ORIGINAL SCIENTIFIC RESEARCH
 

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
Fibroblast growth factor 21 from the perspective of a promising marker of metabolic disorders and premature aging in polymorbid cardiovascular pathology in young and middle-aged people
Galina A. Proshchai, Sergey V. Dudarenko, Alexander S. Partcerniak, Elena Yu. Zagarskikh, Sergey A. Partcerniak
Objective: To evaluate the possibility of using fibroblast growth factor 21 (FGF 21) as a marker of metabolic disorders and premature aging in polymorbid cardiovascular pathology. Research methods: 199 men aged 35–55 years who were stratified into 3 groups were examined: group A – 117 patients with type 2 diabetes mellitus (type 2 diabetes), polymorbid cardiovascular disease (PCVD), obesity, androgen deficiency and anxiety-depressive disorders (ADD); group B – 55 patients with PCVD, obesity and ADD; group C – control group (n = 27). The examination of patients included a laboratory study of the level of FGF 21, indicators of carbohydrate and lipid metabolism, hormonal status, as well as daily monitoring of blood pressure and ECG. Results and conclusions. When compared with the control group, the level of FGF 21 was 3 times higher in the presence of type 2 diabetes. The most intense increase in FGF 21 levels was observed in groups of patients with several diseases. An increase in the level of FGF 21 in young and middle-aged people is probably due to a compensatory reaction to the existing androgen deficiency, disorders of carbohydrate and lipid metabolism. Strong correlations between FGF 21 and glucose, HDL cholesterol, total testosterone, ALT, and SBP during the day allow FGF 21 to be considered an early marker of cardiovascular disease and premature aging (PA) in young and middle-aged people.
2020 Том 4, №2
Medium-term outcomes after correction of long coronary artery lesions with biodegradable vascular scaffolds
N. P. Strygo, V. I. Stelmashok, O. L. Polonetsky
Aim. To establish efficacy and safety of endovascular correction of long coronary lesion with biodegradable scaffolds in comparison with everolimus-eluting metallic coronary stents. Materials and methods. From 2013 to 2018 in Republican Scientific and Practical Centre «Cardiology», Minsk, endovascular correction of long (more than 25 mm) coronary artery lesions was performed on 80 patients. Randomly patients were divided into 2 groups: group 1 (n = 40) – endovascular correction with the biodegradable everolimus-eluting vascular scaffold Absorb BVS, and group 2 (n = 40) – endovascular correction with the everolimus-eluting metallic stent Xience V/Xience Pro. Results. In 12-month observational period there were no cases of death or myocardial infarction in both groups. One-year primary endpoint (death + myocardial infarction + target lesion failure) was 10% in group 1 (scaffolds BVS Absorb) and 8.75% in group 2 (Xience stents), 4 and 3 cases of target lesion failure accordingly (p > 0.05). As secondary endpoints there were 3 cases of target lesion revascularization registered and 4 cases of target vessel revascularization in each group, 5 cases of target vessel failure in group 1 and 4 cases in group 2 (p > 0.05). There was 1 case of confirmed and 1 case of probable scaffold thrombosis in group 1 (cumulative rate 5%), no cases of stent thrombosis in group 2 (p = 0.49). Conclusion. Long lesion correction with biodegradable scaffolds shows similar one-year clinical and angiographic results in comparison with everolimus-eluting stents. Combined endpoint risk (all death cases + myocardial infarction + revascularization due to target lesion failure) statistically did not differ in one-year period in both groups.
2020 Том 4, №2
The causative agents of viral myocarditis
T.V. Amvrosieva, N.P. Mitkovskaya, Z.F. Bohush, A.S. Arinovich, E.M. Balysh
The article describes the algorithm of virological examination of patients with clinically suspected viral myocarditis and presents the results of its use in a group of 49 patients with respect to 12 causative agents of viral infections - cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, human herpes virus type 6, herpes viruses types 1 and 2, enteroviruses, parvovirus B 19, hepatitis C virus, influenza A and B viruses, rhinoviruses and adenoviruses. The presence of serological markers of viral infections (antiviral IgM) was detected in 42.1% of patients, the genetic material of pathogens (RNA / DNA) in the blood serum in 16.0% of patients, in heart tissues – in 75.0%. Among the viral pathogens revealed in the biological material, adenoviruses, parvovirus B 19, and human herpes virus type 6 dominated. According to serodiagnosis IgM to enteroviruses was most often detected in blood serum.
2020 Том 4, №1
Comorbid status of patients with chronic obstructive pulmonary disease
N.Yu. Grigoryeva, M.E. Korolyova, E.M. Yashina
Aim: to study the frequency of occurrence of comorbid pathology in hospitalized patients with chronic obstructive pulmonary disease (COPD). Material and methods. We conducted a retrospective analysis of 688 “inpatient medical records” of patients undergoing treatment from September 2016 to February 2017 in City Hospital No.5 of Nizhny Novgorod, of which 142 (20.6%) patients were diagnosed with COPD. As the main disease, COPD was found in 79.6% of cases, and as a concomitant disease in 20.4% of cases. Of 142 cases, the majority of patients were men – 58.5% (83 patients), whose mean age was 67.8±12.4 years and who had a long history of smoking. 41.5% (59 patients) were women, whose mean age was 73.9±11.8 years.
2020 Том 4, №1
Pain syndrome in the postoperative period after elimination of oropharyngeal obstruction in patients with obstructive sleep apnea syndrome
Ya.E. Yaromenka, V.A. Кarnialiuk, L.E. Makaryna-Kibak, K.S. Tsishkevich
One of the components characterizing the course of the postoperative period is pain. The article analyzes the severity of pain in the postoperative period in patients with uncomplicated snoring and obstructive sleep apnea of varying severity after the surgical treatment of upper respiratory tract obstruction at the oropharyngeal level. Significant differences were found in the severity of pain in patients with uncomplicated snoring and severe obstructive sleep apnea on the 3rd, 7th, 10th and 14th days of the postoperative period. It was found that in patients with obstructive sleep apnea of moderate to severe degree, the severity of pain and dysphagia in the postoperative period and the duration of pain medication use is the greatest (p < 0.05).
2020 Том 4, №1
Differential diagnosis of arterial hypertension syndrome in young men
A.N. Zayats, V.I. Shyshko
Aim: Development of a model for the early diagnosis of arterial hypertension (AH) in men aged 18-29 years based on risk factors and structural and functional parameters of the circulatory system.
2020 Том 4, №1
Prediction of the development of renal dysfunction in patients with chronic heart failure
U.K. Kamilova, Z.D. Rasulova, N.A. Nuritdinov, D.R. Tagaeva
Aim. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for assessing and predicting RD in patients with chronic heart failure (CHF). Methods. Totally, 101 patients with I-III functional class (FC) CHF were examined (according to the classification of the New York Heart Association). Additionally, the patients were distributed depending on the glomerular filtration rate determined by the calculation method according to the formula CKD-EPI (eGFR) into two groups: patients with eGFR ≥ 90 ml/min (n = 20), with eGFR < 90 ml/min (n = 81). In all patients there were determined: creatinine (Cr), eGFR according to the formula SKD-EPI, albumin/creatinine (Al/Cr) (mg/mmol) in morning urine, specific gravity in the morning urine (SG). We also studied renal blood flow according to Doppler ultrasonography readings at the level of the common left and right renal arteries.
2020 Том 4, №1

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