Pub Date : 2023-10-16DOI: 10.15829/1560-4071-2023-5643
M. Mamedov, L. T. Sushkova, R. V. Isakov, V. Kutsenko, O. Drapkina
Aim. To assess the prevalence of chronic stress in the adult population in the Vladimir region, taking into account sex characteristics.Material and methods. This cross-sectional population study was performed in five cities of the Vladimir Oblast (Vladimir, Kovrov, Murom, Yuryev-Polsky and Vyazniki) from May 2018 to March 2020. From six health care facilities, 9 therapeutic areas were selected. Then, from the assigned population aged 30-69 years, respondents from each area were invited to the study. To identify chronic stress, the Reeder questionnaire was used, which makes it possible to identify three types of disorders: low, moderate and severe stress. The study analyzed fully completed Reeder L. chronic stress questionnaires from 1081 respondents (393 men and 688 women).Results. Among men, every second person has a low chronic stress, 42% — moderate stress, while high chronic stress was found in 6.4% of cases. A similar trend is observed among women. High levels of chronic stress were detected in 8% of women, and the gap between the prevalence of low and moderate chronic stress was minimal. In general, the prevalence of various levels of chronic stress between men and women was comparable, without significant differences. Sex variability in the prevalence of chronic stress was revealed in various cities of the Vladimir Oblast. In Vladimir, the prevalence of high stress among men was three times higher than in women, while in Vyazniki and Kovrov the opposite pattern was observed. In the other two cities (Murom and Yuryev Polsky), the prevalence of high chronic stress between men and women was comparable.Conclusion. In the working-age population, a high chronic stress level is detected in up to 10%. In some cities, there are sex differences between men and women. The mean level of chronic stress is determined in 42-43% of cases. The results obtained indicate the need for large-scale preventive measures to combat chronic stress among working-age men and women of in the Vladimir Oblast.
{"title":"Assessment of chronic stress in the adult population of the Vladimir region","authors":"M. Mamedov, L. T. Sushkova, R. V. Isakov, V. Kutsenko, O. Drapkina","doi":"10.15829/1560-4071-2023-5643","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5643","url":null,"abstract":"Aim. To assess the prevalence of chronic stress in the adult population in the Vladimir region, taking into account sex characteristics.Material and methods. This cross-sectional population study was performed in five cities of the Vladimir Oblast (Vladimir, Kovrov, Murom, Yuryev-Polsky and Vyazniki) from May 2018 to March 2020. From six health care facilities, 9 therapeutic areas were selected. Then, from the assigned population aged 30-69 years, respondents from each area were invited to the study. To identify chronic stress, the Reeder questionnaire was used, which makes it possible to identify three types of disorders: low, moderate and severe stress. The study analyzed fully completed Reeder L. chronic stress questionnaires from 1081 respondents (393 men and 688 women).Results. Among men, every second person has a low chronic stress, 42% — moderate stress, while high chronic stress was found in 6.4% of cases. A similar trend is observed among women. High levels of chronic stress were detected in 8% of women, and the gap between the prevalence of low and moderate chronic stress was minimal. In general, the prevalence of various levels of chronic stress between men and women was comparable, without significant differences. Sex variability in the prevalence of chronic stress was revealed in various cities of the Vladimir Oblast. In Vladimir, the prevalence of high stress among men was three times higher than in women, while in Vyazniki and Kovrov the opposite pattern was observed. In the other two cities (Murom and Yuryev Polsky), the prevalence of high chronic stress between men and women was comparable.Conclusion. In the working-age population, a high chronic stress level is detected in up to 10%. In some cities, there are sex differences between men and women. The mean level of chronic stress is determined in 42-43% of cases. The results obtained indicate the need for large-scale preventive measures to combat chronic stress among working-age men and women of in the Vladimir Oblast.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139318545","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 : 2023-10-12DOI: 10.15829/1560-4071-2023-5639
S. Yu. Nikulina, D. A. Zateyshikov
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{"title":"Cardiology 2023: the time of genetics","authors":"S. Yu. Nikulina, D. A. Zateyshikov","doi":"10.15829/1560-4071-2023-5639","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5639","url":null,"abstract":".","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136057460","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 : 2023-10-12DOI: 10.15829/1560-4071-2023-564
E. Taratukhin
The modern idea of a disease as a situation, an event, increasingly includes the social side along with the biological one. Although the biomedical side of the problem still dominates, factors such as adherence, decision-making and informed consent or refusal, psychosocial aspects of etiology and pathogenesis and other non-biological disease components become part of care provision. Of course, the social side was predominant before the development of evidencebased medicine. But in the modern context, the development of the humanities and social sciences, as well as neuroscience and psychology, makes it possible to take into account the biographical narrative of the patient’s personality as an integral part of the doctor-patient relationship. At the intersection of "biological" and "biographical" in the disease nature there are a number of factors, such as loneliness, stress, emotions, that reify, enact a person’s social self into somatic pathology or somatic health. The problem of combining humanities and natural science knowledge is very complex due to the fundamental difference in the methods of study, but for modern medicine such a connection is absolutely necessary.
{"title":"Biology and biography: revisiting the biosocial pathogenesis of non-communicable diseases","authors":"E. Taratukhin","doi":"10.15829/1560-4071-2023-564","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-564","url":null,"abstract":"The modern idea of a disease as a situation, an event, increasingly includes the social side along with the biological one. Although the biomedical side of the problem still dominates, factors such as adherence, decision-making and informed consent or refusal, psychosocial aspects of etiology and pathogenesis and other non-biological disease components become part of care provision. Of course, the social side was predominant before the development of evidencebased medicine. But in the modern context, the development of the humanities and social sciences, as well as neuroscience and psychology, makes it possible to take into account the biographical narrative of the patient’s personality as an integral part of the doctor-patient relationship. At the intersection of \"biological\" and \"biographical\" in the disease nature there are a number of factors, such as loneliness, stress, emotions, that reify, enact a person’s social self into somatic pathology or somatic health. The problem of combining humanities and natural science knowledge is very complex due to the fundamental difference in the methods of study, but for modern medicine such a connection is absolutely necessary.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320154","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 : 2023-10-07DOI: 10.15829/1560-4071-2023-5544
T. G. Vaikhanskaya, T. A. Dubovik, O. D. Levdansky, T. Kurushko, N. Danilenko
Aim. To study the epidemiological profile and long-term prognostic significance of atrial fibrillation (AF) as a risk factor for adverse clinical outcomes in patients with dilated cardiomyopathy (DCM).Material and methods. The study included 270 patients with DCM (206/76,3% men, age 47 [37; 56] years, left ventricular (LV) ejection fraction 29 [21; 35]%). The observation period was 6 years (Me 76 [57; 119] months). To assess the effect of AF on DCM prognosis, Kaplan-Meier curves and Cox regression of clinical outcomes, including cardiovascular death, heart transplantation, and ventricular assist device implantation, were analyzed.Results. Of 270 patients with DCM, paroxysmal AF was detected in 10 (3,7%) patients (initial, 5/1,85%; during the first follow-up year, 5/1,85%). After 5 years, another 65 (24,1%) individuals had AF (paroxysmal, persistent or permanent). Ventricular tachyarrhythmias were registered in 163 (60,4%) patients. Compared with patients maintaining sinus rhythm, patients with AF were older (51,4±10 vs 43,6±13 years, p=0,001) and had lower exercise tolerance (6-minute walk test: 379±45 vs 445±43 meters; p=0,0002) and a higher heart failure functional class (NYHA class III-IV: 38/50,7% vs 52/26,7%; χ2=13,6; p=0 ,0003). In patients with AF, initially more pronounced manifestations of right ventricular contractile dysfunction (TAPSE: 13,1±3,4 vs 15,5±4,6 mm; p=0,0001) and LV diastolic dysfunction (E/A: 2,9±1,5 vs 2,1±1,3; p=0,006; E/e' 15,6±6,9 vs 11,8±7,2; p=0,019), more dilated left atrium (left atrial volume index: 63,3±19 vs 50±18,7 ml/m2; p=0,006). During the 6-year median follow-up, AF was observed in 75 patients (0,46 new cases/100 patients/year). As a result of Cox regression analysis, AF as a time-dependent factor was identified as an independent predictor of cardiovascular death (hazard ratio 3,99; 95% confidence interval, 1,67-8,59; p=0,0001).Conclusion. AF, as one of the most common sustained atrial tachyarrhythmias in the population, demonstrated a lower prevalence (27,8%) in the DCM cohort compared to ventricular tachyarrhythmias (60,4%), but a high prognostic significance of the negative impact on the risk of fatal outcomes. The development of AF in patients with DCM is associated with a 4-fold increase in cardiovascular death risk over a 6-year period.
目的研究心房颤动（AF）作为扩张型心肌病（DCM）患者不良临床结局风险因素的流行病学概况和长期预后意义。研究纳入了 270 名扩张型心肌病患者（206/76.3% 为男性，年龄 47 [37; 56] 岁，左心室射血分数 29 [21; 35]%）。观察期为 6 年（Me 76 [57; 119] 个月）。为评估房颤对 DCM 预后的影响，分析了心血管死亡、心脏移植和心室辅助装置植入等临床结果的 Kaplan-Meier 曲线和 Cox 回归。在270名DCM患者中，有10名（3.7%）患者发现阵发性房颤（最初，5/1.85%；随访第一年，5/1.85%）。5 年后，又有 65 人（24.1%）出现房颤（阵发性、持续性或永久性）。163名（60.4%）患者出现室性快速性心律失常。与保持窦性心律的患者相比，房颤患者的年龄更大（51,4±10 岁 vs 43,6±13 岁，P=0,001），运动耐量更低（6 分钟步行测试：379±45 米 vs 445±43 米；P=0,0002），心衰功能分级更高（NYHA III-IV 级：38/50.7% vs 52/26.7%；χ2=13.6；P=0,0003）。在房颤患者中，右心室收缩功能障碍（TAPSE：13,1±3,4 vs 15,5±4,6 mm；P=0,0001）和左心室舒张功能障碍（E/A：2,9±1,5 vs 2,1±1,3；p=0,006；E/e' 15,6±6,9 vs 11,8±7,2；p=0,019），左心房更加扩张（左心房容积指数：63,3±19 vs 50±18,7 ml/m2；p=0,006）。在 6 年的中位随访期间，75 名患者出现房颤（每 100 名患者每年新增 0.46 例）。通过 Cox 回归分析，房颤作为一个时间依赖因素被确定为心血管死亡的独立预测因素（危险比 3.99；95% 置信区间 1.67-8.59；p=0.0001）。房颤是人群中最常见的持续性房性快速心律失常之一，与室性快速心律失常（60.4%）相比，房颤在 DCM 队列中的发病率较低（27.8%），但其对致命风险的负面影响具有很高的预后意义。在 6 年的时间里，DCM 患者发生房颤会导致心血管死亡风险增加 4 倍。
{"title":"Atrial fibrillation in patients with dilated cardiomyopathy: prevalence, risk factors and prognostic significance","authors":"T. G. Vaikhanskaya, T. A. Dubovik, O. D. Levdansky, T. Kurushko, N. Danilenko","doi":"10.15829/1560-4071-2023-5544","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5544","url":null,"abstract":"Aim. To study the epidemiological profile and long-term prognostic significance of atrial fibrillation (AF) as a risk factor for adverse clinical outcomes in patients with dilated cardiomyopathy (DCM).Material and methods. The study included 270 patients with DCM (206/76,3% men, age 47 [37; 56] years, left ventricular (LV) ejection fraction 29 [21; 35]%). The observation period was 6 years (Me 76 [57; 119] months). To assess the effect of AF on DCM prognosis, Kaplan-Meier curves and Cox regression of clinical outcomes, including cardiovascular death, heart transplantation, and ventricular assist device implantation, were analyzed.Results. Of 270 patients with DCM, paroxysmal AF was detected in 10 (3,7%) patients (initial, 5/1,85%; during the first follow-up year, 5/1,85%). After 5 years, another 65 (24,1%) individuals had AF (paroxysmal, persistent or permanent). Ventricular tachyarrhythmias were registered in 163 (60,4%) patients. Compared with patients maintaining sinus rhythm, patients with AF were older (51,4±10 vs 43,6±13 years, p=0,001) and had lower exercise tolerance (6-minute walk test: 379±45 vs 445±43 meters; p=0,0002) and a higher heart failure functional class (NYHA class III-IV: 38/50,7% vs 52/26,7%; χ2=13,6; p=0 ,0003). In patients with AF, initially more pronounced manifestations of right ventricular contractile dysfunction (TAPSE: 13,1±3,4 vs 15,5±4,6 mm; p=0,0001) and LV diastolic dysfunction (E/A: 2,9±1,5 vs 2,1±1,3; p=0,006; E/e' 15,6±6,9 vs 11,8±7,2; p=0,019), more dilated left atrium (left atrial volume index: 63,3±19 vs 50±18,7 ml/m2; p=0,006). During the 6-year median follow-up, AF was observed in 75 patients (0,46 new cases/100 patients/year). As a result of Cox regression analysis, AF as a time-dependent factor was identified as an independent predictor of cardiovascular death (hazard ratio 3,99; 95% confidence interval, 1,67-8,59; p=0,0001).Conclusion. AF, as one of the most common sustained atrial tachyarrhythmias in the population, demonstrated a lower prevalence (27,8%) in the DCM cohort compared to ventricular tachyarrhythmias (60,4%), but a high prognostic significance of the negative impact on the risk of fatal outcomes. The development of AF in patients with DCM is associated with a 4-fold increase in cardiovascular death risk over a 6-year period.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139322005","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 : 2023-10-07DOI: 10.15829/1560-4071-2023-5528
Y. Lutokhina, O. V. Blagova, E. A. Kogan, A. A. Nartov, V. R. Nartova, E. V. Zaklyazminskaya, S. Dzemeshkevich
Aim. To assess the incidence of myocarditis in patients with primary myocardial hypertrophy and to study its contribution to the disease course.Material and methods. The study included 100 patients with primary left ventricular myocardial hypertrophy, 52 men and 48 women (mean age, 51,5±15,7 years; followup period 10,4 [2,1; 36,1] months). All patients underwent electrocardiography, 24-hour electrocardiographic monitoring, echocardiography, as well as DNA analysis (n=96), myocardium pathological study (n=29), cardiac magnetic resonance imaging (n=31), cardiac multislice computed tomography (n=26), assessment of anti-cardiac antibodies (n=43), free light chain level in serum and urine by immunofixation method (n=10); 99mTc-pyrophosphate myocardial scintigraphy (n=5); biopsy of the rectal mucosa and/or subcutaneous fat for amyloid (n=9).Results. In 68%, true (sarcomeric) hypertrophic cardiomyopathy (HCM) was diagnosed, in 16% — amyloidosis with cardiac involvement, in 10% — storage diseases, in 3% — neuromuscular diseases, in 2% — myocardial hypertrophy was combined with severe restriction (mixed phenotype), and in 1% — LEOPARD syndrome. Concomitant myocarditis was diagnosed in 30% of patients. In HCM, myocarditis was detected in 31% of cases. These patients had a significantly higher heart failure class (heart failure class 3 [2; 3] vs 2 [1; 3], p=0,026) and mortality (33,3% vs 6,4%, p=0,01). In amyloidosis, the incidence of myocarditis was 31,3%. In these patients, ventricular tachycardia was observed significantly more often: 80,0% vs 18,2% (p=0,036). The prevalence of concomitant myocarditis in the subgroup of storage diseases was 30%: 2 patients with Fabry disease and 1 patient with Danon disease. Of the three patients with neuromuscular diseases, myocarditis was diagnosed in 1. In the subgroups with the restrictive phenotype and LEOPARD syndrome, no cases of myocarditis were recorded. Treatment of myocarditis made it possible to stabilize the patients' condition.Conclusion. Concomitant myocarditis led to heart failure progression, worsening ventricular arrhythmias and, as a consequence, an increased risk of sudden cardiac death. It is necessary to actively diagnose and treat myocarditis in patients with primary myocardial hypertrophy.
{"title":"Prevalence of myocarditis and its contribution to the course of primary myocardial hypertrophy","authors":"Y. Lutokhina, O. V. Blagova, E. A. Kogan, A. A. Nartov, V. R. Nartova, E. V. Zaklyazminskaya, S. Dzemeshkevich","doi":"10.15829/1560-4071-2023-5528","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5528","url":null,"abstract":"Aim. To assess the incidence of myocarditis in patients with primary myocardial hypertrophy and to study its contribution to the disease course.Material and methods. The study included 100 patients with primary left ventricular myocardial hypertrophy, 52 men and 48 women (mean age, 51,5±15,7 years; followup period 10,4 [2,1; 36,1] months). All patients underwent electrocardiography, 24-hour electrocardiographic monitoring, echocardiography, as well as DNA analysis (n=96), myocardium pathological study (n=29), cardiac magnetic resonance imaging (n=31), cardiac multislice computed tomography (n=26), assessment of anti-cardiac antibodies (n=43), free light chain level in serum and urine by immunofixation method (n=10); 99mTc-pyrophosphate myocardial scintigraphy (n=5); biopsy of the rectal mucosa and/or subcutaneous fat for amyloid (n=9).Results. In 68%, true (sarcomeric) hypertrophic cardiomyopathy (HCM) was diagnosed, in 16% — amyloidosis with cardiac involvement, in 10% — storage diseases, in 3% — neuromuscular diseases, in 2% — myocardial hypertrophy was combined with severe restriction (mixed phenotype), and in 1% — LEOPARD syndrome. Concomitant myocarditis was diagnosed in 30% of patients. In HCM, myocarditis was detected in 31% of cases. These patients had a significantly higher heart failure class (heart failure class 3 [2; 3] vs 2 [1; 3], p=0,026) and mortality (33,3% vs 6,4%, p=0,01). In amyloidosis, the incidence of myocarditis was 31,3%. In these patients, ventricular tachycardia was observed significantly more often: 80,0% vs 18,2% (p=0,036). The prevalence of concomitant myocarditis in the subgroup of storage diseases was 30%: 2 patients with Fabry disease and 1 patient with Danon disease. Of the three patients with neuromuscular diseases, myocarditis was diagnosed in 1. In the subgroups with the restrictive phenotype and LEOPARD syndrome, no cases of myocarditis were recorded. Treatment of myocarditis made it possible to stabilize the patients' condition.Conclusion. Concomitant myocarditis led to heart failure progression, worsening ventricular arrhythmias and, as a consequence, an increased risk of sudden cardiac death. It is necessary to actively diagnose and treat myocarditis in patients with primary myocardial hypertrophy.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139322011","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 : 2023-10-06DOI: 10.15829/15604071-2023-5559
A. Filatova, E. A. Larina, O. Afanasieva, L. Ilina, N. V. Radukhina, M. Afanasieva, E. Klesareva, A. Shiryaev, S. Kurbanov, E. Vlasova, V. Vasiliev, S. Pokrovsky, T. Arefieva
Aim. To assess the level of lipoprotein (a) (Lp(a)) and other lipid profile parameters, the composition of blood leukocytes in patients with focal and diffuse coronary atherosclerosis who underwent coronary artery bypass surgery (CABG), as well as to study the effect of Lp(a) on the activation of leukocytes in vitro.Material and methods. The study included 120 male patients (mean age, 67±5 years) with multivessel coronary artery disease after elective CABG surgery. According to the type of coronary artery involvement, patients were divided into groups of diffuse (n=77) and focal (n=43) atherosclerosis. In peripheral blood samples, the content of the main fractions of lipoproteins, including Lp(a), was determined. Activation of neutrophil granulocytes upon addition of Lp(a) was assessed in whole blood and in primary cell culture.Results. In patients with diffuse coronary stenosis, there was a tendency to higher Lp(a) levels; no changes in other lipid profile parameters were detected. In this group of patients, an increase in the absolute leukocyte count was noted due to neutrophilic granulocytes. An absolute neutrophil count >2,9 million/mL was associated with diffuse disease (AUC, 0,69 (95% confidence interval (CI) 0,600,77), p=0,0002, sensitivity 85%, specificity 42%). In patients with Lp(a) ³30 mg/dL, the diagnostic value of a neutrophil count >2,9 million/mL for diffuse stenosis was higher (AUC, 0,74 (95% CI 0,60-0,86), p= 0,005, sensitivity 90%, specificity 48%). According to logistic regression analysis with the introduction of neutrophils and conventional risk factors (age, body mass index, hypertension and smoking) into the model, only the number of neutrophils above the threshold level remained an independent factor in diffuse coronary stenosis. Lp(a) can induce neutrophil activation, detected by increased CD66b overexpression in whole blood, as well as the formation of neutrophil extracellular traps in primary cell culture.Conclusion. Neutrophil granulocytes can participate in the formation of diffuse atherosclerotic coronary lesions. One of the neutrophil activators may be Lp(a). The combination of high neutrophil count and Lp(a) level in the blood increases the risk of diffuse coronary atherosclerosis.
{"title":"Number of blood neutrophil granulocytes is associated with diffuse coronary involvement in patients with increased lipoprotein (a)","authors":"A. Filatova, E. A. Larina, O. Afanasieva, L. Ilina, N. V. Radukhina, M. Afanasieva, E. Klesareva, A. Shiryaev, S. Kurbanov, E. Vlasova, V. Vasiliev, S. Pokrovsky, T. Arefieva","doi":"10.15829/15604071-2023-5559","DOIUrl":"https://doi.org/10.15829/15604071-2023-5559","url":null,"abstract":"Aim. To assess the level of lipoprotein (a) (Lp(a)) and other lipid profile parameters, the composition of blood leukocytes in patients with focal and diffuse coronary atherosclerosis who underwent coronary artery bypass surgery (CABG), as well as to study the effect of Lp(a) on the activation of leukocytes in vitro.Material and methods. The study included 120 male patients (mean age, 67±5 years) with multivessel coronary artery disease after elective CABG surgery. According to the type of coronary artery involvement, patients were divided into groups of diffuse (n=77) and focal (n=43) atherosclerosis. In peripheral blood samples, the content of the main fractions of lipoproteins, including Lp(a), was determined. Activation of neutrophil granulocytes upon addition of Lp(a) was assessed in whole blood and in primary cell culture.Results. In patients with diffuse coronary stenosis, there was a tendency to higher Lp(a) levels; no changes in other lipid profile parameters were detected. In this group of patients, an increase in the absolute leukocyte count was noted due to neutrophilic granulocytes. An absolute neutrophil count >2,9 million/mL was associated with diffuse disease (AUC, 0,69 (95% confidence interval (CI) 0,600,77), p=0,0002, sensitivity 85%, specificity 42%). In patients with Lp(a) ³30 mg/dL, the diagnostic value of a neutrophil count >2,9 million/mL for diffuse stenosis was higher (AUC, 0,74 (95% CI 0,60-0,86), p= 0,005, sensitivity 90%, specificity 48%). According to logistic regression analysis with the introduction of neutrophils and conventional risk factors (age, body mass index, hypertension and smoking) into the model, only the number of neutrophils above the threshold level remained an independent factor in diffuse coronary stenosis. Lp(a) can induce neutrophil activation, detected by increased CD66b overexpression in whole blood, as well as the formation of neutrophil extracellular traps in primary cell culture.Conclusion. Neutrophil granulocytes can participate in the formation of diffuse atherosclerotic coronary lesions. One of the neutrophil activators may be Lp(a). The combination of high neutrophil count and Lp(a) level in the blood increases the risk of diffuse coronary atherosclerosis.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139322230","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 : 2023-10-04DOI: 10.15829/1560-4071-2023-5568
E. Grakova, K. V. Kopieva, A. Gusakova, A. Smorgon, A. Maltseva, A. Mochula, A. Svarovskaya, K. Zavadovsky
Aim. In patients with non-obstructive coronary artery disease (CAD), to evaluate the pathophysiological significance and diagnostic effectiveness of catestatin in detecting heart failure with preserved ejection fraction (HFpEF), as well as to assess the relationship of the levels of this biomarker with heart rate variability (HRV) parameters and the severity of diastolic dysfunction.Material and methods. The study included 83 patients (44 men, mean age, 62,0 [57,0; 68,5] years) with non-obstructive CAD and preserved left ventricular (LV) ejection fraction of 63 [60; 64]%). Echocardiography was performed according to a standard protocol. HRV was assessed using 24-hour electrocardiographic monitoring. Serum biomarker levels were determined using enzyme-linked immunosorbent assay.Results. Patients were divided into groups depending on HFpEF presence: group 1 (n=63) included patients with newly diagnosed HFpEF, and group 2 included patients without heart failure (n=20). Serum catestatin concentrations were 43,1% lower (p<0,001) in patients with HFpEF than in patients without it. Catestatin had a negative correlation with levels of N-terminal pro-brain natriuretic peptide and C-reactive protein. Moreover, serum catestatin values were inversely correlated with LV remodeling parameters, whereas no relationship was found with HRV values. According to ROC analysis, catestatin £132,83 μg/ml (AUC=0,884; p<0,001) were defined as threshold values associated with HFpEF.Conclusion. Decreased serum catestatin concentrations were associated with HFpEF and overexpression of heart failure and inflammation biomarkers. Moreover, serum catestatin values had a negative relationship with LV remodeling parameters, while no relationship was found with HRV values.
目的在非阻塞性冠状动脉疾病（CAD）患者中，评估催他汀在检测射血分数保留型心力衰竭（HFpEF）中的病理生理意义和诊断效果，以及评估该生物标志物水平与心率变异性（HRV）参数和舒张功能障碍严重程度的关系。研究共纳入 83 名患者（44 名男性，平均年龄 62.0 [57.0; 68.5]岁），他们都患有非阻塞性 CAD，左心室射血分数保留在 63 [60; 64]%。超声心动图检查按照标准方案进行。心率变异通过 24 小时心电图监测进行评估。使用酶联免疫吸附法测定血清生物标志物水平。根据是否存在高频心力衰竭将患者分为两组：第一组（63人）包括新确诊的高频心力衰竭患者，第二组包括无心力衰竭患者（20人）。与无心衰患者相比，高频心衰患者的血清睾酮浓度低43.1%（P<0.001）。睾酮与 N 端脑钠肽和 C 反应蛋白的水平呈负相关。此外，血清催他汀的值与左心室重塑参数成反比，而与心率变异值没有关系。根据ROC分析，132,83 μg/ml（AUC=0,884；p<0,001）的促肾上腺皮质激素被定义为与HFpEF相关的阈值。结论：血清促胰蛋白酶浓度降低与高频心衰、心衰和炎症生物标志物过度表达有关。此外，血清催产素值与左心室重塑参数呈负相关，而与心率变异值没有关系。
{"title":"Significance of catestatin in the pathogenesis of heart failure with preserved ejection fraction in patients with non-obstructive coronary artery disease","authors":"E. Grakova, K. V. Kopieva, A. Gusakova, A. Smorgon, A. Maltseva, A. Mochula, A. Svarovskaya, K. Zavadovsky","doi":"10.15829/1560-4071-2023-5568","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5568","url":null,"abstract":"Aim. In patients with non-obstructive coronary artery disease (CAD), to evaluate the pathophysiological significance and diagnostic effectiveness of catestatin in detecting heart failure with preserved ejection fraction (HFpEF), as well as to assess the relationship of the levels of this biomarker with heart rate variability (HRV) parameters and the severity of diastolic dysfunction.Material and methods. The study included 83 patients (44 men, mean age, 62,0 [57,0; 68,5] years) with non-obstructive CAD and preserved left ventricular (LV) ejection fraction of 63 [60; 64]%). Echocardiography was performed according to a standard protocol. HRV was assessed using 24-hour electrocardiographic monitoring. Serum biomarker levels were determined using enzyme-linked immunosorbent assay.Results. Patients were divided into groups depending on HFpEF presence: group 1 (n=63) included patients with newly diagnosed HFpEF, and group 2 included patients without heart failure (n=20). Serum catestatin concentrations were 43,1% lower (p<0,001) in patients with HFpEF than in patients without it. Catestatin had a negative correlation with levels of N-terminal pro-brain natriuretic peptide and C-reactive protein. Moreover, serum catestatin values were inversely correlated with LV remodeling parameters, whereas no relationship was found with HRV values. According to ROC analysis, catestatin £132,83 μg/ml (AUC=0,884; p<0,001) were defined as threshold values associated with HFpEF.Conclusion. Decreased serum catestatin concentrations were associated with HFpEF and overexpression of heart failure and inflammation biomarkers. Moreover, serum catestatin values had a negative relationship with LV remodeling parameters, while no relationship was found with HRV values.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139323566","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 : 2023-09-29DOI: 10.15829/1560-4071-2023-5538
N. P. Garganeeva, I. F. Taminova, V. V. Kalyuzhin, E. Kalyuzhina, I. Smirnova, T. V. Sarycheva
Aim. To assess the anthropometric characteristics and functional state of the cardiovascular system in qualified athletes of various sports.Material and methods. A total of 136 male athletes were examined. Qualified athletes (n=116) (age, 22,07±4,10 years, sports experience 9,56±3,08 years) were divided into groups: I (n=30) — wrestling, judo, II (n=27) — cross-country skiing, biathlon, III (n=33) — powerlifting, IV (n=26) — volleyball. Control group (n=20) consisted of those training less than 3 years. We performed anthropometry with assessment of body height and weight, chest circumference, body surface area, body mass index (BMI), Pignet index, Erisman index, grip and back strength test. Echocardiography, cycle ergometry with assessment of physical working capacity (PWC170) and maximum oxygen consumption (MOC). The relationship between traits was assessed using the Spearman rank correlation coefficient (rs). Critical significance level was p=0,05.Results. According to echocardiography, qualified athletes had significant differences in structural parameters. Group II was characterized by an increase in left ventricular (LV) volumetric dimensions and identified correlations of BMI and body surface area with end-diastolic dimension (r=0,602), end-diastolic volume (r=0,591), end-systolic volume (ESV) (r=0,429), stroke volume (r=0,597), PWC170 (r=0,550). Groups I and III were characterized by an increase in LV posterior wall (LVPWT) and interventricular septal (IVST) thickness. In group I, there was a relationship between body surface area and LVPWT (r=0,413); Pignet index with MOC (r=0,623); PWC170 with Erisman index (r=0,573), strength of the right (r=0,610) and left hand (r=0,515), back muscles (r=0,445). Group III had the highest BMI and body surface area, while relationships were identified with LVPWT (r=0,426), IVST (r=0,409), LV mass (LVM) (r=0,453), and back muscle strength (r=0,464); the Erisman index correlated with LVM index (r=0,359). In group IV, the parameters of height, body weight and body surface area are interrelated with LVM (r=0,731), LVPWT (r=0,523), IVST (r=0,399), ESV (r=0,504), end-systolic dimension (r=0,467), right hand strength (r=0,583).Conclusion. The relationships established by correlation analysis showed that anthropometric features are important components and criteria for assessing cardiac hemodynamics function in qualified athletes, depending on the type of sport and the duration of training, which must be taken into account when achieving sports results.
{"title":"Anthropometric features and functional state of the cardiovascular system in qualified athletes of various sports","authors":"N. P. Garganeeva, I. F. Taminova, V. V. Kalyuzhin, E. Kalyuzhina, I. Smirnova, T. V. Sarycheva","doi":"10.15829/1560-4071-2023-5538","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5538","url":null,"abstract":"Aim. To assess the anthropometric characteristics and functional state of the cardiovascular system in qualified athletes of various sports.Material and methods. A total of 136 male athletes were examined. Qualified athletes (n=116) (age, 22,07±4,10 years, sports experience 9,56±3,08 years) were divided into groups: I (n=30) — wrestling, judo, II (n=27) — cross-country skiing, biathlon, III (n=33) — powerlifting, IV (n=26) — volleyball. Control group (n=20) consisted of those training less than 3 years. We performed anthropometry with assessment of body height and weight, chest circumference, body surface area, body mass index (BMI), Pignet index, Erisman index, grip and back strength test. Echocardiography, cycle ergometry with assessment of physical working capacity (PWC170) and maximum oxygen consumption (MOC). The relationship between traits was assessed using the Spearman rank correlation coefficient (rs). Critical significance level was p=0,05.Results. According to echocardiography, qualified athletes had significant differences in structural parameters. Group II was characterized by an increase in left ventricular (LV) volumetric dimensions and identified correlations of BMI and body surface area with end-diastolic dimension (r=0,602), end-diastolic volume (r=0,591), end-systolic volume (ESV) (r=0,429), stroke volume (r=0,597), PWC170 (r=0,550). Groups I and III were characterized by an increase in LV posterior wall (LVPWT) and interventricular septal (IVST) thickness. In group I, there was a relationship between body surface area and LVPWT (r=0,413); Pignet index with MOC (r=0,623); PWC170 with Erisman index (r=0,573), strength of the right (r=0,610) and left hand (r=0,515), back muscles (r=0,445). Group III had the highest BMI and body surface area, while relationships were identified with LVPWT (r=0,426), IVST (r=0,409), LV mass (LVM) (r=0,453), and back muscle strength (r=0,464); the Erisman index correlated with LVM index (r=0,359). In group IV, the parameters of height, body weight and body surface area are interrelated with LVM (r=0,731), LVPWT (r=0,523), IVST (r=0,399), ESV (r=0,504), end-systolic dimension (r=0,467), right hand strength (r=0,583).Conclusion. The relationships established by correlation analysis showed that anthropometric features are important components and criteria for assessing cardiac hemodynamics function in qualified athletes, depending on the type of sport and the duration of training, which must be taken into account when achieving sports results.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334247","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 : 2023-09-29DOI: 10.15829/1560-4071-2023-5631
D. V. Drozdov, L. M. Makarov, V. S. Barkan, T. M. Gazashvili, V. P. Efimova, M. Yu. Zhuk, O. B. Irtyuga, L. A. Kalinin, I. A. Kovalev, V. N. Komolyatova, E. V. Parmon, A. N. Rogoza, P. V. Struchkov, A. A. Tatarinova, Yu. E. Teregulov, T. V. Treshkur, D. V. Shutov
Russian Society of Cardiology (RSC) Developed with the special contribution of the Russian Functional Diagnostics Association, Russian Holter Monitoring and Non-invasive Electrophysiology Society, Russian Pediatric Cardiology Association.
{"title":"Resting 12-lead electrocardiography for adults and children. 2023 Guidelines","authors":"D. V. Drozdov, L. M. Makarov, V. S. Barkan, T. M. Gazashvili, V. P. Efimova, M. Yu. Zhuk, O. B. Irtyuga, L. A. Kalinin, I. A. Kovalev, V. N. Komolyatova, E. V. Parmon, A. N. Rogoza, P. V. Struchkov, A. A. Tatarinova, Yu. E. Teregulov, T. V. Treshkur, D. V. Shutov","doi":"10.15829/1560-4071-2023-5631","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5631","url":null,"abstract":"Russian Society of Cardiology (RSC) Developed with the special contribution of the Russian Functional Diagnostics Association, Russian Holter Monitoring and Non-invasive Electrophysiology Society, Russian Pediatric Cardiology Association.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135342732","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 : 2023-09-29DOI: 10.15829/1560-4071-2023-5527
V. Uspenskiy, V. L. Saprankov, V. I. Mazin, D. G. Zavarzina, A. B. Malashicheva, O. B. Irtyuga, O. M. Moiseeva, M. Gordeev
Aim. To assess the association between pathological ascending aortic (AA) wall changes and its planimetric characteristics in non-syndromic non-familial (sporadic) aneurysm and dilation of the AA.Material and methods. The study included 174 patients with sporadic aneurysms and dilation of the AA, who underwent elective surgery between January 2010 and July 2015 and were divided into 2 groups: patients with AA aneurysm (AAA) (AA diameter >50 mm) and tricuspid aortic valve (AV) with significant aortic stenosis (AS) or regurgitation (AR) (AAA group, n=120), and persons with borderline AA dilatation (AA diameter 45-50 mm), associated with a bicuspid aortic valve (BAV) and significant AS (BD group, n=54). Standard paraclinical investigations and pathological examination of the VA wall were used. Statistical processing was carried out in the SPYDER 4.1.5 environment (Python 3.8), and included univariate correlation analysis, logistic regression analysis, as well as supervised machine learning (ML) methods (support vector machine, k-nearest neighbor method, random forest).Results. Logistic regression revealed positive associations between AA atherosclerosis and age, cystic medial necrosis (CMN) and sinus of Valsalva (SV) diameters. The support vector machine method demonstrated a tendency towards AA expansion at the SV level in individuals with CMN (accuracy, 60,5%), as well as towards expansion of the tubular AA in atherosclerosis (accuracy, 79,2%). During the random forest analysis, the first stage was to construct decision trees to predict three following outcomes: the presence of CMN, atherosclerosis, or normal aortic structure. The model accuracy was 64,2%. Next, the variables "CMN" and "atherosclerosis" were combined, and prediction was made for the outcomes "normal AA wall structure" and "pathological AA wall structure". The model accuracy was 73,5%.Conclusion. The use of ML opens up new opportunities for predicting aortopathy and a patient-centered approach to treatment. In AR, a more aggressive AA intervention is warranted. To predict aortopathies, thoracic aorta diameters indexed to body surface area should not be used. Aortic wall sampling (circular section) followed by a continuous pathological examination may be promising.
目的评估非综合征非家族性（散发性）动脉瘤和主动脉瘤扩张的升主动脉（AA）壁病理变化与其平面特征之间的关联。研究纳入了 2010 年 1 月至 2015 年 7 月间接受择期手术的 174 名散发性动脉瘤和 AA 扩张患者，并将其分为两组：AA动脉瘤（AAA）（AA直径大于50毫米）和三尖瓣主动脉瓣（AV）伴有明显主动脉瓣狭窄（AS）或反流（AR）的患者（AAA组，n=120），以及AA边缘扩张（AA直径45-50毫米），伴有双尖瓣主动脉瓣（BAV）和明显AS的患者（BD组，n=54）。采用标准的临床旁检查和主动脉瓣壁病理检查。统计处理在 SPYDER 4.1.5 环境（Python 3.8）中进行，包括单变量相关分析、逻辑回归分析以及监督机器学习（ML）方法（支持向量机、k-近邻法、随机森林）。逻辑回归显示 AA 动脉粥样硬化与年龄、囊性内膜坏死（CMN）和瓦尔萨尔瓦窦（SV）直径呈正相关。支持向量机方法显示，CMN 患者 SV 层的 AA 有扩大的趋势（准确率为 60.5%），动脉粥样硬化患者的管状 AA 也有扩大的趋势（准确率为 79.2%）。在随机森林分析中，第一阶段是构建决策树来预测以下三种结果：是否存在 CMN、动脉粥样硬化或正常主动脉结构。模型准确率为 64.2%。接下来，将变量 "CMN "和 "动脉粥样硬化 "合并，预测结果为 "正常 AA 壁结构 "和 "病理 AA 壁结构"。模型准确率为 73.5%。使用 ML 为预测大动脉病变和以患者为中心的治疗方法提供了新的机会。在 AR 中，应采取更积极的 AA 干预措施。预测主动脉病变时，不应使用与体表面积相关的胸主动脉直径。对主动脉壁取样（环形切片），然后进行连续的病理检查可能会有希望。
{"title":"Machine learning in assessing the association between the size and structure of the ascending aortic wall in patients with aortic dilatation of varying severity","authors":"V. Uspenskiy, V. L. Saprankov, V. I. Mazin, D. G. Zavarzina, A. B. Malashicheva, O. B. Irtyuga, O. M. Moiseeva, M. Gordeev","doi":"10.15829/1560-4071-2023-5527","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5527","url":null,"abstract":"Aim. To assess the association between pathological ascending aortic (AA) wall changes and its planimetric characteristics in non-syndromic non-familial (sporadic) aneurysm and dilation of the AA.Material and methods. The study included 174 patients with sporadic aneurysms and dilation of the AA, who underwent elective surgery between January 2010 and July 2015 and were divided into 2 groups: patients with AA aneurysm (AAA) (AA diameter >50 mm) and tricuspid aortic valve (AV) with significant aortic stenosis (AS) or regurgitation (AR) (AAA group, n=120), and persons with borderline AA dilatation (AA diameter 45-50 mm), associated with a bicuspid aortic valve (BAV) and significant AS (BD group, n=54). Standard paraclinical investigations and pathological examination of the VA wall were used. Statistical processing was carried out in the SPYDER 4.1.5 environment (Python 3.8), and included univariate correlation analysis, logistic regression analysis, as well as supervised machine learning (ML) methods (support vector machine, k-nearest neighbor method, random forest).Results. Logistic regression revealed positive associations between AA atherosclerosis and age, cystic medial necrosis (CMN) and sinus of Valsalva (SV) diameters. The support vector machine method demonstrated a tendency towards AA expansion at the SV level in individuals with CMN (accuracy, 60,5%), as well as towards expansion of the tubular AA in atherosclerosis (accuracy, 79,2%). During the random forest analysis, the first stage was to construct decision trees to predict three following outcomes: the presence of CMN, atherosclerosis, or normal aortic structure. The model accuracy was 64,2%. Next, the variables \"CMN\" and \"atherosclerosis\" were combined, and prediction was made for the outcomes \"normal AA wall structure\" and \"pathological AA wall structure\". The model accuracy was 73,5%.Conclusion. The use of ML opens up new opportunities for predicting aortopathy and a patient-centered approach to treatment. In AR, a more aggressive AA intervention is warranted. To predict aortopathies, thoracic aorta diameters indexed to body surface area should not be used. Aortic wall sampling (circular section) followed by a continuous pathological examination may be promising.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334263","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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