Highlights

In the current epidemiological situation, special attention should be paid to patients suffering from cardiovascular diseases, as they are more susceptible to the severe course of the new coronavirus infection. The study of aspects of treatment adherence and quality of life of cardiac patients plays an important role in providing these patients with qualified care.

Aim. Study the quality of life and adherence to treatment of patients who applied for elective cardiac care during the pandemic of a new coronavirus infection.

Methods. The study included 310 patients who applied to the cardiological dispensary in March 2021 (n = 123) and in the same period in 2017 (n = 187). To analyze adherence to treatment, the Morisky-Green compliance scale, a modified questionnaire to determine the factors influencing adherence, and the international questionnaire EuroQol EQ5D5L were used. Statistical processing was performed using the STATISTICA 10.0 program.

Results. In 2021, the incidence of diagnosed CHF among patients included in the study was three times higher than in 2017 and amounted to 67.2% (p < 0.001). The level of quality of life on the EQ5D5L scale, as well as self-assessment of the health of patients on the VAS scale, were higher in the 2021 cohort of patients (p < 0.05). Approximately half of the patients surveyed do not comply with medical prescriptions, which is in line with the results of 2017. Forgetfulness remains the main reason for non-compliance with medical recommendations.

Conclusion. During the COVID-19 pandemic, there has been a threefold increase in the proportion of patients suffering from CHF among the studied cohort of patients. At the same time, the level of quality of life and self-esteem of health is higher during the COVID-19 pandemic. Adherence to treatment of patients during the studied period remains low. During the COVID-19 pandemic, the financial aspect has an important impact on therapy adherence. A negative correlation was established between the presence of psychoemotional disorders and the degree of adherence to treatment. This actualizes the need to identify patients with symptoms of anxiety/depression among cardiac patients and provide them with specialized psychological assistance.

Highlights

In patients with coronary artery disease in the presence of hypothyroidism, both manifest and newly diagnosed, more pronounced dyslipidemia is observed, left ventricle diastolic dysfunction and three-vessel coronary disease are more often detected. Taking hormone replacement therapy helps reduce the severity of dyslipidemia. The number of affected coronary arteries is associated with thyroid-stimulating hormone levels. In multivariate analysis, only the presence of hypothyroidism, thyroid-stimulating hormone levels, and heart rate were independently associated with three-vessel coronary artery disease.

Abstract

Aim. To examine the severity of coronary artery disease (CAD) in patients with hypothyroidism and also to evaluate the factors associated with the severity of coronary atherosclerosis in the South Indian region.

Methods. CAD patients (n = 240) were examined at the Kerala Institute of Medical Sciences clinic with laboratory tests (general blood count, biochemical studies, assessment of thyroid hormone levels thyroid stimulating hormone (TSH), free thyroxine (FT4)), instrumental studies – electrocardiography (ECG), echocardiography, and invasive coronary angiography. The subjects were divided into three groups: Group 1 – CAD patients without thyroid pathology (n = 150), Group 2 – CAD patients with newly diagnosed hypothyroidism without therapy (n = 15) and Group 3 (n = 75) CAD patients with hypothyroidism with hormone replacement therapy. The groups were compared according to the studied laboratory parameters and the results of instrumental examination.

Results. In CAD patients with hypothyroidism, both without therapy and with therapy, statistically significant differences were revealed in the increase in the concentration of blood glucose, total cholesterol, triglycerides, low-density lipoproteins and a decrease in the content of anti-atherogenic high-density lipoprotein, compared with CAD patients without hypothyroidism (p <  0.001). In the groups of patients with hypothyroidism who had optimally selected hormone replacement therapy, as well as without therapy, the number of patients with three-vessel coronary artery disease (66.7% and 60.0%) prevailed than in the group of CAD patients without hypothyroidism (13.3%, p < 0.05). Accordingly, when assessing coronary artery disease using the SYNTAX Score, patients with hypothyroidism in both groups were more likely to have severe coronary artery lesion.

In the study group, CAD patients showed statistically significant associations between TSH levels and the number of affected coronary arteries (r = 0.324, p < 0.001). In a multiple binary logistic regression model the following factors had a significant association with 3-vessel disease: group with hypothyroidism (B = 2.151; p = 0.012), free T4 level (B = 0.919; p = 0.021), and heart rate (B = 0.933; p = 0.011).

Conclusions. The results of the present study highlight the need to identify hypothyroidism in patients with coronary artery disease. To correct dyslipidemia in such patients, it is necessary to additionally take hormone replacement therapy. The possibility of improving prognosis through such interventions requires confirmation in further studies.

Highlights

• This study contributes to the subject area and is new due to the fact that the senile group of patients remains the least studied group in relation to revascularization of chronic coronary artery occlusions.
• The results obtained will help to form a more complete picture regarding the safety and expediency of using percutaneous coronary intervention in chronic occlusion of the coronary arteries in this group of patients.

Resume

Aim. To perform a comparative analysis of the hospital results of planned percutaneous coronary intervention in chronic occlusion of the coronary arteries in patients of the senile age group (≥75) and in patients of the elderly age group (up to 74 years).

Methods. In this retrospective study, the results of PCI in the treatment of patients of the senile age group (n = 58) and younger patients (n = 478) were analyzed. The sampling was carried out using a continuous method. Endpoints of the study: mortality from all causes, mortality from cardiac causes, myocardial infarction, acute cerebrovascular accident, repeated unplanned revascularization, combined endpoint. 

Results. A feature of the groups was the age of the included patients who underwent PCI in HOCA. In the control group, patients < 75 years of age were considered, as the main group – patients of the senile age group ≥ 75 years. Most of the interventions were successful (74.6% and 75.8%, p = 0.972, respectively). There were no differences in the frequency of complications, hospital mortality from all causes in the control group was 1 case (0.209%) and 0 in the senile group, p = 0.207, mortality from non-cardiac causes in the control group was 1 case (0.209%) and 0 in the senile group, p = 0.207, emergency postoperative PCI in the control group There was 1 case (0.209%) and 0 in the senile group, p = 0.207, the mortality rate of cardiac causes was zero in both groups. The senile group showed a low percentage of complications: hemopericardium in the control group 6 (1.25%), in the senile group 0, p = 0.844, coronary artery perforation 25 (5.2%) and 1 (1.72%), p = 0.395, intraoperative coronary artery dissection requiring implantation 14 (2.92%) and 1 (1.72%), p = 0.917.

Conclusion. The use of PCI in HOCA on a planned basis in patients with preserved left ventricular ejection fraction of the senile age group ≥ 75 years demonstrated comparable success results, low rates of intraoperative and postoperative complications with PCI in HOCA in people aged < 75 years, which indicates the safety of PCI in HOCA for senile patients and may be the method of choice.

Highlights

• Psycho-emotional stress is a significant risk factor for chronic non-communicable diseases, especially cardiovascular diseases, that simultaneously worsens the quality of life of patients with an existing pathology. Moreover, the issue of psycho-emotional stress at the population level in the Russian Federation remains understudied.
• To enhance prevention of chronic non-communicable diseases, especially cardiovascular pathology, the authors studied epidemiological features of psycho-emotional stress and formed a medical and social portrait of people suffering from high levels of psycho-emotional stress based on the representative samples of 27,950 participants aged 25-64 residing in 17 regions of the Russian Federation.

Abstract

Aim. To analyze socio-demographic, behavioral and biological determinants of the psychological stress (PS) at the population level of the Russian Federation (RF) to further advance the prevention of chronic non-communicable diseases.

Methods. We studied representative samples of the population aged 25–64 years in 17 Russian regions (n = 27 950), examined as part of the Epidemiology of Cardiovascular Diseases in Regions of Russian Federation (ESSE-RF and ESSE-RF2, 2012–2014 and 2017) study. The subjects were interviewed using a questionnaire containing a section on the PS — Perceived Stress Scale-10. PS levels are ranked as follows: “Low” – 0–11, “Medium” – 12–19, “High” – 20–40.

Results. Every fourth person in the Russian Federation (24,8%) experienced a high level of PS, moreover, higher age slightly affected the frequency of PS in both men and women. Determinants of high levels of PS include low level of education, low/moderate income, unemployment, low consumption of vegetables/fruits, short duration of sleep (5–6 hours), anxiety/depression, and a history of ischemic heart disease. Additionally, high levels of PS in women were associated with being single, smoking, having high salt intake, and stroke and cancer in medical history. High levels of PS in men were associated with ages 35–44 years, alcohol abuse, low physical activity, 9–10 hours of sleep, and low-density lipoproteins cholesterol level ≥ 3,0 mmol/L.

Conclusion. We formed a medical and social portrait of people with high levels of PS which will help to develop targeted prevention programs to improve the quality of life for people with poor psycho-emotional health and to prevent chronic non-communicable diseases, including cardiovascular diseases.

Highlights

In this review the authors have described the mechanism of atrial fibrillation (AF) development in patients with different comorbidity – in idiopathic AF, the AF concomitant to atrial hypertension and AF concomitant to ischemic heart disease. Currently, the treatment tactics for AF are based primarily on the duration of arrhythmia episodes, and not on the pathophysiological mechanisms of its development and progression. In our work, we tried to draw attention to the need for a pathogenetic view on the most common heart rhythm disease.

Abstract

The likelihood of atrial fibrillation occurrence increases with age and largely depends on the severity of concomitant cardiac and extracardiac pathology. In this review, we want to present an analysis of the data available in the literature on the pathogenesis and catheter treatment of atrial fibrillation in patients without visible structural and cardiovascular pathology (idiopathic atrial fibrillation), patients with hypertension and patients with coronary heart disease.

Highlights

The review presents an analysis of the current literature on studies of variant pulmonary vein anatomy as a factor that predicts predisposition to atrial fibrillation, as well as the outcome of interventional treatment.

Abstract

This review examines the role of variant pulmonary vein anatomy in predisposition to the development of atrial fibrillation. The use of individual pulmonary vein anatomy in assessing the outcome of interventional treatment is discussed.

Highlights

Given the current trend in coronary surgery towards an increase in the number of bimammary coronary bypass surgeries and conflicting research findings on in-hospital and long-term outcomes, the choice of the optimal method of revascularization in patients with high perioperative risk and comorbid condition remains relevant. A number of studies have demonstrated the advantage of coronary artery bypass grafting using two internal thoracic arteries, but the only randomized multicenter prospective study did not reveal the advantages of this technique compared to the traditional one in patients with coronary artery disease and multivessel coronary artery disease, which necessitates further research to determine the most effective and safe method of surgical myocardial revascularization, including in comorbid patients.

Abstract

This article presents a literature review on the use of bimammary coronary bypass surgery in comorbid patients with diabetes mellitus, obesity, chronic kidney disease and chronic heart failure with a low left ventricular ejection fraction, as well as in patients with certain demographic characteristics: female, elderly and senile age; including an analysis of current data in databases “PubMed” and “Google Scholar” published in 2017–2024. Various techniques for performing coronary bypass surgery using two internal thoracic arteries are presented, the advantages and disadvantages of using bimammary revascularization in comorbid patients are described. Currently, it is not possible to determine the optimal technique for surgical myocardial revascularization, and therefore the issue of bimammary myocardial revascularization in patients with high risk of complications, taking into account all the advantages and disadvantages of this technique, remains unresolved.

Highlights

The presented literature review contains anatomical and topographic features of the aortic root, knowledge of which is necessary for its successful reconstruction.

Abstract

The purpose of this literature review is to study and determine the anatomical features of the structures and topography of the aortic root in the perspective of a reconstructive surgical approach in the treatment of the proximal thoracic aorta. A review was conducted on the anatomy and topography of the aortic root in non-operated patients, without signs of its dilation using radiation, functional diagnostic methods, as well as studies conducted on heart preparations obtained from patients who died of non-cardiac causes. The surgical features of performing reconstructive interventions on the aortic root, taking into account the peculiarities of its anatomy, are also considered. The area of the aortic root is anatomically variable, depending on anthropometric data, race, gender, etc. To successfully perform the reconstruction of the aortic root, it is necessary to achieve certain indexed values between its structures. Absolute knowledge and understanding of the surgical anatomy of the aortic root are necessary for the successful implementation of its reconstruction.

In the Russian Federation, 46% of all deaths from cardiovascular diseases are due to chronic coronary heart disease. According to the registers, even under the conditions of using modern effective medicines, the 5‑year mortality rate of patients with chronic coronary heart disease remains high and is about 20%. The optimal approach to the treatment of patients with coronary heart disease depends on various factors, such as the degree of prevalence and complexity of the pathological process, patient characteristics and individual preferences. The SYNTAX scale can help in decision-making by predicting the risk of adverse events and determining the choice between PCI and CABG, but there is a potential benefit from the assessment on the SYNTAX II scale, which allows for better stratification of patients. The discussion on the choice between CABG and PCI in various clinical situations will continue to evolve as risk stratification tools, technologies and procedural techniques for both CABG and PCI are improved. Due to continuous progress, revascularization recommendations for specific patient groups will change in the coming years. This literature review has a number of differences from previously published ones, including a wide range of studies, a variety of clinical situations, an assessment of long-term results, a broad analysis of patient subgroups, as well as an assessment of the limitations of existing studies.

Highlights

Today, there is a wide variety of vascular accesses for hemodialysis sessions. For the first time, the main advantages and disadvantages of various types of permanent vascular access with prolonged use are described in a structured manner. Currently, the use of allographs and biological prostheses remains poorly understood, and their further study is a promising area.

Absract

To date, there is a wide variety of vascular accesses for hemodialysis sessions, including: dialysis catheter, primary or native arteriovenous fistula, arteriovenous grafts. The main problems of using permanent vascular access, leading to its loss, are revealed: excessive neointimal growth, infections, pulmonary hypertension, steal syndrome (stealing syndrome), aneurysmal dilation. The “gold standard” with the fewest possible complications is the use of native AVF. The dialysis catheter has many problems and is not recommended for long-term permanent use. The use of AVG from synthetic materials has long been described in many foreign studies and occupies an intermediate place among the approaches described above. Currently, the use of biotransplants (biological grafts) and allografts remains a little-studied alternative. Further study of the use of allographs and biological prostheses from the perspective of possible complications of permanent vascular access and comparison of the results obtained with native AVF and AVG will help to form a consensus on these materials among the scientific community.

Highlights
An overview of the latest literature data on the evidence base of invasive treatment of atrial fibrillation
using pulmonary vein isolation and additional effects on the left atrium is presented.

Summary

Atrial fibrillation (AF) is currently the most common arrhythmia encountered in clinical practice. The number of patients is rapidly increasing and over the past 50 years the prevalence of the disease has shown a threefold increase. Despite its non-infectious nature, experts equate the disease to the epidemic of the current century. It has been reliably proven that AF contributes to the development and progression of such dangerous conditions as chronic heart failure, stroke, pulmonary embolism, and arrhythmogenic cardiomyopathy. A rhythm control strategy not only helps relieve arrhythmia symptoms, reducing the burden of patients with AF, but also prevents the diseases described above. Based on the results of current data, catheter-based techniques for the treatment of atrial fibrillation show better efficacy results compared to drug therapy. At the moment, the question of the technique of performing the ablation procedure for different forms of atrial fibrillation remains open. An urgent aspect remains increasing the effectiveness of interventions in different groups of patients. There are both established techniques for isolating the pulmonary veins, with proven effectiveness in numerous studies, and new directions for improving the procedure, including isolation of the posterior wall of the left atrium, additional effects on the autonomic ganglion plexuses, complex fragmented electrograms and isolation of the superior vena cava. The review article presents a variety of intervention options, in accordance with the form of atrial fibrillation and its mechanisms of pathogenesis, as well as data from recent studies reflecting the influence of additional interventions in the left atrium on the effectiveness of the intervention. Ablation techniques are described in detail, taking into account the constant improvement of the medical devices used and the desire to standardize the procedure. Also presented are current diagnostic methods aimed at the most accurate detection of episodes of fibrillation and an objective assessment of the effectiveness of the treatment.

Highlights

This review is focused on up-to-date studies investigating possibility of using microRNAs as diagnostic biomarkers, predictors of unfavorable outcome and potential therapy for chronic heart failure.

Abstract

Chronic heart failure is one of the leading causes of disability and mortality in cardiology patients. Despite significant achievements of modern medicine, the incidence of chronic heart failure and its hospitalization rate increase drastically. Therefore, the search for highly sensitive, specific, reliable and standardized biomarkers for the earliest diagnosis and prevention of chronic heart failure complications seems relevant. MicroRNAs (miRNA) are considered as promising novel genetic biomarkers for purposes of diagnosis and prognosis of cardiovascular diseases. This article provides an overview of data from experimental and clinical studies discussing the possibility of using miRNA for early diagnosis and determining prognosis of chronic heart failure, as well as a possibility of miRNA therapeutic application.

Highlights

Pathology of the aortic valve and aorta occupies a special place among extragenital pathology and is accompanied by high risks of complications, maternal and infant mortality in both the perinatal and intranatal periods. There are various ways to correct this pathology: surgical and transcatheter replacement of the aortic valve, and balloon valvuloplasty. However, there is no unified opinion regarding the preferable methods and timing of surgical correction of aortic stenosis in a pregnant woman, and all available data, due to the lack of large randomized trials and registries, are based on the opinion of experts and reports from centers.

Abstract

The article describes a rare case of transcatheter aortic valve implantation in a pregnant patient with severe aortic stenosis. The research methods included anamnestic analysis, ultrasound examination and computed tomography. Specialists used transcatheter implantation to treat the disease. Due to the rarity of the disease, the high risks of both maternal and infant mortality, and the lack of recommendations in the literature regarding the management of this category of patients based on large randomized trials, we present our own experience of a rare case of transcatheter aortic valve implantation in a pregnant patient.

Highlights
It has been demonstrated for the first time that factors such as arterial hypertension, peripheral atherosclerosis, and previous cardiovascular events (heart attack or stroke) significantly increase the risks of both venous and arterial thromboembolic complications in patients with a combination of cardiovascular diseases and malignant neoplasms. The results obtained emphasize the need to review existing scales for assessing the risk of thrombosis in cancer patients and to develop more accurate preventive approaches, including the use of anticoagulant therapy.

Background. Cardiovascular disease (CVD) and cancer are leading causes of mortality worldwide. Although CVD and cancer are generally considered isolated diseases, potential cardiotoxicity has been observed in patients receiving chemotherapy or radiation therapy for cancer treatment. Despite the extensive data in the literature, studies examining the relationship between thromboembolic complications, cancer, and CVD remain limited, necessitating further exploration of this issue.

Aim. To investigate the association between cardiovascular diseases and cancer concerning the risk of developing and progressing thromboembolic complications.

Methods. We retrospectively screened patients with cancer treated between January 1, 2021, and December 31, 2023, at University Clinical Hospital No. 1 of Sechenov University. The study included 877 patients (ages 19 to 93 years, median age 63 years) with histologically confirmed cancer with a high and very high risk of thrombosis (stomach, pancreas, lung, testicles, ovaries, uterus, breast (HER2+ phenotype)).

Results. Our findings indicated that patients with higher stages of the primary tumor (T), regional lymph node metastases (N), and distant metastases (M) had a significantly elevated risk of thrombosis. Additionally, the presence of arterial hypertension (p = 0.01), peripheral atherosclerosis (p = 0.001), history of myocardial infarction and stroke (p = 0.001), and type 2 diabetes mellitus (p = 0.009) were identified as significant risk factors.

Conclusion. This study demonstrates for the first time that arterial hypertension, peripheral atherosclerosis, diabetes mellitus and a history of myocardial infarction and stroke increase the risks of both venous and arterial venous thromboembolism in patients with cancer and cardiovascular disease. According to the results of the regression analysis, the extent of the primary tumor (T) and the presence of peripheral atherosclerosis appeared to be significant factors.

Highlights

• In patients without structural changes in the heart, predictors of arrhythmogenic cardiomyopathy were recorded significantly more often when polymorphic left ventricular extrasystole was detected.
• When predominantly polymorphic right ventricular extrasystoles were detected in patients without structural changes in the heart, the pathology of the cardiovascular system was not recorded, but with polymorphic left ventricular extrasystole, the development of pathology of the cardiovascular system, such as various clinical forms of coronary heart disease, hypertension, and mitral valve prolapse, was observed.

Summary

Aim. To individualize the choice of drug therapy for polymorphic ventricular extrasystole (PVC) in patients without structural heart changes (PWSHC) by assessing predictors of arrhythmogenic cardiomyopathy (PAC) and the clinical and prognostic value of its course.

Methods. Experimental study. Modeling of PVC was carried out in animals using the mechanism of delayed postdepolarization (LDP) using barium chloride, strophanthin and adrenaline. In electrocardiography (ECG), in addition to generally accepted parameters, PAC such as the pre-ectopic interval, its variability, the maximum index of internal deviation of the PVC (MIVDpvc), the duration of the QRS complex PVC (QRSpvc), QRS sinus rhythm (QRSsr), their ratio (QRSpvc/QRSsr) were analyzed. Clinical study. There were 272 PWSHC aged from 16 to 34 years with PVC classes IV–V (B.Rayn, 1984). The ECG determined the same parameters as for experimental arrhythmias. The duration of observation of patients was up to 10 years. The end point of observation was the detection or absence of pathology of the cardiovascular system.

Results. Experimental study. In all animals, when modeling ventricular arrhythmias using the LDP mechanism, PVC was recorded. PAC were identified when modeling arrhythmia using strophanthin and adrenaline. Clinical study. In PWSHC PVC from the right ventricle without PAC, it was highly correlated with barium chloride-induced ventricular ectopy (r = 0.94). In 160 (58.82%) PWSHC with right ventricular premature complexes, the pathology of the cardiovascular system was not registered, and in 112 (41.18%) – with left ventricular ectopy with detected PAC, an average of 5.5 ± 0.14 years after inclusion in the study was observed development of arterial hypertension, mitral valve prolapses. In all patients, antiarrhythmic drugs of class II and, to a lesser extent, class III were the most effective for stopping polymorphic PVC.

Conclusion. In PWSHC, the development of diseases of the cardiovascular system, such as arterial hypertension, mitral valve prolapse, was observed when polymorphic left ventricular ventricular ectopy was detected in combination with PАC.

Highlights

Reoperations in aortic root surgery are performed with increasing frequency. Such operations are technically difficult to perform and the risk of mortality is significantly higher than in primary operations.

Summary

Aim. Analyze the results of repeated interventions in aortic root surgery

Methods. The study includes 11 patients who underwent repeat surgeries at Sechenov University from 2017 to 2022. Initially, one patient was operated using the Ozaki technique at another clinic. Initially, elderly patients predominantly underwent aortic valve replacement with a biological prosthesis. When the aortic root was narrow (≤ 19 mm), the Ozaki procedure was initially considered.

Results. The most frequent indications for aortic root repair were valve dysfunction, infective endocarditis, and thoracic aortic aneurysm. On average, aneurysms of the ascending or aortic arch developed 5–6 years after primary aortic root surgery. The 30-day mortality rate was 9.09% (1/11).

Conclusion. The method of choice for infective endocarditis is aortic root prosthesis with a homograft. The surgeon's experience and adherence to certain technical protocols allow to achieve acceptable results of repeated interventions.

Highlights
An analysis of a register study involving patients with mitral and aortic valve defects of various etiologies with concomitant secondary tricuspid insufficiency is presented. All patients underwent correction of the primary affected valves, as well as secondary tricuspid valve insufficiency using support rings of various designs (semi-rigid, rigid and flexible). The results obtained demonstrate the comparable effectiveness of the rings used in terms of freedom from recurrence of tricuspid regurgitation in the early postoperative period, as well as hospital mortality.

Abstract

Aim. To compare short-term outcomes of treatment of functional tricuspid regurgitation (TR) using annuloplasty rings of different types (flexible, semi-rigid and rigid) in patients who had undergone surgery for valvular defects.

Methods. The two-center registry-based study included 708 patients with mitral or aortic valve defects and moderate or severe STR requiring surgical treatment. Exclusion criteria were as follows: organic tricuspid valve regurgitation, age below 18 years. Primary endpoints were as follows: in-hospital mortality, recurrent tricuspid regurgitation (> grade 2) in the early postoperative period.

Results. Of the patients included in this study, 400 (56.4%) patients received a semi-rigid ring made by “NeoCor” (the NeoCor group), 154 (21.8%) patients received a flexible ring made by “MedInj” (the Flexible group), and 154 (21.8%) patients received a rigid ring made by “MedInj” (the Rigid group). Most patients presented with the clinical manifestations of chronic heart failure of The New York Heart Association (NYHA) functional class II/III. However, in the NeoCor group the majority of patients presented with (NYHA) functional class IV. Rheumatic valve disease prevailed in the NeoCor group, and connective tissue disorders prevailed in the Flexible and Rigid groups. Initially, in the NeoCor group, STR was marked by a predominance of severe regurgitation. The most frequently reported perioperative complications in the analyzed sample were the need for inotropic support for more than 24 hours, development of atrial fibrillation, hydro- or hemothorax, implantation of permanent pacemakers, prolonged mechanical ventilation. In-hospital mortality did not differ between the groups and amounted to 1.5% in the NeoCor group, 2.6% in the Flexible group and 1.9% in the Rigid group. Echocardiographic examination in the postoperative period did not reveal > grade 2 tricuspid regurgitation in any of the groups.

Conclusion. According to the results of the study, semi-rigid, flexible and rigid annuloplasty rings are equally effective in treating functional TR.

Highlights

The article deepens the understanding of the pathogenesis of brain death in potential organ donors and, in particular, clarifies information on the dynamics of hemodynamic disorders and their contribution to the somatic survival of potential donors, which constitutes the scientific novelty of the study.

Abstract

Aim. To study the development of early central hemodynamic disturbances and evaluate the somatic survival of experimental organ donor animals using an experimental model of brain death

Methods. The experiments were carried out on mature outbred male rats (n = 50). The experimental animals of experimental group №1 (n = 20, normotensive individuals, optimal donors) were anesthetized, invasive mean arterial pressure (MAP) and heart rate (HR) were recorded. Brain death was modeled by creating intracranial pneumopression. For conditioning the potential donor with brain death mean BP and HR were recorded for 3 hours; when mean BP dropped below 75 mm Hg, Gelofusin solution (B. Braun medical, AG, Switzerland) was infused. Animals from experimental group №2 (n = 20, hypotensive individuals, “marginal” donors) were anesthetized, then brain death was modeled in them, and mean BP and HR were monitored in the same way as in experimental group №1, but without correction of developing hemodynamic disorders. Intact anesthetized intubated animals (n = 10), whose hemodynamic parameters were recorded, served as controls.

Results. After 30 minutes from the beginning of the experiment and further at all observation periods, a decrease in mean BP and HR was observed in the groups of normotensive and hypotensive animals compared to the control. By the end of the third hour of the experiment, despite volemic support, in normotensive animals, mean BP decreased to 60 [61; 67] mm Hg (p = 0.01 compared to the control), HR to 250 [248; 260] beats/min (p = 0.03 compared to the control). In the group of hypotensive animals, the dynamics of the decrease in mean BP was more pronounced and by the end of the third hour of the experiment, mean BP was 45 [41; 46] mm Hg (p = 0.01 compared to the control and normotensive animals), HR – 230 [224; 237] beats/min (p = 0.03 compared to the control and normotensive animals). In the normotensive group of animals, death due to progression of circulatory failure occurred in 8 individuals, the mortality rate was 40%, p = 0.02 compared with the control. In the hypotensive group of animals, death occurred in 14 individuals, the mortality rate was 60%, p = 0.01 compared with the control and normotensive animals.

Conclusion. The results of the study of early central hemodynamic disturbances in an experiment on a brain death model indicate the development of more pronounced circulatory failure in marginal donors, which is accompanied by an increase in their mortality within 3 hours after the induction of brain death in comparison with optimal donors. Correction of systemic perfusion disturbances by volemic loading leads to an improvement in hemodynamic parameters and somatic survival of potential donors.

Highlights

• The conducted study allowed us to identify associations between circulatory system disease incidence rates in the working-age population and regional living conditions: socio-geographical, demographic, economic, industrial, and environmental. Improving the effectiveness of government measures to manage population health risks and extend life expectancy requires objective information on population morbidity rates in the working-age population.
• The presented methodological approaches and results can be used to develop scientific, methodological, and practical algorithms for assessing and predicting the impact of various factors on the health of different age categories of the population of the Russian Federation.

Abstract

Aim. To analyze the association between morbidity indicators in working-age population and integrated regional indices of living conditions of the subjects of the Russian Federation.

Methods. We calculated incidence and prevalence rates of circulatory system diseases in the population based on official statistics and assessed living conditions using previously obtained regional socio-geographic, demographic, industrial, environmental, and economic indices for the years 2017 to 2021. Associations between regional living conditions and disease rates were established using generalized linear models.

Results. The findings revealed the relationships between the level of demographic depression, economic development of the regions, socio-geographic, industrial and environmental living conditions and low and high disease incidence and prevalence among the working-age population.

Conclusions. The techniques and results described in the article can be used to develop methodological approaches to assessing and predicting the impact of various factors on the health of different age groups of the population.

Highlights

Consumption of high-calorie Western-type foods in combination with overeating and a sedentary lifestyle causes a violation of the composition of the intestinal microbiota, increased intestinal permeability, increased intake of lipopolysaccharide, trimethylamine-N-oxide and other toxins into the blood, which causes a state of chronic metabolic inflammation followed by accelerated development of ASD. Adherence to the Mediterranean diet normalizes the composition of the intestinal microbiota, promotes the formation of short-chain fatty acids with anti-inflammatory and anti-atherosclerotic effects.

Absract

Despite the introduction of new treatment methods, atherosclerotic cardiovascular diseases (ASCVD) remain the leading cause of morbidity and mortality worldwide. In recent years, it has been established that systemic inflammation plays a crucial role in atherothrombosis, but the factors causing systemic inflammation have not been fully elucidated. The consumption of high-calorie Western-type foods combined with chronic overeating and a sedentary lifestyle in Western societies causes a state of chronic metabolic inflammation, which contributes to the development of ASCVD. A better understanding of how different types of nutrition affect the pathogenesis of atherosclerosis is essential for developing effective strategies for the prevention and treatment of ASCVD. This article reviews the latest data on the pathogenetic mechanisms of the influence of dietary patterns on the development or regression of ASCVD.