Pub Date : 2024-01-09DOI: 10.15829/1560-4071-2024-5730
V. Oleynikov, A. V. Shcherbinina, A. Golubeva, V. Galimskaya, O. D. Vershinina
Aim. To study the diagnostic value of myocardial function parameters to assess their predictive ability in relation to left ventricular (LV) global contractility in patients after myocardial infarction (MI).Material and methods. The final analysis included 97 patients with MI aged 55,9±8,6 years. We performed standard two-dimensional echocardiography and speckle tracking echocardiography with analysis of following myocardial function parameters: global work index (GlobalWI, mm Hg %); global constructive work (GlobalCW, mm Hg %); global wasted work (GlobalWW, mm Hg %); global work efficiency (GlobalWE). The probability of ejection fraction (EF) reduction was analyzed using ROC curves using three criteria. The function parameters with the maximum sum of sensitivity and specificity were selected as the cut-off point.Results. On days 7-9 after MI, depending on the EF, patients were divided into 3 groups: "REF" — patients with EF <40%); "MREF" — with EF from 40 to 49%, and "PEF" — patients with EF ³50%. By the 24th week, GlobalWI increased by 23% in the PEF group and by 33% in the MREF group. In the REF group, there was a gradual decrease in GlobalWI until the end of the study. In the PEF group, GlobalCW increased by 21% by week 24. By the end of follow-up, an increase in GlobalWW of 15% was observed in the REF group. GlobalWI, GlobalCW and GlobalWW were found to have the highest sensitivity values (60%) for reduced EF, ranging from 4049% at 24 weeks from the index event. GlobalWW had the highest specificity value (80%). With regard to a decrease in EF <40% by week 24, the GlobalWW had the highest sensitivity (50%) and specificity (70%).Conclusion. Parameters of myocardial function have diagnostic and prognostic value for assessing LV systolic function after MI. Already in the acute period, myocardial function parameters can be used to determine the risk of decreased LV global contractility.
{"title":"Diagnostic value of non-invasive indicators of myocardial function in patients after myocardial infarction","authors":"V. Oleynikov, A. V. Shcherbinina, A. Golubeva, V. Galimskaya, O. D. Vershinina","doi":"10.15829/1560-4071-2024-5730","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5730","url":null,"abstract":"Aim. To study the diagnostic value of myocardial function parameters to assess their predictive ability in relation to left ventricular (LV) global contractility in patients after myocardial infarction (MI).Material and methods. The final analysis included 97 patients with MI aged 55,9±8,6 years. We performed standard two-dimensional echocardiography and speckle tracking echocardiography with analysis of following myocardial function parameters: global work index (GlobalWI, mm Hg %); global constructive work (GlobalCW, mm Hg %); global wasted work (GlobalWW, mm Hg %); global work efficiency (GlobalWE). The probability of ejection fraction (EF) reduction was analyzed using ROC curves using three criteria. The function parameters with the maximum sum of sensitivity and specificity were selected as the cut-off point.Results. On days 7-9 after MI, depending on the EF, patients were divided into 3 groups: \"REF\" — patients with EF <40%); \"MREF\" — with EF from 40 to 49%, and \"PEF\" — patients with EF ³50%. By the 24th week, GlobalWI increased by 23% in the PEF group and by 33% in the MREF group. In the REF group, there was a gradual decrease in GlobalWI until the end of the study. In the PEF group, GlobalCW increased by 21% by week 24. By the end of follow-up, an increase in GlobalWW of 15% was observed in the REF group. GlobalWI, GlobalCW and GlobalWW were found to have the highest sensitivity values (60%) for reduced EF, ranging from 4049% at 24 weeks from the index event. GlobalWW had the highest specificity value (80%). With regard to a decrease in EF <40% by week 24, the GlobalWW had the highest sensitivity (50%) and specificity (70%).Conclusion. Parameters of myocardial function have diagnostic and prognostic value for assessing LV systolic function after MI. Already in the acute period, myocardial function parameters can be used to determine the risk of decreased LV global contractility. ","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140512104","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 : 2024-01-08DOI: 10.15829/1560-4071-2024-5753
E. A. Polyakova, Y. Khalimov
Aim. In an open-label clinical trial, to evaluate the effectiveness and impact on metabolic parameters of triple antihypertensive combination therapy with amlodipine, indapamide and perindopril arginine (perindopril A) in patients with hypertension (HTN) and stable coronary artery disease (CAD) in combination with abdominal obesity (AO), who have not had an adequate response to dual antihypertensive therapy for at least 4 weeks.Material and methods. The study included 68 adult patients aged 42 to 64 years (51 (47; 60) years) with AO, stable CAD and uncontrolled HTN, despite treatment with two drugs: an angiotensin-converting enzyme (ACE) inhibitor and a thiazide and thiazide-like diuretic. In the study, patients, in accordance with the general characteristics of the drug, after prescribing a free triple-dose combination of amlodipine, indapamide, perindopril in appropriate dosages, received one of the following combination of amlodipine/indapamide/perindopril for 24 weeks: group 1 (n=34) — 10/2,5/10 mg and group 2 (n=34) — 5/1,25/5 mg, one tablet daily. The analysis of the primary endpoint was to assess the change in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the sitting position from baseline to 24 weeks. Secondary efficacy endpoints included the proportion of patients achieving target mean SBP and DBP values for this category in the sitting position of 120-130 mm Hg and 70-79 mm Hg, respectively, at 12, 16, 20 and 24 weeks. Safety was assessed throughout the study. The effect on metabolic parameters was assessed at 24 weeks of the study.Results. Sixty-seven (98,5%) patients completed the study. The mean decrease in blood pressure from the initial level (group 1159/96 mm Hg; group 2161/95 mm Hg) to 24 weeks (group 1 126/76 mm Hg; group 2 132/84 mm Hg) was significant (p<0,0001 for all). The proportion of patients who reached the target mean values of SBP (120-130 mm Hg) and DBP (70-79 mm Hg) in the sitting position by 24 weeks was 80,16% and 79,28% in group 1, respectively; in group 2 — 65,32% and 70,06%, respectively. No serious adverse events were recorded. Its administration, regardless of the doses of individual components in combination, was accompanied not only by metabolic neutrality in relation to carbohydrate, lipid and purine metabolism, a decrease in chronic inflammation, but was also associated with a decrease in serum leptin concentration and subcutaneous adipose tissue, an increase in tissue sensitivity to leptin, as well as a decrease in the size of adipocytes in subcutaneous fat.Conclusion. Triple fixed-dose of amlodipine/indapamide/perindopril in two different dosages is effective, safe and well tolerated in patients with HTN and stable CAD in combination with AO.
{"title":"Triple fixed-dose combination of amlodipine, indapamide and perindopril for hypertension in patients with stable coronary artery disease and abdominal obesity","authors":"E. A. Polyakova, Y. Khalimov","doi":"10.15829/1560-4071-2024-5753","DOIUrl":"https://doi.org/10.15829/1560-4071-2024-5753","url":null,"abstract":"Aim. In an open-label clinical trial, to evaluate the effectiveness and impact on metabolic parameters of triple antihypertensive combination therapy with amlodipine, indapamide and perindopril arginine (perindopril A) in patients with hypertension (HTN) and stable coronary artery disease (CAD) in combination with abdominal obesity (AO), who have not had an adequate response to dual antihypertensive therapy for at least 4 weeks.Material and methods. The study included 68 adult patients aged 42 to 64 years (51 (47; 60) years) with AO, stable CAD and uncontrolled HTN, despite treatment with two drugs: an angiotensin-converting enzyme (ACE) inhibitor and a thiazide and thiazide-like diuretic. In the study, patients, in accordance with the general characteristics of the drug, after prescribing a free triple-dose combination of amlodipine, indapamide, perindopril in appropriate dosages, received one of the following combination of amlodipine/indapamide/perindopril for 24 weeks: group 1 (n=34) — 10/2,5/10 mg and group 2 (n=34) — 5/1,25/5 mg, one tablet daily. The analysis of the primary endpoint was to assess the change in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the sitting position from baseline to 24 weeks. Secondary efficacy endpoints included the proportion of patients achieving target mean SBP and DBP values for this category in the sitting position of 120-130 mm Hg and 70-79 mm Hg, respectively, at 12, 16, 20 and 24 weeks. Safety was assessed throughout the study. The effect on metabolic parameters was assessed at 24 weeks of the study.Results. Sixty-seven (98,5%) patients completed the study. The mean decrease in blood pressure from the initial level (group 1159/96 mm Hg; group 2161/95 mm Hg) to 24 weeks (group 1 126/76 mm Hg; group 2 132/84 mm Hg) was significant (p<0,0001 for all). The proportion of patients who reached the target mean values of SBP (120-130 mm Hg) and DBP (70-79 mm Hg) in the sitting position by 24 weeks was 80,16% and 79,28% in group 1, respectively; in group 2 — 65,32% and 70,06%, respectively. No serious adverse events were recorded. Its administration, regardless of the doses of individual components in combination, was accompanied not only by metabolic neutrality in relation to carbohydrate, lipid and purine metabolism, a decrease in chronic inflammation, but was also associated with a decrease in serum leptin concentration and subcutaneous adipose tissue, an increase in tissue sensitivity to leptin, as well as a decrease in the size of adipocytes in subcutaneous fat.Conclusion. Triple fixed-dose of amlodipine/indapamide/perindopril in two different dosages is effective, safe and well tolerated in patients with HTN and stable CAD in combination with AO.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"27 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140512485","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5543
N. Diaconu, G. Sorici, I. Civirjic, A. Grosu
People who survive an episode of pulmonary embolism have an increased risk of developing chronic complications despite curative anticoagulant treatment. The association of dyspnoea, low functional capacity, right heart failure, chronic thromboembolic pulmonary hypertension, or chronic thromboembolic pulmonary disease is part of the notion of post-pulmonary embolic syndrome (PPES). The symptoms can be limiting, substantially affecting the quality of life. To improve the overall health outcomes of patients with acute pulmonary embolism, adequate measures to diagnose it and strategies to prevent long-term outcomes of pulmonary embolism are essential.The objective of this study is to provide a definition of PPES and review the most recommended patient-reported outcome measures (PROMs) for assessing the functionality of these patients.We searched PubMed for papers from the last 5 years that contain the terms: postpulmonary embolism syndrome; symptoms; PROMs; score; quality of life; dyspnea. Repetitive publications were excluded. The data from the publications have been summarized in this descriptive overview.
{"title":"Assessing long-term symptoms in patients with post-pulmonary embolism syndrome using patientreported outcome measures","authors":"N. Diaconu, G. Sorici, I. Civirjic, A. Grosu","doi":"10.15829/1560-4071-2023-5543","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5543","url":null,"abstract":"People who survive an episode of pulmonary embolism have an increased risk of developing chronic complications despite curative anticoagulant treatment. The association of dyspnoea, low functional capacity, right heart failure, chronic thromboembolic pulmonary hypertension, or chronic thromboembolic pulmonary disease is part of the notion of post-pulmonary embolic syndrome (PPES). The symptoms can be limiting, substantially affecting the quality of life. To improve the overall health outcomes of patients with acute pulmonary embolism, adequate measures to diagnose it and strategies to prevent long-term outcomes of pulmonary embolism are essential.The objective of this study is to provide a definition of PPES and review the most recommended patient-reported outcome measures (PROMs) for assessing the functionality of these patients.We searched PubMed for papers from the last 5 years that contain the terms: postpulmonary embolism syndrome; symptoms; PROMs; score; quality of life; dyspnea. Repetitive publications were excluded. The data from the publications have been summarized in this descriptive overview.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139144105","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5433
D. Panfilov, E. A. Petrakova, B. N. Kozlov
.
.
{"title":"Surgical treatment of coronary subclavian steal syndrome","authors":"D. Panfilov, E. A. Petrakova, B. N. Kozlov","doi":"10.15829/1560-4071-2023-5433","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5433","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139144413","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5583
N. Е. Shirokov, O. N. Kukovskaya, I. O. Malshakov, E. Yaroslavskaya, D. Krinochkin, T. N. Baskakova, N. A. Musikhina
Among various diagnostic methods, echocardiography (EchoCG) is most often used to identify Takotsubo syndrome. Left ventricular apical ballooning and the absence of permanent local contractility disturbances makes it possible to confirm the diagnosis. Currently, the available literature provides insufficient data on longitudinal strain (LS) of various cardiac chambers in this condition. The current case report demonstrates complete restoration of left heart LS within 1 month with its initial significant decrease.
{"title":"Myocardial strain changes over a 1-month follow-up in Takotsubo syndrome: a case report","authors":"N. Е. Shirokov, O. N. Kukovskaya, I. O. Malshakov, E. Yaroslavskaya, D. Krinochkin, T. N. Baskakova, N. A. Musikhina","doi":"10.15829/1560-4071-2023-5583","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5583","url":null,"abstract":"Among various diagnostic methods, echocardiography (EchoCG) is most often used to identify Takotsubo syndrome. Left ventricular apical ballooning and the absence of permanent local contractility disturbances makes it possible to confirm the diagnosis. Currently, the available literature provides insufficient data on longitudinal strain (LS) of various cardiac chambers in this condition. The current case report demonstrates complete restoration of left heart LS within 1 month with its initial significant decrease.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"73 S7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146127","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5704
A. Sumin, F. I. Belyalov
This year, new domestic recommendations for assessing and correcting the risk of cardiac complications during non-cardiac surgery have been published. These guidelines provide simple and practical key messages to facilitate decision-making in real-life clinical practice. The proposed algorithm for the management of patients before non-cardiac operations, focused on integral risk assessment, assessment of functional status and biomarkers. This review provides a summary of perioperative drug therapy, management of the most common CVDs, and focuses on specific care based on the risk of the patient's preexisting clinical conditions. Finally, the document includes practical recommendations for the management of postoperative complications, and also includes a new section on perioperative myocardial infarction/injury.
{"title":"Novel Russian guidelines for the assessment and modification of cardiovascular risk in non-cardiac surgery","authors":"A. Sumin, F. I. Belyalov","doi":"10.15829/1560-4071-2023-5704","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5704","url":null,"abstract":"This year, new domestic recommendations for assessing and correcting the risk of cardiac complications during non-cardiac surgery have been published. These guidelines provide simple and practical key messages to facilitate decision-making in real-life clinical practice. The proposed algorithm for the management of patients before non-cardiac operations, focused on integral risk assessment, assessment of functional status and biomarkers. This review provides a summary of perioperative drug therapy, management of the most common CVDs, and focuses on specific care based on the risk of the patient's preexisting clinical conditions. Finally, the document includes practical recommendations for the management of postoperative complications, and also includes a new section on perioperative myocardial infarction/injury.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"83 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139147257","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5701
Z. F. Kim, A. Galyavich, D. I. Sadykova, L. M. Nurieva
Aim. To analyze the prognostic value of the Dutch Lipid Clinic Network (DLCN) and Simon Broome Register (SBR) screening criteria for familial hypercholesterolemia (FH) in men and women with dyslipidemia.Material and methods. The study included 1233 patients with dyslipidemia.Biomaterial samples from 421 patients were studied using Next Generation Sequencing (NGS) to identify FH-associated genes. Statistical analysis was carried out using the StatTech v program. 3.1.6 (OOO Stattekh, Russia).Results. The most significant factors for predicting the FH in men are the level of low-density lipoprotein cholesterol (LDL-C) (1,77 times), positive family history for coronary artery disease (CAD) (6,26 times), multivessel coronary artery disease (4,05 times); in women before menopause — LDL-C (1,77 times per 1 mmol/l) and/or family history of coronary artery disease (3,31 times), in menopausal women — total cholesterol level (1,79 times per 1 mmol/l), coronary artery disease (6,52 times) and/or family history of stroke (6,04 times), xanthomas (4,24 times). Acute myocardial infarction and/or coronary stenting, arcus senilis, extracranial artery atherosclerosis did not prove to be prognostically significant for FH diagnosis.Conclusion. Diagnostic criteria for potential FH vary among patient populations. Its diagnostic significance depends on sex, and in women, reproductive status.
{"title":"Prognostic value of diagnostic criteria for familial hypercholesterolemia in men and women with dyslipidemia","authors":"Z. F. Kim, A. Galyavich, D. I. Sadykova, L. M. Nurieva","doi":"10.15829/1560-4071-2023-5701","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5701","url":null,"abstract":"Aim. To analyze the prognostic value of the Dutch Lipid Clinic Network (DLCN) and Simon Broome Register (SBR) screening criteria for familial hypercholesterolemia (FH) in men and women with dyslipidemia.Material and methods. The study included 1233 patients with dyslipidemia.Biomaterial samples from 421 patients were studied using Next Generation Sequencing (NGS) to identify FH-associated genes. Statistical analysis was carried out using the StatTech v program. 3.1.6 (OOO Stattekh, Russia).Results. The most significant factors for predicting the FH in men are the level of low-density lipoprotein cholesterol (LDL-C) (1,77 times), positive family history for coronary artery disease (CAD) (6,26 times), multivessel coronary artery disease (4,05 times); in women before menopause — LDL-C (1,77 times per 1 mmol/l) and/or family history of coronary artery disease (3,31 times), in menopausal women — total cholesterol level (1,79 times per 1 mmol/l), coronary artery disease (6,52 times) and/or family history of stroke (6,04 times), xanthomas (4,24 times). Acute myocardial infarction and/or coronary stenting, arcus senilis, extracranial artery atherosclerosis did not prove to be prognostically significant for FH diagnosis.Conclusion. Diagnostic criteria for potential FH vary among patient populations. Its diagnostic significance depends on sex, and in women, reproductive status.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145219","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5432
I. Chernov, S. Enginoev, A. A. Zenkov, U. K. Abdulmejidova, M. A. Guliyev
Aim. To analyze the immediate outcomes of reinterventions after Ross procedure.Material and methods. From April 2009 to December 2022, 224 Ross operations in adults were performed at the Federal Center for Cardiovascular Surgery. The retrospective study included 17 patients who required repeated interventions (14 men/3 women). The mean age of the patients was 38±11 years, with a minimum age of 21 and a maximum of 54 years. A history of infective endocarditis was revealed in 4 (23,5%) patients, hypertension — in 3 (17,6%) patients. Of the 17 included patients, 15 patients underwent the classic Ross operation ("full root replacement"), while 2 — a modified technique (1 — wrapping with aorta, 1 — wrapping with a Dacron graft). Annulus enhancement was previously performed in 3 patients.Results. Interventions on the pulmonary autograft and homograft were performed in 16 and 4 cases, respectively. The main indication for pulmonary autograft intervention was aortic regurgitation in 15 cases, and neoaortic aneurysm in 14 cases. In 3 patients, there was pulmonary homograft stenosis, while in 1 case — thrombosis. Two patients required interventions on other valves: 1 — mitral valve stenosis, 1 — severe tricuspid regurgitation. Mean reoperation, cardiopulmonary bypass and myocardial ischemia time were 289±62, 126±35 and 98±22 min, respectively. Combined interventions were performed in 6 cases. David valve-sparing procedure was performed in 9 patients, Bentall-de Bono technique — in 3, aortic valve repair — in 2, mechanical aortic valve replacement — in 2, supracoronary ascending aorta replacement — in 2, pulmonary homograft replacement — in 2, pulmonary homograft thrombectomy — in 1, pulmonary homograft repair — in 1 patient, mitral valve replacement — in 1 patient, tricuspid valve repair — in 1 patient. One patient required resternotomy for bleeding. There were no postoperative complications (perioperative myocardial infarction, acute kidney injury, stroke, sternal infection, cardiac tamponade) and deaths. The median length of stay in intensive care unit was 21 [16-23] hours.Conclusion. Reoperations after the Ross procedure may be required for different pathologies, but all can be performed surgically with a high safety in experienced operator.
{"title":"Reoperations after Ross procedure: a retrospective study","authors":"I. Chernov, S. Enginoev, A. A. Zenkov, U. K. Abdulmejidova, M. A. Guliyev","doi":"10.15829/1560-4071-2023-5432","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5432","url":null,"abstract":"Aim. To analyze the immediate outcomes of reinterventions after Ross procedure.Material and methods. From April 2009 to December 2022, 224 Ross operations in adults were performed at the Federal Center for Cardiovascular Surgery. The retrospective study included 17 patients who required repeated interventions (14 men/3 women). The mean age of the patients was 38±11 years, with a minimum age of 21 and a maximum of 54 years. A history of infective endocarditis was revealed in 4 (23,5%) patients, hypertension — in 3 (17,6%) patients. Of the 17 included patients, 15 patients underwent the classic Ross operation (\"full root replacement\"), while 2 — a modified technique (1 — wrapping with aorta, 1 — wrapping with a Dacron graft). Annulus enhancement was previously performed in 3 patients.Results. Interventions on the pulmonary autograft and homograft were performed in 16 and 4 cases, respectively. The main indication for pulmonary autograft intervention was aortic regurgitation in 15 cases, and neoaortic aneurysm in 14 cases. In 3 patients, there was pulmonary homograft stenosis, while in 1 case — thrombosis. Two patients required interventions on other valves: 1 — mitral valve stenosis, 1 — severe tricuspid regurgitation. Mean reoperation, cardiopulmonary bypass and myocardial ischemia time were 289±62, 126±35 and 98±22 min, respectively. Combined interventions were performed in 6 cases. David valve-sparing procedure was performed in 9 patients, Bentall-de Bono technique — in 3, aortic valve repair — in 2, mechanical aortic valve replacement — in 2, supracoronary ascending aorta replacement — in 2, pulmonary homograft replacement — in 2, pulmonary homograft thrombectomy — in 1, pulmonary homograft repair — in 1 patient, mitral valve replacement — in 1 patient, tricuspid valve repair — in 1 patient. One patient required resternotomy for bleeding. There were no postoperative complications (perioperative myocardial infarction, acute kidney injury, stroke, sternal infection, cardiac tamponade) and deaths. The median length of stay in intensive care unit was 21 [16-23] hours.Conclusion. Reoperations after the Ross procedure may be required for different pathologies, but all can be performed surgically with a high safety in experienced operator.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"18 2‐3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145974","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5501
N. Chumachenko, N. Kizhvatova, E. Kosmacheva, Z. Tatarintseva
A case report is devoted to the successful management of a 33-year-old patient with subacute infective endocarditis of the tricuspid valve and pacemaker, as well as chronic thromboembolic pulmonary hypertension. There were following therapy stages: 1) pharmacotherapy — antimicrobial agents, treatment of heart failure, pulmonary hypertension; 2) an interventional approach — tricuspid valve replacement with chamber sanitation, pacemaker explantation, endocardial lead removal from the right heart, implantation of a pacemaker with an epicardial lead system and 3) delayed balloon pulmonary angioplasty.
{"title":"Management of a patient with subacute tricuspid valve and pacemaker endocarditis with chronic thromboembolic pulmonary hypertension: a case report","authors":"N. Chumachenko, N. Kizhvatova, E. Kosmacheva, Z. Tatarintseva","doi":"10.15829/1560-4071-2023-5501","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5501","url":null,"abstract":"A case report is devoted to the successful management of a 33-year-old patient with subacute infective endocarditis of the tricuspid valve and pacemaker, as well as chronic thromboembolic pulmonary hypertension. There were following therapy stages: 1) pharmacotherapy — antimicrobial agents, treatment of heart failure, pulmonary hypertension; 2) an interventional approach — tricuspid valve replacement with chamber sanitation, pacemaker explantation, endocardial lead removal from the right heart, implantation of a pacemaker with an epicardial lead system and 3) delayed balloon pulmonary angioplasty.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"101 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146205","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 : 2023-12-29DOI: 10.15829/1560-4071-2023-5520
M. O. Vyalova, Y. Shvarts
Hypertension (HTN) is widespread among middle-aged and elderly people, including those doing sports. For the first time in 2020, the European Society of Cardiology guidelines on sports cardiology and exercise in patients with cardiovascular disease included adult and elderly patients in a separate group. However, this is a heterogeneous category of patients, including everyone over 35 years of age. Therefore, admittance of athletes to training and competitions still remains at the discretion of physician.Aim. To assess the relationship and mutual influence of hypertension, other cardiovascular risk factors and sports in middle-aged and elderly people.Material and methods. Our narrative review is based on 50 articles published on Pubmed, Scopus, Web of Science and eLIBRARY.ru, selected using the keywords "veteran athletes", "arterial hypertension", "cardiovascular risk", "physical activity". Related papers over the past 5 years were evaluated.Results. Currently, there is a trend toward an increase in the number of veteran athletes whose problems are not reflected in guidelines on sports and exercise.Conclusion. In the future, large randomized studies are needed to assess the response of blood pressure (BP) to intense exercise, as well as to determine the normal BP response and clear strategy to manage this category of people, depending on the presence of hypertension.
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