Complex Issues of Cardiovascular Diseases最新文献

{"title":"ANATOMICAL FEATURES OF THE CARDIAC VENOUS SYSTEM, SIGNIFICANT FOR THE LEFT VENTRICULAR LEAD PLACEMENT: LITERATURE REVIEW AND EXPERIENCE","authors":"Oleg L. Dubrovin, S. Mamchur, P. Shugaev","doi":"10.17802/2306-1278-2023-12-2-96-106","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-2-96-106","url":null,"abstract":"HighlightsThe article is a comprehensive literature review on anatomical variations and anomalies of cardiac veins. A classification of coronary venous anatomy and anomalies detailing clinical, anatomical and radiological features is proposed. Developing such classification is important for the field of left ventricular lead placement, as it would cover a variety of clinically significant anomalies of cardiac veins. AbstractWith the advancements in the cardiac resynchronization therapy, the role of cardiac vein anatomy has become vital due to the complications associated with poor left ventricle lead placement. The cardiac vein anatomy varies much more than the anatomy of the coronary arteries, thus making cardiac veins much harder to study. In this article we have analyzed different approaches to description and naming of cardiac veins, and have summarized venous anomalies and features described in literature or encountered in real clinical practice. All anatomical features described in the article have a clinical significance in the left ventricle lead placement. Moreover, we have analyzed the wide variety of suggestions to overcoming anatomical obstacles. As a result of the analysis, we have proposed a clinical classification of the coronary venous anomalies and features that can be used during the implantation of cardiac resynchronization therapy devices.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125983301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary-coronary bypass grafting in a child with a stab wound of the anterior interventricular artery","authors":"","doi":"10.17802/2306-1278-2023-12-1-181-185","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-181-185","url":null,"abstract":"Highlights. A successful case of surgical treatment of a child with a stab wound of the heart and damaged anterior interventricular artery is presented.Abstract. A girl aged 5 years and 9 months was admitted to the hospital in extremely severe condition with multiple stab wounds to the chest and left shoulder and massive bleeding. The child was immediately taken to the operating room due to hemorrhagic shock and injury localized in the anatomical area directly affecting heart function. The wound in the projection of the interventricular sulcus was repaired with one U-shaped suture, hemodynamics was stabilized by inotropic agents. In the postoperative period, heart failure developed due to akinesia of the apical segments, anterior, lateral and anterolateral walls, and reduced ejection fraction. An emergency coronary angiography revealed an occlusion of the anterior interventricular artery (AIV). Emergency repeated surgical intervention was performed. We diagnosed complete intersection of AIV with thrombosis in the proximal and distal segments. Surgical treatment of the coronary stumps enabled satisfactory antegrade and retrograde blood flow. End-to-end coronary-coronary bypass grafting with AIV grafting was performed on the beating heart. The postoperative period was uneventful. Active lifestyle, absence of complaints, and AIV being opaque, including autogenous graft, were reported in the long-term follow up. The presented case proves that effective diagnostic protocol, echocardiography data and appropriate choice of surgical technique led to a positive outcome.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114018600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic monitoring of morphological and hemodynamic evolution of small cerebral aneurysms","authors":"D. Tikhvinskii, Yu. O. Kuyanova, A. V. Bervitskiy, N. Obedinskaya, A. Tulupov, D. Parshin","doi":"10.17802/2306-1278-2023-12-1-172-180","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-172-180","url":null,"abstract":"Highlights. Small cerebral aneurysms (<3 mm), which make up the majority of aneurysms, rupture more frequently, although medium (>3 mm) and giant (>15 mm) aneurysms and have a higher risk of rupture. This article proves for the first time that the rupture risk criteria developed for giant cerebral aneurysms do not work for small aneurysms. The development of small aneurysms in patients was analyzed and measured morphological features of aneurysms were compared with their calculated hydrodynamic characteristics.Aim. To study the dynamics of development of small cerebral aneurysms, to assess the applicability of existing methods for calculating the risk of rupture, to formulate new clarifying hypotheses for calculating the risk of rupture of small cerebral aneurysms.Methods. Patient data were provided by the Federal Center for Neurosurgery, Novosibirsk. CT angiography was performed using a Philips Ingenuite CT scanner (Philips Medical Systems, USA, 128 slices). Aneurysm size dynamics was assessed by measuring three main sizes with an accuracy of 0.1 mm using the IntelliSpace Portal Philips software environment. Numerical calculations were carried out using ANSYS CFX 2020R2.Results. Hemodynamic characteristics change according to the changes of the aneurysm dome. In the case when morphological characteristics of the aneurysm have not changed, a change in the geometry of the patient's circle of Willis (coW) is observed: the curvature of the arteries, the angles of bifurcations (the structure of coW remained unchanged). The PHASES score (absolute risks of rupture for aneurysms) was found to be unusable for the considered aneurysms.Conclusion. This work formulates and morphologically and hydrodynamically confirms for the first time in the volunteers that the change in risk estimates for such aneurysms is fundamentally affected, even insignificantly, by the change in the circle of Willis: a change in the curvature of individual segments of the cerebral arteries, as well as the angles of their bifurcations. The results obtained are aimed at modifying the existing risk criteria for rupture of cerebral aneurysms.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123191860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of coronary bypass grafting supplemented with surgical stimulation of extracardiac myocardial vascularization in patients with diffuse coronary artery disease","authors":"Y. Shevchenko, G. Borshchev, D. S. Ulbashev","doi":"10.17802/2306-1278-2023-12-1-160-171","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-160-171","url":null,"abstract":"Highlights. In recent decades, the number of patients with diffuse, multivessel coronary artery disease has increased due to widespread use of endovascular methods of treatment, long-term conservative management of patients, and the expansion of indications for surgical revascularization. In order to improve the results of treatment, in 2007 academician Yu. L. Shevchenko developed and began using the method of stimulation of extracardiac angiogenesis – «YurLeon». The present article demonstrates the long-term results of supplementing coronary bypass surgery with this method in patients with diffuse coronary artery disease.Aim. To evaluate long-term results of coronary bypass surgery supplemented by extracardiac myocardial revascularization.Methods. The prospective, randomized study included 205 patients with diffuse, multivessel coronary artery disease who were treated at the St. George Thoracic and Cardiovascular Surgery Clinic, National Medical and Surgical Center named after N.I. Pirogov. The majority of patients were men – 75% (n = 153), whereas women accounted for 25% (n = 52), all patients were 60 to 78 years old (67.3±5.74 years). The group I consisted of patients with coronary bypass surgery supplemented with the «YurLeon» technique, the group II consisted of patients with coronary bypass grafting only. All patients provided consent to participate in the study. The clinical condition of patients, echocardiography, myocardial scintigraphy and coronary angiography data, quality of life indicators (the 36-Item Short Form Health Survey) were assessed.Results. In the long-term postoperative period (36 months), the group I, compared with the group II, presented with a statistically significant decrease in the functional class of angina pectoris (1[1–2] vs. 2[1–2], p = 0.02); fewer adverse events: myocardial infarction (4.5% vs. 11.6%, p = 0.011), recurrent angina pectoris (10% vs. 17.9%, p = 0.038); an increase in the left ventricular ejection fraction (59.0±5.15% vs. 53.2±6.13%, p = 0.001); a decrease in the Summed Rest Score (SRS) (4.5±3.5 vs. 8.4±5.7, p = 0.012) according to myocardial scintigraphy with technetril; a decrease in the Summed Thickening Score (STS) (6.1±3.3 vs. 10.7±2.9, p = 0.012); a decrease in the hibernating myocardium (3.5±2.2% vs. 7.4±5.1%, p = 0.03); additional extracardiac sources were found in the group I according to coronary graft angiography, there were no statistically significant differences between the groups by occluded autogenous venous bypass grafts (in the group I – 23 out of 46 venous conduits (49%), in the group II – 30 out of 49 venous conduits (51%), p = 0.089); The groups differed in terms of quality of life (the 36-Item Short Form Health Survey): physical functioning (87.3±10.32 vs. 75.3±14.15 points, p = 0.001); role-based functioning due to physical condition (90.1±10.50 vs. 79.7±7.01 points, p = 0.012); pain (93.10±6.37 vs. 80.5±5.21 points, p = 0.03); the total physical component of health (57.9±5.4","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126664025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient management of patients with peripheral artery disease by cardiologists or surgeons: influence on the prognosis and prevalence of surgical interventions","authors":"A. N. Sumin, Yu. D. Medvedeva, A. V. Shcheglova, S. Ivanov, L. Barbarash","doi":"10.17802/2306-1278-2023-12-1-142-150","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-142-150","url":null,"abstract":"Highlights. The study shows for the first time that during the three-year follow-up of patients with diseases of the arteries of the lower extremities in the observation groups of a general surgeon and a cardiologist, adverse events (myocardial infarction, stroke, amputation, disability) and deaths occurred more often in a surgeon than a cardiologist. The study proves the correctness and real benefit of such an approach with the involvement of a cardiologist to the outpatient stage of management of a complex cohort of patients with atherosclerosis of the vessels of the lower extremities.Aim. To study the effect the outpatient observation of patients with peripheral arteries disease (PAD) by cardiologists and surgeons has on timing and prevalence of reconstructive surgery and the prognosis of patients. Methods We analyzed the data on 585 PAD patients who underwent outpatient observation from 2010 to 2017, dividing them into 2 groups. The first group (131 patients) managed by an surgeon; the second (454 patients) managed by a cardiologist. Since the groups were not comparable in terms of the initial parameters, the comparability of patients in the groups (observation by a surgeon or by a cardiologist) was achieved using pseudorandomization. The follow-up period was three years; we assessed the incidence of deaths, adverse events, and the prevalence of reconstructive operations.Results. During a three-year follow-up the 1st group, compared with the 2nd, had more deaths in general (p<0.001), death from cardiac causes (p = 0.045), from stroke (p><0.001), as well as the total number of adverse events (p><0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients. Conclusion Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries. Keywords Peripheral atherosclerosis • Outpatient follow-up • Optimal drug therapy • Reconstructive surgery>˂ 0.001), death from cardiac causes (p = 0.045), from stroke (p˂ 0.001), as well as the total number of adverse events (p˂ 0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients.Conclusion. Observation of PA","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121843153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dural sinus thrombosis: pre- and postnatal MRI observation","authors":"A. Korostyshevskaya, A. M. Gornostaeva, A. Makogon, A. Khalikov","doi":"10.17802/2306-1278-2023-12-1-135-141","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-135-141","url":null,"abstract":"Highlights. The clinical case report describes the important role of MRI in the perinatal diagnosis of dural sinus thrombosis, timely verification of the diagnosis, differential diagnosis with other vascular and tumor formations of the brain.Abstract. Dural sinus thrombosis (DST) is a rare congenital anomaly. Ultrasound findings usually mimic intracranial tumors. As a result, the condition is often misdiagnosed and its frequency in general population is underestimated. According to literature data, the progression of DST is a favorable prognosis in case of absence of other concomitant pathologies of the fetal brain. We present a case of DST that was detected with ultrasound, and verified by numerous pre and postnatal MRI starting from 22 weeks of gestation till 4 years of life. A case with a favorable neurological outcome, postnatal ventriculosubgaleal shunting, and ventriculoperitoneal shunting was followed with MRI and CT before and after interventions. The aspects of differential diagnosis, factors determining prognosis are presented. The presented case demonstrates a significant role of fetal MRI in DST diagnosis, depiction of the internal structure of the expanded sinus, and exclusion of concomitant pathology of the brain. These MRI data are integral in determining the appropriate perinatal management, and can be used as predictors of the favorable neurological outcome despite of the severity and size of prenatally diagnosed DSТ.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122158812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of coronary artery bypass grafting and percutaneous coronary intervention in high-risk non-ST-segment elevation acute coronary syndromes","authors":"A. B. Nishonov, R. Tarasov, S. Ivanov, L. Barbarash","doi":"10.17802/2306-1278-2023-12-1-151-159","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-151-159","url":null,"abstract":"Highlights. Despite high hospital mortality after coronary bypass grafting in patients with high-risk non–STsegment elevation acute coronary syndrome, surgical myocardial revascularization remains a preferable treatment modality since percutaneous coronary intervention in these patients is associated with high perioperative complications due to severely calcified coronary lesions.Background. The optimal revascularization strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains the subject of many years of controversy. Coronary artery bypass grafting (CABG) improves the long-term prognosis through complete revascularization, however, percutaneous coronary intervention (PCI), due to its availability and low invasiveness, suggests an improvement in hospital outcomes.Aim. To compare hospital outcomes of CABG and PCI performed within 24 hours in high-risk NSTE-ACS patients.Methods. In the present study, the first group included 30 NSTE-ACS patients who underwent CABG in the first 24 hours (the CABG group), whereas 30 NSTE-ACS patients who underwent PCI were included in the second group (the PCI group).Results. The mean age was 64,4±7,3 years, it was comparable in both groups. The main clinical and anamnestic characteristics of patient in both groups were comparable as well. The severity of coronary atherosclerosis according to the Syntax score was 25,6±9,2 in the CABG group, and 21,7±5,7 in the PCI group (p = 0,054). After revascularization, the residual Syntax score did not differ between the groups (p = 0,42), indicating complete revascularization. Hospital mortality was relatively high in the CABG group (13,3%), while no such cases were noted in the PCI group. Most of the patients with adverse outcomes had a critical lesion of the left main coronary artery and a complicated postoperative course.Conclusion. The results of this study demonstrate promising outcome of CABG in patients with severe multivessel coronary disease at high risk of adverse events.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116846267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial appendage exclusion using a stapler with thoracoscopic ablation of atrial fibrillation","authors":"A. Revishvili, M. Kadirova, E. Strebkova, E. S. Malishenko, M. Novikov, E. V. Yalova, K. A. Babadjanova, K. E. Bandurko, G. Karmazanovsky","doi":"10.17802/2306-1278-2023-12-1-58-71","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-58-71","url":null,"abstract":"Highlights. Stroke prevention in patients with atrial fibrillation is extremely important and difficult. Lifelong anticoagulant therapy is not always an effective way of preventing thrombosis in the left atrial appendage in this group of patients. In this regard, one of the most urgent problems of modern surgical arrhythmology and cardiac surgery is the search for new open and minimally invasive surgical methods of excluding the left atrial appendage from the blood flow.Aim. To investigate the safety and efficacy of using the left atrial appendage stapler for video-guided thoracoscopic ablation (TSA) of non-valvular atrial fibrillation (AF).Methods. The retrospective, single-center study included 100 patients with non-valvular AF who underwent video-guided thoracoscopic ablation of AF with single-stage left atrial appendage exclusion using an Endo GIA stapler (Medtronic, Minneapolis, Minnesota, USA).Results. The mean age of the patients was 56,2±8,8 years, the majority of the patients (73 patients, 73%) were male. Patients with persistent 50 (50%) AF and longstanding AF 50 (50%) were included in the study. The duration of atrial fibrillation was 4 (1,7–7) years. The median CHA2DS2-VASc and HAS-BLED scores were 2 (1–1,5) and 1 (0-1), respectively. The mean anticoagulation therapy-to-ablation time was 4,2±1,9 years. Thirty-eight (38%) patients were prescribed warfarin preoperatively. The completeness of left atrial appendage (LAA) exclusion was confirmed by intraoperative transesophageal echocardiography. The average length of the staple lines was 48 (35–75). A single left atrial appendage exclusion was performed using a 60 mm staples. In 12 (12%) patients, stapler exclusions were performed using two 45 mm staples due to insufficient staple length. None of the patients had ruptures, punctures along the staple lines or rupture of the surrounding epicardial tissue. Anticoagulant therapy was discontinued 6 months after TSA in 70 (70%) patients with sustained sinus rhythm observed on 24-h Holter Monitoring, satisfactory CHA2DS2-VASc scores and after confirmation of absence of left atrial thrombus by transesophageal echocardiography and contrast-enhanced MSCT. No strokes were reported within 1,2±0,7 years after discontinuing anticoagulation therapy.Conclusion. Exclusion of LAA using a stapler for TSA is a highly effective and safe technique for patients with non-valvular atrial fibrillation compared to alternative methods of excluding the LAA from the systemic blood flow.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121226959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of orthostatic test (or verticalization) on the blood flow through the internal jugular and vertebral veins","authors":"M. Shumilina, D. V. Kolesnik","doi":"10.17802/2306-1278-2023-12-1-39-48","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-39-48","url":null,"abstract":"Highlights. In the absence of venous pathology during verticalization, there is an increase in venous outflow both through the vertebral veins and through the internal jugular veins. In the absence of venous pathology, the internal jugular veins are the dominant route of venous outflow in clinostasis and orthostasis.Aim. To study the dynamics of venous outflow along the internal jugular veins (IJV) and vertebral veins (VV) during the transition from horizontal to vertical position.Methods. The study included 10 healthy women aged 24±2.91 years. Inclusion criteria were as follows: 1) optimal structure of the venous system, in which both of patient`s IJV are approximately symmetrical in cross-sectional area (CSA) and the intensity of the collapse, CSA of IJV exceeds CSA of the common carotid artery by 2–2.5 times, noticeable efficiency of valves during the Valsalva maneuver; 2) venous pressure (VD) in the brachial vein is 18–20 mm Hg. The exclusion criteria were: 1) a history of any disorders of cerebral circulation, symptoms of venous encephalopathy, vertebrobasilar insufficiency, compression of the neurovascular bundle when exiting the chest, arterial hypertension, any cervical spine pathology, hypertrophy and rigidity of the cervical and nodding muscles, 2) arterial pathology of brachiocephalic/intracranial arteries (stenosis, tortuosity, anomalies of the structure), 3) any cardiac pathology, 4) endocrine diseases. The study involved the method of triplex ultrasound with measurements of the cross-sectional areas of IJV, the diameters of VV, time-averaged mean velocity for volumetric blood flow (TAV) in clinostasis and orthostasis. Changes in volumetric venous outflow during verticalization of patients were evaluated as well.Results. In orthostasis, the mean CSA of IJV decreased from 0.862±0.043 cm2 to 0.19±0.024 cm2 , the mean TAV increased from 6.950±2.373 cm/s to 66,000±6.875 cm/s, the average volumetric blood flow increased from 5.952±2.006 mL/s to 12.425±1.559 mL/s. The mean TAV for VV during verticalization increased from 6,800±2.067 cm/s to 16,000±2.271 cm/s, and the average volumetric blood flow from 0.167±0.051 ml/s to 0.402±0.098 mL/s.Conclusion. In all cases, the volumetric blood flow along IJV dominated the volumetric blood flow along VV in clinostasis and orthostasis. In the absence of venous pathology, the dominant pathway of venous outflow in clinostasis and orthostasis are IJV.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115502294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of twisting mechanisms in childhood: a modern view on the nature of left ventricular rotational mechanisms","authors":"E. N. Pavlyukova, M. V. Kolosova, A. I. Unasheva, R. Karpov","doi":"10.17802/2306-1278-2023-12-1-94-106","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-94-106","url":null,"abstract":"Highlights. The hypothesis of the evolution of LV twisting types is proposed, which is based on the gradual transformation of LV twisting types as a prerequisite for postnatal growth and development of heart chambers in healthy children and adolescents. In the future, the transition of one type of LV twist to another will enable us to diagnose the predominance of growth and maturation of the fibrous skeleton, apex, vortex cordis, trabecular apparatus, as well as creating projections of the individual development and growth of the heart in childhood and adolescence.Abstract. Modern data on the nature of the mechanics of the left ventricle (LV) in postnatal ontogenesis in healthy children and adolescents born full-term are fundamental, since they allow not only to determine ontogenetically conditioned variants of individual development of contractile-rotational mechanisms of LV in the process of growth and development, but also, if necessary, make it possible to identify subclinical dysfunction in the early stages, monitor the effectiveness of complex therapeutic and rehabilitation measures. The article analyzes newly established fact of the absence of static character of the selected various forms of LV twisting into a systole and the ability of their transformation in the process of growth and development. This fact forms the basis of the author's original hypothesis of “the evolution of LV twisting models”, which provides the optimal ontogenetic growth of the child and adolescent heart in the postnatal period. The hypothesis of “evolution of left ventricular twisting types” is based on modern knowledge about multifaceted processes at the tissue level, the mechanics of LV in the individual rate of development and growth of the heart in childhood and adolescence.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114785193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}