Pub Date : 2023-09-21DOI: 10.15829/1560-4071-2023-5381
A. S. Sabirzyanova, A. S. Galyavich, L. V. Baleeva, Z. V. Galeeva
Aim . To evaluate the role of growth differentiation factor-15 (GDF-15) in long-term prognosis in patients with uncomplicated myocardial infarction (MI). Material and methods . The study included 118 patients with uncomplicated ST-elevation and non-ST-elevation MI. In addition to the routine examination, all patients were analyzed for GDF-15, as well as the N-terminal pro-brain natriuretic peptide (NT-proBNP) by enzyme immunoassay in the first 48 hours from the onset of MI symptoms. The changes in the patients' condition were assessed by questioning after 1, 3, 6, 12 months, as well as the analysis of medical records in the event of repeated cardiovascular events and deaths. The endpoints were cardiovascular death, hospitalization for recurrent MI, and/or unstable angina. To assess the value of quantitative variables in predicting recurrent cardiovascular events, the ROC analysis was used. The survival function of patients was assessed using the Kaplan-Meier method. Results. Twelve-month follow-up revealed 29 recurrent cardiovascular events, including 2 deaths and 8 recurrent MIs. GDF-15 was predictive of recurrent cardiovascular events with a sensitivity of 77,3% and a specificity of 56,2% (ROCAUC, 0,7±0,065 (95% confidence interval (CI), 0,572-0,827), p=0,004). Patients with GDF-15 ≥2,075 ng/mL had a higher risk of recurrent cardiovascular events (hazard ratio (HR), 3,4 (95% CI, 1,342-8,613), p=0,005). Another prognostic factor influencing the rate of recurrent cardiovascular events was NT-proBNP. An NTproBNP level ≥578 pg/mL was associated with an increased risk of cardiovascular death and rehospitalization for unstable angina and recurrent MI (HR, 4,3 (95% CI 1,828-10,239), p=0,00019). Conclusion . The combined increase in GDF-15 ≥2,075 ng/mL and NT-proBNP ≥578 pg/mL in patients with uncomplicated MI increases the risk of recurrent cardiovascular events over the next 12 months (HR, 4,5 (95% CI, 2,087-9,736), p=0,00018).
{"title":"Growth differentiation factor-15 — a new indicator of unfavorable prognosis in uncomplicated myocardial infarction","authors":"A. S. Sabirzyanova, A. S. Galyavich, L. V. Baleeva, Z. V. Galeeva","doi":"10.15829/1560-4071-2023-5381","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5381","url":null,"abstract":"Aim . To evaluate the role of growth differentiation factor-15 (GDF-15) in long-term prognosis in patients with uncomplicated myocardial infarction (MI). Material and methods . The study included 118 patients with uncomplicated ST-elevation and non-ST-elevation MI. In addition to the routine examination, all patients were analyzed for GDF-15, as well as the N-terminal pro-brain natriuretic peptide (NT-proBNP) by enzyme immunoassay in the first 48 hours from the onset of MI symptoms. The changes in the patients' condition were assessed by questioning after 1, 3, 6, 12 months, as well as the analysis of medical records in the event of repeated cardiovascular events and deaths. The endpoints were cardiovascular death, hospitalization for recurrent MI, and/or unstable angina. To assess the value of quantitative variables in predicting recurrent cardiovascular events, the ROC analysis was used. The survival function of patients was assessed using the Kaplan-Meier method. Results. Twelve-month follow-up revealed 29 recurrent cardiovascular events, including 2 deaths and 8 recurrent MIs. GDF-15 was predictive of recurrent cardiovascular events with a sensitivity of 77,3% and a specificity of 56,2% (ROCAUC, 0,7±0,065 (95% confidence interval (CI), 0,572-0,827), p=0,004). Patients with GDF-15 ≥2,075 ng/mL had a higher risk of recurrent cardiovascular events (hazard ratio (HR), 3,4 (95% CI, 1,342-8,613), p=0,005). Another prognostic factor influencing the rate of recurrent cardiovascular events was NT-proBNP. An NTproBNP level ≥578 pg/mL was associated with an increased risk of cardiovascular death and rehospitalization for unstable angina and recurrent MI (HR, 4,3 (95% CI 1,828-10,239), p=0,00019). Conclusion . The combined increase in GDF-15 ≥2,075 ng/mL and NT-proBNP ≥578 pg/mL in patients with uncomplicated MI increases the risk of recurrent cardiovascular events over the next 12 months (HR, 4,5 (95% CI, 2,087-9,736), p=0,00018).","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238527","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 : 2023-09-21DOI: 10.15829/1560-40712023-5400
N. P. Shurkevich, A. S. Vetoshkin, A. A. Simonyan, L. I. Gapon, M. A. Kareva
Aim. To determine additional factors and sex differences associated with the intermediate probability of heart failure (HF) with preserved ejection fraction (HFpEF) in asymptomatic patients working in the Arctic on a rotating basis. Material and methods . In the polar village of Yamburg (68° 21' 40 "N), 99 men and 81 women with grade 1 and 2 hypertension (HTN) and normal blood pressure, comparable by age (p=0,450), length of service in the north (p=0,956), office systolic blood pressure (BP) (p=0,251), diastolic BP (p=0,579) were simultaneously examined. We performed echocardiography and assessed the risk of HFpEF by H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure). A treadmill test, Baevsky index, 24-hour BP monitoring, and biochemical blood tests were performed. Results. Depending on H2FPEF score, participants were divided into groups: from 0 to 1 (group 1 — normal), from 2 to 5 (group 2 — intermediate probability of HFpEF). In men with intermediate probability of HFpEF, the Baevsky index (p=0,0048) and the incidence of resting body reserve dysaptation (p=0,0394) were higher, as well as a rapid BP increase during dosed exercise (p=0,0058) and a decrease in chronotropic reserve (p<0,0001) were noted. The presence of HTN in men increased the intermediate probability of HFpEF by 3,6 times, dyspnea at dosed exercise by 10 times, dysaptation to exercise by 5 times, the presence of left ventricular concentric remodeling by 8-10 times. In females with intermediate probability of HFpEF, dysaptation to exercise at rest (p=0,0120) and lower level of oxygen consumption during dosed exercise was more often determined (p=0,0485). The intermediate probability of HFpEF in women increased with autonomic nervous system dysfunction, an increase in the mean 24-hour systolic BP variability, the presence of dyspnea during dosed exercise (10 times), concentric left ventricular remodeling, and an increase in nonspecific inflammation markers (high-sensitivity C-reactive protein, IL-1β, IL-6). Conclusion . Early identification of additional risk factors for intermediate probability of HFpEF in asymptomatic hypertensive patients has the potential to reduce the risk of subsequent clinical heart failure, allowing focus on prevention and intervention strategies in this group of patients.
{"title":"Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic","authors":"N. P. Shurkevich, A. S. Vetoshkin, A. A. Simonyan, L. I. Gapon, M. A. Kareva","doi":"10.15829/1560-40712023-5400","DOIUrl":"https://doi.org/10.15829/1560-40712023-5400","url":null,"abstract":"Aim. To determine additional factors and sex differences associated with the intermediate probability of heart failure (HF) with preserved ejection fraction (HFpEF) in asymptomatic patients working in the Arctic on a rotating basis. Material and methods . In the polar village of Yamburg (68° 21' 40 \"N), 99 men and 81 women with grade 1 and 2 hypertension (HTN) and normal blood pressure, comparable by age (p=0,450), length of service in the north (p=0,956), office systolic blood pressure (BP) (p=0,251), diastolic BP (p=0,579) were simultaneously examined. We performed echocardiography and assessed the risk of HFpEF by H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure). A treadmill test, Baevsky index, 24-hour BP monitoring, and biochemical blood tests were performed. Results. Depending on H2FPEF score, participants were divided into groups: from 0 to 1 (group 1 — normal), from 2 to 5 (group 2 — intermediate probability of HFpEF). In men with intermediate probability of HFpEF, the Baevsky index (p=0,0048) and the incidence of resting body reserve dysaptation (p=0,0394) were higher, as well as a rapid BP increase during dosed exercise (p=0,0058) and a decrease in chronotropic reserve (p<0,0001) were noted. The presence of HTN in men increased the intermediate probability of HFpEF by 3,6 times, dyspnea at dosed exercise by 10 times, dysaptation to exercise by 5 times, the presence of left ventricular concentric remodeling by 8-10 times. In females with intermediate probability of HFpEF, dysaptation to exercise at rest (p=0,0120) and lower level of oxygen consumption during dosed exercise was more often determined (p=0,0485). The intermediate probability of HFpEF in women increased with autonomic nervous system dysfunction, an increase in the mean 24-hour systolic BP variability, the presence of dyspnea during dosed exercise (10 times), concentric left ventricular remodeling, and an increase in nonspecific inflammation markers (high-sensitivity C-reactive protein, IL-1β, IL-6). Conclusion . Early identification of additional risk factors for intermediate probability of HFpEF in asymptomatic hypertensive patients has the potential to reduce the risk of subsequent clinical heart failure, allowing focus on prevention and intervention strategies in this group of patients.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238704","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 : 2023-09-21DOI: 10.15829/1560-4071-20235455
E. Е. Gorbatovskaya, Yu. A. Dyleva, E. V. Belik, E. G. Uchasova, R. S. Tarasov, O. V. Gruzdeva
Aim. To compare the incidence of leptin resistance (LR) in patients with acute and chronic coronary artery disease (CAD) and patients with acquired heart defects (AHD). Material and methods . The study included 234 patients: 114 patients with acute myocardial infarction (MI) and 120 patients with chronic CAD. The comparison group consisted of 48 patients with degenerative non-rheumatic AHD — aortic stenosis (AS). The control group consisted of 40 healthy volunteers. On the 1st day of hospitalization, the concentration of leptin and leptin receptor was measured, and the free leptin index (FLI) was assessed. LR was recorded at leptin >6,45 ng/ ml and FLI >25. Statistical data processing was carried out using the software package Statistica 10.0 and SPSS 17.0 for Windows. Results . Initially, LR in MI, chronic CAD and non-coronary disease was revealed in 64%, 56,2% and 25%, respectively. Significant differences in the incidence of LR were observed between patients with MI and chronic CAD relative to patients with AHD (p=0,02 and p=0,03, respectively), while no differences were found between patients with coronary pathology (p=0,82). Equation of patients for body mass index (BMI) did not affect the incidence of LR. High incidence of LR remained for patients with acute and chronic CAD, and amounted to 63% and 57,3%, respectively, while for patients with AS — 25%. Conclusion . Patients with acute and chronic CAD are characterized by a high LR incidence, in contrast to patients with AHD. The number of LR cases in patients with coronary pathology did not depend on BMI values, which indicates possible alternative leptin sources contributing the development of hyperleptinemia. In addition, studying the mechanisms underlying the leptin receptor decrease in CAD is necessary for adequate leptin effects and the prevention of LR.
{"title":"Identification of leptin resistance in patients with coronary artery disease and heart defects","authors":"E. Е. Gorbatovskaya, Yu. A. Dyleva, E. V. Belik, E. G. Uchasova, R. S. Tarasov, O. V. Gruzdeva","doi":"10.15829/1560-4071-20235455","DOIUrl":"https://doi.org/10.15829/1560-4071-20235455","url":null,"abstract":"Aim. To compare the incidence of leptin resistance (LR) in patients with acute and chronic coronary artery disease (CAD) and patients with acquired heart defects (AHD). Material and methods . The study included 234 patients: 114 patients with acute myocardial infarction (MI) and 120 patients with chronic CAD. The comparison group consisted of 48 patients with degenerative non-rheumatic AHD — aortic stenosis (AS). The control group consisted of 40 healthy volunteers. On the 1st day of hospitalization, the concentration of leptin and leptin receptor was measured, and the free leptin index (FLI) was assessed. LR was recorded at leptin >6,45 ng/ ml and FLI >25. Statistical data processing was carried out using the software package Statistica 10.0 and SPSS 17.0 for Windows. Results . Initially, LR in MI, chronic CAD and non-coronary disease was revealed in 64%, 56,2% and 25%, respectively. Significant differences in the incidence of LR were observed between patients with MI and chronic CAD relative to patients with AHD (p=0,02 and p=0,03, respectively), while no differences were found between patients with coronary pathology (p=0,82). Equation of patients for body mass index (BMI) did not affect the incidence of LR. High incidence of LR remained for patients with acute and chronic CAD, and amounted to 63% and 57,3%, respectively, while for patients with AS — 25%. Conclusion . Patients with acute and chronic CAD are characterized by a high LR incidence, in contrast to patients with AHD. The number of LR cases in patients with coronary pathology did not depend on BMI values, which indicates possible alternative leptin sources contributing the development of hyperleptinemia. In addition, studying the mechanisms underlying the leptin receptor decrease in CAD is necessary for adequate leptin effects and the prevention of LR.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238714","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 : 2023-09-21DOI: 10.15829/1560-4071-2023-5413
E. A. Smirnova, E. V. Sedykh, S. S. Yakushin, S. V. Subbotin
Aim. To study the prevalence of iron deficiency (ID) and anemia, as well as their impact on the clinical performance and quality of life in patients with acute decompensated heart failure (ADHF). Material and methods . The work was performed as part of cross-sectional multicenter screening study of ID in patients with heart failure (HF), managed by the Russian Society of Heart Failure. We examined 80 patients hospitalized in the cardiology department due to ADHF, who signed an informed consent. The diagnosis of ADHF was based on clinical signs of decompensated heart failure requiring intravenous therapy with diuretics, vasodilators, or inotropic agents. Results. The prevalence of ID was 80,0%, anemia — 35,0%, combination of anemia and ID — 31,2%. The mean age of patients with ID was 69,4±10,9 years. Patients with ID had higher HF class (40,6% vs 6,3% without ID, p<0,001), a higher incidence of hydrothorax (65,6% vs 31,3%, p=0,012), higher N-terminal pro-brain natriuretic peptide (5155,5 [3267,3;9786,3] pg/mL vs 2055,5 [708,8;2839,0] pg/mL, p<0,001), lower 6-minute walk test distance (155,9±84,0 m vs 239,6±82,7 m in patients without ID, p=0,01), lower quality of life according to the visual analogue scale (36,4±16,3 vs 46,3±20,7, p=0,036). ID was more often recorded in patients with frailty (95,7% vs 73,7% in patients without frailty, p=0,003), requiring a higher starting dose of intravenous diuretics (50,9±18,9 mg vs 38,6±12,3 mg without ID, p=0,021). Conclusion. In patients hospitalized due to ADHF, the prevalence of ID is 80,0%, anemia — 35,0%, combination of ID and anemia — 31,2%. Patients with ID have a higher N-terminal pro-brain natriuretic peptide level, more severe signs of decompensation, which requires higher starting dose of loop diuretics. Patients with ID are more likely to have frailty, lower exercise tolerance and quality of life.
的目标。探讨急性失代偿性心力衰竭(ADHF)患者缺铁(ID)和贫血的患病率及其对临床表现和生活质量的影响。材料和方法。这项工作是作为心衰(HF)患者ID横断面多中心筛查研究的一部分进行的,由俄罗斯心力衰竭学会管理。我们对80例因ADHF住院的心内科患者进行了调查,这些患者均签署了知情同意书。ADHF的诊断是基于失代偿性心力衰竭的临床症状,需要利尿剂、血管扩张剂或肌力药物的静脉治疗。结果。ID患病率为80.0%,贫血- 35.0%,贫血合并ID - 31.2%。ID患者的平均年龄为69,4±10.9岁。ID患者有较高的HF分级(40.6% vs 6.3%,无ID者,p= 0.036),较高的胸水发生率(65,6% vs 31.3%, p= 0.012),较高的n端脑钠肽前体(5155,5 [3267,3;9786,3]pg/mL vs 2055,5 [708,8;2839,0] pg/mL, p= 0.012),较短的6分钟步行测试距离(155,9±84,0 m vs 239,6±82,7 m, p= 0.01),较低的生活质量根据视觉模拟量表(36,4±16,3 vs 46,3±20,7,p= 0.036)。ID在虚弱患者中更常见(95.7% vs 73.7%,无虚弱患者,p= 0.003),需要更高的静脉利尿剂起始剂量(50.9±18.9 mg vs 38.6±12.3 mg,无ID, p= 0.021)。结论。在ADHF住院患者中,ID患病率为80.0%,贫血患病率为35.0%,ID合并贫血患病率为31.2%。ID患者n端前脑利钠肽水平较高,代偿症状更严重,需要较高的起始剂量的环状利尿剂。ID患者更容易体弱多病,运动耐受性较低,生活质量较差。
{"title":"Prevalence and clinical significance of iron deficiency in patients with acute decompensated heart failure","authors":"E. A. Smirnova, E. V. Sedykh, S. S. Yakushin, S. V. Subbotin","doi":"10.15829/1560-4071-2023-5413","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5413","url":null,"abstract":"Aim. To study the prevalence of iron deficiency (ID) and anemia, as well as their impact on the clinical performance and quality of life in patients with acute decompensated heart failure (ADHF). Material and methods . The work was performed as part of cross-sectional multicenter screening study of ID in patients with heart failure (HF), managed by the Russian Society of Heart Failure. We examined 80 patients hospitalized in the cardiology department due to ADHF, who signed an informed consent. The diagnosis of ADHF was based on clinical signs of decompensated heart failure requiring intravenous therapy with diuretics, vasodilators, or inotropic agents. Results. The prevalence of ID was 80,0%, anemia — 35,0%, combination of anemia and ID — 31,2%. The mean age of patients with ID was 69,4±10,9 years. Patients with ID had higher HF class (40,6% vs 6,3% without ID, p<0,001), a higher incidence of hydrothorax (65,6% vs 31,3%, p=0,012), higher N-terminal pro-brain natriuretic peptide (5155,5 [3267,3;9786,3] pg/mL vs 2055,5 [708,8;2839,0] pg/mL, p<0,001), lower 6-minute walk test distance (155,9±84,0 m vs 239,6±82,7 m in patients without ID, p=0,01), lower quality of life according to the visual analogue scale (36,4±16,3 vs 46,3±20,7, p=0,036). ID was more often recorded in patients with frailty (95,7% vs 73,7% in patients without frailty, p=0,003), requiring a higher starting dose of intravenous diuretics (50,9±18,9 mg vs 38,6±12,3 mg without ID, p=0,021). Conclusion. In patients hospitalized due to ADHF, the prevalence of ID is 80,0%, anemia — 35,0%, combination of ID and anemia — 31,2%. Patients with ID have a higher N-terminal pro-brain natriuretic peptide level, more severe signs of decompensation, which requires higher starting dose of loop diuretics. Patients with ID are more likely to have frailty, lower exercise tolerance and quality of life.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238878","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 : 2023-09-21DOI: 10.15829/1560-4071-2023-5406
S. M. Komissarova, N. M. Rineyskaya, O. P. Melnikova, T. V. Sevruk, A. A. Efimova
Aim. To evaluate the prognostic role of atrial fibrillation (AF) as a predictor of adverse events and outcomes in a cohort of patients with non-compaction cardiomyopathy (NCCM). Material and methods . We examined 216 patients with NCCM (140 men and 76 women, median age, 39 (30; 50) years). In addition to traditional clinical methods, all patients underwent late gadolinium-enhanced cardiac magnetic resonance imaging (MRI). The endpoints of the study included progression of NYHA class III heart failure (HF) with the need for hospitalization, ventricular tachyarrhythmias, and thromboembolic events (TEEs). Results. There were 54 out of 216 (23,6%) patients with AF, of which 18 had paroxysmal AF, 16 — persistent AF, and 20 — permanent AF. During the follow-up period (median follow-up, 36 (6; 72) months), 98 out of 216 (45,4%) patients with NCCM had adverse events and outcomes as follows: 16 (7,4%) had ventricular tachyarrhythmias, of which 12 (5,6%) — sudden cardiac death with successful resuscitation and implantation of an implantable cardioverter-defibrillator; 62 (28,7%) patients had NYHA III-IV class HF progression; 20 (9,3%) patients had TEEs. The rate of adverse cardiac events was significantly higher in patients with AF (74,1% vs 35,8%, χ 2 =23,93, p<0,001) compared with patients without AF, including the incidence of TEEs (20,4% vs 5,6%, χ 2 =10,58, p=0,002) and HF progression to class III (46,3% vs 22,8%, χ 2 =10,9, p=0,002). Multivariate analysis showed that the following most significant predictors of HF progression risk: left ventricular ejection fraction (LVEF) <50% according to cardiac MRI (hazard ratio (HR), 95,8; 95% confidence interval (CI), 10,2 -898,6; p=0,0001), presence of AF (HR, 8,2; 95% CI, 2,2-31,3; p=0,0022) and left atrial volume index (LAVI) >43 ml/m 2 (HR, 5,2; 95% CI, 2,1-12,8; p=0,0004); predictors of TEE risk were the presence of AF (HR, 6,5; 95% CI, 2,0-20,8; p=0,0020) and LAVI >43 ml/m 2 (HR, 6,0; 95% CI, 1,8-19,7; p=0,036). No association of AF with ventricular tachyarrhythmias was found in the study cohort of patients with NCCM. Predictors of ventricular tachyarrhythmias were LVEF <50% (HR, 4,5; 95% CI, 2,950,4; p=0,0241) and the presence of non-sustained ventricular tachycardia (HR, 3,5; 95% CI, 1,3-9,3 p=0,0139). Conclusion. The present study shows that, along with the traditional predictor of adverse events in patients with NCCM (LVEF <50%), the identified additional predictors (AF and LAVI >43 ml/m 2 ) can be used to identify patients at high risk of complicated NCCM for the timely prevention and treatment.
{"title":"Prognostic role of atrial fibrillation in patients with non-compaction cardiomyopathy","authors":"S. M. Komissarova, N. M. Rineyskaya, O. P. Melnikova, T. V. Sevruk, A. A. Efimova","doi":"10.15829/1560-4071-2023-5406","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5406","url":null,"abstract":"Aim. To evaluate the prognostic role of atrial fibrillation (AF) as a predictor of adverse events and outcomes in a cohort of patients with non-compaction cardiomyopathy (NCCM). Material and methods . We examined 216 patients with NCCM (140 men and 76 women, median age, 39 (30; 50) years). In addition to traditional clinical methods, all patients underwent late gadolinium-enhanced cardiac magnetic resonance imaging (MRI). The endpoints of the study included progression of NYHA class III heart failure (HF) with the need for hospitalization, ventricular tachyarrhythmias, and thromboembolic events (TEEs). Results. There were 54 out of 216 (23,6%) patients with AF, of which 18 had paroxysmal AF, 16 — persistent AF, and 20 — permanent AF. During the follow-up period (median follow-up, 36 (6; 72) months), 98 out of 216 (45,4%) patients with NCCM had adverse events and outcomes as follows: 16 (7,4%) had ventricular tachyarrhythmias, of which 12 (5,6%) — sudden cardiac death with successful resuscitation and implantation of an implantable cardioverter-defibrillator; 62 (28,7%) patients had NYHA III-IV class HF progression; 20 (9,3%) patients had TEEs. The rate of adverse cardiac events was significantly higher in patients with AF (74,1% vs 35,8%, χ 2 =23,93, p<0,001) compared with patients without AF, including the incidence of TEEs (20,4% vs 5,6%, χ 2 =10,58, p=0,002) and HF progression to class III (46,3% vs 22,8%, χ 2 =10,9, p=0,002). Multivariate analysis showed that the following most significant predictors of HF progression risk: left ventricular ejection fraction (LVEF) <50% according to cardiac MRI (hazard ratio (HR), 95,8; 95% confidence interval (CI), 10,2 -898,6; p=0,0001), presence of AF (HR, 8,2; 95% CI, 2,2-31,3; p=0,0022) and left atrial volume index (LAVI) >43 ml/m 2 (HR, 5,2; 95% CI, 2,1-12,8; p=0,0004); predictors of TEE risk were the presence of AF (HR, 6,5; 95% CI, 2,0-20,8; p=0,0020) and LAVI >43 ml/m 2 (HR, 6,0; 95% CI, 1,8-19,7; p=0,036). No association of AF with ventricular tachyarrhythmias was found in the study cohort of patients with NCCM. Predictors of ventricular tachyarrhythmias were LVEF <50% (HR, 4,5; 95% CI, 2,950,4; p=0,0241) and the presence of non-sustained ventricular tachycardia (HR, 3,5; 95% CI, 1,3-9,3 p=0,0139). Conclusion. The present study shows that, along with the traditional predictor of adverse events in patients with NCCM (LVEF <50%), the identified additional predictors (AF and LAVI >43 ml/m 2 ) can be used to identify patients at high risk of complicated NCCM for the timely prevention and treatment.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238703","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 : 2023-09-18DOI: 10.15829/1560-4071-2023-5518
E. A. Zakharyan, I. Fomochkina
Aim. To assess markers of serum apoptosis markers depending on the severity of coronary atherosclerosis, as well as to study their relationship with clinical and paraclinical characteristics of patients with coronary artery disease (CAD).Material and methods. The study included 176 people (105 men and 71 women), of which 150 were patients with an established diagnosis of CAD, 26 — healthy volunteers (control group). The patients were divided into the following groups: group 1 — with coronary atherosclerosis without stenosis (n=17); group 2 — with hemodynamically insignificant (stenosis <50%) coronary atherosclerosis (n=21); group 3 — with hemodynamically significant (stenosis >50%) coronary atherosclerosis (n=112). Group 4 was represented by healthy volunteers (n=26). Patients underwent coronary angiography using the SYNTAX score, echocardiography, extracranial artery duplex ultrasound. All subjects were studied for the serum level of apoptosis markers Bcl-2, Bax, Bcl-2/Bax, TRAIL and p53. Statistical processing was carried out using the Statistica 10.0 software. Differences were considered significant at p<0,05.Results. There was a very high correlation between the Bcl-2 (r=-0,84; p<0,001), Bax (r=0,83; p<0,001), Bcl-2/Bax (r=-0,86; p<0,001), p53 (r=0,80; p<0,001), TRAIL (r=-0,78; p<0,001) and the severity of coronary atherosclerosis. A correlation of varying strength and significance was revealed between the values of these apoptosis markers and a number of clinical and paraclinical characteristics of patients. In addition, there were significant differences (p<0,001) in Bcl-2, Bax, Bcl2/Bax, p53 and TRAIL between groups of patients with multifocal atherosclerosis, restenosis after previous revascularization and a history of myocardial infarction in comparison with patients without these signs.Conclusion. The correlations we have identified between laboratory signs of apoptosis and coronary lesions, clinical and paraclinical characteristics of patients, as well as the detected reliability of differences between groups with multifocal atherosclerosis, coronary artery restenosis and myocardial infarction in history, make it possible to consider these biomarkers as indicators of atherosclerosis severity. This can also be the basis for the development of novel treatment and diagnostic strategies.
{"title":"Relationship between apoptosis markers and the severity of coronary atherosclerosis and clinical and paraclinical characteristics of patients with coronary artery disease","authors":"E. A. Zakharyan, I. Fomochkina","doi":"10.15829/1560-4071-2023-5518","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5518","url":null,"abstract":"Aim. To assess markers of serum apoptosis markers depending on the severity of coronary atherosclerosis, as well as to study their relationship with clinical and paraclinical characteristics of patients with coronary artery disease (CAD).Material and methods. The study included 176 people (105 men and 71 women), of which 150 were patients with an established diagnosis of CAD, 26 — healthy volunteers (control group). The patients were divided into the following groups: group 1 — with coronary atherosclerosis without stenosis (n=17); group 2 — with hemodynamically insignificant (stenosis <50%) coronary atherosclerosis (n=21); group 3 — with hemodynamically significant (stenosis >50%) coronary atherosclerosis (n=112). Group 4 was represented by healthy volunteers (n=26). Patients underwent coronary angiography using the SYNTAX score, echocardiography, extracranial artery duplex ultrasound. All subjects were studied for the serum level of apoptosis markers Bcl-2, Bax, Bcl-2/Bax, TRAIL and p53. Statistical processing was carried out using the Statistica 10.0 software. Differences were considered significant at p<0,05.Results. There was a very high correlation between the Bcl-2 (r=-0,84; p<0,001), Bax (r=0,83; p<0,001), Bcl-2/Bax (r=-0,86; p<0,001), p53 (r=0,80; p<0,001), TRAIL (r=-0,78; p<0,001) and the severity of coronary atherosclerosis. A correlation of varying strength and significance was revealed between the values of these apoptosis markers and a number of clinical and paraclinical characteristics of patients. In addition, there were significant differences (p<0,001) in Bcl-2, Bax, Bcl2/Bax, p53 and TRAIL between groups of patients with multifocal atherosclerosis, restenosis after previous revascularization and a history of myocardial infarction in comparison with patients without these signs.Conclusion. The correlations we have identified between laboratory signs of apoptosis and coronary lesions, clinical and paraclinical characteristics of patients, as well as the detected reliability of differences between groups with multifocal atherosclerosis, coronary artery restenosis and myocardial infarction in history, make it possible to consider these biomarkers as indicators of atherosclerosis severity. This can also be the basis for the development of novel treatment and diagnostic strategies.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139339050","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 : 2023-09-12DOI: 10.15829/15604071-2023-5467
A. A. Garanin, V. A. Dyachkov, A. O. Rubanenko, O. A. Reprintseva, D. V. Duplyakov
The aim of this review was to evaluate the current literature on various methods of pulse oximetry, their advantages and disadvantages. Modern pulse oximetry methods generally correlate well with invasive saturation monitoring, which makes it possible to be widely used in clinical practice. At the same time, in order to improve the accuracy of saturation measurements, existing limitations of various pulse oximetry methods should be taken into account. The emergence and introduction into clinical practice of reflectance pulse oximetry can largely compensate for the limitations of traditional transmission pulse oximetry regarding peripheral hypoperfusion, low response time, and features of patient's nails. In the event of special situations when pulse oximetry may not be accurate enough (carbon monoxide poisoning, methemoglobinemia, severe anemia, severe tricuspid insufficiency, etc.), a thorough clinical assessment of the patient is recommen ded, as well as invasive saturation monitoring.
{"title":"Pulse oximetry methods: opportunities and limitations","authors":"A. A. Garanin, V. A. Dyachkov, A. O. Rubanenko, O. A. Reprintseva, D. V. Duplyakov","doi":"10.15829/15604071-2023-5467","DOIUrl":"https://doi.org/10.15829/15604071-2023-5467","url":null,"abstract":"The aim of this review was to evaluate the current literature on various methods of pulse oximetry, their advantages and disadvantages. Modern pulse oximetry methods generally correlate well with invasive saturation monitoring, which makes it possible to be widely used in clinical practice. At the same time, in order to improve the accuracy of saturation measurements, existing limitations of various pulse oximetry methods should be taken into account. The emergence and introduction into clinical practice of reflectance pulse oximetry can largely compensate for the limitations of traditional transmission pulse oximetry regarding peripheral hypoperfusion, low response time, and features of patient's nails. In the event of special situations when pulse oximetry may not be accurate enough (carbon monoxide poisoning, methemoglobinemia, severe anemia, severe tricuspid insufficiency, etc.), a thorough clinical assessment of the patient is recommen ded, as well as invasive saturation monitoring.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885106","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 : 2023-09-12DOI: 10.15829/1560-4071-2023-5345
D. A. Tsygankov, K. E. Krivoshapova, D. P. Tsygankova
With an increase in the average life expectancy of the population, the prevalence of sarcopenic obesity (SO) is correspondingly growing. Existing definitions of SO are based on description of sarcopenia and obesity, but there is currently no consensus defining thresholds for either of these conditions, making an accurate diagnosis difficult. At the same time, its treatment is important to prevent disability in the elderly. In this regard, the purpose of this review was to analyze the ultrasound potential for SO diagnosis. Since ultrasound is cheaper, more portable, and more accessible than other methods, it has the potential to be widely used as a clinical screening tool for identifying people with SO. Also, this method can be used to diagnose obesity, thereby leveling the errors in body mass index.
{"title":"Ultrasound potential in sarcopenic obesity diagnosis: a literature review","authors":"D. A. Tsygankov, K. E. Krivoshapova, D. P. Tsygankova","doi":"10.15829/1560-4071-2023-5345","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5345","url":null,"abstract":"With an increase in the average life expectancy of the population, the prevalence of sarcopenic obesity (SO) is correspondingly growing. Existing definitions of SO are based on description of sarcopenia and obesity, but there is currently no consensus defining thresholds for either of these conditions, making an accurate diagnosis difficult. At the same time, its treatment is important to prevent disability in the elderly. In this regard, the purpose of this review was to analyze the ultrasound potential for SO diagnosis. Since ultrasound is cheaper, more portable, and more accessible than other methods, it has the potential to be widely used as a clinical screening tool for identifying people with SO. Also, this method can be used to diagnose obesity, thereby leveling the errors in body mass index.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"363 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885579","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 : 2023-09-12DOI: 10.15829/1560-4071-2023-5348
E. K. Serezhina, A. G. Obrezan
The current classification of heart failure (HF) is based on the myocardium systolic function. However, due to the polyetiological nature of the HF with preserved ejection fraction (HFpEF) and its increasing prevalence and clinical significance, a more advanced approach to the clinical assessment of patients is needed to determine the management tactics focused on the patient's phenotype. At the same time, a single algorithm for phenotyping patients with HF has not been formulated yet. There is also no terminological unity in approaches. A review of 47 original articles published in the period from 2015 to 2022 in English on Elsevier, Pubmed, Web of Science databases with a following keywords "HFpEF", "phenotype", "clusters", "phenotypic spectrum", "diastolic dysfunction" makes it possible to identify several different approaches to phenotyping HFpEF, which are based on the etiology, pathophysiological mechanisms or clinical manifestations. Differences in the algorithms used for classification lead to the formation of groups of patients with different characteristics. Today it becomes obvious that in order to develop an optimal phenotyping approach and patient-oriented management of HFpEF, a combined analysis of a large number of anamnestic, clinical and paraclinical data is necessary. To solve such a problem, unified clustering system for HFpEF types should be created, which will be basis for phenotyping patients proposed by the authors.
目前心衰(HF)的分类是基于心肌收缩功能。然而,由于具有保留射血分数(HFpEF)的心衰的多学性质及其日益增加的患病率和临床意义,需要一种更先进的患者临床评估方法来确定以患者表型为重点的管理策略。与此同时,一种用于HF患者表型的单一算法尚未制定。在方法上也没有术语上的统一。通过对2015 - 2022年在Elsevier、Pubmed、Web of Science数据库中发表的47篇英文原创文章的回顾,检索关键词为“HFpEF”、“表型”、“聚类”、“表型谱”、“舒张功能障碍”,可以确定几种不同的HFpEF表型分析方法,这些方法基于病因、病理生理机制或临床表现。用于分类的算法的差异导致形成具有不同特征的患者群体。今天,很明显,为了开发一种最佳的表现型方法和以患者为导向的HFpEF管理,有必要对大量的记忆、临床和临床旁数据进行综合分析。为了解决这一问题,需要建立统一的HFpEF分型聚类系统,这将是作者提出的患者表型分型的基础。
{"title":"Features of phenotyping patients with heart failure with preserved ejection fraction","authors":"E. K. Serezhina, A. G. Obrezan","doi":"10.15829/1560-4071-2023-5348","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5348","url":null,"abstract":"The current classification of heart failure (HF) is based on the myocardium systolic function. However, due to the polyetiological nature of the HF with preserved ejection fraction (HFpEF) and its increasing prevalence and clinical significance, a more advanced approach to the clinical assessment of patients is needed to determine the management tactics focused on the patient's phenotype. At the same time, a single algorithm for phenotyping patients with HF has not been formulated yet. There is also no terminological unity in approaches. A review of 47 original articles published in the period from 2015 to 2022 in English on Elsevier, Pubmed, Web of Science databases with a following keywords \"HFpEF\", \"phenotype\", \"clusters\", \"phenotypic spectrum\", \"diastolic dysfunction\" makes it possible to identify several different approaches to phenotyping HFpEF, which are based on the etiology, pathophysiological mechanisms or clinical manifestations. Differences in the algorithms used for classification lead to the formation of groups of patients with different characteristics. Today it becomes obvious that in order to develop an optimal phenotyping approach and patient-oriented management of HFpEF, a combined analysis of a large number of anamnestic, clinical and paraclinical data is necessary. To solve such a problem, unified clustering system for HFpEF types should be created, which will be basis for phenotyping patients proposed by the authors.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135885878","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 : 2023-09-12DOI: 10.15829/1560-4071-2023-5448
N. E. Shirokov, E. I. Yaroslavskaya, D. V. Krinochkin, N. A. Musikhina, T. P. Gizatulina, T. N. Enina, T. I. Petelina, A. M. Soldatova, E. P. Samoilova, N. O. Pogorelov, L. I. Gapon
Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.
{"title":"Principles for diagnosing heart failure with preserved ejection fraction","authors":"N. E. Shirokov, E. I. Yaroslavskaya, D. V. Krinochkin, N. A. Musikhina, T. P. Gizatulina, T. N. Enina, T. I. Petelina, A. M. Soldatova, E. P. Samoilova, N. O. Pogorelov, L. I. Gapon","doi":"10.15829/1560-4071-2023-5448","DOIUrl":"https://doi.org/10.15829/1560-4071-2023-5448","url":null,"abstract":"Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135884197","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}