Issues of pathogenesis of cognitive and psychoemotional disorders in patients with cardiovascular and metabolic diseases


DOI: https://dx.doi.org/10.18565/therapy.2021.8.158-163

Shishkova V.N., Kotova M.B., Kapustina L.A., Imamgayazova K.E.

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, Moscow
Abstract. The article discusses the main pathogenetic mechanisms of the development of cognitive and psychoemotional disorders in patients with cardiovascular and metabolic diseases. The prospects of therapeutic strategies are discussed, the spectrum of influence of the drug Mildronate in relation to this category of patients is considered in detail.
Keywords: Mildronate, cognitive disorders, cardiovascular diseases, diabetes mellitus
Read entire article

Literature


  1. Gorodeski E.Z., Hashmi A.Z. Integrating assessment of cognitive status in elderly cardiovascular care. Clin Cardiol. 2020; 43(2):179–86. doi: 10.1002/clc.23318.

  2. Rodriguez F., Maron D.J., Knowles J.W. et al. Association of statin adherence with mortality in patients with atherosclerotic cardiovascular disease. JAMA Cardiol. 2019; 4(3): 206–13. doi: 10.1001/jamacardio.2018.4936.

  3. Шишкова В.Н. Когнитивные нарушения как универсальный клинический синдром в практике терапевта. Терапевтический архив. 2014; 11: 128–34. [Shishkova V.N. Cognitive impairment as a universal clinical syndrome in the practice of a therapist. Terapevticheskiy arkhiv = Therapeutic Archive. 2014; 11: 128–34 (In Russ.)].

  4. Шишкова В.Н. Значение артериальной гипертензии в развитии поражения головного мозга – от легких когнитивных нарушений к деменции. Системные гипертензии. 2014; 1: 45–51. [Shishkova V.N. Place of arterial hypertension in brain lesion development – from minor cognitive disorders to dementia. Sistemnyye gipertenzii = Systemic Hypertension. 2014; 1: 45–51 (In Russ.)].

  5. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга: эпидемиология. Основы профилактики. М.: МЕДпресс-информ. 2009: 256 c. [Suslina Z.A., Varakin Yu.Ya., Vereshchagin N.V. Vascular diseases of the brain: epidemiology. The basics of prevention. Moscow: MEDpress-inform. 2009: pp. 256 (In Russ.)]. ISBN: 5-98322-490-5.

  6. Jefferson A., Benjamin E. Cardiovascular disease, cognitive decline and dementia. Vascular cognitive impairment in clinical practice. Eds. Wahlung L. Erkinjuntti T., Gauthier S. Cambridge. 2009; pp. 166–77.

  7. Остроумова О.Д., Парфенов В.А., Остроумова Т.М. с соавт. Консенсус экспертов. Влияние антигипертензивной терапии на когнитивные функции. Системные гипертензии. 2021; 1: 5–12. [Ostroumova O. D., Parfenov V.A., Ostroumova T.M. et al. Expert consensus. Effect of antihypertensive therapy on cognitive functions. Sistemnyye gipertenzii = Systemic Hypertension. 2021; 1: 5–12 (In Russ.)]. https://dx.doi.org/10.26442/2075082X.2021.1.200575.

  8. Оганов Р.Г., Погосова Г.В., Шальнова С.А., Деев А.Д. Депрессивные расстройства в общемедицинской практике по данным исследования КОМПАС: взгляд кардиолога. Кардиология. 2005; 8: 37–43. [Oganov R.G., Pogosova G.V., Shalnova S.A., Deev A.D. Depressive disorders in general medical practice in KOMPAS study: outlook of a cardiologist. Kardiologiya = Cardiology. 2005; 8: 37–43 (In Russ.)].

  9. Шишкова В.Н. Коморбидность и полипрогмазия: фокус на цитопротекцию. Consilium Medicum. 2016; 12: 73–79. [Shishkova V.N. Comorbidity and polypharmacy: focus on cytoprotection. Consilium Medicum. 2016; 12: 73–79 (In Russ.)].

  10. O'Brien J.T., Erkinjuntti T., Reisberg B. et al. Vascular cognitive impairment. Lancet Neurol. 2003; 2(2): 89–98. doi: 10.1016/s1474-4422(03)00305-3.

  11. Pullicino P.M., Hart J. Cognitive Impairment in congestive heart failure. Neurology. 2001; 57(11): 1945–46. doi: 10.1212/wnl.57.11.1945.

  12. Trojano L., Incalzi R.A., Acaforo D. et al. Cognitive impairment: A key feature of congestive heart failure in the elderly. J Neurol. 2003; 250(12): 1456–63. doi: 10.1007/s00415-003-0249-3.

  13. Шишкова В.Н., Капустина Л.А. Особенности развития когнитивных нарушений у пациентов с сахарным диабетом типа 2 и метаболическим синдромом. Врач. 2018; 9: 3–10. [Shishkova V.N, Kapustina L.A. Features of the development of cognitive impairment in patients with type 2 diabetes mellitus and metabolic syndrome. Vrach = The Doctor. 2018; 9: 3–10 (In Russ.)]. https://dx.doi.org/10.29296/25877305-2018-09-01.

  14. Остроумова О.Д., Суркова Е.В., Ших Е.В. с соавт. Когнитивные нарушения у больных сахарным диабетом 2 типа: распространенность, патогенетические механизмы, влияние противодиабетических препаратов. Сахарный диабет. 2018; 4: 307–318. [Ostroumova O.D., Surkova E.V., Chikh E.V. et al. Cognitive impairment in patients with type 2 diabetes mellitus: prevalence, pathogenetic mechanisms, the effect of antidiabetic drugs. Sakharnyy diabet = Diabetes. 2018; 4: 307–318 (In Russ.)]. https://dx.doi.org/10.14341/DM9660.

  15. Гринин В.М., Шестемирова Э.И. Демографическое старение в России на современном этапе. Вестник РАМН. 2015; 3: 348–354. [Grinin V.M., Shestemirova E.I. Demographic ageing in Russia at the present stage. Vestnik RAMN = RAMS Bulletin. 2015; 3: 348–354 (In Russ.)]. https://dx.doi.org/10.15690/vramn.v70i3.1332.

  16. Шишкова В.Н. На приеме пожилой коморбидный пациент: расставляем акценты. Consilium Medicum. 2019; 9: 48–53. [Shishkova V.N. An elderly comorbid patient: prioritizing. Consilium Medicum. 2019; 9: 48–53 (In Russ.)]. https://dx.doi.org/10.26442/20751753.2019.9.190500.

  17. Шишкова В.Н., Капустина Л.А. Рациональный подход к решению кардиометаболических проблем в терапии коморбидных пациентов. Врач. 2018; 11: 3–11. [Shishkova V.N, Kapustina L.A. A rational approach to solving cardiometabolic problems in the therapy of comorbid patients. Vrach = The Doctor. 2018; 11: 3–11 (In Russ.)]. https://dx.doi.org/10.29296/25877305-2018-11-01.

  18. Dambrova M., Makrecka-Kuka M., Vilskersts R. et al. Pharmacological effects of meldonium: biochemical mechanisms and biomarkers of cardiometabolic activity. Pharmacol Res. 2016; 113(Pt B): 771–80. doi: 10.1016/j.phrs.2016.01.019.

  19. Шишкова В.Н., Мартынов А.И. Современные возможности терапии метаболической кардиомиопатии и сердечной недостаточности. Терапия. 2020; 6: 139–149. [Shishkova V.N., Martynov A.I. Modern opportunities of therapy for metabolic cardiomyopathy and heart failure. Terapiya = Therapy. 2020; 6: 139–149 (In Russ.)]. https://dx.doi.org/10.18565/therapy.2020.6.139-149 .

  20. Шишкова В.Н., Мартынов А.И. Клинико-патогенетические особенности кардиомиопатии и сердечной недостаточности при инсулинорезистентности, ожирении и сахарном диабете 2 типа. Лечебное дело. 2020; 2: 147–156. [Shishkova V.N., Martynov A.I. Clinical and pathogenetic features of cardiomyopathy and heart failure in patients with insulin resistance, obesity and type 2 diabetes mellitus. Lechebnoye delo = Medical Business. 2020; 2: 147–156 (In Russ.)]. https://dx.doi.org/10.24411/2071-5315-2020-12223.

  21. Liepinsh E., Vilskersts R., Zvejniece L. et al. Protective effects of mildronate in an experimental model of type 2 diabetes in Goto–Kakizaki rats. Br J Pharmacol. 2009; 157(8): 1549–56. doi: 10.1111/j.1476-5381.2009.00319.x.

  22. Dambrova M., Skapare-Makarova E., Konrade I. et al. Meldonium decreases the diet-increased plasma levels of trimethylamine N-oxide, a metabolite associated with atherosclerosis. J Clin Pharmacol. 2013; 53(10): 1095–98. doi: 10.1002/jcph.135.

  23. Jaudzems K., Kuka J., Gutsaits A. et al. Inhibition of carnitine acetyltransferase by mildronate, a regulator of energy metabolism. Journal of Enzyme Inhibition and Medicinal Chemistry. 2009; 24(6): 1269–75.

  24. Visokinskas A., Kalvins I., Knasiene J. et al. Use of mildronate in geriatric patients with congestive heart failure. Journal of the Indian Academy of Geriatrics. 2005; 1(3): 110–13.

  25. Галявич А.С., Галеева З.М., Балеева Л.В. Эффективность и переносимость милдроната при лечении пациентов с хронической сердечной недостаточностью. Российский кардиологический журнал. 2005; 5: 55–59. [Galiavich A.S., Galeeva Z.M., Baleeva Z.V. Mildronate efficacy and tolerance in chronic heart failure patients therapy. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2005; 5: 55–59. (In Russ.)].

  26. Недошивин А.О., Петрова Н.Н., Кутузова А.Е., Перепеч Н.Б. Качество жизни больных с хронической сердечной недостаточностью. Эффект лечения Милдронатом. Терапевтический архив. 1999; 8: 10. [Nedoshivin A.O., Petrova N.N., Kutuzova A.E., Perepech N.B. Quality of life of patients with chronic heart failure. The effect of treatment with Mildronate. Terapevticheskiy arkhiv = Therapeutic Archive. 1999; 8: 10 (In Russ.)].

  27. Карпов Р.С., Кошельская О.А., Врублевский А.В. с соавт. Клиническая эффективность и безопасность Милдроната при лечении хронической сердечной недостаточности у больных ишемической болезнью сердца. Кардиология. 2000; 6: 69–74. [Karpov R.S., Koshelskaya O.A., Vrublevsky A.V. et al. Clinical efficacy and safety of Mildronate in the treatment of chronic heart failure in patients with ischemic heart disease. Kardiologiya = Cardiology. 2000; 6: 69–74 (In Russ.)].

  28. Стаценко М.Е., Туркина С.В., Беленкова С.В. с соавт. Влияние милдроната в составе комбинированной терапии хронической сердечной недостаточности у больных сахарным диабетом типа 2 на углеводный, липидный обмен и показатели оксидативного стресса. Российский кардиологический журнал. 2010; 2: 45–51. [Statsenko M.E., Turkina S.V., Belenkova S.V. et al. Effects of Mildronate, as a part of combined heart failure therapy, on carbohydrate and lipid metabolism and oxidative stress parameters in patients with type 2 diabetes mellitus. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2010; 2: 45–51 (In Russ.)].

  29. Dzerve V., Matisone D., Pozdnyakov Y., Oganov R. Mildronate improves the exercise tolerance in patients with stable angina: results of a long-term clinical trial. Seminars in Cardiovascular Medicine. 2010; 16: 8.

  30. Максимова М.Ю., Федорова Т.Н., Шарыпова Т.Н. Применение Милдроната в лечении больных с нарушениями мозгового кровообращения. Фарматека. 2013; 9: 84–94. [Maksimova M.Yu., Fedorova T.N., Sharypova T.N. The use of Mildronate in the treatment of patients with cerebrovascular accidents. Farmateka. 2013; 9: 84–94 (In Russ.)].

  31. Shishkova V. An assessment of meldonium therapy effect on ciliary neurotrophic factor level in patients with post stroke aphasia and diabetes mellitus. European Stoke Journal. 2017; 2(IS): 364–65.

  32. Shishkova V., Remennik A., Cheremin R. An assessment of meldonium therapy effect on NR2 peptide level in patients with ischemic stroke. Journal of Hypertension. 2019; 37: e278.

  33. Shishkova V., Remennik A., Valyaeva V. An assessment of meldonium therapy effect on glucose, lipid parameters, hba1c and NT-proBNP concentration in post stroke patients with diabetes mellitus and prediabetes. International Journal of Stroke. 2020; 15(Issue: 1 Suppl.): 478.

  34. Shishkova V., Remennik A., Valyaeva V. Efficacy of short-term therapy with partially inhibits c-butyrobetaine hydroxylase in diabetes mellitus with chronic heart failure and atrial fibrillation patients. International Journal of Stroke. 2020; 15(Issue: 1 Suppl.): 550.

  35. Федин А.И., Соловьева Э.Ю., Баранова О.А. Оценка влияния ступенчатой и пероральной терапии препаратом Милдронат на неврологический статус, когнитивные функции и астенический синдром у пациентов с сердечно-сосудистой коморбидность. Нервные болезни. 2020; 3: 15–24. [Fedin A.I., Solovieva E.Yu., Baranova O.A. Evaluation of effects of stepwise and oral Mildronate therapy on neurological status, cognitive functions, and asthenic syndrome in patients with cardiovascular comorbidities. Nervnyye bolezni = Nervous diseases. 2020; 3: 15–24 (In Russ.)]. https://dx.doi.org/10.24411/2226-0757-2020-12225.


About the Autors

Veronika N. Shishkova, MD, head of the Department of prevention of cognitive and psychoemotional disorders, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane. E-mail: veronika-1306@mail.ru
Marina B. Kotova, Candidate of Psychological Sciences, leading researcher of the Department of prevention of cognitive and psychoemotional disorders, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane
Lyudmila A. Kapustina, PhD, researcher of the Department of prevention of cognitive and psychoemotional disorders, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane
Kamilla E. Imamgayazova, junior researcher of the Department of prevention of cognitive and psychoemotional disorders, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane


Similar Articles

Back to Content

Бионика Медиа