Ascending aorta wrapping in surgical correction of aortic valve disease
D. Bozhko
Objective: To study the results of surgical treatment of patients with ascending aorta dilatation and aortic valve disease. Methods: Echocardiographic examination was performed in all patients before surgery, within 1 month after surgery, and in the long-term period - once a year. Computed tomography was performed in patients from the main group as a control research method within 1 month after surgery and in the long-term period – once a year. Results: The results of surgical treatment of 255 patients with aortic valve disease and ascending aorta dilatation from 40 to 55 mm in the early postoperative and long-term periods with an average follow-up period of 3 years were analyzed. The wrapping method of the ascending aorta, performed in 93 patients, led to a significant decrease in the ascending aorta diameter from 45.47±2.96 mm to 35.98±3.88 mm, preventing the progression of its dilatation and aneurysm formation. The method showed a lower risk of complications in the early postoperative period compared to ascending aorta replacement. In the long-term follow-up, the frequency of major cardiovascular events and overall survival after aorta wrapping and aorta replacement in combination with correction of the aortic valve pathology did not differ significantly. After aorta wrapping, according to computed tomography, during the observation period, there were no complications from the ascending aorta in the form of dissection, intimal defects, wrap dislocation, aorta kinking; there was no significant calcification of the xenopericardial wrap. Conclusion: Ascending aorta wrapping can be performed as an alternative method of surgical treatment of the ascending aorta dilatation in aortic valve surgery in a certain cohort of patients with good results in the early postoperative and long-term follow-up periods.
2021 Том 5, №2
Clinical significance of determining the lipocalin associated with neutrophil gelatinase urine levels in patients with st-elevation myocardial infarction and acute ischemic kidney injury
E. Brankovskaya, Е. Grigorenko, T. Statkevich, L. Kartun, E. Hodosovskaya, N. Mitkovskaya
The aim of the study was to assess the clinical significance of determining the level of lipocalin associated with neutrophil gelatinase in urine (uNGAL) at the time of hospital admission in patients with acute ST-elevation myocardial infarction (STEMI) and acute ischemic kidney injury. Conclusion. Acute ischemic kidney injury is a frequent complication of STEMI. Based on the findings of the study uNGAL can be applied as an early marker of acute ischemic kidney injury and a predictor of post-discharge CKD in patients with MI.
2021 Том 5, №2
The role of endocardial catheter ablation in the management of paroxysmal ventricular tachycardia in patient with arrhythmogenic cardiomyopathy
D. Goncharik, L. Plashchinskaya, V. Barsukevich, A. Chasnoit, Ye. Rebeko, M. Zakharevsky, O. Kovalenko
The article describes current approaches to the interventional treatment of patients with arrhythmogenic cardiomyopathy (ACM) complicated with paroxysmal sustained ventricular tachycardia (VT). The advantages and disadvantages of two competing methods for mapping and ablation – activation mapping vs substrate mapping – are analyzed. The rationale for the proposed method of VT substrate mapping in ACM and the authors’ own results are presented. The results obtained by the authors make it possible to recommend substrate ablation according to the proposed technique as an invasive first-line therapy for patients with persistent monomorphic VT and ACM.
2021 Том 5, №2
Cardiac resynchronization therapy in chronic heart failure with atrial fibrillation: analysis and result prediction
A. Kurlianskaya
Aim. To develop a multifactor response prediction model to CRT in patients with CHF complicated by AF taking into consideration myocardium dyssinchrony parameters, clinical, functional, and laboratory predictors of a positive response to interventional treatment. The linear model developed to assess the dynamics of LV ESV allows individualizing the patient selection for interventional treatment in case of predicting an unstable early response to CRT.
2021 Том 5, №2
Dynamics of high residual platelet reactivity in patients with myocardial infarction in thrombolytic therapy
T. Pronko, V. Snezhitskiy, A. Kapytski
The aim of the study was to assess the incidence of high residual platelet reactivity in patients with myocardial infarction (MI), depending on the age and reperfusion therapy at different times from the onset of MI. Conclusion. The study revealed a high percentage of patients with MI with an insufficient response to acetylsalicylic acid and clopidogrel at different times from the onset of MI. There were no differences in the indicators of the aggregatogram depending on the age of the patients. There were no differences in the indicators of the aggregatogram depending on the type of reperfusion therapy performed (only TLT or TLT + PCI). There were no differences in the indicators of the aggregatogram depending on the type of implanted stents.
2021 Том 5, №2
The results of heart transplantation depending on the severity of the left ventricular myocardial hypertrophy of the donor heart
S.V. Spiridonov, D.S. Tretyakov, P.E. Bulavskaya, A.V. Valentyukevich, T.A. Dubovik, N.V. Mankevich, Yu.P. Ostrovsky
The article discusses the impact of donor left ventricular (LV) hypertrophy on the survival of recipients after heart transplantation.
2021 Том 5, №2
Early and alternative markers of chronic heart failure in patients with diabetes mellitus
V. Vasilkova, T. Mokhort, L. Korotaeva, Y. Yarets, I. Pchelin, V. Bayrasheva, O. Shestovets, Y. Borovets, E. Naumenko, N. Filiptsova
Aim: to assess the relationship of proinflammatory cytokines and chemokines with the levels of natriuretic peptides in patients with diabetes mellitus (DM). Materials and methods. A total of 155 patients (14 men and 61 women) with type 1 and type 2 diabetes, aged 34 to 84 years, were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of pro-inflammatory cytokines (interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-alpha), chemokines (monokine induced by interferon-gamma (MIG), regulated upon activation, normal T cell expressed and presumably secreted (RANTES), growth factors (fibroblast growth factor-23 (FGF-23), vascular endothelial growth factor (VEGF-A), natriuretic peptides (B‐type natriuretic peptide (BNP), N‐terminal fragment of B‐type natriuretic peptide (proBNP). Renal function was assessed based on the levels of serum creatinine, glomerular filtration rate (GFR), which was calculated according to the CKD-EPI formula, and albuminuria, which was assessed as albumin/creatinine ratio (A/C). An echocardiographic examination was conducted according to the standard protocol with the calculation of dimensional, volume and speed characteristics. Statistical data analysis was performed using smSTATA 14.2 for Mac (2018).
2021 Том 5, №1
Prognostic factors of Wolff-Parkinson-White syndrome in children
E. Zasim, V. Strogiy
Objective: to determine the prognostic factors determining the severity of Wolff-Parkinson-White syndrome (WPW) in children. Methods: a retrospective analysis of the course of the disease was performed in 108 children with WPW syndrome aged 13.6 (12-16) years. Depending on the number of attacks of paroxysmal tachycardia (PT), all children were divided into 2 groups: group A consisted of 47 children (43.5%) with a history of no more than three attacks of PT and they were rare-group B included 61 children (56.5%) with frequent (more than once a month) attacks of PT, more than four in the history. We studied: the family history, the clinical picture of the disease, the nature of paroxysmal tachycardia, the effectiveness of treatment, and the results of instrumental studies. Using the method of mathematical modeling, the informative value of each feature was determined, and the diagnostic value was determined.
2021 Том 5, №1
Clinical and functional features of the heart condition in patients with stable angina with concomitant bronchial asthma
T. Ilushina, N. Grigoryeva, K. Kolosova
Objective: to analyze the frequency of the combination of coronary heart disease (CHD) and bronchial asthma (BA) in clinical practice and to identify the features of the clinical course of stable angina in concomitant BA of varying severity.
2021 Том 5, №1
Application of photomodification of blood using low-intensity optical radiation in the combination treatment of patients with unstable angina
O. Laskina, G. Zalesskaya, N. Mitkovskaya
The in vivo effect of low-intensity optical radiation (LIOR) on the blood of patients with unstable angina (UA) was studied. The integration of LIOR in the combined therapy of patients with UA proved to result in positive changes in the oxygen uptake system. Changes in the absorption spectra of the patients’ blood samples, blood oxygenation characteristics, and the proportion of metabolic products were studied at all stages of light exposure. The absorption of LIOR by the blood was found to lead to its photomodifica tion, which was manifested in changes of the partial pressure of blood gases, the content of oxyhemoglobin and the degree of saturation of hemoglobin with oxygen. LIOR affects the oxygen exchange in the body of patients with UA, changes the delivery and consumption of oxygen by tissues, initiates positive changes in the balance between the production of reactive oxygen intermediates, acting as physiologically active compounds, and their inhibition by antioxidant systems.
2021 Том 5, №1
Positron emission tomography with 18F-FDG in the diagnosis of prosthetic heart valve endocarditis
A.S. Lukashevich
The purpose of the article is to evaluate the diagnostic significance of positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT) for the diagnosis of prosthetic endocarditis.
2021 Том 5, №1
Off-pump coronary artery bypass grafting without manipulation of the ascending aorta using a non-skeletonized great saphenous vein in patients with multivessel atherosclerotic coronary artery disease
A. Charniak, V. Podpalov, K. Rubakhov, O. Kozak, E. Troshin, A. Ostrovsky
Objective. To compare early postoperative hospital and one-year outcomes of coronary artery bypass grafting on a “working heart” (OPCABG) and coronary bypass grafting without manipulation of the ascending aorta (anCABG) in patients with multivessel atherosclerotic coronary artery disease.
2021 Том 5, №1
Diagnostic signs of myocardial reperfusion injury after coronary artery bypass grafting
Shybekа Nаtallia, Gelis Lyudmila, Rusak Tatsiana
One of the main causes for operative mortality and perioperative complications after coronary artery bypass grafting is myocardial reper fusion injur y following the restoration of the coronar y circulation in the ischemic zone of the myocardium and characterized by myocardial, electrophysiological and vascular dysfunction. In order to identify the diagnostic signs of myocardial reperfusion injury after coronary artery bypass grafting, a prospective study was conducted, which included 89 patients with ischemic heart disease and forthcoming coronary artery bypass grafting either on-pump or off-pump. Postischemic myocardial dysfunction was assessed using transesophageal echocardiography, morphological and functional signs of myocardial reperfusion injury were detected using cardiac magnetic resonance imaging, moreover, the level of highly sensitive troponin, myoglobin, creatine phosphokinase-MB, metalloproteinase-2, and highly sensitive C-reactive protein was measured to assess the contribution of biomarkers to the development of reperfusion injuries. The obtained data allowed us to assess the morphological and functional characteristics of postischemic myocardial dysfunction and identify diagnostic signs of irreversible reperfusion injuries.
2021 Том 5, №1
Anorexia syndrom as a determining factor for timely prevention of severe somatic complications of eating disorders
S. Shubina, O. Skugarevsky, S. Hunich
The research objective was to identify the differences in neurocognitive functioning and social cognition (emotional processing) in the presence of anorexia nervosa and schizophrenia, which will eventually help in developing methodological approaches and improving differential and diagnostic parameters to assess anorexia syndrome associated with these disorders.
2021 Том 5, №1
Structural and functional left heart changes in the working age individuals with obstructive seep apnea syndrome (OSAS)
Е.К. Yushkevich, E.B. Petrova, N.P.Mitkovskaya
The aim of the study. To assess the echocardiographic signs of structural and left heart functional changes in the working age individuals with obstructive sleep apnea syndrome.
2021 Том 5, №1
SARS CO-V-2 coronaviral infection in pregnant women (clinical data USE “6 City Clinical Hospital”)
L. Vasilyeva, E. Nikitina, S. Tsarova, L. Gulyaeva, V. Werbitzky
Аbstract: The article analyzes the features of the course of pregnancy in 110 women hospitalized in the Healthcare Institution “6th City Clinical Hospital” of Minsk for SARS CoV-2 coronavirus infection in April-October 2020. The authors studied the anamnestic data of pregnant women, analyzed the clinical data and the data from the instrumental and laboratory examinations of pregnant women with SARS CoV-2 coronavirus infection in the Republic of Belarus. A comparative analysis was carried out dealing with the treatment of pregnant women for coronavirus infection with SARS CoV-2 in a hospital setting.
2021 Том 5, №1
ST-elevation myocardial infarction and acute ischemic kidney injury
E.Yu. Brankovskaya, L.V. Kartun, E.V. Hodosovskaya, N.P. Mitkovskaya
The aim of the study was to investigate specific clinical manifestations, homeostasis indices and parameters of the cardiovascular system in patients with acute ST-elevation myocardial infarction (STEMI) and acute ischemic kidney injury. Methods. 173 patients with STEMI participated in the study. The study group consisted of 111 patients with acute ischemic kidney injury associated with myocardial infarction (MI); 62 patients with MI and normal kidney function were enrolled in the comparison group. Clinical, anthropometric, laboratory, and instrumental diagnostic methods were used. Results. Compared with patients of the MI and normal kidney function group, those with MI and acute ischemic kidney injury had a higher average heart rate, required more prolonged vasopressor and/or inotropic therapy, and more frequently developed tachyarrhythmias with adverse prognostic impact and postinfarction aneurysms. The study revealed that patients of the MI and acute ischemic kidney injury group demonstrated more severe dilatation of the left ventricle (LV), more pronounced reduction in myocardial LV contractility according to echocardiography results; they developed multivessel coronary artery disease more frequently. Furthermore, patients of this group had a higher incidence of infarction-associated artery damage located in the proximal segments of major coronary arteries and more frequently developed thrombotic occlusion in the infarction-affected artery. Patients with MI and acute ischemic kidney injury had higher levels of inflammatory, myocardial necrosis, hemostasis and neurohormonal activation markers. Higher concentration of neutrophil gelatinase-associated lipocalin (uNGAL) was observed in patients with MI and acute ischemic kidney injury; moreover, in 14,1% of patients belonging to this group, elevated levels of this marker preceded the diagnostically significant increase in creatinine concentration and decrease in glomerular filtration rate.
2020 Том 4, №2
Arterial hypertension and atrial fibrillation: molecular genetic aspects of pathogenesis and complex therapy, focus on the renin-angiotensin-aldosterone system
N.V. Bukvalnaya, L.V. Yakubova, V.A. Snezhitskiy
This article is devoted to the effect of the renin-angiotensin-aldosterone system on the development and maintenance of atrial fibrillation on patients with arterial hypertension. It is noted that the adverse effects of the renin-angiotensin-aldosterone system end products, angiotensin II and aldosterone, can be caused not only by their hyperproduction, but also by the activation of the transforming growth factor β1 initiated by them. This cytokine initiates the process of fibrosis in the left atrium, which is a substrate of arrhythmia. The article features the results of multicenter clinical trial demonstrating the effectiveness of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and mineralocorticoid receptor antagonists in the prevention of atrial fibrillation. The review includes the analysis of the effect of polymorphic variants of the angiotensin-converting enzyme gene ((I/D) ACE), the angiotensin II receptor gene type 1 ((A1166C) AGTR1), the aldosterone synthase gene (C/T (-344) CYP11B2) and the gene of the transforming growth factor β1 (G/C (+915) TGFB1) on the development of arterial hypertension and atrial fibrillation, as well as on the effectiveness of therapy with renin-angiotensin-aldosterone system blocking drugs.
2020 Том 4, №2
Modern opportunities for diagnosis and treatment of systemic vasculitis with kidney involvement in children: researchers own data (part 2)
I.A. Kazyra, A.V. Sukalo
The aim of the study was to analyze clinical, laboratory, immunological, morphological data of children with systemic vasculitis (SV) with kidney involvement to assess mediators of the formation and progression of the disease, as well as factors affecting prognosis. Methods. 20 children (15 girls, 5 boys) with morphologically verified nephritis due to SV (age from 5 to 17 yrs, median 13.5), were under observation at the “2nd Children’s Clinical Hospital” Minsk from 2012–2020. The features of the onset of the disease in childhood are presented, the analysis of clinical, laboratory, immunological (serum concentration of T- and B-lymphocyte activation markers (RANTES and BAFF), proinflammatory (caspase 1, IL1β and TNFα), vascular (VEGF) and tissue (TGF1β) growth factors), metabolic parameters (adiponectin, leptin, obestatin, vitamin D 25 (OH) D), instrumental, morphological changes, and factors affecting the course and outcome. Statistics was carried out using the Statistica 10.0, SPSS.
2020 Том 4, №2

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