The Influence of Multivessel Bypass Surgery on the Onset of Atrial Fibrillation in Elderly Patients

Aim. To study the factors associated with the development of postoperative atrial fibrillation (POAF) with single- or two- or more vascular bypass grafting in elderly patients with coronary heart disease.Methods. The study included 454 patients with coronary artery disease who underwent CABG. Patients were divided into 4 groups: 1 group – with single-vessel bypass, 2 group – with 2-vessels, 3 group – with 3-vessels and 4 group with 4-vessels bypass. During the observation period postoperative atrial fibrillation (POAF) occurred in 7.5% of patients in group 1, 18.4% in group 2, 17.5% in group 3 and 19.2% of patients in group 4. Since there were no significant differences in the incidence of POAF in patients with 2-4-vessels bypass grafting, these groups were combined for further analysis. 2 groups are allocated: Group I comprised patients with single-vessel bypass graft (79 patients, 76.0% of males, the average age of 65.0 [63.0;68.0] years), Group II – with 2-4-vessels bypass grafts (357 patients, 78.4% of males, the median age of 67.5 [64.5;69.0] years).Results. POAF occurred in 7.5% of patients in group I and in 18.4% of patients in group II (p=0.03) on the median 4.9 [1.2;8.7] day after coronary artery bypass graft. The multivariate regression analysis showed that indicators, associated with POAF development in patients undergoing CABG were the following: aortic cross-clamping time >36 min (odds ratio [OR)]1.4; 95% confidence interval (CI) 1.1-2.8; p=0.030), time of ischemia >19 min (OR 1.7; 95% CI 1.2-3.3; p=0.020), age >65 years (OR 1.8; 95% CI 1,1-4,1; p=0.010), left atrium diameter >39 mm (OR 2.9; 95% CI 1.5-5.4; p=0.005), left ventricular ejection fraction <51% (OR 1.9; 95% CI 1.2-3.0; p=0.04).Conclusion. In our study, atrial fibrillation in the early postoperative period was more common in patients undergoing multivessel coronary bypass surgery. Indicators, significantly associated with POAF in patients undergoing Coronary artery bypass graft were aortic cross-clamping time >36 minutes, time of ischemia >19 minutes, age >65 years, left atrium diameter >39 mm and left ventricular ejection fraction <51%

Omega-3 polyunsaturated fatty acids in the prevention of postoperative atrial fibrillation in open heart surgery: a systematic review and meta-analysis

Aim. To evaluate the literature data on the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of postoperative atrial fibrillation (POAF) in elective cardiac surgery, including onor off-pump coronary artery bypass grafting and/or valve replacement and/or repair.Material and methods. The search for studies was carried out using the PubMed database and Google Scholar from 2005 to January 31, 2022. From the initially identified search results, 19 articles were analyzed. The design of articles corresponded to randomized clinical trials. Omega-3 PUFAs was selected as an interventional effect. The studies were to include, as an end point, the assessment of new POAF cases in the early period after open heart surgery.Results. The meta-analysis included 15 studies with 3980 patients, of which 1992 (50,0%) patients took omega-3 PUFAs. POAF occurred in 587 (29,5%) patients receiving omega-3 PUFAs and 679 (34,2%) patients on standard therapy (hazard ratio, 0,8, 0,68-0,93, p=0,004). There is a variation in effect size for POAF patients in the presented randomized clinical trials relative to the axis of the central trend and heterogeneity of studies with a significant number of patients included (I2=51%, p=0,01).Conclusion. Our systematic review and meta-analysis showed the effectiveness of omega-3 PUFAs in the prevention of POAF during open heart surgery

DYNAMICS OF MORPHOLOGICAL CHANGES IN BRACHIOCEPHALIC TRUNK ARTERIES INFLUENCED OF ATORVASTATIN THERAPY IN PATIENTS OF HIGH RISK

Aim - to assess the morphological changes in the extracranial arteries of the brachiocephalic trunk in high-risk patients during atorvastatin therapy. Materials and methods. The study included 78 patients with a high risk of death from cardiovascular disease (mean age 54.8 ± 4.4 years), according to SCORE > 5% an

GENETIC POLYMORPHISMS OF CYTOCHROME P450 2C9, VITAMIN K EPOXIDE-REDUCTASE SUBUNIT 1 AND WARFARIN DOSING IN PATIENTS WITH PERMANENT ATRIAL FIBRILLATION

Aim - to assess the influence of genetic polymorphisms of CYP2C9 and VKORC1 on warfarin dosing in patients with permanent form of atrial fibrillation. Methods. The study included examination of 100 patients with coronary heart disease and permanent form of atrial fibrillation; mean age 60.5±5.8 years. Conclusion. In patients with permanent form of atrial fibrillation, genotypes CYP2C9*1/*3, TT and GG genotypes of VKORC1 are associated with low warfarin dose, compared to other genotypes. Genotype CYP2C9*1/*3 increases the risk of bleeding complication during warfarin therapy

Оптимальне керування нормальними режимами ЕЕС з врахуванням чутливості втрат потужності і технічного стану регулюючих пристроїв

Досліджено існуючі математичні методи визначення чутливості втрат потужності до зміни навантаження в вузлах. Запропоновано при оптимальному керуванні нормальними режимами (НР) електроенергетичних систем (ЕЕС) на етапі формування керуючих впливів враховувати чутливість втрат потужності в вітках до зміни навантаження в вузлах та технічний стан регулюючих пристроїв. Вдосконалено математичну модель коефіцієнту якості функціонування трансформаторів з регуляторами під навантаженням (РПН).The existing mathematical methods for determining power losses sensitivity to a change in the nodes. An optimal control in normal mode (HP) electric power systems (EPS) at the stage of control actions take into account the sensitivity of the power losses in branches to a change in the condition of sites and control devices. Improved mathematical model coefficient as function transformers with regulators under load (RPN)

Розробка та дослідження структури системи автоматичного керування нормальними режимами електроенергетичних систем

Досліджено функції і структуру сучасних систем автоматичного керування режимами електроенергетичних систем. Запропоновані шляхи вдосконалення структурної схеми системи автоматичного керування режимами електроенергетичних систем за рахунок використання програмного комплексу SD Builder і введення додаткових блоків, зокрема блоку розрахунку планового значення технічних втрат потужності і блоку визначення коефіцієнту якості функціонування регулюючих пристроїв.Investigated functions and structure of power systems modern automatic control. Proposed ways to improve the structural scheme of the automatic control by modes of power systems through the use of software SD Builder and the introduction of additional units, including the calculation of technical power losses planned and functioning quality coefficient of regulating devices

Omega-3 Polyunsaturated Fatty Acids: the Role in Prevention of Atrial Fibrillation in Patients with Coronary Artery Disease after Coronary Artery Bypass Graft Surgery

Aim. To estimate the role of omega-3 polyunsaturated fatty acids (PUFAs) administration in atrial fibrillation (AF) prevention after planned coronary artery bypass graft (CABG) surgery.Material and Methods. Studied were 306 patients divided into two groups: patients of group I didn’t receive PUFAs (158 patients, 82.7% males) and patients of group II received PUFAs (148 patients, 89.3% males). PUFAs were prescribed in daily dose 2000 mg 5 days before surgery and in daily dose 1000 mg in postoperative period during 21 days.Results. Postoperative AF (POAF) occurred in 29.7% patients in group I and in 16.9% patients in group II (р=0.009). We found that after CABG in patients of the I group median IL-6 level was 39.3% higher (p=0.001), interleukin-10 – 20.2% higher (p=0.01), superoxide dismutase – 78.9% higher (р<0.001), malondialdehyde – 33.8% higher (p=0.03), docosahexaenoic acid – 31.8% lower (p=0.01) and omega-3 index – 43.4%    lower (p=0.04) than in patients of the II group.According to multivariate regression analysis we found significant association between the factors of inflammation, oxidative stress and the risk POAF development.Conclusions. In patients who took PUFAs, we found less activation of inflammation, oxidative stress, the increasing of docosahexaenoic acid and omega-3 index accompanied by the decreasing of POAF development rates up to 12.8%

CORRECTION OF LIPID AND HEMOSTATIC DISORDERS IN PATIENTS AT HIGH RISK OF CARDIOVASCULAR DEATH

Aim - to study the peculiarities of lipid and coagulation abnormalities in high risk patients, and also the possibilities of their correction with statin therapy. Methods. 102 patients were studied, 1 group included patients with LDL 3.0-3.9 mmol/l (n=59), who received atorvastatin 40 mg daily with titration to 80 mg daily, 2 group - patients with LDL >4.0 mmol/l (n=48), who received rosuvastatin 10 mg daily with titration to 20 mg daily. Results. In the 1 group of patients, after 24 weeks mean LDL level decreased by 43.3% (

Исследование закономерностей изменения сопротивления изоляции сетей оперативного постоянного тока

В статті наголошена важливість мереж оперативного постійного струму (МОПС) гідроелектростанцій (джерел відновлювальної енергії), розглянуто найпоширеніші прилади для контролю стану МОПС. Представлені зовнішні фактори, які найбільше впливають на стан ізоляції цих мереж, а також статистично досліджено і представлено в графічному вигляді влив зовнішнього середовища (дощ, роса, туман, тощо) і сезонності (зима, весна, літо, осінь) на величину опору ізоляції МОПС. Аналіз даних свідчить, що найбільший вплив на рівень ізоляції мають дощ та роса, а в загальному її опір найбільше знижується навесні та восени. На основі отриманих статистичних даних залежностей рівнів ізоляції МОПС від факторів зовнішнього середовища побудована залежність ймовірності виникнення зниження ізоляції цих мереж менше 20кОм в залежності від стану і параметрів МОПС. Використання методу критеріального програмування дозволило розв’язати двоїсту задачу і знайти оптимальні значення контрольованих параметрів, які забезпечують максимальну імовірність прогнозування зниження рівня ізоляції мереж оперативного постійного струму нижче нормативного значення.There is the marked importance of networks of operative direct-current (ODCN) of the hydroelectric power stations (renewable energy sources) in the article, the most widespread devices are considered for control of the state of ODCN. Presented external factors that most influence on the state of isolation of these networks, and also it is statistically investigational and presented in a graphic kind influence of environment (for example, rain, dew, fog, et cetera) and seasonality (winter, spring, summer, autumn) on the size of resistance of isolation of ODCN. The analysis of data testifies that most influence on the level of isolation is had a rain and dew, and in general her resistance most goes down in spring and autumn. On the basis of got these statistical dependences of levels of isolation of ODCN on the factors of environment the built dependence of probability of origin of decline of level of isolation of these networks less than 20kOhm depending on the state and parameters of ODCN. The use of method of the criterion programming allowed to untie an ambivalent task and find the optimal values of the controlled parameters that provide maximal probability of prognostication of decline of level of isolation of networks of operative direct-current below than normative value.В статье отмеченная важность сетей оперативного постоянного тока (СОПТ) гидроэлектростанций (источников возобновляемой энергии), рассмотрены самые распространенные приборы для контроля состояния СОПТ. Представленные внешние факторы, которые больше всего влияют на состояние изоляции этих сетей, а также статистически исследовано и представлено в графическом виде влияние внешней среды (например, дождя, росы, тумана, и т.д.) и сезонности (зима, весна, лето, осень) на величину сопротивления изоляции СОПТ. Анализ данных свидетельствует, что наибольшее влияние на уровень изоляции имеют дождь и роса, а в общем ее сопротивление больше всего снижается весной и осенью. На основе полученных статистических данных зависимостей уровней изоляции СОПТ от факторов внешней среды построенная зависимость вероятности возникновения снижения уровня изоляции этих сетей меньше 20кОм в зависимости от состояния и параметров СОПТ. Использование метода критериального программирования позволило развязать двойственную задачу и найти оптимальные значения контролируемых параметров, которые обеспечивают максимальную вероятность прогнозирования снижения уровня изоляции сетей оперативного постоянного тока ниже нормативного значения

INFLUENCE OF INTERMITTENT PNEUMATIC COMPRESSION ON ARTERIAL BED

Aim - to estimate the influence of intermittent pneumatic compression on arterial bed. Material and methods. The paper presents a literature review concerning the use of pneumatic compression in patients with peripheral artery disease. Results. Possibilities of pneumatic compression for prophylaxis and treatment of chronic ischemia in patients with peripheral artery disease are under discussion. Conclusion. The rapid growth of investigators’ interest in nonmedical methods of influence on arterial bed, and also the search for new and efficient methods and regimens highlight the significance of medical pneumatic compression. Currently, there is limited literature available about customization of pneumatic compression in accordance with nosology and individual indicators of blood circulation in lower extremities. As mentioned above, the most relevant and perspective direction is investigation of complex key indicators of arterial biomechanics with possibilities of the regimen correction, i.e. with implementation of feedback mechanism