Complex Issues of Cardiovascular Diseases最新文献

{"title":"Influence of the polymerization method on the properties of fibrin matrices","authors":"V. Matveeva, E. A. Senokosova, M. Khanova, T. V. Glushkova, L. Antonova","doi":"10.17802/2306-1278-2022-11-4s-134-145","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-134-145","url":null,"abstract":"Highlights. We have proposed and patented a method for obtaining fully autologous fibrin without the use of exogenous thrombin, which can be implemented within the framework of a personalized approach in tissue engineering. Such fibrin, in addition to lower risk of infection and inflammation, possesses greater strength and resistance to degradation, as well as better hemocompatibility compared to fibrin polymerized with exogenous thrombin, which is an undoubted advantage when used as a coating for small-diameter vascular grafts.Background. Autologous fibrin can be used as a coating to impart biomimetic properties to various polymers used in vascular tissue engineering. Traditionally, fibrinogen polymerization is performed with the addition of exogenous thrombin and calcium chloride. Our patented method of obtaining fibrin without the use of exogenous thrombin allows us to obtain a completely autologous material that does not have the risk of infection. The differences in methods polymerization can change the fibrin properties.Aim. To compare the most important properties of vascular tissue  engineering  of fibrin obtained by various methods: using endogenous thrombin and exogenous thrombin in vitro.Methods. The fibrinogen precipitate was obtained with ethanol  precipitation  method  using low concentration of ethanol. The content of fibrinogen in the precipitate was normalized to a final concentration in fibrin of 30 mg/mL. Polymerization  of fibrin polymerized with exogenous thrombin was performed by adding 50 U/ mL and 0.2% calcium chloride to the thrombin precipitate, fibrin polymerized  by activation of endogenous thrombin only by adding 0.2% calcium chloride. The strength properties of the samples were tested on a Z tensile tester (Zwick/ Roell). The structure of fibrin was studied using scanning electron microscopy,   a quantitative analysis of the size of pores and fibers, the density of branching points was carried out. The quantitative content of FXIII in plasma and the resulting precipitate was determined by ELISA. FXIII activity was studied by the formation of γ-γ crosslinks by SDS-PAGE, the resistance of samples to proteolytic and fibrinolytic degradation. The ability of fibrin polymerized by activation of endogenous thrombin and fibrin polymerized with exogenous thrombin to activate contact coagulation and platelet aggregation was evaluated.Results. Thinner fibers predominated in the structure of the fibrin polymerized by activation of endogenous thrombin samples, while the samples were distinguished by greater strength and stiffness. The described features may be associated with  a more efficient activation of FXIII, which is confirmed by the formation of a larger number of γ-γ dimers in fibrin polymerized by activation of endogenous thrombin samples, as well as resistance to proteolytic degradation compared to fibrin polymerized with exogenous thrombin. Moreover, fibrin polymerized by activation of endogenous thrombin samples in vi","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"22 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":"123849309","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":"Information quality management of ambulatory outcome in patients with coronary artery disease","authors":"A. M. Nazarov, D. Kicha, R. Goloshchapov-Aksenov, O. V. Rukodaynyy, A. G. Koledinsky, S. Tolpygina","doi":"10.17802/2306-1278-2022-11-4s-116-124","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-116-124","url":null,"abstract":"Highlights. Using the big data databases of provided medical services belonging to the Territorial Compulsory Medical Insurance Fund and the Unified State Healthcare Information System (USHIS), clinical and statistical analysis of ambulatory follow-up of patients with coronary artery disease was carried out, an algorithm was developed and the effectiveness of the presented information management technology was determined.Aim. To assess and justify the developed information management technology for the quality management of ambulatory follow-up of patients with coronary artery disease (CAD) based on monitoring and analyzing electronic personified data on medical services.Methods. In 2018 the Territorial Compulsory Medical Insurance Fund (TCMIF), the Medical Information and Analytical Center (MIAC) and healthcare organizations of the Orenburg Region implemented information management technology to assess the quality of ambulatory follow-up in patients with CAD, which is based on big data analysis of medical services and information integration “emergency medical services (EMS), hospital-TCMIF + MIAC-polyclinic”. To assess the effectiveness of the technology, the proportion of patients with myocardial infarction (MI), death from coronary artery disease, emergency hospitalizations and emergency calls for angina pectoris were compared. The study involved   two groups of patients: 13 208 ambulatory patients with angina pectoris and 4017 patients without follow-up, according to  the  TCMIF  reports  in  2017.  Out of the 13,208 patients with angina pectoris in 2019, 10,205 patients with continued follow-up presented with the same clinical endpoints. Patients with these unfavorable outcomes in proportion to the total number of patients in each group in 2017 and 2019 were compared as well.Results. The developed and implemented information management technology led to an increase in the number of ambulatory patients with angina pectoris from 63 to 69%, with MI from 78 to 87%, and a reduction of emergency calls and emergency hospitalizations of patients with angina pectoris in the region in 2017 and 2019.Conclusion. Information quality management of ambulatory follow-up of patients with coronary artery disease using electronic personalized data on medical services increases the number of ambulatory patients with angina pectoris and myocardial infarction, and decreases the number of unfavorable outcomes of patients with angina pectoris.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"37 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":"134638894","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":"Development of a system of integrated assessment of efficiency of cardiac care in the Russian Federation regions","authors":"I. Mikhailov, V. V. Omelyanovsky, V. Semenov","doi":"10.17802/2306-1278-2022-11-4s-105-115","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-105-115","url":null,"abstract":"Highlights. Methodology for the development of a system of indicators for the integral assessment of effectiveness and efficiency of cardiac care (cardiovascular surgery) in the subjects of the Russian Federation is proposed and tested.Indicators, such as the length of stay, the number of operations on the heart and blood vessels, the number of ambulatory patients have high overall rating and consistency of expert opinions.Aim. To develop a system of indicators for assessment of the effectiveness of cardiac care, cardiovascular surgery in particular, in the Russian Federation regions.Methods. The study using expert surveys was conducted in the form of a structured interview. At the first stage, the primary selection of indicators was carried out using the annual public and field reports of the national medical research center. At the second stage, experts were selected and the level of expert competence was assessed. In total, out of 14 interviewed specialists, 10 were defined as experts. The average expert authority coefficient was 0.89. To quantify the degree of agreement between the experts` answers, Kendall's coefficient of concordance (W) was calculated. The significance of differences was assessed using the nonparametric Friedman test.Results. The following indicators are recommended as indicators for rating efficiency of cardiac care in the regions of the Russian Federation: mortality after heart surgery, vascular surgery and percutaneous coronary interventions; mortality from diseases of the circulatory system; the number of ambulatory patients; the ratio of the number of endovascular interventions to the total number of discharged patients who suffered from acute coronary syndrome.Conclusion. The selected indicators can be used both for the rating of the constituent entities of the Russian Federation, and in the development of federal projects or ministerial target programs. The results of the study can also be used to organize a system for monitoring the effectiveness of the implementation of these projects and programs.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"23 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":"127669221","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":"Cardiomyocyte mitochondrial respiration and microviscosity in rats of different ages in heart failure","authors":"V. Korepanov, T. Rebrova, A. Gorbunov, S. Afanasiev","doi":"10.17802/2306-1278-2022-11-4s-146-152","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-146-152","url":null,"abstract":"Highlights. Heart failure in older age groups is an urgent medical and social issue. Mitochondrial dysfunction is a key link in the pathogenesis of heart failure. In this study we have demonstrated a decrease in mitochondrial respiratory function in old rats. In this age group, the development of heart failure is accompanied by a further decrease in respiratory control. An increase in the mitochondrial microviscosity in older animals may affect the activity of respiratory chain enzymes in heart failure.Aim. To study the respiratory activity and mitochondrial membrane microviscosity of cardiomyocyte of rats of different ages with heart failure.Methods. The study involved 22 2- and 15-month-old male Wistar rats. The animals were divided into 4 groups: 2 groups of intact animals of both ages (n = 12) and 2 groups of rats with isadrine model of heart failure (HF) (n = 10). HF was modeled by two subcutaneous injections of isoproterenol hydrochloride (170 mg/kg) at interval of 24 hours. Mitochondrial respiratory activity was assessed using respiratory control coefficient. The microviscosity of mitochondrial membranes was evaluated by eximerization coefficients of pyrene-based fluorescent probe in areas of protein-lipid and lipid-lipid contact. Comparative statistical analysis of independent groups was performed using the nonparametric Mann-Whitney test.Results. A decrease in mitochondrial respiratory control in older rats was shown in comparison with young animals. In the HF model, inter-age difference increases, but at the same time, in younger rats, the development of HF is not accompanied by significant changes in mitochondrial respiratory control. An age dependent decrease in the microviscosity of mitochondrial membranes in the area of protein-lipid and lipid-lipid interaction was revealed. In younger rats, the development  of HF is characterized by a significant increase in microviscosity in the area of protein-lipid and lipid-lipid contact. In older rats, the development of the pathology is characterized by a significant decrease in microviscosity in the area of protein-lipid interaction.Conclusion. Multidirectional age-related changes in cardiomyocyte mitochondria of rats with heart failure were revealed. It was shown that mitochondria in younger rats retain their functional activity in the HF model unlike older rats.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"1 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":"116536839","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":"Minimally invasive aortic valve neocuspidization using autologous pericardium – first experience","authors":"R. Komarov, A. M. Ismailbev, O. O. Ognev, A. N. Dzyundzya, A. Danachev, M. Saliba, M. Lenkovets","doi":"10.17802/2306-1278-2022-11-4s-208-214","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-208-214","url":null,"abstract":"Highlights. Conducting minimally invasive aortic valve neocuspidization using autologous pericardium is a difficult task due to pericardial harvesting. Thoracoscopic harvesting of the pericardium provides a pericardial patch of sufficient size under visual control. Thus, thoracoscopic pericardial harvesting can transfer all advantages of minimally invasive cardiac surgery to aortic valve neocuspidization using autologous pericardium.Abstract. Minimally invasive aortic valve (AV) replacement is associated with a decrease in the traumatic nature of the procedure, the length of hospital stay, severity of pain, and provides faster rehabilitation and better cosmetic look compared to the gold standard incision in cardiac surgery –median sternotomy. AV neocuspidization using autologous pericardium is safe, associated with excellent hemodynamic parameters in short- and medium-term follow up. However, this technique requires a large pericardial patch to later form new leaflets, thus complicating the use of minimally invasive approach with this type of intervention. We have addressed this issue by introducing thoracoscopic pericardial harvesting. We report two successful cases of minimally invasive AV neocuspidization using autologous pericardium harvested through a thoracoscopic approach with peripheral cardiopulmonary bypass.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"9 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":"134062522","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":"Propensity score matching analysis of the aortiv valve replacement with the xenopericardial semi-framed prosthesis “T-Ara” and the framed xenopericardial prosthesis “UniLine”. Short-term results","authors":"A. Evtushenko, A. Stasev, S. G. Kokorin, I. Sizova, D. Lebedev, M. K. Duvanov, A. V. Maximov, N. Veselovskaya, K. Y. Scherbakov, L. Barbarash","doi":"10.17802/2306-1278-2022-11-4s-75-87","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-75-87","url":null,"abstract":"Highlights. It is the first pseudorandomized comparative study of xenopericardial frame and half-frame bioprostheses treated with diepoxin in the aortic position use and its direct results.Aim. A comparative assessment using the Propensity Score Matching method of the in-hospital clinical and hemodynamic results of the semi-framed epoxy-treated xenopericardial prosthesis “T-ara” and the framed epoxy-treated xenopericardial prosthesis “UniLine” (“NeoKor”, Kemerovo, Russia) for isolated aortic valve replacement implantation.Methods. 33 recipients of the “UniLine” prosthesis were selected by Propensity Score Matching method in a ratio of 1:1 to 33 observations from the “T-ara” group according to the compliance criteria: gender, age, body surface area, end-diastolic volume of the left ventricle (LV) and the pre-operative presence/absence of the aortic regurgitation.Results. Hospital mortality in the “T-ara” and “UniLine” groups was 3.03 (n = 1) and 6.06% (n = 2), respectively, p = 0.920. Non-fatal complications in the “T-ara” and “UniLine” groups was 7 (21.2%) and 18 (54.6%), p = 0.163. The incidence of postoperative heart failure and arrhythmias was higher in “UniLine” recipients (p = 0.001). The average stay in the intensive care unit was longer in the “UniLine” group than in the “T-ara” group, p = 0.05. Postoperative end-systolic and end-diastolic dimensions and volumes (and the corresponding indexes) of the LV,       as well as the myocardial mass and its index in both groups had no statistically significant changes in relation to preoperative data. The comparative assessment of left ventricular remodeling parameters depending on the prosthetic size revealed no significant differences. The average pressure gradient in the “T-ara» and “UniLine” group of size 21mm was 12.2±7.4 and 12.2±5.0 mm Hg. (p>0.050). The average pressure gradient in the group “T-ara” and “UniLine” size 23–25 mm was 10.2±4.1 and 9.9±0.3 mm Hg, p>0.050. The regression degree of LV myocardial mass index in the groups did not have significant differences.Conclusion. At the hospital stage, the semi-framed epoxy-treated biological prosthesis “T-ara” has a similar clinical and hemodynamic profile with the framed biological prosthesis “UniLine”. The frequency of postoperative heart  failure  and cardiac arrhythmias is statistically significantly higher in the “UniLine” group (framed bioprostheses).","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"1 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":"129821299","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":"A modern view on the diagnostic role of endothelial dysfunction biomarkers and the possibilities of its correction","authors":"E. A. Zakharyan, E. Ageeva, Y. I. Shramko, K. Malyi, A. Gurtovaya, R. Ibragimova","doi":"10.17802/2306-1278-2022-11-4s-194-207","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-194-207","url":null,"abstract":"Highlights. The article presents a review of literature data on the diagnostic role of endothelial dysfunction biomarkers. The review provides an overview of the main indicators, their significance in various pathologies, and presents possible therapeutic strategies for preventing endothelial dysfunction.Abstract. Endothelial dysfunction is a characteristic feature of each stage of the cardiovascular continuum – a series of events from hypertension to the development of atherosclerosis and coronary heart disease, thrombus formation, myocardial infarction, and heart failure. Due to the prominent role of endothelial dysfunction in the pathogenesis of many vascular diseases, it is a significant therapeutic target. It is important to note that circulating markers of endothelial activation and damage characterize the severity of the disease and can be used to evaluate the efficacy of treatment and subsequent prognosis. The purpose of this review is to provide up–to-date data on endothelial function, discussing its clinical relevance in the cardiovascular continuum, the latest insights in molecular and cellular biology, and their implications for clinical practice, with a focus on new methods of therapeutic approaches for correcting endothelial dysfunction.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"94 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132773098","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 model of a primary medical care specialist for cardiovascular diseases","authors":"R. Goloshchapov-Aksenov, O. V. Rukodaynyy, A. G. Koledinsky, R. Shaburov, P. Volkov, A. S. Thakur","doi":"10.17802/2306-1278-2022-11-4s-125-133","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-125-133","url":null,"abstract":"Highlights. Ineffective clinical management of primary health care in the form of staffing shortage and low competence within the model of cardiovascular surgeons further contribute to the progression and complication of cardiovascular diseases. Primary health care specialist for cardiovascular diseases acts as a functional basis for clinical and organizational management of the processes of primary and secondary prevention of cardiovascular complications, the development of patients' adherence to recommendations and the formation of a healthy lifestyle. Improving professional skills and competencies of cardiovascular surgeons providing comprehensive medical care – surgical and conservative (the functional medicine model) remains an urgent healthcare issue.Aim. To develop a model of a PHC specialist (cardiovascular surgeon) in CVD and evaluate the clinical and managerial effectiveness of its implementation.Methods. The study (2016–2022) was conducted at the clinical diagnostic center of the Central Clinical Hospital “Russian Railways-Medicine” (Moscow), “SM-Clinic” (Moscow) and Department of Health Organization, Medication Provision, Medical Technologies and Hygiene of the Medical institute RUDN University. The subject of the study is the competencies and skills of a cardiovascular surgeon in primary care. The development of a model of a PHC specialist was carried out on the basis of personal improvement and integration of professional competencies and skills of cardiovascular surgeons in the aspect of applying clinical management technology in CVD (Kicha D.I., Goloshchapov-Aksenov R.S., 2019). The study included patients over 65 years of age (n = 422). The mean age of the patients was 77±8.6 years. The subjects of the study were cardiovascular surgeons (n = 4) with ≥5 years of work experience. The effectiveness of the model was evaluated according to clinical and managerial indicators of achieving the goal in the implementation of the author's algorithm for the organizational and technological management of PHC (2020). The follow-up was 36 months. We compared the results of 2016–2018 – before the introduction of the model and 2019–2022 – period of use of the model. Research methods were as follows: content analysis, statistical, mathematical, analytical, comparative, expert. The t-White test was used to assess the significance. Differences in the compared parameters were considered significant at p<0.05.Results. The developed model of a PHC specialist included components of patient orientation, the time of primary and repeated outpatient consultations, competencies and skills, adherence to surgical care and long-term clinical management, informatization, automation and systematization of the PHC process, interdisciplinary integration, implementation of the PHC algorithm and assessment efficiency. The obtained performance of the model is confirmed by significant differences in the compared indicators for the periods of 2016–2017 and 2018–2022: an","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"9 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":"116762129","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":"Evaluation of hemodynamic significance for paraprosthetic fistula after transcatheter aortic valve implantation","authors":"E. Ovcharenko, P. Onishchenko, K. Klyshnikov, V. Ganyukov, A. Shilov, I. Vereshchagin, A. Kokov, R. Tarasov, L. Barbarash","doi":"10.17802/2306-1278-2022-11-4s-153-162","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-153-162","url":null,"abstract":"Highlights. Using ECHO and MSCT data, a numerical assessment of hemodynamic effects of paraprosthetic regurgitation following transcatheter aortic valve replacement was performed. A significant increase in the fluid flow, wall and viscous shear stresses in the area of regurgitation is shown. The modeling technique described in the paper can be used prospectively in assessing the optimal treatment modality in terms of predicting the quantitative characteristics of the flow, associated with the risks of destruction of red blood cells and thrombosisAim. To make a numerical assessment of hemodynamic effects of paraprosthetic regurgitation following transcatheter aortic valve replacement based on retrospective clinical data.Methods. The study included echocardiography and multi-slice computed tomography data as input data for modeling one pulsation of a fluid similar in properties to blood. Reconstruction of the paraprosthetic fistula and the ascending aorta was performed in the Mimics medium (Materialise, Belgium). The obtained 3D models were processed in the Salome software (OPEN CASCADE SAS, France), after which they were exported to HELYX-OS (ENGYS, Great Britain) to build a finite element mesh. The flows were modeled using the OpenFOAM software package version 6 (The OpenFOAM Foundation Ltd, UK).Results. The simulation result, expressed quantitatively and qualitatively in the form of diagrams of the measured parameters – fluid flow velocities, wall and viscous shear stresses, shows a significant increase in indicators in the area of paraprosthetic regurgitation. Thus, the velocity in the affected area was 1.9–4.2 m/s, which is 3.8 higher than the average value in the entire computational area. The wall shear stress value was up to 61 Pa in the critical area, which may indicate an increased risk of thrombus formation due to the initiation of the clotting cascade through the von Willebrand factor. The value of viscous shear stress, the main component of the destruction of red blood cells in laminar flow, amounted to 20–26 Pa, which, in general, is not enough for mechanical hemolysis.Conclusion. The modeling technique described in the paper can be used prospectively in assessing the optimal treatment modality in terms of predicting the quantitative characteristics of the flow, associated with the risks of destruction of red blood cells and thrombosis.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"18 2 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":"123575818","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":"Current source density (sLORETA) in patients undergoing cognitive rehabilitation using dual task in the early postoperative period of coronary artery bypass grafting","authors":"I. Tarasova, D. Kupriyanova, O. Trubnikova, I. Kukhareva, A. Sosnina, S. B. Ten, V. G. Shesternin, O. Barbarash","doi":"10.17802/2306-1278-2022-11-4s-65-74","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4s-65-74","url":null,"abstract":"Highlights. For the first time, the method of standardized low resolution electromagnetic tomography – sLORETA was used to assess the neurophysiological correlates of the success of cognitive rehabilitation using dual task to recover the brain functions affected by ischemia during cardiac surgery.The patients who were successfully rehabilitated have demonstrated lower postoperative values of resting state theta activity within the right hemisphere, indicating the transfer effect, which is an important component of successful cognitive rehabilitation.Aim. Visualization and monitoring of brain ischemia is important for the diagnosis of cerebrovascular diseases. The aim of the study was to evaluate the possibilities and applicability of the method of standardized low resolution electromagnetic brain tomography – sLORETA for analyzing brain electrical activity in patients undergoing cognitive rehabilitation using dual tasks to recover impaired brain functions during ischemia associated with cardiac surgery.Methods. The study included 16 male patients (45–75 years old) who were admitted for planned coronary artery bypass grafting (CABG) to the Clinic at the Research Institute for Complex Issues of Cardiovascular Diseases. Clinical and neurophysiological examinations were performed 2–3 days before CABG and 1 week after surgery. All patients underwent cognitive rehabilitation that started at postoperative day 3 or 4 and lasted until discharge, the outcome was assessed as well. Monopolar EEG (62 channels) was recorded at rest in a sitting position with eyes closed in a light- and noise-insulated room using a Neuvo SynAmps2 Amplifier. Data processing of EEG background activity for sLORETA analysis was performed using the EEGLAB in MATLAB software (The MathWorks, Natick, MA, USA). The sLORETA algorithms were used to calculate dynamic cross spectrum and current source density within the analyzed frequency range (4–6 Hz). Statistical analysis of current source density indicators was carried out by using the method of statistical non-parametric mapping in the sLORETA software package, and the difference between the current source density in the pre- and postoperative period (after cognitive rehabilitation) was calculated as well.Results. Cognitive rehabilitation was successful in 44% (7 patients) of cases. The differences have been revealed between the groups with successful and unsuccessful cognitive rehabilitation by using sLORETA. The group with unsuccessful cognitive rehabilitation demonstrated higher current source density estimates in theta rhythm compared with the successful rehabilitation group, it was most pronounced (t>- 8.42; p<0.004) in the right hemisphere – Brodmann area 22, temporal lobe and superior temporal gyrus.Conclusion. The sLORETA method demonstrated the positive effect of cognitive training on changes in the spatial patterns of brain activity in patients undergoing onpump CABG. The successful cognitive rehabilitation was associated wit","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121945145","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}