A. M. Alieva, E. V. Reznik, I. A. Kotikova, I. G. Nikitin
Chronic heart failure (CHF) is a global medical, social, and economic problem. It is a syndrome caused by imbalanced neurohumoral regulation of the cardiovascular system, which is accompanied by impaired systolic and/or diastolic function of the heart. Currently, the search and study of new biological markers that can help in the early diagnosis of CHF, serve as a laboratory tool for assessing treatment effectiveness, or be used as prognostic markers and risk stratification criteria are ongoing. Researchers focused on studying the role of Klotho protein, fibroblast growth factor 23 (FGF23), and sclerostin in patients with CHF. Klotho expression decreases as the body ages, and impaired production has been reported in various aging-related diseases. The FGF23 / Klotho axis plays a key regulatory role in cardiovascular pathology. Laboratory, clinical, and genetic studies have suggested that sclerostin is associated with heart disease, although available data are not entirely consistent. Clinical work conducted on the study of the Klotho protein, FGF-23, and sclerostin indicates the potentially important diagnostic and prognostic significance of their analysis in patients with CHF. Thus, more studies of the issues related to serial testing of these biological markers, including in the aspect of the multibiomarker model, are needed.
{"title":"Klotho protein, fibroblast growth factor 23, and sclerostin in chronic heart failure: literature review","authors":"A. M. Alieva, E. V. Reznik, I. A. Kotikova, I. G. Nikitin","doi":"10.17816/cs625473","DOIUrl":"https://doi.org/10.17816/cs625473","url":null,"abstract":"Chronic heart failure (CHF) is a global medical, social, and economic problem. It is a syndrome caused by imbalanced neurohumoral regulation of the cardiovascular system, which is accompanied by impaired systolic and/or diastolic function of the heart. Currently, the search and study of new biological markers that can help in the early diagnosis of CHF, serve as a laboratory tool for assessing treatment effectiveness, or be used as prognostic markers and risk stratification criteria are ongoing. Researchers focused on studying the role of Klotho protein, fibroblast growth factor 23 (FGF23), and sclerostin in patients with CHF. Klotho expression decreases as the body ages, and impaired production has been reported in various aging-related diseases. The FGF23 / Klotho axis plays a key regulatory role in cardiovascular pathology. Laboratory, clinical, and genetic studies have suggested that sclerostin is associated with heart disease, although available data are not entirely consistent. Clinical work conducted on the study of the Klotho protein, FGF-23, and sclerostin indicates the potentially important diagnostic and prognostic significance of their analysis in patients with CHF. Thus, more studies of the issues related to serial testing of these biological markers, including in the aspect of the multibiomarker model, are needed.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140716888","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}
E. Emelyanchik, Anastasia M. Moiseeva, V. S. Emelyanchik, O. V. Marilovtseva, R. V. Khomchenkov, V. Mosina, I. Cherkashina, Sergei A. Ustyugov, S. Nikulina, Alexey V. Protopopov
BACKGROUND: Considering the high cardiovascular risk in patients with familial hypercholesterolemia (FH), early diagnosis and treatment are the basis for the prevention of vascular accidents. In the absence of universal screening, the results of more targeted diagnostics are of interest — the search for lipid metabolism disorders in young relatives of patients with atherosclerotic vascular diseases. OBJECTIVE: To determine the effectiveness of targeted screening for identifying patients with FH, which will justify its widespread use in clinical practice. MATERIALS AND METHODS: At the start of the observational study, 584 patients were identified from the vascular centers of the Krasnoyarsk Regional Hospital, Krasnoyarsk Interdistrict Clinical Hospital No. 20 named after. I.S. Berzon, who had lipid profile data and early cardiovascular events (all forms of coronary heart diseases), including reconstructive vascular interventions up to 55 years in men and up to 60 years in women in the case of first-degree relatives and up to 50 years in second-degree relatives. The study examined patients’ relatives aged 44 years. To diagnose FH in participants aged 16 years, the scale developed by a network of Dutch lipid clinics was used; in participants aged 16 years, the S. Broome criteria were used. Targeted screening and lipid parameters in individuals with probable, possible, and definite FH were analyzed. Data processing was performed using Microsoft Excel and Statistica v. 12.0 (USA). Parametric (calculation of the median and 25th and 75th quartiles) and nonparametric (statistical significance of differences was determined using the Mann–Whitney and χ2 tests) methods were used. RESULTS: The study examined 70 children and 104 adults aged 44 years whose first- and/or second-degree relatives suffered premature vascular events. In the general group of participants, 42 (24.14%) patients had FH (of which 18 were 17 years old) and 37 (21.2%) had hyperlipoproteinemia (a). Definite FH was documented in 16 (9.1%) patients, probable in another 16, and possible in 9. Hyperlipoproteinemia (a) was found in 37 (21.2% of general group) patients, including 12 children (17.1% of pediatric group). CONCLUSION: Not more than 30% of the population are aware of the hereditary nature of lipid metabolism disorders and atherosclerotic diseases. Targeted screening is the least expensive and most effective tool for identifying patients with FH and hyperdipoproteinemia (a).
{"title":"Efficacy of targeted screening for familial hypercholesterolemia in children and adults aged <44 years: retrospective, prospective observational study","authors":"E. Emelyanchik, Anastasia M. Moiseeva, V. S. Emelyanchik, O. V. Marilovtseva, R. V. Khomchenkov, V. Mosina, I. Cherkashina, Sergei A. Ustyugov, S. Nikulina, Alexey V. Protopopov","doi":"10.17816/cs623868","DOIUrl":"https://doi.org/10.17816/cs623868","url":null,"abstract":"BACKGROUND: Considering the high cardiovascular risk in patients with familial hypercholesterolemia (FH), early diagnosis and treatment are the basis for the prevention of vascular accidents. In the absence of universal screening, the results of more targeted diagnostics are of interest — the search for lipid metabolism disorders in young relatives of patients with atherosclerotic vascular diseases. \u0000OBJECTIVE: To determine the effectiveness of targeted screening for identifying patients with FH, which will justify its widespread use in clinical practice. \u0000MATERIALS AND METHODS: At the start of the observational study, 584 patients were identified from the vascular centers of the Krasnoyarsk Regional Hospital, Krasnoyarsk Interdistrict Clinical Hospital No. 20 named after. I.S. Berzon, who had lipid profile data and early cardiovascular events (all forms of coronary heart diseases), including reconstructive vascular interventions up to 55 years in men and up to 60 years in women in the case of first-degree relatives and up to 50 years in second-degree relatives. The study examined patients’ relatives aged 44 years. To diagnose FH in participants aged 16 years, the scale developed by a network of Dutch lipid clinics was used; in participants aged 16 years, the S. Broome criteria were used. Targeted screening and lipid parameters in individuals with probable, possible, and definite FH were analyzed. Data processing was performed using Microsoft Excel and Statistica v. 12.0 (USA). Parametric (calculation of the median and 25th and 75th quartiles) and nonparametric (statistical significance of differences was determined using the Mann–Whitney and χ2 tests) methods were used. \u0000RESULTS: The study examined 70 children and 104 adults aged 44 years whose first- and/or second-degree relatives suffered premature vascular events. In the general group of participants, 42 (24.14%) patients had FH (of which 18 were 17 years old) and 37 (21.2%) had hyperlipoproteinemia (a). Definite FH was documented in 16 (9.1%) patients, probable in another 16, and possible in 9. Hyperlipoproteinemia (a) was found in 37 (21.2% of general group) patients, including 12 children (17.1% of pediatric group). \u0000CONCLUSION: Not more than 30% of the population are aware of the hereditary nature of lipid metabolism disorders and atherosclerotic diseases. Targeted screening is the least expensive and most effective tool for identifying patients with FH and hyperdipoproteinemia (a).","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720472","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}
V. Karetnikova, A. G. Neeshpapa, Evgenia I. Carpova, O. Barbarash
Currently, increasing evidence shows that people with cardiovascular diseases, including coronary heart disease, have a higher risk of developing pathologies such as sarcopenia, osteopenia, osteosarcopenia, sarcopenic, and osteosarcopenic obesity, which is associated with increased mortality risk. Musculoskeletal and adipose tissue changes have significantly affected the quality of life of patients and are important clinical problems. It is assumed that between the aforementioned disorders and coronary heart disease, a pathogenetic connection with the possibility of mutual aggravation exists. Accordingly, the search for relevant and accurate markers that reflect the severity and characterize the prognosis of a complex of pathological conditions is necessary given the increased proportion of patients in the general population with comorbidities. The article reviews the basic concepts of age-related disorders of body composition and molecular markers and emphasizes on new and potentially promising ones. The results can help in identifying and assessing the severity and prognosis of atherosclerosis, including coronary heart disease, and various disorders of musculoskeletal homeostasis, which reflects the commonality of their pathogenesis.
{"title":"Musculoskeletal disorders and coronary artery disease —promising molecular markers: literature review","authors":"V. Karetnikova, A. G. Neeshpapa, Evgenia I. Carpova, O. Barbarash","doi":"10.17816/cs624809","DOIUrl":"https://doi.org/10.17816/cs624809","url":null,"abstract":"Currently, increasing evidence shows that people with cardiovascular diseases, including coronary heart disease, have a higher risk of developing pathologies such as sarcopenia, osteopenia, osteosarcopenia, sarcopenic, and osteosarcopenic obesity, which is associated with increased mortality risk. Musculoskeletal and adipose tissue changes have significantly affected the quality of life of patients and are important clinical problems. It is assumed that between the aforementioned disorders and coronary heart disease, a pathogenetic connection with the possibility of mutual aggravation exists. Accordingly, the search for relevant and accurate markers that reflect the severity and characterize the prognosis of a complex of pathological conditions is necessary given the increased proportion of patients in the general population with comorbidities. The article reviews the basic concepts of age-related disorders of body composition and molecular markers and emphasizes on new and potentially promising ones. The results can help in identifying and assessing the severity and prognosis of atherosclerosis, including coronary heart disease, and various disorders of musculoskeletal homeostasis, which reflects the commonality of their pathogenesis.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140716955","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}
D. S. Evdokimov, Valeria S. Feoktistova, S. Boldueva, E.D. Resnyanskaya, Svyatoslav L. Plavinsky
BACKGROUND: Until recently, takotsubo syndrome (TS) was considered a fairly benign disease in both early and late periods. However, in recent years, in-hospital complications in the acute period of TS are common and can be life-threatening. AIM: Based on clinical and laboratory-instrumental data, this study aimed to build models for predicting the risk of developing in-hospital complications in patients with TS during the acute period. MATERIALS AND METHODS: This prospective cohort study included 60 patients with TS, with an average age of 65.5±13.4 years. In the acute period (7–14 days), standard clinical and laboratory examination, peripheral arterial tonometry using the «EndoPAT 2000» apparatus, and psychological testing using validated questionnaires (hospital anxiety and depression scale and Beck depression scale) were performed. RESULTS: The integrated model for predicting the risk of acute heart failure (AHF) development (pulmonary edema and cardiogenic shock) identified admission LVEF as the leading prognostic parameter. With LVEF ≤40.5%, the probability of AHF in patients with TS in the acute period was 62.5%, and in patients with TS and QTc interval 487 ms, the risk reached 100%. The sensitivity and specificity of the developed model were 72.7% and 97.4%, respectively. The integrated model for predicting the development of cardiovascular complications (CVCs) revealed that the number of leukocytes in the peripheral blood was the leading risk factor for adverse events in patients with TS in the acute period. With a leukocyte count 11.1×109/L, the risk of CVCs in patients with TS increased to 89.9%, and if the erythrocyte count was 4.69×1012/L or ≤4.29×1012/L, it could reach 100%. The sensitivity and specificity of the resulting model were 92.6 and 97.0%, respectively. CONCLUSION: The models proposed in this study for predicting the likelihood of developing severe AHF and the overall risk of CVCs in the acute period of TS are personalized and easy to use, allowing for the selection of optimized treatment techniques.
{"title":"Prediction of in-hospital complications in takotsubo syndrome: prospective cohort study","authors":"D. S. Evdokimov, Valeria S. Feoktistova, S. Boldueva, E.D. Resnyanskaya, Svyatoslav L. Plavinsky","doi":"10.17816/cs623576","DOIUrl":"https://doi.org/10.17816/cs623576","url":null,"abstract":"BACKGROUND: Until recently, takotsubo syndrome (TS) was considered a fairly benign disease in both early and late periods. However, in recent years, in-hospital complications in the acute period of TS are common and can be life-threatening. \u0000AIM: Based on clinical and laboratory-instrumental data, this study aimed to build models for predicting the risk of developing in-hospital complications in patients with TS during the acute period. \u0000MATERIALS AND METHODS: This prospective cohort study included 60 patients with TS, with an average age of 65.5±13.4 years. In the acute period (7–14 days), standard clinical and laboratory examination, peripheral arterial tonometry using the «EndoPAT 2000» apparatus, and psychological testing using validated questionnaires (hospital anxiety and depression scale and Beck depression scale) were performed. \u0000RESULTS: The integrated model for predicting the risk of acute heart failure (AHF) development (pulmonary edema and cardiogenic shock) identified admission LVEF as the leading prognostic parameter. With LVEF ≤40.5%, the probability of AHF in patients with TS in the acute period was 62.5%, and in patients with TS and QTc interval 487 ms, the risk reached 100%. The sensitivity and specificity of the developed model were 72.7% and 97.4%, respectively. The integrated model for predicting the development of cardiovascular complications (CVCs) revealed that the number of leukocytes in the peripheral blood was the leading risk factor for adverse events in patients with TS in the acute period. With a leukocyte count 11.1×109/L, the risk of CVCs in patients with TS increased to 89.9%, and if the erythrocyte count was 4.69×1012/L or ≤4.29×1012/L, it could reach 100%. The sensitivity and specificity of the resulting model were 92.6 and 97.0%, respectively. \u0000CONCLUSION: The models proposed in this study for predicting the likelihood of developing severe AHF and the overall risk of CVCs in the acute period of TS are personalized and easy to use, allowing for the selection of optimized treatment techniques.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"231 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720009","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}
Omar M. Omarov, G. G. Arabidze, Z. Shogenov, Elena A. Petrik
BACKGROUND: This study focuses on the development of new approaches to the management of patients with acute decompensation of heart failure (ADHF) using sodium-glucose cotransporter type 2 (iHLT-2) inhibitors, particularly dapagliflozin, and its role in early treatment initiation. AIM: Our aim was to determine the predictors of severe ADHF outcomes in patients with low left ventricular ejection fraction (LVEF) and the role of early initiation of iGLT-2 therapy (within the first 24 h). MATERIALS AND METHODS: This prospective randomized study included a total of 140 patients hospitalized with ADHF between January 1 to September 1, 2023. The patients were randomized into two groups: in group 1, iGLT-2 therapy was started within 24 h from the moment of admission (n=70), and in group 2, standard therapy was implemented (n=70). Hospital data were analyzed. The endpoint was the persistence of congestion in one or both circulatory circuits with New York Heart Association Functional Classes III–IV, indicating severe ADHF. RESULTS: The initial demographic and clinical characteristics of both groups were comparable. In both groups 47% patients did not receive optimal drug therapy (excluding iGLT-2) for chronic heart failure, and no differences were found in this indicator (p=0.081). iGLT-2 therapy did not demonstrate a significant effect on the likelihood of an adverse ADHF outcome (odds ratio [OR]=0.88; 95% confidence interval [CI] 0.43–1.78, p=0.719). Multivariate analysis showed an increase in the probability of this outcome for every 1000 pg/mL increase in N-terminal propeptide of brain natriuretic hormone (NT-proBNP) (OR=1.72, 95% CI 1.37–2.17; p 0.001), blood urea per 1 mmol/L (OR=1.54, 95% CI 1.21–1.97; p=0.001), pulmonary hypertension (OR=7.08, 95% CI 2.15–23.34; p=0.001), and a decrease in the probability of outcome with a 1% increase in LVEF (OR=0.91, 95% CI 0.84–0.99; p=0.031). The sensitivity and specificity of the adverse outcome model were 91.3 and 85.1%, respectively. CONCLUSION: The leading predictors of an unfavorable ADHF outcome include increased levels of NT-proBNP and blood urea, pulmonary hypertension, and decreased LVEF.
{"title":"In-hospital results of therapy with the NGLT-2 inhibitor dapagliflozin in patients with acute decompensation of heart failure: prospective randomized study","authors":"Omar M. Omarov, G. G. Arabidze, Z. Shogenov, Elena A. Petrik","doi":"10.17816/cs622928","DOIUrl":"https://doi.org/10.17816/cs622928","url":null,"abstract":"BACKGROUND: This study focuses on the development of new approaches to the management of patients with acute decompensation of heart failure (ADHF) using sodium-glucose cotransporter type 2 (iHLT-2) inhibitors, particularly dapagliflozin, and its role in early treatment initiation. \u0000AIM: Our aim was to determine the predictors of severe ADHF outcomes in patients with low left ventricular ejection fraction (LVEF) and the role of early initiation of iGLT-2 therapy (within the first 24 h). \u0000MATERIALS AND METHODS: This prospective randomized study included a total of 140 patients hospitalized with ADHF between January 1 to September 1, 2023. The patients were randomized into two groups: in group 1, iGLT-2 therapy was started within 24 h from the moment of admission (n=70), and in group 2, standard therapy was implemented (n=70). Hospital data were analyzed. The endpoint was the persistence of congestion in one or both circulatory circuits with New York Heart Association Functional Classes III–IV, indicating severe ADHF. \u0000RESULTS: The initial demographic and clinical characteristics of both groups were comparable. In both groups 47% patients did not receive optimal drug therapy (excluding iGLT-2) for chronic heart failure, and no differences were found in this indicator (p=0.081). iGLT-2 therapy did not demonstrate a significant effect on the likelihood of an adverse ADHF outcome (odds ratio [OR]=0.88; 95% confidence interval [CI] 0.43–1.78, p=0.719). Multivariate analysis showed an increase in the probability of this outcome for every 1000 pg/mL increase in N-terminal propeptide of brain natriuretic hormone (NT-proBNP) (OR=1.72, 95% CI 1.37–2.17; p 0.001), blood urea per 1 mmol/L (OR=1.54, 95% CI 1.21–1.97; p=0.001), pulmonary hypertension (OR=7.08, 95% CI 2.15–23.34; p=0.001), and a decrease in the probability of outcome with a 1% increase in LVEF (OR=0.91, 95% CI 0.84–0.99; p=0.031). The sensitivity and specificity of the adverse outcome model were 91.3 and 85.1%, respectively. \u0000CONCLUSION: The leading predictors of an unfavorable ADHF outcome include increased levels of NT-proBNP and blood urea, pulmonary hypertension, and decreased LVEF.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"1999 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718780","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}
T. N. Zvereva, Anastasia A. Pronina, A. V. Babichuk, S. Pomeshkina, O. Barbarash
BACKGROUND: Despite its relevance and established efficiency, the third stage of cardiac rehabilitation (CR) lacks a universal solution. The longest rehabilitation period requires many resources and effort on the part of the healthcare system. Digital technologies rapidly developing and being introduced into medicine can significantly assist in organizing the CR process. The healthcare system is already mastered and actively adopting telemedicine technologies into daily practice. OBJECTIVE: We aimed to determine the patients’ preparedness for the upcoming surgical treatment of the chronic types of coronary artery disease to engage in remote cardiac rehabilitation programs using telemedicine technologies. MATERIALS AND METHODS: A study of 213 patients treated for artery disease and preparing for planned coronary bypass surgery was conducted. Gender, age, socioeconomic factors, and digital literacy were analyzed. The patients were offered one of two options for completing the third stage of CR: a standard option in which CR is performed under the supervision of a medical worker in a medical organization at the place of residence according to the recommendations received upon hospital discharge or an alternative in which CR is performed at home using remote monitoring under the supervision of specialists from the CR laboratory of the Research Institute for Complex Issues of Cardiovascular Diseases. Patients were divided into two groups based on their choice: those who agreed to participate in the outpatient stage of CR using telemedicine technologies (loyal patients) and those who refused to use telemedicine technologies (nonloyal patients). The factors indicating more loyalty were identified using survey data and correlation analysis, and a portrait of a patient eager to use remote rehabilitation programs was formed. RESULTS: Social factors, such as living in big cities (p 0.001) and having a spouse (p=0,030), were associated with increased loyalty to participating in CR via telemedicine technologies. Male gender (p 0.001), obesity (p 0.001), and smoking (p 0.001) were associated with the reluctance to participate in the alternative CR program. The education level (p=0.060) did not show a significant impact on the loyalty to use telemedicine technologies. CONCLUSION: 46% of patients were interested in using remotely controlled CR programs. The social factors determine the loyalty to telemedicine technologies in patients.
{"title":"Factors determining the readiness of a patient with coronary artery disease to use telemedicine technologies for rehabilitation: prospective cohort study","authors":"T. N. Zvereva, Anastasia A. Pronina, A. V. Babichuk, S. Pomeshkina, O. Barbarash","doi":"10.17816/cs326139","DOIUrl":"https://doi.org/10.17816/cs326139","url":null,"abstract":"BACKGROUND: Despite its relevance and established efficiency, the third stage of cardiac rehabilitation (CR) lacks a universal solution. The longest rehabilitation period requires many resources and effort on the part of the healthcare system. Digital technologies rapidly developing and being introduced into medicine can significantly assist in organizing the CR process. The healthcare system is already mastered and actively adopting telemedicine technologies into daily practice. OBJECTIVE: We aimed to determine the patients’ preparedness for the upcoming surgical treatment of the chronic types of coronary artery disease to engage in remote cardiac rehabilitation programs using telemedicine technologies. MATERIALS AND METHODS: A study of 213 patients treated for artery disease and preparing for planned coronary bypass surgery was conducted. Gender, age, socioeconomic factors, and digital literacy were analyzed. The patients were offered one of two options for completing the third stage of CR: a standard option in which CR is performed under the supervision of a medical worker in a medical organization at the place of residence according to the recommendations received upon hospital discharge or an alternative in which CR is performed at home using remote monitoring under the supervision of specialists from the CR laboratory of the Research Institute for Complex Issues of Cardiovascular Diseases. Patients were divided into two groups based on their choice: those who agreed to participate in the outpatient stage of CR using telemedicine technologies (loyal patients) and those who refused to use telemedicine technologies (nonloyal patients). The factors indicating more loyalty were identified using survey data and correlation analysis, and a portrait of a patient eager to use remote rehabilitation programs was formed. RESULTS: Social factors, such as living in big cities (p 0.001) and having a spouse (p=0,030), were associated with increased loyalty to participating in CR via telemedicine technologies. Male gender (p 0.001), obesity (p 0.001), and smoking (p 0.001) were associated with the reluctance to participate in the alternative CR program. The education level (p=0.060) did not show a significant impact on the loyalty to use telemedicine technologies. CONCLUSION: 46% of patients were interested in using remotely controlled CR programs. The social factors determine the loyalty to telemedicine technologies in patients.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"1 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168382","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}
E. V. Dren’, I. N. Lyapina, T. Pecherina, O. Barbarash
In modern conditions, valvular heart diseases (VHD) are one of the most common pathologies among cardiovascular diseases with a dynamic change in the phenotype of patients. An increase in the prevalence of VHD is currently observed due to the active implementation of diagnostic methods in cardiology. Geographical differences in the genesis of the development of valvular heart defects are noted, and the portrait of patients also changes as a result of aging and the addition of comorbid pathology. The purpose of the literature review was to present current trends in changing phenotype of patients with VHD, to study current data on the epidemiology of valve pathology, the contribution of various cardiovascular risk factors and comorbidity of patients on the course of the disease. Current data on the number of surgical interventions performed for VHD based on Russian, European, American, Australian and other studies, data on patient survival and mortality, as well as differences in these indicators in age groups of different countries are presented. The review will be useful for doctors to understand the modern portrait of a patient with VHD, trends in cardiovascular risk factors that influence the course of the disease and prognosis in patients with VHD.
{"title":"Phenotype of a modern patient with valvular heart diseases: literature review","authors":"E. V. Dren’, I. N. Lyapina, T. Pecherina, O. Barbarash","doi":"10.17816/cs601825","DOIUrl":"https://doi.org/10.17816/cs601825","url":null,"abstract":"In modern conditions, valvular heart diseases (VHD) are one of the most common pathologies among cardiovascular diseases with a dynamic change in the phenotype of patients. An increase in the prevalence of VHD is currently observed due to the active implementation of diagnostic methods in cardiology. Geographical differences in the genesis of the development of valvular heart defects are noted, and the portrait of patients also changes as a result of aging and the addition of comorbid pathology. The purpose of the literature review was to present current trends in changing phenotype of patients with VHD, to study current data on the epidemiology of valve pathology, the contribution of various cardiovascular risk factors and comorbidity of patients on the course of the disease. Current data on the number of surgical interventions performed for VHD based on Russian, European, American, Australian and other studies, data on patient survival and mortality, as well as differences in these indicators in age groups of different countries are presented. The review will be useful for doctors to understand the modern portrait of a patient with VHD, trends in cardiovascular risk factors that influence the course of the disease and prognosis in patients with VHD.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168611","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}
A. M. Alieva, E. Reznik, Natalia V. Teplova, Malika Kh. Gyzyeva, A. M. Rakhaev, I. A. Kotikova, I. G. Nikitin
Despite significant advances in medicine, cardiovascular disease continues to be the leading cause of death worldwide. An important task in cardiology is the search and study of new cardiovascular biological markers. In recent years, salusins have attracted the interest of scientists. Salusins are endogenous biologically active peptides, which were first identified in 2003. Thus far, studies have demonstrated that salusin-α and salusin-β play important roles in vascular remodeling, inflammation, hypertension, and atherosclerotic processes. Salusin-α exhibits an antiatherogenic effect, whereas salusin-β plays a proatherogenic role. Despite the diverse biological, physiological, and pathophysiological aspects of salusins, the exact mechanism of their cardiovascular effects is not fully known. Further in-depth studies of the role of salusins in cardiovascular diseases are required. The regulation of the concentration and expression of salusin-α and salusin-β may prove to be a promising strategy for the treatment of patients with cardiac diseases.
{"title":"Salusin-α and salusin-β as new biological markers in cardiovascular diseases: literature review","authors":"A. M. Alieva, E. Reznik, Natalia V. Teplova, Malika Kh. Gyzyeva, A. M. Rakhaev, I. A. Kotikova, I. G. Nikitin","doi":"10.17816/cs568593","DOIUrl":"https://doi.org/10.17816/cs568593","url":null,"abstract":"Despite significant advances in medicine, cardiovascular disease continues to be the leading cause of death worldwide. An important task in cardiology is the search and study of new cardiovascular biological markers. In recent years, salusins have attracted the interest of scientists. Salusins are endogenous biologically active peptides, which were first identified in 2003. Thus far, studies have demonstrated that salusin-α and salusin-β play important roles in vascular remodeling, inflammation, hypertension, and atherosclerotic processes. Salusin-α exhibits an antiatherogenic effect, whereas salusin-β plays a proatherogenic role. Despite the diverse biological, physiological, and pathophysiological aspects of salusins, the exact mechanism of their cardiovascular effects is not fully known. Further in-depth studies of the role of salusins in cardiovascular diseases are required. The regulation of the concentration and expression of salusin-α and salusin-β may prove to be a promising strategy for the treatment of patients with cardiac diseases.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168307","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}
D. Nikulin, A. Chernova, S. Nikulina, S. Prokopenko, I. Cherkashina
BACKGROUND: The study focused on the identification of new genetic predictors in the Russian population, particularly associations of the rs1132896 polymorphism of the matrix metalloproteinase type 2 gene (MMP-2) with the development of acute cerebrovascular accident (ACVA). OBJECTIVE: To investigate the relationship of rs1132896 gene MMP-2 polymorphisms with ACVA development. MATERIALS AND METHODS: The prospective, case–control study enrolled 318 patients with stroke (main group) and 323 controls (control group). The age of the patients in the main group ranged from 32 to 69 [57.0; 51.0–62.0] years. In the control group, the age of the patients ranged from 37 to 68 [55.0; 51.0–62.0] years, which was comparable to that of the main group. Sexual dimorphism was as follows: 191 men (age [56.5; 51.0–62.0]) and 127 women (age [57.0; 51.0–62.0]). The sex composition in the control group corresponded to that in the main group: 214 men (age [55.0; 51.0–62.0]) and 109 women (age [55.0; 51.0–62.0]). The main group underwent clinical examination, computed tomography of the brain, electrocardiography, echocardioscopy, duplex ultrasound scanning of the extracranial brachiocephalic arteries, 24-h monitoring of blood pressure and heart rate, and analysis of the blood coagulation system. Molecular genetic research was conducted at a branch of the Institute of Cytology and Genetics of the Siberian Branch of RAS (Novosibirsk). All patients provided written informed consent to participate voluntarily in the study. The duration of the study was 3 years, starting in 2019. The primary study endpoint was a diagnosis of stroke, verification of concomitant cardiovascular pathology, and risk factors for stroke development. Statistical processing of the results was performed using SPSS Statistics v. 22 (IBM Corp., USA) and MedCalc 22.006 (Microsoft, USA). When comparing extended variables, the Mann–Whitney U-test was used. Discrete values were compared using Pearson’s χ2 test. RESULTS: When analyzing statistical significance, a predominance of the homozygous CC genotype was recorded in the group of male patients with stroke: n=24 (12.6%) vs n=20 (9.3%; p=0.0324). In addition, in the group of women, a statistically significant predominance of the heterozygous CG genotype was noted in women with stroke: n=67 (52.8%) vs n=42 (38.5%; p=0.0420). CONCLUSION: The homozygous CC genotype in men and the heterozygous CG genotype in women may be genetic predictors of the development of ACVA. The study of genetic factors in the development of ACVA is necessary to create a personalized approach to patient management at the outpatient and inpatient stages of medical care.
{"title":"Associations of the rs1132896 polymorphism of the matrix metalloproteinase type 2 gene with the development of acute cerebrovascular accident: prospective case–control study","authors":"D. Nikulin, A. Chernova, S. Nikulina, S. Prokopenko, I. Cherkashina","doi":"10.17816/cs569019","DOIUrl":"https://doi.org/10.17816/cs569019","url":null,"abstract":"BACKGROUND: The study focused on the identification of new genetic predictors in the Russian population, particularly associations of the rs1132896 polymorphism of the matrix metalloproteinase type 2 gene (MMP-2) with the development of acute cerebrovascular accident (ACVA). OBJECTIVE: To investigate the relationship of rs1132896 gene MMP-2 polymorphisms with ACVA development. MATERIALS AND METHODS: The prospective, case–control study enrolled 318 patients with stroke (main group) and 323 controls (control group). The age of the patients in the main group ranged from 32 to 69 [57.0; 51.0–62.0] years. In the control group, the age of the patients ranged from 37 to 68 [55.0; 51.0–62.0] years, which was comparable to that of the main group. Sexual dimorphism was as follows: 191 men (age [56.5; 51.0–62.0]) and 127 women (age [57.0; 51.0–62.0]). The sex composition in the control group corresponded to that in the main group: 214 men (age [55.0; 51.0–62.0]) and 109 women (age [55.0; 51.0–62.0]). The main group underwent clinical examination, computed tomography of the brain, electrocardiography, echocardioscopy, duplex ultrasound scanning of the extracranial brachiocephalic arteries, 24-h monitoring of blood pressure and heart rate, and analysis of the blood coagulation system. Molecular genetic research was conducted at a branch of the Institute of Cytology and Genetics of the Siberian Branch of RAS (Novosibirsk). All patients provided written informed consent to participate voluntarily in the study. The duration of the study was 3 years, starting in 2019. The primary study endpoint was a diagnosis of stroke, verification of concomitant cardiovascular pathology, and risk factors for stroke development. Statistical processing of the results was performed using SPSS Statistics v. 22 (IBM Corp., USA) and MedCalc 22.006 (Microsoft, USA). When comparing extended variables, the Mann–Whitney U-test was used. Discrete values were compared using Pearson’s χ2 test. RESULTS: When analyzing statistical significance, a predominance of the homozygous CC genotype was recorded in the group of male patients with stroke: n=24 (12.6%) vs n=20 (9.3%; p=0.0324). In addition, in the group of women, a statistically significant predominance of the heterozygous CG genotype was noted in women with stroke: n=67 (52.8%) vs n=42 (38.5%; p=0.0420). CONCLUSION: The homozygous CC genotype in men and the heterozygous CG genotype in women may be genetic predictors of the development of ACVA. The study of genetic factors in the development of ACVA is necessary to create a personalized approach to patient management at the outpatient and inpatient stages of medical care.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169581","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}
V. Bazylev, A. B. Voevodin, V. A. Karnakhin, I. D. Potopalskiy
BACKGROUND: An alternative to plastic surgery on the bicuspid aortic valve (BAV) can be replacement of the leaflets with autopericardium using the Ozaki technique. The procedure is characterized by excellent hemodynamic results in the short and long term in patients with tricuspid aortic valve (TAV). However, the question remains about the long-term results of the procedure and the frequency of reoperations in patients with BAV. OBJECTIVE: To analyze the midterm outcomes of the Ozaki procedure in patients with BAV. MATERIALS AND METHODS: Retrospective single-center, non-randomized, parallel-group study was conducted. Since January 2015 to October 1, 2023, the clinic performed 809 Ozaki procedures. The work included 540 patients with studied midterm and long-term outcomes for up to 5 years. Both isolated aortic valve replacement and combined operations with coronary artery bypass grafting and (or) correction of mitral and tricuspid valve defects were performed. RESULTS: Midterm mortality was 5.7% (n=3) in the group with BAV and 7.3% (n=36) in the group with TAV. Reoperation for aortic regurgitation was required in 16 patients (2.9%): 1 patient (1.9%) in BAV group and 15 (3.3%) in TAV group. Freedom from reoperations in patients with BAV after the Ozaki procedure for up to 5 years was 95.4%, in the group with TAV — 92.6%. The peak gradient on the aortic valve in the group with BAV was 16±7.3, in TAV group— 16.4±10.9. 5 years after surgery, the mean gradient on the aortic valve does not exceed 10 mm Hg. CONCLUSION: The Ozaki operation in patients with BAV is an effective and safe procedure in the midterm follow-up period.
{"title":"Midterm outcomes of the Ozaki procedure in patients with a bicuspid aortic valve: retrospective single-center, non-randomized, parallel-group study","authors":"V. Bazylev, A. B. Voevodin, V. A. Karnakhin, I. D. Potopalskiy","doi":"10.17816/cs607383","DOIUrl":"https://doi.org/10.17816/cs607383","url":null,"abstract":"BACKGROUND: An alternative to plastic surgery on the bicuspid aortic valve (BAV) can be replacement of the leaflets with autopericardium using the Ozaki technique. The procedure is characterized by excellent hemodynamic results in the short and long term in patients with tricuspid aortic valve (TAV). However, the question remains about the long-term results of the procedure and the frequency of reoperations in patients with BAV. OBJECTIVE: To analyze the midterm outcomes of the Ozaki procedure in patients with BAV. MATERIALS AND METHODS: Retrospective single-center, non-randomized, parallel-group study was conducted. Since January 2015 to October 1, 2023, the clinic performed 809 Ozaki procedures. The work included 540 patients with studied midterm and long-term outcomes for up to 5 years. Both isolated aortic valve replacement and combined operations with coronary artery bypass grafting and (or) correction of mitral and tricuspid valve defects were performed. RESULTS: Midterm mortality was 5.7% (n=3) in the group with BAV and 7.3% (n=36) in the group with TAV. Reoperation for aortic regurgitation was required in 16 patients (2.9%): 1 patient (1.9%) in BAV group and 15 (3.3%) in TAV group. Freedom from reoperations in patients with BAV after the Ozaki procedure for up to 5 years was 95.4%, in the group with TAV — 92.6%. The peak gradient on the aortic valve in the group with BAV was 16±7.3, in TAV group— 16.4±10.9. 5 years after surgery, the mean gradient on the aortic valve does not exceed 10 mm Hg. CONCLUSION: The Ozaki operation in patients with BAV is an effective and safe procedure in the midterm follow-up period.","PeriodicalId":502399,"journal":{"name":"CardioSomatics","volume":"35 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169055","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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