Pub Date : 2023-12-20DOI: 10.15829/1560-4071-2023-5563
O. V. Gritsenko, O. Gruzdeva, G. A. Chumakova, O. Barbarash
Osteosarcopenic obesity syndrome involves the simultaneous deterioration of bone, muscle, and excess fat accumulation, resulting in systemic metabolic dysregulation. Currently, the relevance of this problem is increasing due to the global population aging, the high incidence of obesity, type 2 diabetes, sarcopenia and frailty in developed countries of the modern world. In this regard, novel diagnosis methods for this condition, including laboratory markers, should be developed. The review examines modern biomarkers of osteosarcopenic obesity.
{"title":"Laboratory markers of osteosarcopenic obesity","authors":"O. V. Gritsenko, O. Gruzdeva, G. A. Chumakova, O. Barbarash","doi":"10.15829/1560-4071-2023-5563","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5563","url":null,"abstract":"Osteosarcopenic obesity syndrome involves the simultaneous deterioration of bone, muscle, and excess fat accumulation, resulting in systemic metabolic dysregulation. Currently, the relevance of this problem is increasing due to the global population aging, the high incidence of obesity, type 2 diabetes, sarcopenia and frailty in developed countries of the modern world. In this regard, novel diagnosis methods for this condition, including laboratory markers, should be developed. The review examines modern biomarkers of osteosarcopenic obesity.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"37 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956484","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5581
V. Larina, V. Kokorin, V. Larin, V. I. Lunev, N. A. Suvorova, I. K. Skiba, E. S. Shcherbina
The article presents a brief analytical review of the European Society of Cardiology consensus statement on the definition and clinical features of heart failure (HF) with a summary of the latest results on the treatment and prevention of exacerbation. The main viewpoints are compared with existing approaches in the Russian Federation. The definition and classification of worsening HF (WHF), as well as its main clinical manifestations, epidemiology, outcomes, pathophysiology, approaches to early detection, patterns of in- and outpatient treatment of WHF are discussed. Attention is paid to the terminology necessary to identify a cohort of patients with HF exacerbation with a previously established diagnosis of HF in order to unify approaches to diagnosis and treatment.
{"title":"Decompensated heart failure: a reconceptualization in the light of updated consensus statement of the European Society of Cardiology","authors":"V. Larina, V. Kokorin, V. Larin, V. I. Lunev, N. A. Suvorova, I. K. Skiba, E. S. Shcherbina","doi":"10.15829/1560-4071-2023-5581","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5581","url":null,"abstract":"The article presents a brief analytical review of the European Society of Cardiology consensus statement on the definition and clinical features of heart failure (HF) with a summary of the latest results on the treatment and prevention of exacerbation. The main viewpoints are compared with existing approaches in the Russian Federation. The definition and classification of worsening HF (WHF), as well as its main clinical manifestations, epidemiology, outcomes, pathophysiology, approaches to early detection, patterns of in- and outpatient treatment of WHF are discussed. Attention is paid to the terminology necessary to identify a cohort of patients with HF exacerbation with a previously established diagnosis of HF in order to unify approaches to diagnosis and treatment.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956507","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5646
T. Brodovskaya, D. V. Kasyanov
The diagnosis of hypertension (HTN) has been known to doctors for many years. Current clinical guidelines represent a unified approach to the treatment and prevention of hypertension in patients of both sexes. Meanwhile, there are data that the development, course, progression and treatment of the disease may differ depending on sex.The aim of the review was to systematize modern ideas about sex differences in hypertension, as well as to substantiate the differentiated treatment among men and women. A literature search for 2013-2023 was conducted in the PubMed, Cochrane Library, Embase, Google Scholar, eLibrary databases using the search phrase "sex differences in hypertension".This work reflects current data regarding sex-specific differences in hypertension, including its development, blood pressure regulation, sex characteristics of risk factors, target organ damage, and features of antihypertensive treatment. Differentiated approach considering sex differences may provide novel strategies for preventing the progression of cardiovascular disease.
{"title":"Sex-specific differences in hypertension","authors":"T. Brodovskaya, D. V. Kasyanov","doi":"10.15829/1560-4071-2023-5646","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5646","url":null,"abstract":"The diagnosis of hypertension (HTN) has been known to doctors for many years. Current clinical guidelines represent a unified approach to the treatment and prevention of hypertension in patients of both sexes. Meanwhile, there are data that the development, course, progression and treatment of the disease may differ depending on sex.The aim of the review was to systematize modern ideas about sex differences in hypertension, as well as to substantiate the differentiated treatment among men and women. A literature search for 2013-2023 was conducted in the PubMed, Cochrane Library, Embase, Google Scholar, eLibrary databases using the search phrase \"sex differences in hypertension\".This work reflects current data regarding sex-specific differences in hypertension, including its development, blood pressure regulation, sex characteristics of risk factors, target organ damage, and features of antihypertensive treatment. Differentiated approach considering sex differences may provide novel strategies for preventing the progression of cardiovascular disease.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"37 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956512","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 : 2023-12-20DOI: 10.15829/1560-4071-2023-5717
E. Usova, A. S. Alieva, N. Zvartau, E. Shlyakhto
Published studies demonstrate insufficient implementation of clinical guidelines into actual clinical practice. Successful implementation of diagnostic and treatment guidelines for patients with lipid metabolism disorders directly depends on the identification of barriers and timely application of strategies to overcome them. A three-level remote structural questionary of healthcare quality for patients with dyslipidemia involved practitioner, heads of outpatient medical organizations and chief outpatient specialists to identify key barriers to implementation and compliance with clinical guidelines in real world setting. The obtained data in combination with implementation science approaches will facilitate development of strategies aimed to improvement of compliance with the guidelines for the management of patients with lipid metabolism disorders in practice.
{"title":"Rationale for implementation study to introduce clinical guidelines on lipid metabolism disorders into routine practice","authors":"E. Usova, A. S. Alieva, N. Zvartau, E. Shlyakhto","doi":"10.15829/1560-4071-2023-5717","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5717","url":null,"abstract":"Published studies demonstrate insufficient implementation of clinical guidelines into actual clinical practice. Successful implementation of diagnostic and treatment guidelines for patients with lipid metabolism disorders directly depends on the identification of barriers and timely application of strategies to overcome them. A three-level remote structural questionary of healthcare quality for patients with dyslipidemia involved practitioner, heads of outpatient medical organizations and chief outpatient specialists to identify key barriers to implementation and compliance with clinical guidelines in real world setting. The obtained data in combination with implementation science approaches will facilitate development of strategies aimed to improvement of compliance with the guidelines for the management of patients with lipid metabolism disorders in practice.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"106 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138958830","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5665
E. Loginova, G. I. Nechaeva, A. N. Dakuko, I. V. Bogatyrev, V. V. Potapov, I. V. Sharun
Aim. To evaluate the left ventricular longitudinal strain in patients with arrhythmia and undifferentiated connective tissue disease (UCTD).Material and methods. This cross-sectional comparative study included young patients with arrhythmia and UCTD (43 men and 84 women; mean age, 30,82±8,17 years (group 1, n=127)). The control group included volunteers with single phenotypic characteristics of UCTD, comparable in age and sex (9 men and 21 women, mean age, 34,13±6,87 years (group 2, n=30)). A standard clinical examination, 72-hour electrocardiographic monitoring, and speckle-tracking echocardiography were performed.Results. Patients of group 1 were characterized by lower global systolic longitudinal myocardial strain compared to the control group: -22,96% [-24,56%; -21,50%] in group 1 vs -24,73% [-25,25%; -23,84%] in group 2 (p=0,016). A local decrease in longitudinal myocardial strain (in two or more segments) was noted in 62,2% of patients in group 1 and 13,3% of patients in group 2 (p=0,025). In group 1, a relationship was revealed between class I premature ventricular contractions (PVCs) and a longitudinal strain decrease in the medial anterior (r1=0,253, p=0,004) and apical anterior (r1=0,253, p=0,004) segments, as well as between class V PVCs and strain decrease in the basal lower (r1=0,215, p=0,021) and middle anterior (r1=0,211, p=0,023) segments. In addition, there was a moderate correlation between mitral valve prolapse (MVP) and a decrease in longitudinal systolic strain in the basal inferolateral (r1=0,405, p=0,041) and basal anterior (r1=0,519, p=0,003) segments.Conclusion. Local decrease in left ventricular longitudinal systolic strain in association with arrhythmia and MVP in patients with UCTD makes it possible to recommend speckle-tracking echocardiography for early non-invasive assessment of myocardial remodeling in this cohort of patients.
{"title":"Left ventricular longitudinal strain in patients with undifferentiated connective tissue disease and arrhythmia","authors":"E. Loginova, G. I. Nechaeva, A. N. Dakuko, I. V. Bogatyrev, V. V. Potapov, I. V. Sharun","doi":"10.15829/1560-4071-2023-5665","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5665","url":null,"abstract":"Aim. To evaluate the left ventricular longitudinal strain in patients with arrhythmia and undifferentiated connective tissue disease (UCTD).Material and methods. This cross-sectional comparative study included young patients with arrhythmia and UCTD (43 men and 84 women; mean age, 30,82±8,17 years (group 1, n=127)). The control group included volunteers with single phenotypic characteristics of UCTD, comparable in age and sex (9 men and 21 women, mean age, 34,13±6,87 years (group 2, n=30)). A standard clinical examination, 72-hour electrocardiographic monitoring, and speckle-tracking echocardiography were performed.Results. Patients of group 1 were characterized by lower global systolic longitudinal myocardial strain compared to the control group: -22,96% [-24,56%; -21,50%] in group 1 vs -24,73% [-25,25%; -23,84%] in group 2 (p=0,016). A local decrease in longitudinal myocardial strain (in two or more segments) was noted in 62,2% of patients in group 1 and 13,3% of patients in group 2 (p=0,025). In group 1, a relationship was revealed between class I premature ventricular contractions (PVCs) and a longitudinal strain decrease in the medial anterior (r1=0,253, p=0,004) and apical anterior (r1=0,253, p=0,004) segments, as well as between class V PVCs and strain decrease in the basal lower (r1=0,215, p=0,021) and middle anterior (r1=0,211, p=0,023) segments. In addition, there was a moderate correlation between mitral valve prolapse (MVP) and a decrease in longitudinal systolic strain in the basal inferolateral (r1=0,405, p=0,041) and basal anterior (r1=0,519, p=0,003) segments.Conclusion. Local decrease in left ventricular longitudinal systolic strain in association with arrhythmia and MVP in patients with UCTD makes it possible to recommend speckle-tracking echocardiography for early non-invasive assessment of myocardial remodeling in this cohort of patients.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960637","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5711
M. V. Zhuravleva, S. Tereshchenko, F. Paleev, Yu. V. Gagarina, E. A. Shabalina
Aim. To assess cost-effectiveness of valsartan+sakubitril, dapagliflosin and empagliflosin for prevention of cardiovascular death and achieving the target indicator "reduction of cardiovascular mortality" of the State Program "Health Development" in patients with heart failure (HF) of the entire profile of left ventricular ejection fraction in 2023-2024Material and methods. The target population was Russian patients who had acute cardiovascular disease (CVD) and a verified diagnosis of HF and received subsidized drug coverage. Parametric modeling was used to predict cardiovascular mortality. In the corresponding comparative pair, the amount of drug costs required to prevent one cardiovascular death (CVD) was calculated, as well as to achieve a 1% target for reducing cardiovascular mortality in the whole country and separately in each region.Results. To prevent one cardiovascular event, the costs of 1-year val-sartan+sacubitril therapy was RUB11,80 million, dapagliflozin — RUB7,07 million, empagliflozin — RUB13,83 million. The costs required to achieve a 1% target for reducing cardiovascular mortality for valsartan+sacubitril, dapagliflozin and empagliflozin were:• in 2023, RUB6534,0 million, RUB3915,0 million and RUB7654,2 million, respectively;• in 2024, RUB1100,6 million, RUB659,5 million and RUB1289,7 million, respectively.Conclusion. The use of dapagliflozin is characterized by the lowest costs for preventing one cardiovascular event and achieving a 1% target for reducing cardiovascular mortality in 2023-2024.
{"title":"Cost-effectiveness of valsartan+sakubitril, dapagliflosin and empagliflosin for prevention of cardiovascular death and reducing cardiovascular mortality within the State Program \"Health Development\" in patients with heart failure","authors":"M. V. Zhuravleva, S. Tereshchenko, F. Paleev, Yu. V. Gagarina, E. A. Shabalina","doi":"10.15829/1560-4071-2023-5711","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5711","url":null,"abstract":"Aim. To assess cost-effectiveness of valsartan+sakubitril, dapagliflosin and empagliflosin for prevention of cardiovascular death and achieving the target indicator \"reduction of cardiovascular mortality\" of the State Program \"Health Development\" in patients with heart failure (HF) of the entire profile of left ventricular ejection fraction in 2023-2024Material and methods. The target population was Russian patients who had acute cardiovascular disease (CVD) and a verified diagnosis of HF and received subsidized drug coverage. Parametric modeling was used to predict cardiovascular mortality. In the corresponding comparative pair, the amount of drug costs required to prevent one cardiovascular death (CVD) was calculated, as well as to achieve a 1% target for reducing cardiovascular mortality in the whole country and separately in each region.Results. To prevent one cardiovascular event, the costs of 1-year val-sartan+sacubitril therapy was RUB11,80 million, dapagliflozin — RUB7,07 million, empagliflozin — RUB13,83 million. The costs required to achieve a 1% target for reducing cardiovascular mortality for valsartan+sacubitril, dapagliflozin and empagliflozin were:• in 2023, RUB6534,0 million, RUB3915,0 million and RUB7654,2 million, respectively;• in 2024, RUB1100,6 million, RUB659,5 million and RUB1289,7 million, respectively.Conclusion. The use of dapagliflozin is characterized by the lowest costs for preventing one cardiovascular event and achieving a 1% target for reducing cardiovascular mortality in 2023-2024.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962755","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5535
O. V. Atamas, M. Antonyuk, T. Novgorodtseva, T. A. Gvozdenko, O. Kytikova
Aim. To study the serum content of brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) in patients with coronary artery disease (CAD) and evaluate the relationship of BDNF/TrkB signaling with the severity of coronary atherosclerosis, systemic inflammation (IL-2, IL-4, IL-6, IL-10, TNF-α) and angiogenesis (VEGF).Material and methods. The study included 99 patients with stable CAD who underwent coronary angiography and 30 healthy volunteers. Coronary atherosclerosis was assessed using the Gensini score (GS). In blood serum, the concentrations of BDNF, TrkB, VEGF, IL-2, IL-4, IL-6, IL-10, TNF-α were determined using the enzyme immunoassay. Cluster, correlation, and regression analyzes were used.Results. In patients with CAD, a wide range of variations in BDNF concentrations was observed. To determine homogeneous groups using the k-means clustering, three clusters with different BDNF/TrkB axis vectors were identified. Patients differed in the severity of coronary atherosclerosis, the manifestation of the inflammatory reaction, and the intensity of angiogenesis. In patients with initial and moderate atherosclerotic changes in the coronary arteries, a normal concentration of BDNF and an increased level of TrkB (22,35/1,18 ng/ml) were noted. In patients with severe coronary atherosclerosis, two different BDNF/TrkB variants have been identified. Decreased BDNF and increased TrkB (6,0/1,52 ng/ml) were associated with low VEGF and increased IL-6. Elevated BDNF and normal TrkB values (26,95/0,96 ng/ml) were characteristic of patients with high VEGF expression, indicating angiogenesis activation and/or vulnerable plaques. A direct relationship between BDNF and VEGF (r=0,536, p<0,001) and an inverse relationship with TrkB (r=-0,301, p=0,019), IL-6 (r=-0,306, p=0,002) was revealed. TrkB levels were correlated with TNF-α (r=0,403, p=0,001). Regression analysis showed that BDNF expression is influenced by TrkB (β=-0,237, p=0,009), VEGF (β=0,490, p<0,001), IL-6 (β=-0,339, p<0,001).Conclusion. In patients with stable CAD, different levels of BDNF/TrkB expression were found, which were associated with coronary atherosclerosis severity. BDNF/TrkB signaling is involved in the regulation of inflammation and angiogenesis in stable CAD.
{"title":"BDNF/TrkB signaling in stable coronary artery disease","authors":"O. V. Atamas, M. Antonyuk, T. Novgorodtseva, T. A. Gvozdenko, O. Kytikova","doi":"10.15829/1560-4071-2023-5535","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5535","url":null,"abstract":"Aim. To study the serum content of brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) in patients with coronary artery disease (CAD) and evaluate the relationship of BDNF/TrkB signaling with the severity of coronary atherosclerosis, systemic inflammation (IL-2, IL-4, IL-6, IL-10, TNF-α) and angiogenesis (VEGF).Material and methods. The study included 99 patients with stable CAD who underwent coronary angiography and 30 healthy volunteers. Coronary atherosclerosis was assessed using the Gensini score (GS). In blood serum, the concentrations of BDNF, TrkB, VEGF, IL-2, IL-4, IL-6, IL-10, TNF-α were determined using the enzyme immunoassay. Cluster, correlation, and regression analyzes were used.Results. In patients with CAD, a wide range of variations in BDNF concentrations was observed. To determine homogeneous groups using the k-means clustering, three clusters with different BDNF/TrkB axis vectors were identified. Patients differed in the severity of coronary atherosclerosis, the manifestation of the inflammatory reaction, and the intensity of angiogenesis. In patients with initial and moderate atherosclerotic changes in the coronary arteries, a normal concentration of BDNF and an increased level of TrkB (22,35/1,18 ng/ml) were noted. In patients with severe coronary atherosclerosis, two different BDNF/TrkB variants have been identified. Decreased BDNF and increased TrkB (6,0/1,52 ng/ml) were associated with low VEGF and increased IL-6. Elevated BDNF and normal TrkB values (26,95/0,96 ng/ml) were characteristic of patients with high VEGF expression, indicating angiogenesis activation and/or vulnerable plaques. A direct relationship between BDNF and VEGF (r=0,536, p<0,001) and an inverse relationship with TrkB (r=-0,301, p=0,019), IL-6 (r=-0,306, p=0,002) was revealed. TrkB levels were correlated with TNF-α (r=0,403, p=0,001). Regression analysis showed that BDNF expression is influenced by TrkB (β=-0,237, p=0,009), VEGF (β=0,490, p<0,001), IL-6 (β=-0,339, p<0,001).Conclusion. In patients with stable CAD, different levels of BDNF/TrkB expression were found, which were associated with coronary atherosclerosis severity. BDNF/TrkB signaling is involved in the regulation of inflammation and angiogenesis in stable CAD.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 373","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960602","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5502
O. Aidumova, Y. Shchukin, A. O. Rubanenko
Aim. To develop a predictive model of the risk of adverse outcomes within 12 months after myocardial infarction (MI) in patients over 70 years of age with frailty syndrome.Material and methods. This prospective observational study included 92 patients over 70 years of age with MI who were treated in the cardiology departments of Samara State Medical University Clinics from 2020 to 2021. Levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and growth stimulation expressed gene 2 (ST2) were determined in serum by enzyme-linked immunosorbent assay on day 5 of hospitalization. Frailty syndrome was identified 5th day of hospitalization using "Age is not a hindrance" questionnaire. The observation period was 12 months. The end point was the adverse event occurrence (all-cause death, cardiovascular death, recurrent MI, cerebrovascular accident). Statistical nonparametric methods, correlation analysis, ROC analysis, and logistic regression were used.Results. There are following significant predictors of unfavorable outcome within 12 months after MI in patients over 70 years: age over 80 years (odds ratio (OR) 5,57, 95% confidence interval (CI) 2,07-14,96, with p=0,001), history of MI (OR 3,96, 95% CI 1,36-10,26, at p<0,05), CKD-EPI glomerular filtration rate <55 ml min/1,73 m2 (OR 4,05, 95% CI 1,55-10,57, with p=0,004), pulmonary artery systolic pressure above 38 mm Hg (OR 4,5, 95% CI 1,69-11,96, with p=0,003), Simpson's left ventricular ejection fraction <45% (OR 12,21, 95% CI 4,2-35,57, with p<0,001), as well as "Age is not a hindrance" questionnaire score ≥3 (OR 9,62, 95% CI 2,96-31,25, with p<0,001), Charlson Comorbidity Index score ≥6 (OR 10,4, 95% CI 2,84-38,12, with p<0,001), NT-proBNP ≥1400 pg/ml (OR 7,09, 95% CI 2,53-19,89, with p<0,001) and ST2 ≥8,2 ng/ml (OR 9,13, 95% CI 2,79-29,89, p<0,001). Percutaneous coronary intervention during the current hospitalization reduced the risk of adverse outcomes (OR 0,24, 95% CI 0,09-0,69, p=0,015). Predictive model for unfavorable outcome within 12 months after MI for patients over 70 years of age based on the "Age is not a hindrance" questionnaire score, serum ST2 level in ng/ml and left ventricular ejection fraction in % in ROC analysis has an area under the curve of 0,87 (95% CI 0,79-0,95), sensitivity — 86%, specificity — 71% (p<0,001).Conclusion. Prediction of an unfavorable outcome based on the "Age is not a hindrance" questionnaire score, Simpson's left ventricular ejection fraction in %, and ST2 concentration can improve risk stratification for adverse outcomes within 12 months after MI in patients over 70 years.
目的建立70岁以上患有虚弱综合征的心肌梗死（MI）患者在术后12个月内不良预后风险的预测模型。这项前瞻性观察研究纳入了2020年至2021年期间在萨马拉国立医科大学诊所心脏科接受治疗的92名70岁以上心肌梗死患者。住院第 5 天，通过酶联免疫吸附法测定血清中 N 端前脑钠肽 (NT-proBNP) 和生长刺激表达基因 2 (ST2) 的水平。使用 "年龄不是障碍 "问卷在住院第 5 天确定虚弱综合征。观察期为 12 个月。终点为不良事件发生率（全因死亡、心血管死亡、复发性心肌梗死、脑血管意外）。研究采用了非参数统计方法、相关性分析、ROC分析和逻辑回归。70 岁以上患者在心肌梗死后 12 个月内出现不良预后的重要预测因素如下：年龄超过 80 岁（比值比 (OR) 5,57，95% 置信区间 (CI)2,07-14,96，P=0,001）、有心肌梗死病史（OR 3,96，95% CI 1,36-10,26，P<0,05）、CKD-EPI 肾小球滤过率 <55 ml min/1、73 m2（OR 4,05，95% CI 1,55-10,57，P=0,004）、肺动脉收缩压高于 38 mm Hg（OR 4,5，95% CI 1,69-11,96，P=0,003）、辛普森左心室射血分数<45%（OR 12、21，95% CI 4,2-35,57，P＜0,001），以及 "年龄不是障碍 "问卷评分≥3（OR 9,62，95% CI 2,96-31,25，P＜0,001）、Charlson 综合征指数评分≥6（OR 10、4，95% CI 2,84-38,12，P<0,001）、NT-proBNP ≥1400 pg/ml（OR 7,09，95% CI 2,53-19,89，P<0,001）和 ST2 ≥8,2 ng/ml（OR 9,13，95% CI 2,79-29,89，P<0,001）。在本次住院期间进行经皮冠状动脉介入治疗可降低不良预后风险（OR 0.24，95% CI 0.09-0.69，p=0.015）。基于 "年龄不是障碍 "问卷评分、血清 ST2 水平（纳克/毫升）和左心室射血分数（%）的 ROC 分析，对 70 岁以上患者心肌梗死后 12 个月内不良预后的预测模型的曲线下面积为 0.87（95% CI 0.79-0.95），灵敏度为 86%，特异度为 71%（p<0.001）。根据 "年龄不是障碍 "问卷评分、辛普森左心室射血分数（%）和 ST2 浓度预测不良预后可改善 70 岁以上患者心肌梗死后 12 个月内不良预后的风险分层。
{"title":"Prediction of adverse outcomes within 12 months after myocardial infarction in patients over 70 years of age with frailty syndrome","authors":"O. Aidumova, Y. Shchukin, A. O. Rubanenko","doi":"10.15829/1560-4071-2023-5502","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5502","url":null,"abstract":"Aim. To develop a predictive model of the risk of adverse outcomes within 12 months after myocardial infarction (MI) in patients over 70 years of age with frailty syndrome.Material and methods. This prospective observational study included 92 patients over 70 years of age with MI who were treated in the cardiology departments of Samara State Medical University Clinics from 2020 to 2021. Levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and growth stimulation expressed gene 2 (ST2) were determined in serum by enzyme-linked immunosorbent assay on day 5 of hospitalization. Frailty syndrome was identified 5th day of hospitalization using \"Age is not a hindrance\" questionnaire. The observation period was 12 months. The end point was the adverse event occurrence (all-cause death, cardiovascular death, recurrent MI, cerebrovascular accident). Statistical nonparametric methods, correlation analysis, ROC analysis, and logistic regression were used.Results. There are following significant predictors of unfavorable outcome within 12 months after MI in patients over 70 years: age over 80 years (odds ratio (OR) 5,57, 95% confidence interval (CI) 2,07-14,96, with p=0,001), history of MI (OR 3,96, 95% CI 1,36-10,26, at p<0,05), CKD-EPI glomerular filtration rate <55 ml min/1,73 m2 (OR 4,05, 95% CI 1,55-10,57, with p=0,004), pulmonary artery systolic pressure above 38 mm Hg (OR 4,5, 95% CI 1,69-11,96, with p=0,003), Simpson's left ventricular ejection fraction <45% (OR 12,21, 95% CI 4,2-35,57, with p<0,001), as well as \"Age is not a hindrance\" questionnaire score ≥3 (OR 9,62, 95% CI 2,96-31,25, with p<0,001), Charlson Comorbidity Index score ≥6 (OR 10,4, 95% CI 2,84-38,12, with p<0,001), NT-proBNP ≥1400 pg/ml (OR 7,09, 95% CI 2,53-19,89, with p<0,001) and ST2 ≥8,2 ng/ml (OR 9,13, 95% CI 2,79-29,89, p<0,001). Percutaneous coronary intervention during the current hospitalization reduced the risk of adverse outcomes (OR 0,24, 95% CI 0,09-0,69, p=0,015). Predictive model for unfavorable outcome within 12 months after MI for patients over 70 years of age based on the \"Age is not a hindrance\" questionnaire score, serum ST2 level in ng/ml and left ventricular ejection fraction in % in ROC analysis has an area under the curve of 0,87 (95% CI 0,79-0,95), sensitivity — 86%, specificity — 71% (p<0,001).Conclusion. Prediction of an unfavorable outcome based on the \"Age is not a hindrance\" questionnaire score, Simpson's left ventricular ejection fraction in %, and ST2 concentration can improve risk stratification for adverse outcomes within 12 months after MI in patients over 70 years.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 357","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960607","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5613
A. G. Muradov, Yu. I. Grinshtein, D. Drobot, V. A. Sakovich
Aim. To evaluate the long-term results of complete bilateral internal thoracic artery (BITA) grafting and traditional coronary bypass grafting (CABG) in patients with multivessel CAD.Material and methods. From June 2018 to December 2021, 646 CABG operations were performed in patients with multivessel CAD at the Federal Center for Cardiovascular Surgery (Krasnoyarsk). There were 178 patients receiving BITA grafting and 468 — traditional revascularization technique. After propensity score matching, 356 patients were selected, of which 99 had on-pump BITA (group 1), 178 — on-pump traditional revascularization (group 2), and 79 — off-pump BITA (group 3). There were more males (p=0,143 and p=0,547). The groups were comparable in age (p=0,343 and p=0,104), body mass index (p=0,532 and p=0,759), diabetes (p= 0,705 and p=0,667), the number of hemodynamically significant coronary stenoses (p=0,370 and p=0,595).Results. The follow-up period lasted 32,8±8,52 months. Long-term patient survival was 83,9% in group 2,93% in group 1 (p=0,041) and 94% in group 3 (p=0,039). Freedom from cardiovascular mortality was 100% in both groups of BITA grafting and 92,5% in group 2 (p=0,001 and p=0,039), freedom from major cardiovascular events was 94,2% in group 1, 85,1% in group 2 and 98,5% in group 3 (p=0,032 and p=0,03).Conclusion. BITA grafting is a modern effective and safe method of surgical myocardial revascularization both on- and off-pump. Up to 33 months. BITA grafting was associated with significantly better patient survival, complete freedom from cardiovascular mortality and a lower incidence of major cardiovascular events.
{"title":"Long-term outcomes of complete bilateral internal thoracic artery grafting and traditional coronary bypass surgery in patients with multivessel coronary artery disease","authors":"A. G. Muradov, Yu. I. Grinshtein, D. Drobot, V. A. Sakovich","doi":"10.15829/1560-4071-2023-5613","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5613","url":null,"abstract":"Aim. To evaluate the long-term results of complete bilateral internal thoracic artery (BITA) grafting and traditional coronary bypass grafting (CABG) in patients with multivessel CAD.Material and methods. From June 2018 to December 2021, 646 CABG operations were performed in patients with multivessel CAD at the Federal Center for Cardiovascular Surgery (Krasnoyarsk). There were 178 patients receiving BITA grafting and 468 — traditional revascularization technique. After propensity score matching, 356 patients were selected, of which 99 had on-pump BITA (group 1), 178 — on-pump traditional revascularization (group 2), and 79 — off-pump BITA (group 3). There were more males (p=0,143 and p=0,547). The groups were comparable in age (p=0,343 and p=0,104), body mass index (p=0,532 and p=0,759), diabetes (p= 0,705 and p=0,667), the number of hemodynamically significant coronary stenoses (p=0,370 and p=0,595).Results. The follow-up period lasted 32,8±8,52 months. Long-term patient survival was 83,9% in group 2,93% in group 1 (p=0,041) and 94% in group 3 (p=0,039). Freedom from cardiovascular mortality was 100% in both groups of BITA grafting and 92,5% in group 2 (p=0,001 and p=0,039), freedom from major cardiovascular events was 94,2% in group 1, 85,1% in group 2 and 98,5% in group 3 (p=0,032 and p=0,03).Conclusion. BITA grafting is a modern effective and safe method of surgical myocardial revascularization both on- and off-pump. Up to 33 months. BITA grafting was associated with significantly better patient survival, complete freedom from cardiovascular mortality and a lower incidence of major cardiovascular events.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963166","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 : 2023-12-19DOI: 10.15829/1560-4071-2023-5532
A. R. Mingalimova, N. Gumanova, N. M. Bikbova, O. N. Dzhioeva, M. S. Pokrovskaya, I. Efimova, Z. Z. Serebryanskaya, N. Bogdanova, A. I. Borisova, O. Drapkina
Aim. To evaluate the serum fibronectin level in patients with multivessel coronary artery disease, and to identify the relationship of fibronectin level with atrial fibrillation (AF) developed in the hospital after coronary artery bypass grafting (CABG) and types of left ventricular (LV) structural remodeling.Material and methods. This prospective observational study of 80 patients after elective CABG at the Cardiac Surgery Department № 1 of the N.V. Sklifosovsky Research Institute for Emergency Medicine from October 2020 to May 2022. The groups were divided depending on the development of AF after CABG surgery (19 patients with AF developed in the hospital after CABG (up to 10 days), 61 patients — control group). All patients underwent a general clinical examination and transthoracic echocardiography, with estimation of left ventricular remodeling type. Serum fibronectin level was determined by enzyme immunoassay using the Fibronectin agent (Technozym, Austria).Results. The median fibronectin values in the group with AF was 110,10 [86,86; 134,00] mcg/ml versus 120,90 [92,01; 161,50] µg/ml of the comparison group (p=0,19). The following LV patterns were observed: normal LV geometry (NLVG) — in 1 patient (5,26%), concentric LV remodeling (CLVR) — in 3 patients (15,79%), concentric LV hypertrophy (CLVH) — in 10 patients (52,63%), eccentric LV hypertrophy (ELVH) — in 5 patients (26,32%). In the group without AF, 25 patients (40,98%) were diagnosed with NLVG, 26 patients (42,62%) — CLVR, 6,56% (n=4) — CLVR, while ELVH was diagnosed in 6 patients (9,84%). Differences in geometry types between groups were significant (p<0,0001). Multivariate analysis adjusted for gender, age, cardiopulmonary bypass time, the predictive value remained for CLVH — odds ratio 15,83 (95% confidence interval, 4,082-1,442,00; p=0,0001) and ELVH — odds ratio 5,17 (95% confidence interval, 1,365-19,573; p=0,015). A further study showed that fibronectin <116,496 µg/ml with a sensitivity of 78% and specificity of 53% is associated with CLVH (p=0,006) in patients of both groups.Conclusion. Fibronectin <116,496 µg/ml is associated with CLVH in patients with multivessel coronary artery disease (sensitivity 78%, specificity 53%; p=0,006).
{"title":"Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease","authors":"A. R. Mingalimova, N. Gumanova, N. M. Bikbova, O. N. Dzhioeva, M. S. Pokrovskaya, I. Efimova, Z. Z. Serebryanskaya, N. Bogdanova, A. I. Borisova, O. Drapkina","doi":"10.15829/1560-4071-2023-5532","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5532","url":null,"abstract":"Aim. To evaluate the serum fibronectin level in patients with multivessel coronary artery disease, and to identify the relationship of fibronectin level with atrial fibrillation (AF) developed in the hospital after coronary artery bypass grafting (CABG) and types of left ventricular (LV) structural remodeling.Material and methods. This prospective observational study of 80 patients after elective CABG at the Cardiac Surgery Department № 1 of the N.V. Sklifosovsky Research Institute for Emergency Medicine from October 2020 to May 2022. The groups were divided depending on the development of AF after CABG surgery (19 patients with AF developed in the hospital after CABG (up to 10 days), 61 patients — control group). All patients underwent a general clinical examination and transthoracic echocardiography, with estimation of left ventricular remodeling type. Serum fibronectin level was determined by enzyme immunoassay using the Fibronectin agent (Technozym, Austria).Results. The median fibronectin values in the group with AF was 110,10 [86,86; 134,00] mcg/ml versus 120,90 [92,01; 161,50] µg/ml of the comparison group (p=0,19). The following LV patterns were observed: normal LV geometry (NLVG) — in 1 patient (5,26%), concentric LV remodeling (CLVR) — in 3 patients (15,79%), concentric LV hypertrophy (CLVH) — in 10 patients (52,63%), eccentric LV hypertrophy (ELVH) — in 5 patients (26,32%). In the group without AF, 25 patients (40,98%) were diagnosed with NLVG, 26 patients (42,62%) — CLVR, 6,56% (n=4) — CLVR, while ELVH was diagnosed in 6 patients (9,84%). Differences in geometry types between groups were significant (p<0,0001). Multivariate analysis adjusted for gender, age, cardiopulmonary bypass time, the predictive value remained for CLVH — odds ratio 15,83 (95% confidence interval, 4,082-1,442,00; p=0,0001) and ELVH — odds ratio 5,17 (95% confidence interval, 1,365-19,573; p=0,015). A further study showed that fibronectin <116,496 µg/ml with a sensitivity of 78% and specificity of 53% is associated with CLVH (p=0,006) in patients of both groups.Conclusion. Fibronectin <116,496 µg/ml is associated with CLVH in patients with multivessel coronary artery disease (sensitivity 78%, specificity 53%; p=0,006).","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138961508","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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