Diabetes mellitus and heart failure — a modern look at the mechanisms of development

Heart failure (HF) is a pressing public health problem. According to the literature, the presence of diabetes mellitus (DM) significantly increases the risk of repeated hospitalizations and the length of hospital stay in patients with heart failure. The proportion of HF remains high due to increased life expectancy, higher prevalence of risk factors and improved survival rates. Currently, advances in the treatment of coronary heart disease (CHD) and valvular disease have significantly improved survival rates, but the prognosis for heart failure remains extremely poor. Among the most important medical problems, heart failure occupies a special place in patients with type 2 diabetes. DM contributes to the onset of HF through a variety of mechanisms, including a complex of specific structural, functional, and metabolic changes in the myocardium called diabetic cardiomyopathy. Despite the active study of the causes of cardiomyopathy, the search and implementation of new approaches in assessing the risk of developing this pathological phenomenon in patients with heart failure remains relevant. This review examines current hypotheses for the development of diabetic cardiomyopathy, such as insulin resistance, endothelial dysfunction, fibrosis, lipotoxicity, and energy disorders

Low temperature sintering of electroexplosive nanopowders

By means of the methods of conductivity measurement and transmitting electron microscopy of sintered metal layer it has been shown that electroexplosive copper and zink powders are sintered with the formation of strong aggregates of corresponding compact metals. It has been also shown that sels-sintereing is a cause of below reduction of metal powder particle size obtained by the method of semiconductor electrical explosion

Anthropometric indices and their relationship with poor prognosis in patients with coronary artery disease and obesity

Aim. To assess the association of anthropometric indices in patients with coronary artery disease (CAD) and obesity and to study their predictive value in the development of adverse cardiovascular events.Material and methods. The study included 229 patients with CAD (median age, 55±7,56 years). Depending on the presence of obesity according to the World Health Organization criteria (1999), patients were divided into 2 groups. The 1st group included 107 obese patients, while the 2nd group — those without obesity (n=122). The groups were comparable in age. We measured waist (WC) and hip circumference (HC), followed by waist-to-hip ratio and body mass index calculation. The lipid profile parameters were determined by the enzymatic colorimetric method. During the study, the following indices were calculated: body mass index, visceral adiposity index, insulin resistance index, body shape index (BSI), fasting triglyceride (TG)/plasma glucose index, waist-to-height ratio, lipid accumulation product, TG-to-high density lipoprotein cholesterol ratio.Results. During the follow-up period, adverse cardiovascular events in the 1st group of patients were found in 37 (34,5%) patients, while in the 2nd group, the composite endpoint was revealed in 12,3% of patients. In order to develop a model for predicting the risk of an unfavorable CAD course in obese patients, we performed a logistic regression analysis, which showed that the following were the most significant predictors of unfavorable cardiovascular outcomes: TG/glucose index and BSI.Conclusion. Thus, of all the considered anthropometric indices, only two were associated with unfavorable CAD course — TG/glucose index and BSI. The data obtained indicate the validity of the search for novel useful obesity indicators with a good predictive value

Charlson comorbidity index in predicting deaths in COVID-19 patients

Aim. To assess the clinical performance and factors associated with inhospital mortality in patients with coronavirus disease 2019 (COVID-19).Material and methods. Our results are based on data from hospital charts of inpatients hospitalized in the Asinovskaya District Hospital in the period from March 11, 2020 to December 31, 2020, with a verified COVID-19 by polymerase chain reaction. The study included 151 patients, the median age of which was 66,2 (50- 92) years (women, 91; 60,3%). The study endpoints were following hospitalization outcomes: discharge or death. Depending on the outcomes, the patients were divided into 2 groups: the 1st group included 138 patients (survivors), while the 2nd one included 13 patients (death). To objectify the severity of multimorbidity status, the Charlson comorbidity index was used. The final value was estimated taking into account the patient age by summing the points assigned to a certain nosological entity using a calculator table.Results. Hypertension was recorded in the majority of patients — 79,5%, chronic kidney disease — in 61,1%. The prevalence of type 2 diabetes and coronary artery disease was high — 31,8% each. Prior myocardial infarction was diagnosed in 11,3% of cases. The prevalence of percutaneous coronary intervention and coronary bypass surgery was 5,3% and 3,3%, respectively. Stroke was detected in 9,3% of participants. Prior chronic pulmonary pathologies in COVID-19 patients were rare (asthma — 3,3%, chronic obstructive pulmonary disease — 2,0%). In order to predict the death risk in COVID-19 patients, a logistic regression analysis was performed, which showed that age and Charlson comorbidity index were the most significant predictors.Conclusion. Independent factors of inhospital mortality were age and Charlson’s comorbidity index. The risk assessment model will allow clinicians to identify patients with a poor prognosis at an earlier disease stage, thereby reducing mortality by implementing more effective COVID-19 treatment strategies in conditions with limited medical resources

Prognostic value of the Metabolic Score for Insulin Resistance in the development of myocardial infarction in patients with coronary artery disease and obesity after coronary stenting

Aim. To assess the predictive value of anthropometric indices in relation to the risk of myocardial infarction in patients with coronary artery disease (CAD) and obesity after coronary stenting.Material and methods. The study included 229 patients with class II-IV angina pectoris, hospitalized for elective percutaneous coronary intervention with stenting. The median age was 55±7,5 years. Depending on the presence of obesity according to the World Health Organization criteria (1999), patients were divided into 2 groups. Group 1 included 107 obese patients, while group 2 — 122 non-obese patients. Patients were measured waist circumference (WC) and hip circumference (HC). In addition, waist-to-hip ratio was assessed. Lipid spectrum parameters were determined (total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). The following indices were calculated: body mass index, visceral adiposity index, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Metabolic Score for Insulin Resistance (METS-IR), TG-glucose index, lipid accumulation product, TG/HDL-C ratio, and metabolic index.Results. In the group of patients with obesity, higher values of cholesterol (p<0,001), TG (p<0,001), LDL-C (p=0,006), and lower HDL-C (p<0,001) levels were established. Comparative analysis of metabolic indices showed that all indices significantly differed in both groups. In order to determine the critical values for quantitative predictors, ROC curves were constructed with the determination of threshold values that increase the likelihood of myocardial infarction after revascularization. It has been shown that only the METS-IR has prognostic significance. It was found that the METS-IR >48,16 is a predictor of myocardial infarction in patients with CAD and obesity (area under the ROC curve, 0,653, sensitivity — 75%, specificity — 64,39%; 95% confidence interval: 0,587-0,716; p=0,045).Conclusion. In our study, we demonstrated the significance of the novel METS-IR. We found that the value of METS-IR >48,16 is a predictor of myocardial infarction in patients with CAD and obesity after coronary revascularization (area under the ROC curve, 0,653, sensitivity — 75%, specificity — 64,39%)

Synthesis and Characterization of Electro-Explosive Magnetic Nanoparticles for Biomedical Applications

Nowadays there are new magnetic nanostructures based on bioactive metals with low toxicity and high efficiency for a wide range of biomedical applications including drugs delivery, antimicrobial drugs design, cells' separation and contrasting. For such applications it is necessary to develop highly magnetic particles with less than100 nm in size. In the present study magnetic nanoparticles Fe, Fe[3]O[4] and bimetallic Cu/Fe with the average size of 60- 90 nm have been synthesized by electrical explosion of wire in an oxygen or argon atmosphere. The produced nanoparticles have been characterized with transmission electron microscopy, X-ray phase analysis, and nitrogen thermal desorption. The synthesized particles have shown antibacterial activity to gram-positive (S. aureus, MRSA) and gramnegative (E. coli, P. aeruginosa) bacteria. According to the cytological data Fe, Fe[3]O[4]and Cu/Fe nanoparticles have effectively inhibited viability of cancer cell lines Neuro-2a and J774. The obtained nanoparticles are promising for new antimicrobial drugs and antitumor agents' developmen

Risk factors for heart failure in patients with COVID-19

Aim. To establish risk factors for heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).Material and methods. Medical records of 151 patients treated in an infectious disease hospital from November 3, 2020 to February 2, 2021 with a confirmed diagnosis of COVID-19 were retrospectively selected. The collection of clinical, history and laboratory data were carried out by analyzing electronic medical records. We analyzed information on age, sex, body mass index, smoking, and comorbidities. Following laboratory studies were analyzed: complete blood count, biochemical blood tests, coagulation profile, acute phase proteins (C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH)), procalcitonin. The diagnosis of HF was confirmed by clinical performance, echocardiography, and elevated levels of the N-terminal pro-brain natriuretic peptide (NT-proBNP). The risk of HF was taken as the endpoint of the study.Results. The studied sample of patients was divided into two groups depending on HF: the 1st group included 46 patients with HF, the 2nd group — 105 patients without HF. The median age was 66,2 (50-92) years (women, 91 (60,3%)). Laboratory indicators, such as the levels of CRP, LDH, procalcitonin, creatinine, bilirubin, differed significantly from each other, and the median values were higher in patients with HF. The neutrophil-to-lymphocyte ratio (NLR) showed significant intergroup differences: in the group of patients with HF, the median was 4,97% vs 3,62% (p=0,011) in the group of patients without HF. There were following most significant predictors increasing the HF risk: age ≥66 years (odds ratio, 8,038, p<0,001), procalcitonin level, which increases the HF risk in patients by 3,8 times (p><0,001), NLR ≥4,11% (p=0,010), thrombocytopenia ≤220×109/l (p=0,010), history of chronic kidney disease (CKD) (p=0,018). Conclusion. The following predictors of HF were established: age ≥66 years, procalcitonin ≥0,09 ng/ml, NLR ≥4,11%, thrombocytopenia ≤220×109/l, history of CKD, LDH ≥685 U/l and creatinine ≥102 µmol/l, international normalized ratio ≥1,19, QTc interval ≥407,5 ms, bilirubin ≤10,7 µmol/l. It is worth noting that the best accuracy values are demonstrated by the Random Forest algorithm (88,5% on the validation set), but the mathematical model of the neural network turned out to be the most sensitive (90,0% on the validation set). Keywords: novel coronavirus infection, heart failure, prognosis>˂0,001), procalcitonin level, which increases the HF risk in patients by 3,8 times (p˂0,001), NLR ≥4,11% (p=0,010), thrombocytopenia ≤220×109/l (p=0,010), history of chronic kidney disease (CKD) (p=0,018).Conclusion. The following predictors of HF were established: age ≥66 years, procalcitonin ≥0,09 ng/ml, NLR ≥4,11%, thrombocytopenia ≤220×109/l, history of CKD, LDH ≥685 U/l and creatinine ≥102 µmol/l, international normalized ratio ≥1,19, QTc interval ≥407,5 ms, bilirubin ≤10,7 µmol/l. It is worth noting that the best accuracy values are demonstrated by the Random Forest algorithm (88,5% on the validation set), but the mathematical model of the neural network turned out to be the most sensitive (90,0% on the validation set)

Synthesis and Characterization of Electro-Explosive Magnetic Nanoparticles for Biomedical Applications

Nowadays there are new magnetic nanostructures based on bioactive metals with low toxicity and high efficiency for a wide range of biomedical applications including drugs delivery, antimicrobial drugs design, cells' separation and contrasting. For such applications it is necessary to develop highly magnetic particles with less than100 nm in size. In the present study magnetic nanoparticles Fe, Fe[3]O[4] and bimetallic Cu/Fe with the average size of 60- 90 nm have been synthesized by electrical explosion of wire in an oxygen or argon atmosphere. The produced nanoparticles have been characterized with transmission electron microscopy, X-ray phase analysis, and nitrogen thermal desorption. The synthesized particles have shown antibacterial activity to gram-positive (S. aureus, MRSA) and gramnegative (E. coli, P. aeruginosa) bacteria. According to the cytological data Fe, Fe[3]O[4]and Cu/Fe nanoparticles have effectively inhibited viability of cancer cell lines Neuro-2a and J774. The obtained nanoparticles are promising for new antimicrobial drugs and antitumor agents' developmen

Chemical behaviour of Al/Cu nanoparticles in water

Bimetallic Al/Cu nanoparticles with Al/Cu composition 10:90, 20:80, 40:60 were produced by method of simultaneous electrical explosion of metal pairs in the argon atmosphere. Nanopowders containing 20% and 40% (mass) of aluminum interacted with water at 40–70 °C and formed composite particles that were porous structures of nanopetal pseudoboehmite with nanosized copper-containing inclusions inside. Aluminum in nanopowder with Al/Cu composition 10:90 did not react with water, as far as it is in the phase of intermetallic compounds СuAl2 and Сu4Al9. Nanocomposite produced can be used as an active component of antibacterial agents

Synthesis of novel hierarchical micro/nanostructures AlOOH/AlFe and their application for As(V) removal

Hierarchical micro/nanostructured composites, which contain iron and/or its (hydr)oxides, demonstrate high rate and capacity of arsenic adsorption. The main objective of this paper is the use of novel low toxicity AlOOH/AlFe hierarchical micro/nanostructures for arsenic removal. AlOOH/AlFe composite was obtained by simple water oxidation in mild conditions using AlFe bimetallic nanopowder as a precursor. AlFe bimetallic nanopowder was produced by electrical explosive of two twisted wires in argon atmosphere. The productivity of the electrical explosion assembly was 50 g/h, with the consumption of the electrical energy was 75 kW·h/kg. AlFe bimetallic nanoparticles were chemically active and interacted with water at 60 °C. This nanocomposite AlOOH/AlFe is low cost and adsorbs more than 200 mg/g As(V) from its aqueous solution. AlOOH/AlFe composite has flower-like morphology and specific surface area 247.1 m2/g. The phase composition of nanostructures is present AlOOH boehmite and AlFe intermetallic compound. AlOOH/AlFe composite was not previously used for this. The flower-shape AlOOH morphology not only facilitated deliverability, but increased the As(V) sorption capacity by up to 200 mg/g. The adsorption kinetics has been found to be described by a pseudo-second-order equation of Lagergren and Weber-Morris models while the experimental adsorption isotherm is closest to the Freundlich model. This indicates the energy heterogeneity of the adsorbent surface and multilayer adsorption. The use of non-toxic nanostructures opens up new options to treat water affected by arsenic pollution