Pub Date : 2024-03-12DOI: 10.38109/2225-1685-2024-1-126-132
A. S. Tereshchenko, E. G. Zhelyakov, E. V. Merkulov, D. V. Puzenko, O. V. Strunin, A. V. Ardashev
The volume of the left atrium is one of the key factors associated with both the development of primary atrial fibrillation and its progression. Open atrial communication is considered as a factor predisposing to dilation and remodeling of the heart cavities. We present a clinical case of endovascular closure of an open oval window in a patient with a persistent form of AF, a moderately reduced left ventricular ejection fraction, who had previously undergone radiofrequency ablation, and persistent manifestations of heart failure. A 58-year-old patient was hospitalized in November 2019 with clinical manifestations of increasing heart failure. History: persistent form of atrial fibrillation with pronounced ventricular tachysystole. In April 2019, the patient underwent radiofrequency ablation, during which signs of open oval window were revealed. The initial left ventricular ejection fraction is 41%, the anterior–posterior left atrium size is 47 mm, the NT-proBNP level is 912 pg/m. In the subsequent period, steady sine waves were recorded.
{"title":"Case report: the effect of endovascular closure of an open oval window on the course of atrial fibrillation and the processes of reverse remodeling of the heart chambers","authors":"A. S. Tereshchenko, E. G. Zhelyakov, E. V. Merkulov, D. V. Puzenko, O. V. Strunin, A. V. Ardashev","doi":"10.38109/2225-1685-2024-1-126-132","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-126-132","url":null,"abstract":"The volume of the left atrium is one of the key factors associated with both the development of primary atrial fibrillation and its progression. Open atrial communication is considered as a factor predisposing to dilation and remodeling of the heart cavities. We present a clinical case of endovascular closure of an open oval window in a patient with a persistent form of AF, a moderately reduced left ventricular ejection fraction, who had previously undergone radiofrequency ablation, and persistent manifestations of heart failure. A 58-year-old patient was hospitalized in November 2019 with clinical manifestations of increasing heart failure. History: persistent form of atrial fibrillation with pronounced ventricular tachysystole. In April 2019, the patient underwent radiofrequency ablation, during which signs of open oval window were revealed. The initial left ventricular ejection fraction is 41%, the anterior–posterior left atrium size is 47 mm, the NT-proBNP level is 912 pg/m. In the subsequent period, steady sine waves were recorded.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12DOI: 10.38109/2225-1685-2024-1-108-115
M. Zykov, O. Barbarash
The review is devoted to the analysis of literature data on the features of the course, diagnosis and treatment of myocardial infarction at a young age. Despite the relevance of the problem of myocardial infarction in young people, there is no specific approach to the management and examination of such patients in current clinical guidelines. Literature search was carried out in the following databases: PubMed, Google Scholar, Web of Science from 1990 to 2023 for all studies with the keywords “myocardial infarction and young age”, “atherosclerosis and young age”, “atherothrombosis and young age”. An analysis of all available clinical recommendations of leading specialized societies in the field of cardiology, hematology, and angiology was also carried out. The presented review is not systematic view of the specifics of the subject, its breadth, as well as the task set – to expand the clinical thinking of the doctor. It is undeniable that primary prevention of myocardial infarction is more effective. Given the annual increase in the number of myocardial infarctions at a young age, it is necessary to create a special tool for risk stratification in young patients, since there is no such tool in the clinical guidelines. Despite the greater contribution of non-atherogenic causes to the development of myocardial infarction in young patients, atherosclerosis is still the main cause of its development. The authors of the review confirm the fact that there is currently no specially developed algorithm for managing patients with myocardial infarction at a young age, based on the identification of a number of traditional and non-traditional risk factors, on enhanced rehabilitation measures. All these positions are currently formulated in the aims and objectives of a special sevenyear study of myocardial infarction in young patients planned at our institute.
这篇综述专门分析了有关青少年心肌梗死的病程特点、诊断和治疗的文献资料。尽管青少年心肌梗死问题与我们息息相关，但在目前的临床指南中，并没有专门针对此类患者的管理和检查方法。我们在以下数据库中进行了文献检索：PubMed、Google Scholar、Web of Science（1990 年至 2023 年），以 "心肌梗死与年轻"、"动脉粥样硬化与年轻"、"动脉粥样硬化栓塞与年轻 "为关键词搜索所有研究。此外，还对心脏病学、血液学和血管病学领域主要专业学会的所有现有临床建议进行了分析。鉴于该主题的特殊性、广泛性以及既定任务--拓展医生的临床思维，所提交的综述并不系统。不可否认，心肌梗死的一级预防更为有效。鉴于每年年轻心肌梗死患者人数的增加，有必要为年轻患者的风险分层创建一个特殊工具，因为临床指南中没有这样的工具。尽管非致癌因素对年轻患者心肌梗死的发生有较大影响，但动脉粥样硬化仍是心肌梗死发生的主要原因。这篇评论的作者证实了一个事实，即目前还没有专门制定的算法来管理年轻心肌梗死患者，这些算法基于对一些传统和非传统风险因素的识别以及强化康复措施。目前，我们研究所计划对年轻心肌梗死患者进行为期七年的专项研究，其目的和目标就是要确定所有这些立场。
{"title":"Myocardial infarction in young patients. Is everything so obvious?","authors":"M. Zykov, O. Barbarash","doi":"10.38109/2225-1685-2024-1-108-115","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-108-115","url":null,"abstract":"The review is devoted to the analysis of literature data on the features of the course, diagnosis and treatment of myocardial infarction at a young age. Despite the relevance of the problem of myocardial infarction in young people, there is no specific approach to the management and examination of such patients in current clinical guidelines. Literature search was carried out in the following databases: PubMed, Google Scholar, Web of Science from 1990 to 2023 for all studies with the keywords “myocardial infarction and young age”, “atherosclerosis and young age”, “atherothrombosis and young age”. An analysis of all available clinical recommendations of leading specialized societies in the field of cardiology, hematology, and angiology was also carried out. The presented review is not systematic view of the specifics of the subject, its breadth, as well as the task set – to expand the clinical thinking of the doctor. It is undeniable that primary prevention of myocardial infarction is more effective. Given the annual increase in the number of myocardial infarctions at a young age, it is necessary to create a special tool for risk stratification in young patients, since there is no such tool in the clinical guidelines. Despite the greater contribution of non-atherogenic causes to the development of myocardial infarction in young patients, atherosclerosis is still the main cause of its development. The authors of the review confirm the fact that there is currently no specially developed algorithm for managing patients with myocardial infarction at a young age, based on the identification of a number of traditional and non-traditional risk factors, on enhanced rehabilitation measures. All these positions are currently formulated in the aims and objectives of a special sevenyear study of myocardial infarction in young patients planned at our institute.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140248601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12DOI: 10.38109/2225-1685-2024-1-100-106
Y. Aksenova, Y. Osmolovskaya, A. A. Petrukhina, I. V. Zhirov, A. Beniashvili, S. N. Tereshchenko, M. A. Morozova
Heart failure is a serious chronic illness and a global healthcare problem. Patients with heart failure have increased hospital readmission rates and mortality around the world. Heart failure often coexists with comorbidities of which cognitive impairment is particularly important. Сognitive impairment is present in around 30% to 80% in heart failure decreases quality of life and increases the frequency of repeated hospitalizations, increases mortality and worsens the prognosis in such patients. Despite existing research, the underlying pathophysiology of the relationship between heart failure and cognitive impairment remains poorly understood. The article discusses the best available evidence concerning different pathophysiological mechanisms behind cognitive impairment in individuals with heart failure. Heart failure and cognitive impairment have a number of common pathophysiological pathways including reduced cerebral blood flow, inflammation, neurohumoral activations, oxidative stress and changes in serum biomarkers or proteins. Understanding the pathophysiology of diseases will allow the effective evaluation of health status and development of suitable treatments. Prompt detection of cognitive impairment will bring about better clinical outcomes in heart failure patients. This review raises questions about the relationship between heart failure and cognitive dysfunction, provides evidence on the impact of new therapeutic options for treating heart failure on cognitive function, and suggests potential future research directions. For example, implantation of an artificial left ventricle may improve cognitive function; however, there are studies on immediate improvement in cognitive function followed by gradual deterioration over time after implantation of an artificial left ventricle, which requires long-term study In addition, evidence is provided for the effectiveness of using a relaxation scenario in virtual reality technology to reduce anxiety and affective complaints in somatic hospitalized patients, but the ability to improve cognitive function in patients with chronic heart failure remains to be explored.
{"title":"Cognitive impairment in chronic heart failure. How new therapeutic options for the treatment of chronic heart failure affect cognitive function?","authors":"Y. Aksenova, Y. Osmolovskaya, A. A. Petrukhina, I. V. Zhirov, A. Beniashvili, S. N. Tereshchenko, M. A. Morozova","doi":"10.38109/2225-1685-2024-1-100-106","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-100-106","url":null,"abstract":"Heart failure is a serious chronic illness and a global healthcare problem. Patients with heart failure have increased hospital readmission rates and mortality around the world. Heart failure often coexists with comorbidities of which cognitive impairment is particularly important. Сognitive impairment is present in around 30% to 80% in heart failure decreases quality of life and increases the frequency of repeated hospitalizations, increases mortality and worsens the prognosis in such patients. Despite existing research, the underlying pathophysiology of the relationship between heart failure and cognitive impairment remains poorly understood. The article discusses the best available evidence concerning different pathophysiological mechanisms behind cognitive impairment in individuals with heart failure. Heart failure and cognitive impairment have a number of common pathophysiological pathways including reduced cerebral blood flow, inflammation, neurohumoral activations, oxidative stress and changes in serum biomarkers or proteins. Understanding the pathophysiology of diseases will allow the effective evaluation of health status and development of suitable treatments. Prompt detection of cognitive impairment will bring about better clinical outcomes in heart failure patients. This review raises questions about the relationship between heart failure and cognitive dysfunction, provides evidence on the impact of new therapeutic options for treating heart failure on cognitive function, and suggests potential future research directions. For example, implantation of an artificial left ventricle may improve cognitive function; however, there are studies on immediate improvement in cognitive function followed by gradual deterioration over time after implantation of an artificial left ventricle, which requires long-term study In addition, evidence is provided for the effectiveness of using a relaxation scenario in virtual reality technology to reduce anxiety and affective complaints in somatic hospitalized patients, but the ability to improve cognitive function in patients with chronic heart failure remains to be explored.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12DOI: 10.38109/2225-1685-2024-1-116-125
D. A. Kuzhel, E. A. Savchenko
Premature ventricular complexes (PVC) is one of the most common arrhythmias in daily clinical practice. In the vast majority of cases, PVC has a good prognosis, but in some cases it can cause serious, including lifethreatening complications. On the other hand, asymptomatic, frequent PVC can lead to the development of left ventricular (LV) systolic dysfunction, which can be reversible with effective therapy. Medications remain the mainstay of therapy for PVC. However, the effectiveness of some drugs is quite low, while other drugs have significant side and proarrhythmic effects. Technological advances in the field of radiofrequency (RF) catheter ablation in recent years have opened up tremendous prospects in the radical correction of PVC and put forward this approach in selective cases as the method of choice. However, this invasive technology may at the same time carry the risks of serious complications, which can occur in up to 5% of individuals undergoing this procedure. The potential risks of RF catheter ablation largely depend on the accessibility of the ectopic focus. In this regard, differential diagnosis of the source of ectopia is of great importance for a balanced assessment of the possible risks and effectiveness of this invasive method. Standard diagnostic methods, such as 12-lead electrocardiography, Holter monitoring and echocardiography, allow in many cases to make the best decision regarding further management tactics. Frequent, asymptomatic PVC needs in annual monitoring to prevent LV systolic dysfunction development in cases high potential RF catheter ablation risks and drugs ineffectiveness. Traditional echocardiography and novel ultrasound technologies can help in this difficult of choice cases.
{"title":"Premature ventricular complexes: new possibilities of diagnostics and management","authors":"D. A. Kuzhel, E. A. Savchenko","doi":"10.38109/2225-1685-2024-1-116-125","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-116-125","url":null,"abstract":"Premature ventricular complexes (PVC) is one of the most common arrhythmias in daily clinical practice. In the vast majority of cases, PVC has a good prognosis, but in some cases it can cause serious, including lifethreatening complications. On the other hand, asymptomatic, frequent PVC can lead to the development of left ventricular (LV) systolic dysfunction, which can be reversible with effective therapy. Medications remain the mainstay of therapy for PVC. However, the effectiveness of some drugs is quite low, while other drugs have significant side and proarrhythmic effects. Technological advances in the field of radiofrequency (RF) catheter ablation in recent years have opened up tremendous prospects in the radical correction of PVC and put forward this approach in selective cases as the method of choice. However, this invasive technology may at the same time carry the risks of serious complications, which can occur in up to 5% of individuals undergoing this procedure. The potential risks of RF catheter ablation largely depend on the accessibility of the ectopic focus. In this regard, differential diagnosis of the source of ectopia is of great importance for a balanced assessment of the possible risks and effectiveness of this invasive method. Standard diagnostic methods, such as 12-lead electrocardiography, Holter monitoring and echocardiography, allow in many cases to make the best decision regarding further management tactics. Frequent, asymptomatic PVC needs in annual monitoring to prevent LV systolic dysfunction development in cases high potential RF catheter ablation risks and drugs ineffectiveness. Traditional echocardiography and novel ultrasound technologies can help in this difficult of choice cases.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12DOI: 10.38109/2225-1685-2024-1-92-99
T. Martynyuk
Pulmonaryarterialhypertension(PAH)isalife-threateningcardiovascular disease that is characterized by a marked increase in pulmonary vascular resistance and pulmonary artery pressure due to obstructive remodeling of the pulmonary vascular bed with the development of right ventricular heart failure as a cause of premature mortality. Impaired synthesis and reduced bioavailability of nitric oxide is one of the key pathophysiological mechanisms of the development and progression of the disease. The review paper presents key data from the evidence base on the clinical use of tadalafil, a phosphodiesterase type 5 inhibitor (PDE5), which in August 2023 approved by the Pharmaceutical Committee of the Russian Ministry of Health for the indication – treatment of patients with PAH. Tadacardil from Canonpharma Production is the first and only drug in Russian practice today with the active substance tadalafil with the registered indication “PAH”, approved in the Eurasian Guidelines for the diagnosis and treatment of pulmonary hypertension 2023 and available on the territory of the Russian Federation and the EAEU. Tadacardil is indicated for use in adult patients with PAH functional class II and III according to the WHO classification to increase exercise tolerance. The efficacy of tadalafil has been shown in idiopathic PAH and PAH associated with connective tissue diseases. The recommended dose is 40 mg (2 tablets of 20 mg) once a day. The paper describes the mechanism of action and pharmacological effects of PDE5 inhibitors, features of the pharmacokinetics of tadalafil in comparison with other drugs of the class. The advantages of Tadacardil from Canonpharma Production are the proven effecacy of use in patients with PAH, ease of use due to a single dose of 2 tablets of 20 mg once a day in a standard dose; good tolerability and favorable safety profile; proven bioequivalence to the reference drug. In light of the new Eurasian recommendations for the diagnosis and treatment of PH, tadalafil has a wide field for clinical use, which will improve the treatment options for patients with PAH both in mono- and combination therapy.
{"title":"The place of tadalafil in the treatment of PAH in the light of new clinical guidelines of the Eurasian Association of Cardiologists","authors":"T. Martynyuk","doi":"10.38109/2225-1685-2024-1-92-99","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-92-99","url":null,"abstract":"Pulmonaryarterialhypertension(PAH)isalife-threateningcardiovascular disease that is characterized by a marked increase in pulmonary vascular resistance and pulmonary artery pressure due to obstructive remodeling of the pulmonary vascular bed with the development of right ventricular heart failure as a cause of premature mortality. Impaired synthesis and reduced bioavailability of nitric oxide is one of the key pathophysiological mechanisms of the development and progression of the disease. The review paper presents key data from the evidence base on the clinical use of tadalafil, a phosphodiesterase type 5 inhibitor (PDE5), which in August 2023 approved by the Pharmaceutical Committee of the Russian Ministry of Health for the indication – treatment of patients with PAH. Tadacardil from Canonpharma Production is the first and only drug in Russian practice today with the active substance tadalafil with the registered indication “PAH”, approved in the Eurasian Guidelines for the diagnosis and treatment of pulmonary hypertension 2023 and available on the territory of the Russian Federation and the EAEU. Tadacardil is indicated for use in adult patients with PAH functional class II and III according to the WHO classification to increase exercise tolerance. The efficacy of tadalafil has been shown in idiopathic PAH and PAH associated with connective tissue diseases. The recommended dose is 40 mg (2 tablets of 20 mg) once a day. The paper describes the mechanism of action and pharmacological effects of PDE5 inhibitors, features of the pharmacokinetics of tadalafil in comparison with other drugs of the class. The advantages of Tadacardil from Canonpharma Production are the proven effecacy of use in patients with PAH, ease of use due to a single dose of 2 tablets of 20 mg once a day in a standard dose; good tolerability and favorable safety profile; proven bioequivalence to the reference drug. In light of the new Eurasian recommendations for the diagnosis and treatment of PH, tadalafil has a wide field for clinical use, which will improve the treatment options for patients with PAH both in mono- and combination therapy.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140395495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-11DOI: 10.38109/2225-1685-2024-1-6-85
I. Chazova, T. Martynyuk, A. A. Shmalts, V. Gramovich, N. M. Danilov, T. Veselova, I. Z. Korobkova, A. S. Sarybaev, O. V. Stukalova, V. Azizov, O. Barbarash, A. Galyavich, S. Gorbachevsky, E. A. Medvedeva, Y. Matchin, M. Mukarov, S. N. Nakonechnikov, E. V. Filippov, I. Chernogrivov
.
.
{"title":"Eurasian guidelines for the diagnosis and treatment of pulmonary hypertension (2023)","authors":"I. Chazova, T. Martynyuk, A. A. Shmalts, V. Gramovich, N. M. Danilov, T. Veselova, I. Z. Korobkova, A. S. Sarybaev, O. V. Stukalova, V. Azizov, O. Barbarash, A. Galyavich, S. Gorbachevsky, E. A. Medvedeva, Y. Matchin, M. Mukarov, S. N. Nakonechnikov, E. V. Filippov, I. Chernogrivov","doi":"10.38109/2225-1685-2024-1-6-85","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-6-85","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140252117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-11DOI: 10.38109/2225-1685-2024-1-86-91
A. I. Pivovarova, G. N. Soboleva, O. V. Stukalova, S. K. Ternovoy
Aim. To evaluate the features of myocardial perfusion according to stress CMR with adenosine triphosphate (ATP) in patients with type 2 diabetes mellitus (DM) and obstructive and non-obstructive coronary arteries (CA).Materials and Methods. Stress СMR with ATP was provided in 55 patients with a suspected or known ischemic heart disease. 39 patients of them had DM type 2. All patients were provided with invasive coronary angiography or non-invasive CT angiogram to evaluate lesions of CA. Study protocol included providing myocardial perfusion in a rest and stress with ATP in dose 160 mkg/ kg/min during 3-6 min.Results. The detection of stress-induced perfusion defects was statistically significantly associated with the obstructive CA lesions of more than 50% (p<0,001). With non-obstructive CA lesions less than 50%, perfusion defects were found more often in patients with DM (36.4%) than in patients without DM (16.7%). Furthermore, the detection of stress-induced myocardial ischemia of patients with DM was not statistically significantly associated with obstructive CA (p=0,071) In case of positive result of stress CMR, patients with DM had a more widespread zone of stress-induced ischemia in the form of increase involved segments (6,45±3,78 (4,78-8,13) than patients without DM (3,17±1,60 (1,49-4,85), p=0,050).Conclusion. Patients with DM and non-obstructive CA are more likely to have a myocardial perfusion disorder than patients without DM due to coronary microvascular dysfunction.
目的根据三磷酸腺苷（ATP）应激CMR评估2型糖尿病（DM）、冠状动脉（CA）阻塞性和非阻塞性患者的心肌灌注特征。55名疑似或已知缺血性心脏病患者接受了ATP应激СMR检查。其中 39 名患者患有 2 型糖尿病。所有患者均接受了有创冠状动脉造影或无创 CT 血管造影，以评估 CA 病变。研究方案包括在静息状态下提供心肌灌注，并在3-6分钟内使用剂量为160毫克/千克/分钟的ATP进行应激。应激诱导灌注缺损的检测结果与 50%以上的 CA 阻塞性病变有显著统计学相关性（P<0.001）。在非阻塞性CA病变小于50%的情况下，DM患者（36.4%）比非DM患者（16.7%）更容易发现灌注缺损。此外，DM 患者应激诱发心肌缺血的检测结果与阻塞性 CA 并无显著统计学关联（P=0,071）。如果应激 CMR 检测结果为阳性，DM 患者的应激诱发缺血区范围更广，受累节段增多（6,45±3,78 (4,78-8,13)），而非 DM 患者的受累节段较少（3,17±1,60 (1,49-4,85)，P=0,050）。由于冠状动脉微血管功能障碍，DM和非阻塞性CA患者比非DM患者更容易出现心肌灌注障碍。
{"title":"Myocardial perfusion in patients with diabetes mellitus according to stress CMR with adenosine triphosphate","authors":"A. I. Pivovarova, G. N. Soboleva, O. V. Stukalova, S. K. Ternovoy","doi":"10.38109/2225-1685-2024-1-86-91","DOIUrl":"https://doi.org/10.38109/2225-1685-2024-1-86-91","url":null,"abstract":"Aim. To evaluate the features of myocardial perfusion according to stress CMR with adenosine triphosphate (ATP) in patients with type 2 diabetes mellitus (DM) and obstructive and non-obstructive coronary arteries (CA).Materials and Methods. Stress СMR with ATP was provided in 55 patients with a suspected or known ischemic heart disease. 39 patients of them had DM type 2. All patients were provided with invasive coronary angiography or non-invasive CT angiogram to evaluate lesions of CA. Study protocol included providing myocardial perfusion in a rest and stress with ATP in dose 160 mkg/ kg/min during 3-6 min.Results. The detection of stress-induced perfusion defects was statistically significantly associated with the obstructive CA lesions of more than 50% (p<0,001). With non-obstructive CA lesions less than 50%, perfusion defects were found more often in patients with DM (36.4%) than in patients without DM (16.7%). Furthermore, the detection of stress-induced myocardial ischemia of patients with DM was not statistically significantly associated with obstructive CA (p=0,071) In case of positive result of stress CMR, patients with DM had a more widespread zone of stress-induced ischemia in the form of increase involved segments (6,45±3,78 (4,78-8,13) than patients without DM (3,17±1,60 (1,49-4,85), p=0,050).Conclusion. Patients with DM and non-obstructive CA are more likely to have a myocardial perfusion disorder than patients without DM due to coronary microvascular dysfunction.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140253529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-22DOI: 10.38109/2225-1685-2023-4-90-93
M. Belkind, E. Butorova, O. V. Stukalova, S. Gaman, S. M. Smirnov
Caseous calcification of the mitral annulus (CCMA) is a rare form of degenerative lesion of the mitral valve fibrous ring. It’s a biochemical transformation of calcification area accompanied with formation of masses of a curdled consistency (caseosis). It is usually located in the area of the posterior mitral valve. In most cases, it is asymptomatic or minimally symptomatic, and is an incidental finding during imaging studies. The causes and pathogenesis of CCMA are unknown, however, there is a connection with disorders of calcium and phosphorus metabolism and there is no connection with an valve infection. There is no specific treatment. In cases where CCMA leads to significant disturbances of cardiac hemodynamics and/or there is a high probability of ebolism, it needs to be treated surgically.Differential diagnosis is carried out with other cardiac mass.
{"title":"Caseous calcification of the mitral annulus","authors":"M. Belkind, E. Butorova, O. V. Stukalova, S. Gaman, S. M. Smirnov","doi":"10.38109/2225-1685-2023-4-90-93","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-4-90-93","url":null,"abstract":"Caseous calcification of the mitral annulus (CCMA) is a rare form of degenerative lesion of the mitral valve fibrous ring. It’s a biochemical transformation of calcification area accompanied with formation of masses of a curdled consistency (caseosis). It is usually located in the area of the posterior mitral valve. In most cases, it is asymptomatic or minimally symptomatic, and is an incidental finding during imaging studies. The causes and pathogenesis of CCMA are unknown, however, there is a connection with disorders of calcium and phosphorus metabolism and there is no connection with an valve infection. There is no specific treatment. In cases where CCMA leads to significant disturbances of cardiac hemodynamics and/or there is a high probability of ebolism, it needs to be treated surgically.Differential diagnosis is carried out with other cardiac mass.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-22DOI: 10.38109/2225-1685-2023-4-76-82
K. Aitbaev, I. Murkamilov, Z. Murkamilova, V. V. Fomin, I. Kudaibergenova, T. F. Yusupova, F. Yusupov
Uncovering the secrets of genome flexibility not only contributed to the development of research in this area, but also served as an impetus for the development of new treatments for human diseases. A better understanding of the biology of chromatin (DNA/histone complexes) and non-coding RNAs (ncRNAs) has enabled the development of epigenetic (epi) preparations capable of modulating transcriptional programs associated with cardiovascular disease. This is especially true in heart failure, where epigenetic mechanisms have been shown to underlie the development of several pathological processes such as left ventricular hypertrophy, fibrosis, cardiomyocyte apoptosis, and microvascular dysfunction. Targeting epigenetic signals may represent a promising approach, especially in patients with heart failure with preserved ejection fraction (HFpEF), where the prognosis remains poor and effective treatments are not yet available. Under these conditions, epigenetics can be used to develop individualized therapeutic approaches, paving the way for personalized medicine. Although the beneficial effects of epi-drugs are gaining more attention, the number of epigenetic compounds used in clinical practice remains low, suggesting the need to develop more selective epi-drugs. In this review, we present a list of new promising epi-drugs for the treatment of cardiovascular diseases, with a focus mainly on HFpEF. The therapeutic effect of these drugs is due to the impact on at least one of the three main epigenetic mechanisms: DNA methylation, histone modification, and non-coding RNA.
{"title":"Epigenetic drugs: a new frontier in the treatment of heart failure","authors":"K. Aitbaev, I. Murkamilov, Z. Murkamilova, V. V. Fomin, I. Kudaibergenova, T. F. Yusupova, F. Yusupov","doi":"10.38109/2225-1685-2023-4-76-82","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-4-76-82","url":null,"abstract":"Uncovering the secrets of genome flexibility not only contributed to the development of research in this area, but also served as an impetus for the development of new treatments for human diseases. A better understanding of the biology of chromatin (DNA/histone complexes) and non-coding RNAs (ncRNAs) has enabled the development of epigenetic (epi) preparations capable of modulating transcriptional programs associated with cardiovascular disease. This is especially true in heart failure, where epigenetic mechanisms have been shown to underlie the development of several pathological processes such as left ventricular hypertrophy, fibrosis, cardiomyocyte apoptosis, and microvascular dysfunction. Targeting epigenetic signals may represent a promising approach, especially in patients with heart failure with preserved ejection fraction (HFpEF), where the prognosis remains poor and effective treatments are not yet available. Under these conditions, epigenetics can be used to develop individualized therapeutic approaches, paving the way for personalized medicine. Although the beneficial effects of epi-drugs are gaining more attention, the number of epigenetic compounds used in clinical practice remains low, suggesting the need to develop more selective epi-drugs. In this review, we present a list of new promising epi-drugs for the treatment of cardiovascular diseases, with a focus mainly on HFpEF. The therapeutic effect of these drugs is due to the impact on at least one of the three main epigenetic mechanisms: DNA methylation, histone modification, and non-coding RNA.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-22DOI: 10.38109/2225-1685-2023-4-32-40
D. S. Bubnov, R. S. Atanesyan, Z. B. Kardanakhishvili, F. T. Ageev, Y. Matchin
Aim. To determine the reproducibility of the results of instantaneous wavefree ratio (iFR) and angiography coregistration in patients with coronary heart disease (CAD) with multilevel and diffuse lesions of the coronary arteries.Materials and methods. The study included 34 patients with chronic ischemic heart disease (CAD) with diffuse and/or multilevel coronary stenoses >50%. In 41 coronary arteries, two consecutive iFR pullback of the conductor were performed and paired iFR angio-coregistrations were formed, reflecting changes in iFR gradients (Δ iFR) along the entire length of the studied artery. To compare the results of paired studies, the following values were used: 1) indices of distal iFR; 2) maximum Δ iFR; 3) Δ iFR of all stenoses ˃50%.Results. Comparable values of distal iFR were obtained 0,84 [0,78; 0,89] vs. 0,85 [0,77; 0,88]) with an average difference of the first and second measurements of 0,001, maximum ΔiFR (0,08 [0,05; 0,14] vs. 0,08 [0,05; 0,13]) with a mean difference of -0,004 and ΔiFR of all stenoses >50% (0,05 [0,02; 0,11] vs. 0,05 [ 0,02; 0,10]) with an average difference of -0.001. Lin’s concordance correlation coefficient and Intraclass Correlation Coefficients calculated for the three parameters studied showed a good level of agreement (0,97; 0,98; 0,98) with excellent reliability (0,97; 0,98; 0,97).Conclusion. In patients with multilevel and diffuse lesions of the coronary artery, iFR angio-coregistration has a fairly high reproducibility.
{"title":"Reproducibility of instantaneous wave-free ratio and angiography coregistration in patients with coronary heart disease and diffuse and multilevel coronary artery lesion","authors":"D. S. Bubnov, R. S. Atanesyan, Z. B. Kardanakhishvili, F. T. Ageev, Y. Matchin","doi":"10.38109/2225-1685-2023-4-32-40","DOIUrl":"https://doi.org/10.38109/2225-1685-2023-4-32-40","url":null,"abstract":"Aim. To determine the reproducibility of the results of instantaneous wavefree ratio (iFR) and angiography coregistration in patients with coronary heart disease (CAD) with multilevel and diffuse lesions of the coronary arteries.Materials and methods. The study included 34 patients with chronic ischemic heart disease (CAD) with diffuse and/or multilevel coronary stenoses >50%. In 41 coronary arteries, two consecutive iFR pullback of the conductor were performed and paired iFR angio-coregistrations were formed, reflecting changes in iFR gradients (Δ iFR) along the entire length of the studied artery. To compare the results of paired studies, the following values were used: 1) indices of distal iFR; 2) maximum Δ iFR; 3) Δ iFR of all stenoses ˃50%.Results. Comparable values of distal iFR were obtained 0,84 [0,78; 0,89] vs. 0,85 [0,77; 0,88]) with an average difference of the first and second measurements of 0,001, maximum ΔiFR (0,08 [0,05; 0,14] vs. 0,08 [0,05; 0,13]) with a mean difference of -0,004 and ΔiFR of all stenoses >50% (0,05 [0,02; 0,11] vs. 0,05 [ 0,02; 0,10]) with an average difference of -0.001. Lin’s concordance correlation coefficient and Intraclass Correlation Coefficients calculated for the three parameters studied showed a good level of agreement (0,97; 0,98; 0,98) with excellent reliability (0,97; 0,98; 0,97).Conclusion. In patients with multilevel and diffuse lesions of the coronary artery, iFR angio-coregistration has a fairly high reproducibility.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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