I n the light of COVID-19 pandemic caused by SARS-CoV-2 virus, cardiovascular complications become a medical and social problem, the significance of which increases in the post-acute phase. Cardiovascular events against COVID-19 include both acute ischemic and non-ischemic myocardial injury – up to 21%, acute heart failure, rhythm and conduction disorders (up to 15%), venous (up to 7% in patients in the general department and up to 22% in the intensive care unit) and arterial thrombotic complications (up to 11%). The retrospective analysis of medical records of 10 908 inpatients aged 18 to 90 years, who were treated from June 01, 2020 to May 31, 2021 in The 4th City Clinical Hospital named after M.J. Saŭčanka was performed. Prevalence of myocardial injury developed against the background of SARS-CoV-2 was 5.28% (n = 576), it was observed in patients of different age groups, including those without previous cardiovascular history. The article presents an analysis of current worldwide data on pathogenetic aspects of acute myocardial injury in patients with COVID-19. It is noted that cardiac MRI is an effective, accurate and noninvasive method of differential diagnosis of ischemic and inflammatory myocardial injury in COVID-19. The algorithm for differential diagnostics of acute myocardial injury in this category of patients is proposed.
2023 Том 7, №1

Cardiac biomarkers are recommended to stratify the risk of surgery in general surgical practice, but their adoption in cardiac surgery patients is limited. The aim of our study is assessing the prognostic possibility and predictive significance of modern cardiac-specific biomarkers (NT-proBNP, sST-2, hsTn-I, Galectin-3, hsCRP and IL-6) in the determining of patient-oriented treatment strategies. In the open prospective cohort study 352 patients with moderate or severe functional ischemic mitral regurgitation (IMR) were included. The inclusion criteria in the study were the reduced myocardial contractility (LV EF < 40%) in chronic CAD patients. CABG combined with mitral valve repair was performed in 239 patients (67.9%), mitral valve replacement in 35 patients (9.9%), and isolated in 78 patients (22.2%). The primary end-point of the study was defined as a complicated postoperative period with worsening of heart failure. Complicated postoperative period has been registered in 80 patients (22.7% of cases). The complicated early postoperative period did not relate to surgical strategies (χ2 = 0.398, p = 0.528). We didn’t find any difference in the degree of left ventricle (LV) remodeling between patients with complicated or not postoperative course (mean LV EDD – 68.2 mm, LV ESD – 56.3 mm, iEDV – 118.9 ml/m2 and iESV – 81.2 ml/m2 , p > 0.05). By contrast, all of the used pre-operative biomarker tests differed in the examined groups of patients (p < 0,001). The complicated postoperative course was observed in 24.6% of cases with isolated elevation of NT-proBNP > 136 pg/ml, in 44.4% of cases with isolated elevation of sST2 > 35.8 ng/ml, and 59.3% of cases in combined increase in thresholds and sST2 and NT-proBNP (χ2 = 71.67, p = 0.001). The highest quality of the model and the estimate forecast of the postoperative low-output syndrome was measured for sST2 and NT-proBNP biomarkers (AUC = 0,792, 95% CI 0,709–0,846). The inclusion of both thresholds of sST2 and NT-proBNP retained their reliable influence on the forecast, with the model showed a high level of consent (79.7% of correctly recognized cases).
2022 Том 6, №2

Objective. To study the structural and functional state of proteins in erythrocyte membranes of AH patients with asymptomatic brain lesions (ABL) and AH patients without brain lesions who suffered from cerebrovascular accident (CVA). Methods. The study included 47 patients diagnosed with AH. The study groups were formed based on the detected neuroimaging changes in the brain and analysis of the structural and functional state of proteins in the membranes of erythrocytes in patients with AH. The following groups were identified: 1-рatients with AH without BL 2-patients with AH and ABL 3-patients with previous cerebrovascular accident.
2022 Том 6, №2

Cold agglutinins are IgM autoantibodies that bind to antigens on the surface of erythrocytes with higher affinity at low temperatures and lose activity when the temperature increases to 37°C. In the population, the presence of cold agglutinins can be both asymptomatic and clinically manifested by cold agglutinin disease. If these antibodies are detected in low titers or do not cause clinical symptoms at normal body temperature, they are considered subclinical or asymptomatic. This article presents two clinical cases of detection of cold antibodies in patients directed to cardiac surgery treatment with the use of cardiopulmonary bypass. These cases are of interest due to the lack of clear indications for preoperative screening for cold antibodies. Besides, it remains unclear under what conditions and at what temperature clinically significant agglutination is achieved in cases of systemic hypothermia and with cold blood cardioplegia in case of detection of cold agglutinins. This article also discusses decision-making tactics after obtaining a positive screening result.
2022 Том 6, №2