PATHOGENETIC ASPECTS OF THE INFLUENCE OF SEASONALITY ON THE HEALTH OF PATIENTS WITH CHRONIC PATHOLOGY OF THE CARDIOVASCULAR SYSTEM: LITERATURE REVIEW

Purpose. To summarize and systematize the literature data on the pathogenetic aspects of the influence of seasonality on the health status of patients with chronic pathology of the cardiovascular system. Materials and methods. To analyze the literature, materials from the PubMed and PubMed Central resources of the US National Library of Medicine, Google Scholar, Elsevier Clinical Key and Elsevier Science Direct, as well as in the Russian RSCI database were used. The sample consisted of scientific papers devoted to the pathogenetic aspects of the influence of various meteorological factors on the course of cardiovascular pathology. Results. The generalized results of clinical and experimental studies presented in this review indicate both direct and indirect effects on the state of the cardiovascular system of seasonal changes in air temperature, atmospheric pressure, solar radiation, air humidity and geomagnetic indicators. Conclusion. Meteorological factors have a pronounced effect on the course of cardiovascular diseases both through direct mechanisms of influence, and through the inclusion in the pathogenesis of these diseases and the aggravation of existing risk factors. The pathogenetic mechanisms of the influence of weather factors on the state of the cardiovascular system are important for understanding the application points that can be influenced and improved by primary and secondary prevention of cardiovascular pathology

Assessment of the quality of life in elderly and senile age patients with chronic heart failure

The present study aimed to compare the QOL in patients with heart failure with mid-range ejection fraction (HFmrEF) in different age groups, taking into account gender difference

Anticoagulation after typical atrial flutter ablation

The specifics of the anticoagulant therapy after radiofrequency ablation of the cavotricuspid isthmus have not been sufficiently studied, therefore, the recommendations for prescribing the anticoagulant therapy usually do not distinguish between atrial flutter and atrial fibrillation. In contrast to the case of atrial fibrillation, the effectiveness of the interventional treatment for typical atrial flutter reaches 90%. This procedure may save the patient from a long-term anticoagulant therapy in the absence of recurrence of typical atrial flutter. The decision to stop the anticoagulant therapy after successful radiofrequency ablation of the cavotricuspid isthmus should take into account the potential induction of atrial fibrillation in patients undergoing the interventional treatment. In addition to the CHA2DS2-VASc scale, which characterizes the patient's comorbidity, it is important to take into account the echocardiographic morphofunctional criteria to assess the risk of atrial fibrillation. Currently, this protocol is not regulated in the clinical guidelines. The analysis of the literature data and the authors' own experience allow us to conclude that the optimal time for stopping the anticoagulant therapy is a relapse-free period of 34 months after the radiofrequency ablation of the cavotricuspid isthmus, since it is at this time that the effectiveness of the interventional treatment can be objectified

The first experience of a hybrid approach in the surgical treatment of atrial fibrillation

Background: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is associated with an increased risk of death, progression of heart failure, and the development of cardiogenic thromboemboli. Despite the significant success in the management of AF in the paroxysmal form, the results of the treatment for patients with persistent forms of AF remain unsatisfactory. Though the surgical approach provides higher rates of efficiency regarding the restoration of a sinus rhythm, transmural lesions are not always attainable, as a result, the rate of AF recurrence in the long-term period remains fairly high. It is also impossible to create ablative patterns to the mitral and tricuspid valves during thoracoscopic epicardial ablation, which can cause the development of recurrent AF, perimitral and typical atrial flutter. Therefore, the development of hybrid approaches combining the advantages of catheter and thoracoscopic techniques is an urgent task of contemporary surgical and interventional arrhythmology. Aims: to estimate the immediate results of a hybrid approach in the management of patients with persistent AF. Methods: We report the first experience of a hybrid treatment of patients with persistent AF. 6 patients aged 53-64 years (1 female, 5 males) were included in the study. At the first stage, thoracoscopic epicardial bipolar ablation was performed (modified GALAXY protocol); the second stage (in 3 to 6 months after the thoracoscopic stage) included an intracardiac electrophysiological study with three-dimensional endocardial mapping followed by endocardial ablation. Results: The thoracoscopic stage of the hybrid treatment included ablation according to the box lesion scheme using a bipolar irrigation equipment. No lethal outcomes and severe, life-threatening complications were registered. The duration of the inpatient period was 510 hospital-days. The 2nd stage of the hybrid treatment was limited to intracardiac electrophysiological examination only in 2 patients. In 4 patients, epicardial radiofrequency ablation was complemented by endocardial radiofrequency exposure. In 3 of the 4 patients who underwent endocardial radiofrequency ablation, catheter ablation of the mitral and cavotricuspid isthmus was required because of the induction of perimitral and typical flutter, respectively. After the 2nd stage of the hybrid treatment, at the time of discharge all the patients maintained a stable sinus rhythm. There were no severe complications or lethal outcomes. Conclusion: a hybrid approach in the AF management is a safe and effective method of treatment, which combines the advantages of minimally invasive surgery and endocardial intervention in patients with persistent AF. The technique is safe and has acceptable short-term results

Суправентрикулярные (наджелудочковые) тахикардии у детей

Rhythm and conduction disorders of the heart occupy one of the leading places in the structure of cardiovascular pathology in children. Supraventricular tachycardias means tachyarrhythmias, caused by abnormal myocardial excitation with the source of rhythm localization above the His bundle bifurcation — in the atria, atrioventricular junction (node), and also arrhythmias with circulation of the excitation wave between the atria and the ventricles with additional atrial compounds. The team of authors presents clinical recommendations developed on the principles of evidence-based medicine, including all stages of diagnosis and treatment of children with supraventricular tachycardias. The use of recommendations in clinical practice allows to selecte the best strategy for diagnosis and treatment of supraventricular tachycardia in a particular patient.Нарушения ритма и проводимости сердца занимают одно из ведущих мест в структуре сердечно-сосудистой патологии у детей. Суправентрикулярные тахикардии — тахиаритмии, обусловленные аномальным возбуждением миокарда с локализацией источника ритма выше бифуркации пучка Гиса — в предсердиях, атриовентрикулярном соединении (узле), а также аритмии с циркуляцией волны возбуждения между предсердиями и желудочками с участием дополнительных предсердно-желудочковых соединений. Коллектив авторов представляет разработанные на основании принципов доказательной медицины клинические рекомендации, включающие все этапы диагностики и лечения детей с суправентрикулярными тахикардиями. Использование рекомендаций в клинической практике позволит осуществлять выбор наилучшей стратегии в диагностике и лечении суправентрикулярной тахикардии у конкретного пациента

Stroke epidemiology in Krasnoyarsk Region

Aim. To study stroke risk factors (RF), morbidity, mortality, and lethality in the Krasnoyarsk Region. Material and methods. The Stroke Register (National Stroke Association Form 01) was used for adult population (25-74 years) of Krasnoyarsk Region pilot territories in 2001-2003. Results. Leading RF for stroke were arterial hypertension (51.4%-82%) and heart disease, including atrial fibrillation (40.7%-60%). Stroke morbidity varied from 4.1 to 5.8 per 1000 people annually, both in big industrial cities and country districts, and tended to be increasing. Mortality varied from 0.77 to 2.01 per 1000, and was significantly higher in country districts. At-home lethality was 35.5% in Krasnoyarsk City and 86.4% in country districts, due to deficit in neurologists and hospital places for patients with acute cerebrovascular pathology in city and country clinics. Percentage of ante-mortem acute stroke verification was 8-10% in Krasnoyarsk City and Achinsk, and 0% in country districts. Conclusion. In 2001-2003, cerebrovascular pathology, RF prevalence, stroke morbidity and mortality remained high in Krasnoyarsk Region

Potentiation effect of the AMPK activator A-769662 on cardiac myocytes metabolism and survival

Abstract 286 van Poster session 2 Frontiers in CardioVascular Biology, London 30th March – 1st April 2012 Second Congress of the ESC Council on Basic Cardiovascular Science