The article reflects the history of creation, formation and development of the cardiology service of Kuzbass region, Kuzbass cardiology, role of the centre in providing care to patients with cardiovascular diseases from the beginnings to the present day. The main stages of formation and implementation of scientific fields and practical activities of the center, and also the contribution of leading scientists and all the staff in the implementation of fundamental and applied problems.

Purpose. Retrospective analysis of the immediate results of the treatment of these patients will form an idea of the need for a prospective randomized study.

Materials and methods. Are analyzed the results of 411 operations performed in patients with aortic stenosis. The first group – 227 patients with implanted bioprosthesis in the aortic position UniLine, the second group – 184 patients with implanted stented bioprosthesis Biolab.

Results. Postoperative mortality in group I was 1.8 % (4 patients), in group II – 2.7 % (5 patients) (p=0.8). To determine the factors
that have a connection to the pressure gradient in the aortic prosthesis, regression analysis was performed. In group I, the relationship between the peak pressure gradient and body mass index (p = 0.001). In group II, the relationship peak pressure gradient and stroke volume of the left ventricle, body mass index and diameter of the prosthesis. In group I in the perioperative period required reimplantation valve 1 (0.4 %) patient. Reason dysfunction – iatrogenic damage to the prosthesis. In group II all recorded 3 (1.6 %) early prosthetic dysfunction, including 1 (0.5 %) – iatrogenic and 2 (1 %) – due to the prosthesis itself.

Conclusion. A prospective randomized controlled study conducted over a long period of time, a few clinics at the same time, allow more objectively assess the advantages and disadvantages of dentures and to define prospects of development of this direction in Russia.

Purpose. To detect the potential of different qualitative, semi-quantitative and quantitative transthoracic Doppler signs for successful evaluation of stenotic left main coronary artery (LMCA) and left anterior descending artery (LAD).

Materials and methods. 173 patients (52±10 years; 149 men) with chest pain, sinus rhythm and scheduled quantitative coronary
angiography (CAG) were evaluated at rest by non-contrast transthoracic echocardiography (TT E). LMCA and proximal (p), mid (m) and distal (d) parts of the LAD were examined. The Doppler signs of coronary stenosis >50 % were determined as follows: 1 – local Doppler aliasing with the Nyquist limit set at 60 cm/s; 2 – maximal peak diastolic velocity (Vpd) >60 cm/s; 3 – ratio of stenotic/prestenotic Vpd >2.0; 4 – stenosis >50 % according to flow continuous equation: stenosis, % = 100 × (1 – prestenotic VTId / stenotic VTId), where VTId – diastolic time velocity integral. CAG was performed within 1 week after TT E. Stenosis >50 % of diameter reduction was considered as significant.

Results. Sensitivity (Sens), specificity (Sp) and diagnostic accuracy (Ac) of different Doppler stenotic signs for stenotic LMCA and
LAD are presented in Table 1. Thus, TT E is a method for correct evaluation of stenotic LMCA and LAD. Quantitative ratio of stenotic to prestenotic coronary flow velocities is a more sensitive sign for detecting stenosis >50 %, than qualitative and semi-quantitative evaluation of maximal coronary flow velocity only.

Purpose. To investigate the composition and concentration of the polymer solutions on structure and physico-mechanical properties of the electrospun scaffolds.

Materials and methods. We prepared electrospun scaffolds from poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), polycaprolactone (PCL), and poly(D,L-lactide) (PLA) in concentrations of 6, 8, and 10 %. We investigated mechanical properties of the scaffolds, fiber diameter, and pore size.

Results. Concentration of the polymer solution significantly affected fiber diameter but not pore size. The optimal concentrations of PHBV, PLA, and PCL were 8–10 %. Use of PHBV/PLA composition lowered fiber diameter and pore size whilst PHBV/PCL composition increased elasticity of the scaffolds.

Conclusion. Composition and concentration of the polymer solutions significantly affects pore size, structure, and diameter of electrospun scaffolds, that influences physico-mechanical properties of the scaffolds.

Purpose. The article is to demonstrate the possibility of manufacturing a prototype of transcatheter aortic valve prosthesis, followed by evaluation of its hydrodynamic performance under conditions simulating physiological blood flow.

Materials and methods. In this paper we used the model of self-expanding transcatheter valve obtained on the basis of previous studies. The physical model of the prosthesis are made by high-precision laser cutting of tubes SE508 nickel-titanium alloy (Nitinol) with a further shape training under the control of differential scanning calorimeter (DSC). On the support frame were mounted xenopericardial leaflets stabilized with ethylene glycol diglycidyl ether (EGDE). Thus it was produced a working prototype of self-expanding aortic valve prosthesis. Research was performed in the pulse duplicator Vivitro-Systems (Vivitro Labs inc, Canada) while simulating the physiological mode of heart function: cardiac output of 5 L/min, the frequency of 70 beats/min, the average pressure heart rate in the aorta 100 mmHg, systolic contraction relative duration of 35 %.

Results. The prototype of the transcatheter bioprosthesis showed the average value of the transprosthesis pressure gradient 18.01±0.55 mmHg, vs. 19.72±0.16 mmHg – for control (3F Enable, Medtronic Inc, USA) (p=0.37). Also, the prototype demonstrated lower transvalvular flow: the average value 253.62±3.88 ml/s vs. 272.3 1.18 ml/s (control, p=0.29). The regurgitation fraction, calculated as paravalvular and transvalvular leaks for the prototype was 5.08±1.06 %, the amount of leakage was 2.40±0.78 ml, and the closing volume was 1.67±0.15 ml. Similar rates were not significantly different to the control sample: 3.66±0.81 %; 1.28±0.51 ml and 1.57±0.12 ml, respectively (p=0.19; p<0.1; p=0.56).

Conclusion. This work demonstrates the feasibility of manufacturing the prototype of transcatheter aortic valve prosthesis with Nitinol frame, having hydrodynamic performance, comparable to those used in clinical bioprostheses with seamless method of fixation. However, the evaluation of the possibility of clinical application of applied chosen design requires further research in durability, biocompatibility, and its in-depth study in vivo experiments, but the results and evaluation methods used may be useful in creating new transcatheter heart valve bioprosthesis.

This article provides an overview of the literature on the issue of minimally invasive hybrid revascularization in patients with stable multivessel coronary artery disease. It is announced design of randomized study HREVS (Hybrid REvascularization Vs Surgery), to compare the results of myocardial revascularization using three strategies: 1) hybrid revascularization minimally invasive on pump coronary artery bypass surgery LIMA to LAD (MID CAB) and stenting of other coronary arteries using drug-eluting stents); 2) coronary artery bypass grafting with cardiopulmonary bypass; 3) multivessel coronary stenting with drug-eluting stents.

Purpose. To assess the value of cardio-ankle vascular index in patients with coronary artery disease with different types of left ventricular diastolic dysfunction (LVDD ).

Materials and methods. The study included 223 patients with CHD within the register prior to bypass surgery, the groups were identified with different types LVDD and its absence. Cardio-ankle vascular index (CAVI) was evaluated on the unit VaSera-1000.

Results. LVDD detected in 78 % of patients, when comparing groups differences in the values of CAVI is not revealed. Independent predictors of the LVDD presence in CHD patients were increasing age and the presence of multivessel coronary artery disease.

Purpose. Сomparing the level of cardiovascular health among the rural population of the Republic of Adygea in people with and without cardiovascular disease based on age, ethnicity, and education.

Materials and methods. The study included 364 adults in rural zhitelya: 151 male (41.5 %) and 213 women (58.5 %), of which 258 Russian (70.9 %) and 106 Circassians (29.1 %). The average age of the patients was 51,78±16,17 years. 7, each of the risk factors (smoking, BMI, physical activity, diet, total cholesterol level, blood pressure, and fasting glucose) points were assigned numbers from 0 (poor) to 2 (good) depending on the presence of the factor and degree of correction. The maximum total figure was 14 points, and the good state of health reflects the absence of cardiovascular disease (CVD) with a maximum of 7 points under the factors. Comparing the frequency of registration of «good», «average» and «poor» health status in groups performed using χ2 test. Cardiovascular health relationship with risk factors, education level, ethnicity, and age was assessed using multivariate regression analysis.

Results. Ideal cardiovascular health is registered in 25 patients (6.8 %; 95 % CI 4,3–9,5): 88 % (95 % CI 75,3–100) – women, 88 % (95 % CI: 75, 3 100) – Russian; 52 % (95 % CI 32,4–71,6) with higher education. On the overall level of cardiovascular health statistically significant influenced by factors such as age (p<0.0001), the presence of cardiovascular health (p<0.0001), ethnicity (p<0.0001), educational level (p=0.004). Worst level of cardiovascular health had patients with the lowest levels of education combined with older age. Circassians had the worst performance SSzdorovya, taking into account age, gender, level of education and the availability of additional cardiovascular disease.

Conclusion. The level of cardiovascular health among the rural population of the Republic of Adygea low. The presence of cardiovascular disease is not accompanied by the rejection of an unhealthy lifestyle. Socio demographic portrait of a villager with a perfect cardiovascular zdorovem- young woman with higher education.

Today remains a topical issue of studying risk factors for stroke. One such factor is the level of pathological ankle-brachial index and gender sensitive.

Purpose. The purpose of the study. To examine gender-specific factors associated with a pathologic ankle-brachial index (ABI) in patients with acute violation of cerebral circulation (cerebral vascular accident).

Materials and methods. The patients were evaluated with the presence of cardiovascular disease, previous cardiovascular events, type, and subtype of stroke, neurological status. To assess the presence of atherosclerosis performed color duplex scanning of brachycephalic arteries and laboratory studies (lipid profile).

Results. In the present study, no significant differences in the value of ABI in men and women with acute ischemic stroke (37.0 and 42.3 % respectively, p=0, 29). However, there are gender differences in factors associated with the presence of a pathological ABI. Independent factors associated with abnormal ABI in men, are the increased levels of LDL cholesterol (p=0.02), KIM thickening (p=0.04), presence of bilateral stenosis GCA (p=0.0002) and extent of stenosis of the carotid arteries (p=0.03); in women – only the presence of bilateral stenosis GCA (p=0.03).

Conclusions. Evaluation of LPI is appropriate in patients with stroke, regardless of gender to identify the groups with increased risk of subsequent cardiovascular events and for targeted preventive actions.

The registries of acute coronary syndrome (ACS) are significant tools of obtaining objective data on triage and management of patients in clinical practice.

Purpose. To assess the compliance with clinical practice guidelines and its association with clinical outcomes in patients with non ST-segment elevation acute coronary syndrome (NSTE-ACS) in Russian hospitals, participating in the ACS registry RECORD-3.

Materials and methods. The analysis was conducted based on the data of the Russian ACS Registry RECORD-3, which included 47 hospitals from 37 Russian cities. 2370 consecutive patients with ACS admitted to participating hospitals in the period from March to April, 2015 were enrolled in the registry. Out of those, 1502 (63.4 %) patients were present with NSTE-ACS. The compliance with clinical guidelines was assessed using the following criteria: the implementation of the class I-A or I-B recommendations from 2015 European Society of Cardiology guidelines. The number of recommendations used by physicians (from 8 to 15) was calculated for each patient. The number of implemented recommendations was calculated and presented as percentage.

Results. 100 % implementation rate of the class I-A or I-B recommendations was determined in 1.4 % of patients. Over 75 % of the recommendations were implemented in 19% of patients, and less than 50 % – in 14.6 % of patients. The median implementation rate of clinical guidelines was 63.6 % (the first-third quartiles of 54.5–72.7 %). The proportion of patients with the first and the second quartiles of implemented clinical practice guidelines (poor management) was 54.0 %. The proportion of patients with the third and the fourth quartiles (good management) was 46.0 %. The mortality rate in the group of patients with good physician compliance with clinical practice guidelines was 1.0 %, whereas in patients with poor physician compliance, it was 3.7 % (p=0.0015). The independent predictors of poor physician compliance with clinical practice guidelines were identified and included Killip class IV congestive heart failure, admission to a “non-invasive” hospital, as well as self/family referrals to the hospital, positive history of atrial fibrillation, the absence of ST-segment depression and elevated troponin levels, non-use of acetylsalicylic acid and angiotensin-converting enzyme / sartana, initial blood glucose levels ≤6 mmol / l.

Conclusion. 75 % of clinical guidelines for the management of patients with NSTE-ACS were implemented by physicians only in 19 % of patients; the in-hospital mortality in patients assigned to poor physician management was significantly higher than in patients with good management (3.7 % vs. 1.0 %, p=0.0015); the independent predictors of poor physician management were determined, allowing defining a group of ACS patients, who require active and complete implementation of clinical practice guidelines by physicians

Purpose. To compare memory, attention and cognition status in patients with Ischemic heart disease (IHD), before, at early (5–7 days) and long-term (30–40 days) periods after implantation of permanent pacemaker, depending on initial rhythm and conductivity disorders.

Materials and methods. 80 patients with IHD: 1st group: 23 patients with atrial fibrillation (AF): 2nd group: 57 patients with the syndrome of sick sinus syndrome (SSS) and/or atrioventricular block (AVB) of a high degree were evaluated for memory, attention and cognition status, before and early (5–7th day) and long-term (30–40th day) periods after implantation of permanent pacemaker, considering initial rhythm and conductivity disorders.

Results. Patients of both groups demonstrate decrease in memory, attention and cognition indexes. Implantation of permanent pacemaker at an early period resulted in improvement of certain cognitive functions, predominantly in patients with initial SBWS and AVB than with AF. At long-term period, cognitive functions declined in both groups, likely due to increase of personal and situational anxiety and adaptation to pacemaker work.

Conclusion. Permanent pacemaker at early periods improve cognitive function indexes depending on initial rhythm and conductivity disorders. At long-term periods after a month, its decline occurs.

The report describes the case of slow/slow type of atrioventricular nodal reentrant tachycardia in first degree atrioventricular block which simulate atrial ectopic or orthodromic tachycardia. Differential diagnosis technique is described and mechanisms of the phenomenon are illustrated.

Now the rehabilitation of patients with aphasia after ischemic stroke consist of techniques to restore articulation apparatus in accordance with the federal assistance program for cardiovascular patients, while the pathogenesis of speech disorders in aphasia in most cases is much more complicated than the simple dysfunction articulation, and it involves a violation speechmental activity in general, and as a result – a violation of the nominative function of language. Anthropocentric paradigm of language learning, replacing central sistemic aimed at the study of linguistic phenomena from a cognitive point. Cognitive linguistics not only helps to understand the mechanism and speechmental and speechgeneric human activity but allows effects on links of these processes, in particular the reduction of speech in patients with aphasia. The proposed concept of the voice of resocialization aimed at the rehabilitation of patients with ischemic stroke due to the excitation of new functional areas of the brain are unaffected and not involved before by the activation of brain areas when damaged morphological Broca and Wernicke zones as a result of a stroke. Application personolal sociolinguistic factors and rehabilitation (profession, hobbies, education, gender and other) allows to personalize developing a universal technique in each case. 
The effectiveness of rehabilitation in aphasia is possible to evaluate the use of NIHSS, and MMSE score, including elements of neuropsychological testing and functional magnetic resonance imaging (fMRI) based on the sequence of BOLD.

Purpose. Warfarin, an indirect anticoagulant, is commonly prescribed to patients who are at high risk for thrombotic complications. The achieved target hypocoagulation range allows to prevent thrombotic and hemorrhagic complications. Centralized international normalized ratio (INR) control increases the time in therapeutic range, improves quality control, reduces the rate of hospitalizations for bleeding and thromboembolism, suggesting its economic efficiency and allows to recommend this method of INR control for practical use. The current article presents the rationale for implementing centralized IRN control in the Kuzbass region in order to improve the efficiency and safety of ACT.