The aim of the work was to evaluate the hydrodynamic characteristics of the heart valve bioprosthesis «UniLine», intended for prosthetics of the aortic valve.

Materials and methods. In the contest three prostheses «UniLine» with a size of 21, 23, 25 mm, intended for clinical use. The evaluation of the hydrodynamic parameters was carried out in a Vivitro pulsating flow setup (Vivitro Labs, Canada) simulating the operation of the «left» half of the heart. Estimated hydrodynamic function of all prostheses when creating the physiological mode of operation of the unit - impact volume = 70 ml, minute volume = 5 l/min, mean aortic pressure = 100 mmHg.

Results. The average trans-prosthetic gradient was 5,4-15,5 mmHg.; the maximum trans-prosthetic gradient was 11,9-25,2 mmHg; effective orifice area 1,38-2,15 cm2; regurgitation fraction 1,5-3,905%; productivity index, calculated from the inner orifice diameter 47,4-68,5%.

Conclusion. Bioprostheses «UniLine», intended for aortic position, demonstrated satisfactory hydrodynamic in vitro characteristics, comparable with existing world analogues. The existing design has the potential to increase hydrodynamic efficiency, but requires advanced approaches and methods, such as FSI, for its implementation. 

Abstract. To endow the luminal surface of the vascular grafts of functional, we applied arginine-glycineaspartic acid (RGD)-containing peptides, which are the ligands for integrins.

The aim to study the effect of modification of small-diameter vascular grafts from polycaprolactone on the patency, speed and quality of endothelization of the internal surface after implantation of grafts into the abdominal part of the aorta of small laboratory animals by the RGD peptides.

Materials and methods.Vascular grafts diameter 2 mm were fabricated of poly(ε-caprolactone) (PCL) using electrospinning following optional conjugation with RGD peptides by the method of carbodiimide binding. The surface morphology, physical-mechanical properties of PCL and PCL-RGD grafts was studied before implantation. Either PCL and PCL-RGD grafts were implanted into abdominal aorta of rats for 1, 3, 6, or 9 months following explantation along with the adjacent aortic regions and further histological and immunofluorescence examination.

Results. We found that immobilization of RGD peptides at the luminal surface did not alter structure and mechanical properties of PCL grafts. Primary patency of the RGD-treated grafts was 50% higher while the prevalence of inflammation was 2-fold lower compared to PCL grafts at all the time points. Moreover, we identified CD31+vWF+ cells at the luminal surface of RGD-PCL grafts as early as 1 month postimplantation in comparison with 3 months postimplantation in PCL grafts.

Conclusion. Immobilization of RGD peptides at the PCL grafts increases the primary grafts patency, induces rapid endothelialization and decreases granulomatous inflammation. 

The purpose. Determination of tissues of physico-mechanical properties of demineralized bone matrix of spongy and compact human bone important for bioengineering.

Material and Methods.The methods for studying micromorphological, piezoelectric and transport properties, adapted for measuring the materials of potential scaffolds.

Results. The results of studying the physico-mechanical properties of the demineralized bone matrix of spongy and compact human bones are presented. It is shown that the demineralized spongy bone possesses the best characteristics of the pore system for the colonization of matrix cells. The tensile strength and modulus of elasticity of samples from the demineralized heads of the femurs extracted during the initial hip arthroplasty vary widely. The modulus of elasticity varied from 50 to 250 MPa, and the ultimate strength was from 1.1 to 5.5 MPa.

Conclusion. Methods for measuring micromorphological, piezoelectric and transport properties for materials of potential matrices were developed and / or adapted. It is shown that in the samples of materials from the human bone, these characteristics, as a rule, vary considerably. Proceeding from this, it becomes obvious that the development of protocols of measurement methods of the above listed properties is an important work for the creation of technology of bioengineering of tissue implants for reconstructive surgery. 

The purpose. Assessment of the contribution of CRP gene polymorphisms rs3093077, rs1130864 and rs1205 to the development of atrial fibrillation (AF) in CAD patients depending on gender and age.

Material and methods. The study included 302 patients with stable coronary artery disease. C-reactive protein (CRP) concentration was measured by high-sensitive immunoturbidimetric assay. The genotyping was performed in 96-well plates using TaqMan assay.

Results. The elderly age > 65 years and the presence of type 2 diabetes mellitus are the clinical and anamnestic predictors of AF development (р=0.003; 0.01). G/A rs1130864 CRP heterozygous carriers have a 4-fold increased risk of AF development among the patients with coronary artery disease (p=0.0025) according to the overdominant inheritance model. Men who are the carriers of С/Т rs1205 CRP genotype have on average a 5-fold increased risk of AF development in case of CAD presence (according to the overdominant model, р=0.022). A 5-fold increased risk of AF development is associated with men carrying G/A rs1130864 CRP genotype (p=0.015), meanwhile the men < 65 years, who carry the same genotype (rs1130864 CRP), have a 9-fold increased risk of AF development (p=0.025), as compared to the patients who are the carriers of other genotypes.The patients of both genders < 65 years, carrying the С/Т rs1205 CRP genotype, have a 10-fold increased risk of AF development as compared to the carriers of other genotypes (OR =10.03 (1.26-79.59); 95% CI).

Conclusion. The genetic markers should be considered to assess the risk of AF development. 

Introduction. The modern development of chemistry and chemical technologies allow us to produce synthetic materials that exhibit physical characteristics similar to the characteristics of the tissues of the body, a satisfactory biocompatible and thromboresistant. Such materials are demanded in vascular surgery, but their practical use is required to improve their biological properties, namely the ability to form normal endothelium on the inner surface and the cell layers inside the wall. Biodegradable synthetic polymeric 3D matrices, populated by functional endothelial (EC) and smooth muscle (SMC) cells of the recipient can be a suitable option for reconstructive surgical interventions on the vessels.

The purpose. To evaluate bio - and hemocompatible of the tissue-engineered polycaprolactone scaffolds, seeded by donors EC and SMC in experiment in vivo.

Materials and methods. 3D-matrices (polycaprolactone+ gelatin) made by electrospinning method, seeded in vitro human EC and SMC, which were obtained from heart tissue. Cells were cultured on these matrices for 7 days, then were implanted in the abdominal aorta of 23 SCID mice. 3D matrices without cells were implanted 12 mice for control. After 2, 4, 12 and 24 weeks after implantation, performed ultrasound scan and MRI of the abdominal aorta, immune histological studies explanted patches.

Results. Polycaprolactone patchs seeded by functional EC and SMC enhanced local neovascularization in the area of their implantation, with the development of a vascularized fibrous capsule, promote adhesion and proliferation of EC and SMC, provide good patency of the mice abdominal aorta during 24 weeks of observation. Conclusion. Cell-populated polycaprolactone matrices can be used to create patient-specific vascular grafts. 

Abstract. A scaffold usage for the cell culturing is a widespread tissue engineering approach, including culturing in a bioreactor, however the effective use of a bioreactor requires adaptation of the scaffold at the stage of its design. In our opinion, this means assessment of the perfusion properties of the scaffold.

Aim of the study: Aim of the study was the assessment of the perfusion properties of a scaffold sheet made of 11% w/v polycaprolactone (PCL) composite material with gelatinization of 0.5%, 2%, and 4% w/v and fabricated with different electrospinning parameters and hydrostatic pressure (5, 10, and 15 mm Hg).

Materials and methods: To produce composite material, polycaprolactone, gelatin (type B), and solvents: 1,1,1,3,3,3-hexafluoroisopropanol, 2,2,2-trifluoroethanol and chloroform were used. Three composite variants of 11% w/v PCL with gelatinization of 0.5%, 2%, and 4% w/v were prepared. Perfusion properties of the scaffold sheet were assessed with an original experimental equipment. Structural analysis was carried out using the laser confocal microscopy.

Results: Polymer scaffold sheet fabricated with electrospinning demonstrated the possibility of the transverse and longitudinal perfusion through the sheet under hydrostatic pressure of 5, 10, and 15 mm Hg. Also was found what time of 1 mL saline transverse and longitudinal perfusion through a PCL electrospun sheets depends from gelatinization and electrospinning parameters (transverse perfusion time of the sheet fabricated with the electrospinning collector speed of 450 rpm was 10 times lower than sheets fabricated with speed 90-180 rpm), with equal samples thickness and perfusion pressure.

Conclusion: An obtained results allows to optimize the polymer scaffold fabrication process with electrospinning to achieve the optimal characteristics of the perfusion through the scaffold. 

The purpose. To estimate hospital and three-year results of reperfusion treatment in pulmonary embolism (PE) patients.

Methods. One-center prospective study included 30 patients with intermediate high-risk and high-risk acute PE that had indications for reperfusion: thrombolytic therapy (TLT) and / or surgical thrombectomy. The endpoints of the study in the hospital and long-term follow-up period were such unfavorable cardiovascular events as death, myocardial infarction, acute cerebrovascular accident / transient ischemic attack, re-PE.

Results. It was shown that reperfusion treatment had satisfactory rates of hospital survival (97%), efficacy, with significant regression of clinical symptoms and pulmonary hypertension (from 56.93 ± 17.18 to 36.72 ± 14.47 mm Hg.). There was a significant decrease of tricuspid insufficiency (from 77% initially to 24% at the time of discharge) (p <0.05). After 3 years, the rate of fatal outcomes reached 33%, most of which occurred in the TLT group and was associated with re-PE. Fifty fife percent of the surviving patients had pulmonary hypertension, 15% had major or segmental perfusion defects according to perfusion lung scintigraphy (PSL) data.

Conclusion. The presence of significant pulmonary perfusion defects according to the results of PSL in one out of seven surviving patients in more than half of the cases is likely to be a result of insufficiently frequent use of the surgical option of treatment in clinical practice. The high frequency of fatal outcomes in the long-term follow-up period, realized through re-PE, indicates insufficient compliance of patients to medical therapy. 

The purpose. Тo study set of the risk factors (RF) which are most significantly connected with risk of coronary atherosclerosis at men with the metabolic syndrome (MS).

Material and methods. The research included 82 men from MS by criteria of ВНОК, 2009, at the age of 39 - 73 years (56,42±7,3 years). Group 1 (n=40), patients with MS and a coronary heart disease: angina of pectoralis of IIIII f.cl. and a coronary atherosclerosis according to a coronaroangiography, group 2 (n=42), patients about the MS which don’t have a coronary heart disease: angina of pectoralis and symptoms of coronary atherosclerosis. In groups of comparison the analysis of the main and additional metabolic RF and by means of a method of logistic regression search of the most adverse set of RF bound to a coronary atherosclerosis at patients with MS was carried out.

Results. At patients of group 1 (n=40) higher rates of insulin (р<0,001), HOMA-IR index (р<0,001), Apo B (р<0,05), LPa (р<0,05), IL-6 (р<0,05), ФНО-α (р<0,05), CRP (р<0,05) and lower indicators of ApoA1 (р<0,05), apelin (р<0,001), than in group 2 (n=42) were defined. The predictors which are the most significantly connected with coronary atherosclerosis at patients with in steel MS: apelin, ApoB, insulin, IL-6, CRP and waist circumference.

Conclusion. The received set of predictors allows to choose more perspective and schemes of prophylaxis of cardiovascular complications at patients with MS are rational. The obtained data, are also valuable material for carrying out further scientific research with studying of a role of neurohormonal and pro-inflammatory activity of visceral adipose tissue in risk of development of a coronary heart disease in patients with MS.

The purpose. Мodification of scanning electron microscopy method in backscattered electrons to research biological samples with massive metal or mineral inclusions.

Materials and methods. In the article the alternative method without cutting sections were supplied. Samples for researching (plates from NiTi surrounded by tissues after subcutal implantation, explanted stents, explanted epoxy covered xenoaortic bioprosthetic heart valves , explanted biodegradable vascular grafts from rats abdominal aorta) were embedded in epoxy risin, polymerized, made surface slices from blocks with samples, contrasted by uranyl acetate and lead citrate and researched in backscattered electrons.

Results. By using the proposed method samples acquired composite contrast and subcellular structures had good visualization in scanning electron microscopy.

Conclusion. Our research showed availability this method to research microstructural characteristics of contacts between hard material and biological tissues and to analyze cellular structure on implant- tissue border. Besides, this method is universal for researching different biological samples, and it has special advantages for research materials with volumetric metal and mineral inclusions. Another advantage of this method is ability to research samples with large square of surface, what can’t be made by using transmission electron microscopy method. 

Purpose. To assess factors associated with pre-hospital delay in seeking medical care in patients with myocardial infarction.

Materials and Methods: 51 patients with myocardial infarction, included in the original single-center research trial, were surveyed to assess the differences in the time intervals from the onset of symptoms to the decision to seek medical care, as well as the factors, associated with delay in calling emergency medical service.

Results. We found that the majority of patients (> 70%) with myocardial infarction, admitted to the Kemerovo Regional Clinical Cardiology Dispensary, applied for medical care within 6 hours from the onset of symptoms. However, there was a group of patients with increased pre-hospital delay time. Patient delay may affect the effectiveness of treatment for acute coronary syndrome. These patients were commonly of younger age and males, with higher education working in the urban areas. Information campaigns targeted at this group of patients should be launched to raise their awareness and highlight the crucial role of prompt and timely calling EMS after the onset of myocardial infarction.

Conclusion. It seems to be a rationale to launch informational campaigns targeting this group of patients (young working men living in large industrial cities) to highlight the importance of early and prompt seeking of medical care after the onset of MI symptoms. 

Abstract. The aim of the study was a quantitative assessment of abdominal and epicardial depot visceral adipose tissue with the use of modern methods of tomography in patients with stable coronary heart disease (CHD).

Material and methods. 88 patients were examined with multislice computed and magnetic resonance tomography.

Results. According to a survey of abdominal visceral obesity was observed in 70.4% of the sample of patients and only 35.2% identified BMI. In patients with CHD severity of abdominal and epicardial visceral obesity is not dependent on sex. Separating patients under standard boundary values of visceral fat area (130sm²) revealed significant differences in the layer thickness of both the left epicardial fat (p = 0.00015) and right ventricle (p = 0.00126).

Conclusion. Approaches to the definition of obesity, currently used underestimate the true prevalence of this pathology. Morphometric evaluation of visceral fat depot using tomographic techniques can reliably and noninvasively verify adipose tissue and highlight the category of patients with visceral obesity. 

The review presents data describing the current state of knowledge about the link between gut microbiota, obesity and metabolic syndrome. Pathophysiological role of gut microbiota in the development of obesity and metabolic syndrome is discussed. Potential of alternative therapy in controlling energy consumption and reducing the prevalence of obesity and metabolic syndrome is considered.

Here we review the modifications of the metal stents to enhance in situ endothelialization, particularly antibody-mediated adhesion of endothelial progenitor cells. We focus on the strategies employing cell adhesion molecules and extracellular matrix proteins. We also encompass other physical and chemical approaches for surface biofunctionalization with their advantages and shortcomings.

Here we review the recent literature on adhesive disease, a common complication of surgery. In particular, we focus on drug-eluting electrospun adhesion barriers fabricated of biodegradable polymers. This can be a promising approach for the development of novel adhesion barriers.

Ischaemia/reperfusion cardiac injury contributes to morbidity and mortality during percutaneous coronary intervention, heart surgery and transplantation. Even when the recanalization of an infarct-related coronary artery is carried out successfully, there is still a risk of death due to reperfusion injury. Numerous pharmacological interventions have been found in experiments on animals. However, the translation of these interventions to clinical practice has been disappointing. None of the drug treatment has been able to improve in-hospital mortality of patients with acute myocardial infarction. The search for pharmacological agents able to salvage myocardium during reperfusion continues. Opioid receptor (OR) agonists represent one of the promising group of drugs for treatment of patients with myocardial infarction. It has been found that µ-, δ- and κ-OR agonists are able to attenuate heart injury when administered before or at the beginning of reperfusion. However, what kind of OR receptors need to be activated in order to protect the heart during reperfusion and the precise mechanism of this effect have yet to be elucidated.

Adipose tissue is of interest in the context of its role in pathogenesis of cardiovascular diseases, endothelium and myocardium dysfunction, hypertension, atherosclerosis and a number of other pathological conditions. The accumulation of knowledge about secretory functions of adipocytes is leading to recognition of the role of adipose tissue in regulation of cardiovascular system functioning. Studies of molecular-genetic basis of the functioning of adipose tissue can help to understand etiopathogenetic mechanisms of cardiovascular diseases and develop an effective strategy for their prevention and control. In this review, the information about adipokines and cytokines secreted by various types of adipose tissue (subcutaneous, epicardial, perivascular), as well as changes in the expression of key genes in adipocytes obtained from various fat depots in patients with cardiovascular diseases was analyzed.

Coronary artery bypass grafting (CABG) remains the gold-standard treatment for coronary artery disease (CAD). Preoperative management (prehabilitation) and postoperative rehabilitation are pivotal for positive effects of myocardial revascularization. Ischemic preconditioning is one of the methods for cardioprotection in the preoperative period. Exercise trainings may have beneficial effects on ischemic preconditioning in the preoperative period, limiting infarct size, producing antiarrhythmic effects, and improving endothelial function. Exercise trainings produce beneficial effects on the outcomes of surgical treatment.