ORIGINAL SCIENTIFIC RESEARCH
 

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
Effectiveness and safety of coronary arteries chronic total occlusions recanalization by retrograde approach
V.I. Stelmashok, O.L. Polonetsky, N.P. Strygo, M.G. Tsybulski, O.V. Zotova
Aim. To study effectiveness and safety of coronary arteries chronic total occlusions (CTO) recanalization by retrograde approach.
2020 Том 4, №1
Correlation of left ventricular hypertrophy with impaired filtration and tubulointerstitial kidney function in patients with hypertension
A.I. Chernyavina, N.A. Koziolova
Aim: to identify the correlation of left ventricular hypertrophy (LVH) with the development of early renal dysfunction in patients with uncomplicated HT without CKD.
2020 Том 4, №1
Clinical and epidemiological profile of outpatient venous thromboembolic complications
V.Ya. Khryshchanovich, S.S. Kalinin, I.P. Klimchuk, N.A. Rogovoy
To determine the demographic and clinical structure of venous thromboembolic (VTE) complications in the population of a large industrial center.
2020 Том 4, №1
Association of HIF-1α genetic polymorphism with the risk of obstructive sleep apnea-hypopnea syndrome in atrial fibrillation patients with ischemic heart disease and/or arterial hypertension
T.I. Balabanovich, V.I. Shishko, T.L. Stepuro, V.R. Shulika
Aim: to explore the relationship between hypoxia inducible factor-1α (HIF-1α) (С1772T) gene polymorphism and the risk of obstructive sleep apnea-hypopnea syndrome (OSAHS) in atrial fibrillation (AF) patients with ischemic heart disease and/or arterial hypertension.
2019 Том 3, №2
Wrapping of the dilated ascending aorta in patients with aortic valve pathology
D.А. Bozhko, Y.М. Chesnov, S.V. Spiridonov, S.А. Kurganovich
The method for ascending aorta wrapping developed at the “Cardiology” Republican Scientific and Practical Centre, Belarus, has been used in the treatment of 93 patients. The analysis of early and long-term treatment results was performed. A short time of ischemia and cardiopulmonary bypass, a low level of postoperative complications, including repeated operations for bleeding (3.23%) were noted. According to echocardiography data, a significant decrease in the average diameter of the ascending aorta, from 45.33 ± 3.12 mm to 36.26 ± 4.09 mm, was marked. In the long-term follow-up period no significant changes in the size of the ascending aorta at all levels were observed; rapid aorta dilatation, aneurysm formation, dissection, aorta rupture, and such complications as uterus erosion, dislocation of the wrap and aortic kinking were also not revealed.
2019 Том 3, №2
Specific features of lipid metabolism in children with cardiac risk factors
O.N. Volkova, V.D. Yushko, N.N. Bylinskiy, V.V. Strogiy
The article presents the data on the role of lipid metabolism disorders, including fatty acid metabolism disorders, among children with cardiac risk factors: arterial hypertension, obesity and aggravated atheroselrosis heredity.
2019 Том 3, №2
The role of endothelial dysfunction and oxidative stress in the formation of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease
N.Yu. Grigoryeva, M.V. Mayorova, M.O. Samoluk, T.P. Ilyushina
The purpose of this study was to evaluate oxidative stress and endothelial dysfunction in patients with chronic obstructive pulmonary disease (COPD) who had concomitant cardiovascular pathology.
2019 Том 3, №2
The level of homocysteine and polymorphisms of genes of folate exchange in patients with coronary heart disease and diabetes mellitus type 2
E.V. Davydchyk, V.A. Snezhitskiy, T.L. Stepuro, E.M. Doroshenko, V.Yu. Smirnov
The aim of the study is to investigate the level of homocysteine (Hcy), distribution of frequencies of alleles and genotypes of polymorphic options С677Т, А1298С of gene MTHFR, A66G of gene MTRR, А2756G of gene MTR in patients with chronic coronary heart disease (CHD) in combination with diabetes mellitus (DM) type 2.
2019 Том 3, №2

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