Research Institute for Cardiology

Tomsk, Russia

Research Institute for Cardiology

Tomsk, Russia
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Kovalev I.A.,Yu Da University | Ovroutski S.,Deutsches Herzzentrum Berlin | Plotnikova I.V.,Research Institute for Cardiology | Tupikina A.A.,Research Institute for Cardiology
Kardiologiya | Year: 2017

Heart failure (HF) is a predictable outcome of nearly all cardiovascular diseases including congenital heart diseases (CHD). A special category comprises patients with functional single ventricle (FSV) of the heart because of extreme diversity of anatomical changes of the heart and great vessels, complex mechanisms of development of HF, multistage surgical correction of the defect, presence of arrhythmias, progressive rise of pulmonary vascular resistance, etc. Prevention and treatment of HF in patients with FSV includes surgical optimization of pulmonary blood flow during neonatal period, timely staged surgical correction of the defect, pharmacotherapy, cardiac resynchronization therapy, and in severe cases mechanical cardiac support and heart transplantation. This article contains review of the mechanisms of HF development in patients with FSV as well as analysis of current approaches to recognition and treatment of this condition.


Vasiltseva O.Ya.,Research Institute for Cardiology | Vorozhtsova I.N.,Siberian State Medical University | Krestinin A.V.,Research Institute for Cardiology | Stefanova E.V.,Regional Medical Statistics Bureau | Karpov R.S.,Research Institute for Cardiology
Kardiologiya | Year: 2017

Objective: to study impact of main nosological pathology and selected strategy of medical management on outcome of pulmonary artery thromboembolism (PE) in patients admitted to hospitals in the city of Tomsk. Material and methods. Using data of hospital PE registry in Tomsk we conducted a retrospective clinical-pathoanatomical study on 751 patients with PE diagnosed during hospitalization or at autopsy who died during period from 2002 to 2012. Using multiple linear regression, we assessed relationships between assessment factor of underlying disease, assessment factor of erroneous strategy of medical management, and resulting parameter - number of inhospital deaths. Results. During 10-year period there occurred increase of per patient quantity of risk factors of PE development and of diseases, considered at autopsy as primary pathology. A gradual increase in the contribution of variations of nosological forms and decrease in contribution of strategy of medical management in development of lethal outcome of patients with PE were also observed.


Maslov L.N.,Research Institute for Cardiology | Khaliulin I.,University of BristolBristol | Oeltgen P.R.,University of Kentucky | Naryzhnaya N.V.,Research Institute for Cardiology | And 4 more authors.
Medicinal Research Reviews | Year: 2016

It has now been demonstrated that the μ, δ1, δ2, and κ1 opioid receptor (OR) agonists represent the most promising group of opioids for the creation of drugs enhancing cardiac tolerance to the detrimental effects of ischemia/reperfusion (I/R). Opioids are able to prevent necrosis and apoptosis of cardiomyocytes during I/R and improve cardiac contractility in the reperfusion period. The OR agonists exert an infarct-reducing effect with prophylactic administration and prevent reperfusion-induced cardiomyocyte death when ischemic injury of heart has already occurred; that is, opioids can mimic preconditioning and postconditioning phenomena. Furthermore, opioids are also effective in preventing ischemia-induced arrhythmias. © 2016 Wiley Periodicals, Inc.


Boshchenko A.A.,Research Institute for Cardiology | Vrublevsky A.V.,Research Institute for Cardiology | Karpov R.S.,Research Institute for Cardiology
Kardiologiya | Year: 2011

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.


Lishmanov Yu.B.,Research Institute for Cardiology | Maslov L.N.,Research Institute for Cardiology
Kardiologiya | Year: 2010

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.


Vechersky Yu.Yu.,Research Institute for Cardiology | Zatolokin V.V.,Research Institute for Cardiology | Andreev S.L.,Research Institute for Cardiology | Shipulin V.M.,Research Institute for Cardiology
Kardiologiya | Year: 2016

We have prospectively collected data from 43 patients who underwent coronary artery bypass surgery and received bilateral internal thoracic artery (ITA) graft. Left ITA was harvested on full length from ostium to bifurcation. Right ITA harvesting included mobilization of only its proximal stump (5-6 cm long), that allowed its distal segment to remain intact. Proximal stump of right ITA was lengthened by radial artery or large subcutaneous vein grafts in order to reach various parts of coronary vascular bed. After comparative intraoperative manometry of ante- And retrograde pressures in right ITA patients were divided into two groups. In group 1 patients (n28) difference between ante- And retrograde systolic pressure (112.5±17.4 and 92.4±19.6 mm Hg, respectively) was <30%; in group 2 patients (n15) difference between ante- And retrograde pressure (110.2±14.1 and 68.9±12.3 mm Hg, respectively) was 230%. Lower limb and carotid (arteries stenotic lesions (stenosis >60-70%) were more frequent in group 2 (n8; 18.6%) than in group 1 (n4; 9%). However postoperative ultrasound study detected no significant differences between two groups in systolic retrograde blood flow velocity in intact portion of right ITA (29.8 ± 8.7 and 23.1 ± 8.0 cm/s, respectively, p> 0.05). Absence of sternal wound healing complications confirmed efficacy of sternal retrograde blood supply through lower and upper epigastric arteries. Patency rate of composite grafts according to angiography (n19) performed in 3±0.8 years after surgery was high (94.7%). Our data confirm high functionality of bilateral ITA grafts with preservation of sternal supply.


Boshchenko A.A.,Research Institute for Cardiology | Vrublevsky A.V.,Research Institute for Cardiology | Karpov R.S.,Research Institute for Cardiology
Kardiologiya | Year: 2016

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.


PubMed | Research Institute for Cardiology
Type: Journal Article | Journal: Bulletin of experimental biology and medicine | Year: 2016

CB receptor agonist HU-210 exhibits an infarction-limiting effect during in vitro reperfusion of the heart after focal ischemia. This effect is paralleled by a decrease in left-ventricular developed pressure and double product. In addition, HU-210 reduces end-diastolic pressure during the reperfusion period, which indirectly attests to reduced Ca


Boshchenko A.A.,Research Institute for Cardiology | Vrublevsky A.V.,Research Institute for Cardiology | Karpov R.S.,Research Institute for Cardiology
Kardiologiya | Year: 2016

Transthoracic echocardiography (TTE) has been described as an accurate technique for noninvasive evaluation of coronary flow reserve (CFR) of the left anterior descending artery (LAD) and posterior descending artery (PDA). Aim of this study was to find out whether serial measurement of CFR in LAD and PDA using TTE allows detection of stenosis elimination after intracoronary intervention and is a marker of successful procedure. Methods. The study group comprised 14 patients with single-vessel coronary disease (stenosis 82±14%) of the LAD (9 patients) or right coronary artery (RCA, 5 patients) scheduled for stent implantation. All patients underwent dipyridamole stress echo with CFR evaluation of either distal LAD or PDA 1 day before and 6-9 days after successful stent implantation. CFR was calculated as the ratio of hyperemic to basal peak diastolic velocity. A CFR value of <2.0 was considered abnormal. Results. Adequate Doppler signals to measure CFR were obtained in 13 patients (93%). Abnormal pre-procedure CFR value was revealed in 12 assessed patients (92%). Significant increase of CFR due to a decrease of coronary flow velocity at rest and its more pronounced hyperemic rise was found in all patients after stent implantation (CFR: 1.28 ±0.52 before and 2.53 ±0.37 after stenting; p< 0.001). Using a cut-off value of CFR ∗2.0 to identify absence of significant coronary artery disease, TTE detected successful stent implantation with a sensitivity of 91.7% and specificity of 100% for both LAD and RCA. CFR was still abnormal in only 1 patient with pre-procedure >90% LAD stenosis. Conclusion. TTE is a feasible technique for serial CFR evaluation in LAD and PDA. Cut-off CFR value a2.0 is a sensitive and specific criterion of successful stent implantation in LAD and RCA.


Vershinina E.O.,Research Institute for Cardiology | Ryabova T.R.,Research Institute for Cardiology | Repin A.N.,Research Institute for Cardiology
Kardiologiya | Year: 2015

Performed an open, prospective, randomized, controlled clinical trial, including 63 patients stable coronary artery disease on the background of carbohydrate metabolism disorders. All patients underwent elective coronary stenting. Patients of the main group (n = 32) within 2 weeks before the intervention received trimetazidine 35 mg x 2 times a day in addition to standard therapy. Patients in the control group (n = 31) PCI and follow-up was performed with standard therapy and without the use of metabolic drugs. Revealed that long reception of myocardial cytoprotector trimetazidine leads to a significant improvement of the contractile function of the left ventricular myocardium at a distant period according to echocardiography (reducing end diastolic index by 5.5%, decrease in end-systolic index by 4.4%, increase in LVEF of 2.5% in 12 months after endovascular revascularization compared with baseline).

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