2018 Том 2, №2
 

Word rector
A.V. Sikorsky
The scientific and practical peer-reviewed journal Emergency Cardiology and Cardiovascular Risks covers the results of fundamental and applied interdisciplinary medical research, modern clinical guidelines and protocols aimed at developing and improving medical care.
Department of cardiology and internal diseases of Belarusian state medical university - 10 years!
The Department of Cardiology and Internal Diseases of the educational institution "Belarusian State Medical University" was organized on August 27, 2008. The need for progressive development of the medical education system, understanding the need for graduates of the university to develop the skills of fast and professional response in emergency situations, the study of emergency cardiology, the development of modern methods of diagnosis and treatment were the basis for making a positive decision and supporting the ideology of doctor of medical sciences, professor NP Mitkovskaya on the creation of a new progressive young department by the Department of Medical Sciences of the National Academy of Sciences of Belarus, the Ministry of Health of the Republic of Belarus and the country's leading cardiologists - Doctor of Medical Sciences, Professor, Academician of the National Academy of Sciences of Belarus G.I. Sidorenko, Doctor of Medical Sciences, Professor, Academician of the National Academy of Sciences of Belarus A.G. Mrochek, doctor of medical sciences, professor, corresponding member of the National Academy of Sciences of Belarus V.A. Snezhitsky.
Cardiac myxoma - difficult diagnosis cases
E.L. Trisvetova, M.I. Guseva, K.M. Kaminsky, E.I. Shkrebneva
Absence of characteristic signs leads to late diagnosis of myxoma of the heart, complicated by congestive heart failure, embolism in various vascular regions, cardiac arrhythmias, sudden cardiac death. Nonspecific clinical syndromes due to the presence, localization or structural features of the tumor including systemic manifestations, congestive heart failure caused by obstructive intracardiac disorders or embolism in the vessels of the systemic and pulmonary circulation justify the performance of diagnostic methods of heart visualization. An informative noninvasive method of diagnosis is echocardiography, which, in two cases of observation, revealed myxoma of the heart.
Successful surgical repair of ventricular septal defect and left ventricle aneurysm in acute myocardial infarction
A.V. Yanushko, S.L. Salauyou, Yu.T. Liutkevich, I.L. Kiziukevich
Postinfarction ventricular septal defect (VSD) is a rare, but fatal complication developing within the first two weeks from the onset of myocardial infarction (MI). Patients with VSD most frequently die of acute decompensated heart failure within several days. Nevertheless, the timing of surgical repair still remains under consideration. A more «aggressive» approach implies closing the defect in the shortest possible time period after VSD is diagnosed; whereas some surgeons advocate stabilization of patients’ hemodynamics by means of circulatory support devices with the subsequent delayed surgical treatment. We present a clinical case of the patient with acute myocardial infarction who underwent successful surgical treatment for two life-threatening complications of acute MI: VSD and posterior aneurysm of the left ventricle.
Dysglycemia of critical conditions
O.N. Isachkina, L.I. Danilova
Dysglycemia develops in the form of hyperglycemia, hypoglycemia and marked glucose variability in critically ill adults whether they are known to have premorbid diabetes or not. Patients with such glucose dysregulation have increased morbidity and mortality. Substantial data obtained over the past decade provide evidence that quality glucose management in these individuals improves clinical outcomes. Multicentre trials did not confirm the benefits of tight control of blood glucose. The general consensus now is that excessive hyperglycemia (>10 mmol/L) and severe hypoglycemia (<2.2 mmol/L) should be avoided in critically ill adults. This review describes the epidemiology, pathophysiology and management of dysglycemia in critically ill patients.
Topical issues of managing patients with hypertensive crises
V.N. Khirmanov
Doctors of different specialties often see patients with hypertensive crises, the need to provide urgent care for these rather diverse pathological conditions and to manage such patients in the future. This article presents current data, mainly expert advice, on how to choose the proper treatment tactics in patients with hypertensive crises.
Smoking and the results of percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (according to the data of Tyumen
I.S. Bessonov, V.A. Kuznetsov, I.P. Zyryan ov, G.S. Pushkarev
The aim of this study was to evaluate the effect of smoking on the results of percutaneous coronary interventions (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).
Pharmacogenetic testing in percutaneous coronary interventions
S.S. Galitskaya, E.S. Smirnova, A.A. Gusina, E.A. Sulimchik, T.V. Statkevich, N.P. M itkovskaya
The aim of the study was to analyze the influence of genetic polymorphisms of ABCB1 and CYP2C19 on the developament of recurrent coronary events in patients with STA segment elevation acute coronary syndrome undergoing primary percutaneous coronary intervention. During the study laboratory, instrumental and statistical methods were used. Genetic testing was performed in 64 patients. Characteristic features of polymorphic variants of ABCB1 and CYP2C19 and their relation to the development of recurrent coronary events were analyzed. Genetic testing in patients undergoing percutaneous coronary interventions for STA segment coronary syndrome may contribute to the prevention of serious complications of the disease.
Myocardial remodeling and liver transplantation: results of a prospective single-center study
E.A. Grigorenko, S. Kibira, O.O. Rummo, N.P. Mitkovskaya
The article identifies the structural and functional features of the heart in patients with chronic terminal liver disease (CTEP) in need of transplantation, and their dynamics in liver transplant recipients in the postoperative period.
Myocardial remodeling and liver transplantation: the results of prospective single-center study
E.A. Grigorenko, S. Kibira, O.O. Rummo, N.P. Mitkovskaya
Objective: to determine structural and functional characteristics of the heart in patients with chronic terminal hepatopathy in need of transplantation and their dynamics in liver transplant recipients in the postoperative period.
Physiological evaluation of spectrometry results of oxyhemoglobin content and response of microvessels to hemodynamic changes
A.I. Kubarko, V.A. Firago
Spectroscopic measurements of the density and cross-sectional area of microcirculation vessels of superficial tissues, oxyhemoglobin blood content in these vessels and their response to the blood flow cessation, restriction of arterial blood flow and blockade of venous outflow have been analyzed. The character and direction of the revealed changes are consistent with the existing concepts of the physiological and pathophysiological mechanisms of vascular and tissue metabolism response to the local blood flow disorders. The spectrometry method can be used to assess the compliance of microcirculation to the tissues metabolic needs in functional stress and pathology.
Cardiovascular risk stratification in patients with chronic obstructive pulmonary disease
D.V. Lapitski
Objectives. To perform cardiovascular risk stratification and comorbidity assessment, to find out forced desaturation impact on the cardiovascular system in patients with chronic obstructive pulmonary disease (COPD) and to improve COPD patients’ management tactics based on the data obtained.
Endovascular left atrial appendage occlusion in nonvalvular atrial fibrillation
A.S. Postojalko, S.A. Sivak, M.I. Kudash, S.S. Galitskaya
The aim of the study was to investigate the immediate and follow up results of the first Belarus experience of transcatheter left atrial appendage occlusion with the Watchman device in patients with nonvalvular atrial fibrillation.
Atherosclerotic internal carotid arteries stenosis: clinical manifestations and outcomes of chronic cerebral ischemia
E.K. Sidorovich, S.A. Likchachev, N.I. Chernenko
The aim: to study the clinical manifestations, elastic properties of the carotid arteries and the outcomes in the patients with chronic cerebral ischemia (CCI) and the internal carotid artery (ICA) bilateral atherosclerotic stenosis.
Pulmonary embolism: characteristic features of the course in the presence of heart failure
T.V. Statkevich, I.V. Patsiayuk, E.M. Balysh, E.B. Petrova, E.V. Moklaya, I.E. Levkovich, N.P. Mitkovskaya
Aim: to determine characteristic features of the disease in the presence of heart failure syndrome (HF) based on the study of clinical findings, laboratory markers of dysfunction and damage to the right ventricle and the results of instrumental methods of examination of patients with pulmonary embolism (PE).
The state of vascular-platelet hemostasis in children with arterial hypertension
V.V. Strogiy, O.N. Volkova, V.D. Yushko, E.V., Kilchevskaya
The purpose of the study was to study the state of primary hemostasis in children with arterial hypertension (AH) and assess the effect on obesity, weighed heredity of atherosclerosis. The study of primary hemostasis was performed by studying the number and function of platelets among 146 children with hypertension. Of these, 49 children had concomitant obesity, 53 children had hereditary atherosclerosis and 44 children had AH without concomitant pathology. Children with AH have an increase of the aggregation process at more pronounced at low concentrations of the ADP solution (0.5 mmol / L) and enhancing the adhesive properties of the platelets themselves. Obesity promotes maximum growth of adhesive-aggregation potential of platelets in children with AH. The presence of weighed heredity in atherosclerosis in patients with AH promoted a more pronounced increase in aggregation and adhesive properties of platelets, caused by dyslipidemia, hereditary predisposition.
Antianginal treatment options of patients with incomplete myocardial revascularization in the long-term period after primary percutaneous coronary intervention
N.L. Tsapaeva, N.V. Tarashkevich, E.V. Mironova, Chernoglaz, D.I. Yurievich
The aim of the present study is to investigate the clinical and microcirculatory status and possibilities of ranolazin treatment in patients with in complete myocardial revascularization in long -term follow -up after primary percutaneous coronary intervention.
Risk stratification of cardiovascular interventions in patients with reduced myocardial contractility. Part 2. Markers of myocardial
V.V . Shumavets, A.V . Pankratov, M.G . Kaljadka, I.I. Grinchuk, I.I. Russkih, I.V . Sidorenko, Y.P. O strovski
Background: Novel biomarkers now exist to potentially improve preoperative stratification models. We aimed to assess the expression and significance of novel bio markers perioperatively in open heart surgery in patients with low ejection fraction (EF).
Risk stratification of cardiovascular interventions in patients with reduced myocardial contractility. Part2. Markers of myocardial stress and injury
V.V. Shumavets, A.V. Pankratov, M.G. Kaljadka, N. Shibeko, l.l. Grinchuk, l.l. Russkih, E.R. Lysenok, Y.P. Ostrovski
Background: Background: Background: Background: Background: Only clinical risk factors alone are used in current preoperative models estimating risk of hospital mortality following cardiac surgery. However, novel biomarkers such as Nterminal pro Btype natriuretic peptide (NTProBNP), high - sensitivity troponin I (hsTnI) or Galectin$3 potentially can improve the predictive ability and capacity to risk stratify patients before cardiac surgery. In this part we aimed to assess these novel biomarkers of cardiac remodeling and injury periope-ratively open heart surgery in patients with low ejection fraction.
Cardiovascular risk stratification in patients with chronic obstructive pulmonary disease
D.V. Lapitski
Objectives. To perform cardiovascular risk stratification and comorbidity assessment, to find out forced desaturation impact on the cardiovascular system in patients with chronic obstructive pulmonary disease (COPD) and to improve COPD patients’ management tactics based on the data obtained.
The role of vascular and metabolic factors in the pathogenesis of nontraumatic avascular necrosis of bone tissue
N.A. M artusevich, E.V. G udkevich, A.E. Murzich
Avascular necrosis of bone is a disease affecting predominantly men of working age. It steadily progresses to secondary osteoarthritis. The rate of disability is high because hip joint is most commonly affected by avascular necrosis; moreover, the rate of bilateral hip joint involvement is also high. The aim of the present review is to analyze and discuss several pathophysiological mechanisms of avascular necrosis in the context of metabolic syndrome and bone turnover. Avascular necrosis occurs due to critically decreased blood flow to the bone, which results from a) vascular occlusion with local thrombi, emboli, vasospasm or b) extrinsic compression of intraosseous vessels due to increased pressure within the bone. It is important to discuss the components of metabolic syndrome pathogenesis, which may possibly lead to avascular necrosis due to both aforementioned mechanisms. Particularly, in patients with metabolic syndrome avascular necrosis may be caused by endothelial dysfunction, dyslipidemia, increased intraosseous pressure and development of osteoporosis. The recent findings demonstrate that in avascular necrosis there is a possible interaction between bone turnover and vascular pathology, which occurs through OPG/RANK/RANKL axis. This fact represents a new concept of understanding avascular necrosis pathways.
Evolving views on antithrombotic therapy in acute coronary syndrome
A.S. Rudoy
The review article presents current data on one of the key issues of modern cardiology - the duration of dual antiplatelet therapy in patients with acute coronary syndrome, including postcoronary angioplasty. The analysis of current clinical recommendations (including ESC-2017 for dual antiplatelet therapy and acute coronary syndrome with ST segment elevation) was carried out, the results of recent clinical studies and meta-analyzes were high-lighted. Given the dilemma of balancing the risks of thrombotic events and complications of bleeding in these patients, a scale for assessing the risks of ischemic and hemorrhagic events, formed on the basis of the results of the DAPT and PRECISE-DAPT studies, is presented.
Antiarrhythmic therapy: harm and benefit
D. P. Salivonchik
The widespre ad use of antiarrhythmic therapy for common rhythm and conduction disorders led to the registration of pro-rhythmogenic manifestations of these ECG preparations with the form a tion of stable ventricular tachyarrhythmias and, consequently, fata loutcomes. Conducting randomized studies allowed changing the strategy and tactics in the treatment of arrhythmias and stratifying the benefit and harm of antiarrhyth mic therapy before treatment as well as the likelihood of sudden cardiac death. Control of risk factors, optimal drug therapy, stratification of the risk of sudden death, revascularization, catheter ablation, implantation of cardioverter-defibrillators can reduce deaths from ventricular arrhythmias and the need for antiarrhythmic therapy.