Репозиторий Университета

© 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.

© 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.

© Russian Journal of Cardiology. In the article, an analysis provided of recent views on the overtraining syndrome by the data from local and foreign publications. The witness of the problem actuality is also an existence of controversial opinions and absence of clear definitions on properties of the condition. It has been revealed that the main role in pathogenesis of the overtraining syndrome do play the changes of cardiovascular, endocrine and central nervous systems. These changes are complicated and ambiguous, depend upon multiple factors, as the type of sport, specifics of exertion and loads, stage of pathophysiological process. Entraining effect of exertion, if incorrectly utilized, underestimation of current condition of a sportsman, might not lead to expected results. Moreover, non-rational application of exertion might lead to opposite effect, that is, to decrease adaptation potential and reserves, towards the edge of the condition as an overtraining syndrome, which shows phasic, progressing character, starting from fatigue and mild disorders, to persistent, rigidly reversible processes. Due to controversy, multiple stages and multifactorial of the overtraining syndrome, by now there is no unified approach to its definition, as no unified standards to its diagnostics, treatment and prevention.

© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The article is devoted to the study of attributive components of people diagnosed with Ischemic heart disease. Effort angina. The results of empirical studies of the attributive process are discussed in the article. Now more and more researchers, both domestic and foreign, are beginning to consider attribution as one of the principles of human existence. Attributive processes initially began to be developed in line with the cognitive orientation of social psychology. Currently, they are actively considered in the framework of the psychology of social cognition. Method: We conducted a study on 24 subjects with an average cholesterol level of 7.426 mmol / l (concomitant diseases-hypertension, diabetes, obesity, metabolic syndrome), who underwent treatment in the Central City Clinical Hospital in the rehabilitation department with the diagnosis of Ischemic Heart Disease. Effort Angina. Initially, we conducted the survey of subjects in order to identify their subjective judgment about the cause of the disease. They were asked a question: “In your opinion, what is the cause of your heart disease?” Results: The results of the survey conducted testify that only a small percentage of the subjects believe that they could exert any influence on their health and, for example, to reduce environmental or biological factors. One would assume that such results may be a specific demonstration of the fact that an individual gains experience that it is precisely human health that is difficult to correct and change and simply does not solve it due to the complexity of the problem. However, data obtained in the course of other experiments and studies [19] show that a person is inclined to explain what is happening by circumstances or situational causes, rather than personal ones. The results obtained with the help of T. Dembo’s cognitive self-assessment technique indicate that women believe that they actually have much less physical exertion and their daily routine is more correct than people who are close to them, in their opinion, think about it. We can assume that introjects are more often peculiar to women than men that are related to housekeeping, which sometimes requires considerable physical activity and time. When a woman has to, at the insistence of a doctor, reduce her physical activity and somehow comply with the daily regimen, she feels discomfort because of which she believes that she “does nothing at all”, although her relatives continue to persuade her to have a rest. Here it is appropriate, in our opinion, to raise the problem of accepting oneself and, as a sequence, to take adequate care of oneself. Significant differences in the self-attributive and reflexive components were also discovered in the emotional sphere of the female subjects. In their opinion, they experience low intensity of negative emotions, such as fear and anger, but at the same time they believe that their close relatives radically disagree. This situation can be explained either by the fact that they assume that they have negative emotions more strongly than they would like (and what they admit to this in the study), or they are judged by the words of relatives who can also make their judgments by interpreting the facts with varying degrees of adequacy. Conclusion: In conclusion, it should be noted that during the analysis we encountered at least two facts that require further empirical research. Firstly, we identified three types of explanations (attributions) in the subjects’ answers: adverbial, subjective and personal, and the latter type of causal attribution is not expressed clearly in the subjects of the study. This poses new questions: does a particular type of situation contribute to this perception, or are there any other factors (including personal ones) playing the role here. Secondly, the following questions arise: how exactly does a subject choose only one alternative from a variety of explanatory reasons. All these questions will be understood as a part of our further research.

© 2018, Silicea-Poligraf. All rights reserved. Aim. To evaluate the prevalence of myocarditis in adult patients with non-compaction myocardium (NCM) of the left ventricle (LV), and its influence on the disease course, results of treatment and outcomes. Material and methods. To the study, 103 adult patients included, with NCM, 61 males, mean age 45,6±14,9 y. o. (from 18 to 78). Mean end diastolic LV size was 6,0±0,8 сm, EF LV 38,8±14,5%. Diagnosis of NCM had been done by echocardiography, multispiral computed tomography (n=81) and magnetic resonance tomography (n=39). DNA-diagnostics was performed by NGS method with further Senger sequencing. Pathogenic mutations were found in 9% of patients in the genes MYH7, MyBPC3, LAMP2, DES, DSP, TTN. The investigation also included anticardiac antibodies, genome of cardiotropic viruses by PCR, coronary arteriography (n=26), scintigraphy (n=25). Morphological assessment of the myocardium was done in 19 patients (12 endomyocardial biopsies), 1 intraoperation biopsy, 3 explanted hearts, incl. 2 after biopsy, and 5 autopsies. Mean follow-up 12 [2; 32] months. Results. Myocarditis was found in 53,4%, incl. virus-positive in 32,7% of those, with morphology done for 19 patients (active myocarditis in 10, borderline in 6; with minimal signs of activeness in 3). Viral genome in myocardium found in 8 patients (42,1%). The prevalence of myocarditis 44,4% in an arrhythmic variant of NCM, 12,5% in chronic ischemic, 57,5% in dilation cardiomyopathy, 50,0% in NCM patients with other cardiomyopathies. Special cases were acute/subacute myocarditis in NCM (10,7% of all), acute necrosis (infarction) in 4,9%. Comorbidity with myocarditis in NCM led to significantly more severe LV dysfunction (CHF FC 2 [1; 3] v 1,75 [0; 2], p<0,01, EF 33,8±13,5 v 44,7±13,6%, p<0,001), more prevalent non-sustained ventricular tachycardia (67,3% v 29,3%, p<0,01), proper shocks (38,9% v 0, p<0,05), deaths (16,4 and 4,2%, OR 5,75, 95% CI 1,21-27,43, p<0,05) and transplantation (7,3% v 2,1%, p>0,05). Only in myocarditis patients, as a result of basis (antiviral, immune suppression) and cardiotropic therapy there was significant increase of EF (in acute myocarditis from 25,4±7,9 to 38,6±9,5%, p<0,01), decrease of LV size and pulmonary systolic pressure. Conclusion. Myocarditis is typical phenomenon developing in patients with the primary, i. e. genetically verified NCM. The nature of myocarditis in NCM varies (primary infectious-autoimmune, secondary as a response on genetic/ischemic damage of cardiomyocytes), however regardless of this, it leads to significant worsening of structural and functional parameters, increase of the life-threatening arrhythmias rate, and outcomes (death + transplantation, proper shocks), demanding for active basic therapy.

© 2018 Stavropol State Medical University. All Rights Reserved. Myocardial micro-alternation index (IMM) is one of the characteristics of the ECG dispersion mapping (DM) which is widely used for screening of the population. We studied the relationship between IMM, age and gender. We also investigated the prevalence of different IMM ranges: normal (<15 %, 15-21 % - boundary, >21 % - pathological) in visitors of the health centers (HC). Data of 537 820 visitors of the HC from 25 regions of Russia were analyzed. The visitors underwent ECG DM recording, anthropometry, measurement of blood pressure, glucose and cholesterol in capillary blood. The results have shown that IMM dependence on age and sex is very weak, so the special criteria are not required. The prevalence of IMM ranges («normal», «borderline values» and «pathology») is found to be age-dependent: the prevalence of pathological and borderline IMM values increased from 55 years and 35 years respectively. From the same age there is a decrease in the proportion of visitors with normal IMM values. The share of visitors with risk factors for non-communicable diseases is maximal among those whose values are in the IMM range considered as «pathology» and minimal in the range of «normal».