Complex Issues of Cardiovascular Diseases最新文献

{"title":"RA-associated atherosclerosis: mechanisms of development and therapeutic perspectives","authors":"V. I. Ponkratov, N. S. Mescherina","doi":"10.17802/2306-1278-2022-11-4-105-117","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-105-117","url":null,"abstract":"According to data from large population trials and meta-analyses, mortality in rheumatoid arthritis (RA) significantly exceeds that in the general population. Cardiovascular diseases (CVD) rather widely contribute to the excess mortality in RA patients. Despite the recent emergence of a large number of innovative drugs for RA treatment, CVD mortality in this pathology persists at the level of the cardiovascular risk (CVR) typical for diabetes mellitus. With that, currently there is a clear trend among physicians for underestimating CVR in these patients. The review analyzes discovered pathogenetic mechanisms of CVR development in RA, which are represented by an integrated complex of vascular (endothelial dysfunction), cellular (T-cell dysfunction), and humoral (proinflammatory mediators, autoantibodies, complement activation) disorders. Besides, despite a large amount of disease-modifying antirheumatic drugs that can provide CVR decrease due to selective effects on separate mechanisms, the current lack of comparative trials does not allow to readily define specific drugs that are beneficial for the specific CVD decrease. Due to this, the promising trend of applied clinical medicine presumes the implementation of the interdisciplinary approach to CVR correction in RA patients, which will account not only for the treatment administered by the rheumatologist, but also the risk stratification, patient compliance, and multidisciplinary treatment efficacy control. This will allow for optimal CVD prevention in RA patients, thus significantly improving their quality of life and prognosis.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123087492","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":"Comparative analysis of mid-term outcomes of Rigid and NeoRing support rings in mitral regurgitation surgery: a prospective randomized trial","authors":"I. V. Dvadtsatov, A. Evtushenko, O. Kuzmina, L. Barbarash","doi":"10.17802/2306-1278-2022-11-4-62-71","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-62-71","url":null,"abstract":"Highlights. For the first time, as part of a prospective randomized study, a comparative assessment of the mid-term results of mitral valve annuloplasty using a new biological NeoRing ring (CJSC NeoKor, Kemerovo) and a RIGID ring (CJSC NPP MedInzh, Penza) in patients with connective tissue dysplasia was carried out. Predictors of the conversion of sinus rhythm to atrial fibrillation and residual mitral insufficiency in the medium-term follow-up period were determined.Aim. To analysis and compare mid-term results of mitral valve annuloplasty conducted using NeoRing и RIGID rings.Methods. From November 2019 to March 2022, 62 patients with mitral valve (MV) dysplasia underwent MV annuloplasty using NeoRing semi-rigid rings (CJSC NeoKor, Kemerovo, n = 31) and rigid RIGID rings (CJSC NPP MedInzh, Penza, n = 31). There were no differences between the groups at baseline.Results. Two deaths were registered during inpatient treatment in the RIGID group. Both devices showed a satisfactory outcome during inpatient treatment in the form of restoration of MV function (p<0.001) and the frequency of detected maximum residual mitral regurgitation (MR) up to grade 1 in the NeoRing group 9.7% and in the RIGID group 29%, respectively, no statistically significant intergroup differences were noted (p = 0.292). After 12 months, freedom from ≥2 grade MR in the NeoRing group was 93.5% and 77.4% in the RIGID group (p = 0.147). In the RIGID group, patients had higher values of the transvalvular mitral diastolic gradient – PAV 3.70 [3.00–4.40] mm Hg vs. NeoRing group 2.3 [2.05–2.85] mmHg (p<0.001), as well as a higher transvalvular flow rate – VAV 79 [71–94] cm/sec vs. 70 [64–79] cm/sec (p = 0.017). The analysis of the achievement of composite primary endpoint (recurrence of ≥2 grade MR, MACCE, new onset arrhythmias, reoperations) by the device was carried out. The composite endpoint rate in the RIGID group was 3.067 times higher compared to the NeoRing group, odds differences were statistically significant (p = 0.037, 95% CI: 1.053–8.934).Conclusion. The outcome of MV annuloplasty conducted using rigid and semi-rigid rings revealed no significant differences in long-term survival and recurrence of MR between groups. Given the statistically significant difference in achieving the combined endpoint, lower inpatient and long-term indicators of transmitral pressure gradient, and a positive effect on cardiac chambers reverse remodeling, it was concluded that the use of semi-rigid NeoRing rings for MV annuloplasty when performing valvepreserving operations for connective tissue dysplasia is preferable.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124960531","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":"Modifiable and nonmodifiable risk factors in redo mitral surgery","authors":"A. Stasev, I. K. Halivopulo, A. V. Shabaldin, V. I. Afanasyev, A. V. Yevtushenko, L. Barbarash","doi":"10.17802/2306-1278-2022-11-4-35-46","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-35-46","url":null,"abstract":"Highlights. In the present study, we conducted a retrospective analysis redo mitral valve replacement due to prosthesis failure. Predictors of adverse events and death have been analyzed. The quality of obtained predictors was verified using ROC analysis.Aim. To analyze predictors of adverse events and death in redo mitral procedure for treating mitral bioprostheses failure.Methods. The retrospective registry study of catamnesis of patients undergoing treatment for mitral valve prosthesis dysfunction was carried out. The age and gender of patients, medical history, underlying and comorbid diseases, features of primary replacement and reoperation, durability of the primary prosthesis, adverse events and death after redo mitral valve replacement and others (more than 30 factors) were taken into account. Stepwise logistic regression was used for statistical processing. The quality of obtained predictors was verified using ROC analysis.Results. The results of the study have revealed that there are modifiable risk factors such as cardiopulmonary bypass time, ischemia time, and nonmodifiable risk factors like reoperation, baseline severity of the patient's condition, complications of median resternotomy, concomitant interventions on aortic valve during reoperation. Moreover, treating atrial fibrillation during primary replacement proved to have an overall protective effect.Conclusion. Тhe only modifiable factors that can be influenced during redo mitral valve replacement due to biological prosthesis failure are cardiopulmonary bypass duration and aortic cross-clamping time.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127567926","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":"Surgical treatment of paroxysmal atrial fibrillation concomitant to coronary artery bypass grafting: pulmonary vein isolation or maze V?","authors":"A. Revishvili, V. Popov, V. V. Aminov, G. Plotnikov, E. Malyshenko, M. M. Anishchenko, M. Svetkin","doi":"10.17802/2306-1278-2022-11-4-47-61","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-47-61","url":null,"abstract":"Highlights. Maze V significantly reduces the recurrence of AF compared to bipolar RFA for PVI in the short and mid-term period.Aim. To assess the effectiveness and safety of pulmonary vein isolation (PVI) in comparison with Maze V for treating paroxysmal atrial fibrillation (AF) concomitant to coronary artery bypass grafting (CABG).Methods. Medical records of 139 patients with coronary artery disease and concomitant paroxysmal AF were retrospectively analyzed. All patients were divided into two groups: Group 1 patients (n = 71) underwent CABG + bipolar radiofrequency ablation for PVI, and Group 2 patients (n = 68) underwent Maze V + CABG. Propensity score-matched (PSM) analysis with a 1:1 nearest-neighbor matching was done. 30 patients were selected from each group. The exclusion criteria were as follows: emergent CABG, concomitant valvular heart disease, non-paroxysmal AF, decompensation of chronic diseases, and cancer. On-pump CABG was performed at normothermia with warm blood hyperkalemia cardioplegia. RFA for PVI and Maze V were performed before CABG under parallel perfusion without aortic cross-clamping. The primary and secondary endpoints included recurrent AF/atrial flutter, sinus rhythm at discharge and in the long-term period, permanent pacemaker implantation, major cardiovascular and cerebrovascular events.Results. After the PSM analysis, the CABG+Maze V group and CABG+RFA for PVI differed significantly in the duration of surgery (330 [310; 375] vs. 255 [225; 270] min, p = 0.0001), cardiopulmonary bypass time (131 [113; 144] min vs. 89 [74; 98] min, p = 0.0001), duration of AF treatment (53 [44; 59] min vs. 10 [9; 12] min, p = 0.0001). The structure and rate of complications in both groups were comparable. There were no in-patient deaths. Recurrent AF/atrial flutter significantly reduced in the CABG+Maze V group compared to the CABG+RFA for PVI group (13.3% vs. 33.3%, respectively; p = 0.044). Sinus rhythm was restored in all cases. The rate of transient sinus node dysfunction (no more than 5 days) was 6.7% in the Group 1 and 16.6% in the Group 2. The difference did not reach statistical significance (p = 0.128). The 12-months cumulative freedom from AF/atrial flutter without antiarrhythmic drug therapy was significantly higher in the CABG+Maze V group compared to the CABG+RFA for PVI group (97% vs. 83.5%, respectively; p = 0.020). The freedom from MACE in both groups was 96.7%.Conclusion. Maze V for treating concomitant paroxysmal AF prolonged the duration of cardiopulmonary bypass and the surgery itself, but did not affect the postoperative period, indicating its safety and effectiveness. Maze V procedure concomitant to CABG significantly reduced the recurrence of AF compared to RFA for PVI both in the short- and mid-term period. Thus, it is reasonable to perform Maze V+CABG in patients with paroxysmal AF and a high risk of disease progression.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"71 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113954172","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":"Acute kidney injury in patients with myocardial infarction and percutaneous coronary interventions: laboratory markers and the influence on the frequency of recurrent cardiovascular events","authors":"O. Demchuk, I. Sukmanova","doi":"10.17802/2306-1278-2022-11-4-25-34","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-25-34","url":null,"abstract":"Highlights. Biomarkers of acute kidney injury and their effect on the frequency of recurrent coronary events in patients with myocardial infarction after percutaneous coronary interventions.Aim. To study biomarkers of acute kidney injury (AKI) and prognosis, as well as the frequency of recurrent cardiovascular events in patients with myocardial infarction and percutaneous coronary interventions.Methods. 166 patients with myocardial infarction and performed percutaneous coronary interventions were studied, divided into 2 groups: with acute kidney injury (n = 91) and without it (n = 50), the control group consisted of 25 people. All patients underwent standard general clinical and biochemical blood tests to assess the level of C-reactive protein, markers of myocardial necrosis, natriuretic peptide (NTproBNP), microalbuminuria (MAU). In both groups, the glomerular filtration rate (GFR) was calculated using the CKD-EPI formula. An increase in serum creatinine by 26.5 mmol/L or more during the first 3 days from the value at admission was the reason for the study of the level of Kidney Injury Molecule-1 (KIM-1) and interleukin 18 (IL-18) in urine on the 3rd and 14th days from hospitalization. All patients underwent coronary angiography and stenting of the infarct-dependent artery. 6 months and 1 year after discharge for this acute coronary event, repeated examinations of patients were performed to assess the frequency of repeated cardiovascular events and kidney function.Results. It was revealed that the creatinine level in the examined patients did not differ statistically significantly at admission, but there was a decrease in the filtration function of the kidneys in patients with AKI. On the third day of hospitalization, there was an increase in creatinine levels in the first group of patients with a decrease in GFR. The level of the KIM-1 and IL-18 molecules on the 3rd day of hospitalization in the first group was higher than the corresponding indicator of the comparison group. Also, patients with AKI showed a significant increase in the level of NTproBNP and MAU in the early period of kidney damage. When studying correlations, it was revealed that the level of MAU in the group with AKI is interrelated with the indicator of C-reactive protein and creatinine on the 3rd day of hospitalization. Also, a positive statistically significant correlation was found between the level of the KIM-1 molecule, IL-18, creatinine level on the 3rd day of hospitalization, NTproBNP and the level of MAU. During the follow-up of patients 6 months and a year after discharge, unstable angina pectoris, myocardial infarction, as well as progression of chronic heart failure were more often detected in the group with AKI. A persistent decrease in kidney function after a year was observed in most patients of the first group.Conclusion. The data obtained indicate the influence of acute kidney injury on the progression of renal dysfunction and the frequency of recurrent cardiov","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132881462","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":"Epidemiology of cardiovascular risk factors and the medical care appealability","authors":"A. S. Agienko, I. L. Strokolskaya, V. Y. Heraskov, G. V. Artamonova","doi":"10.17802/2306-1278-2022-11-4-79-89","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-79-89","url":null,"abstract":"Highlights. Unique epidemiological data were obtained on the effectiveness of preventive services of healthcare organizations in relation to cardiovascular diseases, adherence to lifestyle modification recommendations, and presence of risk factors for cardiovascular diseases in these citizens.Aim. To assess healthcare services uptake in large industrial Siberian region, as well as the adherence of population to lifestyle modification recommendations (epidemiological data).Methods. The study included 729 residents of Kemerovo and Kemerovo region. The assessment of the main risk factors for cardiovascular diseases was carried out in accordance with the Russian recommendations for cardiovascular prevention. Uptake and adherence to lifestyle modification recommendations was assessed using the Health System Assessment Questionnaire of the International Prospective Study of Urban and Rural Epidemiology.Results. Among the 729 study participants, the urban population is represented by 67.3%, rural – 32.6%. The population was majority represented by women (69.7%). The mean age of participants was 59.0 (51.0; 65.0) years. Smokers accounted for 18.6% of the participants, the majority represented by men (p = 0.000). Excessive weight was more often observed in women (p = 0.013), the mean body mass index in women was 29.5 kg/m2 . The mean values of the analyzed laboratory parameters (cholesterol, low- and highdensity lipoprotein cholesterol, triglycerides, glucose) were within the range of normal values. Previously diagnosed hypertension was noted in 64.6% of the participants, diabetes in 12%, coronary heart disease in about 7%, stroke in 1.6% of the participants. Assessment of cardiovascular risk according to SCORE scale showed that 17% of participants were at low risk, 50% – moderate risk in, and 29.2% – high-very high risk. Upon visiting healthcare provider, only 38.1% of subjects received recommendations for lifestyle changes. Respondents were frequently given recommendations to adjust their diet, followed by recommendations regarding weight loss, increased physical activity; smoking cessation and lower alcohol consumption were recommended less often. Respondents changed their lifestyle significantly more often in accordance with the recommendations received at the time of visit (p = 0.000); out of them, 56.7% had moderate cardiovascular risk, 26.7% had high and very high risk, and low risk according to SCORE – 16.7%. However, study participants were more likely to not follow received recommendations (p = 0.000).Conclusion. Due to high uptake of healthcare services in the population, high prevalence of risk factors and low adherence of the population to prevention, it can be concluded that the current model of prevention does not work. Innovative tools are needed to manage risk factors for cardiovascular diseases and positively change a person`s lifestyle.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"137 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114268383","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":"Risk factors for unfavorable prognosis in patients with coronary artery disease and age-related disorders undergoing coronary artery bypass grafting","authors":"N. A. Terentyeva, N. A. Galimova, E. Bazdyrev, K. E. Krivoshapova, D. Tsygankova, S. Ivanov, V. Masenko, A. Kokov, O. Barbarash","doi":"10.17802/2306-1278-2022-11-4-13-24","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-13-24","url":null,"abstract":"Highlights. Patients with coronary artery disease and age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) who underwent elective on-pump coronary artery bypass grafting are at higher risk of developing cardiovascular complications, non-infectious complications, and death.Musculoskeletal disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) in combination with traditional predictors (age, diabetes mellitus, prior myocardial infarction and stroke, cancer) are risk factors for unfavorable prognosis of postoperative period of coronary artery bypass grafting. Aim. To assess risk factors for unfavorable prognosis in patients with coronary artery disease (CAD) undergoing elective on-pump coronary artery bypass grafting, taking into account age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia).Methods. This single-center study included 387 CAD patients admitted for elective coronary artery bypass grafting. Taking into account the diagnosed age-related disorders, four groups of patients were formed. The first group consisted of 52 (13.4%) patients with sarcopenia, the second group was comprised of 28 (7.2%) patients with osteopenia (osteopenia/osteoporosis), the third group included 25 (6.5%) patients with osteosarcopenia, and the fourth group consisted of 282 (72.9%) participants with coronary artery disease and without musculoskeletal disorders (MSD). Risk factors for a composite endpoint (myocardial infarction, stroke, paroxysmal atrial fibrillation, cardiac rhythm disturbances) and death, and noninfectious complications (resternotomy for bleeding, pneumothorax aspiration and thoracentesis) were assessed.Results. The composite endpoint occurred more frequently in patients with osteopenia (group I – 9.6%, group II – 32.1%, group III – 12%, group IV – 12.8%; p = 0.029), and non-infectious complications occurred more frequently in patients with sarcopenia and osteosarcopenia (group I – 17.3%, group II – 7.1%, group III – 12%, group IV – 5.3%; p = 0.002). MSD were associated with the risk of composite endpoint (odds ratio (OR) 1.73, p = 0.035), and osteopenia increased it three-fold (OR 3.01, p = 0.046). Moreover, MSD were associated with higher risk of non-infectious complications (OR 1.71, p = 0.026), especially in patients with sarcopenia (OR 2.02, p = 0.034). The assessment of risk factors for unfavorable prognosis highlighted the presence of osteopenic syndrome (100 CU), prior stroke (88 CU) and myocardial infarction (85 CU). The risk of non-infectious complications was associated with prior ischemic events (ranking level for myocardial infarction – 100 CU, stroke – 75 CU), and MSD (89 CU) and its types (osteosarcopenia – 77 CU, osteopenia – 69 CU, sarcopenia – 52 CU).Conclusion. Age-related disorders in combination with MSD increase the risk of a composite endpoint and non-infectious complications by one to three times.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114562145","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":"Coping strategies and attitudes towards health in cardiac patients","authors":"E. A. Zakharyan, R. Ibragimova","doi":"10.17802/2306-1278-2022-11-4-7-12","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-7-12","url":null,"abstract":"Highlights. The importance of psychological assessment and psychological support in Cardiology Departments has been demonstrated. For the first time, predominant coping strategy in cardiac patients was revealed.Background. Why do patients with the same disease, disease course, prognosis and treatment have different outcomes? One hypothesis points to the influence of internal resources used in coping with the disease. A.B. Smulewicz in 1984 identified the association between the clinical symptoms and mental state of the patient.Aim. To determine characteristics of coping behavior and attitude toward health in cardiac patients from Surgical and Therapeutic Departments.Methods. 122 patients admitted to the State Autonomous Healthcare Institution “N.A. Semashko Republican Clinical Hospital” were included in the study. The 1st group consisted of in-patients from the Department of Surgical Treatment of Heart Rhythm Disorders and Electrical Cardiac Stimulation (61 patients); the 2nd group consisted of patients from the 1st Cardiology Department (61 patients). A questionnaire developed by R. Lazarus and S. Falkman in 1988 was used to determine coping strategies, and a questionnaire developed by R. A. Berezovskaya in 2005 was used to assess attitudes towards health.Results. Active coping strategy predominates in surgical patients, and distancing and avoidant strategies predominate in therapeutic patients. Correlation between characteristics of coping strategy and attitudes toward health was analyzed: active coping strategies are accompanied by high behavioral, cognitive, and emotional aspects. An inverse correlation is noted in distancing and avoidant coping strategies.Conclusion. Psychological comfort and correct attitude of patient to his/her disease is an important part of rehabilitation that highlights the significance of psychometric testing in cardiac patients.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133895119","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":"Updating the procedures for providing medical care services to patients with cardiovascular diseases","authors":"D. O. Roshchin, O. Aleksandrova","doi":"10.17802/2306-1278-2022-11-4-72-78","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-4-72-78","url":null,"abstract":"Highlights. The process of updating the procedures for providing medical care services affects the quality and safety of patients. The current requirements and the results of public health surveillance are analyzed. Hypotheses have been formed for expert analysis in case of update of regulatory and administrative laws.Aim. To analyze the procedures for providing medical care services to further search for appropriate updating mechanisms.Methods. The study focuses on the analysis of the current procedures for provision of medical care services to the adult population suffering from cardiovascular diseases, and the analysis of 1319 reports published by governmental organizations during public healthcare surveillance for the period from 2015 to 2019 which revealed violations of the procedures for provision of medical care services to patients with cardiovascular diseases.Results. The procedures for providing medical care services to patients with cardiovascular diseases contain 983 provisions. 768 (78.13%) of them are equipment standards. Out of the remaining 215 provisions, excluding the equipment standards, 130 (60.46%) meet the criteria for mandatory requirements, and 63 provisions (29.30%) are unique (i.e., not duplicated in other legal acts). Of the 1319 inspections conducted by Roszdravnadzor (Federal Service for Surveillance in Healthcare) in 2015- 2019, 190 cases contained violations of the procedures for providing medical care services to cardiac patients. Of the 308 cases of detected violations, 206 (66.88%) were due to the absence of certain items provided for by the equipment standard. At the same time, 93.14% of all violations that were not associated with the equipment standards, occurred due to violation of 7 provisions of the Order of the Ministry of Healthcare of Russian Federation No. 918n. Identification of pattern of these violations revealed that issues related to the absence of two regulations of the equipment standard in medical organizations have never been addressed.Conclusion. The procedures for provision of medical care services to patients with cardiovascular diseases contain a relatively small number of mandatory requirements (compared to the total number of provisions contained in the procedures). Identification of the same type of violations of the regulatory act committed by numerous medical organizations indicates necessity to further assess their real contribution to the quality and safety of healthcare. The analysis of the reports published by governmental organizations made it possible to develop hypotheses that can be analyzed as “input” data by experts who participate in the process of updating the procedures for providing medical care services. The existence of data that could initiate the process of updating the procedures (or the process of rejecting the amendments) will assist in systematization of this work.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115379345","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":"Non-invasive methods of in vivo functioning analysis of the “TiAra” stentless valve prosthesis","authors":"P. Onishchenko, K. Klyshnikov, E. Ovcharenko, A. Stasev, A. Kokov, N. Brel, A. Yevtushenko, L. Barbarash","doi":"10.17802/2306-1278-2022-11-3-143-151","DOIUrl":"https://doi.org/10.17802/2306-1278-2022-11-3-143-151","url":null,"abstract":"Highlights. Non-invasive method for the assessment of the mobility and deformation of the wire element of the bioprosthesis in the cardiac cycle based on the developed mathematical algorithm is presented. Numerical analysis of the behavior of the wire element of the “TiAra” bioprosthesis is shown for the first time. The developed method can be used for other medical devices as well.Aim. To develop a method for non-invasive assessment of the mobility and deformation of the wire element of the aortic heart valve bioprosthesis in the cardiac cycle based on mathematical processing of visual medical data.Methods. Multidetector computed tomography data of patient P. (male, 66 years old), who received the “TiAra” aortic bioprosthesis (NeoCor CJSC, Kemerovo), were used for the study. Using the built-in tools in the Mimics Medical Image Processing Software (Materialize, Belgium), based on the radio density, 5 stages of movement of  the  wire  element  of  the  bioprosthesis  were  reconstructed  in  the  form  of 3D-models.  The  differences between  the  models,  characterizing  deformation in the cardiac cycle, were quantitatively assessed using a proprietary Matlab algorithm (The MathWorks, USA), calculating the distance between similar points. Moreover, obtained data on displacements was used in the numerical study of the stress-strain state of a 3D-model of the wire element by the finite element method in the Abaqus/CAE software (Dassault Systèmes SE, France).Results. The proposed method for assessing the mobility of the wire element made it possible to quantitatively evaluate the biomechanics of the “TiAra” stentless bioprosthesis based on multidetector computed tomography, a non-invasive clinical tool. The movements that the bioprosthesis undergoes during the cardiac cycle (the maximum value is 2.04 mm in the radial direction) are comparable to the movement of the aortic root of a healthy patient. The results of the numerical modeling of the stress state of the wire element did not indicate high amplitudes (peak value – 564 MPa) that would be capable of causing critical damage to the wire. It allows us to confirm the clinical safety of the bioprosthesis in real conditions like asymmetric and uneven loads. Moreover, deformations observed in the bioprosthesis are similar in the amplitude to the displacements of the aortic root described in the literature, which highlights the main feature of the bioprosthesis – ensuring the physiological biomechanics throughout the cardiac cycle.Conclusion. The presented method of qualitative computer assessment of the movement of the wire element of heart valve prosthesis using the “TiAra” bioprosthesis as an example demonstrates its validity as a tool for studying prosthesis functioning.","PeriodicalId":227108,"journal":{"name":"Complex Issues of Cardiovascular Diseases","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115019869","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}