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Russian Journal Of Cardiology, 2017, 11 (22)

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CLINICAL MEDICINE NEWS

Clinical medicine updates: a review of international news

Russ J Cardiol 2017, 11 (151): 6

Address to the readers

Russ J Cardiol 2017, 11 (151): 7

ORIGINAL ARTICLES

SIX-MONTH OUTCOMES IN ACUTE CORONARY SYNDROME PATIENTS INCLUDED IN THE REGISTRY RECORD-3

Erlikh A. D. on behalf of the RECORD-3* working team

Abstract

Aim. Evaluation of 6-month observation of acute coronary syndrome (ACS) patients included into the ACS registry RECORD-3.

Material and methods. To the registry RECORD-3, all ACS patients were being included if hospitalized during 1 month in 2015 (march-april) in 47 centers among 37 Russia cities. Follow-up lasted for 6 months with telephone calls, in 35 centers.

Results. Among all participants (n=2370), 6-month outcomes were collected in 1433 (64%). By most demographic, anamestic and clinical characteristics the group of those failed to collect data was comparable with the others. Frequency of fatal outcomes after discharge in 6 months post ACS was 4,2%, new myocardial infarction (MI) — 3,2%, stroke — 0,7%. Frequency of combination events (death+MI), death+MI+stroke reached 5,7% and 8,5%, respectively. Coronary intervention in 6 months was done in 12,0% (2/3 underwent PCI, 1/3 — bypass surgery). In 19% cases the intervention was urgent. There were no statistically significant differences by the prevalence of adverse events and bypass surgery among those with diagnosed MI in-patient and non-MI, as between ACS with ST elevation (STEACS) or no (NSTEACS), excluding the prevalence of fatal outcomes: 2,8% in STEACS and 5,0% in NSTEACS (p=0,038). The grade of frequency decline of prescribed medication intake by 6 months reached 12% for aspirin, 29% for clopidogrel, 33% for ticagrelor, 29% for oral anticoagulants, 28 for ACEi/ARB, 19% for beta-blockers, 21% for statins.

Conclusion. By multifactorial regression analysis, the independent predictors of fatal outcomes were found, that developed in 6 months post discharge.

Russ J Cardiol 2017, 11 (151): 8–14

http://dx.doi.org/10.15829/1560-4071-2017-11-8-14

Key words: acute coronary syndrome, registry, RECORD-3, long term outcomes, treatment adherence.

N. E. Bauman City Clinical Hospital № 29, Moscow, Russia.

ST ELEVATION ACUTE CORONARY SYNDROME IN NON-OBSTRUCTIVE LESION OF CORONARY ARTERIES: DATA FROM THE REGISTRY RECORD-3

Ryabov V. V.1,2,3, Syrkina А. G.1, Belokopytova N. V.1, Markov V. А.1,2, Erlikh А. D.4

Abstract

Aim. To evaluate the prognosis and key management issues in patients with nonobstructive atherosclerosis of coronary arteries (NOCA) comparing to the group with obstructive lesion (OCA).

Material and methods. The data used, from the acute coronary syndrome registry RECORD-3, in the emergency cardiology department of Tomsk SRI of Cardiology, together with another 51 center in Russia. Based on the absence of presence of NOCA, patients with ST elevation myocardial infarction, who had undergone coronary arteriography, were selected to two independent groups: 27 with NOCA and 571 with OCA.

Results. There were no significant differences in the clinical portrait of NOCA and OCA patient. However, palpitation followed angina attack in NOCA patients. In the NOCA, there was significantly lower number of persons with diagnostically relevant raise of cardio specific enzymes. Indirectly, it points on temporary ischemia with no necrosis, or that the area of necrotic myocardium is not large. In NOCA patients, statistically more significantly were absent reciprocal ECG changes. Endpoints as mortality and novel heart failure development had tendency to statistically more significant decrease of prevalence in NOCA patients. As final diagnosis at discharge, in NOCA patients more often another diagnosis was mentioned (including unstable angina, etc.), but not myocardial infarction. The key issues in hospital management of these two groups were identical, except more often prescription of dihydropiridine calcium channel blockers to NOCA patients, and rarer prescription of antiplatelet drugs at discharge.

Conclusion. Regardless the fact that prognosis in ACS with NOCA and intact arteries is better than in OCA, it is necessary to analyze thoroughly pathogenesis of the disease in every case, as in this category of patients especially, it is most heterogenic. As these patients have comorbid factors, it is necessary to select the leading one, and to intensify efforts on this factor directly.

Russ J Cardiol 2017, 11 (151): 15–21

http://dx.doi.org/10.15829/1560-4071-2017-11-15-21

Key words: non-obstructive atherosclerosis of coronary arteries, MINOCA, ST elevation myocardial infarction.

1Cardiology Research Institute, Tomsk National Research Medical Centre of RAS, Tomsk; 2Siberian State Medical University (SSMU), Tomsk; 3National Research Tomsk State University, Tomsk; 4N. E. Bauman SI City Clinical Hospital № 29, Moscow, Russia.

MORTALITY FROM MYOCARDIAL INFARCTION IN RUSSIA IN THE YEARS 2006 AND 2015

Samorodskaya I. V.1, Barbarash О. L.2,3, Kashtalap V. V.2,3, Starinskaya М. А.1

Abstract

Aim. To compare and analyze the rates of mortality from myocardial infarction (MI), recurrent and first, in various age groups, in the years 2006 and 2015, in Russian Federation.

Material and methods. In the study, the data used from official statistics of Russian Statistics Agency, on the numbers of died due to various death causes, based on the Short Nomenclature of Lethal Causes. Standardized mortality coefficients (SMC), as the age-related, were calculated with original software (State registration software ID 216661114); the European standard was applied. Absolute values of growth/wastage calculated, and the representation values.

Results. During the period 2006-2015 SMC from MI in general declined by 13,91%, SMC from acute MI — by 14,3%, recurrent — by 12,82%. Main impact on the decrease of SMC in dynamics during 2006-2015 do make male patients with primary (acute) MI. Decrease of SMC from MI in males was found in all ages, in women — excluding the groups of 20-29 y. o., 80-89 and ≥90 y. o. The most prominent decrease of SMC from MI in 2015 in relation with 2006 was found among men 20-29 y. o. (-47,03%), and in women of this age group there was increase of SMC by almost a third (+32,28%). Minimal SMC decrease was found in men 70-79 y. o. (-6,60%), in women 30-39 y. o. (-5,66%).

Conclusion. Generally positive changes in statistics of MI mortality in Russia during 2006-2015 y. are related to objective factors (as the successful realization of organizational solutions for the volumes and approachability of high-technology medical care for cardiovascular patients, improvement of outpatient-prevention care, prevention improvement) and “subjective” (related to the primary death cause assignment and coding in statistical documents).

Russ J Cardiol 2017, 11 (151): 22–26

http://dx.doi.org/10.15829/1560-4071-2017-11-22-26

Key words: myocardial infarction, mortality, ICD-10, Brief nomenclature of the causes of death of the Russian Federal State Statistics Service, age.

1National Research Center for Preventive Medicine of the Ministry of Health, Moscow; 2Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 3Kemerovo State Medical University of the Ministry of Health, Kemerovo, Russia.

POPULATIONAL STUDY OF LONG TERM OUTCOMES OF ACUTE MYOCARDIAL INFARCTION IN TOMSK

Garganeeva A. A., Kuzheleva E. A., Aleksandrenko V. A.

Abstract

Aim. To evaluate long term outcomes of acute myocardial infarction (MI), based on the populational registry.

Material and methods. In the study, the survived post-MI patients were included, in the year 2007 registered in database of MI (n=439). Prospective observation was done during 5 years after index event. In the case of fatal outcome the protocols were analyzed, of pathology studies and summaries of forensic autopsies; relatives were interviewed and the witnesses of clinical cases. For statistics, the software “Statistiсa” V.10 was applied.

Results. Mortality among patients included into the study, was 11% in one year post MI, and 35% at 5 years. In overall structure of the causes of fatal outcomes there were cases of second MI — 37%. Chronic coronary heart disease was found as a cause of death in 21%, and in 2% there was fatal stroke; in 5% pulmonary embolism, and in 5% sudden cardiac death. In 17% causes of death were not related to cardiovascular pathology.

Conclusion. Patients after MI do demonstrate high level of mortality in 5 year outcomes. Leading causes of fatal outcomes during first 2 years are recurrent acute coronary events, acute strokes, thromboembolism.

Russ J Cardiol 2017, 11 (151): 27–30

http://dx.doi.org/10.15829/1560-4071-2017-11-27-30

Key words: myocardial infarction, long term outcome, myocardial infarction registry.

Cardiology Research Institute, Tomsk National Research Medical Centre of RAS, Tomsk, Russia.

OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION IN ST ELEVATION MYOCARDIAL INFARCTION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Polikutina O. M., Slepynina Yu. S., Bazdyrev E. D., Barbarash O. L.

Abstract

Aim. To evaluate the influence of comorbid chronic obstructive pulmonary disease (COPD) on the prognosis of ST elevation myocardial infarction patients (STEMI) underwent percutaneous coronary intervention (PCI) during acute phase.

Material and methods. In the study, 529 STEMI patients included, males — 343 (64,8%), hospitalized during 24 hours from MI onset. Group 1 consisted of patients previously diagnosed with COPD — 65 (12,3%), group 2 — non-COPD — 464 (87,7%). PCI was done for 46,2% COPD and 47,8% non-COPD patients.

Results. During one year post MI in the group of comorbid COPD, there was more common angina progression, decompensation of CHF and all non-fatal endpoint (p=0,0022). Presence of COPD in PCI patients increased 3,5 times the risk of combination endpoints (95% CI 1,5-8,1; p=0,0031).

Conclusion. Patients with cardiopulmonary comorbidity require special control at outpatient stage after myocardial revascularization.

Russ J Cardiol 2017, 11 (151): 31–35

http://dx.doi.org/10.15829/1560-4071-2017-11-31-35

Key words: myocardial infarction, chronic obstructive pulmonary disease, percutaneous coronary intervention.

Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.

IMPLEMENTATION OF THE GRACE SCORE IN ACUTE CORONARY SYNDROME WITH RENAL DYSFUNCTION

Zykov M. V.1, Kashtalap V. V.1,2, Bykova I. S.1, Gruzdeva O. V.1, Karetnikova V. N.1,2, Barbarash О. L.1,2

Abstract

Aim. To investigate on the most significant predictors of cardiovascular risk in acute coronary (ACS) and kidney dysfunction (KD) patients, underwent percutaneous coronary intervention (PCI).

Material and methods. Totally, 206 patients included into the study. As the criteria of KD glomerular filtration rate below 60 mL/min/1,73 m2 was taken, by CKD-EPI (2011) based on the blood creatinine concentration at hospitalization. In-hospital mortality was 13,1% (n=27). All-cause annual mortality was 15,5% (n=32), 3-year mortality — 21,8% (n=45).

Results. Monofactorial analysis showed that the most significant factors of inhospital and long-term mortality in ACS and KD patients after PCI were congestive heart failure, stroke, myocardial infarction anamnesis, acute heart failure (AHF), hyperglycemia, prominent systolic dysfunction of myocardium, tachicardia and hypotension at admittance, multivessel disease, as acute kidney injury (AKI) developed during hospitalization (criteria RIFLE and AKIN). Step-by-step selection in Cox regression showed that the factors of in-hospital mortality were anamnesis of stroke, AHF at admittance, AKI development during hospitalization. C-statistics of the developed model was 0,82, that is seriously more significant than that of GRACE 2,0-0,74 score. In the analysis of long-term survival by Cox, it was revealed that stroke and myocardial infarction anamnesis, as AHF at admittance and AKI regardless of other factors, are related to the increase of fatal outcomes rate during one and three years of observation. Also, the area under ROC of the invented risk models was 0,84 and 0,76, respectively, for 1 and 3 years. In GRACE 2,0 such parameter was more significantly lower — 0,78 and 0,69, respectively.

Conclusion. The results witness on the significance of additional risk factors introduction into risk assessment in patients with ACS and baseline KD, and the developed novel models were better than GRACE.

Russ J Cardiol 2017, 11 (151): 36–42

http://dx.doi.org/10.15829/1560-4071-2017-11-36-42

Key words: risk factors, acute coronary syndrome, renal dysfunction, percutaneous coronary intervention.

1Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo;

2Kemerovo State Medical University of the Ministry of Health, Kemerovo, Russia.

TOPICAL DIAGNOSTICS OF SINGLE CORONARY ARTERY OCCLUSION IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS

Khafizov R. R.1, Zagidullin B. I.2, Lakman I. А.3, Mustafina I. А.1, Zagidullin N. Sh.1,3

Abstract

In ST elevation myocardial infarction (STEMI) diagnostics, main role is played by electrocardiography (ECG), which makes it to define MI itself as, in many cases, localization of occlusion.

Aim. To investigate on the efficacy of topical diagnostics of coronary arteries lesion in STEMI with single vessel disease, by ECG.

Material and methods. Totally, 200 STEMI patients (59,9±0,93 лет) included, with single vessel disease. The accuracy of diagnostics evaluated, of the coronary occlusion localization in three coronary arteries and in 2 segments in each of them, by original diagnostical algorithm.

Results. An algorithm invented, for diagnostics of multivessel disease of three coronary arteries, that makes it to perform topical diagnostics of the left anterior descending artery (sensitivity 92,2% and specificity 96,5%), of the right coronary artery (92,3% and 95,1%) and, at lesser grade, of the circumflex artery (81,5% and 66,7%), as two sectors in each of them with sensitivity 48,8-66,7% and specificity 60,0-74,5%.

Conclusion. In STEMI, an algorithm invented, and the software that calculates risk of occlusion of an exact coronary artery and its segments, as the risk of fatal outcome.

Russ J Cardiol 2017, 11 (151): 43–46

http://dx.doi.org/10.15829/1560-4071-2017-11-43-46

Key words: STEMI, electrocardiography, biomarkers, single vessel lesion, occlusion.

1Bashkirsky State Medical University of the Ministry of Health, Ufa; 2SAHI of Tatarstan Republic, Hospital of Emergency Care, Naberezhnye Chelny; 3Ufimsky State Aviation Technics University, Ufa, Russia.

OPTIMIZATION OF PATIENTS MANAGEMENT IN MYOCARDIAL INFARCTION COMORBIDITY WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Belaya I. E.

Abstract

Aim. To investigate on the efficacy of thiotriazoline (TTZ) in complex management of acute myocardial infarction (AMI) patients with hepatic steatosis.

Material and methods. Totally, 32 left ventricle AMI patients included, comorbid with non-alcoholic fatty liver disease. Assessment of electrical activity of myocardium was done on improved polygraph with electro- and vectorcardiogram registration

before and post three week basic therapy in 16 patients (13 males and 3 females, mean age — 60,5±3,74 y. o.) and management with added TTZ (8 males and 8 females, mean age – 62,94±2,71 y. o.).

Results. On basic therapy, there was ongoing decline in electromotive force of the heart with slower impulse conduction and disordered repolarization in atrial myocardium, with decreasing area of damage in the left ventricle and atrial overload. Concomitant TTZ usage with basic therapy led to minimal positive shifts in electromotive force of the heart. Also, there was increase of ischemia zone due to decrease of myocardial damage area, more prominent normalization of left atrium compartment and stabilization of repolarization processes in atria.

Conclusion. Under the combination treatment by TTZ there was significant change of the grade of electrical activity of the heart electrical activity disorder comparing to basic therapy.

Russ J Cardiol 2017, 11 (151): 47–55

http://dx.doi.org/10.15829/1560-4071-2017-11-47-55

Key words: acute period of myocardial infarction, non-alcoholic fatty liver disease, vectorcardiography, thiotraizoline.

Lugansk State Medical University, Lugansk.

CD68 AND STABILIN-1 POSITIVE MACROPHAGES IN POSTINFARCTION MYOCARDIAL REGENERATION

Gombozhapova A. E .1,2, Rogovskaya Yu. V.1,2, Rebenkova М. S.1,2, Kzhyshkovskaya Yu. G.2,4, Ryabov V. V.1,2,3

Abstract

Aim. Translation of experimental data on cardiac macrophages populations in postinfarction cardiac regeneration, into clinical practice.

Material and methods. In the study, 41 patients included, with fatal myocardial infarction (MI) type 1. All patients were selected to 4 groups according to fatal outcome timing. Together with routine pathohistology, immune histochemistry was done, on macrophageal infiltration. As the markers of macrophagal line we used CD68; stabilin-1 was used for M2 macrophages.

Results. The amount of CD68+ and stabilin-1+ macrophages in infarction zone increased and reached the peak in regeneratory phase, and did not decline at later stage. In peri-infarction area the amount of CD68+ macrophages increased during inflammatory phase, reached peak at reparation phase and did not change anymore either. By the results of multiple regression, the model was proposed, showing interrelations between the grade of macrophage infiltration and clinical markers of MI course.

Conclusion. Our study translates experimental results on cardiac macrophages subpopulations in postinfarction cardiac regeneration into clinical area. We observed a biphasic response of cardiac macrophages on acute ischemia, similar of that in mice. The grade stabilin-1+ macrophagal infiltration intensity increased at regeneration phase. There was significant strong positive correlation of the numbers of stabilin1+ macrophages and MI course phase, that underlies potential application of stabilin-1 as diagnostic biomarker of M2 macrophages in MI patients.

Russ J Cardiol 2017, 11 (151): 56–61

http://dx.doi.org/10.15829/1560-4071-2017-11-56-61

Key words: myocardial infarction, cardiac remodelling, macrophages, biomarkers, stabilin-1.

1Cardiology Research Institute, Tomsk National Research Medical Centre of RAS, Tomsk; 2National Research Tomsk State University, Tomsk; 3Siberian State Medical University (SSMU), Tomsk, Russia; 4University of Heidelberg, Germany.

FOR PRACTITIONER

QUALITATIVE TEST FOR THE FATTY ACID BINDING CARDIAC PROTEIN IN EARLY DIAGNOSTICS OF MYOCARDIAL INFARCTION: SUBANALYSIS OF RUSSIAN MULTI-CENTER STUDY ISPOLIN

Kokorin V. A.1, Gasanov М. Z.2, Gordeev I. G.1, Gritsanchuk А. М.3, Dzhaiani N. А.3, Kalinichenko R. М.4, Kashtalap V. V.5, Kopylov F.Yu.6, Kositsyna I.V.3, Kylbanova Е.S.7, Lapina Е.S.8, Laryushkina Е.D.3, Nikanorov V.N.9, Khripun А.V.10, Yakushin S.S.11

Abstract

Aim. To specify diagnostic characteristics of the test for qualitative measurement of the fatty acid binding protein, cardiac fraction (cFABP), in patients with suspected acute coronary syndrome (ACS) based on the subanalysis of ISPOLIN study.

Material and methods. To the subanalysis, 592 patients included, admitted to inpatient institutions of 8 centers in 5 cities, with suspected ACS during 24 hours from the onset of clinical signs. At admittance, all patients underwent cFABP test in whole venous blood with immune chromatography express test “CardioFABP” (SPI “Biotest”, Novosibirsk, Russia) and level of cardiac troponin I by qualitative and quantitative methods. For both markers, the values were assessed of sensitivity, specificity, diagnostic accuracy, positive and negative predictive value in general, and various timing intervals from the moment of clinical ACS signs presentation and ECG changes.

Results. During first 6 hours from the pain onset, cFABP test performed better than cTnI by sensitivity, diagnostic accuracy and negative predictive significane (p<0,01), and no worse than specificity and positive predictive value (p>0,05). With the pain less than 3 hours and 3-6 hours, ROC areas for cFABP are better than those for cTnI. With the duration of clinical signs more than 6 hours, sensitivity and diagnostic accuracy were better than of cTnI. In anamnesis of the patients with false positive results of cFABP test there were kidney diseases and anemia. They also had GFR <30 mL/min/1,73 m2 at admission and higher in-hospital mortality (p<0,01).

Conclusion. Qualitative express-test “CardioFABP” makes it to more accurately diagnose MI at early stages of the disease comparing to cTnI. The test might be useful in cases when MI diagnostics is complicated or if there are no ways to measure levels of troponins.

Russ J Cardiol 2017, 11 (151): 62–67

http://dx.doi.org/10.15829/1560-4071-2017-11-62-67

Key words: fatty acid binding cardiac protein, express test, acute coronary syndrome, myocardial infarction, early diagnostics.

1N. I. Pirogov Russian National Research Medical University (RNRMU), Moscow; 2Rostov State Medical University, Rostov-na-Donu; 3A. I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD), Moscow; 4Center for Speech Pathology and Neurorehabilitation, Moscow; 5Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo; 6I. M. Sechenov First Moscow State Medical University of the Ministry of Health, Moscow; 7M. K. Amosov North-Eastern Federal University, Yakutsk; 8Ryazanskaya Oblast Clinical Cardiological Dispensary, Ryazan; 9RS(Ya) Republic Hospital № 3, Yakutsk; 10Rostovskaya Oblast Clinical Hospital, Rostov-na-Donu; 11I. P. Pavlov Ryazan State Medical University, Ryazan, Russia.

THE ASSESSMENT OF PRETEST PROBABILITY IN OBSTRUCTIVE CORONARY LESION DIAGNOSTICS: UNRESOLVED ISSUES

Sumin A. N.

Abstract

Invasive coronary arteriography is a gold standard in CHD diagnostics, however in many cases it ends with none significant obstructive lesions revealed. Recently, an algorithm was implemented, based on the assessment of pretest probability (PTP) of coronary heart disease. It is noteworthy that current international guidelines do differently recommend the PTP calculation, there are differences in further tactics of non-invasive and invasive investigation. Also, real clinical practice witness on significant overestimation of PTP when the recommended scores are in use. The review is focused on different PTP scores, the reasons discussed for differences in results of application. This helps to make clinical usage more conscious.

Russ J Cardiol 2017, 11 (151): 68–76

http://dx.doi.org/10.15829/1560-4071-2017-11-68-76

Key words: CHD diagnostics, pre-test probability.

Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia.

CLINIC AND PHARMACOTHERAPY

ROLE OF GENDER SPECIFICS IN MYOCARDIAL REMODELLING, CARDIOVASCULAR COMPLICATIONS DEVELOPMENT AND EFFICACY OF PHARMACOTHERAPY IN HEART FAILURE PATIENTS AFTER CARDIAC

SURGERY

Liskova Yu. V.1,2, Stadnikov А. А.1, Salikova S. P.2

Abstract

Aim. To assess gender influence on myocardial remodelling, pharmacotherapy efficacy and complications development in chronic heart failure patients (CHF) post cardiac surgery.

Material and methods. In the study, 87 patients included, both genders, with CHF, who had been planned for cardiac surgery. All underwent standard investigations and CHF treatment, as other pathologies. Myocardium specimens from the right atrium appendage (RAA) were collected during surgery, investigated with general histology, immune histochemistry (expression of MMP-9, TIMP-1 and р38αMAPK) methods. For the evaluation of treatment influence on myocardium, intervention groups were selected: enalapril and metoprolol, perindopril and amlodipine (Prestance®, “Les Laboratoires Servier”, France). In all participants, at 10-14 day post surgery, the rate of complications was evaluated, by groups. At least one complication led to selection the participant as adverse in-hospital outcome. The relations were studied, of post-surgery complications with EchoCG data and morphological changes in LAA myocardium, taken the gender and left ventricle ejection fraction (LVEF).

Results. In cardiac surgery group with heart failure and preserved LVEF (HFpEF) with the increase of CHF functional class, normal LVEF remained, and there was worsening of the LV diastolic function. In HFpEF males there was decrease of EF with transition to “grey zone” by III functional class, and eccentric remodeling predominated with unchanged diastolic function. In HF mid-range EF group, regardless of gender, there was eccentric LV remodelling. In RAA myocardium of women there was lower grade of myocardial fibrosis and mononuclear areas of infiltration, and there was higher rate of cardiovascular as extracardiac complications. High grade of MMP-9 in RAA revealed in the group of HF mid-range EF and adverse outcome, regardless gender, and increased expression of р38αMAPK in females of this group. In perindopril and amlodipine group there was lower grade of MMP-9 and р38αMAPK expression.

Conclusion. The study demonstrated gender differences in remodelling of myocardium in HFpEF patients. This makes to consider female gender, HF midrange EF, MMP-9 expression in RAA myocardium, as prognostic markers of surgery adverse outcome. Combination of perindopril and amlodipine demonstrated protective influence on myocardium, with more prominent effect in females.

Russ J Cardiol 2017, 11 (151): 77–85

http://dx.doi.org/10.15829/1560-4071-2017-11-77-85

Key words: heart failure, remodelling, cardiac surgery, gender, matrix metalloprotease-9, pharmacotherapy

1OrSMU of the Ministry of Health, Orenburg; 2S. M. Kirov Military Medical Academy of Ministry of Defense, Saint-Petersburg, Russia.

LITERATURE REVIEWS

MULTIPLE ROLE OF LEUCOCYTES IN CORONARY HEART DISEASE

Gavrisheva N. А.1, Alekseeva G. V.2, Boyko А. I.1, Panov А. V.2

Abstract

A summary provided, on the role of leucocytes as an independent risk factor for coronary heart disease (CHD). Various aspects analyzed, of the leucocytes role in atherosclerosis and CHD development. Predictive value assessed of the leucocytes number shifts in a range of CHD types.

Russ J Cardiol 2017, 11 (151): 86–92

http://dx.doi.org/10.15829/1560-4071-2017-11-86-92

Key words: atherosclerosis, leucocytes, reactive oxygen species, cellular adhesion molecules, proteases, cytokines, apoptosis, telomeres.

1I. P. Pavlov First Saint-Petersburg State Medical University of the Ministry of Health, Saint-Petersburg; 2Federal Almazov North-West Medical Research Centre of the Ministry of Health, Saint-Petersburg, Russia.

SIGNIFICANCE OF COPEPTIN IN DIAGNOSTICS OF MYOCARDIAL INFARCTION

Kremneva L. V.

Abstract

In the review, studies results are presented on the significance of laboratory marker copeptin in diagnostics of myocardial infarction (MI) and further prognosis evaluation. Copeptin (surrogate marker of vasopressin) represents the severity of endogenic neurohormonal stress and significantly increases in blood during the first hour of MI course, declining at tenth hour from onset. Negative values of copeptin and troponin T make it with high grade of credibility to rule out MI. Grade of copeptin increase correlates with the size of myocardium necrosis focus and further prognosis of the disease: sudden death risk and progression of chronic heart failure.

Russ J Cardiol 2017, 11 (151): 93–97

http://dx.doi.org/10.15829/1560-4071-2017-11-93-97

Key words: myocardial infarction, diagnostics, copeptin.

Tymen State Medical University, Tyumen, Russia.

JUBILEE

Rafael G. Oganov

Russ J Cardiol 2017, 11 (151): 98-99

Anatoliy V. Govorin

Russ J Cardiol 2017, 11 (151): 100-101

7 декабря 2017 г.
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