Ukraïnsʹkij kardìologìčnij žurnal最新文献

{"title":"QT prolongation as a significant cardiovascular complication in cancer therapy","authors":"S. M. Kozhukhov, S. I. Deyak, O. Ye. Bazyka, N. V. Dovganich, O. Ya. Yarynkina, N. V. Tkhor","doi":"10.31928/2664-4479-2023.3-4.5665","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.5665","url":null,"abstract":"Стрімке впровадження нових протипухлинних засобів та технологій лікування сприяло підвищенню виживання хворих на рак. Однак, розвиток серцево-судинних ускладнень на тлі протипухлинного лікування нерідко призводить до зниження якості та тривалості життя онкологічних хворих.Одним з проявів серцево-судинних ускладнень при застосуванні протипухлинних лікарських засобів є подовження інтервалу QT з різними порушеннями серцевого ритму.Стаття базується на аналізі рандомізованих клінічних досліджень і метааналізів та рекомендаціях Європейського товариства кардіологів з кардіо-онкології. Наведено опис факторів ризику і класифікація подовження інтервалу QT, спричиненого протипухлинною терапією. Проаналізовані основні групи протипухлинних лікарських засобів, які індукують зміни інтервалу QT. Розглянуті етапи і кратність огляду онкологічних хворих при різних патологічних станах та порушеннях гемостазу, що можуть призводити до подовження інтервалу QT під час лікування та в різні періоди після його проведення.Огляд присвячений аналізу змін інтервалу QT та клінічному застосуванню алгоритмів прийняття рішень щодо мінімізації кардіотоксичності з метою підвищення ефективності протипухлинного лікування онкологічних хворих.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203253","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":"Предиктори утримання синусового ритму в пацієнтів із пізньою персистентною фібриляцією передсердь після електричної кардіоверсії під час 6-місячного проспективного спостереження","authors":"Ya. V. Skybchyk, O. J. Zharinov","doi":"10.31928/2664-4479-2023.3-4.719","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.719","url":null,"abstract":"The aim – to study the predictors of sinus rhythm (SR) maintenance in patients with persistent atrial fibrillation (AF) and duration of AF episode ≥90 days at 6-months follow-up after elective direct current (DC) cardioversion.Materials and methods. The cohort single-center study analyzed clinical and instrumental data from 59 persistent AF patients with duration of its episode ≥90 days (up to 12 months), who underwent an elective DC cardioversion. At 6-months follow-up, patients were subdivided into the groups depending on SR maintenance: 32 (54 %) patients with a maintained SR (G1), and 27 (46 %) patients with a failure to maintain SR (G2).Results. G2, as compared to G1, demonstrated more advanced heart failure (stage C occurred in 74 % and 44 %, respectively [p=0,019]). According to transthoracic echocardiography (TTE) data, G1, as opposed to G2, was characterized by better baseline structure parameters of left heart chambers, particularly the diameter of left atrium (LA), end-diastolic and end-systolic volumes left ventricular (LV) volumes, higher LV systolic function (by LV ejection fraction [EF]), and the majority of the cases without or with mild pulmonary hypertension (PH). Transesophageal echocardiography data suggested the cases of LA spontaneous (echo) contrast and LA appendage flow velocity (LAAFV) ≤ 40 cm/s to be more frequent in G2, in contrast to G1. We revealed the following predictors of SR maintenance after DC cardioversion at 6-months follow-up: higher LV EF (OR 1,07 (95 % CI 1,01–1,13); р=0,021); LAAFV > 40 cm/s (OR 4,33 (95 % CI 1,06–17,78); р=0,042), and less advanced PH (OR 0,24 (95 % CI 0,06–0,93); р=0,038). TTE data from G1 at 6-months follow-up after DC cardioversion suggested the reverse remodeling of both atria (the decrease of LA diameter, LA and right atrium volumes and their indexes). Additionally, G2 demonstrated a worsening in LV systolic function (the rise of LV end-systolic volume and decrease of LV EF), as opposed to G1. Moreover, at 6-months follow-up, G2 patients presented with more advanced severity of PH, as well as mitral and tricuspid regurgitation, in contrast to G1.Conclusions. Better LV systolic function, LAAFV > 40 cm/s and less advanced PH were the predictors of SR maintenance in patients with persistent AF and duration of its episode ≥ 90 days at 6-months follow-up after elective DC cardioversion. The SR maintenance at 6-months follow-up associated with the reverse remodeling of let heart chambers and right atrium. On the contrary, a failure to maintain SR associated with the decrease of LV systolic function, and more advanced PH, mitral and tricuspid regurgitation.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"777 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203260","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":"Клінічний та фармакологічний менеджмент гіпертонічної хвороби в осіб старших вікових груп","authors":"O. M. Kovalyova","doi":"10.31928/2664-4479-2023.3-4.6672","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.6672","url":null,"abstract":"The article is presented the review of published sources devoted the strategy of treatment the older patients with hypertension according to the geriatric symptoms and syndromes. The definition of orthostatic and postprandial hypotension, hypotension-hypertension syndrome is shown. Based on the analyses of publication are taken the data related to prevalence, prognostic meaning, clinical outcomes of frailty in older people. The influence of geriatric signs on cardiovascular risk is pointed out. The discussion questions of the association between administration of medications and orthostatic hypertension in older patients are considered. The recommendations of optimal pharmacological management of hypertension in older patients into account of personification principles with assessment of aging changes and their dynamics during treatment are given.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203252","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":"Демографічні й антропометричні фактори формування та змін перебігу фібриляції передсердь після перенесеної інфекції COVID-19","authors":"O. S. Sychov, O. V. Stasyshena","doi":"10.31928/2664-4479-2023.3-4.2028","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.2028","url":null,"abstract":"The aim – to analyze the probability of the development of atrial fibrillation (AF) «de novo», as well as to determine the course of an already existing rhythm disturbance after a transferred infection of COVID-19 in patients with different age, gender and anthropometric characteristics.Materials and methods. The study involved 116 patients with AF who were hospitalized in the department of clinical arrhythmology and electrophysiology from September 20.09.2020 to 21.12.2021 and had a history of coronavirus infection (CI). The 1st group – 36 people (31 %) in whom AF occurred after CI. The 2nd group – 25 patients in whom the form of AF has changed. The 3rd group – 55 patients in whom the form of AF did not change. In the 3rd group, two subgroups were formed: 3A – 35 patients in whom, although the form of AF did not change, the frequency or duration of arrhythmia paroxysms increased, and 3B – 20 patients without significant changes in the course of AF. As the first control group (C1), 49 patients with AF without a history of CI were examined. The second control group (C2) was formed by 22 patients after a CI in whom AF did not develop.Results and discussion. C1 patients were older than C2 patients by 10.4 years, p<0.0001. Individuals of groups 2 and 3 were probably older by an average of 2.5 years than the patients of the first control group. Group 2 patients were statistically significantly older (by 3.6 years) than group 3 patients. A large difference in age (by 12.9 years, p<0.001) of patients of the 1st group compared to the second control group was noted. That is, the older age of the patients was the cause of both «de novo» AF after a CI and the worsening of the course of this arrhythmia in those patients who had it before the infection of COVID-19. There were more women than men in the 2nd and 3rd compared to each other (where the ratio was 1.16:1.0) and compared to the control group (where the ratio was 0.44:1.0). Among the patients of the 3rd group, the frequency and duration of paroxysms increased in subgroup 3A, where there were statistically more women than in subgroup 3B and in the first control group. In addition, there were significantly more women than men in subgroup 3A (ratio 1.5:1.0, p<0.0001), which is a significant difference in the ratio of female to male patients in patients of subgroup 3B, where their ratio was 1.0:1.0. Therefore, female gender is a risk factor for the deterioration of the course of AF after infection with COVID-19.Excess body weight was found in 60 % of cases in patients who underwent CI and had AF. Patients of the 1st group, in contrast to C2, more often had excess body weight (BMI from 25 kg/m2 to 29 kg/m2). In subgroup 3A, unlike subgroup 3B, the average value of BMI was higher by 9 %. Excess weight contributes to the appearance of AF after CI and worsens the course of this arrhythmia.Conclusions. Excess body weight or obesity was found in 60 % of cases – i.e. in the vast majority of OG patients who under","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"189 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203259","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":"Захворюваність на COVID-19 та її вплив на смертність у хворих з легеневою артеріальною гіпертензією та хронічною тромбоемболічною легеневою гіпертензією","authors":"Yu. M. Sirenko, G. D. Radchenko, O. O. Torbas, Yu. A. Botsiuk, O. L. Rekovets","doi":"10.31928/2664-4479-2023.3-4.2937","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.2937","url":null,"abstract":"The aim – the COVID-19 pandemic influenced seriously on people life in all of the world, including patients with such hard-chronic diseases like pulmonary hypertensions. The aim of our study was to evaluate the COVID-19 morbidity and its influence on mortality during the first 13 pandemic months in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods. We provided the retrospective analysis of the patient data which were included in the center register before 31 March 2021. The evaluation of COVID-19 morbidity and mortality rate was done for the period between 01 March 2020 and 31 March 2021 (the period without active vaccination in Ukraine). The information about virus disease had to be confirmed by source documents. Results and discussion. Till 31 March 2021 the data of 494 patients with PAH/CTEPH were included in the register. 75 (15.2 %) patients died. During the follow-up period 44 patients suffered from COVID-19 (10.2 % among all (n=433) who were alive at 01 March 2020 or included in register after 01 March 2020). The most patients (91 %) with COVID-19 had the pneumonia, but only 9 (20.5 %) were hospitalized and 4 (9.1 %) were moved to the intensive care unit and died. In general PAH/CTEPH cohort the mortality rate was 2.9 % during the first 13 months of the pandemic. It did not significant differ with mortality rates in previous years, except 2015 year when the mortality rate was 12.3 %.Conclusion. The COVID-19 mortality was higher in pulmonary hypertensive patients in comparison with general Ukrainian population. But COVID-19 pandemic did not influence significantly on mortality rate in general PAH/CTEPH cohort during the first 13 pandemic months.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203045","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":"Стимуляційно-індукована кардіоміопатія в пацієнтів із постійною правошлуночковою стимуляцією та збереженою систолічною функцією лівого шлуночка: характеристика, методи лікування та профілактика","authors":"E. O. Perepeka, M. M. Sychyk, O. M. Trembovetska, V. V. Lazoryshynets","doi":"10.31928/2664-4479-2023.3-4.3847","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.3847","url":null,"abstract":"The aim – to determine the frequency of occurrence and describe the characteristics of pacing-induced cardiomyopathy (PICM) in patients with permanent right ventricular pacing (at least 90 %) and preserved left ventricular ejection fraction (LVEF) (≥ 50 %).Materials and methods. The study included 34 patients with indications for permanent ventricular pacing who had pacemaker implantation from 2012 to 2022 (mean follow-up period was 44.97±28.45 months). PICM was defined as a decrease in LVEF < 45 % during follow-up.Results and discussion. The incidence of PICM in this study was 26 %. The average value of LVEF and EDI at the time of the control follow-up was significantly different in the PICM group and non-PICM group: 38.6±5.9 vs. 53.5±5.7 % (p<0.001) and 97.90±20.75 vs. 60.90±19.32 ml/m2 (p<0.001). All patients from the study group during follow-up went through protocol echocardiography, at which intraventricular and interventricular asynchrony were examined, the number of left ventricular segments with reduced deformation were fixed, and the global longitudinal deformation of the left ventricle (GLS) was calculated. The values of these parameters differed significantly in the PICM group and non-PICM group: intraventricular asynchrony was 261.1±61.0 vs. 146.1±62.8 ms (p<0.001), interventricular asynchrony 91.0±36.4 vs. 54.2±22.2 ms (p=0.014), the number of segments with reduced deformation 8.1±2.6 vs. 3.91±2.30 (p<0.001), GLS -9.7±2.6 vs. -14.9±3.4 (p<0.001). At the time of the follow-up examination, sensitivity on ventricular lead in the PICM group was significantly reduced compared to patients with preserved LVEF (6.26±4.02 vs. 11.56±3.86 mV; p=0.045). The paced QRS width in the PICM group was significantly greater (163.0±22.7 vs. 150.8±14.5; p=0.046) and there were more patients with rate-adapted cardiac pacing in the PICM group (4 (40 %) vs. 2 (8 %)), p=0.0305).Conclusions. According to the obtained data, cardiomyopathy due to right ventricular pacing develops rather instantaneously in the first years after PM implantation, rather than slowly progressing over time, although a multivariate regression analysis of risk factors for the development of PICM has yet to be performed on the obtained clinical data. Biventri­­­cular paicng effectively eliminates the consequences of non-physiological right ventricular myocardial paicng, improves LV systolic function. Conduction system pacing may potentially reduce the risk of right ventricular pacing-induced cardiomyopathy in patients with preserved LVEF.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"225 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135207529","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":"Проблема госпітальних тромбозів коронарних артерій у пацієнтів із COVID-19 на тлі інтенсивної антитромботичної терапії","authors":"D. I. Besh, M. Yu. Sokolov, D. D. Zerbino, O. I. Boyko","doi":"10.31928/2664-4479-2023.3-4.4855","DOIUrl":"https://doi.org/10.31928/2664-4479-2023.3-4.4855","url":null,"abstract":"Myocardial infarction claims million lives on the planet each year. Pharmacotherapy in combination with percutaneous coronary interventions have significantly reduced morbidity and mortality in this cohort. Despite optimal therapy and prophylaxis, there is a group of patients with recurrent, often fatal, coronary thromboses. During the COVID-19 pandemic, some patients developed episodes of thrombosis in blood vessels of various organs, including brain, heart or lungs, even on therapeutic anticoagulation. The patient was admitted to the department of cardiology and reperfusion therapy, with a confirmed diagnosis of COVID-19 resulted in acute ST-segment elevation myocardial infarction. Patient underwent urgent coronary angiography with thromboaspiration and stenting of the infarct-dependent right coronary artery followed by optimal medical treatment with the use of triple antithrombotic therapy. His condition became stable with the resolution of ST-segment elevation on electrocardiogram. A few days later, the condition of the patient deteriorated again with recurrent of chest pain and a new ST segment elevation. Repeated coronary angiography revealed recurrent thrombosis in the right coronary artery. The mechanisms of thrombosis in COVID-19 are not fully understood. Among possible, the direct effect of the virus on tissues, activation of pro-inflammatory system and coagulation system, impaired vasodilation, and decreased fibrinolytic activity are discussed. These mechanisms may lead to vascular thrombosis in different organs, particularly heart, lungs, and brain.","PeriodicalId":486888,"journal":{"name":"Ukraïnsʹkij kardìologìčnij žurnal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135203251","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}