Characteristics of woman`s heart with disorder of coronary circulation

We present review of current evidence on ischemic heart disease in women. The risk factors, clinical manifestations, diagnosis and treatment  and prevention of ischemic heart diseases in women are discussed

Anomalous origin of right coronary artery from left coronary sinus associated with aneurysm of aortic root

Prevalence of anomalous origin of right coronary artery (RCA) from left coronary sinus in population according to autopsy studies is 0.026%. Origin of left main coronary artery and RCA from opposite sinus of Valsalva with further course of anomalous vessels between aorta and pulmonary artery often is linked to sudden death.  We present a case of anomalous origin of RCA from left coronary sinus and aneurysm of aortic root. Our case demonstrates that when both coronary arteries` ostia are close to each other coronary arteries can be re-implanted on common area.  Firstly, this prevents distention and deformation of coronary arteries that might cause myocardial infarction. Secondly, it reduces time of placing anastomosis thus decreasing period of myocardial ischemia and cardiopulmonary bypass time

Results of the Thoracoscopic Radiofrequency Epicardial Ablation with a Bipolar Electrode During Longstanding Persistent form of Atrial Fibrillation

Thoracoscopic ablation using the ‘box lesion’ technique was performed using a bipolar radio frequency clamp. A total of 48 patients, including 38 men and 10 women, mean age 58 years (range 33 74). The mean duration of AF was 4 yrs (range 1.5 months 21), the mean size of the atrium 4.15 ± 0.9 cm (2.9-8.8 cm), mean LVEF was 57.7% (39 -73%). Mitral regurgitation of 1-2 degrees was present in 14 patients, EDV LV 147.7 ml (81-224). Primary catheter ablation was performed in 22 patients, where 5 of them (22,7%) were performed repeatedly. Resection of the left atrial appendage (LAA) during the operation was performed in 44 patients (91%). Input and output block was achieved in all patients. In the postoperative period, all patients were administered supporting antiarrhythmic therapy with amiodarone and β-blockers, anticoagulant therapy with warfarin or PLA for 6-12 months. The effectiveness of treatment was monitored by a cardiomonitor Reveal XT in the period 1, 3, 6, 12, 24 months after surgery, the mean follow-up length was 498 ± 19 days. Sinus rhythm was restored during surgery in all patients and remained until discharge

Prognostic value of serum soluble ST2 in professional athletes.

Background: The predictive value of serum soluble ST2 (sST2) biomarker for diagnostics of cardiovascular pathologies is still poorly understood as well as the role of psychological stress on the risk of heart disease. Aim: This study aimed at determining the diagnostic significance of the sST2 level in athletes involved in speed-strength sports. In addition, stress as a risk factor for the development of cardiovascular pathology was assessed and analysed as well. Methods: A prospective study on Greco-Roman wrestlers was carried out at the Centre for Sports Medicine and Rehabilitation (Almaty, Republic of Kazakhstan). All participants (n = 30) were males aged 20 to 34 years. The control group consisted of volunteers (VO) (n = 30). Anthropometric and hemodynamic parameters of athletes were studied along with electrocardiography (ECG) and ECG tests. The sST2 level was determined before (BT) and immediately after (AT) training. The stress level was determined using The Perceived Stress Scale-10 (PSS-10). Results: The average age of the athletes was 26.57 ± 3.6 years. The total training experience was 14.57 ± 4.02 years. According to the ECG data, minor deviations from the norm (13.3%) and an abnormal ECG (33.3%) were identified. Echo-CG data showed "moderate" and "pronounced changes" in 23.3% and 53.3% of cases, respectively. The sST2 level of VO (337.1 ± 61.8 pg / mL) was lower than that of BT (548.1 ± 32.6 pg / mL) (p ≤ 0.001). The sST2 level of AT, it was significantly higher (830.01 ± 71.6 pg / mL) than BT (p ≤ 0.001). The average and high level of stress among athletes was in 43.3% and 56.7% of cases, respectively. Stress increased the likelihood of developing distinctly abnormal ECG (OR = 1.06, 95% CI 1.01–1.08; p = 0.02). The stress level showed a positive correlation with the sST2 level (r = 0.752, p = 0.01). The sST2 concentration and categorical echocardiography data demonstrated a dependent positive correlation (r = 0.6, p = 0.01). Conclusions: Athletes' sST2 levels exceeded thresholds both before and after training. Moreover, the relationship between an increase in sST2 levels and abnormal ECG abnormalities and a high level of stress in athletes was determined. sST2 concentration was associated with cardio-pulmonary stress triggered by the cumulative exercise dose as well as with lifelong psychological stress. Our findings indicate that the elevated sST2 concentrations in athletes could be used as the predictive value. However, clinical relevance and results validity require further intensive studies.Antecedentes: El valor predictivo del biomarcador ST2 soluble en suero (sST2) en la enfermedad cardiovascular aún no se conoce bien, así como el papel del estrés psicológico en el riesgo de enfermedad cardiovascular. Objetivos: Este estudio tuvo como objetivo determinar la importancia diagnóstica del nivel de sST2 en atletas involucrados en deportes de velocidad-fuerza. Además, también se evaluó y analizó el estrés como factor de riesgo para el desarrollo de patología cardiovascular. Métodos: Se llevó a cabo un estudio prospectivo sobre luchadores grecorromanos en el Centro de Medicina y Rehabilitación del Deporte (Almaty, República de Kazajstán). Todos los participantes (n = 30) eran hombres de entre 20 y 34 años. El grupo de control estaba formado por voluntarios (VO) (n = 30). Se estudiaron los parámetros antropométricos y hemodinámicos de los atletas junto con las pruebas de electrocardiografía (ECG). El nivel de sST2 se determinó antes (BT) e inmediatamente después (AT) del entrenamiento. El nivel de estrés se determinó utilizando la Escala de Estrés Percibido-10 (PSS-10). Resultados: La edad promedio de los deportistas fue de 26,57 ± 3,6 años. La experiencia de formación total fue de 14,57 ± 4,02 años. Según los datos del ECG, se identificaron desviaciones menores de la norma (13,3%) y un ECG anormal (33,3%). Los datos de Echo-CG mostraron cambios "moderados" y "pronunciados" en el 23,3% y el 53,3% de los casos, respectivamente. El nivel de sST2 del grupo VO (337,1 ± 61,8 pg / mL) fue menor que el de BT (548,1 ± 32,6 pg / mL) (p ≤ 0,001),). El nivel de sST2 en AT fue significativamente mayor (830.01 ± 71.6 pg / mL) que en BT (p ≤ 0.001). El nivel medio y alto de estrés entre los deportistas fue del 43,3% y el 56,7% de los casos, respectivamente. El estrés aumentó la probabilidad de desarrollar un ECG claramente anormal (OR = 1,06; IC del 95%: 1,01-1,08; p = 0,02). El nivel de estrés mostró una correlación positiva con el nivel de sST2 (r = 0,752, p = 0,01). La concentración de sST2 y los datos de la ecocardiografía categórica demostraron una correlación positiva dependiente (r = 0,6, p = 0,01). Conclusión: Los niveles de sST2 de los atletas excedieron los umbrales tanto antes como después del entrenamiento. Además, se determinó la relación entre un aumento en los niveles de sST2 y anomalías anormales del ECG y un alto nivel de estrés en los atletas. La concentración de sST2 se asoció con el estrés cardiopulmonar desencadenado por la dosis acumulativa de ejercicio, así como con el estrés psicológico de por vida. Nuestros hallazgos indican que las concentraciones elevadas de sST2 en los atletas pueden usarse como valor predictivo. Sin embargo, se requieren más estudios