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Lishmanov Yu.B.,Research Institute for Cardiology | Maslov L.N.,Research Institute for Cardiology

The authors of the review have analyzed papers published during last six years on the problem of ischemic postconditioning of the heart. Postconditioning has been shown to decrease infarct size, prevent apoptosis of cardiomyocytes, improve cardiac contractility in reperfusion period, prevent appearance of reperfusion arrhythmias, prevent development of no-reflow phenomenon. Analyzes of published data demonstrate that adenosine, endogenous opioids, bradykinin, calcitonin gene-related peptide may be triggers of postconditioning. Data on successful use of postconditioning in patients with acute myocardial infarction and cardiac surgery patients are also presented and possibility of clinical use of adenosine receptor agonists and opioids is discussed. Source

Rogovskaya Y.,Tomsk State University | Botalov R.,Tomsk State University | Ryabov V.,Siberian State Medical University | Rebenkova M.,Research Institute for Cardiology | And 3 more authors.
Key Engineering Materials

Endomyocardial biopsy is the gold standard in the diagnosis of myocardial pathology. Intravital study of endomyocardial samples offers the possibility to determine the morphological substrate and etiology of disease, to monitor the effectiveness of treatment. We studied morphological features, viral antigens, macrophages and specifically alternatively activated macrophages in endomyocardial biopsies of 25 patients with idiopathic arrhythmias and heart failure. Immunohistological study was performed to identify type of lymphocytes, macrophages and antigens of cardiotropic viruses. We observed the presence of alternatively activated macrophages in myocardium of patients with myocarditis and without it. We detected the presence of viral antigens in the myocardium of patients with myocardial fibrosis without of histological criteria myocarditis. Small focal infiltration of the myocardial CD68+ macrophages associated with heart failure and ventricular arrhythmias. The presence of virus antigens in myocardium associated with fewer myocardial stabilin-1+ macrophages [negative correlation]. On the other side small focal infiltration of stabilin-1+ macrophages correlated with severity of myocardial interstitial fibrosis [positive correlation]. © Copyright 2016 Trans Tech Publications Ltd, Switzerland. Source

Maslov L.N.,Tomsk Polytechnic University | Vychuzhanova E.A.,Research Institute for Cardiology | Gorbunov A.S.,Research Institute for Cardiology | Tsibulnikov S.Yu.,Tomsk Polytechnic University
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk

Habitation within the polar circle increases cardiovascular mortality rate and particularly increases mortality as a result of coronary events. The main reason of elevation of mortality from these diseases is a dyslipidemia which developed more among alien population residing long time in Far North. Dyslipidemia is less found among aboriginal population of Arctic Circle keeping traditional way of life and respectively it is low rate of mortality from coronary heart disease. The data showed that low rate of dyslipidemia among aboriginal population of North regions depends on fish consumption which is high content of ω3-polyunsaturated fatty acids. © 2014, Izdatel'stvo Meditsina. All rights reserved. Source

Boshchenko A.A.,Research Institute for Cardiology | Vrublevsky A.V.,Research Institute for Cardiology | Karpov R.S.,Research Institute for Cardiology

Analysis of possibilities of transthoracic echocardiography (TTEchoCG) diagnosis of hemodynamically significant stenoses of anterior descending and right coronary arteries (ADCA and RCA) based on Doppler assessment of coronary reserve (CR) was carried out in 73 patients with cardiac pain syndrome (mean age 48±7 years, 60 men, 13 women). As a referent method we used coronary angiography. Coronary blood flow at baseline and during administration of a vasodilator (dipyridamole up to 0.84 mg/kg) was assessed by broadband ultrasound transducer in the mode of noncontrast tissue second harmonic imaging in distal segments of ADCA and posterior interventricular artery (PIVA). CR was calculated as ratio of peak hyperemic to baseline diastolic coronary blood flow velocity. CR <2.0 was diagnosed as lowered. We found that TTEchoCG was simple noninvasive method of assessment of CR in distal thirds of ADCA and PIVA, which can be fulfilled in 90 and 86%of patients, respectively. We also revealed that hemodynamically significant stenoses of ADCA and PIVA caused CR lowering distally to zone of stenosis and that degree of CR lowering depended on severity of vascular narrowing. We found that CR<2.0 in distal third of ADCA was a predictor of its >50% narrowing with sensitivity 78%, specificity 85%, positive predictive value (PPV) 67%, and negative predictive value (NPV) 90%. In the presence of >70% ADCA stenosis sensitivity and NPV of the parameter reached 100%. We revealed that CR<2.0 in PIVA served as a marker of >50% RCA stenosis with sensitivity 88%, specificity 86%, PPV 68%, and NPV 95%. In the presence of >70% RCA stenosis sensitivity and NPV of the parameter rose up to 92 and 97%, respectively. Source

Boshchenko A.A.,Research Institute for Cardiology | Vrublevsky A.V.,Research Institute for Cardiology | Karpov R.S.,Research Institute for Cardiology

Aim: to assess additive diagnostic value of simultaneous evaluation of coronary flow reserve (CFR) in the left anterior descending (LAD) artery and posterior descending artery (PDA) during dipyridamole stress echocardiography (stress-Echo) for detection of LAD and PDA stenoses >50%. Methods: 108 in-patients (mean age 50 ± 11 years) with cardiac chest pain underwent dipyridamole stress-Echo with ECG-analysis, wall motion analysis by 2-dimentional imaging (2D) and coronary flow reserve (CFR) evaluation in both LAD and PDA by pulse-wave Doppler. The 2D test was considered positive when ≥2 segments demonstrated wall motion abnormalities. CFR was calculated as ratio of hyperemic to basal peak diastolic blood flow velocity. CFR <2.0 was considered reduced. Coronary angiography was performed within one week after stress-Echo. Results: 34 of 97 patients with CFR in the LAD and wall motion in the LAD territory had LAD stenosis >50%, and 22 of 90 patients with evaluated CFR in the PDA and wall motion in the RCA territory had RCA stenosis >50%. Thus stenosis >50% was detected in 56 of 187 evaluated LAD and RCA. The 2D test and ECG results were positive for 35 arterial territories, reduced CFR - for 48 arteries. With combined evaluation of ECG, 2D test and CFR, accuracy was not significantly higher (80% for ECG + 2D test, 82% for CFR and 80% for combined test) but sensitivity and negative predictive value increased (sensitivity: 63% for ECG+2D test, 86% for CFR and 91% for combined test; negative predictive value: 85% for ECG+2D test, 93% for CFR and 95% for combined test). Conclusion. Assessment of CFR in both LAD and PDA is feasible for majority of patients and can increase sensitivity and negative predictive value of dipyridamole stress-Echo for the detection of LAD and RCA stenosis >50%. Reduced CFR in LAD and PDA reveals and normal CFR excludes LAD and RCA stenosis with greater assurance than ECG changes and wall motion abnormalities. Source

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