Ukrainian Journal of Cardiology最新文献

{"title":"Реєстр PULSE-COR: взаємозв’язок між еластичністю лівого шлуночка та жорсткістю артерій у пацієнтів з есенціальною артеріальною гіпертензією","authors":"O. Torbas, S. O. Progonov, Y. Sirenko, G. D. Radchenko","doi":"10.31928/2664-4479-2024.1.7178","DOIUrl":"https://doi.org/10.31928/2664-4479-2024.1.7178","url":null,"abstract":"For a long time, the problem of the formation of diastolic dysfunction (DD) of the left ventricle (LV) in patients with arterial hypertension (AH) remained insufficiently studied. It was demonstrated that the formation of LV DD is largely related to the increase in stiffness of this heart chamber. We decided to evaluate the extent to which increased LV stiffness, determined noninvasively by echocardiography, is associated with LV diastolic dysfunction and determine the relationship of this method with arterial stiffness indicators for which validated methods have been developed.Materials and methods. A one-center registry called PULSE-COR was established in 2011 and is still in operation. There were 779 AH participants in our sample. A distinct cohort of patients (n=283) with essential AH and no substantial comorbidities were found from the final analysis, which comprised 320 patients who had undergone all requisite diagnostic procedures. Our tool of choice for measuring carotid-femoral pulse wave velocity (cfPWV) was the SphygmoCor device (AtCor, Australia). We also used the VaSera 1500 device (Fukuda Denshi, Japan) to measure cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI). Vascular ultrasound and intima-media thickness measurement (IMT) were included in the ultrasound diagnosis. The ASE 2016 recommendations were followed for the evaluation of diastolic LV function, and the standardized ASE protocol was followed for echocardiography. A standardized formula was used to assess the ventriculo-arterial coupling (VAC) which also included LV end-systolic elastance (Ees) and arterial elastance (Ea) evaluation. We conducted Spearman correlation analysis to identify relationships.Results and discussion. Our cohort were patients with AH, 51 % males; the mean age was 53.6±2.0 years. Mean office blood pressure (BP) was 159.8±4.5 mm Hg for systolic (SBP), 97.9±2.6 mm Hg for diastolic (DBP), 62.0±3.5 mm Hg for pulse blood (PBP) BP, and 76.6±2.2 bits per minute was the mean heart rate (HR). Both the left and right CAVI (R=0.698; p=0.012 and R=0.683; p=0.014) showed a strong correlation with VAC. Both E/A and E/e showed a substantial correlation with ABI (R=0.716; p=0.006 and R=0.764; p=0.002, respectively). cfPWV was linked with nearly the same parameters (R=0.248; p=0.001 for correlation with IMT, R=0.382; p=0.01 for correlation with low-density lipoproteins). Ea was substantially associated with IMT (R=0.491; p=0.24), total cholesterol (R=0.499; p=0.07), and low-density lipoproteins (R=0.687; p=0.001). Ees was substantially correlated with end diastolic volume (R=0.644; p=0.001), blood lymphocytes (R=–0.678; p=0.001), E/A (R=0.159; p=0.007), and E/e’ (R=–0.130; p=0.029).Conclusions. We have found a substantial correlation between validated arterial stiffness measurements and non-invasive LV stiffness evaluation parameters (VAC). VAC also was associated with LV diastolic function parameters","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140420919","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":"Імунопатологічні аспекти етіопатогенезу міокардиту","authors":"F. Hladkykh","doi":"10.31928/2664-4479-2024.1.103112","DOIUrl":"https://doi.org/10.31928/2664-4479-2024.1.103112","url":null,"abstract":"Myocarditis is a group of inflammatory diseases of the heart muscle against the background of the absence of acute or chronic ischemic heart disease, which are diagnosed according to established histological, immunological and immunohistochemical criteria.Objective. Summarize current information on the immunopathogenesis of myocarditis based on data from open sources of information.Methods. Publications were selected based on PubMed, Clinical Key Elsevier, Cochrane Library, eBook Business Collection and Google Scholar databases, which covered information on the immunopathogenesis of myocarditis.Results. Viral infections are the most common cause of myocarditis, along with some bacteria and protozoa. Chronic immune stimulation or autoimmunity in chronic viral myocarditis results from incomplete resolution of the viral infection or response to a previous virus or immune-mediated chronic tissue injury. An active autoimmune response in human myocarditis, both at the cellular and humoral levels, is the immunological basis for the development of this pathology. Myocarditis caused by COVID-19 is a new entity. At the moment, four main manifestations of myocarditis in the context of SARS-CoV-2 have been identified: myocarditis associated with an acute infection of COVID-19, post-acute syndrome of COVID-19 (or prolonged syndrome of COVID-19), multisystem inflammatory syndrome, and myocarditis due to related to vaccination. Autoimmune reactions probably contribute to molecular mimicry – they activate virus-specific T-cells that attack the myocardium. During this phase, high concentrations of cytokines (eg, tumor necrosis factor, interleukins 1a, 1b, 2, and interferon-γ) are produced. These cytokines, together with antibodies against viral and cardiac proteins, further exacerbate cardiac damage and systolic dysfunction due to contractile dysfunction and matrix proteins.Conclusions. CD4+T-cells are defined as the main driving forces of heart-specific autoimmunity in myocarditis. Dysregulated CD4+ T-cell populations and their associated cytokines are critical for the development and progression of myocarditis and may serve as therapeutic targets and the development of new treatment approaches.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140421166","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":"Physical functional recovery in the early period after hospitalization for COVID-19: impact of hypertension and outcome prediction model","authors":"O. Honchar","doi":"10.31928/2664-4479-2024.1.5970","DOIUrl":"https://doi.org/10.31928/2664-4479-2024.1.5970","url":null,"abstract":"The aim – to study the influence of hypertension (HT) on the dynamics of natural recovery of physical functional status in the early period after hospitalization for COVID-19 and to develop a model for predicting recovery results at 1 month after discharge.Materials and methods. 221 hospitalized patients with COVID-19 (age 53.4±13.6 years, 53 % women) were included in the study, 176 of whom underwent the 6-minute walk test (6MWT) using an extended protocol within 1-2 days before discharge. A repeat visit to assess the dynamics of natural recovery was performed at 1 month after discharge.Results and discussion. Pre-discharge 6-minute walk distance was 378±57 m in patients with HT and 418±75 m without it, p=0.001, during the second visit – 440±52 versus 478±68, p=0.002; the achieved percentage of the individually predicted distance was 67.4±10.5 vs. 69.5±13.6 % and 81.6±9.9 vs. 81.9±15.7 %, respectively, p>0.05 for both visits. The increase in heart rate during the test at visit 1 was 18.5±8.3 versus 30.1±19.3 bpm, p<0.001, the percentage of chronotropic reserve utilizatoin was 21.3±9.6 % versus 29.2±11.4 %, p<0.001. During the second visit, residual manifestations of this trend were observed, with an increase in HR by 24.0±9.5 vs. 30.8±12.1, p=0.003 and the use of chronotropic reserve of 28.1±10.1 % vs. 33.4±12.4 %, respectively, p=0.029. The developed multivariate linear regression model explained 59 % of the variability in the achieved percentage of the individually predicted 6-minute walk distance at 1 month after discharge. The use of machine learning allowed to create an artificial neural network based regression model that used age, height, use of remdesivir in treatment, and SBP and DBP values at the time of discharge as predictors, and explained 90 % of observed variability.Conclusions. Hospitalized patients with COVID-19 were characterized by a decrease in the general physical functional status as assessed by 6MWT at the time of discharge and incomplete recovery after 1 month. Presence of hypertension was associated with more pronounced disturbances of the autonomic regulation of heart rate, but did not affect the reached percentage of the distance walked. The proposed artificial neural network based regression model allows for a high accuracy prediction of the 6MWT results at 1 month after discharge, which can be used in the selection of candidates for cardiopulmonary rehabilitation programs.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"53 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140422032","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":"Changes in the normal blood pressure profile under various stress conditions in patients with arterial hypertension","authors":"O. Torbas, Y. Sirenko, S. Progonov","doi":"10.31928/2664-4479-2023.1-2.4047","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.4047","url":null,"abstract":"The aim – to assess the influence of various external factors and stress due to a large-scale military invasion on the daily blood pressure (BP) profile.Materials and methods. This was a retrospective analysis of examined patients who underwent ABPM in the last 5 years. We conditionally divided the observation period into several time intervals: the «War» – 1st group, the «Before the war» – 2nd group, the «Covid» – 3rd group, and the «Peace» – 4th group, in each of it 20 patients were selected by the method of random numbers. All patients underwent ABPM using the Watch BP 03 device (Microlife AG, Switzerland).Results. All groups were comparable according to the age, gender, and average daily BP and heart rate parameters of participants. Patients of all groups were middle-aged, the amount of men and women was equal in all groups, groups were comparable according to the results of average daily systolic (SBP), diastolic (DBP), pulse (PBP) BP and heart rate. We found that the 1st group had a significantly lower percentage of SBP and DBP decrease at night compared to all other groups (7.6±1.3% for SBP and 10.2±1.4% for DBP). The standard deviation of SBP and DBP was significantly higher in the 2nd group (19.8±1.1 and 14.2±0.7, respectively) compared to the 1st group (16.0±0.9 and 11.7±0.6, respectively) and 3rd (16.2±0.7 and 11.8±0.7, respectively). The highest frequency of non-dippers for SBP and DBP was observed in the 1st group (60 and 45 % respectively).Conclusions. During the war, the reduction of SBP and DBP at night in patients with hypertension was significantly lower than in the period before the war, pandemic Covid-19, and peace pre-war. There was also a higher number of non-dippers in this group.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77791588","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":"Nebivolol as a beta-blocker with vasodilating properties: achievements and prospects","authors":"G. Solovyan, Т. V. Міkhalieva, L. O. Androsova","doi":"10.31928/2664-4479-2023.1-2.7382","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.7382","url":null,"abstract":"A literature review deals with the clinical use of nebivol as a beta-blocker (BB) with vasodilating properties. The principal pharmacological properties and characteristics of the drug, its cardioselectivity and mechanisms of vasodilation are presented. The special place of nebivolol in the treatment of essential arterial hypertension (AH), coronary heart disease (CHD) and heart failure (HF) is outlined. The drug does not possess a diabetogenic activity with a long-term use, and impacts favourably on the parameters of lipid and carbohydrate metabolism. In CHD patients, nebivolol demonstrates the antianginal and antiischemic activities, and reduces the frequency of angina recurrence after coronary artery interventions. The drug is well tolerated and characterized by a high effectiveness with respect to the reduction of mortality rates in patients with chronic HF over 70 years of age, regardless of the left ventricular ejection fraction. Vasodilating BB are preferred in the treatment of CHD patients with type 2 diabetes. In case of non-obstructive coronary lesions, nebivolol is chosen among existing BBs for the treatment of microvascular angina. The use of nebivolol in AH patients, in addition to the antihypertensive effect, is characterized by a favorable impact on the function of endothelium, the metabolic profile, central hemodynamics, health-related quality of life of patients, as well as more favorable profile of side effects","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88886500","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":"Atrial fibrillation as prognostic factor in patients with pulmonary embolism","authors":"V. Tseluyko, R. Askerov","doi":"10.31928/2664-4479-2023.1-2.719","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.719","url":null,"abstract":"The aim – to analyze the clinical course and prognostic factors in patients with pulmonary embolism (PE) and concomitant atrial fibrillation (AF).Materials and methods. We analyzed 243 medical cards of patients with diagnosis «PE» who were hospitalized to Kharkiv City Clinical Hospital No.8. during 01.01.2018 – 01.01.2020 period. The inclusion criteria was diagnosis «PE» verified by multispiral computed tomography angiography (CTPA) of pulmonary arteries and/or by autopsy. Patients were divided in several groups: 1 – PE with AF (45 pts – 18.5 %), 2 – PE with no AF (198 pts – 81.5 %). Patients from group 1 were divided in such subgroups as: 1А – PE + AF de novo (22 pts – 48.8 %); 1В – PE + AF existing before acute PE (23 pts – 51.2 %). Clinical, anamnestic, biochemical, instrumental parameters, mortality rates were measured; statistical analysis was done.Results and discussion. Pts from group 1 were older (67.2±10.6 vs 58.6±14.6), had more cases of ischemic strokes in past. By admission to hospital most of high-risk patients were among group 1. We noticed that patients from group 1 who had low-risk profile also had respectively higher points measured by PESI. Patients with PE + AF had respectively lower saturation and higher heart rate; granulocyte count and serum creatinine ration. Several parameters measured with CTPA and echocardiography differed significantly in PE + AF and PE without AF groups: diameter pulmonary trunk; diameter of pulmonary arteries, size of the left and right atrium, left ventricle (LV) end diastolic diameter, LV end systolic diameter, LV ejection fraction and mean pulmonary arterial pressure (PAP). There were several differences between 1A and 1B groups: patients with PE + AF existing before had more cases of ischemic stroke. High-risk status was much common among patients with PE + AF de novo despite the fact that all patients with PE + AF with low-risk status had high points and classes measured with PESI. We noticed that patients with PE + AF had also respectively differences in granulocyte count and serum creatinine. There were also differences in echocardiographic parameters as size of left atrium (bigger in group 1B) while mean PAP was much bigger in group 1A. It should be mentioned that general mortality rate was 18.5 %, while there were big differences between mortality rates in groups 2 and 1 (13.6 % vs 44.4 %). Mortality rate differed significantly in patients with PE + AF de novo and PE + AF existing before (67.5 % vs 21.7 %). We used uni- and multivariate analyses to find out prognostic factors (AF is among them).Conclusions. AF was found in 18.5 % of patients with PE, AF de novo – in 9 %. Patients with PE + AF were 8.6 years older than patients with PE without AF. Vein thrombosis is less common among patients with PE + AF. Patients with PE + AF have larger sizes of left and right atrium and more poor ejection fraction of left ventricle. AF, as age, blood saturation, obesity, PESI score, is independent prognost","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78712729","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 an innovative technology for predicting the course of COVID-19 based on the analysis of clinical and anamnestic data","authors":"O. Shumakov, O. Parkhomenko, O. Golubovska","doi":"10.31928/2664-4479-2023.1-2.4856","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.4856","url":null,"abstract":"The aim – to determine a prognostically significant set of anamnestic (primarily cardiovascular) risk factors and indicators of the initial clinical condition in the population of patients with COVID-19, on the basis of which to develop a scale for assessing the clinical condition to identify patients with a more severe subsequent course of the disease for the individualization of treatment tactics.Materials and methods. The retrospective analysis included data on 104 patients with COVID-19 (50 men and 54 women, aged 24 to 84 years), who during 2020-2021 underwent treatment (16 days) in clinics of Ukraine within the framework of the program for studying the effectiveness of treatment COVID-19. Risk factors (advanced age, inflammatory diseases, hypertension, obesity, diabetes, coronary heart disease, heart failure (HF)), dynamics of the clinical state (heart rate, body temperature, blood pressure, SpO2, respiratory rate (RR), clinical symptoms and signs from all systems of the body) were assessed. Based on the dynamics of the clinical condition (according to a specially developed scale), all patients were divided into subgroup A (66 patients, more severe hospital course of COVID-19, ≥ 7 points) and subgroup B (38 patients, milder course of COVID-19, < 7) points).Results and discussion. Among the anamnestic risk factors (RF) of a more severe hospitalization for COVID-19, the following were more informative than others: age > 53 years (HR 1.8 (1.11–3.02)), history of coronary artery disease (HR 1.42 (1.09–1.85)) and SN (HR 1.67 (1.41–1.96)), as well as a model built taking into account all the estimated RFs according to their significance (HR = 1.88 (1.37–2.74), area under the ROC curve (ROC) 0.73). Among the clinical markers (CM) of the first day, the most informative were: RR > 20/min (HR 1.74 (1.10–2.74)), body temperature > 37.8 °C (HR 1.48 (1.13–1.94)) and a model with eight KM (HR 2.45 (1.55–3.87), ROC 0.80). The obtained scales were additive: the combined scale of RF and CM had ROC 0.84, value > 21 units on the first day of COVID-19 had a sensitivity of 76 % and a specificity of 76 % (HR 2.38 (1.58–3.58)) in predicting the adverse course of the disease during the next 16 days.Conclusions. The risk assessment system developed by us, based on clinical and anamnestic data, on the first day of treatment for COVID-19 allows predicting a more severe course of the disease. The data obtained by us require further study in a prospective study.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86405008","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":"Adherence to treatment in patients with resistant arterial hypertension","authors":"O. Rekovets, Y. Sirenko","doi":"10.31928/2664-4479-2023.1-2.3039","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.3039","url":null,"abstract":"The aim – to identify patients with true resistant arterial hypertension and to assess patients’ adherence to treatment on the background of a fixed combination of antihypertensive drugs.Materials and methods. 1146 patients with resistant hypertension were included in the study. Men and women over the age of 18 were included, provided that the average level of office blood pressure (BP) was greater than 140/90 mm Hg, when taking 3 or more antihypertensive drugs. Morisky – Green Questionnaire (in a modified scale) (MMAS-8) on patient adherence to treatment. To determine adherence to treatment in some patients, determination of drugs in urine was carried out in the central laboratory. All patients were initially subjected to the following tests: measurement of office SBP, DBP and heart rate, daily monitoring of BP, biochemical blood test.Results and discussion. 51.4 % of patients took 3 antihypertensive drugs. 48.6 % took 4-6 antihypertensive drugs: among them, 4 drugs – 37.1 %, 9.1 % – took 5 drugs, and 2.4 % – 6 drugs. The degree of decrease in office BP among patients taking 3 or more antihypertensive drugs was 43.47 ± 0.65 mm Hg for systolic BP, and 20.33 ± 0.74 mm Hg for diastolic BP (p<0.001 for both values). 355 (31 %) patients failed to achieve the target level of office BP. They had true resistant hypertension. According to the Morisky – Green adherence questionnaire, on the background of the fixed triple combination of valsartan/amlodipine/hydrochlorothiazide, there was a significant improvement in adherence for all questions of the questionnaire. Patients began to forget to take pills significantly less, therapy became stable and regular, there were much fewer cases of stopping taking drugs due to deterioration of the patient’s condition after taking them, all 100 % of patients took antihypertensive drugs on the eve of the visit to the doctor, patients stopped canceling therapy due to their well-being at against the background of treatment, much fewer patients were bothered by the inconvenient regimen of taking drugs. Patient pill size was significant in only 11.4 % of patients at baseline and did not significantly change after 3 months of treatment with the fixed triple combination. But if patients had a choice, 60 % of them would choose the smaller pill. According to the determination of drugs in urine among 12 patients, we found that 25 % of patients (n=3) did not take drugs at all.Conclusions. Resistant arterial hypertension was found in 31 % of patients taking 3 or more antihypertensive drugs. When determining adherence to treatment based on the detection of drugs in urine, 25 % of patients with resistant arterial hypertension did not take the prescribed drugs at all, that is, they had pseudoresistance.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90685587","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":"Diagnostic and prognostic value of glycemic variability in patients with obstructive coronary artery disease after percutaneous coronary intervention","authors":"Ya.Yu. Dzhun, G. Mankovsky","doi":"10.31928/2664-4479-2023.1-2.5766","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.5766","url":null,"abstract":"The aim – assessment of the diagnostic and prognostic value of glycemic variability indicators in patients with coronary artery disease (CAD) after percutaneous coronary intervention followed by optimal drug therapy.Materials and methods. 121 patients with impaired glucose metabolism took part in the study, who, depending on the presence of CAD, were divided into two groups: group I (n=65) – CAD (+), group II (n=56) – CAD (-). Glucose variability was determined using a continuous glucose monitoring system for 6 days before the start of the study. The method of choice for coronary artery revascularization was percutaneous coronary intervention followed by optimal drug therapy. The results of the study were evaluated by the presence of clinical manifestations of the progression of coronary heart disease and the development of acute cardiovascular events in patients.Results and discussion. Distribution of patients by gender, bad habits and most concomitant diseases, both groups were comparable, the average age of patients was 54.2 years. With comparable initial values ​​of glycated hemoglobin (7.3±0.9 % vs 7.5±1.2 %, p=0.29), the indicators of glycemia variability were significantly higher in patients with coronary artery disease (mean glucose 8.6±2.1 vs 7.5±1.9 mmol/L; p<0.05). During the observation period (2 years), 20 patients (16.5 %), of which 17 (14.1 %) had a history of CHD and 3 (2.5 %) without a previous diagnosis of CHD, had clinical signs of progression of this disease. 7 (5.8 %) patients developed an acute coronary syndrome, among which 3 (2.5 %) had unstable angina, 3 (2.5 %) had an acute non-Q myocardial infarction, and 1 (0.8 %) had an acute Q-myocardial infarction. When comparing the frequency of development and assessing the relative risk of progression of clinical symptoms of CAD and the development of acute cardiovascular events, the most significant factors were the percentage of time below the target range of glycemia < 3.9 mmol/l more than 5 % per day and SD above 2.Conclusion. Increased glycemic variability (SD > 2 mmol/L) and period of hypoglycemia < 3.9 mmol/L more than 3 % per day are negatively associated with clinical progression of CAD and the development of recurrent acute cardiovascular events in middle-aged patients with concomitant diabetes mellitus after percutaneous coronary intervention followed by optimal drug therapy.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90755195","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":"Soluble ST2 association with outcome of revascularization and the heart failure development in patients with acute myocardial infarction with ST segment elevation","authors":"M. Kopytsya, Y. Hilova, I. M. Kutya, Y. Rodionova, L. L. Petieniova","doi":"10.31928/2664-4479-2023.1-2.2029","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.1-2.2029","url":null,"abstract":"The aim – to study the relationship between the sST2 level and the degree of epicardial blood flow recovery and with the heart failure (HF) development in 6 month follow-up in patients with STEMI after PCI.Materials and methods. The study involved 61 patients with STEMI – 51 (83.6 %) males and 10 (16.4 %) females, with average age of 59.85±10.01 years. Standard clinical and biochemical parameters were determined, as well as sST2 level was measured by enzyme immunoassay using a reagent kit «Presage ST2 analysis, Critical Diagnosis» (USA) in all patients, on the first day of the disease. Patients were divided into two groups depending on the degree of blood flow recovery in a culprit artery (TIMI) The first group (n=12) included patients with TIMI 0, I, II, the second group (n=49) with TIMI III.Results and discussion. The sST2 level was significantly higher in the first hours of the disease in the group with unrepaired or decreased epicardial blood flow (TIMI 0–II) after PCI (p=0.003). ROC analysis showed that sST2 levels above 34.2 ng/ml, detected in the first hours of the disease, is an independent marker of adverse revascularization (TIMI 0–I) in patients with STEMI with a sensitivity of 92.3 % and a specificity of 62.5 %; the area under curve (the AUC) is 0.8 (95 % CI=0.651–0.873; p=0.001). When conducting a univariate (χ2=17.741; p=0.04) and multivariate (χ2=9.293; p=0.004) logistic analyzes, sST2 was a significant influencer of the unfavorable outcome of epicardial vascular revascularization (TIMI 0–ІІ).Conclusions. sST2 is highly associated with the degree of epicardial blood flow recovery in patients with STEMI and is of great clinical importance as diagnostic marker.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85176233","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}