Pathogenetic mechanisms of repeated adverse cardiovascular events development in patients with coronary heart disease: the role of chronic inflammation

Stent restenosis is the most unfavorable complication of interventional treatment for coronary heart disease. We already know from various literature sources that the causes for stent restenosis in patients are both mechanical damage (partial opening, stent breakage, extended stented area, calcification, incomplete stent coverage of atherosclerotic plaque, weak radial stiffness of the stent metal frame, lack of stent drug coating), and the neointimal hyperplasia formation which is closely related to the de novo atherosclerosis development, being a predictor of the recurrent cardiovascular event. Considering this event, it is necessary to understand all the pathogenetic and pathophysiological processes of atherosclerosis. This review aims to comprehensively highlight the main issues of pathogenesis and the development of stent restenosis in the coronary artery after percutaneous transluminal coronary angioplasty. The review is based on relevant publications found by a selective search of PubMed, Google Scholar, Scopus, Web of Science, and eLibrary, including works published within the last 20 years. The influence of various factors of the pathogenetic process on the risk of stent restenosis has been demonstrated

Sarcopenic obesity in comorbid patients

Sarcopenia is a multifactorial syndrome with an insufficiently studied pathogenesis, manifested by a generalized loss of muscle mass and skeletal muscle strength. Despite the fact that sarcopenia is a risk factor for mortality and disability, especially in the elderly, this pathology is rarely diagnosed. The lack of the uniform criteria for the diagnosis and comorbidity of the elderly patients create difficulties in the differential diagnosis of this condition. Sarcopenia is most often combined with endocrine pathologies, such as obesity and diabetes mellitus. An accelerated decrease in the muscle mass leads to a decrease in insulin sensitivity, resulting in insulin resistance, which, in turn, leads to the excessive accumulation of adipose tissue sarcopenic obesity. The results of the studies indicate a higher risk of metabolic syndrome, type 2 diabetes mellitus and atherosclerosis among individuals with sarcopenic obesity, as opposed to those with simple obesity or sarcopenia. A vicious circle consisting of age-related changes in the skeletal muscles, obesity and impaired glucose regulation leads to a more severe course of diseases and a negative impact on a person's life expectancy. Due to the fact that there are presently no clear criteria for the diagnosis of sarcopenic obesity, there are no unambiguous data on its prevalence. A search for the modern methods of research, prevention and treatment of this condition is required

The Importance of Clinical and Biochemical Markers in the Diagnosis of Disorders of the Psychomotor and Physical Development of Children who Underwent Perinatal CNS Lesions

The purpose of this study was to evaluate the blood level of neurotrophic factors (S100 protein, nerve growth factor, L- homocysteine and angiotensin II) in the diagnosis of disorders of the psychomotor and physical development of children who underwent perinatal CNS lesions. A comprehensive approach to assessing the blood levels of neurotrophic factors, along with methods of neuroimaging in children in the first 6 months of the postnatal period, allows identification of the total result of multidirectional degenerative-reparative processes in the neurovascular components of CNS and construction of the diagnostically significant criteria of the severity of neuropathology, which determines the physical development of children in the first year of life

Relationship Between Indices of Oxidative Stress, Endothelial Dysfunction and Chaperone Activity and the Severity of Coronary Atherosclerosis

The aim of this research was to study the relationship between the indices of oxidative stress, endothelial dysfunction and chaperone activity of proteins with the severity of coronary atherosclerosis. In patients with coronary heart disease, we found gender-related differences in the severity of coronary atherosclerosis. Significant differences in the indices of oxidative stress, endothelial dysfunction and chaperone activity were revealed depending on the severity of coronary atherosclerosis and the type of atherosclerotic lesion. The determination of studied parameters can serve as a good indicator of the severity of coronary atherosclerosis

АНАЛИЗ ПСИХОЭМОЦИОНАЛЬНОГО СТАТУСА ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА С ГИПЕРТОНИЧЕСКОЙ БОЛЕЗНЬЮ, ПЕРЕНЕСШИХ НОВУЮ КОРОНАВИРУСНУЮ ИНФЕКЦИЮ (СOVID-19)

HighlightsThe study of severity of psychological and emotional disorders in hypertensive patients with comorbidity who suffered COVID-19, as well as their association with clinical and laboratory indicators reflecting the course of diseases, is of high interest in the current epidemiological situation. Patients with hypertension who suffered COVID-19 presented with mild dementia and geriatric depression. Significant associations between systolic blood pressure and lung damage, between diastolic blood pressure and the average score on the geriatric depression scale, and lung damage were revealed. AbstractBackground. Modern studies have highlighted a more severe course of the new coronavirus infection (COVID-19) in elderly patients with hypertension, diabetes mellitus and cerebrovascular disease. The basis of the pathogenesis of COVID-19 is cerebrovascular ischemia, which arose as a result of coagulopathy with an increased risk of thrombotic complications, the clinical reflection of which is the development of mental and emotional disorders as a part of the post-covid syndrome.Aim. To analyze the severity of psychological and emotional disorders in hypertensive patients with comorbidity who suffered COVID-19.Methods. The study included 40 patients with arterial hypertension (AH) and comorbid pathology, aged 60 to 90 years. Taking into account the lung damage due to COVID-19, the patients were divided into 2 groups: the group 1 included 17 AH patients with lung damage of grade 1–2 according to computed tomography, and the group 2 included 13 AH patients with grade 3 lung damage. The control group consisted of 10 AH patients who did not suffer COVID-19. The Statistica 6.0 program was used for statistical processing of the data.Results. According to our data, patients in the group 2 suffered a more severe clinical course of COVID-19, the number of AH patients taking angiotensin-converting enzyme inhibitors (ACE inhibitors) in the group 2 was higher (85%) compared with the group 1 (47%), (p = 0.009). In the post-covid period, AH patients in the group 2 who suffered COVID-19 and had grade 3 lung damage presented with mild dementia and geriatric depression. AH patients in the group 1 with grade 1-2 lung damage presented with mild cognitive impairment (cognitive impairment no dementia) in the post-covid period. The analysis revealed a significant correlation between the score on the geriatric depression scale and the duration of fever and oxygen support. Moreover, the results of the analysis indicate a moderately negative correlation between the score on the geriatric depression scale and the minimum oxygen saturation, hemoglobin and leukocyte levels, a moderately negative correlation between MMSE scores and myalgia, and a moderate negative relationship between the scores on the geriatric depression scale and MMSE scale.Conclusion. The results obtained confirm the data on the development of mental health disorders in short and long-term periods after COVID-19.Основные положенияВ условиях текущей эпидемиологической ситуации значительный научный интерес представляет изучение выраженности психоэмоциональных нарушений у коморбидных больных гипертонической болезнью, перенесших COVID-19, и их взаимосвязи с клинико-лабораторными показателями, характеризующими течение заболеваний. У пациентов с гипертонической болезнью, перенесших COVID-19, выявлены деменция легкой степени выраженности и вероятная гериатрическая депрессия. Зафиксированы достоверные корреляционные связи между уровнем систолического артериального давления и стадией КТ-поражения легких, между уровнем диастолического артериального давления и средним баллом по гериатрической шкале депрессии, стадией КТ-поражения легких. Аннотация.Актуальность. Данные современных исследований продемонстрировали более тяжелое течение новой коронавирусной инфекции (COVID-19) у больных пожилого возраста, имеющих в анамнезе артериальную гипертензию, сахарный диабет и цереброваскулярную болезнь. Основой патогенеза действия COVID-19 является цереброваскулярная ишемия, возникающая в результате коагулопатии с повышенным риском тромботических осложнений, клиническим отражением которой служит формирование психических и эмоциональных нарушений в рамках постковидного синдрома.Цель исследования. Изучение выраженности психоэмоциональных нарушений у коморбидных пожилых пациентов с гипертонической болезнью (ГБ), перенесших СOVID-19.Материалы и методы. Обследовано 40 больных ГБ в возрасте от 60 до 90 лет с коморбидной патологией. С учетом стадии КТ-поражения легких в результате COVID-19 пациенты разделены на две группы: первая группа – 17 больных ГБ с 1–2-й стадией поражения легких по данным КТ, вторая группа – 13 больных ГБ с 3-стадией по данным КТ. Группа контроля состояла из 10 пациентов с ГБ, не болевших COVID-19. Для выявления депрессии использовали гериатрическую шкалу депрессии. Для определения и оценки тяжести когнитивных нарушений применяли краткую шкалу оценки психического статуса (MMSE).Результаты. COVID-19 протекала тяжелее у больных второй группы, в которой число пациентов, принимавших ингибиторы ангиотензинпревращающего фермента, было выше по сравнению с первой группой – 85 против 47% соответственно (p = 0,009). В постковидном периоде у больных второй группы, перенесших COVID-19 с 3-й стадией КТ-поражения легких, выявлены деменция легкой степени выраженности и вероятная гериатрическая депрессия. В постковидном периоде у больных первой группы, со стадией КТ-поражения легких 1–2, зарегистрированы недементные когнитивные нарушения. Выявлены достоверные корреляционные связи между суммой баллов по гериатрической шкале депрессии и длительностью лихорадки, наличием кислородной поддержки. Корреляционная взаимосвязь суммы баллов по гериатрической шкале депрессии и минимальной сатурации кислорода, уровня гемоглобина и лейкоцитов была умеренной отрицательной. Также обнаружена умеренная отрицательная взаимосвязь суммы баллов по шкале MMSE и миалгии. Корреляционный анализ продемонстрировал умеренную отрицательную связь между суммой баллов по гериатрической шкале депрессии и шкале MMSE.Заключение. Полученные результаты подтверждают данные литературы о развитии когнитивных и психоэмоциональных расстройств в раннем и отсроченном периодах COVID-19

A clinical case of post-COVID-19 myoendocarditis and arrhythmic syndrome at the outpatient stage

Background: Infection with the SARS-CoV-2 virus entails the development of complications which affect the prognosis of the underlying disease. More than 40% of COVID-19 complications represent diseases of the cardiovascular system, most of which are the rhythm and conduction disturbances. In order to avoid these complications, it is necessary to detect cases of infection in a timely manner at the outpatient stage. Clinical case description: A 40-year-old patient came to the clinic with complaints of interruptions in the heart rhythm that appeared after the coronavirus infection. The laboratory examination (CBC) revealed signs of systemic inflammation (leukocytosis 12.6×109 U/l; erythrocyte sedimentation rate 18 mm/h, C-reactive protein 18 mg/l); the instrumental examination of the heart revealed the rhythm disturbances in the form of frequent ventricular ectopic activity and weakness of the SA node. The patient received propafenone (150 mg, 3 times a day) as a therapy with a positive effect. Against the background of improvement in the patient’s condition and despite the history of myocarditis and a positive result of enzyme immunoassay for antibodies to SARS-CoV-2 (IgG, 10 BAU/ml), the patient was prescribed immunization with the CoviVac vaccine. After the immunization, the condition worsening was observed in the form of an increase in the rhythm disturbances, which required an inpatient treatment. A clinical diagnosis of recurrent ventricular arrhythmia — ventricular extrasystole was established, and the therapy was corrected. The outcome was favorable. Conclusion: Myocarditis is one of the most common complications of SARS-CoV-2 and should be kept in mind at all stages of medical care. This clinical case demonstrates the importance of the correct diagnosis and treatment of post-COVID myocarditis, as well as the need to assess contraindications for SARS-CoV-2 vaccination in patients with cardiac complications

Pathogenetic mechanisms of repeated adverse cardiovascular events development in patients with coronary heart disease: the role of chronic inflammation

Stent restenosis is the most unfavorable complication of interventional treatment for coronary heart disease. We already know from various literature sources that the causes for stent restenosis in patients are both mechanical damage (partial opening, stent breakage, extended stented area, calcification, incomplete stent coverage of atherosclerotic plaque, weak radial stiffness of the stent metal frame, lack of stent drug coating), and the neointimal hyperplasia formation which is closely related to the de novo atherosclerosis development, being a predictor of the recurrent cardiovascular event. Considering this event, it is necessary to understand all the pathogenetic and pathophysiological processes of atherosclerosis. This review aims to comprehensively highlight the main issues of pathogenesis and the development of stent restenosis in the coronary artery after percutaneous transluminal coronary angioplasty. The review is based on relevant publications found by a selective search of PubMed, Google Scholar, Scopus, Web of Science, and eLibrary, including works published within the last 20 years. The influence of various factors of the pathogenetic process on the risk of stent restenosis has been demonstrated

Serum Level of Homocysteine and Perinatal CNS Lesions in Infants

This study reports an assessment of adaptive possibilities of the central nervous system (CNS) in infants. The study shows how the homocysteine level depends on the severity of neurological deficit (ND) in infants, and how the serum homocysteine level changes during the various treatment regimens