Complex Issues of Cardiovascular Diseases最新文献

{"title":"Assessment of disorders of hemodynamics and csf dynamics in idiopathic intracranial hypertension syndrome according to MRI data","authors":"O. Bogomyakova, G. Valova, A. Khe, A. Cherevko","doi":"10.17802/2306-1278-2023-12-1-84-93","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-84-93","url":null,"abstract":"Highlights. An increase in the pulsatility index of intracranial venous blood flow and cerebrospinal fluid flow at the foramen magnum level, and a decrease in arteriovenous delay and an intracranial compliance index indicate disturbances in the pulse wave distribution, and a decrease in compliance/extensibility of the brain due to increased intracranial pressure.Aim. To assess the parameters of hemodynamics and cerebrospinal fluid dynamics in patients with idiopathic intracranial hypertension syndrome according to phase-contrast MRI.Methods. The study included 18 patients with idiopathic intracranial hypertension syndrome and 20 controls, all patient were examined using the Ingenia 3,0T MRI scanner. The analysis was performed using phase-contrast MRI to assess quantitative parameters of hemodynamics and cerebrospinal fluid (CSF) dynamics in 14 different structures. The blood and CSF volumes, pulsatility index (PI), arterio-venous delay, and intracranial compliance index were calculated. The Mann-Whitney U-test reliability was used to assess the differences between the controls and patients.Results. The group of patients had an increased CSF systolic peak at the foramen magnum without significant changes in CSF volume, and significantly increased CSF PI at the cervical level by 11.88% (p<0,05). There was a tendency toward an increase in the intracranial venous blood volume, as well as a tendency toward significant increase in PI at the straight and superior sagittal sinuses by 1,3 times (p><0,01, p><0,05). Moreover, there was a reduction of intracranial arterio-venous delay by 1,9 times (p><0,05), and a significant decrease in the intracranial compliance index by 1,2 times (p><0,05). Conclusion We have assessed the parameters of hemodynamics and CSF dynamics in patients with idiopathic intracranial hypertension and revealed disturbances in CSF dynamics and pulse wave propagation in the intracranial regions. Such changes may indicate a decrease in compliance/increase in stiffness of the brain tissue due to an increase in intracranial pressure and a possible diffuse stagnation of interstitial fluid. Keywords Phase-contrast magnetic resonance imaging • Central nervous system • Idiopathic intracranial hypertension • Hemodynamics • Cerebrospinal fluid dynamics • Intracranial compliance index>˂0,05). There was a tendency toward an increase in the intracranial venous blood volume, as well as a tendency toward significant increase in PI at the straight and superior sagittal sinuses by 1,3 times (p˂0,01, p˂0,05). Moreover, there was a reduction of intracranial arterio-venous delay by 1,9 times (p˂0,05), and a significant decrease in the intracranial compliance index by 1,2 times (p˂0,05).Conclusion. We have assessed the parameters of hemodynamics and CSF dynamics in patients with idiopathic intracranial hypertension and revealed disturbances in CSF dynamics and pulse wave propagation in the intracranial regions. Such changes may indicate a decrease in comp","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114842411","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":"Ultrasound and magnetic resonance of extrinsic stenosis and hypoplasia of internal jugular veins","authors":"S. Semenov, D. Bondarchuk, I. Malkov, M. Shatokhina","doi":"10.17802/2306-1278-2023-12-1-72-83","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-72-83","url":null,"abstract":"Highlights. Ultrasound and MR venography of internal jugular veins in case of unilateral cerebellar hypoplasia or extrinsic stenosis enables noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.Aim. To compare the visual and hemodynamic characteristics of ultrasound and magnetic resonance venography of extrinsic stenosis and hypoplasia of internal jugular veins (IJV).Methods. Ultrasound and magnetic resonance (MR) venography were performed in 47 patients with extrinsic stenosis and 23 patients with hypoplasia of one of internal jugular veins, and in the control group (30 patients).Results. In case of obvious vein compression and deformation and local stenosis (65% on average), there is a decrease in the vein cross-sectional area by 2 times compared with the contralateral vein, the blood flow velocity in the stenotic vein in acute cases increases (on average, up to 45 cm/s), and in chronic cases it significantly (p = 0.00001) decreases (to 13 cm/s on average). The criteria for hypoplasia are the small caliber of the vein (on average 0.22 cm², within the range of 0.13–0.46 cm²) throughout its entire length - with the cross-sectional area not exceeding that of the common carotid artery, and the vein being 4 times smaller than IJV on contralateral side, as well as a significant (p = 0.0006) velocity increase on the contralateral side (on average 40.9±12.52 cm/s) with normal velocity in the hypoplastic vein. Ultrasound assessment of the arterial-venous balance (AVB) makes it possible to evaluate the contribution of each IJV to the outflow of venous blood from the brain separately. From the hypoplastic side it was only 11.01±6.72%, and from the stenotic side it was 18.22±17 42% on average, which is significantly (p = 0.000001) below the norm, but does not allow us to differentiate these conditions. The total AVB for IJVs on both sides was within normal values (65–85%), and the absence of a pronounced expansion of the vertebral veins during MR venography confirms their insignificant role in the compensatory mechanisms of ensuring adequate outflow of venous blood from the brain in cases of unilateral hypoplasia and extrinsic stenosis of IJV.Conclusion. Ultrasound and MR venography of internal jugular veins in cases of unilateral hypoplasia or extrinsic stenosis enable noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131063605","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":"Structure, place, and clinical efficacy of the interactive brain therapy (stimulation) technology in cerebrovascular diseases","authors":"A. Savelov, N. A. Khrushcheva, K. Kalgin, L. I. Kozlova, D. Bezmaternykh, M. E. Melnikov, K. Mazhirina, A. Shurunova, E. V. Predtechenskaya, M. Shtark","doi":"10.17802/2306-1278-2023-12-1-25-38","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-25-38","url":null,"abstract":"Highlights. Interactive brain stimulation is the next step in neurofeedback technology, it implies the possibility of volitional regulation of the hemodynamic response of specific brain region in order to transform entire brain network and obtain the desired clinical and behavioral dynamics in patients (subjects). One of the indications for using the technology is post-stroke movements disorders when the volitional influence is focused on the motor area of the brain.Background. Neurofeedback and closely related concepts of neural interface system and “interactive brain” are considered as the foundation for developing algorithms for controlling neuroplasticity. Interactive brain therapy (stimulation) is a recently developed type of neurofeedback therapy, which implies dependence of feedback on a hemodynamic response signal recorded by functional magnetic resonance imaging (fMRI). The technology focuses on the region of interest with good accuracy and enables teaching the subject to control the activity of both individual cerebral structures and the functional connectivity between them, causing behavioral metamorphoses.Aim. To demonstrate the study design involving interactive stimulation of secondary motor areas of the brain using a bimodal fMRI-electroencephalography platform, and to describe the dynamics of the motor networks during treatment in patients with hemiparesis in the early period of recovery from stroke.Methods. The study involved 11 patients who were trained to regulate the activity of the secondary motor area and premotor cortex of the affected hemisphere, receiving feedback on the fMRI signal and the activity of the mu- (8–13 Hz) and beta2 (18–26 Hz) EEG ranges of the areas of interest. The block-designed training consisted of 6 sessions (imagination of movement – rest) with an interval of 2–3 days. During treatment the dynamics of the hemodynamic response of the areas of interest was analyzed. In test sessions (before treatment, immediately after the end, and six months later) functional connections within the motor network were reconstructed and hand function was assessed (grip strength, Fugle-Meyer Assessment, Box and Blocks test).Results. Upon completion of treatment, an increase in grip strength and dexterity was achieved; there was an increase in the fMRI signal of the premotor cortex of the ipsilateral hemisphere, and a strengthening of the interhemispheric functional connectivity of the secondary motor areas.Conclusion. fMRI and the interactive brain therapy technology built on its basis, on the one hand, provide the technological foundation for the “interactive brain” and the transformation of spontaneous neuroplasticity into a controlled one, and on the other hand, serve as an important tool for monitoring the process of restructuring of cerebral networks after a stroke, providing the ability to record the emergence (or disappearance) of connectivity between brain regions, and to measure its strength in dynamics, that is,","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116501906","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":"Serum biomarkers and left ventricular mechanics in the diagnosis of diastolic dysfunction in patients with epicardial obesity","authors":"O. V. Gricenko, G. Chumakova, E. Bobrovskaya","doi":"10.17802/2306-1278-2023-12-1-6-15","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-6-15","url":null,"abstract":"Highlights. Patients with epicardial obesity develop myocardial fibrosis (the underlying mechanism of left ventricular diastolic dysfunction) the preclinical diagnosis of which is difficult to perform. In this regard, the search for non-invasive methods for diagnosing diastolic dysfunction at an early stage, including the methods of determining the serum level of biomarkers of heart failure and studying the parameters of left ventricular mechanics using speckle-tracking echocardiography, seems quite relevant.Background. Currently, the search for serum biomarkers and non-invasive methods for diagnosing diastolic dysfunction (DD) of the left ventricle (LV) at the preclinical stage in obese patients is relevant.Aim. To study the levels of heart failure biomarkers and their association with profibrotic factors and LV mechanics in patients depending on the presence of epicardial obesity (EO).Methods. Out of 143 men with general obesity, depending on the severity of EO, determined by the thickness of epicardial adipose tissue (tEАT), 2 groups of patients were identified: the EO (+) group with tEАT 7 mm or more (n = 70), and the EO (–) group with tEАT less than 7 mm (n = 40). The exclusion criteria from the study were: arterial hypertension, type 2 diabetes mellitus, coronary artery disease, and the presence of LVDD detected by echocardiography (echo). Levels of profibrotic factors (type I and type III collagen, procollagen type I C-terminal propeptide (PICP), matrix metalloproteinase-3 (MMP-3), transforming growth factor-β (TGF-β), vascular endothelial growth factor A (VEGF-A), sST2, and NT-proBNP were determined in all patients using enzyme immunoassay. With the help of speckle-tracking echocardiography, the mechanics of LV were analyzed.Results. The EO (+) group presented with increased sST2 level (22.11±7.36 ng/mL) compared to the EO (–) group (sST2 level 9.79±3.14 ng/mL (p<0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover, in the EO (+) group, a statistically significant relationship between sST2 and type III collagen was revealed (p = 0.01). When comparing the parameters of speckle-tracking echo, the EO group (+) presented with increased LV untwisting rate of –128.31 (–142.0; –118.0) deg/s-1 (p = 0.002), and increased time to LV peak untwisting rate of – 476.44 (510.0; 411.0) msec compared with the EO group (–) (p = 0.03). Moreover, a significant association between LV untwisting rate and sST2 level was revealed in the EO (+) group (r = 0.35; p = 0.02).>˂0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover,","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128671090","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":"Therapeutic angiogenesis as an advanced direction for potentiating the angiogenic effect of coronary artery bypass grafting","authors":"B. Oleynik, V. Plechev, V. I. Starodobov, V. A. Evdakov, R. I. Izhbuldin","doi":"10.17802/2306-1278-2023-12-1-118-128","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-118-128","url":null,"abstract":"Highlights. This review systematizes the results of experimental and clinical studies on the impact of coronary artery bypass grafting on angiogenesis and potential use of pyrimidine derivatives for therapeutic angiogenesis.Abstract. Coronary artery bypass grafting is the preferred treatment modality for multivessel coronary artery disease. However, the clinical efficacy of the procedure decreases over time due to the progression of atherosclerosis in the bypass grafts and native coronary arteries. In this regard, it is of great scientific and practical interest to disclose the mechanisms affecting the development of the microvasculature during myocardial surgical revascularization, as well as the search for pharmacological substances capable of stimulating the process of angiogenesis during these surgeries to improve short and long-term outcomes. The article presents a review of experimental and clinical studies on the effect of coronary artery bypass surgery on angiogenesis and highlights the place of pyrimidine derivatives in therapeutic angiogenesis in coronary artery disease.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131555982","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":"Historical aspects of aortic valve replacement using autologous pericardium: do we know everything?","authors":"R. Komarov, M. Tkachev, V. A. Savina, S. Chernyavsky, O. Drakina, A. M. Ismailbayev, M. S. Lenkovets, V. K. Noginov","doi":"10.17802/2306-1278-2023-12-1-107-116","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-107-116","url":null,"abstract":"Highlights. The article describes the contribution of foreign and Russian surgeons to the development of aortic valve replacement using autologous tissue, and presents the evolution of the technique. The authors tried to answer the question whether the Japanese professor S. Ozaki actually developed something new or the discovery was already made 40 years ago. At the end of the article, the technique developed by a Russian cardiac surgeon is presented, casting doubt on the use of templates in this procedure.Abstract. Aortic valve replacement using autologous pericardium (neocuspidalization) is becoming an increasingly attractive option that can be applied to a wide range of aortic valve diseases. This technique avoids the need for lifelong administration of anticoagulant drugs, and provides the maximum effective orifice area, resulting in a low transvalvular gradient. The new technique, introduced by Shigeyuki Ozaki, has made the procedure more reproducible with promising medium- and longterm results. But is Ozaki the predecessor of this technique or is “all new is well forgotten old”? This review focuses on the historical aspects of the development of neocuspidalization of the aortic valve using autologous pericardium, the first interventions for valve reconstruction are mentioned, the evolution in the technique of preparation and fixation of the leaflets is reflected.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134511799","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":"Multifaceted autonomic dysfunction syndrome: A case of combined Kimmerle`s anomaly and Chiari malformation","authors":"","doi":"10.17802/2306-1278-2023-12-1-129-134","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-129-134","url":null,"abstract":"Highlights. Autonomic dysfunction syndrome is an urgent issue in modern medicine, however, it should be an exceptional diagnosis, established after a comprehensive diagnostic study, as many diseases can often appear as this syndrome. The presented case describes the patient with a combined pathology of Kimmerle`s anomaly and Chiari malformation, who was diagnosed with autonomic dysfunction long time ago.Abstract. Autonomic dysfunction syndrome (ADS) is a topical issue of modern medicine. Differential diagnosis of this syndrome is often a difficult task for a practicing physician, because an organic disease of various etiologies can be hidden under the guise of autonomic dysfunction. The article analyzes a clinical case of a patient with a combined pathology of Kimmerle`s and Arnold-Chiari anomalies, which were not diagnosed for a long time due to the fact that clinical symptoms (syncope and presyncope conditions, dizziness, pain in the occipital region, aggravated by physical exertion and emotional stress, rises in blood pressure up to 160 mm Hg) are identical to those in ADS. After prolonged treatment of ADS without any positive effect, the child was sent to the Research Clinical Institute of Pediatrics and Pediatric Surgery named after academician Yuri Veltischev. Having received surgical treatment, the patient had no complaints for 6 months. The presented clinical case confirms that the diagnosis of ADS should be an exceptional diagnosis, established only after a complex and comprehensive examination.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132931574","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":"Association between the results of neuropsychological testing and indicators of regional cerebral blood flow according to SPECT data of cardiac surgical patient","authors":"A. Korotkevich, S. Semenov, O. Maleva, O. Trubnikova","doi":"10.17802/2306-1278-2023-12-1-49-57","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-49-57","url":null,"abstract":"Highlights. The article provides new data on the association between changes in regional cerebral blood flow during SPECT and cognitive impairment in patients who underwent coronary artery bypass grafting and combined carotid endarterectomy and coronary artery bypass grafting with cardiopulmonary bypass. The possibilities of using SPECT as a diagnostic tool in localization of areas with a similar association, in assessing the dynamics in brain perfusion and cognitive functions in the pre- and postoperative period are shown.Aim. To determine the presence of an association between the indicators of regional cerebral blood flow according to single-photon emission computed tomography (SPECT) data and the data of neuropsychological testing in cardiac surgery patients.Methods. We studied the parameters of regional cerebral blood flow (rCBF) and the data of neuropsychological testing in 34 cardiac surgical patients who underwent coronary artery bypass grafting (CABG, n = 13) and combined carotid endarterectomy and CABG (n = 21). The state of the brain was assessed by SPECT using a radiopharmaceutical 99mTc-HMPAO (Ceretek). Assessment of cognitive functions before surgery, 2–3 days before, and in the early postoperative period, on days 5–7, was carried out using a hardware-software complex Status-PF.Results. A statistically significant relationship was found between the indices of rCBF according to neuropsychological testing data in the pre- and postoperative period. We noted a moderate correlation with the Beck Depression Scale indicators in the 1st (p = 0.010943) and 2nd (p = 0.000604) groups before surgery. There was a high correlation with visual-motor response time (VMR) before (p = 0.003878) and after the procedure (p = 0.001251), a moderate correlation with the number of errors (VMR) before the procedure (p = 0.042911) and a high correlation after the procedure (p = 0.003521) in the 1st group; in the 2nd group, there was a moderate correlation before (p = 0.004625) and after the procedure (p = 0 .005689). A moderate correlation with the indicators of attention after the procedure (p = 0.049611) was noted in the 1st group, in the 2nd group, we noted a moderate correlation before (p = 0.021969) and after the procedure (p = 0.008905). In the 2nd group there was a moderate correlation with the number of processed symbols (the Bourdon test) during the 1st minute before the procedure (p = 0.016491), a high correlation after the procedure (p = 0.007920), and a high correlation with the number of processed symbols during the 4th minute before the procedure (p = 0.001473). There was a moderate correlation with a total with number of processed symbols in the 2nd group before (p = 0.029073) and after the procedure (p = 0.024164), and a high correlation with the number of errors made after the procedure in the 1st (p = 0.006367) and 2nd (p = 0.013780) groups. A high correlation with indicators of attention after surgery (p = 0.000153) was noted as wellConclus","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124726266","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":"Outcome of implementation of the project aimed to prevent cardiovascular diseases in the regional vascular center","authors":"O. O. Panteleev, S. V. Demyanov, E. Vyshlov, V. Ryabov","doi":"10.17802/2306-1278-2023-12-1-16-24","DOIUrl":"https://doi.org/10.17802/2306-1278-2023-12-1-16-24","url":null,"abstract":"Highlights. The article presents an analysis of the outcome of the project dedicated to cardiovascular disease prevention in the Regional Vascular Center, the analysis involved the assessment of changes in the characteristics of deceased patients. The study made it possible to identify changes in mortality rate, the impact of new diagnostic and treatment techniques and administrative decisions on the change in mortality, as well as aspects that prevent further reduction in mortality.Aim. To assess the results of the implementation of new methodological approaches to cardiovascular diseases prevention, myocardial infarction in particular, in the Regional Vascular Center.Methods. The study involved the analysis of the data (entered in real time) from the Emergency Cardiac Care Department of the Сardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, and data from the Department`s database containing anamnestic and clinical characteristics of patients, and recording of deaths in the period from 2014 to 2019. Statistical data processing was performed using the StatSoft Statistica software (ver. 10.0).Results. From 2014 to 2019, percutaneous coronary intervention (PCI) in myocardial infarction (MI) increased from 48 to 67.4% (p˂0.05); the primary PCI in MI with ST segment elevation (STEMI) increased from 24% to 32% (p˂0.001), the overall frequency of PCI in STEMI (primary + rescue + delayed) increased from 59.6% to 73% (p˂0.05); PCI in MI without ST segment elevation (NSTEMI) increased from 23.9% to 43.9% (p˂0.001), the frequency of intra-aortic balloon counterpulsation increased from 0.6% to 1.5% (p˂0.05), the frequency of mechanical ventilation did not change (8,3 and 8,5%), moreover the widespread use of ticagrelor and prasugrel was noted. At the same time, hospital mortality of patients with MI decreased from 9.8 to 8.0% (p>0,05): in patients with STEMI it decreased from 10.7% to 7.7% (p = 0.047), in patients with NSTEMI there was no change in mortality, it remained equal to 8–9%. Implementation of coronary reperfusion strategies that do not involve streptokinase is associated with a decrease in hospital mortality of patients with STEMI.Conclusion. The widespread introduction of modern invasive and medicinal technologies has led to a decrease in mortality of patients with STEMI. Further increasing the number of available invasive procedures – PCI, intra-aortic balloon counterpulsation and mechanical ventilation for the purposes of reducing mortality of patients with MI seems questionable.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"417 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127602359","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":"Remodeling versus reimplantation in aortic root surgery – comparative results and risk factors for aortic insufficiency","authors":"R. Komarov, A. Ismailbaev, A. N. Dzyundzya, S. V. Chernyavskii, S. S. Badalyan, A. Danachev, O. O. Ognev","doi":"10.17802/2306-1278-2022-11-4s-182-193","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-182-193","url":null,"abstract":"Highlights. The main approaches to the aortic root valve-sparing surgery of are reimplantation and remodeling;The literature review demonstrates either the relative identity of the reimplantation and remodeling clinical outcomes, or the advantage of reimplantation in relation to long-term results.Abstract. In recent decades, valve-sparring methods of aortic root replacement, including reimplantation and remodeling, as well as their modifications, have been developed and put into widespread practice. The effectiveness and durability of these two approaches is the subject of discussions in the modern cardiac surgery community. The global experience in performing remodeling and reimplantation procedures allows  for a comprehensive literature review to compare the results of these approaches.  The presented review is devoted to the comparison of surgical aspects and clinical outcomes of reimplantation and remodeling techniques, the analysis of the feasibility of restoring the physiological architectonics of the aortic root in valve-sparring operations using Valsalva grafts, as well as the assessment of risk factors for residual aortic insufficiency after such interventions. The search strategy included the analysis of international (PubMed, Scopus, Embase) databases for the following keywords: “reimplantation versus remodeling for aortic root valve-sparring procedures”, “David procedure versus Yacoub procedure”, “Valsalva graft for aortic root valve-sparring procedures”, “Valve-sparing aortic root repair with an anatomically shaped sinus prosthesis”. Literature analysis demonstrates either the relative identity of early and long-term results of reimplantation and remodeling procedures, or the advantage of reimplantation in terms of freedom from late mortality and residual aortic insufficiency. Preservation of the physiology of the aortic root by implantation of Valsalva grafts or remodeling provides better hemodynamics and reduces stress on the leaflets, however, these postulates run counter to the data of clinical studies analyzing postoperative outcomes and demonstrating the lack of advantages of Valsalva grafts over linear prostheses in terms of freedom from aortic valve surgery. Residual postoperative regurgitation of a mild degree, a decrease in the effective height below 9 mm and additional interventions on the leaflets are reliable factors of significant aortic insufficiency in the long-term period after valve-sparring operations on the aortic root.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"152 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117155571","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}