Aleksey Simion

@vrngmu.ru

Assistant Professor of the Department of Faculty Therapy
N.N. Burdenko Voronezh State Medical University

Aleksey Simion


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https://researchid.co/alex199478

RESEARCH, TEACHING, or OTHER INTERESTS

Multidisciplinary
4

Scopus Publications

Scopus Publications

  • Expanding the concept of chronic obstructive pulmonary disease: The concept of Preserved Ratio Impaired Spirometry (PRISm)
    A. V. Budnevsky, S. N. Avdeev, O. S. Saurina, A. Yu. Simion
    Meditsinskiy Sovet, 2025
    Introduction. Chronic obstructive pulmonary disease has a high prevalence, morbidity and mortality, which makes the problem of early diagnosis of precursor conditions, including PRISm, relevant. Despite the growing interest in PRISm, the pathogenesis and clinical consequences of this condition remain poorly understood. Aim. To conduct а search and analysis of scientific data on PRISm, including epidemiology, pathogenesis, diagnostics, and the relationship of this condition with other diseases. Mat erials and methods. The material was searched in the electronic databases eLIBRARY.ru, CyberLeninka, PubMed, Cochrane Library for 2009–2025 by keywords. Publications of the results of original studies were selected for analysis. Results. Analysis of modern research results indicates that PRISm is a heterogeneous condition characterized by a decrease in FEV₁ (<80%) with a preserved FEV₁/FVC ratio (>70%). The prevalence of PRISm varies from 3 to 20% and is associated with risk factors such as smoking, obesity, air pollution, metabolic disorders (eg, type 2 diabetes mellitus), and genetic predisposition. Pathogenetic mechanisms include restrictive changes (fibrosis, decreased lung tissue compliance), systemic inflammation (increased IL-6, TNF-α levels), and oxidative stress. PRISm is associated with an increased risk of progression to COPD, cardiovascular disease, and all-cause mortality, which emphasizes its clinical significance. Conclusion. PRISm is a heterogeneous and clinically significant condition that requires a multidisciplinary approach to diagnosis and treatment. Further research is needed to clarify its pathophysiology, develop standardized diagnostic criteria, and personalized therapeutic strategies. The results of current scientific research emphasize the importance of early detection of PRISm to improve patient prognosis.
  • The six-minute walk test prognostic value in heart failure patients
    R. E. Tokmachev, A. V. Budnevsky, A. V. Kontsevaya, A. Ya. Kravchenko, A. A. Natarov, A. Yu. Simion, M. S. Kostrykina
    Meditsinskiy Sovet, 2025
    Introduction . Heart failure is one of the most common non-communicable diseases. A non-invasive stress test for diagnosing this disease is the six-minute walk test. This research method is a promising method for determining the heart failure prognosis. Aim . To analyze scientific data on the assessment of the six-minute walk test prognostic role in heart failure patients. Materials and methods. The material was searched in the electronic databases eLIBRARY.ru, CyberLeninka, PubMed, Cochrane Library by keywords. Publications of the original studies results were selected for analysis. Results . The review summarizes the current research results reflecting the six-minute walk test prognostic value in heart failure patients. The results of large international studies indicate the a relationship existence between the test indicators and the disease clinical outcomes. It has been established that a decrease in the traveled distance is reliably associated with an increased risk of death and the hospitalizations frequency. Particular interest are the data confirming the determining possibility the traveled distance clear prognostic threshold values. These data will allow differentiating patients with different risk levels and can serve as an important guideline for making clinical decisions. At the same time, the results comparison of the six-minute walk test with other, new and accurate methods for assessing physical activity, shows the data comparability, which allows using this method for research and clinical purposes. Conclusion. The six-minute walk test, being a well-studied diagnostic method, does not lose its relevance. The test methodology does not require costs, expensive equipment, participation of narrow specialists, while it is well tolerated by most patients and can be widely used to determine the prognosis, risk of death / hospitalization due to heart failure decompensation. At the same time, modern technologies make it possible to simplify the procedure for its implementation, including remotely from medical institutions.
  • The influence of physical rehabilitation of patients on the course of chronic heart failure
    R. E. Tokmachev, A. Ya. Kravchenko, A. V. Budnevsky, А. V. Kontsevaya, A. Yu. Simion, et al.
    Meditsinskiy Sovet, 2024
    I Intriduction. Complex rehabilitation programs makes an important role in improving exercise tolerance and patients functional status with cardiovascular pathology. Aim. To study the physical rehabilitation effect on the functional status, pro-inflammatory cytokines levels and cardiovascular inflammation biomarker (high-sensitivity C-reactive protein) in heart failure patients with different ejection fractions. Materials and methods. The study included 160 patients with chronic heart failure (84 men and 76 women, mean age 69.4 ± 8.8 years). Two groups of patients with preserved and reduced left ventricular ejection fraction were identified. The groups were divided into two subgroups: the first – those who underwent physical rehabilitation for a year and received standard drug therapy; the second one received exclusively standard drug therapy. At inclusion and after a year of observation, patients were examined: determination of functional status, levels of pro-inflammatory cytokines, serum hs-C-reactive protein, NT-proBNP. Results. Regardless of left ventricular ejection fraction, in the studied patients subgroups undergone physical rehabilitation, a statistically significant decrease in the proinflammatory cytokines levels, NT-proBNP and hs-C-reactive protein was noted. The study also demonstrated the physical rehabilitation beneficial effects on the patients with HF functional status. Thus, the distance walked within 6 minutes and its relation to the proper indicator in patients who underwent physical rehabilitation increased in comparison with the initial indicators during the initial examination of patients and in comparison with control subgroups. This may indicate the positive properly selected physical activity impact on circulatory compensation and the HF course. Conclusion. Carrying out physical rehabilitation for chronic heart failure leads to an improvement in functional status, a decrease in the NT-proBNP, pro-inflammatory cytokines and high-sensitivity C-reactive protein level in comparison with the results of managing patients on drug therapy (without rehabilitation).
  • Features of the course of stable exertional angina against the background of iron deficiency anemia in outpatient practice
    A. Yu. Simion, A. V. Budnevsky, Е. S. Ovsyannikov, N. E. Nekhaenko, Н. И. Остроушко, et al.
    Meditsinskiy Sovet, 2023
    Introduction. Iron-deficiency accompanies many diseases, including cardiovascular pathology, so timely diagnosis and correction of this condition is necessary. Aim. To study the features of the course of stable exertional angina against the background of iron deficiency anemia before and after correction with iron (III) polymaltose hydroxide in patients in primary health care using a computerized patient register. Materials and methods . 1210 patients with stable exertional angina aged 50–85 years (309 men, 901 women) were included. A special computer program was created for data analysis. In 500 out of 1210 patients, IDA was detected (385 women, 115 men). Mild anemia – 410 patients, moderate – 75, severe – 15. The main group – patients with stable exertional angina and Irondeficiency anemia (the first subgroup – patients treated with iron (III) polymaltose hydroxide and the second subgroup – patients who did not receive the drug iron (III) polymaltose hydroxide due to refusal of treatment or contraindications) and the control group – patients with stable exertional angina without Iron-deficiency anemia. All patients received standard therapy recommended for the treatment of stable exertional angina (the main group additionally received iron (III) polymaltose hydroxide). Results. In the first subgroup of the main group, after treatment with iron (III) hydroxide polymaltose, there was a statistically significant increase in hemoglobin levels by 11,7%, hematocrit by 5%, erythrocytes by 4%, serum iron by 112,8%, and an improvement in exercise tolerance by 48,7%, episodes of ST segment depression by 30,2%. In the second subgroup and the control group, there were no significant changes in the above parameters. Conclusion. Iron-deficiency anemia contributes to the severe course of stable exertional angina, which is confirmed by the high frequency of III-IV functional class exertional angina, a decrease in tolerance to exercise stress. Correction of Iron-deficiency anemia reduces the frequency of episodes of transient myocardial ischemia in the main group.