Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi最新文献

{"title":"Analysis of the Use of Non-Invasive Lung Ventilation Support in Newborns and Young Children after Cardiac Surgery","authors":"Olena O. Yakimishen, Olena I. Tsymbal, Serhii M. Boiko, Iaroslav P. Truba","doi":"10.30702/ujcvs/23.31(03)/yt046-5863","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/yt046-5863","url":null,"abstract":"Background. Non-invasive ventilatory support for artificial lung ventilation (ALV) in infants with congenital heart disease after cardiac surgery helps to reduce the duration of invasive ALV, reduce the number of mechanical and infectious complications, and reduce or eliminate the need for sedation.&#x0D; The aim. To analyze the experience of using non-invasive ventilatory support after surgical correction of congenital heart disease in infants and compare its effectiveness with invasive mechanical ventilation.&#x0D; Materials and methods. We conducted a retrospective analysis of the use of non-invasive ALV and its effectiveness compared to invasive mechanical ventilation in children under 1 year of age after cardiac surgery from 2020 to 2022 at the Department of Cardiac Arrest in Newborns and Young Children of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. During this period, 134 patients were operated on (38 children under 1 month old, 96 children under 1 year old). In the postoperative period, 85 children (55.9%) needed prolonged mechanical ventilation (more than 24 hours), of which non-invasive ventilation support was used in 32 patients (37.6%) and invasive ventilation in 53 (62.3%) patients.&#x0D; Results. The patients on non-invasive ALV (n = 32) had lower weight (p = 0.23), shorter ventilation time (p = 0.56), and the time spent at the intensive care unit (p = 0.61), required less sedation (p = 0.29), and had lower mortality (p = 0.42) compared to the group of children who received only invasive ventilatory support (n = 53), but this difference was not statistically significant. The need for non-invasive ventilation was higher in 9 (28.12%) infants than in 8 (15.09%) other infants and was statistically significant (p < 0.001).&#x0D; Conclusions. Our study showed that the use of non-invasive ALV can shorten the length of stay at the intensive care unit and the time spent on ventilation, reduce or avoid the use of sedation, and prevent pulmonary complications (infectious and mechanical) with long-term treatment. However, there was no significant difference between non-invasive and invasive ventilation in terms of mortality.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426026","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}

{"title":"Alternative Method of Surgical Treatment of Post-Infarction Left Ventricular Free Wall Rupture. Case Report","authors":"Volodymyr S. Ivashchenko, Kostiantyn P. Chyzh, Serhii A. Sokur","doi":"10.30702/ujcvs/23.31(03)/ic016-134138","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/ic016-134138","url":null,"abstract":"Acute myocardial infarction (AMI) is one of the causes of death in developed countries, despite the latest medical technologies. AMI is usually accompanied by numerous fatal complications. One of these complications is left ventricular free wall rupture (LVFWR). Myocardial rupture after AMI can occur from 1 day to 3 weeks after the infarction. Most ruptures occur 3-5 days after a heart attack. Left ventricular free wall rupture requires only emergency surgical intervention, which in most cases consists in applying U-shaped sutures or wrapping sutures using Teflon patch.&#x0D; The aim. To demonstrate an example of alternative surgical tactics and intraoperative management of a patient with myocardial infarction complicated by rupture of the free wall of the heart with the transition to cardiogenic shock.&#x0D; Case report. We presented the clinical case of patient V., 72 years old, who was delivered by ambulance on January 10, 2023 to the intensive care department of the National Amosov Institute of Cardiovascular Surgery (Kyiv, Ukraine). Main diagnosis: ischemic heart disease, acute coronary syndrome with ST-elevation myocardial infarction, cardiogenic shock.&#x0D; Conclusion. The only effective method of treatment of rupture of the free wall of the heart is surgical intervention. Using a sandwich patch with resection of necrotic areas of the myocardium and U-shaped sutures with Teflon patch passed from the side of the left ventricular cavity through the myocardium in the peri-infarct zone and through a patch from a vascular prosthesis allows hermetically sew up the LVFWR.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426476","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}

{"title":"Capabilities of the Treadmill Test in Modern Cardiological Practice","authors":"Olena K. Gogayeva, Liudmyla S. Dzakhoieva","doi":"10.30702/ujcvs/23.31(03)/gd040-3135","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/gd040-3135","url":null,"abstract":"Many publications in recent years have been dedicated to the search for the best preliminary method of diagnosing coronary artery disease (CAD), where the availability of technology and staff experience are the determining factors. According to the National Cardiovascular Data Registry of the American College of Cardiology, 58.4% of patients referred for coronary angiography after functional testing do not have significant coronary artery stenoses. European guidelines for the diagnosis and management of patients with chronic coronary syndrome recommend the use of imaging diagnostic tests instead of exercise electrocardiography for the diagnosis of obstructive CAD.&#x0D; The aim. To analyze the capabilities of the exercise electrocardiography test for patients in modern cardiological practice.&#x0D; Materials and methods. A treadmill test was performed on 406 patients, among whom 317 (78.07%) were men, 89 (21.9%) were women, the mean age was 44.7±17.3 years. The test was carried out according to the Bruce protocol on the Valiant Ergometric Treadmill.&#x0D; Results. The patients were divided into groups depending on the area of diagnostic search: verification of CAD in cardiac pain (n=184); evaluation of the long-term results of cardiac surgery (n=74); visualization of myocardial ischemia in borderline stenoses of coronary arteries (n=4); screening in the presence of additional CAD risk factors (n=49); in the case of heart rhythm disorders in order to decide on further treatment tactics and evaluation of the effectiveness of the antiarrhythmic treatment (n=34); evaluation of the coronary artery in patients with congenital heart defects (n=7); determination of tolerance to physical exertion (n=54). Among the examined patients, there were 48 (11.8%) with positive, 246 (60.5%) with negative, and 112 (27.5%) with doubtful treadmill test. Among 48 patients with a positive treadmill test, myocardial revascularization was performed in 41 (85.4%) cases.&#x0D; Conclusions. Exercise electrocardiography is an affordable tool for diagnostic research which, with its high-quality performance and interpretation, can be an alternative to modern imaging techniques.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426650","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}

{"title":"The Impact of Chronic Heart Failure Treatment on Glycemic Variability in Patients without Diabetes Mellitus","authors":"Georgiy B. Mankovsky, Yevhen Yu. Marushko, Yanina A. Saienko, Ivanna V. Zubovych, Yana Yu. Dzhun, Olha O. Monashnenko, Nadiya M. Rudenko, Borys M. Mankovsky","doi":"10.30702/ujcvs/23.31(03)/mm030-7177","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/mm030-7177","url":null,"abstract":"Background. According to statistics, about 26 million people worldwide suffer from heart failure (HF). Currently, sodium-glucose cotransporter 2 inhibitors are widely prescribed for treatment of HF with reduced left ventricular ejec-tion fraction (LVEF) throughout the world. Therefore, prescribing drugs that have anti-hypoglycemic effect in patients without diabetes mellitus still raises some concerns, considering the possible risk of developing hypoglycemia.&#x0D; The aim. To assess the effect of dapagliflozin on glycemic variability in treatment of HF with reduced LVEF in patients without diabetes mellitus.&#x0D; Materials and methods. The study was conducted at the premises of the Department of Cardiometabolic Diseases of the Ukrainian Children’s Cardiac Center. Twenty-three patients with HF with reduced LVEF of various etiologies without diabetes mellitus were evaluated. The variability of glycemia in the study group was assessed using continuous glucose monitoring. For this, the MiniMed iPro2 continuous glucose monitoring system (Medtronic, USA) was used.&#x0D; The sensor was inserted on day 1 and removed on day 7. Average value of glycemia during the day, time in range (TIR) and time below range (TBR) were calculated on the basis of data about the level of glucose in the intercellular fluid obtained for 6 days of monitoring. Dapagliflozin 10 mg once a day was prescribed to all the patients included in the study for the treatment of HF with reduced LVEF. The average follow-up period was 7 months.&#x0D; Results. The examined patients were divided according to clinical and laboratory characteristics. Assessment of daily variability of glycemia during 6 days of observation using continuous glucose monitoring in patients on dapagliflozin revealed average blood glucose level from 4.4 mmol/L (minimum value) to 6.0 mmol/L (maximum value). These results indicate minimal risk of hypoglycemia and safety of using dapagliflozin in case of HF with reduced LVEF without concomi-tant type 2 diabetes mellitus. TIR and TBR indicators were also evaluated in patients with and without prediabetes. The obtained data allows to assert the same safety of taking dapagliflozin in both these groups, due to the fact that time of glycemia <3.9 mmol/l does not exceed the indicator of 5%.&#x0D; Conclusion. The use of dapagliflozin as part of complex therapy of HF with reduced LVEF does not elevate the risk of developing hypoglycemia in patients without diabetes mellitus.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426653","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}

{"title":"A Case of Duodenal Bleeding in a One-Year-Old Child in the Early Postoperative Period after the Surgical Correction of Congenital Heart Defect","authors":"Olena I. Tsymbal, Serhii M. Boyko","doi":"10.30702/ujcvs/23.31(03)/tb029-139142","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/tb029-139142","url":null,"abstract":"Background. Gastrointestinal bleeding in children is a rather rare pathology. This especially applies to the bleeding in the postoperative period after surgical interventions that are not related to the pathology of the gastrointestinal tract. As a result, clinicians are not alert to the occurrence of such complications, which, in turn, can lead to late diagnosis and delay in the treatment of bleeding.&#x0D; Case report. We present a clinical case of duodenal bleeding in a one-year-old child in the early postoperative period after radical repair of ventricular septal defect by patching the defect. Laboratory parameters on admission: hemoglobin 120 g/L, red blood cells 4.37×1012/L. On the first postoperative day, hemoglobin was 103 g/L, hematocrit was 33%. On the 5th day after the operation, the boy had a currant jelly stool. Hemostatic therapy was provided: transfusion of fresh frozen plasma at a dose of 10 mL/kg, single administration of tranexamic acid at a dose of 10 mg/kg. The bleeding was stopped. After hemostatic therapy, hemoglobin was 105 g/L, hematocrit was 31%. Within 24 hours, fibrogastroduode-noscopy was performed which revealed an ulcer of the duodenal bulb covered with fibrin. The boy was consulted by gastroenterologist. Pathogenetic therapy was prescribed: proton pump inhibitors, antacids, enveloping drugs. The child was discharged home in a satisfactory condition on the 15th day after the operation under the supervision of a district pediatrician, cardiologist, and gastroenterologist. Laboratory parameters at discharge: hemoglobin 91 g/L, red blood cells 3.3×1012/L.&#x0D; Conclusion. The problem of gastrointestinal complications, including gastrointestinal bleeding in young children af-ter cardiac surgery, is extremely insufficiently covered in the scientific literature. Many questions remain unsolved re-garding the prevention, early diagnosis and treatment of bleeding, so research in this field remains relevant for both clinicians and scientists.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427000","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}

{"title":"Diagnosis and Surgical Treatment of a Gunshot Fragment Wound of the Heart with a Threat of Coronary Artery Perforation","authors":"Kostiantyn V. Humeniuk, Oleksandr V. Kupchynskyi, Vasyl V. Fylypchuk, Maryna M. Serdiuk, Volodymyr O. Kupchynskyi, Artem M. Petlytskyi, Rostyslav M. Vitovskyi, Vasyl V. Lazoryshynets","doi":"10.30702/ujcvs/23.31(03)/gk035-9398","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/gk035-9398","url":null,"abstract":"Each case of fragment heart damage is unique and requires careful preparation for surgical intervention. Complexity of such operations is explained by the probability of unwanted complications associated with technical measures and aimed at extracting fragments of the most diverse localization.&#x0D; The aim. To demonstrate the possibilities of effective diagnosis and optimal surgical treatment of a gunshot fragment wound of the heart with the threat of coronary artery perforation.&#x0D; Material and methods. The article presents a case of diagnosis and surgical treatment of a fragment heart damage with intramyocardial damage of the left ventricular wall with localization under the circumflex branch of the left coronary artery with the threat of its perforation. One day has passed since a mine blast injury. Diagnosis was based on the use of contrast enhanced computed tomography (CT) and coronary angiography.&#x0D; Results. During the diagnostic process, the need to use a CT scan with mandatory contrast media arose, which made it possible to confirm the presence of a fragment in the immediate vicinity of the coronary artery. Coronarography provided additional information which revealed contact of the fragment with the coronary artery with the threat of its perforation. Immediate surgery with artificial blood circulation with stepwise application of magnets of increasing power allowed safe removal of the fragment, avoiding damage to the coronary artery.&#x0D; Conclusions. The most accurate topical diagnosis of fragment localization in heart damage requires CT diagnosis with mandatory contrast media and, if possible, with 3D reconstruction, which allows for surgical intervention with a minimal risk of intraoperative complications. Location of the fragments near the coronary vessels may threaten their damaging during removal and requires careful manipulation to prevent injury to the heart vessels. Detection and removal of sharp fragments located near the coronary vessels require stepwise application of magnets of increasing power to bring the fragment to a safe zone with its subsequent extraction.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426479","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}

{"title":"Features of the Course of Atrial Fibrillation in Patients with the History of COVID-19: Impact on the Possibility and Tactics of Restoring Sinus Rhythm","authors":"Oksana V. Stasyshena, Oleg S. Sychov","doi":"10.30702/ujcvs/23.31(03)/ss044-8792","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/ss044-8792","url":null,"abstract":"Introduction. Atrial fibrillation (AF) is a potentially life-threatening complication of infection. In general, AF has a high prevalence in elderly population with cardiovascular risk factors and comorbidities. Thus, the presence of AF correlates with adverse outcomes in patients with previous coronavirus disease (COVID-19) which deserves increased attention and should be appropriately treated to prevent adverse outcomes.&#x0D; The aim. To analyze the prevalence and clinical course of AF in hospitalized patients after COVID-19 to determine approaches to restoring sinus rhythm.&#x0D; Materials and methods. The study included 179 patients with various types of heart rhythm and conduction disorders who suffered from COVID-19 and were hospitalized to the Department of Clinical Arrhythmology and Electrophysiology of the National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the NAMS of Ukraine” from 09/20/2020 to 12/21/2021. 116 patients were hospitalized with AF who suffered from coronavirus infection between 1 and 12 months ago (5.1 ± 0.2 months on average). Other heart rhythm and conduction disorders were the cause of hospitalization for 63 patients (35.2%). The first group was formed by 36 people (31%) in whom AF occurred after coronavirus infection. The second group included 25 patients in whom the form of AF changed, namely: there was a transition from paroxysmal form of AF to persistent AF, or persistent AF to a permanent form of AF. The third group included 55 patients in whom the form of AF did not change. However, in the third group, two subgroups were formed: 3A consisting of 35 patients, in whom, although the form of AF did not change, the frequency or duration of paroxysms increased, and 3B, which included 20 patients without significant changes in the course of AF. As a control group, 49 patients with AF without a history of coronavirus infection were examined.&#x0D; Results. In most patients (65%), the reason for hospitalization was AF. The first recorded paroxysms of this arrhythmia were recorded in 31% of patients 2 months after the coronavirus infection. In this group, more than half of the cases (58.4%) were patients with persistent AF, and 8.3% of those hospitalized failed to restore sinus rhythm. In those who had AF before COVID-19, 75% of its course worsened: the frequency or duration of paroxysms increased. The persistent form of AF was dominant and occurred after a previous infection in 58% of cases. In patients who had AF before COVID-19, its course worsened (in 76% of the examined persons) after the infection. Patients with a history of coronavirus infection had more frequent use of drug therapy, which is probably due to the delayed time of hospitalization to the clinic from the onset of the paroxysm.&#x0D; Conclusion. AF is the most common arrhythmia and has a worse course in hospitalized patients after coronavirus infection.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426027","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}

{"title":"Features of Catheter Treatment of Non-Isthmus-Dependent Atrial Flutter","authors":"Pavlo O. Almiz, Borys B. Kravchuk, Rostyslav H. Maliarchuk, Eugene O. Perepeka, Dmytro A. Tymoshenko, Alona V. Pokanevich","doi":"10.30702/ujcvs/23.31(03)/ak037-7882","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/ak037-7882","url":null,"abstract":"Atrial flutter (AF) is caused by the re-circulation of the wave of electrical excitation of the myocardium (reentry) around the anatomical substrate which circulates within the atrial tissues. This is always a macro re-entry. Such an anatomical barrier, around which circulation can occur, can be the superior or inferior vena cava, rings of the tricuspid or mitral valves, the mouth of the coronary sinus, pulmonary veins, postoperative scar.&#x0D; The aim. To determine the specifics of elimination, success rate, and long-term outcome with various preablation and postablation diagnostic techniques for non-isthmus-dependent atrial flutter (NIDAFL).&#x0D; Materials and methods. The study included 26 patients who underwent radiofrequency ablation of atypical NIDAFL.&#x0D; Results. As a result of radiofrequency ablation, a sinus rhythm was restored in 17 patients during the procedure. In 7 cases, when the typical, isthmus-dependent AF was removed, the tachycardia cycle and the morphology of the R wave changed. Mapping showed that in 7 cases the direction of the re-entry front changed, and instead of the circulation of excitation through the cavatricuspid isthmus, it then passed around the atriotomy scar. In 2 cases, a change in the cardiac cycle was observed after radiofrequency ablation, but the excitation circulation was the same around the atriotomy scar, only the tachycardia cycle increased. As a result of the use of our techniques, arrhythmia was eliminated in all 21 patients with an atriotomy AF during one procedure. Five patients with AF of a different localization of the re-entry circuit also had their arrhythmia eliminated, although 8 procedures (for five patients) were performed (on average 1.6). There were no complications. During the follow-up period of 1.8±0.7 years, 2 patients had a recurrence of arrhythmia, and they underwent a repeat procedure to eliminate the arrhythmia. One patient developed typical AF that had not been observed before, which was successfully eliminated.&#x0D; Conclusion. Catheter treatment of atypical NIDAFL is quite a non-trivial task, because, as our experience shows, several types of tachycardia occur in a significant number of patients. In cases of restoration of sinus rhythm as a result of the application, it is necessary to check the inducibility of another arrhythmia. But despite everything, catheter removal of NIDAFL is quite effective, especially for atriotomy AF, although it requires more X-ray exposure and a relatively large number of applications. The use of navigation systems has helped to improve the results of such interventions in more complex cases.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426028","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}

{"title":"Immunological Reactivity and Intensity of Oxidative Stress in Stable Coronary Artery Disease","authors":"Tetiana І. Gavrilenko, Oleksandr M. Lomakovskyi, Olena A. Pidgaina, Olga V. Rasputniak, Nataliia O. Ryzhkova, Natalia V. Grechkovskaya","doi":"10.30702/ujcvs/23.31(03)/gl008-2230","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/gl008-2230","url":null,"abstract":"The aim. To analyze the relationship between immune response factors and the intensity of oxidation of lipoproteins and proteins in patients with stable coronary artery disease (CAD) to clarify the pathogenesis of coronary atherosclerosis.&#x0D; Materials and methods. A total of 179 patients with stable CAD of II-IV functional class, mean age 56 (49-62) years (main group) and 30 healthy individuals, mean age 49 (45-53) years (control group) were examined. The material for immunological research was peripheral venous blood. To determine the indicators of immunity, flow laser cytometry and enzyme-linked immunosorbent assay were used. Spectrophotometric and fluorometric methods were used to determine the levels of intermediate and final oxidation products of lipids and proteins, as well as antioxidant protection enzymes in the blood serum and in atherogenic lipoproteins.&#x0D; Results. A direct relationship between the activity of lipoprotein peroxidation and protein oxidation with a cell-type immune response and immune inflammation was revealed.&#x0D; Conclusions. The high intensity of lipid peroxidation and protein oxidation in patients with stable CAD (stable angina pectoris) is combined with significant activation of the T-cell component of the immune response (in terms of the ratio of helper and cytotoxic subpopulations of T-lymphocytes, high concentrations of pro-inflammatory cytokines, the state of the CD40/CD40L system, the level of expression of the CD95 apoptosis marker on cells), which indicates interdependence of T-cell immunity and oxidative stress in the pathogenesis of atherosclerosis. The dependence of the hyperproduction of pro-inflammatory cytokines by mononuclear blood cells on free radical oxidation of proteins, peroxidation of apoB proteins and the intensity of antiperoxide protection (catalase and superoxide dismutase enzymes) in patients with stable CAD indicates a contribution to the presence of oxidative stress and the development of immune inflammation. A comprehensive study of the factors of immunological reactivity, the violation of which can lead to the development of immunopathological reactions, and the intensity of oxidation of lipoproteins and proteins in patients with stable CAD helps to clarify the pathogenetic relationship between chronic immune inflammation, endothelial dysfunction and oxidative stress, and also substantiates the expediency of general therapeutic approaches to the treatment of CAD.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426652","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}

{"title":"Analysis of Cardiovascular Risk Factors in Patients with Coronary Heart Disease Qualified for Off-Pump Coronary Bypass","authors":"Serhii S. Sas, Serhii A. Rudenko","doi":"10.30702/ujcvs/23.31(03)/sr039-1521","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(03)/sr039-1521","url":null,"abstract":"The aim. To analyze the prevalence of cardiovascular risk factors for circulatory diseases in patients with coronary heart disease (CHD) after coronary bypass surgery (off-pump coronary artery bypass grafting).&#x0D; Material and methods. The study included 991 subjects (786 men, 205 women), mean age 64.3 ± 1.4 years. All the study participants underwent off-pump coronary bypass surgery.&#x0D; Results. Based on modern ideas about risk factors for circulatory diseases and CHD, it is impossible to ignore the influence of cardiovascular factors, both modifiable and non-modifiable. The analysis of medical and social risk factors for CHD, which include age, body weight, eating habits and smoking, showed that these medical and social factors are common among patients with CHD. It was found that the prevalence of excess body weight among men with CHD was significantly higher in patients with multivessel lesions than in those with 1-vessel lesions (p=0.05, χ2=3.69). Among women with CHD, excess body weight was significantly higher in the clinical group with multivessel lesions compared to 2-vessel lesions (p=0.002, χ2=9.06). It was also found that the prevalence of excess body weight was significantly higher in clinical groups with 1-vessel lesions among men compared to women (p=0.04, χ2=3.95). It was established that the frequency of obesity was significantly more common in women of different clinical groups compared to men: with 1-vascular lesions (p=0.04, χ2=3.95); with 2-vessel lesions (p=0.0001, χ2=24); with multivessel lesions (p=0.0001, χ2=186.57). It was established that men smoke significantly more often than women (p=0.0001, χ2=31.22). The obtained results complement the scientific data of the world epidemiological studies regarding the determination of the role of medical and social factors in the development of CHD. The article analyzes excess body weight, obesity and smoking as the leading etiological factors for CHD. It was established that the risk of developing CHD is reliably associated with excess body weight, obesity and smoking, among different clinical groups of male and female patients, both with single-vessel lesions and with multivessel lesions in CHD.&#x0D; Conclusions. Analysis of cardiovascular risk factors for the development of CHD, which include age, body weight, eating habits, and smoking, showed that their further study is relevant, as these are common among patients with CHD. It was established that frequency of excess body weight in patients with CHD, both in men and women, was significantly higher among individuals with multivessel lesions. The prevalence of obesity among patients with CHD presented for off-pump coronary artery bypass grafting was significantly higher among women in groups with different numbers of affected coronary vessels. As for smoking, it was established that this behaviorally associated habit is significantly more common among men with CHD. The reliable patterns of prevalence of excess body weight","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426651","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}