Этот номер журнала посвящен разнообраз­ ным проблемам сердечно-сосудистой патоло­гии – от экспериментального обоснования идеи создания сосудов малого диаметра до практи­ческих аспектов ведения пациентов после им­ плантации биологических протезов клапанов сердца.

The evaluation of cardiotoxicity of the degradation products of electrospunpolyhydroxybutyrate-valerate and polycaprolactone tubular matrices, subjected to 6-month hydrolytic degradation in sterile phosphate buffered saline (PBS) at 37 ºC, was performed. After matrices incubation in PBS, high performance liquid chromatography was used to analyze individual analytes for the presence of monomers and other compounds each month. Cardiotoxicity of analytes was evaluated in a model of isolated perfused rat heart (male Wistar rats) using the Langendorff technique. The rate of coronary flow and enzymatic activity of creatine phosphokinase and lactate dehydrogenase myocardial fractions were measured during the analytes injections. Both, polyhydroxybutyrate-valerate and polycaprolactone, had no significant signs of hydrolytic degradation of polymers into monomers after 6-month storage time. PBS after 6-month incubation of the studied samples did not produce any cardiotoxic effect in the experiments on isolated rat heart and did not demonstrate any significant increase of enzyme activity in the perfusate.

This review describes the main trends in the creation of tissue-engineered vascular grafts. These grafts are intended for use in urgent vascular surgery. Therefore, they should be ready-to-use and be able to sustain cell migration, proliferation, and viability in vivo. To achieve this aim, various research groups attempt to develop highly porous tubular constructs with surface architectonics similar to the extracellular matrix structure. This promotes a colonization of this construct by the host cells after the vascular implantation. Highly porous constructs made of nano- and microfibers are able to enhance the restoration of the endothelial monolayer on the inner surface and de novo tissue formation in the walls due to migration of cells from the bloodstream and surrounding tissues. Biocompatible biodegradable polymers are frequently used as a material for the scaffolds of tissue-engineered vascular grafts; electrospinning is the most widespread technique for the preparation of highly porous vascular grafts. However, pore size is often not enough for efficient cell migration and proliferation after the vascular implantation. Therefore, we focused on techniques for increasing the pore size.

In work the correct method of modeling the experimental anthracosilicosis (AS) is presented. Results of the scanning electron microscopy of samples of abdominal aorta walls of white laboratory rats testify about morphological diseases of blood vessels. These diseases are associated with chronization of pneumoconiotic process in dynamics of AS progression.

Purpose. To reveal the association of polymorphisms within the genes encoding Toll-like receptors (TLRs) with carbohydrate metabolism disorders (CMDs) in patients with coronary artery disease (CAD).

Materials and methods. Study sample included 292 patients with coronary artery disease. We investigated 8 polymorphisms within 4 genes: TLR1 (rs5743551 and rs5743611), TLR2 (rs3804099 and rs5743708), TLR4 (rs4986790 and rs4986791), TLR6 (rs3775073 and rs5743810).

Results. T allele of the rs4986791 (Thr399Ile) polymorphism and G allele of rs4986790 (Asp299Gly) polymorphism within TLR4 gene are significantly associated with decreased risk of CMDs, whereas G allele of rs5743611 polymorphism within TLR1 gene is significantly associated with higher risk of CMDs.

Conclusion. We found significant associations of the polymorphisms within the genes encoding TLRs (T allele of rs4986791 polymorphism and G allele of rs4986790 polymorphism within TLR4 gene and G allele of rs5743611 polymorphism within TLR1 gene) with CMDs in patients with CAD.

Published data on the impact of the experimental atherosclerosis on the infarct-limiting effect of ischemic postconditioning (IPost) are controversial. The reviewed data indicate that aging eliminates or reduces the infarct-limiting effect of postconditioning but does not affect the antiarrhythmic effect of IPost. Most of the experimental data reported that streptozotocin-induced diabetes removes the infarct-limiting effect of IPost. Regarding the second type of diabetes, information is contradictory: some authors argue that this diabetes completely eliminates the cardioprotective effect of IPost, others say that it only weakens but does not eliminate the infarct-limiting effect of IPost. Postconditioning in rats with high blood pressure prevents the appearance of reperfusion contractile dysfunction of the heart and provides the infarct-limiting effect. Cardiac hypertrophy, post-infarction remodeling and dilated cardiomyopathy have no effect on the infarct-reducing and inotropic effect of postconditioning. The majority of publications indicates that IPost enhances the inotropic and cardioprotective effect of cardioplegia. Data on the effect of postconditioning on the tolerance of the human heart to ischemia/reperfusion are limited and do not allow to make an unambiguous conclusion about whether IPost prevents reperfusion myocardial injury in cardiac patients.

Purpose. To analyze the long-term survival of patients with myocardial infarction (MI), according to its type (primary or recurrent MI), age and gender.

Materials and methods. 791 patients with MI admitted to the Kemerovo Cardiology Dispensary in 2006 were included in the study. The follow-up period was 8,5 years. The Kaplan-Meier analysis was performed to estimate the survival rates. A p value of 0,05 is considered statistically significant. The odds ratio (OR) with the 95 % confidence interval was calculated.

Results. A total of 791 patients, 565 (71,4 %) of whom were present with primary and 226 (28,6 %) with recurrent MI were included in the study. Overall, 446 (56,3 %) patients died during the follow-up period. The cause of death was known in 365 patients (81,8 %). The major cause of death was circulatory system diseases (88,2 %). The survival rate for seven years in patients with primary MI was 49,8 % and in patients with recurrent MI – 31,5 % (p=0,00001, OR=2,2 [1,5, 3,0]). The risk of death was greatest in the first year after any type of MI; however, the risk of death after recurrent MI increased 2-fold, compared with primary MI. The long-term survival was lower in females than in males (p=0,0065, OR=1,42 [1,07; 1,90]). In case of primary IM, this parameter was also worse in females than in males (p=0,002, OR=1,6 [1,1; 2,2]). However, there were no gender-related differences in the long-term survival after recurrent MI (p=0,33, OR=1,1 [0,6; 1,9]).

Conclusion. The results of the present study suggest a higher risk of death and poor long-term survival in patients with recurrent myocardial infarction compared to patients with primary MI.

The article presents the main provisions on the use of possibilities of bariatric surgery for obesity treatment.

Purpose. To study the endothelial function in the onset of arterial hypertension (AH) in perimenopausal women and to evaluate the possibility of the influence of antihypertensive therapy on endothelial dysfunction.

Materials and methods. The study included 81 patients with essential hypertension (EH) I–II stage of 1–2 degrees and 23 healthy perimenopausal women. The level of estradiol and follicle stimulating hormone (FSH) were analyzed. Endothelial function was assessed by endothelium-dependent (EDVD), endothelium-independent (ENVD) vasodilation of the brachial artery and laboratory markers.

Results. Regardless of the AH stage and degree 50 % of patients had endothelial dysfunction by EDVD / ENVD and vasoconstriction endothelial markers (endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA)) were increased. 12 weeks of treatment showed a statically significant reduction (p<0,05) in the concentration of ET-1 and ADMA, and increasing NO production (p<0,05) in all patients with hypertension.

Conclusion. Perimenopausal women with EH regardless of the stage and degree blood pressure had a violation of EDVD/ ENVD and a change of endothelial markers. Monotherapy blockers of the renin-angiotensin-aldosterone system (RAAS) showed blood pressure normalisation and endothelial function improvement in most women with AH stage I-II and 1 degree, with 2 degree required a combination therapy with the addition of bisoprolol and low doses of hydrochlorothiazide to RAAS.

This review provides evidence of the relevance of the search for new factors associated with complications of acute coronary syndrome. Renal dysfunction is one such factor, its predictive role is extremely high. In recent years there have been a lot of conflicting information on the new biochemical and genetic markers renal injury and renal dysfunction. These factors dictate the need for systematization and revision of existing ideas about the issue.

A clinical case of bioprosthetic heart valve replacement in a young patient is presented. Common problems in outpatient management of bioprosthetic heart valves recipients have been discussed.

A 73-year-old patient with mitral valve bioprosthesis dysfunction underwent successful redo heart valve replacement. The problems of the patient’s preoperative management, anesthetic management, redo procedure, early postoperative period have been discussed as well as their possible solutions.