Pub Date : 2020-09-30DOI: 10.38109/2225-1685-2020-3-86-92
V. G. Tregubov, P. V. Khilkevich, I. Z. Shubitidze, V. M. Pokrovsky
Objective. To determine the effect of bisoprolol or carvedilol therapy on the regulatory-adaptive status (RAS) of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV) the background of hypertensive disease (HD).Material and methods. The study involved 68 patients with CHF and pEF of the LV, who were randomized into two groups for treatment with bisoprolol (7,3±2,4 mg/day, n=34) and carvedilol (28,4±12,3 mg/day, n=34). As part of the combination therapy, quinapril was prescribed (13,5±2,5 mg/ day, n=34 and 12,6±2,9 mg/day, n=34), and if indicated – atorvastatin (16,3±5,0 mg/day, n=11 and 15,5±5,2 mg/day, n=11) and acetylsalicylic acid in the intestinal soluble shell (93,8±17,7 mg/day, n=8 and 94,4±15,8 mg/day, n=8), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of RAS (by means of a sample of cardiac-respiratory synchronism), treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal fragment of brain natriuretic peptide, echocardioscopy, daily monitoring of blood pressure.Results. Both regimens of combined drug therapy had comparable cardioprotective, hypotensive and neuromodulating effects, equally increased exercise tolerance. In comparison with bisoprolol, carvedilol differed positive impact on RAS, improved quality of life more.Conclusion. In patients with CHF and pEF LV in combination therapy, the use of carvedilol, in comparison with bisoprolol, may be preferable due to the positive effect on the RAS.
{"title":"DETERMINATION OF THE IMPACT OF BISOPROLOL AND СARVEDILOL ON REGULATORY-ADAPTIVE STATUS OF PATIENTS WITH CHRONIC HEART FAILURE AND PRESERVED LEFT VENTRICULAR FRACTION","authors":"V. G. Tregubov, P. V. Khilkevich, I. Z. Shubitidze, V. M. Pokrovsky","doi":"10.38109/2225-1685-2020-3-86-92","DOIUrl":"https://doi.org/10.38109/2225-1685-2020-3-86-92","url":null,"abstract":"Objective. To determine the effect of bisoprolol or carvedilol therapy on the regulatory-adaptive status (RAS) of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV) the background of hypertensive disease (HD).Material and methods. The study involved 68 patients with CHF and pEF of the LV, who were randomized into two groups for treatment with bisoprolol (7,3±2,4 mg/day, n=34) and carvedilol (28,4±12,3 mg/day, n=34). As part of the combination therapy, quinapril was prescribed (13,5±2,5 mg/ day, n=34 and 12,6±2,9 mg/day, n=34), and if indicated – atorvastatin (16,3±5,0 mg/day, n=11 and 15,5±5,2 mg/day, n=11) and acetylsalicylic acid in the intestinal soluble shell (93,8±17,7 mg/day, n=8 and 94,4±15,8 mg/day, n=8), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of RAS (by means of a sample of cardiac-respiratory synchronism), treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal fragment of brain natriuretic peptide, echocardioscopy, daily monitoring of blood pressure.Results. Both regimens of combined drug therapy had comparable cardioprotective, hypotensive and neuromodulating effects, equally increased exercise tolerance. In comparison with bisoprolol, carvedilol differed positive impact on RAS, improved quality of life more.Conclusion. In patients with CHF and pEF LV in combination therapy, the use of carvedilol, in comparison with bisoprolol, may be preferable due to the positive effect on the RAS.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88833358","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 : 2020-03-30DOI: 10.38109/2225-1685-2020-1-136-139
N. Meladze, E. Strazden, E. Vlasova, S. Korolev, O. V. Stukalova
Among the large number of benign tumors of the heart myxoma most frequently diagnosed neoplasm intracavitary (occurs in 50%). The clinical picture of a myxoma is extremely various. Often it is diagnosed as a casual find. Usually the diagnosis is established according to an echocardiography. Magnetic resonance imaging is used for inspection of patients with suspicion on myxoma in cases when information of echocardiography is not enough and before surgical treatment. We present clinical follow-up 58 years old patients with left atrial myxoma, which before surgical treatment has executed a heart MRI.
{"title":"MR-TOMOGRAPHY OF THE HEART IN A PATIENT WITH LEFT ATRIUM MYXOMA BEFORE SURGICAL TREATMENT","authors":"N. Meladze, E. Strazden, E. Vlasova, S. Korolev, O. V. Stukalova","doi":"10.38109/2225-1685-2020-1-136-139","DOIUrl":"https://doi.org/10.38109/2225-1685-2020-1-136-139","url":null,"abstract":"Among the large number of benign tumors of the heart myxoma most frequently diagnosed neoplasm intracavitary (occurs in 50%). The clinical picture of a myxoma is extremely various. Often it is diagnosed as a casual find. Usually the diagnosis is established according to an echocardiography. Magnetic resonance imaging is used for inspection of patients with suspicion on myxoma in cases when information of echocardiography is not enough and before surgical treatment. We present clinical follow-up 58 years old patients with left atrial myxoma, which before surgical treatment has executed a heart MRI.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82494843","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 : 2020-03-30DOI: 10.38109/2225-1685-2020-1-124-128
S. E. Qasimov
The purpose of this study was a comparative assessment of pathological changes in the morpho-functional condition of the heart in groups of patients with arterial hypertension, divided by salt sensitivity.Material and methods. 93 patients with arterial hypertension (AH) and concomitant coronary heart disease were included in the study. All patients were subjected to a salt load, after which all patients were divided into groups of salt-sensitive (SS) and nonsalt-sensitive (NSS) patients. Along with this, the patient was replicated with an echocardiographic examination of the heart to determine the functional state of the heart muscle. Patients in the SS and NSS groups were compared by heart echocardiography results.Results. Left ventricular hypertrophy was found to be more prevalent in the group of SS patients compared to the NSS group (82.6% vs. 17.0%) and the differences between the groups were statistically significant (p<0.001). In many cases, some echocardiographic parameters, such as left ventricular posterior wall thickness and intra-ventricular thickness, were higher in patients with SS, which indicated significant early remodeling of the heart in these patients.Conclusions. The obtained data allow us to judge about the more pronounced and early occurrence of myocardial hypertrophy in SS patients.
本研究的目的是比较评估动脉高血压患者心脏形态功能状况的病理变化，按盐敏感性分组。材料和方法。93例动脉性高血压(AH)合并冠心病患者纳入研究。所有患者均接受盐负荷，然后将所有患者分为盐敏感组(SS)和非盐敏感组(NSS)。与此同时，对患者进行心脏超声心动图检查，以确定心肌的功能状态。比较SS组和NSS组患者的超声心动图结果。与NSS组相比，SS组左室肥厚发生率更高(82.6% vs. 17.0%)，两组间差异有统计学意义(p<0.001)。在许多情况下，SS患者的一些超声心动图参数，如左室后壁厚度和室内厚度，都较高，这表明这些患者有明显的早期心脏重构。所得数据使我们能够判断心肌肥大在SS患者中更为明显和早期发生。
{"title":"RELATIONSHIP BETWEEN SALT SENSITIVITY AND MORPHO-FUNCTIONAL CONDITION OF HEART","authors":"S. E. Qasimov","doi":"10.38109/2225-1685-2020-1-124-128","DOIUrl":"https://doi.org/10.38109/2225-1685-2020-1-124-128","url":null,"abstract":"The purpose of this study was a comparative assessment of pathological changes in the morpho-functional condition of the heart in groups of patients with arterial hypertension, divided by salt sensitivity.Material and methods. 93 patients with arterial hypertension (AH) and concomitant coronary heart disease were included in the study. All patients were subjected to a salt load, after which all patients were divided into groups of salt-sensitive (SS) and nonsalt-sensitive (NSS) patients. Along with this, the patient was replicated with an echocardiographic examination of the heart to determine the functional state of the heart muscle. Patients in the SS and NSS groups were compared by heart echocardiography results.Results. Left ventricular hypertrophy was found to be more prevalent in the group of SS patients compared to the NSS group (82.6% vs. 17.0%) and the differences between the groups were statistically significant (p<0.001). In many cases, some echocardiographic parameters, such as left ventricular posterior wall thickness and intra-ventricular thickness, were higher in patients with SS, which indicated significant early remodeling of the heart in these patients.Conclusions. The obtained data allow us to judge about the more pronounced and early occurrence of myocardial hypertrophy in SS patients.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74201589","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 : 2020-03-30DOI: 10.38109/2225-1685-2020-1-130-135
V. S. Dulchenko, A. Vasilenko, A. H. Magomedova, L. Khidirova
To date, there is a sufficient amount of data on the nature of diseases associated with the risk of sudden death. It is shown that many of them are genetically determined, and this is particularly dangerous, since not only the patient who has been diagnosed with the disease, but also his children and close relatives are at risk. Such diseases are rarely detected in normal clinical practice, and patients die, as a rule, not in specialized hospitals, but at home or on the street, and the doctor of the polyclinic or the ambulance crew remains to state the death. Cardiologists often pay attention only to the first symptoms of the disease, primarily syncope and palpitations, but also often the first and last manifestation of the disease is sudden death. Modern clinical medicine identifies a number of diseases and syndromes that are closely associated with a high risk of sudden death at a young age. These include one of the most «mysterious» diseases — Brugada syndrome (SB).
{"title":"MAIN ASPECTS OF BRUGADA SYNDROME","authors":"V. S. Dulchenko, A. Vasilenko, A. H. Magomedova, L. Khidirova","doi":"10.38109/2225-1685-2020-1-130-135","DOIUrl":"https://doi.org/10.38109/2225-1685-2020-1-130-135","url":null,"abstract":"To date, there is a sufficient amount of data on the nature of diseases associated with the risk of sudden death. It is shown that many of them are genetically determined, and this is particularly dangerous, since not only the patient who has been diagnosed with the disease, but also his children and close relatives are at risk. Such diseases are rarely detected in normal clinical practice, and patients die, as a rule, not in specialized hospitals, but at home or on the street, and the doctor of the polyclinic or the ambulance crew remains to state the death. Cardiologists often pay attention only to the first symptoms of the disease, primarily syncope and palpitations, but also often the first and last manifestation of the disease is sudden death. Modern clinical medicine identifies a number of diseases and syndromes that are closely associated with a high risk of sudden death at a young age. These include one of the most «mysterious» diseases — Brugada syndrome (SB).","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83884465","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 : 2020-03-30DOI: 10.38109/2225-1685-2020-1-140-145
Yu. I. Minyuk, E. V. Saliyeva, Z. S. Tamoyan, Ju. R. Urmanova, L. U. Taipova, A. Khasanov
Purpose. To describe a clinical case of coronary burden without stenosing lesions of the main branches of the coronary arteries in a patient with microvascular angina with subsequent development of myocardial infarction with the formation of ischemic hypokinesis of the anterior-apical region of the left ventricle in the absence of elevated levels of serum markers of myocardial necrosis.Materials and methods. The study is based on a single clinical case. The object of the study is the patient in whom there were complaints of pressing pain localized behind the sternum and radiating to the left arm, accompanied by a mixed shortness of breath that occurred at rest, poorly stoped short-range nitrates and narcotic analgesics, sharp General weakness. Under primary inspection state of ailing average extent of gravity, consciousness clear, position active, skin integuments and visible mucous of clean, conventional painting. The patient was evaluated laboratory parameters, ECG, echo-cardiography (ECHO-kg), chest x-ray (OGK), coronary angiography (CAG), followed by transfer to the emergency Department of cardiology.Results. The conducted clinical and laboratory study revealed the presence of leukocytosis in the patient with the clinic of acute coronary syndrome, without increasing cardiospecific enzymes (CFC, CFC-MB, troponin test), as well as high activity of coagulogram indicators (fibrinogen, ACTV, rfmc). When conducting radiography of OGK in direct projection-congestive lungs, a picture of chronic bronchitis in combination with left ventricular myocardial hypertrophy.Conclusion. In the presented clinical case was described an example of development of microvascular lesions in coronary arteries in a patient with manifestation of acute coronary syndrome with severe prolonged chest pain and repolarization changes on ECG and without elevated levels of serum markers of myocardial necrosis, which probably leads to the definition of this state as fragile (or sharp) microvascular dysfunction with myocardial infarction.
{"title":"CLINICAL CASE OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH MICROVASCULAR ANGINA","authors":"Yu. I. Minyuk, E. V. Saliyeva, Z. S. Tamoyan, Ju. R. Urmanova, L. U. Taipova, A. Khasanov","doi":"10.38109/2225-1685-2020-1-140-145","DOIUrl":"https://doi.org/10.38109/2225-1685-2020-1-140-145","url":null,"abstract":"Purpose. To describe a clinical case of coronary burden without stenosing lesions of the main branches of the coronary arteries in a patient with microvascular angina with subsequent development of myocardial infarction with the formation of ischemic hypokinesis of the anterior-apical region of the left ventricle in the absence of elevated levels of serum markers of myocardial necrosis.Materials and methods. The study is based on a single clinical case. The object of the study is the patient in whom there were complaints of pressing pain localized behind the sternum and radiating to the left arm, accompanied by a mixed shortness of breath that occurred at rest, poorly stoped short-range nitrates and narcotic analgesics, sharp General weakness. Under primary inspection state of ailing average extent of gravity, consciousness clear, position active, skin integuments and visible mucous of clean, conventional painting. The patient was evaluated laboratory parameters, ECG, echo-cardiography (ECHO-kg), chest x-ray (OGK), coronary angiography (CAG), followed by transfer to the emergency Department of cardiology.Results. The conducted clinical and laboratory study revealed the presence of leukocytosis in the patient with the clinic of acute coronary syndrome, without increasing cardiospecific enzymes (CFC, CFC-MB, troponin test), as well as high activity of coagulogram indicators (fibrinogen, ACTV, rfmc). When conducting radiography of OGK in direct projection-congestive lungs, a picture of chronic bronchitis in combination with left ventricular myocardial hypertrophy.Conclusion. In the presented clinical case was described an example of development of microvascular lesions in coronary arteries in a patient with manifestation of acute coronary syndrome with severe prolonged chest pain and repolarization changes on ECG and without elevated levels of serum markers of myocardial necrosis, which probably leads to the definition of this state as fragile (or sharp) microvascular dysfunction with myocardial infarction.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79035830","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 : 2019-12-30DOI: 10.38109/2225-1685-2019-4-98-107
N. S. Lisyutenko, N. Morova, V. N. Tsekhanovich
The goal of research is to study the influence of the initial state of left ventricular myocardium, as well as the technical features of the coronary artery bypass graft (CABG) on the prognosis of the functioning of coronary shunts.Materials and methods. 46 men, who had CABG for stable angina class III, were examined. 23 of them had 2 type diabetes mellitus (DM2), 23 of them did not have carbohydrate metabolism disorders. On the eve of the surgery, all patients underwent transthoracic echocardiography to determine the indicators of left ventricular function. Information about the technical features of the CABG were taken from the surgical reports. One year after the surgery, all patients underwent a coronary and bypass angiography.Results. Occlusion of coronary shunts was detected in 10 patients with DM2, and in 6 patients without DM2 (p value for Fisher’s exact test is 0.177). A larger left ventricle end-diastolic and end-systolic diameter (p value for the Mann-Whitney test is 0.004; 0.012), as well as a larger left ventricle end-diastolic and end-systolic volume (p value for the Mann-Whitney test is 0.012; 0.006) were associated with the presence of coronary shunt occlusions in patients with DM2. Also in the group of patients with DM2, sequential venous shunts were significantly more frequently occluded (p value for Fisher’s exact test is 0.004). Dysfunctioning shunts were associated with abovementioned figures among patients without carbohydrate metabolism disorders.Conclusion. The results of the research confirm the mutual confounding influence of risk factors on the prognosis after CABG
{"title":"INFLUENCE OF THE ORIGINAL STATE OF THE LEFT VENTRICLE AND TECHNICAL FEATURES OF CORONARY ARTERY BYPASS SURGERY ON THE FUNCTIONAL SAFETY OF GRAFTS","authors":"N. S. Lisyutenko, N. Morova, V. N. Tsekhanovich","doi":"10.38109/2225-1685-2019-4-98-107","DOIUrl":"https://doi.org/10.38109/2225-1685-2019-4-98-107","url":null,"abstract":"The goal of research is to study the influence of the initial state of left ventricular myocardium, as well as the technical features of the coronary artery bypass graft (CABG) on the prognosis of the functioning of coronary shunts.Materials and methods. 46 men, who had CABG for stable angina class III, were examined. 23 of them had 2 type diabetes mellitus (DM2), 23 of them did not have carbohydrate metabolism disorders. On the eve of the surgery, all patients underwent transthoracic echocardiography to determine the indicators of left ventricular function. Information about the technical features of the CABG were taken from the surgical reports. One year after the surgery, all patients underwent a coronary and bypass angiography.Results. Occlusion of coronary shunts was detected in 10 patients with DM2, and in 6 patients without DM2 (p value for Fisher’s exact test is 0.177). A larger left ventricle end-diastolic and end-systolic diameter (p value for the Mann-Whitney test is 0.004; 0.012), as well as a larger left ventricle end-diastolic and end-systolic volume (p value for the Mann-Whitney test is 0.012; 0.006) were associated with the presence of coronary shunt occlusions in patients with DM2. Also in the group of patients with DM2, sequential venous shunts were significantly more frequently occluded (p value for Fisher’s exact test is 0.004). Dysfunctioning shunts were associated with abovementioned figures among patients without carbohydrate metabolism disorders.Conclusion. The results of the research confirm the mutual confounding influence of risk factors on the prognosis after CABG","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86101438","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 : 2019-12-30DOI: 10.38109/2225-1685-2019-4-4-85
S. Golitsyn, E. Panchenko, E. Kropacheva, L. Y. Layovich, E. B. Maikov, N. Y. Mironov, O. Shakhmatova
.
．
{"title":"EURASIAN CLINICAL RECOMMENDATIONS ON DIAGNOSIS AND TREATMENT OF ATRIAL FIBRILLATION","authors":"S. Golitsyn, E. Panchenko, E. Kropacheva, L. Y. Layovich, E. B. Maikov, N. Y. Mironov, O. Shakhmatova","doi":"10.38109/2225-1685-2019-4-4-85","DOIUrl":"https://doi.org/10.38109/2225-1685-2019-4-4-85","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81139853","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 : 2019-12-30DOI: 10.38109/2225-1685-2019-4-86-96
V. N. Kandilova
Actuality. It is known that each of the factors (arterial hypertension (AH) and age) has a negative effect on the remodeling of both the heart and vessels, while their combined effect has not been sufficiently studied. The aim. Assessment of manifestations of cardiac and vascular remodeling (by the example of common carotid arteries (СCA) and vasomotor endothelium function (right brachial artery)) in patients with AH degree I-III in different age groups.Material and methods. The study involved 124 (86 men and 38 women) patients at the age from 27 to 81 years (average age of patients 55.7+1.01 years) with AH degree I-III. The presence and variant of myocardial remodeling with calculation of criteria of left ventricular hypertrophy (LVH), myocardial mass (MM) and MM index (MMI) of LV by indexation to the patient’s body surface area were studied in all patients by means of echocardiographic investigation (EchoCG) using the Vivid S5 3Sc-RS echocardiograph with a multifrequency sensor 2.0-3.5 MHz. Normal values of MM were considered to be 67-162 grams (g) for women and 88-224 for men, and MMI - not more than 95 and 115 g/m2, respectively. Types of LVH were determined according to recommendations of Pugliese N.R. et al. (2017), being subdivided into concentric (C) and eccentric (E) LVH. Ultrasound scanning was used to investigate CCA on both sides. The results of reactive hyperemia test on the right brachial artery and blood lipid profile were studied with the calculation of atherogenicity coefficient (AC). The data analysis was carried out with the help of Statistica 12 application package with determination of mean values (M), minimum, maximum and mean error (m), median and interquartile range for the CCA intima-media thickness (IMT). The Spearman rank correlation coefficient (r) was used to estimate the relationship between these variables. The significance level of all statistical tests was accepted at p˂0.05.The results of the study confirmed the presence of cardiac and vascular remodeling in patients with AH of different degrees with the tendency to increase in older age groups. The CCA remodeling parameter values were also significantly higher in the groups of middle-aged and elderly persons, some of which also had atherosclerotic plaques (AP). The number of patients with disturbed endothelial vasomotor function also somewhat increased with age.Conclusion. Thus, the age of the examined patients with AH had a significant influence on aggravation of the heart and vessel remodeling processes and increasing frequency of endothelial dysfunction development
{"title":"HEART AND VESSEL REMODELING IN DIFFERENT AGE GROUPS OF PATIENTS WITH ARTERIAL HYPERTENSION","authors":"V. N. Kandilova","doi":"10.38109/2225-1685-2019-4-86-96","DOIUrl":"https://doi.org/10.38109/2225-1685-2019-4-86-96","url":null,"abstract":"Actuality. It is known that each of the factors (arterial hypertension (AH) and age) has a negative effect on the remodeling of both the heart and vessels, while their combined effect has not been sufficiently studied. The aim. Assessment of manifestations of cardiac and vascular remodeling (by the example of common carotid arteries (СCA) and vasomotor endothelium function (right brachial artery)) in patients with AH degree I-III in different age groups.Material and methods. The study involved 124 (86 men and 38 women) patients at the age from 27 to 81 years (average age of patients 55.7+1.01 years) with AH degree I-III. The presence and variant of myocardial remodeling with calculation of criteria of left ventricular hypertrophy (LVH), myocardial mass (MM) and MM index (MMI) of LV by indexation to the patient’s body surface area were studied in all patients by means of echocardiographic investigation (EchoCG) using the Vivid S5 3Sc-RS echocardiograph with a multifrequency sensor 2.0-3.5 MHz. Normal values of MM were considered to be 67-162 grams (g) for women and 88-224 for men, and MMI - not more than 95 and 115 g/m2, respectively. Types of LVH were determined according to recommendations of Pugliese N.R. et al. (2017), being subdivided into concentric (C) and eccentric (E) LVH. Ultrasound scanning was used to investigate CCA on both sides. The results of reactive hyperemia test on the right brachial artery and blood lipid profile were studied with the calculation of atherogenicity coefficient (AC). The data analysis was carried out with the help of Statistica 12 application package with determination of mean values (M), minimum, maximum and mean error (m), median and interquartile range for the CCA intima-media thickness (IMT). The Spearman rank correlation coefficient (r) was used to estimate the relationship between these variables. The significance level of all statistical tests was accepted at p˂0.05.The results of the study confirmed the presence of cardiac and vascular remodeling in patients with AH of different degrees with the tendency to increase in older age groups. The CCA remodeling parameter values were also significantly higher in the groups of middle-aged and elderly persons, some of which also had atherosclerotic plaques (AP). The number of patients with disturbed endothelial vasomotor function also somewhat increased with age.Conclusion. Thus, the age of the examined patients with AH had a significant influence on aggravation of the heart and vessel remodeling processes and increasing frequency of endothelial dysfunction development","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81183601","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 : 2019-12-30DOI: 10.38109/2225-1685-2019-4-144-155
Z. Valieva, T. Martynyuk
Idiopathic pulmonary arterial hypertension (IPAH) is a rather rare cardiovascular disease of unknown origin and, at the same time, the most common form of pulmonary arterial hypertension (PAH). It is characterized by increased mean pulmonary artery pressure of ≥ 25 mm Hg and increased pulmonary vascular resistance of > 3 Wood units. One of the key components of IPH pathogenesis is the disorder in the prostacyclin pathway leading to hypertrophy of the smooth muscle and endothelial cells, fibrotic changes, inflammatory response and vasoconstriction, which results in small artery and arteriole remodeling. For severe cases of PAH, in Russia only used one drug acting on the prostacyclin pathway, i.e., iloprost for inhalation. However, this therapy has a number of restrictions on the use. Selexipag is the first selective oral prostacyclin IP-receptor agonist intended for the treatment of patients with PAH. The efficacy and safety of Selexipag in patients with PAH were investigated in GRIPHON study, the largest-scale clinical trial ever conducted in patients with pulmonary hypertension. The publication presents a case of successful use of Selexipag as a part of the combination therapy in a patient with IPAH.
{"title":"CASE REPORT ON THE SUCCESSFUL USE OF A NEW SELECTIVE PROSTACYCLIN IP RECEPTOR AGONIST, SELEXIPAG, IN A PATIENT WITH IDIOPATHIC PULMONARY HYPERTENSION","authors":"Z. Valieva, T. Martynyuk","doi":"10.38109/2225-1685-2019-4-144-155","DOIUrl":"https://doi.org/10.38109/2225-1685-2019-4-144-155","url":null,"abstract":"Idiopathic pulmonary arterial hypertension (IPAH) is a rather rare cardiovascular disease of unknown origin and, at the same time, the most common form of pulmonary arterial hypertension (PAH). It is characterized by increased mean pulmonary artery pressure of ≥ 25 mm Hg and increased pulmonary vascular resistance of > 3 Wood units. One of the key components of IPH pathogenesis is the disorder in the prostacyclin pathway leading to hypertrophy of the smooth muscle and endothelial cells, fibrotic changes, inflammatory response and vasoconstriction, which results in small artery and arteriole remodeling. For severe cases of PAH, in Russia only used one drug acting on the prostacyclin pathway, i.e., iloprost for inhalation. However, this therapy has a number of restrictions on the use. Selexipag is the first selective oral prostacyclin IP-receptor agonist intended for the treatment of patients with PAH. The efficacy and safety of Selexipag in patients with PAH were investigated in GRIPHON study, the largest-scale clinical trial ever conducted in patients with pulmonary hypertension. The publication presents a case of successful use of Selexipag as a part of the combination therapy in a patient with IPAH.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80532776","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 : 2019-12-30DOI: 10.38109/2225-1685-2019-4-122-132
A. Zairova, A. Rogoza, A. Avalyan, E. Oshchepkova
The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology.Materials and methods. 40 women with triple negative breast cancer aged 27 to 75 years (47.5±12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (β-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI - augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound α7 ultrasound machine using echo tracking technology.Results. After combined chemotherapy the parameters b, Ep, PWV not significantly changed (9,3±4,3 vs 8,9±4,5, р=0,63 ;128,73±65,9 vs 119,0±69,5 кПа, р=0,29 ; 6,7±1,5 vs 6,3±1,5 m/s, р=0,24 respectively). Statistically significant decrease in AI from 14, 5±11.3 to 11.1±10.6% (p=0.009) and an increase in AC from 0.72±0.25 to 0.87±0.3 mm2 / kPa (p=0.004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129.5±14.0 to 118.5±14.5 mm Hg (p=0.0001) and an increase in heart rate from 67.9±10.7 to 76.6±12.1 bpm (p=0.0004), lower the level of hemoglobin from 129.6±20.4 to 102.2±16.3 g / l (p=0.00001) and red blood cells from 4.7±0.4 to 3.3±0.6 1012 / l (p=0.00001).Conclusion: In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.
本研究的目的是研究联合化疗对女性乳腺癌(BC)动脉硬度和脉冲波的影响，超声检查颈总动脉(CCA)采用回声跟踪技术。材料和方法。40例27 ~ 75岁(47.5±12.0)三阴性乳腺癌患者接受蒽环类药物(阿霉素)、紫杉醇类药物(紫杉醇)和铂衍生物(顺铂)化疗后及化疗初期检查。采用回声跟踪技术，在Aloka ProSound α7超声机上研究了距离分叉2 cm远端CCA动脉刚度参数(β-刚度指数、ep -弹性模量、ac -动脉顺应性、pwv脉搏波速)和AI增强指数。联合化疗后b、Ep、PWV参数无明显变化(9,3±4,3 vs 8,9±4,5,r =0,63;128,73±65,9 vs 119,0±69,5 кПа， r =0,29;6,7±1,5 vs 6,3±1,5 m/s，分别为0,24)。AI从14.5±11.3下降到11.1±10.6% (p=0.009)， AC从0.72±0.25上升到0.87±0.3 mm2 / kPa (p=0.004)，收缩压(SBP)从129.5±14.0下降到118.5±14.5 mmhg (p=0.0001)，心率从67.9±10.7上升到76.6±12.1 bpm (p=0.0004)，血红蛋白从129.6±20.4下降到102.2±16.3 g / l (p=0.00001)，红细胞从4.7±0.4下降到3.3±0.6 1012 / l (p=0.00001)。结论:早期乳腺癌妇女在蒽环类药物(阿霉素)、紫杉醇(紫杉醇)和铂衍生物(顺铂)联合化疗后，颈总动脉僵硬度未增加。假性阳性变化表现为血管壁伸展性增加和增强指数降低，这可以用一般血流动力学变化来解释，表现为收缩压降低、心率增加以及化疗期间贫血。
{"title":"THE EFFECT OF COMBINED CHEMOTHERAPY IN WOMEN WITH BREAST CANCER ON THE STIFFNESS OF THE COMMON CAROTID ARTERY AND PULSE WAVE PARAMETERS STUDIED BY ECHO TRACKING","authors":"A. Zairova, A. Rogoza, A. Avalyan, E. Oshchepkova","doi":"10.38109/2225-1685-2019-4-122-132","DOIUrl":"https://doi.org/10.38109/2225-1685-2019-4-122-132","url":null,"abstract":"The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology.Materials and methods. 40 women with triple negative breast cancer aged 27 to 75 years (47.5±12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (β-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI - augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound α7 ultrasound machine using echo tracking technology.Results. After combined chemotherapy the parameters b, Ep, PWV not significantly changed (9,3±4,3 vs 8,9±4,5, р=0,63 ;128,73±65,9 vs 119,0±69,5 кПа, р=0,29 ; 6,7±1,5 vs 6,3±1,5 m/s, р=0,24 respectively). Statistically significant decrease in AI from 14, 5±11.3 to 11.1±10.6% (p=0.009) and an increase in AC from 0.72±0.25 to 0.87±0.3 mm2 / kPa (p=0.004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129.5±14.0 to 118.5±14.5 mm Hg (p=0.0001) and an increase in heart rate from 67.9±10.7 to 76.6±12.1 bpm (p=0.0004), lower the level of hemoglobin from 129.6±20.4 to 102.2±16.3 g / l (p=0.00001) and red blood cells from 4.7±0.4 to 3.3±0.6 1012 / l (p=0.00001).Conclusion: In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.","PeriodicalId":11859,"journal":{"name":"Eurasian heart journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88675597","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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