{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:31:33Z","timestamp":1793640693271,"version":"4.5.1"},"reference-count":17,"publisher":null,"issue":"7","license":[{"start":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T00:00:00Z","timestamp":1563494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/lib.ossn.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kardiologiia"],"abstract":"<jats:p>\n                    <jats:underline>Objective:<\/jats:underline>\n                    to study clinical and cluster features of cardiovascular burdening taking into account the comorbid polymorbid background in patients of middle age (45\u201360 years) with the presence of multifocal atherosclerosis (MFA).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:underline>Materials and methods.<\/jats:underline>\n                    Patients were examined in the Regional Vascular Center of Ufa (RVCU). Depending on the predominant localization of lesions in the vascular bed patients were divided into 3 clusters by the method of hierarchical analysis of categorical variables according to the clinical manifestation of atherosclerotic lesions of the heart, brain and lower limb arteries confirmed by coronary angiography, ultrasound Doppleroscopy of main arteries of the head and lower extremities. Ninety-six patients had predominant lesions in the heart (1\n                    <jats:sup>st<\/jats:sup>\n                    cluster), 96 \u2013 in carotid arteries (2\n                    <jats:sup>nd<\/jats:sup>\n                    cluster), and 96 patients had ischemia of lower extremities (3\n                    <jats:sup>rd<\/jats:sup>\n                    cluster). Examination during hospitalization in RVCU included when indicated echocardiography, magnetic resonance imaging of the chest and abdomen, ultrasound studies of abdomen, kidney, and pelvis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:underline>Results.<\/jats:underline>\n                    According to data obtained the following conditions were most often observed in different combinations and with varying degrees of severity of clinical manifestation.\n                  <\/jats:p>\n                  <jats:p>Claster 1. Clinical manifestation of atherosclerotic heart disease mainly due to stage III hypertension, history of myocardial infarction were combined with pneumonia, chronic obstructive pulmonary disease with the outcome in pneumosclerosis and emphysema, as well as the presence of cholecysto-cardial syndrome, chronic gastritis, chronic cholecysto-pancreatitis, abdominal ischemic syndrome, rheumatoid arthritis, diabetes mellitus, and chronic pyelonephritis.<\/jats:p>\n                  <jats:p>Claster 2. Hemodynamically significant lesions of brachiocephalic arteries mainly with acute ischemic disturbance of cerebral circulation were combined with bronchial asthma, (the development of which was associated with prolonged persistent eosinophilic inflammation), worsening of chronic kidney disease with urolithiasis, angionephropathy and iron deficiency anemia, as well as the presence of dorsopathy associated with stenotic atherosclerosis of brain vessels.<\/jats:p>\n                  <jats:p>Claster 3.Hemodynamic ischemia with clinical manifestation of vascular lesions of lower extremities was accompanied by type 2 diabetes, chronic cholecysto-pancreatitis, erosive and ulcerative lesions in the stomach and duodenum, polyosteoarthrosis, abdominal-ischemic syndrome. Type 2 diabetes prevailed in patients with occlusion of right posterior tibial artery and trophic ulcer of the right foot.<\/jats:p>\n                  <jats:p>\n                    <jats:underline>Conclusion.<\/jats:underline>\n                    Interdependence of comorbid and polymorbid background and cardiovascular burdening changes their clinical picture and course, increases number of complications and their severity.\n                  <\/jats:p>","DOI":"10.18087\/cardio.2019.7.n599","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T05:32:52Z","timestamp":1563514372000},"page":"31-36","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Features of Comorbid Cluster and Premorbidly Manifestations in Patients with High Vascular Risk in the Middle Age Category with the Presence of Multifocal Atherosclerosis"],"prefix":"10.68900","volume":"59","author":[{"given":"A. \u041ah.","family":"Khasanov","sequence":"first","affiliation":[{"name":"Bashkiria State Medical University; Emergency Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. A.","family":"Bakirov","sequence":"additional","affiliation":[{"name":"Bashkiria State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Davletshin","sequence":"additional","affiliation":[{"name":"Bashkiria State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Nurmukhametova","sequence":"additional","affiliation":[{"name":"Bashkiria State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Kudlay","sequence":"additional","affiliation":[{"name":"Institute of Immunology Federal Medical-Biological Agency of Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"ref1","unstructured":"Arieva G.T., Sovetkina N.V., Ovsiannikova N.A., Ariev A.L. Comorbid and multimorbid conditions in geriatrics (review). Success of gerontology. 2011;24(4):612\u20139."},{"key":"ref2","unstructured":"Vertkin A.L., Skotnikov A.S. Comorbidity. Attending physician. 2013;6:66\u20139."},{"key":"ref3","unstructured":"Nadal-Ginard K. When one interferes with the other \u2013 comorbidity at the mercy of the day. New medicine millennium. 2012;6:22\u20134. \u0414\u043e\u0441\u0442\u0443\u043f\u043d\u043e \u043d\u0430: http:\/\/nmt-journal.com\/arch\/files\/full\/2012_6.pdf]"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Feinstein AR. Pretherapeutic classification of comorbidity in chronic diseases. Journal of Chronic Diseases. 1970;23(7):455\u201368. PMID: 26309916","DOI":"10.1016\/0021-9681(70)90054-8"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Shirinsky IV, Shirinsky VS. Treatment of erosive osteoarthritis with peroxisome proliferator-activated receptor alpha agonist fenofibrate: a pilot study. Rheumatology International. 2014;34(5):613\u2013 6. DOI: 10.1007\/s00296-013-2766-4","DOI":"10.1007\/s00296-013-2766-4"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Bhatt DL, Eagle KA, Ohman EM, Hirsch AT, Goto S, Mahoney EM et al. Comparative Determinants of 4-Year Cardiovascular Event Rates in Stable Outpatients at Risk of or With Atherothrombosis. JAMA. 2010;304(12):1350\u20137. DOI: 10.1001\/jama.2010.1322","DOI":"10.1001\/jama.2010.1322"},{"key":"ref7","unstructured":"Barbarash L.S., Shafranskaya K.S., Ivanov S.V., Moiseenkov G.V., Kazachek Ya.V., Barbarash O.L. Possibility of modified EUROSCORE use for evaluation of one-year prognosis in polyvascular atherosclerosis patients after coronary artery bypass graft surgery. Circulation Pathology and Cardiac Surgery. 2010;2:52\u2013 6."},{"key":"ref8","unstructured":"Barbarash L.S., Kashtalap V.V., Zykov M.V., Usoltseva E.N., Yakubik G.G., Karetnikova V.N. et al. Prevalence and clinical value of multifocal atherosclerosis in patients with myocardial infarction and ST segment elevation. Cardiology and cardiovascular surgery. 2010;3(5):31\u20136."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Aboyans V, Lacroix P, Postil A, Guilloux J, Roll\u00e9 F, Cornu E et al. Subclinical Peripheral Arterial Disease and Incompressible Ankle Arteries Are Both Long-Term Prognostic Factors in Patients Undergoing Coronary Artery Bypass Grafting. Journal of the American College of Cardiology. 2005;46(5):815\u201320. DOI: 10.1016\/j.jacc.2005.05.066","DOI":"10.1016\/j.jacc.2005.05.066"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Kablak-Ziembicka A, Przewlocki T, Pieniazek P, Musialek P, Sokolowski A, Drwila R et al. The role of carotid intima-media thickness assessment in cardiovascular risk evaluation in patients with polyvascular atherosclerosis. Atherosclerosis. 2010;209(1):125\u201330. DOI: 10.1016\/j.atherosclerosis.2009.08.019","DOI":"10.1016\/j.atherosclerosis.2009.08.019"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Tsivgoulis G, Bogiatzi C, Heliopoulos I, Vadikolias K, Boutati E, Tsakaldimi S et al. Low Ankle-Brachial Index predicts early risk of recurrent stroke in patients with acute cerebral ischemia. Atherosclerosis. 2012;220(2):407\u201312. DOI: 10.1016\/j.atherosclerosis.2011.11.009","DOI":"10.1016\/j.atherosclerosis.2011.11.009"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"van Kuijk JP, Flu WJ, Welten GMJM, Hoeks SE, Chonchol M, Vidakovic R et al. Long-term prognosis of patients with peripheral arterial disease with or without polyvascular atherosclerotic disease. European Heart Journal. 2010;31(8):992\u20139. DOI: 10.1093\/eurheartj\/ehp553","DOI":"10.1093\/eurheartj\/ehp553"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid Diseases: Implications for Pay for Performance. JAMA. 2005;294(6):716\u201324. DOI: 10.1001\/jama.294.6.716","DOI":"10.1001\/jama.294.6.716"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Caughey GE, Vitry AI, Gilbert AL, Roughead EE. Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health. 2008;8(1):221. DOI: 10.1186\/1471-2458-8-221","DOI":"10.1186\/1471-2458-8-221"},{"key":"ref15","unstructured":"Lazebnik L.B. Ageing and polymorbidity. Consilium Medicum. 2005;7(12):993\u20136."},{"key":"ref16","unstructured":"Samoylova Y.G., Rotkank M.A., Zhukova N.G. et al. The use of magnetic resonance research methods of the brain in patients with type 1 diabetes mellitus and cognitive dysfunction. Nevrology journal. 2018;23(2):86\u201392]."},{"key":"ref17","unstructured":"Mamaev A.N., Kudlay D.A. Data visualization in presentations, reports and research M.: Practical medicine 2011;39 s."}],"container-title":["Kardiologiia"],"original-title":[],"link":[{"URL":"https:\/\/lib.ossn.ru\/jour\/article\/viewFile\/599\/456","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:16:29Z","timestamp":1793639789000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardio.elpub.ru\/jour\/article\/view\/599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,19]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,19]]}},"URL":"https:\/\/doi.org\/10.18087\/cardio.2019.7.n599","relation":{},"ISSN":["2412-5660","0022-9040"],"issn-type":[{"value":"2412-5660","type":"electronic"},{"value":"0022-9040","type":"print"}],"subject":[],"published":{"date-parts":[[2019,7,19]]}}}