), and to identify predictors of early arrhythmia recurrence.
Design and methods. The study included 104 patients with persistent or long-standing persistent atrial fibrillation who underwent pharmacological (cavutilide) or electrical cardioversion. Prospective follow-up was conducted for 1 week.
Results. The groups of patients undergoing electrical or pharmacological cardioversion were comparable by baseline clinical and echocardiographic parameters. The efficacy of pharmacological cardioversion with cavutilide was comparable to that of electrical cardioversion (50/59 (84,7 %) vs. 41/45 (91,1 %), p = 0,331). Predictors of failure to restore sinus rhythm included: duration of the current episode of persistent AF and prior cardioversion. The rate of early arrhythmia recurrence in the pharmacological and electrical cardioversion groups was comparable (17/50 (34 %) vs. 11/41 (26,8 %), p = 0,461). Patients with early AF recurrence demonstrated more pronounced enlargement of the left and right atria. The most significant predictor of early AF recurrence was a higher left atrial volume index (LAVI), with a ROC analysis-derived threshold value of 50,5 mL/m², associated with the 2,34‑fold increase in the risk of arrhythmia recurrence.
Conclusion. The efficacy of pharmacological cardioversion with cavutilide is comparable to that of electrical cardioversion. Predictors of failure to restore sinus rhythm include the duration of the current AF episode and prior cardioversion. Left atrial volume index exceeding 50,5 mL/m² is associated with the 2,34‑fold increase in the risk of arrhythmia recurrence within 1 week after cardioversion.

Background. The protective effects of vitamin D in relation to atherogenesis are realized by vitamin D receptors (VDR). Variants rs10735810, rs731236, rs1544410 and rs797532 of the VDR gene are involved in regulating the stability of its mRNA. МicroRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21 bind to the 3’regulatory domain of the VDR gene and affect VDR protein expression.
Оbjective. To evaluate the expression levels of microRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21 in coronary heart disease (CHD) patients with rs10735810, rs731236, rs1544410 and rs797532 variants of the VDR gene.
Design and methods. The genotypes of the VDR gene were determined in 766 CHD patients and in 336 people without CHD (comparison group) by polymerase chain reaction (PCR) followed by restriction analysis. MicroRNA expression was determined by real-time PCR.
Results. The ff, Ff genotypes and the f allele of the VDR gene (rs10735810) were more often detected in CHD patients than in the comparison group (p = 0,001, p = 0,03 and p = 0,047, respectively). Carriage of the ff (rs10735810) genotype of the VDR gene was associated with an increased risk of CHD (odds ratio (OR) = 1,80; 95 % confidence interval (CI): 1,30–2,50, p = 0,0004). The aa genotype of the VDR gene (rs797532) and the bb genotype of the VDR gene (rs1544410) were more common in CHD patients than in the comparison group (p = 0,008 and p = 0,001). The presence of the aa and bb genotypes of the VDR gene was associated with an increased risk of CHD (OR = 1,50; 95 % CI: 1,11÷2,02, p = 0,008, OR = 1,77; 95 % CI: 1,35÷2,32, p = 0,001, respectively). The expression levels of microRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21 in the blood are higher in CHD patients than in the control group (p < 0,001). The expression of microRNA‑125a was higher in smoking patients than in non-smokers (59,85 (21,69; 73,06) conventional units of expression (UE) and 32,00 (4,59; 67,85) UE, respectively; p = 0,04). In CHD patients with Tt genotype of the VDR gene (rs731236), the expression of microRNA‑214 is higher than in carriers of the tt genotype of the VDR gene (p = 0,03). In CHD patients with the aa genotype of the VDR gene (rs797532), the expression of microRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21 in the blood is higher than in patients with the AA genotype of the VDR gene (p < 0,05). The expression of microRNA‑125a, microRNA‑125b and microRNA‑21 in the blood of CHD patients, carriers of the bb genotype of the VDR gene (rs1544410), is higher than in those with the BB genotype of the VDR gene (p < 0,05). Conclusion. MicroRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21, genotypes aa, ff and bb of the VDR gene (rs797532, rs10735810, and rs1544410 variants), represent promising markers of CHD. Variants of the VDR gene can affect the expression levels of microRNA‑214, microRNA‑125a, microRNA‑125b and microRNA‑21.

Background. Endothelial dysfunction is considered one of the possible pathophysiologic mechanisms of decreased exercise tolerance in patients after COVID‑19.
Objective. To evaluate the structural and functional vascular changes and exercise tolerance in patients at the long-term follow-up after hospitalization for COVID‑19.
Design and methods. Patients older than 18 years of age from the epidemiological ESSE-RF study were examined: COVID‑19 group (n = 31) — patients hospitalized due to COVID‑19; control group (n = 31) — patients not hospitalized due to COVID‑19. Endothelial state was assessed by levels of von Willebrand factor (vWF), interleukin 6 (IL‑6), and trimethylamine-N-oxide (TMAO); arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) and by cardio-ankle vascular index (CAVI); exercise tolerance was evaluated by cardiopulmonary exercise testing (CPET).
Results. The patients were examined at 570 ± 179 days after hospitalization for COVID‑19. There were no differences in vascular parameters between the COVID‑19 group and the control group (p > 0,05): vWF — 2,2 (0,5; 2,7) vs. 2,3 (1,0; 2,9) U/mL, IL‑6–1,5 (1,0; 3,1) vs. 1,6 (1,0; 3,5) pg/mL, TMAO — 1023,9 (712,7; 1284,7) vs. 896,9 (731,0; 1061,1) pg/mL, cfPWV — 8,4 (7,1; 9,5) vs. 8,2±1,1 m/s, CAVI — 8,0 ± 1,1 vs. 8,2 ± 1,1; as for the results of the CPET: VO2peak — 86,0 (81,0; 92,7) % predicted vs. 86,0 (81,0; 91,5) % predicted, VE/VCO2peak — 28,7 ± 4,5 vs. 27,6 ± 4,8, breathing reserve — 54,7 ± 10,0 % vs. 58,3 ± 8,1 %.
Conclusion. Patients in the long-term period after hospitalization for COVID‑19 show no structural and functional changes or exercise tolerance issues in CPET compared with patients who were not hospitalized for COVID‑19.

Objective — to determine the effectiveness of a new method for diagnosing cognitive impairment in patients with hypertension with long COVID.
Material and methods. In a single-stage screening clinical study, over the course of 3 years, 205 patients (23,4 %) with long COVID were selected out of 878 hypertensive patients. Patients were divided into 2 groups depending on the presence or absence of cognitive impairment based on the Mini Mental State Examination (MMSE). To assess the effectiveness of a new method for detecting cognitive impairments, the “SEMOGRAPH” multi-user information system was used as a tool for processing and analyzing patients’ oral answers in the form of “free speech” to the questions of a specially developed questionnaire, taking into account the relationship with COVID‑19 infection.
Results. The mean age of patients included in the study was 57,2 ± 12,4 years, the mean duration of long COVID was 7,3 [3,2; 12,8] months. Among hypertensive patients with long COVID syndrome, 74 (36,1 %) subjects were diagnosed with cognitive impairment using the MMSE, while cognitive decline was found in 80 (39,0 %) subjects with the help of the “SEMOGRAPH” information system. Based on the Receiver Operating Characteristic (ROC) curve, the new method for diagnosing cognitive impairment using the “SEMOGRAPH” information system was comparable to the “gold standard” — the MMSE scale: the area under the ROC curve was 0,855, p < 0,001; sensitivity 85,6 %, specificity 90,1 %.
Conclusion. A new method using the “SEMOGRAPH” information system, which eliminates the doctor’s subjectivity and the need to process questionnaires manually, in comparison with the “gold standard” — the MMSE scale, allowed for an accurate verification of cognitive impairment in hypertensive patients with long COVID.