The article presents modern views on the main functions of microcirculation. In this aspect, two key positions are considered: the main blood flow through the microcirculatory vessels and the transcapillary exchange of fluid between the vascular and interstitial compartments.

   The purpose of the main microcirculatory blood flow is, first of all, to provide surrounding cells with oxygen, which is carried out by arteriolar diffusion of oxygen, as well as to remove carbondioxide and other metabolic products from the intercellular space.

   We describe a feature of capillary blood flow caused by speed fluctuations, which is associated with some changes in the deformability of leukocytes and their adhesive properties under the influence of various regulatory factors. An important characteristic of the microcirculation system is highlighted, which is the state of microhemorrheology, it depending on the pressure gradient, hematocrit and the ability of red blood cells to deform. The principle of fluid exchange between capillaries and tissue spaces is considered in the form of an updated version of the Starling–Landis equation and pressure distribution in the microcirculatory compartment of various capillary segments. Modern views on oxygen transport carried out by a complex intact cascade are presented. The main regulatory mechanisms in the microcirculation system are described in detail, including the three occurrence mechanisms of hyperpolarization of endothelial cells and vasodilation.

   Currently, arterial and venous thrombosis are among the leading causes of morbidity and mortality. Anticoagulant therapy is one of the most popular approaches in practical medicine in the treatment and prevention of thrombotic conditions. The article presents the most commonly used direct-acting anticoagulants in clinical practice and their comparative clinical and pharmacological characteristics. The main recommendations for medical prevention of venous thrombosis are provided, taking into account the nature of surgical procedures and patient risk factors. The features of the use of low molecular weight heparins and unfractionated heparin against the background of regional anesthesia are given. Algorithms for interrupting antithrombotic therapy during planned and emergency surgical interventions are presented.

   Aim. To study myocardial perfusion and assess cardiovascular risk in patients with long-term ventricular pacing in the long period.

   Materials and methods. The study included 40 young patients (23 men and 17 women) with atrioventricular (AV) blocks and implanted pacemakers (pacers). Group 1 consisted of 20 patients with postoperative AV block after surgical correction of congenital heart disease; group 2–20 patients with non-surgical AV block. The age range at the time of the study was 22.8 (19.8; 24.0) years in group 1 and 22.5 (20.4; 24.8) years in group 2 (U = 181.0, p = 0.620). The duration of pacing in the groups was 15.5 (12.8; 18.9) years and 15.7 (14.1; 18.2) years, respectively (U = 193.0, p = 0.862). At the time of examination, all patients had a dual-chamber pacemaker implanted with 100 % ventricular pacing. All patients underwent a general clinical examination and single-photon emission computed tomography of the myocardium.

   Results. Perfusion disorders were detected in 52.5 % of young patients with prolonged ventricular stimulation, regardless of the cause of AV block; in 25 % of the subjects they were pronounced. Transient LV myocardial ischemia was detected in 42.5 % of individuals included in the study. Significant myocardial ischemia (with an SDS value of > 4 points) in patients with prolonged ventricular stimulation, regardless of the cause of AV block, was accompanied by changes in volumetric parameters and impaired LV systolic function during exercise (Stress LV EDVI, Stress LV ESVI, Stress LV EF, ΔEF LV), myocardial systolic thickening (WT-SSS). Transient dilatation (especially in combination with myocardial ischemia) is an unfavorable risk factor for the development of cardiovascular events. A combination of stress-induced ischemia and the “stunning” phenomenon (with a decrease in LVEF by 5 % or more) was identified in 15 % of patients with prolonged ventricular stimulation, regardless of the cause of AV block, which is an independent predictor of the development of adverse cardiovascular events. A statistically significant relationship was established between the development of myocardial ischemia and the indicators of the difference (delta) in LV wall thickening (ΔWT-SDS) and the difference (delta) in LVEF (ΔLVEF) during the study at rest and during the stress test. A mathematical model has been proposed for calculating the probability of developing transient myocardial ischemia according to SPECT data with the inclusion of these indicators, the area of the ROC curve was AUC = 0.854 ((95 % CI 0.707 – 0.946), p < 0.001, sensitivity 81.8 %, specificity 72.4 %).

   Conclusion. In young patients with prolonged ventricular stimulation, regardless of the cause of AV block, significant perfusion disturbances, stress-induced transient ischemia in combination with the phenomenon of “stunning” (decrease in LVEF ≥ 5 %), which were accompanied by remodeling and impairment of LV systolic function during load. The identified perfusion disorders may be significant predictors of adverse cardiovascular events in this population.

   Background. Despite the successes in the prevention and treatment of diseases of the circulatory system, mortality from ischemic heart disease (IHD) among the population of the Republic of Belarus occupies a leading position. Late seeking of medical care by patients with coronary artery disease may be due to the peculiarities of the course of the disease, asymptomatic episodes of myocardial ischemia, which do not allow timely suspicion and prevention of an impending coronary catastrophe without conducting instrumental studies and assessing cardiovascular risk. Acute surgical pathology of the abdominal organs can serve as a stress trigger that will worsen the course of asymptomatic coronary atherosclerosis and lead to the manifestation of an ischemic event.

   Aim. To assess the incidence and develop a prognostic model for the occur rence of ST segment depression on the resting electrocardiogram (ECG) in patients after cholecystectomy in the early postoperative period.

   Material and methods. The study included patients with moderate, high and very high risk of cardiovascular complications according to the recommendations of the European Society of Cardiology [1], who had indications for urgent cholecystectomy. Ischemic depression of the ST segment was considered to be an oblique or horizontal depression with a depth of 0.05 mV or more in the standard leads and 0.1 mV or more in the precordial leads, measured at a point 60–80 ms from the point of transition of the S wave to the ST segment.

   Results and discussion. In patients who underwent cholecystectomy but did not use cardioprotective therapy, ST segment depression on the ECG was more common on the 4^th day after surgery. The prevalence of ischemic ST segment depression was higher in both standard and precordial leads. An increase in the incidence of new episodes of myocardial ischemia by day 4 in patients after cholecystectomy without concomitant cardioprotective therapy was also revealed. A model was developed to estimate the likelihood of episodes of ST segment depression after emergency cholecystectomy in the early postoperative period.

   Conclusion. In patients after cholecystectomy in the early postoperative period, episodes of ST segment depression were recorded on the resting ECG. The frequency of asymptomatic episodes of ischemia was higher in the group of patients who underwent cholecystectomy, where no additional cardioprotective therapy was prescribed.

   The analysis of cytokine profile markers with reference to the clinical and functional features of the heart condition in case of new coronavirus infection (COVID-19) can provide valuable information about the pathogenetic mechanisms of cardiovascular complications and be considered as an additional factor of unfavorable prognosis in patients with concomitant coronary heart disease (CHD).

   Aim. To study the clinical and functional features of the heart condition and the expanded cytokine profile in hospitalized patients with COVID-19 coronavirus infection and concomitant coronary artery disease.

   Material and methods. The retrospective study included an analysis of medical documentation to determine the main characteristics of patients, mortality rates, assessment of the polymorbid background, and autopsy results in 247 patients hospitalized with COVID-19. The prospective study included 90 patients undergoing inpatient treatment in the cardiology department with a diagnosis of COVID-19. The patients were divided into 2 groups: group 1 represented by patients with COVID-19 and coronary heart disease (n = 42), group 2 – patients with COVID-19 without coronary heart disease (n = 48). The examination of patients included the determination of standard biochemical parameters, assessment of the cytokine profile (48 cytokines and chemokines), echocardiography (ECHO), computed tomography of the lungs (CT).

   Results. In the study of autopsy material of the cardiovascular system, left ventricular hypertrophy was detected in 185 patients (74.9 %). According to the results of the conducted studies, the highest values of inflammatory cytokinesinterleukins(IL): IL-1, IL-6,granulocyte colony-stimulating factor (G-CSF), monocyte chemoattractant protein-1(MCP-1),interferon γ-induced protein-10 (IP-10), macrophage inflammatory protein-1b(MIP-1b), tumor necrosis factor-a(TNF-a) were observed in group 1 relative to group 2. A positive relationship was revealed between the level of C-reactive protein and IL-2, IL-6, IL-7,IL-17a, G-CSF, MCP-1, IP-10, macrophage inflammatory protein-1a(MIP1a), MIP1b, TNFa, ferritin and IL-2, IL-6, IL-17a, G-CSF, MCP-1, IP-10, MIP1a, MIP1b, TNFa, as well as between the D-dimer level and IL-2, IL-6, IL-7, IL-17a, MIP1a, MIP1b, TNF-a. According to ECHO data, a statistically significant increase in the longitudinal size of the right atrium, the level ofmeanpulmonary artery pressure (mPAP), and an expansion of the transverse size of the left atrium were revealed in group 1 compared with group 2 (p < 0.05).

   Conclusion. Based on the findings obtained regarding pronounced systemic inflammation that develops in patients with coronavirus infection associated with concomitant coronary heart disease, it resulting in rapidly developing morpho-functional changes in the myocardium, coronavirus infection can be considered as a factor exacerbating the further course of coronary heart disease.

   Aim. To assess the impact of frailty and comorbidity on treatment outcomes in patients aged 60 years and older starting chronic dialysis.

   Methods. A single-center trial included 245 patients aged 60 years and older with chronic kidney disease stage 5 (CKD 5). All the patients were examined for hyperhydration and residual renal function and pre-dialysis blood parameters (creatinine, urea, potassium, albumin, lymphocytes, hemoglobin) were evaluated. The Cumulative Frailty Index (CFI) and Charlson Comorbidity Index (CCI) were used to assess frailty and comorbid disease burden, respectively. Survival analysis was performed using the Kaplan–Meier estimator, Cox proportional hazard regression model was used to assess the impact of individual parameters on patient survival.

   Results. As a result of the univariate statistical analysis, variables independently associated with worse survival were: age > 65 years, residual renal function (glomerular filtration rate (GFR) according to the CKD-EPI formula ≤ 3 ml/min/1.73 m², diuresis < 400 ml/day), hyperhydration, uremia indicators (creatinine ≤ 520 µmol/l, urea > 44 mmol/l), protein-energy undernutrition (PEU) laboratory signs (albumin ≤ 30 g/l, lymphocytes ≤ 0.6 × 10⁹/l ), as well as CFI ≥ 0.5 (3.5 (2.4–5.1), p < 0.001), CCI > 5 points (1.6 (1.2–2.3), p = 0.005). All the patients were divided into group 1 (patients with CFI ≥ 0.5), group 2 subgroup 1 (CFI < 0.5 and CCI > 5 points), group 2 subgroup 2 (CFI < 0.5 and CCI ≤ 5 points).There were differences in median survival (44 vs 279 vs 672 days), one- and two-year survival in the selected groups and subgroups. It was revealed that the greatest influence on life expectancy in ≥ 60 year-old patients with CKD 5 on chronic dialysis was not exerted by the classic criteria of age, renal nitrogen excretion function and PEU, but by the presence of severe frailty and high comorbidity, which made it possible to identify groups at risk of death: the high-risk group included patients with CFI ≥ 0.5, the intermediate-risk group – patients with CFI < 0.5 and CCI > 5 points, the standard-risk group – patients with CFI < 0.5 and CCI ≤ 5 points.

   Conclusion. CFI and CCI are superior to azotemia, PEU, and GFR in predicting and stratifying risk of death in ≥ 60 year-old patients with CKD 5. We, therefore, propose that CFI and CCI be used to determine treatment modality for CKD 5 in this cohort of patients.

   Purpose of the study: to evaluate the relationship of cardiac-ankle vascular index (CAVI), ankle-brachial index (ABI) and brachiocephalic artery ultrasound findings and lipid profile in asymptomatic working-age patients with subclinical hypothyroidism.

   The design of the study. A cross-sectional cohort study analyzing data from 70 patients of working age with different thyroid hormonal status without clinical signs of chronic insufficiency of cerebral circulation.

   Materials and methods. The study included 70 persons of working-age without clinical signs of chronic insufficiency of cerebral circulation: 46 with laboratory-confirmed subclinical hypothyroidism (thyroid stimulating hormone (TSH) level > 4.0 mIU/L with normal thyroid hormone free fractions) and 24 patients without thyroid dysfunction. The groups were comparable in terms of age, sex, smoking, arterial hypertension. All patients underwent comparative analysis of lipid spectrum parameters (Total Cholesterol (TC), Triglycerides (TG), Low-Density Lipoprotein Cholesterol (LDL-C), High-Density Lipoprotein Cholesterol (HDL-C), Low- and High-Density Apolipoproteins) and ultrasound examination of carotid arteries. One of the used methods of preclinical diagnostics of atherosclerosis – volumetric sphygmography with assessment of cardiac-ankle vascular index (CAVI) and ankle-brachial index (ABI) – is described in detail in the article.

   Results. Patients with subclinical hypothyroidism exhibited significantly higher levels of TC, LDL-C, ApoB, ApoB/ApoA1 ratio, and atherogenic coefficient, and lower levels of HDL-C compared to patients without thyroid dysfunction. Additionally, a higher proportion of patients with subclinical hypothyroidism had elevated total cholesterol and LDL-C levels. Our data indicate that a significantly higher proportion of patients with subclinical hypothyroidism have atherogenic types of hyperlipidemia compared to those without thyroid dysfunction. Specifically, Type IIa hyperlipidemia was more prevalent in the subclinical hypothyroidism group. A direct, moderately strong association between elevated TSH level and atherogenic type of hyperlipidemia (r = 0.60; p < 0.01), atherosclerotic (r = 0.58; p < 0.01), multivessel (r = 0.54; p < 0.05) lesion of brachiocephalic arteries, presence of signs of atherosclerotic plaque instability (r = 0.64; p < 0.01) were found. In the group of patients with subclinical hypothyroidism, the proportion with low ABI was significantly higher: 34.7 % (n = 16) vs 12.5 % (n = 3) (F = 0.057; p < 0.05). A direct association between the reduced ABI value and the presence of ultrasound signs of multivessel atherosclerotic lesion of brachiocephalic arteries (r = 0.337, p < 0.001), and a negative association between ABI < 1.00 and atherogenic hyperlipidemia type IIa (r = 0.43; p < 0.05) were established.

   Conclusion. In clinically healthy working-age patients with subclinical hypothyroidism compared to those with normal thyroid function, there is a higher proportion of individuals with atherosclerotic multivessel lesions of the precerebral basin (32.6 % (n = 15) vs. 8.3 % (n = 2), χ² = 5.05; p < 0.05). The disease progression is associated with a background of atherogenic type 2a hyperlipidemia (93.5% (n = 43) vs. 70.8% (n = 17), χ² = 6.60; p < 0.05) combined with a deficiency of antiatherogenic high-density lipoproteins (HDL-C) (1.0 ± 0.09 mmol/L vs. 1.3 ± 0.06 mmol/L; p < 0.05). The etiopathogenetic mechanisms of “early vascular aging”, the criteria for stratification of risk groups for atherosclerosis-associated cardiovascular diseases, the selection of diagnostic algorithms for visualizing preclinical stages of atherogenesis, and timely antiatherogenic strategies in asymptomatic patients with comorbid thyroid pathology require further exploration. Active implementation in practical healthcare of the assessment of regional (segmental) vascular stiffness using volumetric sphygmography based on the characteristics of the main (CAVI) and peripheral (ABI) blood flow can be proposed for diagnosing preclinical stages of atherogenesis in comorbid patients with endocrinopathies. Verification of a stenosing hemodynamically significant or non-hemodynamically significant atherosclerotic lesion of the coronary arteries, irrespective of the clinical component, is a factor of high cardiovascular risk necessitating immediate correction of hyperlipidemia.

   Aim. To examine the mechanisms of coronary artery vessel wall remodeling based on the analysis of the results of optical coherence tomography after correction of long coronary lesions.

   Material and methods. This study includes 80 patients who underwent endovascular correction of long (more than 25 mm) coronary lesions at the Republican Scientific and Practical Centre “Cardiology”. The patients were randomly divided into two groups: the main group (MG) of 40 patients – lesion correction with biodegradable vascular scaffolds BVS Absorb and the control group (CG) of 40 patients – correction of lesions with drug-eluting metal stent Xience V/Xience Pro.

   Results. In OCT study after implantation procedure, the lumen area inside the stent/scaffold was statistically different between groups and was 6.89 ± 1.93 mm² in the main group and 8.33 ± 2.94 mm² in the control group. At the 12-month follow-up, there was a significant decrease in the lumen area in the main and control groups: to 6.13 ± 2.30 mm² and 7.72 ± 3.11 mm², respectively. Analysis of implant fragments revealed a significant difference in the incidence of strut malposition between the MG and CG both initially (1.29 % versus 1.56 %) and at 12-month follow-up (0.19 % versus 0.38 % in the control group). The number of protruding struts, in turn, was significantly higher in the main group (2.26 % versus 0.14 %). There was a significant difference in mechanisms of stents/scaffolds neointimal coverage at the 12-month control: the neointima was more smoothly distributed in the main group with minimum thickness of 50 µm versus 40 µm in control, while the incidence of uncovered struts was significantly lower in the main group than in the control group – 1.26 % versus 12.6 %. In both groups, the development of evaginations of the vascular wall at the site of implantation was revealed with significant differences between the groups: in the control group, 2 such patients (5 %) were identified with a total volume of evaginations of 5.4 mm³ and a maximum depth of up to 0.58 mm, while in the MG there was 12 such patients (30 %) with a total volume of evaginations of 148.3 mm³ and a maximum depth of up to 1.64 mm. Moreover, one patient from the main group with the maximum volume, number and depth of evaginations was the only one in the entire sample with confirmed thrombosis in the scaffold.

   Conclusion. Scaffolds Absorb BVS have smoother and more complete neointimal coverage at 12-month follow-up compared to Xience V/Xience Pro metal stents. At the same time, arteries at the sites of implantation of Absorb BVS scaffolds have a significantly greater tendency to form big protrusions of the vascular wall – evaginations. The formation of these evaginations can explain greater tendency to thrombosis of the coronary arteries in the area of the implanted device. With scaffold degradation the number and volume of evaginations decreases, so we can expect a decrease in the number of possible negative outcomes.

   The aim is to study the effect of sleep disorders on the degree of deterioration of military work productivity.

   Methods. The study involved 14 men aged 24 to 42 years old fit for military service for health reasons. At the preliminary stage of the survey, 26 people participated: all participants kept a sleep diary for a week and filled out a Horne-Östberg questionnaire to determine the chronotype. Persons with sleep disorders during the previous 2 weeks and extreme variants of the chronotype “purely evening” and “purely morning” chronotype (12 people) were excluded from the study. The effect of sleep deprivation was explored using a pilot study technique. The protocol assumed a double examination of each of the subjects: 1 – the initial examination (in the morning, after proper rest), 2 – the follow-up examination (in the morning, after night duty in conditions of complete sleep deprivation). The examination involved psychophysiological diagnostic methods: determination of the time and characteristics of characteristics of a simple visual-motor reaction and complex visual-motor reactions on the Psychotest computer-aided complex (Neurosoft Company, Russian Federation).

   Results. The study was performed on the Psychotest equipment (Neurosoft company, Russia). Working in the conditions of sleep deprivation led to a deterioration in the results of all the tests used, except for the indicators of the functional level of the system in the “Noise immunity” test and the preservation of the parameters of decision-making time (DMT), which confirms the preservation of the mobilization readiness of the central nervous system. The indicators in conditions of proper sleep and in case of sleep deprivation were as follows, respectively. Simple hand-eye reaction (217; 229), complex hand-eye reaction (306; 322), attention (221; 280), noise immunity – RT (248; 297). The analysis of the obtained data was carried out using standard methods of mathematical and statistical processing using the Statistica 10.0 program and the built-in mathematical functions. Nonparametric criteria were used for statistical processing of the results: the Mann-Whitney criterion, the Wilcoxon criterion. For all criteria and tests, the value of the critical significance level was assumed to be 0.05, i. e. the differences were recognized as statistically significant at p ≤ 0.05.

   Conclusions. They being associated with general fatigue after night duty, we noticed a number of impaired psychophysiological indicators characterizing the speed and accuracy of the reaction. The number of mistakes made when performing a difficult task increased, but the mobilization readiness of the central nervous system persisted, which was probably due to the high level of professionalism of the individuals.

   Aim. To estimate the level of cardiac biomarkers and metalloproteinases (MMPs) in breast cancer patients’ plasma 12 months after the end of chemotherapy (CT) with doxorubicin; to determine the relationship between changes in their level and the occurrence of early cardiotoxicity (CT) taking into account arterial hypertension (AH) and the prescription of cardiotropic therapy (CTT).

   Materials and methods. The study involved patients with a confirmed diagnosis of breast cancer. Before and 12 months after the end of chemotherapy, the level of MMPs and cardiac markers in blood plasma were determined using the enzyme immunoassay method.

   Results. A statistically significant increase in the level of cardiac troponins (TnI, TnT) and a decrease in NT-proBNP in the CT+ and CT- subgroups 12 months after the end of chemotherapy with doxorubicin were revealed. Differences between CT+ and CT- were detected only for TnI hs (2.8 times, p = 0.011). In the CTT+ subgroup, no statistically significant differences were observed between the level of the studied parameters in KT+ and KT-. The differences identified without taking into account CTT remained in the subgroup of CTT- patients. The level of TnI hs in CT+ and CTT+ patients was lower (median 6.7 pg/ml) compared to KT+ and KTT- (median 16.8 pg/ml). An increase in the level of MMP-2 and a decrease in MMP-9 and MMP-3 were observed in patients in the CT+ and CT- subgroups. The median values of MMP-3 level in the CT+ subgroup were statistically significantly lower than those in the CT- subgroup by 16.6 % (p = 0.021). In CTT+ there were no statistically significant differences between the level of MMP in CT+ and CT-, but in case of CTT- the level of MMP-3 was statistically significantly different in the CT+ and CT- subgroups. There was no relationship between the level of MMP and hypertension before the start of chemotherapy.

   Conclusion. An increased level of plasma TnI hs and a decreased level of plasma MMP-3 12 months after the end of chemotherapy hold the potential to reveal the early signs of CT. The sensitivity and specificity of potential markers increase in patient groups not receiving CTT. It was confirmed that there was no connection between the presence of hypertension in patients, the level of the studied biochemical parameters and CT.

   The article presents a clinical case of heart conduction system pacing (left branch of bundle (LBB)area) after radiofrequency ablation (RFA) of an accessory pathway with rare localization and features (Maheim tract) in a patient with atrioventricular block (AV-block) and arrhythmogenic cardiomyopathy. We have also covered the issues of diagnosis and management of the ventricular pre-excitation syndrome determined by Maheim tract and prospects of the new method of physiological electrocardiostimulation, i. e. of LBB areapacing.

   In order to improve the diagnosis of arrhythmogenic cardiomyopathy (ACM) in 2023, leading European experts validated new recommendations and a consensus report with augmented criteria for diagnosis of ACM (based on modified ITF criteria 2010 and Padua criteria 2020). The article highlights the crucial aspects of diagnosis and practical experience of novel criteria for the recognition of various phenotypes of ACM.

   In recent years, much attention has been paid to the excellent oxygen transport properties of Hemoglobin-based oxygen carriers (HBOCs), which deliver oxygen to organs and tissues via arterial blood by binding oxygen and carbon dioxide via venous blood back to the lungs for respiratory elimination from the body. Studies have shown that HBOCs, which are characterized by low immunogenicity, little risk of hemolytic reaction, low viscosity, and enhanced diffusive oxygen transport, can show excellent results in clinical applications in the field of organ transplantation. Early HBOCs generations had a short intravascular circulation life-time, could cause vasospastic and toxic side effects induced by free hemoglobin circulation. Polymerization of hemoglobin molecules significantly increased the size of acellular hemoglobin, thus minimizing the extravasation and prolonging their half-life in intravascular circulation, and was considered to be the key factor in mitigating the vasoconstriction effects.

   The aim of this paper is to provide an in-depth review of the current status of research and application of HBOCs in organ transplantation, as well as to look forward to their future application in this field.

   The article presents contemporary domestic and foreign literature data on the variant anatomy of the aortic and pulmonary semilunar leaflets. The anatomical features shown include the differences in the structure and number of semilunar leaflets, of their structural asymmetry, and the variation in morphometric characteristics. Attention is given to the changes in anatomical terminology since 2019, which now distinguishes the valvular complex of the heart, consisting of the fibrous skeleton of the heart, atrioventricular valves, and the roots of the aorta and pulmonary trunk. It is shown that there is a limited amount of data in the literature regarding the sizes and positions of nodules on the semilunar leaflets of the aortic and pulmonary valves. The article focuses on the prevalence of openings and their morphometric characteristics in the semilunar leaflets of the studied valves. Histological features of the semilunar leaflets are presented, which include thickening and changes in cellular and fibrous composition depending on the age of the individual.

   Anxiety-depressive disorders (ADD) are often found in patients with cardiovascular diseases (CVD). ADR reduces the quality of life, aggravates the course, increases the risk of complications of CVD. Timely diagnosis and effective treatment of ADR is most effective in primary healthcare. The article describes the characteristics of psychosomatic comorbidity in patients with various cardiac diseases, presents the features of the diagnosis and treatment of ADR in patients with CVD.

   The original meaning of the word medicine is to know, understand, comprehend, and distinguish. It is the comprehension and understanding of the processes occurring in the patient’s body that is the basis for recognizing the disease and choosing treatment for the disease. Modern medical science has two forms: medicine itself as the treatment of a sick person and healthcare as a complex of public organizational and managerial measures aimed at maintaining public health. Given the undoubted synergy of these two humanitarian foundations, it should be recognized that the dominance of social forms of medicine has an inhibitory effect on individual medicine. At the same time, individual health care is a priority for the individual. Modern scientific opinions are based on stereotypes derived from statistical conclusions, and not on an understanding of the pathogenetic mechanisms of diseases and their healing. This is largely facilitated by the uncontrolled circulation of unprofessional pseudoscientific information on the Internet and the media. As a result, ideas about the essence of diseases and methods of therapy are formed in the form of primitive clichés of the “good and bad” type. Such stereotypes include views on oxidative processes in the body and especially on antioxidants: “Reactive oxygen species are very bad, antioxidants are good.” In this article we would like to present a scientific point of view on this issue, drawing on the achievements of physiology and biochemistry, especially since this section of science is intensively developing at the present time.