The possibilities of using a new fixed-dose combination of rosuvastatin and acetylsalicylic acid: Focus groups of patients
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01.01.2018 |
Ostroumova O.
Kochetkov A.
Voevodina N.
Sharonova S.
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Rational Pharmacotherapy in Cardiology |
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0 |
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© 2018 Stolichnaya Izdatelskaya Kompaniya. The review focuses on the impairment of the carotid, coronary arteries and lower-extremity arterial disease. Systemic involvement of various vascular beds in atherogenesis is emphasized. Epidemiological characteristics of morbidity and mortality from the main clinical manifestations of atherosclerosis - ischemic stroke, ischemic heart disease and lower-extremity arterial disease are given. The current principles of drug therapy are considered from the point of view of improving the prognosis and eliminating ischemia. The basic positions of International and Russian clinical recommendations on the management of patients with the presence of certain clinical manifestations of atherosclerosis are discussed. Detailed administration schemes and the preferred doses of statins and antiplatelet agents depending on the localization of atherosclerotic lesion and the severity of stenosis are described. The target blood lipids levels in the treatment with statins are given. The advantages of statins as drugs that reduce the risk of cardiovascular complications are presented. Current data on the pattern of antiplatelet use, including acetylsalicylic acid, in individuals with clinical manifestations of atherosclerosis are given. The principal tactic of dual antiplatelet therapy and schemes of its use in patients undergoing percutaneous coronary intervention, coronary artery bypass surgery and in individuals with a history of acute coronary disorders are considered..
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The estimated efficiency of pneumococcal vaccination in able-bodied men
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01.01.2018 |
Briko N.
Batyrshina L.
Briko A.
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Profilakticheskaya Meditsina |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Objective - to evaluate the possible epidemiological and economic efficiency of pneumococcal vaccination in men with different chronic diseases. Material and methods. A prognostic (Markov) model was constructed based on the data available in the literature. The estimated efficiency of pneumococcal vaccination in reducing mortality, preventable diseases, and economic damage over a 5-year period was evaluated in able-bodied men. According to official statistics, the group at high risk for pneumonia in the Russian Federation includes 21,575,887 able-bodied men. The sources of data on the cost of the disease were governmental tariffs in the compulsory health insurance system in 2016 and those of vaccination cost were the results of competitive bidding for the procurement of 13-valent pneumococcal conjugate vaccine (PCV13). Results. The results of extrapolation of data from Russian and foreign studies in patients with chronic respiratory diseases, circulatory diseases, or diabetes mellitus showed a significant reduction in the risk of complications due to the underlying disease (RR=0.58; p<0.05), the number of hospitalizations (RR=0.02; p<0.05), and expected postvaccination mortality. The cost of vaccination in the assessed patient group was 25,869.5 million rubles. The use of PCV13 significantly reduces the number of exacerbations and, accordingly, hospitalizations, which saves about 14,359.9 million rubles in each subsequent year after vaccination. Thus, the total budget savings can reach 2,850.3 million rubles just during 2 years. A single dose of PCV13 will save at least 61,702 lives over 5 years. Conclusion. The results of this investigation suggest that pneumococcal vaccination has high epidemiological and clinical efficiency in able-bodied men with chronic diseases. This intervention reduces morbidity rates, the number of exacerbations and hospitalizations, as well as deaths in the vaccinated group, and it is a cost-effective investment in public health service.
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Efficacy of myocardial revascularization in potential recipients of heart with the chronic ischemic heart failure
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01.01.2018 |
Gautier S.
Mironkov A.
Sakhovsky S.
Koloskova N.
Muminov I.
Spirina E.
Tunyaeva I.
Mironkov B.
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 Russian Transplant Society. All rights reserved. Aim: To evaluate clinical efficiency of percutaneous coronary interventions (PCI) at potential recipients of heart with the chronic ischemic heart failure (CHF). Materials and methods. In this retrospective study results of treatment at 76 patients with CHF NYHA III and 36 patients with CHF NYHA IV by scheduled PCI are presented. Duration of observation was from 6 to 160 months. The age of patients at the time of intervention was 61,7 ± 0,62 years (from 33 to 76). 108 male and 4 female. Defined life expectancy and echocardiography parameters of the left ventricle (LV) of heart. Results. 20 patients were died, 16 of them from cardiovascular events. 18 patients during this period undergo orthotopic heart transplantation (HT). The endovascular revascularization leads to LV volumes reduction, increase of ejection fraction and decrease of pulmonary artery pressure. Progress CHF is followed by negative dynamics of these characteristics and need of HT performance. In 74% of cases the effect of myocardial revascularization allows to provide increase in life expectancy of potential recipients of heart with the chronic ischemic heart failure. Conclusion. Performance of PCI at patients with the chronic ischemic heart failure can delay heart transplantation or become its alternative.
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The problems and the optimization of non-pulsating pumps of the assisted blood circulation
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01.01.2018 |
Itkin G.
Gautier S.
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 Russian Transplant Society. All rights reserved. The method of mechanical circulation support using non-pulsating flow pumps, built on the principle of rotary (centrifugal and axial) pumps, took the leading direction (94%) in the world clinical practice for the treatment of the patients with terminal heart failure. Despite this, the clinic application of these pumps in a number of cases faced with the numbers of negative problems associated with this technology. This is stimulated of a new direction of principles for a control of the rotary pumps, based on the modulation of the speed pumps. The article analyzes the negative factors of the clinical application of non-pulsating flow pumps and gives an overview of the methods the optimization of the control pump based on the modulation of the output flow.
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Heart transplantation waiting list of V.I. Shumakov National medical research center of transplantology and artificial organs. Trends from 2010 to 2017
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01.01.2018 |
Gautier S.
Poptsov V.
Koloskova N.
Zakharevich V.
Shevchenko A.
Muminov I.
Nikitina E.
Kvan V.
Halilulin T.
Zakiryanov A.
Golts A.
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 National Research University Higher School of Economics. All Rights Reserved. The aim: to analyze the waiting list for heart transplantation from 2010 to 2017 and to characterize recipients with chronic heart failure III–IV NYHA Class. Methods. The study comprised 997 patients (139 [14%] females and 858 [86%] males) included in the waiting list for heart transplantation the period from January 2010 to December 2017. The average age of patients on the waiting list was 49.0 ± 12.0 (from 10 to 78 years). Before making a decision on inclusion in the waiting list, all patients underwent clinical and instrumental examination, including general clinical studies, echocardiography, measurement of central hemodynamic parameters using a Swan–Gans catheter, computer and/or magnetic resonance imaging of the chest, abdominal and brain. Results. Heart transplantation was performed on 728 patients (99 females – 13.6% and 629 males – 86.4%) including 18 children aged 12 to 17 years (14.18 ± 2.07 years). Mortality in the waiting list in 2010 was 16.1%, compared with 3.2% in 2017.
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The effects of angiotensin-converting enzyme inhibitors in heart recipients: A single center experience
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01.01.2018 |
Shevchenko A.
Faradzhov R.
Izotov D.
Koloskova N.
Nikitina E.
Gichkun O.
Orlov V.
Tunyaeva I.
Mironkov B.
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 Russian Transplant Society. All Rights Reserved. Aim. To study the effect of ACE inhibitors (ACEI) in heart recipients on the prognosis and myocardial remodeling. Materials and methods. Three hundred and eighty-six patients who received orthotopic heart transplantation (HT) were consequently enrolled to the study from February 2009 to November 2016. Results. Thirty days after the HT, ACEIs were assigned to 141 recipients. Arterial hypertension was diagnosed in all cardiac recipients who received ACEI and among 48 patients (19.5%) from non-ACEI group. Patients receiving ACEI had significantly better event-free survival than control group (p = 0.045) during the follow-up for 1361,6 ± 36,9 days. Left ventricle (LV) end-diastolic dimension did not change over the time in both groups, whereas LV posterior wall thickness in non-ACEI group significantly increased from 1.35 ± 0.03 cm to 1,23 ± 0.05 cm (p < 0.05). Conclusion. Cardiac recipients who received ACE inhibitors had better survival and less transplant left ventricle progression, that could reflect beneficial effects of renin-aldosterone-angiotensin system inhibition after heart transplantation.
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Magnetic resonance imaging of the heart in the diagnosis of sarcoidosis
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01.01.2018 |
Stukalova O.
Meladze N.
Ivanova D.
Shvecz T.
Gaman S.
Butorova E.
Guchaev R.
Kostyukevich M.
Ternovoy S.
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Terapevticheskii Arkhiv |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Heart sarcoidosis diagnosis presents great difficulties due to the absence of specific clinical manifestations. Most often, the diagnosis is established during autopsy. Magnetic resonance imaging (MRI) of the heart with contrast enhancement is one of the most informative methods of intravital diagnosis of cardiac sarcoidosis. In this article, two clinical cases, shows the role of MRI of the heart with contrast enhancement in the diagnosis of cardiac sarcoidosis.
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Clinical types (classification) of the right ventricle arrhythmogenic dysplasia: Specifics of diagnostics and management
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01.01.2018 |
Lutokhina Y.
Blagova V.
Nedostup V.
Shestak G.
Zaklyazminskaya V.
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Russian Journal of Cardiology |
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0 |
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© 2018, Silicea-Poligraf. All rights reserved. Aim. To classify established clinical types of the right ventricle arrhythmogenic dysplasia (RVAD) taken a variety of genetic and inflammatory mechanisms, and to analyze the specifics of differential diagnostics and management of the respective types. Material and methods. Main group consisted of 50 patients with evident (n=26), probable (n=13) and possible (n=11) RVAD diagnosis, mean age 38,1±14,6 y. o., males — 20 (40%), follow up time 13,5 [4; 34] months. Comparison group consisted of 58 patients with some of the RVAD criteria insufficient for evident diagnosis. All patients underwent ECG, Holter ECG 24 hours, EchoCG; in the main group additionally — DNA-diagnostics (n=46), cardiac MRI (n=44), high definition ECG (n=16), endomyocardial biopsy of the RV (n=2), autopsy (n=2). In comparison group, MRI was done in 32 patients, biopsy to 7, and in 1 case — autopsy. Results. Based upon the clinical data and specifics of the disease course, 4 types of established clinical RVAD were selected, that do not tend to overlap: latent arrhythmic (50% patients), manifest arrhythmic (20%), RVAD with predominant biventricular chronic heart failure (CHF, 16%), and RVAD with non-compaction left ventricle myocardium (14%). The development of one or another type is based on genetic factors, as on comorbid myocarditis (in percent in the following, respectively). In diagnostics of the latent arrhythmic type (frequent right ventricle extrasystoly, VE and/or non-sustained right ventricular tachicardia, VT) the key role played female sex, syncopes in anamnesis (16%), family history of sudden death (12%), ECG-criteria and positive results of DNA diagnostics (24%). For manifest arrhythmic type (sustained VT) — sudden death family anamnesis (in 20%), MRI-criteria (enlarged RV with lower EF), ECG-criteria and positive DNA tests (50%). For RVAD with progressing CHF — sustained VT (50%), syncopes (37,5%), predominance of RV failure with its severely reduced EF (25,7±15,0%), major MRI-and ECG-criteria, decreased QRS-voltage and positive DNA test (38%). Comorbidity of RVAD and non-compaction myocardium differ by frequent VE, aggressive VT (57,1%), syncope (42,9%) and CHF with significantly lower than in DCMP EF LV. Mortality rate in I-IV types was, respectively, 0%, 10%, 25%, 14,3%, and relevant shocks in 8 of 13 (61,5%) patients with ICD. Conclusion. It is worthy to use the proposed RVAD classification in clinical practice to define the spectrum of diagnostical and management events and assess the individual patient prognosis.
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The perfusion of cisplatin and cisplatin structural analogues through the isolated rat heart: The effects on coronary flow and cardiodynamic parameters
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01.01.2018 |
Stojic I.
Jakovljevic V.
Zivkovic V.
Srejovic I.
Nikolic T.
Jeremic J.
Jeremic N.
Djuric D.
Radonjic K.
Labudovic-Borovic M.
Bugarcic Z.
Bogojeski J.
Novokmet S.
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General Physiology and Biophysics |
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0 |
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© 2018, Slovak Academy of Sciences. All rights reserved. The therapeutic use of cisplatin for the treatment of solid tumours is associated with organ toxicity. Amongst those, the cardiotoxicity is an occasional but very serious and severe side effect. To prevent or reduce these negative effects, many cisplatin analogues have been synthesized and evaluated in terms of being a less toxic and more effective agent. In present study, we examined the effects of cisplatin and its three analogues in the isolated rat heart to determine whether changes in the structure of the platinum complexes (changing of carrier ligands – ethylenediamine; 1,2-diaminocyclohexane; 2,2’:6’,2’’-terpyridine) can influence their cardiotoxic effects. The results of our research indicate that the introduction of aromatic rings in the structure of the platinum complexes has a negative influence on the heart function. Conversely, the other two examined complexes had less negative effects on heart function compared to cisplatin. Our findings may be of interest for a possible synthetic strategy of introducing a carrier ligand that will exert a less cardiotoxic effect.
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Coenzyme Q10 in cardiovascular and metabolic diseases: Current state of the problem
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01.01.2018 |
Zozina V.
Covantev S.
Goroshko O.
Krasnykh L.
Kukes V.
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Current Cardiology Reviews |
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3 |
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© 2018 Bentham Science Publishers. The burden of cardiovascular and metabolic diseases is increasing with every year. Although the management of these conditions has improved greatly over the years, it is still far from perfect. With all of this in mind, there is a need for new methods of prophylaxis and treatment. Coenzyme Q10 (CoQ10) is an essential compound of the human body. There is growing evidence that CoQ10 is tightly linked to cardiometabolic disorders. Its supplementation can be useful in a variety of chronic and acute disorders. This review analyses the role of CoQ10 in hypertension, ischemic heart disease, myocardial infarction, heart failure, viral myocarditis, cardiomyopathies, cardiac toxicity, dyslipidemia, obesity, type 2 diabetes mellitus, metabolic syndrome, cardiac procedures and resuscitation.
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The gut microbiota in cardiovascular diseases: From biomarkers and potential targets to personalized interventions
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01.01.2018 |
Ashikhmin Y.
Syrkin A.
Zamyatnin A.
Zhang Y.
Kopylov P.
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Current Pharmacogenomics and Personalized Medicine |
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1 |
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© 2018 Bentham Science Publishers. Background: This study discusses the crucial factors responsible for the progression of atherosclerotic cardiovascular disease (CVD). The interaction between the gut microbiota, heart and vessels in CVD pathogenesis is extremely complex and includes components such as direct bacterial translocation from the gut to vessels and metabolitemediated damage. To a greater extent, CVD seems to be entangled with a subtle immune system-to-microbiota interface. From among the most significant advances in recent years in this area, it is necessary to highlight the discovery of the pro-atherogenic effect of trimethylamine-N-oxide (TMAO) and changes in the activity of effector T-cells in the settings of dysbiosis. Currently, we are witnessing an explosive growth in interest in using the microbiota and interlinked cascades as a target for therapeutic interventions, including direct microbiome targeting, the attenuation of toxic metabolite-induced damage, the modulation of intestinal immunity, and downstream inhibition of systemic inflammatory pathways. Objective: In this brief review, modern strategies of microbiome-based therapies for the prevention and treatment of CVD are classified and discussed from the perspective of personalized medicine.
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Results of experimental studies of the children’s axial pump «Don-3»
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01.01.2018 |
Itkin G.
Dmitrieva O.
Buchnev A.
Drobyshev A.
Kuleshov A.
Volkova A.
Halilulin T.
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 Russian Transplant Society. All rights reserved. Aim. To evaluate the functioning of an implantable pediatric axial pump «DON-3» for bypassing the left ventricle of the heart in experiments on sheep. Materials and methods. Five sheeps at the age of 12–18 months performed paracorporeal installation of the children’s axial pump «DON-3» according to the scheme «left ventricle – aorta». Results. A technique was developed and 5 chronic experiments were conducted on sheep to assess the model of the children’s axial pump «DON-3». The duration of the experiments in this series averaged 9 ± 5 days. The main indicators of hemodynamics, acid-base balance were within the norm. Conducted morphological and histological studies of the kidneys, liver and lungs did not reveal the presence of zones of ischemia and thromboembolism. Conclusion. The results of this series of experiments showed satisfactory results, suggesting further research on the development of prototypes of a pediatric pump for clinical practice.
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Tricuspid valve insufficiency in recipients with transplanted heart
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01.01.2018 |
Orlov V.
Saitgareev R.
Shevchenko
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Vestnik Transplantologii i Iskusstvennykh Organov |
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0 |
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© 2018 Russian Transplant Society. All rights reserved. Tricuspid valve insufficiency is one of the most common variants of valve pathology of transplanted heart. The review is sanctified to the analysis of modern looks to on causes, potentially influencing on development of tricuspid valve insufficiency of transplanted heart, and also methods sent to declines risk his development.
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The use of a specialized food product based on fermented milk whey to enhance the adaptive potential of athletes (skiers-riders)
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01.01.2018 |
Litvin F.
Bruk T.
Klochkova S.
Kalosha A.
Nikityuk D.
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Voprosy Pitaniia |
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1 |
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© 2018 Nutritec. All rights reserved. Specialized sports nutrition is one of the most important factors in the extension of the functional potential of athletes, providing adaptive resistance to physical stress, which determines the high physical performance and prolongs athletic longevity of the athletes. The study involved 30 skiers-racers (the average age of 19.5±1.8 years). 12 skiers of the main group within 21 days consumed a specialized food product, obtained on the basis of fermented milk whey containing amino acids, several vitamins, minerals and trace elements, live culture of lactic acid bacteria: L. lactis, L. thermophilus, L. bulgaricus (1.2 × 10s CFU/cm3). The control group consisted of 18 skiers, those taking the placebo (food starch of the same consistency). After a course of product intake, blood level of hemoglobin increased by 6%, of leukocytes - by 10% due to an increase in the number of granulocytes by 32%, and segmented neutrophils by 16% (p<0.05), there was a tendency to increase the number of red blood cells by 7% with a significant decrease in lymphocyte count by 19%. Erythrocyte sedimentation rate in blood of the skiers from the comparison group increased by 41% (p<0.05), while in the athletes of the main group it decreased by 16% (p>0.05). After product intake it has been established by the method of laser Dopplerflowmetry that there was a tendency to increase blood perfusion by 15%, a statistically reliable increase in the flux by 53%, which is based on the improvement of the internal mechanisms of microcirculation regulation. According to the mathematical analysis of cardiac rhythm, centralization of regulation decreased while the activity of an autonomous mechanism for controlling the work of the heart increased. The revealed functional changes ensured an increase of absolute (by 31%, p<0.05) and relative (by 33%, p<0.05) physical performance and aerobic endurance of skiers, contributed to the improvement of short-Term memory. The conclusion is made about the expediency of the intake of the specialized food product to enhance the adaptive capacity of athletes under the influence of systematic physical loads.
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Psychophysiologic features and personal-adaptive potential of students with limited abilities
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01.01.2018 |
Kalenik E.
Salakhova V.
Mikhaylovsky M.
Zhelezniakova M.
Bulgakov A.
Oshchepkov A.
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Electronic Journal of General Medicine |
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11 |
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© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The article contains the results of studying homeostasis of the cardiovascular system by the method of cardiointervalography in students with limited abilities of various programs of study at university. A psychological assessment of the attitude of students with limited abilities to their health was made. The problem of the components of the personal-adaptive potential has been studied. A study of the level of human potential of students on a separate component of “health” and in the aggregate has been conducted, as well as conclusions based on this research work have been drawn. Method: To solve the objectives set in the study, the following methods were used: the review of scientific and methodological literature, instrumental and calculated physiological research methods: variational pulsometry; mathematical analysis of the heart rate variability; calculation method for assessing adaptive capacity-adaptive capacity offered by Bayevsky; the questionnaire “Psychological features of a person’s attitude to his health”, in the framework of a study of the human potential index (health component), a questionnaire was developed based on a questionnaire for assessing the quality of life, developed at the Institute of Stress Medicine (USA) in 1993, methods-descriptive mathematical statistics and testing the hypothesis by Student’s t-test. Results: The analysis of the activity index of the sympathic regulation link-mode amplitude (AMo%) according to the standards of homeostasis, in view of variation pulsograms, is characterized in the studied groups, as moderate sympathicotonia. The AMo index in the groups is not statistically different, reflects the stabilizing effect of centralization of the heart rate control, and indicates the activation of the sympathic division of the autonomic nervous system (ANS). AMo 1 year = 40.8 ± 8.1%; AMo 2 year = 44.9 ± 4.8%; AMo 3 year = 43.9 ± 8.8% the index is in the upper limits of the norm, the index is normal only in the group of first year students. It can be stated that the body of students with limited abilities reacts with a nonspecific adaptive response to the study load, and this depends on the specifics of the diseases and functional reserves that are low in this category of students. The indicator of urgent adaptation-vagosympathetic balance (LF / HF) shows the greatest stress in the group of first-year students. The index is statistically reliably different from the LF / HF1 year = 2.074 ± 0.39 * (according to the paired Student’s t-criterion of dependent indices p ≤ 0.5) from that of students in the second LF / HF2 year = 1.174 ± 0.25 and the third LF / HF3 year = 1.308 ± 0.26 years of study, indicating an increase in sympathic influences. A decrease in the ratio of the LF / HF index in the groups of second and third year students can be interpreted as a positive effect. There was general adaptation to the educational process at the university, and the correct construction of training and health-related workloads, in accordance with the medical diagnosis, led to a balanced regulation of the sympathic and parasympathic nervous system. Conclusion: The stress level of regulatory systems is assessed by the value of the adaptation potential. The higher is the adaptive capacity of the circulatory system, the lower the values of the adaptive potential. The adaptive potential is an indicator that determines the interrelation of two opposite concepts: “health” and “disease”, morpho-functional changes. In case of illness, a shift towards disadaptation takes place.
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Prenatal Atrioventricular Septal Defect (AVSD) as a planned congenital heart disease with different outcome depending on the presence of the coexisting extracardiac abnormalities (ECA) and/or malformations (ECM)
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01.01.2018 |
Słodki M.
Soroka M.
Rizzo G.
Respondek-Liberska M.
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Journal of Maternal-Fetal and Neonatal Medicine |
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0 |
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© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Prenatal atrioventricular septal defect (AVSD) on frequent occasions coexists with other cardiac or extracardiac abnormalities or malformation which may change the prognosis and the management with the fetus and the newborn. The aim of the research was to assess the prognosis and the outcome of prenatally diagnosed AVSD based on the classification which also includes coexisting extracardiac abnormalities and malformations as well as its influence on the prenatal consultation. Methods: It was a retrospective analysis of 113 patients with prenatally diagnosed AVSD. The group was selected out of 871 patients with CHD. Out of 113 fetuses with AVSD we exclude those in whom AVSD was coexistent with other cardiac malformations (n = 41). Extracardiac abnormalities [ECA] were defined as problems which do not require surgical intervention after delivery, they were usually markers of a genetic syndrome. Extracardiac malformations [ECM] were defined as problems requiring surgical interventions after delivery or lethal malformations. All 72 fetuses with an isolated AVSD were classified to one of the three groups: (1) Simple AVSD–(sAVSD)–a fetus with isolated AVSD without coexisting ECA and ECM (n = 6), (2) sAVSD + ECA–a fetus with isolated AVSD, with coexisting ECA (n = 28), (3) sAVSD + ECM–a fetus with isolated AVSD, with coexisting ECM (n = 38). Results: The pregnancy from the groups sAVSD + ECM were, in fact, more often referred to the prenatal cardiology centers on account of the existing ECM (p=.03). There were no differences between the two subgroups in regard to: the mean age of the pregnancy, the mean age of the fetus at the time of diagnosis and during diagnostic testing at the referral center, the gender of the fetus. An increased nuchal translucency (NT) was most often found in fetuses from the group AVSD + ECA (n = 13/23), which was connected with more frequent occurrence of abnormal karyotype (p=.048). The trisomy 21 more frequently referred to pregnancy with sAVSD + ECA than those with sAVSD + ECM (p=.0006). In the group sAVSD + ECM there was the highest number of fetuses small for the gestational age detected −48.65% (p=.01). Most often premature deliveries were found in the group sAVSD + ECM (72.73%). The duration of gestation in the group sAVSD + ECM turned out to be much shorter than that in the group with the isolated sAVSD (p=.01) and sAVSD + ECA (p=.03). The lowest Apgar score was in the newborns from the group sAVSD + ECM (p=.002). Longer period of gestation was connected with the higher score on Apgar scale (R = 0.541; p=.001). The average delivery weight of the newborns was the lowest in the group sAVSD + ECM (p=.04). sAVSD + ECM was connected with the significantly higher death rate than the isolated sAVSD (p=.0047) or sAVSD + ECA (p<.00001). The fatality rate of the newborns/ fetuses from the pregnancies lasting less than 37 weeks turned out to be much higher than in the case of the remaining pregnancies (sAVSD p=.002). Conclusions: (1) The majority of fetuses with AVSD remained the patients of just obstetricians and prenatal cardiologists because of highly heterogeneous of the coexisting malformations and abnormalities and since they perish in the period of fetal or neonatal life usually they are not seen by the pediatricians or cardiac surgeons. (2) The classification of the AVSD in fetus to a particular group of the prognostic classification of the fetal heart defects helps to plan perinatal management and supplies information regarding the prognosis. (3) The highest mortality rate was in a group of AVSD + ECM, probably due to shorter time of pregnancy duration, fetuses grow restriction and low Apgar score in 1 minute of life.
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Mesenchymal stem cell therapy for ischemic heart disease: Advances and challenges
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01.01.2018 |
Konoplyannikov M.
Kotova S.
Baklaushev V.
Konoplyannikov A.
Kalsin V.
Timashev P.
Troitskiy A.
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Current Pharmaceutical Design |
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3 |
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© 2018 Bentham Science Publishers. Ischemic Heart Disease (IHD) has been recognized as the main cause of mortality in the modern world. Application of cell therapy technologies for the IHD treatment has been actively studied from the beginning of 2000s. The review is dedicated to the use of mesenchymal stem cells (MSC) in the therapy of IHD. The strategies of the MSC modification in vitro for improvement of their regenerative potential are extensively discussed, including preconditioning to enhance the cell survival, boosting their paracrine effect and manipulating their car-diomyogenic differentiation. The optimization of the MSC delivery and opportunities related to the use of biomaterials as cell carriers are also discussed. The results of the most important clinical studies on the MSC-based IHD therapy are presented, including those completed and published in the literature and the ongoing clinical trials registered at clinicaltrials.gov by June 2018.
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Inhibition of HIF-prolyl 4-hydroxylases as a promising approach to the therapy of cardiometabolic diseases
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01.01.2018 |
Aitbaev K.
Murkamilov I.
Fomin V.
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Terapevticheskii Arkhiv |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Prolyl-4-hydroxylases of hypoxia-inducible factor (HIF-P4Hs) are enzymes that, under the conditions of normoxia, cause degradation of the HIF-transcriptional protein, which regulates a number of metabolic processes, including erythropoiesis, glucose level and lipid metabolism. In hypoxic conditions, on the contrary, their activity is suppressed and HIF stabilization takes place. This mechanism, i.e. stabilization of HIF by inhibition of HIF-P4Hs was the basis for the development of drugs designed for treatment of renal anemia, which are currently in stages 2 and 3 of clinical trials and are showing encouraging results. Recently, it has also been reported that inhibition of HIF-P4Hs can be effective in treatment of cardiometabolic diseases - coronary heart disease, hypertension, obesity, metabolic syndrome, diabetic cardiomyopathy and atherosclerosis. The review, based on the most recent data, discusses in detail molecular mechanisms of therapeutic effect of HIF-P4Hs inhibition in these pathological conditions and provides evidence that these mechanisms are associated with HIF stabilization and gene expression, improving perfusion and endothelial function, reprogramming metabolism from oxidative phosphorylation to anaerobic glycolysis, reducing inflammation and having beneficial effect on the innate immune system.
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Novel combination of the angiotensin converting enzyme inhibitor perindopril and highly selective β-adrenoblocker bisoprolol: Prime among the equal
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01.01.2018 |
Ostroumova O.
Kochetkov I.
Starodubova V.
Guseva F.
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Cardiovascular Therapy and Prevention (Russian Federation) |
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© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. The article is focused on a broad evidence of antihypertension efficacy of perindopril and bisoprolol. The issues considered, of the drugs usage in patients with arterial hypertension, ischemic heart disease and chronic heart failure according to the international and local clinical guidelines. Special attention is paid for the influence of perindopril and bisoprolol on prognosis - the risk of cardiovascular complications from the evidence based medicine perspective. The data provided on a novel unique combination of these medications, and the benefits are accounted, as the mechanism of complimentary interaction; the results of randomized trials, clinical trials provided, that point on the high potential of this sort of combinational treatment.
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Myocarditis with outcome in dilated cardiomyopathy complicated by refractory heart failure and requiring heart transplantation
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01.01.2018 |
Balykova L.
Leontyeva I.
Urzyaeva N.
Schekina N.
Petrushkina Y.
Ivyanskaya N.
Soloviev V.
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Rossiyskiy Vestnik Perinatologii i Pediatrii |
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© Team of authors, 2018. The article describes the clinical case of subacute myocarditis in a child with an outcome in dilated cardiomyopathy, complicated with congestive heart failure. Difficulties in diagnosing the disease that manifested with cardiac arrhythmia are discussed. The main signs suggesting postmiocardic cardiomyopathy included a reduced deflection voltage and frequent ventricular extrasystoles with episodes of the ventricular tachycardia in the onset of the disease, left ventricular dilatation, a significant decrease in ejection fraction, increased activity of natriuretic peptide, findings of perfusion scintigraphy and magnetic resonance imaging. Medical therapy and implantation of a cardioverter defibrillator were ineffective. The child repeatedly suffered from syncopal conditions with circulatory arrest, which required resuscitation. Due to the ineffectiveness of drug therapy conducted in the leading federal centres, considering cardiac transplantation abroad was recommended.
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