24 research outputs found

    Exact and quasi-classical density matrix and Wigner functions for a particle in the box and half space

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    The exact expressions for density matrix and Wigner functions of quantum systems are known only in special cases. Corresponding Hamiltonians are quadratic forms of Euclidean coordinates and momenta. In this paper we consider the problem of one-dimensional free particle movement in the bounded region 0 is less than x is less than a (including the case a = infinity)

    First national survey of anti-tuberculosis drug resistance in Azerbaijan and risk factors analysis.

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    SETTING: Civilian population of the Republic of Azerbaijan. OBJECTIVES: To determine patterns of anti-tuberculosis drug resistance among new and previously treated pulmonary tuberculosis (TB) cases, and explore their association with socio-demographic and clinical characteristics. DESIGN: National cross-sectional survey conducted in 2012-2013. RESULTS: Of 789 patients (549 new and 240 previously treated) who met the enrolment criteria, 231 (42%) new and 146 (61%) previously treated patients were resistant to any anti-tuberculosis drug; 72 (13%) new and 66 (28%) previously treated patients had multidrug-resistant TB (MDR-TB). Among MDR-TB cases, 38% of new and 46% of previously treated cases had pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. In previously treated cases, 51% of those who had failed treatment had MDR-TB, which was 15 times higher than in relapse cases (OR 15.2, 95%CI 6-39). The only characteristic significantly associated with MDR-TB was a history of previous treatment (OR 3.1, 95%CI 2.1-4.7); for this group, history of incarceration was an additional risk factor for MDR-TB (OR 2.8, 95%CI 1.1-7.4). CONCLUSION: Azerbaijan remains a high MDR-TB burden country. There is a need to implement countrywide control and innovative measures to accelerate early diagnosis of drug resistance in individual patients, improve treatment adherence and strengthen routine surveillance of drug resistance

    Bariatric operation in treatment of morbidian obesity and metabolic syndrome (revier of literature)

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    Morbid obesity, associated with various metabolic disorders leading to a decrease in the quality of life and its duration. Conservative treatment of morbid obesity is often ineffective, and therefore bariatric surgery is becoming more common. The review analyzed clinical recommendations and our experience in selecting patients for bariatric surgery, assessed the effectiveness and safety of various types of operations, and outlined the main problems of these operational benefits.ΠœΠΎΡ€Π±ΠΈΠ΄Π½ΠΎΠ΅ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅, ассоциировано с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ мСтаболичСскими Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡΠΌΠΈ приводящими ΠΊ сниТСнию качСства ΠΆΠΈΠ·Π½ΠΈ ΠΈ Π΅Π΅ ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ. консСрвативныС ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ лСчСния ΠΌΠΎΡ€Π±ΠΈΠ΄Π½ΠΎΠ³ΠΎ оТирСния Π½Π΅Ρ€Π΅Π΄ΠΊΠΎ ΠΎΠΊΠ°Π·Ρ‹Π²Π°ΡŽΡ‚ΡΡ нСэффСктивными, Π² связи с Ρ‡Π΅ΠΌ, бариатричСская хирургия ΠΏΠΎΠ»ΡƒΡ‡ΠΈΠ»Π° ΡˆΠΈΡ€ΠΎΠΊΠΎΠ΅ распространСниС. Π’ ΠΎΠ±Π·ΠΎΡ€Π΅ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ клиничСскиС Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΈ ΠΈ наш ΠΎΠΏΡ‹Ρ‚ ΠΏΠΎ ΠΎΡ‚Π±ΠΎΡ€Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π½Π° бариатричСскиС ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΈ, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡ†Π΅Π½ΠΊΠ° эффСктивности ΠΈ бСзопасности Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π²ΠΈΠ΄ΠΎΠ² ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ ΠΈ ΠΎΠ±ΠΎΠ·Π½Π°Ρ‡Π΅Π½Ρ‹ основныС ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ Π΄Π°Π½Π½Ρ‹Ρ… ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½Ρ‹Ρ… пособий

    Study of reproductive function in patients with morbid obesity after bariatric surgery

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    Purpose of the study. To study the effectiveness of bariatric surgeries for reproductive health of patients suffering from morbid obesity.Materials and methods. The medical history of 270 patients suffering from morbid obesity with a violation of the reproductive function was studied. Patients were divided into two groups: 181 of them women, 89 men with a BMI of 45-65 kg / m2. The age of the operated women was from 18 to 58 years old, 7 of them (3.9% of the group of 181 patients) were postmenopausal. Out of 174 patients of 45 - of childbearing age, they complained of a violation of the ovarian-menstrual function. The number of operated men was 89 people aged 18 to 60 years. In the postoperative period, hormone concentrations were studied: testosterone, estrogen, progesterone. The obtained data were compared with the original values. Results. The following signs of clinical improvement of the reproductive system were found: in 36 patients (92%) normalization of the cycle duration occurred. The following group of 31 (91%) patients noted a return to the normal duration of menstrual bleeding. In the last group, menorrhagia disappeared in 11 patients (79%).Treatment led to a normalization of the concentration of hormones studied. Estradiol indicators after a year of the postoperative period decreased to 462 Β± 128.4 pmol / l (p <0.01). Similarly, testosterone levels fell to 0.89 Β± 0.71 nmol / L (p <0.01). The progesterone content increased to 43 Β± 8.3 nmol / l (p <0.01). In 89 male patients with morbid obesity, there was a violation of the background of sex hormones in the form of hypoterosteronemia to 5.34 Β± 1.91 nmol / L, hypoprogesteronemia 0.12 Β± 0.09 nmol / L and hyperestrogenemia 278 Β± 53.8 Pkmol / l. In a laboratory study one year after the operation, the indices were as follows: 1.53 Β± 0.92 nmol / L to 5.34 Β± 1.91 nmol / L (p <0.01), as did progesterone with 0.12 Β± 0 , 09 nmol / l to 2.31 Β± 0.83 nmol / l (p <0.01). It is important that the concentration of estradiol 278 Β± 53.8 Pkmol / l decreased to 72.3 Β± 21.2 Pkmol / l (p <0.01). Discussions. Treatment of patients with both sexes surgically led to a stable, positive result, improving the quality of life. Thanks to bariatric surgery, the patients returned to normal after a certain time, reproductive function was also restored. Reduction of visceral adipose tissue in the patients led to normalization of the hormonal background, which is proved by laboratory tests of blood. And as a consequence of the restoration of reproductive function. The conclusion. Surgical treatment in people with morbid obesity and metabolic syndrome gives good results. Modern surgery allows you to solve problems of infertility associated with excess fat tissue and a broken hormonal background.ЦСль исслСдования. Π˜Π·ΡƒΡ‡ΠΈΡ‚ΡŒ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ бариатричСских ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ для восстановлСния Ρ€Π΅ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ Π·Π΄ΠΎΡ€ΠΎΠ²ΡŒΡ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΡΡ‚Ρ€Π°Π΄Π°ΡŽΡ‰ΠΈΡ… ΠΌΠΎΡ€Π±ΠΈΠ΄Π½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π˜Π·ΡƒΡ‡Π΅Π½Ρ‹ истории Π±ΠΎΠ»Π΅Π·Π½ΠΈ 270 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…, ΡΡ‚Ρ€Π°Π΄Π°ΡŽΡ‰ΠΈΡ… ΠΌΠΎΡ€Π±ΠΈΠ΄Π½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ, ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΡ… Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ Ρ€Π΅ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ Π±Ρ‹Π»ΠΈ Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Ρ‹ Π½Π° Π΄Π²Π΅ Π³Ρ€ΡƒΠΏΠΏΡ‹: ΠΈΠ· Π½ΠΈΡ… ΠΆΠ΅Π½Ρ‰ΠΈΠ½ 181 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ, ΠΌΡƒΠΆΡ‡ΠΈΠ½ 89 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ с показатСлями Π˜ΠœΡ‚ 45-65 ΠΊΠ³/ΠΌ2 . Возраст ΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΠΆΠ΅Π½Ρ‰ΠΈΠ½ составил ΠΎΡ‚ 18 Π΄ΠΎ 58 Π»Π΅Ρ‚ ΠΈΠ· Π½ΠΈΡ… 7 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠΊ (3,9% ΠΎΡ‚ Π³Ρ€ΡƒΠΏΠΏΡ‹ 181 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ) Π½Π°Ρ…ΠΎΠ΄ΠΈΠ»ΠΈΡΡŒ Π² постмСнопаузС. Из 174 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠΊ 45 - Π΄Π΅Ρ‚ΠΎΡ€ΠΎΠ΄Π½ΠΎΠ³ΠΎ возраста ΠΏΡ€Π΅Π΄ΡŠΡΠ²Π»ΡΠ»ΠΈ ΠΆΠ°Π»ΠΎΠ±Ρ‹ ΠΏΠΎ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡŽ ΠΎΠ²Π°Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎ-ΠΌΠ΅Π½ΡΡ‚Ρ€ΡƒΠ°Π»ΡŒΠ½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ. Число ΠΎΠΏΠ΅Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΠΌΡƒΠΆΡ‡ΠΈΠ½ составило 89 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ Π² возрастС ΠΎΡ‚ 18 Π΄ΠΎ 60 Π»Π΅Ρ‚. Π’ послСопСрационном ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ ΠΈΠ·ΡƒΡ‡Π°Π»ΠΈΡΡŒ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ²: тСстостСрона, эстрогСна, прогСстСрона. ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ Π΄Π°Π½Π½Ρ‹Π΅ сравнивали с ΠΏΠ΅Ρ€Π²ΠΎΠ½Π°Ρ‡Π°Π»ΡŒΠ½Ρ‹ΠΌΠΈ значСниями. Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Ρ‹ ΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠ΅ ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ клиничСского ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ Ρ€Π΅ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ систСмы: Ρƒ 36 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… (92%) ΠΏΡ€ΠΎΠΈΠ·ΠΎΡˆΠ»Π° нормализация Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ Ρ†ΠΈΠΊΠ»Π°. Π‘Π»Π΅Π΄ΡƒΡŽΡ‰Π°Ρ Π³Ρ€ΡƒΠΏΠΏΠ° ΠΈΠ· 31 (91 %) ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ ΠΎΡ‚ΠΌΠ΅Ρ‚ΠΈΠ»ΠΈ Π²ΠΎΠ·Π²Ρ€Π°Ρ‰Π΅Π½ΠΈΠ΅ ΠΊ Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½ΠΎΠΉ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ ΠΌΠ΅Π½ΡΡ‚Ρ€ΡƒΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ кровотСчСния. Π’ послСднСй Π³Ρ€ΡƒΠΏΠΏΠ΅ исчСзли ΠΌΠ΅Π½ΠΎΡ€Ρ€Π°Π³ΠΈΠΈ Ρƒ 11 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… (79%). Π›Π΅Ρ‡Π΅Π½ΠΈΠ΅ ΠΏΡ€ΠΈΠ²Π΅Π»ΠΎ ΠΊ Π½ΠΎΡ€ΠΌΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ исслСдуСмых Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ². ΠŸΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ эстрадиола ΠΏΠΎ ΠΏΡ€ΠΎΡˆΠ΅ΡΡ‚Π²ΠΈΠΈ Π³ΠΎΠ΄Π° послСопСрационного ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π° снизились Π΄ΠΎ 462Β±128,4 пкмоль/Π» (Ρ€ <0,01). Π°Π½Π°Π»ΠΎΠ³ΠΈΡ‡Π½ΠΎ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ тСстостСрона снизились Π΄ΠΎ 0,89Β±0,71 нмоль/Π» (Ρ€ <0,01). Π‘ΠΎΠ΄Π΅Ρ€ΠΆΠ°Π½ΠΈΠ΅ прогСстСрона возросло Π΄ΠΎ 43Β±8,3 нмоль/Π» (Ρ€ <0,01). Π£ 89 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² муТского ΠΏΠΎΠ»Π° с ΠΌΠΎΡ€Π±ΠΈΠ΄Π½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ΠΌ ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠ΅ Ρ„ΠΎΠ½Π° ΠΏΠΎΠ»ΠΎΠ²Ρ‹Ρ… Π³ΠΎΡ€ΠΌΠΎΠ½ΠΎΠ² Π² Π²ΠΈΠ΄Π΅ гипотСстостСронСмии Π΄ΠΎ 5,34Β±1,91 нмоль/Π», гипопрогСстСронСмии 0,12Β±0,09 нмоль/Π» ΠΈ гипСрэстрогСнСмии 278Β±53,8 Пкмоль/Π». ΠŸΡ€ΠΈ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½ΠΎΠΌ исслСдовании Ρ‡Π΅Ρ€Π΅Π· Π³ΠΎΠ΄ послС ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ Π±Ρ‹Π»ΠΈ ΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠΌΠΈ: 1,53Β±0,92 нмоль/Π» Π΄ΠΎ 5,34Β±1,91 нмоль/Π» (Ρ€ <0,01), Ρ‚Π°ΠΊ ΠΆΠ΅ увСличиваСтся прогСстСрон с 0,12Β±0,09 нмоль/Π» Π΄ΠΎ 2,31Β±0,83 нмоль/Π» (Ρ€ <0,01). Π’Π°ΠΆΠ½ΠΎ, Ρ‡Ρ‚ΠΎ концСнтрация эстрадиола 278Β±53,8 Пкмоль/Π» ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΠΎΡΡŒ Π΄ΠΎ 72,3Β±21,2 Пкмоль/Π» (Ρ€ <0,01). обсуТдСния. Π›Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΎΠ±ΠΎΠΈΡ… ΠΏΠΎΠ»ΠΎΠ² хирургичСским способом ΠΏΡ€ΠΈΠ²Π΅Π»ΠΎ ΠΊ стойкому, ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΌΡƒ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρƒ, ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ качСства ΠΆΠΈΠ·Π½ΠΈ. [10] Благодаря бариатричСским опСрациям ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ спустя ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½Π½ΠΎΠ΅ врСмя ΠΏΡ€ΠΈΡ…ΠΎΠ΄ΠΈΠ»ΠΈ ΠΊ Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½Ρ‹ΠΌ показатСлям, рСпродуктивная функция Ρ‚Π°ΠΊ ΠΆΠ΅ Π²ΠΎΡΡΡ‚Π°Π½Π°Π²Π»ΠΈΠ²Π°Π»Π°ΡΡŒ [7]. УмСньшСниС Π²ΠΈΡΡ†Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ Π² ΠΎΡ€Π³Π°Π½ΠΈΠ·ΠΌΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΠ»ΠΎ ΠΊ Π½ΠΎΡ€ΠΌΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ Ρ„ΠΎΠ½Π°, Ρ‡Ρ‚ΠΎ доказываСтся Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹ΠΌΠΈ исслСдованиями ΠΊΡ€ΠΎΠ²ΠΈ. И ΠΊΠ°ΠΊ слСдствиС восстановлСниС Ρ€Π΅ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π›Π΅Ρ‡Π΅Π½ΠΈΠ΅ хирургичСским ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ Ρƒ людСй с ΠΌΠΎΡ€Π±ΠΈΠ΄Π½Ρ‹ΠΌ ΠΎΠΆΠΈΡ€Π΅Π½ΠΈΠ΅ ΠΈ мСтаболичСским синдромом Π΄Π°Π΅Ρ‚ Ρ…ΠΎΡ€ΠΎΡˆΠΈΠ΅ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. БоврСмСнная хирургия позволяСт Ρ€Π΅ΡˆΠ°Ρ‚ΡŒ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ бСсплодия связанныС с ΠΈΠ·Π±Ρ‹Ρ‚ΠΊΠΎΠΌ ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ Ρ‚ΠΊΠ°Π½ΠΈ ΠΈ Π½Π°Ρ€ΡƒΡˆΠ΅Π½Π½Ρ‹ΠΌ Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½Ρ‹ΠΌ Ρ„ΠΎΠ½ΠΎΠΌ

    Influence of collaterals on the left ventricular end-diastolic pressure and serum NT-proBNP levels in patients with coronary chronic total occlusion

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    Objective: Although numerous studies have shown the protective effects of the well-developed coronary collaterals on left ventricular functions, the relationship between collateral grade and left ventricular end diastolic pressure has not been studied in chronic total occlusion patients. Also, there are conflicting data on the effect of collaterals on NT-proBNP levels. The aim of our study was to evaluate the relationship between coronary collateral circulation and left ventricular end diastolic pressure and NT-proBNP levels in chronic total occlusion patients. Methods: Study group was retrospectively selected from the patients who had undergone coronary angiography at our hospital between June 2011 and March 2013. Clinical, biochemical, angiographic and hemodynamic data of 199 consecutive patients having at least one totally occluded major epicardial coronary artery were evaluated. Coronary collateral circulation was graded according to Rentrop classification. While Rentrop grade 3 was defined as well-developed, all the remaining collateral grades were regarded as poor collaterals. Results: Overall 87 patients were found to have good collaterals and 112 patients had poor collaterals. There was no significant difference between the patients with well- or poorly developed coronary collaterals with regard to left ventricular end diastolic pressure (16.84Β Β±Β 5.40Β mmHgΒ vs 16.10Β Β±Β 6.09, respectively, pΒ =Β 0,632) and logNT-proBNP (2.46Β Β±Β 0.58 vs 2.59Β Β±Β 0.76, respectively, pΒ =Β 0,335). Conclusion: In patients with coronary chronic total occlusion even well-developed coronary collaterals are not capable of protecting the rise of left ventricular end diastolic pressure and NT-proBNP levels which are reliable markers of the left ventricular dysfunction
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