Effect of Combined Oral Ferrotherapy with L-carnitine on Exercise Tolerance of Patients with Chronic Heart Failure with Reduced Ejection Fraction of Left Ventricle with Concomitant Iron Deficiency Anemia

According to numerous studies, a high prevalence of iron deficiency (ID) with anaemic syndrome and its association with mortality during chronic heart failure (CHF) have been revealed. Ferrocorrection of anaemia during CHF is important both to improve the clinical condition and to optimize the long-term prognosis of patients. However, the pathogenetic justification is the use of agents that have antihypoxic, antioxidant and membrane-stabilizing effects, except iron preparations, and at the same time exert a regulatory effect on the metabolism of physiologically active compounds and improve the functional condition of patients.The aim. The aim of this study was to identify and compare the effect of oral ferrotherapy and combined use of ferrotherapy with L-carnitine on exercise tolerance (ET) of patients with CHF with reduced ejection fraction of left ventricle (LVEF) with concomitant iron deficiency anemia (IDA) was determined and compared.Materials and methods. The study includes 62 patients with CHF with reduced LVEF FC II-III according to NYHA with IDА. Patients with hypertensive and ischemic etiology of HF took part in the study. Among them, 45 (72.6 %) were men and 17 (27.4 %) were women aged 70.0±0.9 years. Two study groups were formed: in addition to the standard therapy, the patients in the 1st group (n=32) were prescribed oral ferrous sulfate in a dose of 320 mg, equivalent to 100 mg of bivalent iron and 60 mg of ascorbic acid 2 tablets per day for 6 months; the patients in the 2nd group (n=30) received the standard therapy of CHF and not only iron, but also L-carnitine.Results and discussion. The use of two variants of ferrocorrection as an application to the standard treatment of CHF among the total number of studied patients with IDA indicates the sufficient effect both to eliminate the signs of anemia and to eliminate ID. The analysis of the dynamics of the passed test distance with a 6-minute walk in 32 patients with IDA on the background of standard treatment and additional ferrotherapy after 6 months showed an increase of the actual distance by 8.9 % (from 249.4 to 272.3 m, p<0.0001). The analysis of changes in the value of travelled distance among patients with IDA who received combined 6-month ferrotherapy with L-carnitine also revealed a significant positive trend. In addition, the value obtained was significantly higher compared to the results of patients with only additional ferrotherapy, an increase of 19.4 % (from 259.5 to 304.5 m, p<0.0001).Conclusions. The use of metabolic therapy with oral ferrotherapy is accompanied by a greater increase in ET, which is reflected in a significantly longer test distance with a 6-minute walk and greater frequency of decrease of FC of HF among patients, compared with using only iron sulfate ferrocorrection

EFFECT OF COMBINED ORAL FERROTHERAPY WITH L-CARNITINE ON EXERCISE TOLERANCE OF PATIENTS WITH CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION OF LEFT VENTRICLE WITH CONCOMITANT IRON DEFICIENCY ANEMIA

According to numerous studies, a high prevalence of iron deficiency (ID) with anaemic syndrome and its association with mortality during chronic heart failure (CHF) have been revealed. Ferrocorrection of anaemia during CHF is important both to improve the clinical condition and to optimize the long-term prognosis of patients. However, the pathogenetic justification is the use of agents that have antihypoxic, antioxidant and membrane-stabilizing effects, except iron preparations, and at the same time exert a regulatory effect on the metabolism of physiologically active compounds and improve the functional condition of patients. The aim. The aim of this study was to identify and compare the effect of oral ferrotherapy and combined use of ferrotherapy with L-carnitine on exercise tolerance (ET) of patients with CHF with reduced ejection fraction of left ventricle (LVEF) with concomitant iron deficiency anemia (IDA) was determined and compared. Materials and methods. The study includes 62 patients with CHF with reduced LVEF FC II-III according to NYHA with IDА. Patients with hypertensive and ischemic etiology of HF took part in the study. Among them, 45 (72.6 %) were men and 17 (27.4 %) were women aged 70.0±0.9 years. Two study groups were formed: in addition to the standard therapy, the patients in the 1st group (n=32) were prescribed oral ferrous sulfate in a dose of 320 mg, equivalent to 100 mg of bivalent iron and 60 mg of ascorbic acid 2 tablets per day for 6 months; the patients in the 2nd group (n=30) received the standard therapy of CHF and not only iron, but also L-carnitine. Results and discussion. The use of two variants of ferrocorrection as an application to the standard treatment of CHF among the total number of studied patients with IDA indicates the sufficient effect both to eliminate the signs of anemia and to eliminate ID. The analysis of the dynamics of the passed test distance with a 6-minute walk in 32 patients with IDA on the background of standard treatment and additional ferrotherapy after 6 months showed an increase of the actual distance by 8.9 % (from 249.4 to 272.3 m, p<0.0001). The analysis of changes in the value of travelled distance among patients with IDA who received combined 6-month ferrotherapy with L-carnitine also revealed a significant positive trend. In addition, the value obtained was significantly higher compared to the results of patients with only additional ferrotherapy, an increase of 19.4 % (from 259.5 to 304.5 m, p<0.0001). Conclusions. The use of metabolic therapy with oral ferrotherapy is accompanied by a greater increase in ET, which is reflected in a significantly longer test distance with a 6-minute walk and greater frequency of decrease of FC of HF among patients, compared with using only iron sulfate ferrocorrection

EFFECT OF COMBINED ORAL FERROTHERAPY WITH L-CARNITINE ON EXERCISE TOLERANCE OF PATIENTS WITH CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION OF LEFT VENTRICLE WITH CONCOMITANT IRON DEFICIENCY ANEMIA

According to numerous studies, a high prevalence of iron deficiency (ID) with anaemic syndrome and its association with mortality during chronic heart failure (CHF) have been revealed. Ferrocorrection of anaemia during CHF is important both to improve the clinical condition and to optimize the long-term prognosis of patients. However, the pathogenetic justification is the use of agents that have antihypoxic, antioxidant and membrane-stabilizing effects, except iron preparations, and at the same time exert a regulatory effect on the metabolism of physiologically active compounds and improve the functional condition of patients.The aim. The aim of this study was to identify and compare the effect of oral ferrotherapy and combined use of ferrotherapy with L-carnitine on exercise tolerance (ET) of patients with CHF with reduced ejection fraction of left ventricle (LVEF) with concomitant iron deficiency anemia (IDA) was determined and compared.Materials and methods. The study includes 62 patients with CHF with reduced LVEF FC II-III according to NYHA with IDА. Patients with hypertensive and ischemic etiology of HF took part in the study. Among them, 45 (72.6 %) were men and 17 (27.4 %) were women aged 70.0±0.9 years. Two study groups were formed: in addition to the standard therapy, the patients in the 1st group (n=32) were prescribed oral ferrous sulfate in a dose of 320 mg, equivalent to 100 mg of bivalent iron and 60 mg of ascorbic acid 2 tablets per day for 6 months; the patients in the 2nd group (n=30) received the standard therapy of CHF and not only iron, but also L-carnitine.Results and discussion. The use of two variants of ferrocorrection as an application to the standard treatment of CHF among the total number of studied patients with IDA indicates the sufficient effect both to eliminate the signs of anemia and to eliminate ID. The analysis of the dynamics of the passed test distance with a 6-minute walk in 32 patients with IDA on the background of standard treatment and additional ferrotherapy after 6 months showed an increase of the actual distance by 8.9 % (from 249.4 to 272.3 m, p<0.0001). The analysis of changes in the value of travelled distance among patients with IDA who received combined 6-month ferrotherapy with L-carnitine also revealed a significant positive trend. In addition, the value obtained was significantly higher compared to the results of patients with only additional ferrotherapy, an increase of 19.4 % (from 259.5 to 304.5 m, p<0.0001).Conclusions. The use of metabolic therapy with oral ferrotherapy is accompanied by a greater increase in ET, which is reflected in a significantly longer test distance with a 6-minute walk and greater frequency of decrease of FC of HF among patients, compared with using only iron sulfate ferrocorrection

ST2 PLASMA LEVEL IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITHOUT ST ELEVATION AND DIFFERENT CLINICAL CHARACTERISTICS

The aim. Estimation of ST2 plasma level in patients with acute myocardial infarction without ST elevation (NSTEMI) and its relationship with different clinical characteristics. Materials and methods. 165 patients aged from 35 to 79 (average of 60.7±0.8 years) with various forms of coronary artery disease (CAD) with and without arterial hypertension were examined. The variability of plasma ST2 level in different forms of CAD and in NSTEMI group was analyzed depending on gender-age and clinical characteristics and features of the disease course. Results: The results of the present investigation were that the ST2 level in the main cohort was in range from 5.5 to 233.9 (in the middle – 49.8±3.5 ng / ml (median indicator – 34.7 and the interquartile range – 21.9 and 59.1 respectively). Significantly higher ST2 levels were found in patients with NSTEMI, unlike the comparison group, in the median analysis (35.9 vs. 27.7 ng/ml, p=0.047) and no statistical differences were observed in the mean values. In patients with NSTEMI, a certain association of ST2 level in plasma with the MI course was detected. A higher level of neurohormone is registered with anterior unlike posterior ECG localization of MI; at high unlike moderate risk on the GRACE scale; when complicated unlike the uncomplicated course of MI; in the case of acute HF and cardiac arrhythmias unlike patients with the absence of these manifestations in the acute period of MI. Conclusions. High variability of ST2 level in plasma was demonstrated in patients with NSTEMI on the first day after destabilization (minimum and maximum values – 12.7 and 233.9 respectively, median – 35.9 and interquartile range – 25.9 and 55.7 ng / ml). It is shown that significantly higher ST2 level in plasma is determined in patients with acute MI regardless of its variant among different clinical forms of CAD. It is found that significantly higher level of ST2 in patients with NSTEMI is recorded in the case of concomitant HTN and type 2 diabetes, with smoking and heavy cardiovascular heredity. Proved influence of the character of MI course on the level of ST2 in plasma, significantly higher level of neurohormone was determined with anterior localization of MI, high risk on the GRACE scale (≥ 140 points), complicated course of MI, development of cardiac arrhythmias and HF in the acute period of MI

Peculiarities Of Changes Of Apelin-13 Concentration In Patients With Essential Hypertension And Extrasystole

Introduction. Hypertension is one of the leading causes of disability and mortality among cardiovascular diseases, so today new metabolic markers of cardiovascular risk are being actively studied. One of them is apelin-13. Objective: to assess the concentration of apelin-13 in patients with essential hypertension and frequent extrasystole. Materials and methods. 156 patients with stage II essential hypertension were examined. 124 of them had frequent symptomatic extrasystoles, 32 patients had no arrhythmias and were considered to the comparison group. 30 practically healthy normotensive persons were considered to the control group. All patients underwent a complete clinical and anthropometric examination, blood pressure measurement, automatic daily blood pressure monitoring, daily electrocardiogram monitoring, echocardiography and the assessment of serum apelin-13 concentration. Results. It was found that the concentration of apelin-13 in patients with hypertension was significantly lower compared to the control group. Moreover, the average content of apelin-13 was significantly (p = 0.02) lower in patients with extrasystole than in those without arrhythmia. The lowest concentration of apelin-13 was noticed in patients with ventricular arrhythmias. Conclusion. The results confirm the existing assumptions about the protective role of apelin-13 in preventing the progression of cardiovascular diseases due to counteracting the increase in blood pressure and life-threatening arrhythmias. Keywords: essential arterial hypertension, apelin-13, extrasystole, smoking, obesity

Comprehensive assessment of deformation of rigid reinforcing system during convergence of mine shaft lining in unstable rocks

Operation of vertical mine shafts in complex mining and geological conditions is associated with a number of features. One of them is a radial displacement of the concrete shaft lining, caused by the influence of mining pressure on the stress-strain state of the mine workings. A rigid reinforcing system with shaft buntons fixed in the concrete lining thus experiences elastoplastic deformations, their value increases with time. It results in deviation of conductors from design parameters, weakening of bolt connections, worsening of dynamic properties of geotechnical system “vehicle – reinforcing”, increase of wear rate of reinforcing system elements, increase of risks for creating an emergency situation. The article offers a comprehensive assessment of displacements of characteristic points of the bunton system based on approximate engineering relations, numerical modeling of the deformation process of the bunton system and laser measurements of the convergence of the inner surface of the concrete shaft lining. The method was tested on the example of the reinforcing system of the skip-cage shaft of the potash mine. Displacement of the characteristic points of the reinforcing system is determined by the value of radial displacements of the surface of the concrete shaft lining. Evaluation of the radial displacements was made using monitoring measurements and profiling data. The results obtained make it possible to justify the need and timing of repair works. It is shown that the deterioration of the reinforcing system at different levels occurs at different rates, defined, among other things, by mechanical properties of the rock mass layers located at a given depth

Об условии удвоения для положительно определенных функций на полуоси со степенным весом

Continuous non-negative positive definite functions satisfy the followingproperty:$$\int_{-R}^{R}f(x)\,dx\le C(R)\int_{-1}^{1}f(x)\,dx,\quad R\ge 1,\tag{$*$}$$where the smallest positive constant $C(R)$ does not depend on $f$. For $R=2$,this property is well known as the doubling condition at zero. Theseinequalities have applications in number theory.In the one-dimensional case, the inequality ($*$) was studied by B.F.~Logan(1988), as well as recently by A.~Efimov, M.~Ga\'al, and Sz.~R\'ev\'esz (2017).It has been proven that $2R-1\le C(R)\le 2R+1$ for $R=2,3,\ldots$, whence itfollows that $C(R)\sim 2R$. The question of exact constants is still open.A multidimensional version of the inequality ($*$) for the Euclidean space$\mathbb{R}^{n}$ was investigated by D.V.~Gorbachev and S.Yu.~Tikhonov (2018).In particular, it was proved that for continuous positive definite functions$f\colon \mathbb{R}^{n}\to \mathbb{R}_{+}$$$\int_{|x|\le R}f(x)\,dx\le c_{n}R^{n}\int_{|x|\le 1}f(x)\,dx,$$where $c_{n}\le 2^{n}n\ln n\,(1+o(1))(1+R^{-1})^{n}$ при $n\to \infty$. Forradial functions, we obtain the one-dimensional weight inequality$$\int_{0}^{R}f(x)x^{n-1}\,dx\le c_{n}R^{n}\int_{0}^{1}f(x)x^{n-1}\,dx,\quad n\in\mathbb{N}.$$We study the following natural weight generalization of such inequalities:\int_{0}^{R}f(x)x^{2\alpha+1}\,dx\leC_{\alpha}(R)\int_{0}^{1}f(x)x^{2\alpha+1}\,dx,\quad \alpha\ge -1/2,where $f\colon \mathbb{R}_{+}\to \mathbb{R}_{+}$ is an even positive definitefunction with respect to the weight $x^{2\alpha+1}$. This concept has beenintroduced by B.M.~Levitan (1951) and means that for arbitrary$x_{1},\ldots,x_{N}\in \mathbb{R}_{+}$ matrix$(T_{\alpha}^{x_i}f(x_j))_{i,j=1}^{N}$ is semidefinite. Here $T_{\alpha}^{t}$is the Bessel--Gegenbauer generalized translation. Levitan proved an analogueof the classical Bochner theorem for such functions according to which $f$ hasthe nonnegative Hankel transform (in the measure sense).We prove that for every $\alpha\ge -1/2$c_{1}(\alpha)R^{2\alpha+2}\le C_{\alpha}(R)\le c_{2}(\alpha)R^{2\alpha+2},\quadR\ge 1.The lower bound is trivially achieved on the function $f(x)=1$. To prove theupper bound we apply lower estimates of the sums$\sum_{k=1}^{m}a_{k}T^{x_{k}}\chi(x)$, where $\chi$ is the characteristicfunction of the segment $[0,1]$, and also we use properties of the Besselconvolution.Непрерывные неотрицательные положительно определенные функции удовлетворяютследующему свойству:$$\int_{-R}^{R}f(x)\,dx\le C(R)\int_{-1}^{1}f(x)\,dx,\quad R\ge 1,\tag{$*$}$$где наименьшая положительная константа $C(R)$ не зависит от $f$. При $R=2$ этосвойство хорошо известно как условие удвоения в нуле. Данные неравенства имеютприложения в теории чисел.В одномерном случае неравенство~($*$) изучалось Б.Ф.~Логаном (1988), а такженедавно А.~Ефимовым, М.~Гаалом и Сц.~Ревешем (2017). Было доказано, что$2R-1\le C(R)\le 2R+1$ для $R=2,3,\ldots$, откуда следует, что $C(R)\sim 2R$.Вопрос о точных константах здесь открыт.Многомерный вариант неравенства ($*$) для евклидова пространства$\mathbb{R}^{n}$ исследовался Д.В.~Горбачевым и С.Ю.~Тихоновым (2018). Вчастности доказано, что для непрерывных положительно определенных функций$f\colon \mathbb{R}^{n}\to \mathbb{R}_{+}$$$\int_{|x|\le R}f(x)\,dx\le c_{n}R^{n}\int_{|x|\le 1}f(x)\,dx,$$где $c_{n}\le 2^{n}n\ln n\,(1+o(1))(1+R^{-1})^{n}$ при $n\to \infty$. Отсюда нарадиальных функциях получаем одномерное весовое неравенство$$\int_{0}^{R}f(x)x^{n-1}\,dx\le c_{n}R^{n}\int_{0}^{1}f(x)x^{n-1}\,dx,\quad n\in \mathbb{N}.$$Мы изучаем следующее естественное весовое обобщение данных неравенств:\int_{0}^{R}f(x)x^{2\alpha+1}\,dx\leC_{\alpha}(R)\int_{0}^{1}f(x)x^{2\alpha+1}\,dx,\quad \alpha\ge -1/2,где $f\colon \mathbb{R}_{+}\to \mathbb{R}_{+}$~--- произвольная четнаянепрерывная положительно определенная функция относительно веса$x^{2\alpha+1}$. Это понятие было введено Б.М.~Левитаном (1951) и означает, чтодля произвольных $x_{1},\ldots,x_{N}\in \mathbb{R}_{+}$ матрица$(T_{\alpha}^{x_i}f(x_j))_{i,j=1}^{N}$ неотрицательно определенная. Здесь$T_{\alpha}^{t}$~--- оператор обобщенного сдвига Бесселя--Гегенбауэра. Левитандоказал аналог классической теоремы Бохнера для таких функций, согласнокоторому $f$ имеет неотрицательное преобразование Ганкеля (в смысле меры).Мы доказываем, что для каждого $\alpha\ge -1/2$c_{1}(\alpha)R^{2\alpha+2}\le C_{\alpha}(R)\le c_{2}(\alpha)R^{2\alpha+2},\quadR\ge 1.Нижняя оценка тривиально достигается на функции $f(x)=1$. Для доказательстваверхней оценки мы применяем нижние оценки сумм вида$\sum_{k=1}^{m}a_{k}T^{x_{k}}\chi(x)$, где $\chi$~--- характеристическаяфункция отрезка $[0,1]$, а также свойства свертки Бесселя

Весовые неравенства для потенциала Данкля–Рисса

For the classical Riesz potential or the fractional integral $$I_{\alpha}$$, the Hardy--Littlewood-- Sobolev--Stein--Weiss $$(L^p, L^q)$$-boundedness conditions with power weights are well known. Using the Fourier transform $$\mathcal{F}$$, the Riesz potential is determined by the equality $$\mathcal{F}(I_{\alpha}f)(y)=|y|^{-\alpha}\mathcal{F}(f)(y)$$. An important generalization of the Fourier transform became the Dunkl transform $$\mathcal{F}_k(f)$$, acting in Lebesgue spaces with Dunkl's weight, defined by the root system $$R\subset \mathbb{R}^d$$, its reflection group G and a non-negative multiplicity function k on R, invariant with respect to G.S. Thangavelu and Yu.~Xu using the equality $$\mathcal{F}_k (I_{\alpha}^kf)(y)=|y|^{-\alpha}\mathcal{F}_k(f)(y)$$ determined the D-Riesz potential $$I_{\alpha}^k$$. For the D-Riesz potential, the boundedness conditions in Lebesgue spaces with Dunkl weight and power weights, similar to the conditions for the Riesz potential, were also proved. At the conference "Follow-up Approximation Theory and Function Spaces"   in the Centre de Recerca Matem`atica (CRM, Barcelona, 2017) M.L. Goldman raised the question about $$(L_p,L_q)$$-boundedness conditions of the D-Riesz potential with piecewise-power weights. Consideration of piecewise-power weights makes it possible to reveal the influence of the behavior of weights at zero and infinity on the boundedness of the D-Riesz potential. This paper provides a complete answer to this question. In particular, in the case of the Riesz potential, necessary and sufficient conditions are obtained. As auxiliary results, necessary and sufficient conditions for the boundedness of the Hardy and Bellman operators are proved in Lebesgue spaces with Dunkl weight and piecewise-power weights.Для классического потенциала Рисса или дробного интеграла $$I_{\alpha}$$ хорошо известны условия Харди-Литлвуда-Соболева-Стейна-Вейса $$(L^p, L^q)$$ -ограниченности со степенными весами. С помощью преобразования Фурье $$\mathcal{F}$$ потенциал Рисса определяется равенством $$\mathcal{F}(I_{\alpha}f)(y)=|y|^{-\alpha}\mathcal{F}(f)(y)$$. Важным обобщением преобразования Фурье стало преобразование Данкля $$\mathcal{F}_k$$, действующее в лебеговых пространствах с весом Данкля, определяемым с помощью системы корней $$R\subset\mathbb{R}^d$$, ее группы отражений G и неотрицательной функции кратности k на R, инвариантной относительно G. С. Тангавелу и Ю. Шу с помощью равенства $$\mathcal{F}_k(I_{\alpha}f)(y)=|y|^{-\alpha}\mathcal{F}_k(f)(y)$$ определили D-потенциал Рисса. Для D-потенциала Рисса также были доказаны условия ограниченности в лебеговых пространствах с весом Данкля и степенными весами, аналогичные условиям для потенциала Рисса. На конференции "Follow-up Approximation Theory and Function Spaces" в Centre de Recerca Matem`atica (CRM, Barcelona, 2017)  М.Л. Гольдман поставил вопрос об условиях $$(L_p,L_q)$$-ограниченности D-потенциала Рисса с кусочно-степенными весами. Рассмотрение кусочно-степенных весов позволяет выявить влияние на ограниченность D-потенциала Рисса поведения весов в нуле и бесконечности. В настоящей работе на этот вопрос дается полный ответ. В частности,в случае потенциала Рисса получены необходимые и достаточные условия. В качестве вспомогательных результатов доказаны необходимые и достаточные условия ограниченности операторов Харди и Беллмана в лебеговых пространствах с весом Данкля и кусочно-степенными весами

Assessment of naphazoline effect on erythrocyte superoxide dismutase activity in rats under experimental modeling of acute radiation sickness

Aim to assess the activity of superoxide dismutase in erythrocytes of rats after a single intramuscular injection of naphazoline in radiofrequency dose and in experimental simulation of acute radiation sickness. Material and methods. The activity of erythrocytes superoxide dismutase (SOD) after single intramuscular injection of nafazoline in experimental modeling of acute radiation sickness was investigated. The pharmacological properties and mechanisms of radioprotective action of nafazoline were clarified based on the dynamics of activity of erythrocytes SOD in intact and irradiated animals with the dose of 7,4 Gy. Results. The superoxide dismutase activity was found to increase significantly 60 min after single intramuscular administration of nafazolin at a dose of 5 mg/kg. Under experimental conditions of acute radiation disease modeling, a decrease in superoxide dismutase activity was observed within the first hour after exposure, evidencing the direct involvement of the antioxidant system components in the inactivation of free-radical reaction products. Conclusion. The radioprotective properties of naphazoline may be due not only to reduction of oxygen delivery to the cells of radiosensitive tissues and inhibition of their metabolism by effect on 2-adreno- and imidazoline receptors, but also by activation of antioxidant system links