Russian Journal of Cardiology
ISSN / EISSN : 15604071 / 26187620
Current Publisher: Silicea - Poligraf, LLC (10.15829)
Total articles ≅ 1,207
Latest articles in this journal
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-48-54
Abstract:Aim. To modernize the computed tomography angiography (CTA) protocol with advanced data processing for the diagnosis of ascending aortic (AA) aneurysms, determining the aortic distensibility and compliance. Material and methods. We examined 24 patients (14 men) aged 43 to 72 years old with aneurysm or dilatation of ascending aorta (AA). CTA was performed on Siemens Somatom Definition AS and Philips Ingenuity Elite 128-slice scanners with electrocardiographic (ECG) synchronization after a bolus injection of contrast agents (100-120 ml). End-systolic and end-diastolic frames, maximum aortic diameter and cross-sectional area were determined; aortic distensibility and compliance were calculated.Results. According to AA diameter in end-diastolic frame, patients were divided into 3 groups. Group 1 — 6 patients, d< 45 mm (39 [39; 40] mm), group 2 — 7 patients, d =45-50 mm (48 [46; 49] mm) and group 3 — 11 patients, d >50 mm (51 [51; 54] mm). A correlation between aortic distensibility and compliance and such parameters as age, systolic blood pressure, systolic and was found. Correlation between the aortic compliance and diastolic diameter can be used for predicting of diameter increase rate.Conclusion. The designed CTA protocol with advanced data processing allows evaluating the AA distensibility and compliance by the diameter and cross-sectional area in patients with AA dilatation. These criteria provide additional information about the aortic elastic properties and can be used for determining the management strategy.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-62-69
Abstract:Aim. To study the clinical significance of the gradient of narrowing of arterial lumen (GNL) for atherosclerotic stenosis of the internal carotid artery (ICA) as a risk factor for ischemic brain damage.Material and methods. We proposed a new parameter of hemodynamic severity of ICA atherosclerotic stenosis — GNL. It calculated as ratio of the difference in the ICA cross section areas on the stenotic lesion and the near non-stenotic region to the distance between them: Snorm — Sstenosis)/Dnorm — stenosis, mm2 /mm. We examined 25 patients with advanced atherosclerosis and with uni(n=22) or bilateral (n=3) ICA stenosis >50% according to European Carotid Surgery Trial, and 11 individuals without ICA stenosis. Each participant underwent magnetic resonance angiography (MRA) of the carotid arteries with reconstruction of the arteries from C6-C7 level to the parietal bones, and the GNL was calculated. The thickness of the baseline slice was 0,8-1 mm. Each subject also underwent cerebral magnetic resonance imaging (MRI) in T1-, T2-, PD-, flair-weighted protocols. Results. Patients were divided into groups: group 1 (n=12) — without ischemic injury in the ICA system, and group 2 (n=13) — with MRI signs ischemic injury history. The groups did not differ in proportion of stenosis (74,9±4,25% and 77,8±3,8%, p2 and 1,14±0,17 mm2 , p2 /mm. Groups 1 and 2 significantly differed (2,47±0,41 mm2 /mm and 4,60±0,51 mm2 /mm, p3,35 mm2 /mm, and, in group 1, 9 out of 12 — less than 3,35 mm2 /mm. GNL did not correlate significantly with other parameters of ICA stenosis. Two patients with the highest GNL in each group (5,5 and 8,6 mm2 /mm) had a fatal ischemic stroke within six monthsConclusion. Firstly, proposed parameter of stenosis hemodynamic severity GNL is independent, informative and prognostically important indicator for carotid artery atherosclerotic lesion.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-16-21
Abstract:Aim. Coronary artery calcification is a characteristic of coronary atherosclerosis, which is often detected by chest computed tomography (CT). The aim of this study is to assess the efficiency of low-dose chest CT in calcium score (CS) determining and to compare it with conventional method and results of CT and selective coronary angiography.Material and methods. A total of 251 patients underwent a low-dose chest CT and a CS determining. Coincidence between the two methods was evaluated by the absolute CS values and by stratification of patients into five risk categories (“zero” CS values were excluded from the analysis). Eighty patients underwent CT or selective coronary angiography and the results were divided into two groups according to the degree of coronary stenosis — ˂50% and ≥50%. The CS values determined by chest CT are compared with the results of coronary angiography. Results. In 79 patients (31%), the CS was 0 and they were excluded from further analysis. The absolute CS values comparability between the two scanning methods in other 172 patients was very high (r=0,978, p400 significant coronary stenosis was detected, in comparison with 22 patients from 52 patients with a CS more than 400 (p Conclusion. The research showed that low-dose chest CT can be used to determine CS. Studied values correlate with the results of coronary angiography.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-169-174
Abstract:Despite the long history of the concept where infection plays a significant role in cardiovascular diseases (atherosclerosis in particular), today it is relevant and represented a significant interest.This article discusses H. pylori role in mechanisms of cardiovascular homeostasis disturbance. H. pylori involvement in atherogenic damage of arteries, and/or plaque destabilization is no doubt. This vidence is detailed in this review article.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-40-46
Abstract:Aim. To assess the role of global and selected scintigraphic scores of myocardial perfusion, blood flow and reserve in the anatomical and functional significance of coronary artery (CA) stenosis.Material and methods. The double-blind comparative study included 23 patients (mean age 61,2±6,8 years, 12 (52%) women, 11 (48%) men). All patients underwent stress dynamic single-photon emission computed tomography (SPECT) with adenosine triphosphate (ATP) (140 µg/kg/min in 6 minutes). Myocardial perfusion disorders were assessed by a semi-quantitative method, the total Summed Stress Score (SSS), the Summed Rest Score (SRS), and the Summed Difference Score (SDS) were determined. Global (g) and regional (r) myocardial perfusion (MP) were evaluated; myocardial perfusion reserve (MPR) was calculated as the ratio of MP at stress and at rest. Coronary angiography (CAG) was performed within 1 week after SPECT, the amount of CA narrowing was evaluated by diameter. Stenoses >50% were considered anatomically significant. The assessment of the fractional flow reserve (FFR) was performed by the ratio of the mean intracoronary pressure at the CA ostia to the pressure distal to the stenosis at the ATP infusion peak. FFR ≤0,80 was considered a sign of hemodynamically significant stenosis. Results. Neither regional nor global scintigraphic scores reflecting myocardial perfusion showed statistical significance as markers of CA stenosis >50%. Among perfusion markers, only SSSg (>4) showed good sensitivity and specificity in the diagnosis of hemodynamically significant (FFR ≤0,80) stenoses (AUC 0,76; p=0,002; sensitivity 81,8%, specificity 83,3%). The following regional flow scores allowed identification of hemodynamically significant CA: stress MPr ≤0,54 ml/min/g (AUC 0,8; p=0,0003; sensitivity 57%, specificity 92%) and MPR ≤1,5 (AUC 0,86; p< 0,0001; sensitivity 71,4%, specificity 92,8%).Conclusion. It is proved that global and regional scintigraphic scores of MP and MPR are sensitive and specific markers of hemodynamically significant (FFR ≤0,80) coronary stenosis. It can be more useful for localization diagnosis of the lesion than standard SPECT.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-153-161
Abstract:Coronary artery calcification (CAC) is characteristic of coronary atherosclerosis, which is often detected by chest computed tomography. The standardized method for assessing CAC is the calcium score (CS) using the Agatston scoring system. A semi-quantitative ECG-synchronized assessment of coronary calcium score is considered a strong prognostic factor for coronary events in asymptomatic patients. Zero CS can serve as the strongest unfavorable risk factor for cardiovascular events in 10-15 years. According to international guidelines, CS should be used in patients of intermediate and low risks with a family history of cardiovascular diseases, as well as in patients with diabetes older than 40 years. The aim of this review was to summarize current data on the clinical significance of CS taking into account the results of international multicenter studies, current international guidelines and further prospects for its wider use in cardiology practice.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-137-147
Abstract:Reducing of cardiovascular risk, morbidity and mortality is considered as one of the main aims of modern cardiology, which should help increase life expectancy. Oral anticoagulants are the basis for the cardioembolic stroke prevention in patients with atrial fibrillation, which is common in patients with coronary artery disease. According to statistics, about a quarter of patients with atrial fibrillation have to perform percutaneous coronary intervention at some point in their life. This is due to stable angina or acute coronary syndrome, which is accompanied by difficulties with antithrombotic therapy. This article discusses the main clinical data and recommendations on the optimal use of combination antithrombotic therapy in patients after percutaneous coronary intervention.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-131-136
Abstract:Imaging techniques currently play a key role in cardiovascular assessing. Cardiac magnetic resonance imaging (MRI) is one the main elements of diagnosis and prognostic significance of hypertrophic cardiomyopathy (HCMP). The article provides a brief overview on both conventional and novel areas of MRI use in HCMP patients. Particular attention is paid to the MRI role in the patient selection for the surgical treatment.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-109-113
Abstract:The aim of the study was to present the performance parameters, their assessment and their predictors in the group of amateur cross-country skiers at the beginning of the preparatory period. For this purpose, incremental exercise tests were carried out on the treadmill. Body composition measurement was performed using impedance analyzer. The main findings of the study were that the most correlated with VO2 relative (max) were percentages of body fat, running speed (maximum) (km/h), running speed (final) (km/h), ventilation (L/min) and physiological cost of running (ml/kg/km). The appointment of the predictors can be an effective tool to assess the efficiency of this group and prepare a proper training plan for them.
Russian Journal of Cardiology; doi:10.15829/1560-4071-2019-12-55-61
Abstract:Aim. To develop and test a risk-stratification model for patients with coronary artery disease (CAD) and non-ischemic pathologies based on a computer analysis of electrical instability ECG markers.Material and methods. In the period from 2011 to 2018, the study included 1014 patients with CAD and non-ischemic pathologies. Depending on ventricular arrhythmia status, the analyzed cohort was divided into 3 groups: 1) 644 patients without lifethreatening ventricular tachyarrhythmias (-VTA), mean age 51,7±16,1 years; 2) 280 patients with clinically significant ventricular arrhythmias (+csVA): ventricular extrasystoles (VES) >1500/24 h, coupled VES >50/24 h or unstable ventricular tachycardia (uVT), mean age 46,7±14,0 years; 3) 90 patients with life-threatening ventricular tachyarrhythmias (+VTA): persistent VT (pVT), successful cardiopulmonary resuscitation (CPR), appropriate discharges by implanted cardioverter defibrillator (CVD), sudden cardiac death (SCD), mean age 46,8±12,7 years.Using the Intekard 7.3 software, ECG markers of myocardial electrical instability were analyzed: T wave alternation, QT interval and dispersion, fragmented QRS, spatial QRS-T angle, turbulence onset and slope, and heart rate deceleration/acceleration.Results. Statistically significant differences were found between the values of T wave alternation, QT interval, fragmented QRS and QRS-T angle in groups 1 and 3 (-VTA) and (+VTA), pPersonalized model was formed for predicting the risk of life-threatening VTA (primary endpoints: pVT, appropriate CVD discharges, CPR, SCD) in patients with CAD and non-ischemic pathologies (cardiomyopathy, channelopathy) in 5 years follow-up. Integral score of myocardial electrical instability is proposed as new quantitative parameter for risk stratification (sensitivity 75%, specificity 78%, accuracy 77%).Conclusion. The myocardial electrical instability score provides the individual assessment of the dynamic SCD risk. The Intekard 7.3 software is a simple, economic and accessible ECG tool for arrhythmia monitoring.