Highlights. The importance of psychological assessment and psychological support in Cardiology Departments has been demonstrated. For the first time, predominant coping strategy in cardiac patients was revealed.
Background. Why do patients with the same disease, disease course, prognosis and treatment have different outcomes? One hypothesis points to the influence of internal resources used in coping with the disease. A.B. Smulewicz in 1984 identified the association between the clinical symptoms and mental state of the patient.
Aim. To determine characteristics of coping behavior and attitude toward health in cardiac patients from Surgical and Therapeutic Departments.
Methods. 122 patients admitted to the State Autonomous Healthcare Institution “N.A. Semashko Republican Clinical Hospital” were included in the study. The 1st group consisted of in-patients from the Department of Surgical Treatment of Heart Rhythm Disorders and Electrical Cardiac Stimulation (61 patients); the 2nd group consisted of patients from the 1st Cardiology Department (61 patients). A questionnaire developed by R. Lazarus and S. Falkman in 1988 was used to determine coping strategies, and a questionnaire developed by R. A. Berezovskaya in 2005 was used to assess attitudes towards health.
Results. Active coping strategy predominates in surgical patients, and distancing and avoidant strategies predominate in therapeutic patients. Correlation between characteristics of coping strategy and attitudes toward health was analyzed: active coping strategies are accompanied by high behavioral, cognitive, and emotional aspects. An inverse correlation is noted in distancing and avoidant coping strategies.
Conclusion. Psychological comfort and correct attitude of patient to his/her disease is an important part of rehabilitation that highlights the significance of psychometric testing in cardiac patients.

Highlights. Patients with coronary artery disease and age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) who underwent elective on-pump coronary artery bypass grafting are at higher risk of developing cardiovascular complications, non-infectious complications, and death.
Musculoskeletal disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) in combination with traditional predictors (age, diabetes mellitus, prior myocardial infarction and stroke, cancer) are risk factors for unfavorable prognosis of postoperative period of coronary artery bypass grafting. 
Aim. To assess risk factors for unfavorable prognosis in patients with coronary artery disease (CAD) undergoing elective on-pump coronary artery bypass grafting, taking into account age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia).
Methods. This single-center study included 387 CAD patients admitted for elective coronary artery bypass grafting. Taking into account the diagnosed age-related disorders, four groups of patients were formed. The first group consisted of 52 (13.4%) patients with sarcopenia, the second group was comprised of 28 (7.2%) patients with osteopenia (osteopenia/osteoporosis), the third group included 25 (6.5%) patients with osteosarcopenia, and the fourth group consisted of 282 (72.9%) participants with coronary artery disease and without musculoskeletal disorders (MSD). Risk factors for a composite endpoint (myocardial infarction, stroke, paroxysmal atrial fibrillation, cardiac rhythm disturbances) and death, and noninfectious complications (resternotomy for bleeding, pneumothorax aspiration and thoracentesis) were assessed.
Results. The composite endpoint occurred more frequently in patients with osteopenia (group I – 9.6%, group II – 32.1%, group III – 12%, group IV – 12.8%; p = 0.029), and non-infectious complications occurred more frequently in patients with sarcopenia and osteosarcopenia (group I – 17.3%, group II – 7.1%, group III – 12%, group IV – 5.3%; p = 0.002). MSD were associated with the risk of composite endpoint (odds ratio (OR) 1.73, p = 0.035), and osteopenia increased it three-fold (OR 3.01, p = 0.046). Moreover, MSD were associated with higher risk of non-infectious complications (OR 1.71, p = 0.026), especially in patients with sarcopenia (OR 2.02, p = 0.034). The assessment of risk factors for unfavorable prognosis highlighted the presence of osteopenic syndrome (100 CU), prior stroke (88 CU) and myocardial infarction (85 CU). The risk of non-infectious complications was associated with prior ischemic events (ranking level for myocardial infarction – 100 CU, stroke – 75 CU), and MSD (89 CU) and its types (osteosarcopenia – 77 CU, osteopenia – 69 CU, sarcopenia – 52 CU).
Conclusion. Age-related disorders in combination with MSD increase the risk of a composite endpoint and non-infectious complications by one to three times.

Highlights. Biomarkers of acute kidney injury and their effect on the frequency of recurrent coronary events in patients with myocardial infarction after percutaneous coronary interventions.
Aim. To study biomarkers of acute kidney injury (AKI) and prognosis, as well as the frequency of recurrent cardiovascular events in patients with myocardial infarction and percutaneous coronary interventions.
Methods. 166 patients with myocardial infarction and performed percutaneous coronary interventions were studied, divided into 2 groups: with acute kidney injury (n = 91) and without it (n = 50), the control group consisted of 25 people. All patients underwent standard general clinical and biochemical blood tests to assess the level of C-reactive protein, markers of myocardial necrosis, natriuretic peptide (NTproBNP), microalbuminuria (MAU). In both groups, the glomerular filtration rate (GFR) was calculated using the CKD-EPI formula. An increase in serum creatinine by 26.5 mmol/L or more during the first 3 days from the value at admission was the reason for the study of the level of Kidney Injury Molecule-1 (KIM-1) and interleukin 18 (IL-18) in urine on the 3rd and 14th days from hospitalization. All patients underwent coronary angiography and stenting of the infarct-dependent artery. 6 months and 1 year after discharge for this acute coronary event, repeated examinations of patients were performed to assess the frequency of repeated cardiovascular events and kidney function.
Results. It was revealed that the creatinine level in the examined patients did not differ statistically significantly at admission, but there was a decrease in the filtration function of the kidneys in patients with AKI. On the third day of hospitalization, there was an increase in creatinine levels in the first group of patients with a decrease in GFR. The level of the KIM-1 and IL-18 molecules on the 3rd day of hospitalization in the first group was higher than the corresponding indicator of the comparison group. Also, patients with AKI showed a significant increase in the level of NTproBNP and MAU in the early period of kidney damage. When studying correlations, it was revealed that the level of MAU in the group with AKI is interrelated with the indicator of C-reactive protein and creatinine on the 3rd day of hospitalization. Also, a positive statistically significant correlation was found between the level of the KIM-1 molecule, IL-18, creatinine level on the 3rd day of hospitalization, NTproBNP and the level of MAU. During the follow-up of patients 6 months and a year after discharge, unstable angina pectoris, myocardial infarction, as well as progression of chronic heart failure were more often detected in the group with AKI. A persistent decrease in kidney function after a year was observed in most patients of the first group.
Conclusion. The data obtained indicate the influence of acute kidney injury on the progression of renal dysfunction and the frequency of recurrent cardiovascular events, which is confirmed by the obtained associative relationships of the level of the KIM-1 molecule, creatinine and GFR with the prognosis of cardiovascular disease. 

Highlights. In the present study, we conducted a retrospective analysis redo mitral valve replacement due to prosthesis failure. Predictors of adverse events and death have been analyzed. The quality of obtained predictors was verified using ROC analysis.
Aim. To analyze predictors of adverse events and death in redo mitral procedure for treating mitral bioprostheses failure.
Methods. The retrospective registry study of catamnesis of patients undergoing treatment for mitral valve prosthesis dysfunction was carried out. The age and gender of patients, medical history, underlying and comorbid diseases, features of primary replacement and reoperation, durability of the primary prosthesis, adverse events and death after redo mitral valve replacement and others (more than 30 factors) were taken into account. Stepwise logistic regression was used for statistical processing. The quality of obtained predictors was verified using ROC analysis.
Results. The results of the study have revealed that there are modifiable risk factors such as cardiopulmonary bypass time, ischemia time, and nonmodifiable risk factors like reoperation, baseline severity of the patient's condition, complications of median resternotomy, concomitant interventions on aortic valve during reoperation. Moreover, treating atrial fibrillation during primary replacement proved to have an overall protective effect.
Conclusion. Тhe only modifiable factors that can be influenced during redo mitral valve replacement due to biological prosthesis failure are cardiopulmonary bypass duration and aortic cross-clamping time.

Highlights. Maze V significantly reduces the recurrence of AF compared to bipolar RFA for PVI in the short and mid-term period.
Aim. To assess the effectiveness and safety of pulmonary vein isolation (PVI) in comparison with Maze V for treating paroxysmal atrial fibrillation (AF) concomitant to coronary artery bypass grafting (CABG).
Methods. Medical records of 139 patients with coronary artery disease and concomitant paroxysmal AF were retrospectively analyzed. All patients were divided into two groups: Group 1 patients (n = 71) underwent CABG + bipolar radiofrequency ablation for PVI, and Group 2 patients (n = 68) underwent Maze V + CABG. Propensity score-matched (PSM) analysis with a 1:1 nearest-neighbor matching was done. 30 patients were selected from each group. The exclusion criteria were as follows: emergent CABG, concomitant valvular heart disease, non-paroxysmal AF, decompensation of chronic diseases, and cancer. On-pump CABG was performed at normothermia with warm blood hyperkalemia cardioplegia. RFA for PVI and Maze V were performed before CABG under parallel perfusion without aortic cross-clamping. The primary and secondary endpoints included recurrent AF/atrial flutter, sinus rhythm at discharge and in the long-term period, permanent pacemaker implantation, major cardiovascular and cerebrovascular events.
Results. After the PSM analysis, the CABG+Maze V group and CABG+RFA for PVI differed significantly in the duration of surgery (330 [310; 375] vs. 255 [225; 270] min, p = 0.0001), cardiopulmonary bypass time (131 [113; 144] min vs. 89 [74; 98] min, p = 0.0001), duration of AF treatment (53 [44; 59] min vs. 10 [9; 12] min, p = 0.0001). The structure and rate of complications in both groups were comparable. There were no in-patient deaths. Recurrent AF/atrial flutter significantly reduced in the CABG+Maze V group compared to the CABG+RFA for PVI group (13.3% vs. 33.3%, respectively; p = 0.044). Sinus rhythm was restored in all cases. The rate of transient sinus node dysfunction (no more than 5 days) was 6.7% in the Group 1 and 16.6% in the Group 2. The difference did not reach statistical significance (p = 0.128). The 12-months cumulative freedom from AF/atrial flutter without antiarrhythmic drug therapy was significantly higher in the CABG+Maze V group compared to the CABG+RFA for PVI group (97% vs. 83.5%, respectively; p = 0.020). The freedom from MACE in both groups was 96.7%.
Conclusion. Maze V for treating concomitant paroxysmal AF prolonged the duration of cardiopulmonary bypass and the surgery itself, but did not affect the postoperative period, indicating its safety and effectiveness. Maze V procedure concomitant to CABG significantly reduced the recurrence of AF compared to RFA for PVI both in the short- and mid-term period. Thus, it is reasonable to perform Maze V+CABG in patients with paroxysmal AF and a high risk of disease progression.

Highlights. For the first time, as part of a prospective randomized study, a comparative assessment of the mid-term results of mitral valve annuloplasty using a new biological NeoRing ring (CJSC NeoKor, Kemerovo) and a RIGID ring (CJSC NPP MedInzh, Penza) in patients with connective tissue dysplasia was carried out. Predictors of the conversion of sinus rhythm to atrial fibrillation and residual mitral insufficiency in the medium-term follow-up period were determined.
Aim. To analysis and compare mid-term results of mitral valve annuloplasty conducted using NeoRing и RIGID rings.
Methods. From November 2019 to March 2022, 62 patients with mitral valve (MV) dysplasia underwent MV annuloplasty using NeoRing semi-rigid rings (CJSC NeoKor, Kemerovo, n = 31) and rigid RIGID rings (CJSC NPP MedInzh, Penza, n = 31). There were no differences between the groups at baseline.
Results. Two deaths were registered during inpatient treatment in the RIGID group. Both devices showed a satisfactory outcome during inpatient treatment in the form of restoration of MV function (p<0.001) and the frequency of detected maximum residual mitral regurgitation (MR) up to grade 1 in the NeoRing group 9.7% and in the RIGID group 29%, respectively, no statistically significant intergroup differences were noted (p = 0.292). After 12 months, freedom from ≥2 grade MR in the NeoRing group was 93.5% and 77.4% in the RIGID group (p = 0.147). In the RIGID group, patients had higher values of the transvalvular mitral diastolic gradient – PAV 3.70 [3.00–4.40] mm Hg vs. NeoRing group 2.3 [2.05–2.85] mmHg (p<0.001), as well as a higher transvalvular flow rate – VAV 79 [71–94] cm/sec vs. 70 [64–79] cm/sec (p = 0.017). The analysis of the achievement of composite primary endpoint (recurrence of ≥2 grade MR, MACCE, new onset arrhythmias, reoperations) by the device was carried out. The composite endpoint rate in the RIGID group was 3.067 times higher compared to the NeoRing group, odds differences were statistically significant (p = 0.037, 95% CI: 1.053–8.934).
Conclusion. The outcome of MV annuloplasty conducted using rigid and semi-rigid rings revealed no significant differences in long-term survival and recurrence of MR between groups. Given the statistically significant difference in achieving the combined endpoint, lower inpatient and long-term indicators of transmitral pressure gradient, and a positive effect on cardiac chambers reverse remodeling, it was concluded that the use of semi-rigid NeoRing rings for MV annuloplasty when performing valvepreserving operations for connective tissue dysplasia is preferable.

Highlights. The process of updating the procedures for providing medical care services affects the quality and safety of patients. The current requirements and the results of public health surveillance are analyzed. Hypotheses have been formed for expert analysis in case of update of regulatory and administrative laws.
Aim. To analyze the procedures for providing medical care services to further search for appropriate updating mechanisms.
Methods. The study focuses on the analysis of the current procedures for provision of medical care services to the adult population suffering from cardiovascular diseases, and the analysis of 1319 reports published by governmental organizations during public healthcare surveillance for the period from 2015 to 2019 which revealed violations of the procedures for provision of medical care services to patients with cardiovascular diseases.
Results. The procedures for providing medical care services to patients with cardiovascular diseases contain 983 provisions. 768 (78.13%) of them are equipment standards. Out of the remaining 215 provisions, excluding the equipment standards, 130 (60.46%) meet the criteria for mandatory requirements, and 63 provisions (29.30%) are unique (i.e., not duplicated in other legal acts). Of the 1319 inspections conducted by Roszdravnadzor (Federal Service for Surveillance in Healthcare) in 2015- 2019, 190 cases contained violations of the procedures for providing medical care services to cardiac patients. Of the 308 cases of detected violations, 206 (66.88%) were due to the absence of certain items provided for by the equipment standard. At the same time, 93.14% of all violations that were not associated with the equipment standards, occurred due to violation of 7 provisions of the Order of the Ministry of Healthcare of Russian Federation No. 918n. Identification of pattern of these violations revealed that issues related to the absence of two regulations of the equipment standard in medical organizations have never been addressed.
Conclusion. The procedures for provision of medical care services to patients with cardiovascular diseases contain a relatively small number of mandatory requirements (compared to the total number of provisions contained in the procedures). Identification of the same type of violations of the regulatory act committed by numerous medical organizations indicates necessity to further assess their real contribution to the quality and safety of healthcare. The analysis of the reports published by governmental organizations made it possible to develop hypotheses that can be analyzed as “input” data by experts who participate in the process of updating the procedures for providing medical care services. The existence of data that could initiate the process of updating the procedures (or the process of rejecting the amendments) will assist in systematization of this work.

Highlights. Unique epidemiological data were obtained on the effectiveness of preventive services of healthcare organizations in relation to cardiovascular diseases, adherence to lifestyle modification recommendations, and presence of risk factors for cardiovascular diseases in these citizens.
Aim. To assess healthcare services uptake in large industrial Siberian region, as well as the adherence of population to lifestyle modification recommendations (epidemiological data).
Methods. The study included 729 residents of Kemerovo and Kemerovo region. The assessment of the main risk factors for cardiovascular diseases was carried out in accordance with the Russian recommendations for cardiovascular prevention. Uptake and adherence to lifestyle modification recommendations was assessed using the Health System Assessment Questionnaire of the International Prospective Study of Urban and Rural Epidemiology.
Results. Among the 729 study participants, the urban population is represented by 67.3%, rural – 32.6%. The population was majority represented by women (69.7%). The mean age of participants was 59.0 (51.0; 65.0) years. Smokers accounted for 18.6% of the participants, the majority represented by men (p = 0.000). Excessive weight was more often observed in women (p = 0.013), the mean body mass index in women was 29.5 kg/m2 . The mean values of the analyzed laboratory parameters (cholesterol, low- and highdensity lipoprotein cholesterol, triglycerides, glucose) were within the range of normal values. Previously diagnosed hypertension was noted in 64.6% of the participants, diabetes in 12%, coronary heart disease in about 7%, stroke in 1.6% of the participants. Assessment of cardiovascular risk according to SCORE scale showed that 17% of participants were at low risk, 50% – moderate risk in, and 29.2% – high-very high risk. Upon visiting healthcare provider, only 38.1% of subjects received recommendations for lifestyle changes. Respondents were frequently given recommendations to adjust their diet, followed by recommendations regarding weight loss, increased physical activity; smoking cessation and lower alcohol consumption were recommended less often. Respondents changed their lifestyle significantly more often in accordance with the recommendations received at the time of visit (p = 0.000); out of them, 56.7% had moderate cardiovascular risk, 26.7% had high and very high risk, and low risk according to SCORE – 16.7%. However, study participants were more likely to not follow received recommendations (p = 0.000).
Conclusion. Due to high uptake of healthcare services in the population, high prevalence of risk factors and low adherence of the population to prevention, it can be concluded that the current model of prevention does not work. Innovative tools are needed to manage risk factors for cardiovascular diseases and positively change a person`s lifestyle.

Highlights. It is assumed that pre-colonization by endothelial cells of the inner surface of tissue-engineered vessels of small diameter can serve as an effective way to prevent thrombosis. The question of choosing the optimal source of endothelial cells for use in tissue engineering remains debatable. The paper considers the features of the culture of colony-forming endothelial cells obtained from the peripheral blood of patients with coronary heart disease, in comparison with mature endothelial cells from the coronary artery.
Aim. To study the effect of laminar flow on the morphological and functional characteristics of mature endothelial cells and peripheral blood-derived endothelial colony-forming cells.
Methods. Coronary artery endothelial cells were purchased from the Cell Applications, Inc. Colony-forming endothelial cells were obtained from the peripheral blood of patients with coronary artery disease who underwent percutaneous coronary intervention. The cells were isolated using a Ficoll gradient and cultured in EGM-2MV culture medium containing 5% fetal bovine serum. The cells of the experimental group were cultured in µ-Luer plates in a perfusion system with a shear stress of 3 dyn/cm2 . The cultivation time was 2 days. The cells of the control group were cultured under static conditions. At the end of the cultivation we performed immunofluorescent staining for CD31, KDR/CD309, CD144, vWF, type IV collagen, F-actin.
Results. Colony-forming endothelial cells and coronary artery endothelial cells retained high density and viability both under static and laminar flow conditions. Shear stress stimulated a change in the phenotype of colony-forming endothelial cells towards a mature endothelial cells, in particular, a significant increased the expression of KDR/CD309 and CD31. The action of laminar flow reduced the synthesis of von Willebrand factor, stimulated the synthesis of type IV collagen. Shear stress promoted the development of structural rearrangements in cells in response to transduction, which manifested in a change in F-actin fibrils orientation on the flow direction.
Conclusion. Colony-forming endothelial cells showed a characteristic response to the action of shear stress, consisting in a change in morphology, phenotype, and secretory activity of cells, comparable to that of coronary artery endothelial cells.

Highlights. Notch signaling is known to be important regulator of endothelium homeostasis and cardiovascular disease. Particularly, Notch seems to be associated with pathological changes in endothelium epigenome although no such Notch effects have been found. We have discovered that activation of Notch signaling alters histone 1 repertoire in the human endothelial cells and this is the first example of epigenomic Notch targets.
Aim. The disturbance of blood flow and alteration of physiological shear stress is one of the main reasons for endothelial dysfunction. Mechanosensitive and dosedependent Notch pathway is assumed to be an important player of endothelial dysfunction progression, but the molecular mechanisms of the influence of Notch dysregulation on endothelium are still not understood. In particular, there is no data about possible targets of Notch in the endothelial epigenome.
Methods. Here we focused on the analysis of changes in histone code of human umbilical vein endothelial cells (HUVEC) after activation of Notch. For this purpose, we transduced cells by lentiviruses with construction for Notch 1 intracellular domain (N1ICD) overexpression or by empty vector (control). Then we isolated histone enriched fraction and secretome proteins and performed their shotgun proteomics analysis on timsToF Pro instrument. Proteomics data are available via ProteomeXchange with identifier PXD032978.
Results. We found the shift in proteomics profile of HUVEC caused by Notch activation and, particularly, the increase in the levels of N-terminal acetylated forms of histone 1: H1-0, H1-3, H1-4, H1-5, H1-10. We also found changes in the cell secretome profile which are associated with the decrease in proangiogenic effect of HUVEC secretome.
Conclusion. Our data identified epigenomic Notch targets and we assume that changes in H1 repertoire might be associated with cardiovascular disease progression in vivo.

According to data from large population trials and meta-analyses, mortality in rheumatoid arthritis (RA) significantly exceeds that in the general population. Cardiovascular diseases (CVD) rather widely contribute to the excess mortality in RA patients. Despite the recent emergence of a large number of innovative drugs for RA treatment, CVD mortality in this pathology persists at the level of the cardiovascular risk (CVR) typical for diabetes mellitus. With that, currently there is a clear trend among physicians for underestimating CVR in these patients. The review analyzes discovered pathogenetic mechanisms of CVR development in RA, which are represented by an integrated complex of vascular (endothelial dysfunction), cellular (T-cell dysfunction), and humoral (proinflammatory mediators, autoantibodies, complement activation) disorders. Besides, despite a large amount of disease-modifying antirheumatic drugs that can provide CVR decrease due to selective effects on separate mechanisms, the current lack of comparative trials does not allow to readily define specific drugs that are beneficial for the specific CVD decrease. Due to this, the promising trend of applied clinical medicine presumes the implementation of the interdisciplinary approach to CVR correction in RA patients, which will account not only for the treatment administered by the rheumatologist, but also the risk stratification, patient compliance, and multidisciplinary treatment efficacy control. This will allow for optimal CVD prevention in RA patients, thus significantly improving their quality of life and prognosis.

The cohort of patients with postcapillary pulmonary hypertension (PH), associated with the left heart diseases, is the most numerous, but is still not fully understood. This review presents the pathophysiological aspects of the PH group 2 development as well as the influence of comorbid pathology on the course of the PH. The features of the differential diagnosis of post-capillary PH and combined post-/ precapillary PH, as well as methods of the differential diagnosis of these forms of PH with pulmonary arterial hypertension using modern non-invasive and invasive approaches are discussed.

Oxytocin is synthesized in endothelial cells of the cardiovascular system and exerts its effects by oxytocin receptors. The effect of oxytocin on vascular tone, blood pressure, vascular growth and remodeling, as well as participation in cardiovascular regulation has been proven. The positive effect of oxytocin on infarct size and recovery of contractile function in reperfusion is well studied. It should be noted that the mechanisms of this cardioprotective effect have not yet been studied. Research evidence suggests that oxytocin therapy significantly improves cardiac function, reduces inflammation and apoptosis, and improves scar vascularization. Oxytocin stimulates the transformation of stem cells into clones of cardiomyocytes. Oxytocin promotes angiogenesis by stimulating the formation of endothelial and smooth muscle cells. Increased consumption of glucose by cardiomyocytes, inhibition of cardiomyocyte hypertrophy, and a decrease in oxidative stress are the reasons for the positive effects of oxytocin. Oxytocin reduces inflammation, improves cardiovascular and metabolic function. This is the manifestation of the cardioprotective effect of oxytocin. Potential treatment of cardiovascular diseases with oxytocin is possible due to the pleiotropic nature of oxytocin effects. This review indicates the likely mechanisms of oxytocin action at the cellular level that are involved in cardioprotection.

Aim. To study clinical and anamnestic data of patients with implantable cardioverterdefibrillators (ICD) for primary or secondary prevention of sudden cardiac death (SCD) based on the data from the Kuzbass ICD registry.
Methods. Retrospective analysis of demographic, clinical and anamnestic data from the “Kuzbass Registry of Patients with Implanted Cardioverter-Defibrillator”, which includes 286 patients admitted at the Kuzbass Cardiology Center in 2015–2019, was carried out.
Results. The age of patients included in the registry was 59 (53; 66) years, 239 (83.6%) were men; all patients were diagnosed with heart failure. ICD for primary prevention of SCD was prescribed in 171 (63.6%) patients (group 1) and for secondary prevention in 98 (36.4%) patients (group 2). The groups were comparable in age, sex, main nosology (coronary artery disease), left ventricular ejection fraction (31.4 (26; 35) and 30 (10; 68)%, p = 0.389). Compared with the group 2, the group 1 had fewer working patients, higher incidence of heart defects, severe heart failure, higher incidence of paroxysmal supraventricular tachycardia (68.7% versus 44.8%, p = 0.001), and higher rates of revascularization (48, 9% and 31.7%, respectively, p = 0.006). Before ICD implantation for heart failure, 210 (73.4%) patients were receiving renin angiotensin aldosterone system inhibitors, 259 (90.6%) – beta-blockers, 167 (58.4%) – mineralocorticoid receptor antagonists. There were no differences in prescribed treatment between the groups. Only 137 (47.9%) patients, 86 (47.3%) patients in the group 1 and 51 (49.0%) patients in the group 2 received triple neurohormonal blockade. Remote monitoring was used only within the framework of research programs.
Conclusion. The primary cohort of patients with ICD is the primary SCD prevention group. Regardless of the type of SCD prevention, the underlying disease is coronary artery disease. Current guidelines for optimal drug therapy and myocardial revascularization are not always followed prior to ICD implantation. The creation of registries of patients with ICD is an effective way to identify existing problems in ICD patient selection and to optimize follow-up and treatment.

Background. Coronary artery bypass grafting (CABG) remains the most common cardiac surgery in the world. In the long-term follow-up period after surgery, graft failure occurs in a substantial proportion of CABG conduits and is a complex pathomorphological process. Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that allows to assess in-vivo endothelial integrity.
Aim. To substantiate the efficacy and safety of OCT assessment of the conduitanastomosis-artery system in CABG patients.
Methods. The prospective observational cohort study included 21 patients with chronic coronary artery disease who underwent CABG. 3–5 days after CABG, patients underwent OCT and angiography of arterial and vein grafts, including distal anastomosis and nearby segment of the target coronary artery. At 12-month follow-up, all patients underwent repeated OCT and angiography of the conduitanastomosis-artery system to assess the changes. The primary endpoint of the study was graft failure; secondary endpoints of the study included unplanned repeat myocardial revascularization, cardiac death, and myocardial infarction due to graft failure.
Results. At 12-month follow-up, 14.3% of graft failure and 9.5% of cases of unplanned repeated myocardial revascularization were registered. In most cases of graft failure, primary OCT revealed pronounced changes in the conduit and the native coronary artery (conduit/artery diameter ratio was more than 2 mm), whereas the diameter of the coronary artery anastomosis was less than 2.5 mm. Myocardial infarctions and death within 12 months were not registered.
Conclusion. Thus, OCT is an effective and safe intravascular imaging technique for assessing coronary arteries and the conduit-anastomosis-artery system. OCT makes it possible to identify morphological changes in coronary bypass grafts, which can predict their early failure. The conduit/artery diameter ratio greater than 2 and target coronary artery diameter less than 2.5 mm was associated with graft failure within 12 months after CABG.

Background. It is known that DNA damage in smooth muscle cells can trigger their clonal expansion and transformation into foam cells. Thus, the study of the molecular genetic mechanisms of the vascular smooth muscle cells response to genotoxic exposure is important and relevant in the context of an in-depth understanding of atherogenesis.
Aim. To study mRNA level and concentration of proinflammatory cytokines IL6 and IL8 in the human coronary artery smooth muscle cells exposed to alkylating mutagen.
Methods. Gene expression signature of studied cytokines in the human coronary artery smooth muscle cells was accessed by quantitative polymerase chain reaction in the two timepoints – immediately after six-hour exposure to mitomycin C (point 1) and after six-hour exposure to mitomycin C followed by 24 hours of cells being cultivated on mitomycin C-free cell growth medium (point 2). Smooth muscle cells cultured according to the above scheme without genotoxin were used as controls. HPRT1, GAPDH and B2M were used as the reference genes. Gene expression level was calculated by ΔCt method. IL6 and IL8 concentration was evaluated in the culture media in points 1 and 2 by enzyme-linked immunosorbent assay. Statistical analysis was performed in GraphPad Prism 9 software.
Results. Immediately after mutagenic exposure (point 1) we discovered no significant changes in the expression level of IL6 and IL8 in the mitomycin C exposed smooth muscle cells compared to controls. Removal of mutagen increased expression of IL6 and IL8 in the experimental group (0,36- and 0,67-fold, respectively). At the same time, we discovered no significant differences in the studied cytokines concentration in the culture medium of mutagen-exposed cells compared to the nonexposed controls.
Conclusion. Genotoxic stress in human coronary artery smooth muscle cells exposed to alkylating mutagen (mitomycin C) leads to differential expression but not secretion of proinflammatory cytokines IL6 and IL8. Thus, exposure of smooth muscle cells to mitomycin C do not trigger their proinflammatory phenotype. 

Aim. To analyze medical and demographic situation and morbidity in the population of different age groups in the Russian Federation, the Far Eastern Federal District and the Amur Region in order to develop management decisions for the health protection of the population at the regional levels.
Methods. Statistical and analytical analysis were conducted. The reports of the Ministry of Health of the Russian Federation and Federal State Statistics Services were used as the material.
Results. The mortality rates in the population of the Amur Region are higher than in the Far Eastern Federal District and in the Russian Federation for all years of analysis (2016–2020) and have amounted to 16.2 in 2020; 13.9; 14.6 per 1000 population respectively. In the Amur Region, mortality from injuries, poisoning and some other consequences of external causes is 2 times higher than in the Russian Federation; from diseases of the digestive system 1.6 times higher, from diseases of the respiratory system 1.5 times higher. Mortality from COVID-19 in the Amur Region is 84.3‰00, which is lower than in the Russian Federation (98.8). There is a higher rate of general morbidity in the Amur Region (2020, 162484.1 per 100 thousand population) compared to the Russian Federation (156111.4), and to the Far Eastern Federal District (146365.3), respectively. A significantly high incidence of diseases of the digestive system (16871.3‰00), compared to the Russian Federation (10092.1), and the Far Eastern Federal District (11230.8) has been noted. The incidence of COVID-19 in the Amur Region have decreased from 84678.4 per 100 thousand population (2019) to 80294.8‰00 (2020), while 3141.3‰00 cases have been registered in 2020; a 2.6-fold increase in the incidence of pneumonia has been observed for the first time. At the same time, the primary incidence of circulatory system diseases has decreased by 12.1%, which is the result of lacking dispensary and preventive services associated with the pandemic. The frequency of COVID-19 in the Amur Region in 2020 is 3141.3‰00, in the Russian Federation – 3384.5, in the Far Eastern Federal District – 3394.9, respectively. Higher rates of morbidity (2020) are noted in children – 166656.9 per 100 thousand of the corresponding population compared to the adolescents – 147023.43‰00, which is significantly higher compared to the entire population – 80294.83‰00.
Conclusion. The results of the study should be used by government representatives to develop managerial decisions regarding the health of the population, especially the future generation.

This analytical review presents data on brain injury in surgical management of congenital heart disease. A brief description of mechanisms of brain injury and methods of its prevention are given, moreover, a clinical case applying such techniques is given. The neurovascular unit in vitro model and its advantages are presented. The protocol for modelling, the further application of the model, and the prospects of using it for studying intraoperative hypoxia and systemic inflammatory response on the patient`s brain are described.

Lipid metabolism disorders remain a significant medical and social problem associated with mortality, disability, morbidity and pathologies of the circulatory system. According to international and Russian epidemiological studies, hypertriglyceridemia is a common risk factor for coronary heart disease. Isolated use of non-pharmacological therapy and statin monotherapy is not effective enough, and therefore it is necessary to propagate the experience of combined treatment, supported by modern recommendations. This work shows the possibilities of effective use of combined therapy of lipid metabolism disorders (statin, ezetimibe, alirocumab, fenofibrate) in patients with mixed hypertriglyceridemia.

The article provides an overview of key studies on vagus nerve stimulation. The vagus nerve stimulation method affects the nerve fibers of the internal and external nerve plexuses, enhancing the parasympathetic effect. The positive therapeutic effect has been achieved in various experimental and clinical studies on the treatment of neurological and cardiac diseases, metabolic syndrome, and obesity. It has been shown that vagus nerve stimulation reduces epileptic seizures frequency, cardiac arrhythmias, and is prognostically favorable for the treatment of ischemia and reperfusion injury of the myocardium. Recent studies have examined the inflammatory reflex involved in the pathogenesis of obesity. The role of bioelectronic vagus nerve stimulation is being actively investigated for the treatment of obesity and metabolic syndrome.