409 research outputs found
PROGNOSTIC ROLE OF EEG INDICATORS FOR CHANGES IN COGNITIVE PERFORMANCE IN PATIENTS IN THE EARLY AND LONG-TERM POSTOPERATIVE PERIODS OF CORONARY ARTERY BYPASS GRAFTING
Aim. To study the prognostic role of background EEG activity indicators recorded in patients in the preoperative period of coronary artery bypass grafting (CABG) for the development of cognitive impairment in the early and late postoperative periods.Methods. A total of 85 patients with coronary artery disease (CAD) who underwent CABG were included in the study. Before CABG (3-5 days) all neuropsychological testing and EEG studies were performed, at the 7-10th days and 1 year after CABG only neuropsychological testing. EEG predictors of early (n = 85) and long-term (n = 65) postoperative cognitive dysfunction were detected using the method of multiple linear regression.Results. EEG predictors of deterioration of cognitive status in the early postoperative period of CABG were basic higher values of theta-rhythm power in the posterior regions of the cortex of both hemispheres with closed and open eyes. Whereas higher preoperative parameters of beta2-rhythm biopotentials in the left frontal areas with eyes open and lower alpha-rhythm power in the left occipital parts of the cerebral cortex with eyes closed were associated with long-term postoperative cognitive dysfunction.Conclusion. associations of preoperative eeg indicators with deteriorations of cognitive status in the early and longterm postoperative periods of cabg were revealed.Β Aim. To study the prognostic role of background EEG activity indicators recorded in patients in the preoperative period of coronary artery bypass grafting (CABG) for the development of cognitive impairment in the early and late postoperative periods.Methods. A total of 85 patients with coronary artery disease (CAD) who underwent CABG were included in the study. Before CABG (3-5 days) all neuropsychological testing and EEG studies were performed, at the 7-10th days and 1 year after CABG only neuropsychological testing. EEG predictors of early (n = 85) and long-term (n = 65) postoperative cognitive dysfunction were detected using the method of multiple linear regression.Results. EEG predictors of deterioration of cognitive status in the early postoperative period of CABG were basic higher values of theta-rhythm power in the posterior regions of the cortex of both hemispheres with closed and open eyes. Whereas higher preoperative parameters of beta2-rhythm biopotentials in the left frontal areas with eyes open and lower alpha-rhythm power in the left occipital parts of the cerebral cortex with eyes closed were associated with long-term postoperative cognitive dysfunction.Β Conclusion. associations of preoperative eeg indicators with deteriorations of cognitive status in the early and longterm postoperative periods of cabg were revealed
THE EFFECT OF MILD COGNITIVE IMPAIRMENT ON EEG TOPOGRAPHIC CHANGES AFTER ON-PUMP CORONARY ARTERY BYPASS GRAFTING
The purpose. Previously it was shown that on-pump coronary artery bypass grafting (CABG) induced cerebralΒ ischemia and cognitive decline. The patients with mild cognitive impairment (MCI) could be a high-risk group ofΒ CABG-associated cognitive decline. Non-invasive neuromonitoring can provide information regarding subclinicalΒ symptoms and topography of cerebral ischemia. The aim of this study was to investigate the topographic changesΒ in electroencephalogram (EEG) spectral power in coronary artery disease (CAD) patients with or without MCIΒ before and after on-pump CABG.Methods: 62 males with CAD were divided into two groups according to their Mini-Mental State Examination:Β without MCI (n = 37) and with MCI (n = 25). Clinical factors were assessed, including the severity of coronary lesionsΒ (SYNTAX score), the left ventricular ejection fraction (LVEF). Eyes-closed rest EEG was recorded from 62 channelsΒ positioned according to the International 10β20 system. Spectral EEG power was calculated for frequencies fromΒ 0.1 to 50 Hz.Results: The patients with MCI had theta-1 (4β6 Hz) power increase 7-10 days after on-pump CABG only inΒ frontal and fronto-central clusters of right and left hemispheres as compared to the preoperative values, whereasΒ in the groups without MCI this effect was widespread over the brain. In the beta-1 band (13β20 Hz), CABG patientsΒ with MCI had power increase in the frontal, fronto-central and fronto-temporal regions of the brain cortex. SimilarΒ power changes in patients without MCI were observed only for occipital brain clusters.Conclusions: CAD patients with MCI have demonstrated EEG signs of cortical dysfunction focused on theΒ frontal brain areas. Cortical dysfunction in this localization can be associated with the progression of cognitiveΒ deficits, causing loss social integration in CAD patients with MCI.The purpose. Previously it was shown that on-pump coronary artery bypass grafting (CABG) induced cerebralΒ ischemia and cognitive decline. The patients with mild cognitive impairment (MCI) could be a high-risk group ofΒ CABG-associated cognitive decline. Non-invasive neuromonitoring can provide information regarding subclinicalΒ symptoms and topography of cerebral ischemia. The aim of this study was to investigate the topographic changesΒ in electroencephalogram (EEG) spectral power in coronary artery disease (CAD) patients with or without MCIΒ before and after on-pump CABG.Methods: 62 males with CAD were divided into two groups according to their Mini-Mental State Examination:Β without MCI (n = 37) and with MCI (n = 25). Clinical factors were assessed, including the severity of coronary lesionsΒ (SYNTAX score), the left ventricular ejection fraction (LVEF). Eyes-closed rest EEG was recorded from 62 channelsΒ positioned according to the International 10β20 system. Spectral EEG power was calculated for frequencies fromΒ 0.1 to 50 Hz.Results: The patients with MCI had theta-1 (4β6 Hz) power increase 7-10 days after on-pump CABG only inΒ frontal and fronto-central clusters of right and left hemispheres as compared to the preoperative values, whereasΒ in the groups without MCI this effect was widespread over the brain. In the beta-1 band (13β20 Hz), CABG patientsΒ with MCI had power increase in the frontal, fronto-central and fronto-temporal regions of the brain cortex. SimilarΒ power changes in patients without MCI were observed only for occipital brain clusters.Β Conclusions: CAD patients with MCI have demonstrated EEG signs of cortical dysfunction focused on the frontal brain areas. Cortical dysfunction in this localization can be associated with the progression of cognitive deficits, causing loss social integration in CAD patients with MCI
ΠΠΠΠ’ΠΠΠ¬ΠΠΠ‘Π’Π¬ ΠΠΠΠΠΠΠ ΠΠΠ’ΠΠ’Π ΠΠΠΠΠ¦ΠΠ’ΠΠ ΠΠΠ Π’ΠΠ ΠΠΠΠ
The review article updates on the key challenge in the present-day cardiology duration of dual antiplatelet Β therapy (DAPT) in patients with a history of acute coronary syndrome. The relevant clinical guidelines are analyzed, and results of the recent clinical trials and meta-analyses Β are highlighted. A risk assessment scale for evaluating ischemic and bleeding risks based on the study of DAPT is presented.Π ΠΎΠ±Π·ΠΎΡΠ½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΏΠΎ ΠΎΠ΄Π½ΠΎΠΌΡ ΠΈΠ· ΠΊΠ»ΡΡΠ΅Π²ΡΡ
Π²ΠΎΠΏΡΠΎΡΠΎΠ² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΊΠ°ΡΠ΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ β ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π΄Π²ΠΎΠΉΠ½ΠΎΠΉ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠΠ’Π’) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΠ΅Π½Π½ΡΠΌ ΠΎΡΡΡΡΠΌ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ, ΠΎΡΠ²Π΅ΡΠ΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π½Π΅Π΄Π°Π²Π½ΠΈΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠ°Π°Π½Π°Π»ΠΈΠ·ΠΎΠ². ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΡΠΊΠ°Π»Π° ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΈΡΠΊΠΎΠ² ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ±ΡΡΠΈΠΉ, ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΠΏΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ DAPT
EFFECT OF METOPROLOL ON COGNITIVE FUNCTION IN HYPERTENSIVE PATIENTS OF YOUNG TO MIDDLE AGE
Aim. To evaluate the effect of metoprolol tartrate on blood pressure (BP) and cognitive function in young to middle aged patients with essential hypertension (HT).Material and methods. 40 men (age of 49,0Β±1,9 y.o.) with HT of I-II stage not taking antihypertensive medication regularly were enrolled into the study. All patients were given metoprolol tartrate (start dose 50-100 mg/d). Variables of 24-h BP monitoring and clinic BP, left ventricular mass index (measured by echocardiography) and characteristics of cognitive function (memory, attention, thinking and neurodynamic) were assessed at the start, after 1 and 6 months of therapy.Results. Good and satisfactory antihypertensive effect was achieved in 75% of hypertensive patients with metoprolol (186,6Β±13,4mg/d) monotherapy. Metoprolol significantly decreased maximum day-time systolic and diastolic BP, maximum night-time diastolic BP, mean day-time systolic and night-time diastolic BP, time-index, load-index and variability-index for night-time diastolic BP, day-time and night-time pulse BP. Left ventricular mass index reduced significantly (p<0,0001). After 6 months of therapy significant improvement of memory, attention, thinking and neurodynamic was observedConclusion. Metoprolol had beneficial effect on cognitive function in hypertensive patients, which demonstrate its cerebroprotective properties in addition to antihypertensive action. Metoprolol can reduce the risk of dementia in young to middle aged patients with HT
Clustering of indicators of the cognitive status in cardiac surgery patients to assess the risk of postoperative decline
The aim of the study. To determine the informational value of psychometric indicators used for the integral assessment of cognitive status in cardiac patients, andΒ toΒ find those that would help differentiate the individual sensibility to postoperative cognitive dysfunction (POCD).Materials and methods. The clustering methods were analyzed the extended psychometric testing data in 256Β cardiac surgery patients. The psychometric testing carried out 3β5Β days before and on days 7β10 after surgery using the psychophysiological complex program βStatus PFβ.Results. The cluster analysis revealed that the most informative tests for a screening risk assessment of POCD are the testing the speed of response to visual stimuli with feedback of changes in the stimuli exposition according to the individual reaction time and the testing short-term memory (memorized words). While the analysis ofΒ postoperative psychometric indicators, the patients in a modified clustering group were characterized by a deterioration of verbal memory and a decrease of the time reaction to visual stimuli whereas that its observed acceleration in the general βstableβ group.Conclusion. The clustering methods enabled the identification of cardiac surgery patients in the preoperative stage who had less cognitive reserve for recovery after surgery. The changes in the relationship of complex visual and motor response, attention, and memory indicators, which depended on the belonging to the identified clusters, suggest that the preoperative period is characterized by the dedifferentiation of cognitive functions indicating a cognitive deficit
Acute coronary syndrome in patients with prior coronary artery bypass grafting. Literature review
Invasive management of patients with ST- segment elevation acute coronary syndrome (ST-ACS) and non-ST-elevation acute coronary syndrome (NSTE-ACS) is a priority and reflected in the current guidelines for management of this category of patients with a high evidence level (class I, level of evidence A). One of the limitations in invasive strategy is prior coronary artery bypass grafting in patients with multivessel artery coronary disease. This analytical review reflects modern ideas about the features of diagnosis and management of patients with acute coronary syndrome and previous coronary artery bypass surgery, approaches to revascularization from the standpoint of efficiency and safety
ΠΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² ΡΡΡΡΠΊΡΡΡΠ΅ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ ΡΡΠ½ΠΊΡΠΈΠΉ ΠΈ ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎΡΡΠΈ Ρ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² ΡΠΎΠ½Π½ΡΡ Π°ΡΡΠ΅ΡΠΈΠΉ
Highlights. The article revealed that severe (more than 50%) carotid artery (CA) stenosis was associated with significant slowdown of the information selection processes, and these patients were characterized by older age and tendency to an increase in trait anxiety compared to the patients without CA stenosis.It was found that the reduced attention and memory was a typical feature of the cognitive status in patients with severe CA stenosis in the early postoperative period of cardiac surgery in comparison with the patients without CA stenosis. At the same time the speed characteristics indicators of the information selection processes in these patients are positively related to state anxiety.Aim. The cardiac surgery patients were studied in order to analyze the postoperative changes in the efficiency of selection information and memory processes depending on the degree of carotid artery (CA) stenosis (including more than 50%) and the age and the role of the trait anxiety indicator assessed before surgery.Methods. The prospective study included 229 patients undergoing elected coronary artery bypass grafting (CABG) or CABG and carotid endarterectomy (CEE). Each study participant underwent clinical, instrumental and extended psychometric examination before cardiac surgery and at 7-10 days after surgery. The evaluation of the extracranial vessels state was carried out before surgery using color duplex scanning. Based on the results of assessing the extracranial vessels state, all patients were divided into three groups: no stenosis (n = 124), CA stenosis less than 50% (n = 69) and more than 50% (n = 36).Results. It was found out that the patients with CA stenoses more than 50% are characterized by a slower reaction under different conditions of visual stimuli selection and by an older age as compared with patients with no stenoses as well as patients with stenoses less than 50%. In the postoperative period of cardiac surgery in comparison with testing before surgery there was an improvement in the information selection stability (an increase in the number of processed symbols per 4 minute of the Bourdon's test (p<0.00006)) and short-term memory (p = 0.03) only in the group of patients without stenoses. The patients with stenoses of less than 50% had an increase the of the information selection stability but the short-term memory decrease (p<0.05) whereas the group with stenoses more than 50% had a decrease in both the stability of information selection and short-term memory (p<0,05). Additional factors of cognitive deficit in CA stenosis patients were trait anxiety associated with memory impairment and a history of stroke that related to a decrease in the effectiveness of a complex visual-motor reaction.Conclusion. The comprehensive analysis of the cognitive status of cardiac surgery patients with different severity of CA stenosis showed that an increase in the age and stenosis degree is the factor of the reaction time slowdown under different conditions of information selection. To differentiate groups of patients depending on the severity of stenosis in the postoperative period the testing short-term memory and stability of attention is informative. These indicators improve in the group without stenosis but decrease in the group with pronounced stenosis. The trait anxiety and the history of stroke were the additional factors of memory impairment due to CA stenosis.ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ. ΠΠΏΠ΅ΡΠ²ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΉ (Π±ΠΎΠ»Π΅Π΅ 50%) ΡΡΠ΅Π½ΠΎΠ· ΡΠΎΠ½Π½ΡΡ
Π°ΡΡΠ΅ΡΠΈΠΉ (Π‘Π) ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ Π·Π½Π°ΡΠΈΠΌΠΎΠΌΡ Π·Π°ΠΌΠ΅Π΄Π»Π΅Π½ΠΈΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅Π°ΠΊΡΠΈΠΈ ΠΏΡΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΡΡ ΡΡΠ°ΡΡΠΈΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ ΠΈ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΠ΅ΠΉ ΠΊ ΡΠΎΡΡΡ Π»ΠΈΡΠ½ΠΎΡΡΠ½ΠΎΠΉ ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ Ρ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ΠΌ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² Π‘Π.ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ, ΡΡΠΎ ΠΎΡΠ»ΠΈΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΌΠΈ ΡΡΠ΅Π½ΠΎΠ·Π°ΠΌΠΈ Π‘Π Π² ΡΠ°Π½Π½Π΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΡΠ»ΡΠΆΠ°Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΎΠ±ΡΠ΅ΠΌΠ° Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ ΠΈ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ Ρ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ΠΌ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² Π‘Π, ΠΏΡΠΈ ΡΡΠΎΠΌ ΡΠΊΠΎΡΠΎΡΡΠ½ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ²ΡΠ·Π°Π½Ρ Ρ Π»ΠΈΡΠ½ΠΎΡΡΠ½ΠΎΠΉ ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎΡΡΡΡ.Π¦Π΅Π»Ρ. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΏΠ°ΠΌΡΡΠΈ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠ΅Π½ΠΎΠ·Π° ΡΠΎΠ½Π½ΡΡ
Π°ΡΡΠ΅ΡΠΈΠΉ (Π‘Π) (Π±ΠΎΠ»Π΅Π΅ 50%) ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈ Π²ΡΡΡΠ½ΠΈΡΡ ΡΠΎΠ»Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Π»ΠΈΡΠ½ΠΎΡΡΠ½ΠΎΠΉ ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎΡΡΠΈ, ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π΄ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 229 Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΠΎΠ΅ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΠ¨) Π»ΠΈΠ±ΠΎ ΠΠ¨ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΊΠ°ΡΠΎΡΠΈΠ΄Π½ΠΎΠΉ ΡΠ½Π΄Π°ΡΡΠ΅ΡΡΠΊΡΠΎΠΌΠΈΠ΅ΠΉ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅, ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΈ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΠΎΠ΅ ΠΏΡΠΈΡ
ΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ Π΄ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΈ Π½Π° 7-10-Π΅ ΡΡΡ ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ. ΠΡΠ΅Π½ΠΊΠ° ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΡΠΊΡΡΡΠ°ΠΊΡΠ°Π½ΠΈΠ°Π»ΡΠ½ΡΡ
ΡΠΎΡΡΠ΄ΠΎΠ² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° Π΄ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠ²Π΅ΡΠ½ΠΎΠ³ΠΎ Π΄ΡΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΡΡΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½Ρ ΡΡΠΈ Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²: ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΡΠ΅Π½ΠΎΠ·Π° Π‘Π (n = 124), ΡΡΠ΅Π½ΠΎΠ· Π‘Π ΠΌΠ΅Π½Π΅Π΅ 50% (n = 69) ΠΈ Π±ΠΎΠ»Π΅Π΅ 50% (n = 36).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠ»ΡΠ½ΡΠ΅ ΡΠΎ ΡΡΠ΅Π½ΠΎΠ·Π°ΠΌΠΈ Π‘Π Π±ΠΎΠ»Π΅Π΅ 50% ΠΎΡΠ»ΠΈΡΠ°ΡΡΡΡ ΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ΠΌ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² ΠΈ ΡΡΠ΅Π½ΠΎΠ·Π°ΠΌΠΈ ΠΌΠ΅Π½Π΅Π΅ 50% Π±ΠΎΠ»Π΅Π΅ ΠΌΠ΅Π΄Π»Π΅Π½Π½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠ΅ΠΉ Π² ΡΠ°Π·Π½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ Π·ΡΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΡΠΈΠΌΡΠ»ΠΎΠ² ΠΈ ΡΡΠ°ΡΡΠΈΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ. Π ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ² ΡΠΎΠ»ΡΠΊΠΎ Π² Π³ΡΡΠΏΠΏΠ΅ Π»ΠΈΡ Π±Π΅Π· ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ (ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° ΠΎΠ±ΡΠ°Π±Π°ΡΡΠ²Π°Π΅ΠΌΡΡ
Π·Π° 4 ΠΌΠΈΠ½ΡΡΡ ΡΠΈΠΌΠ²ΠΎΠ»ΠΎΠ² ΡΠ΅ΡΡΠ° ΠΊΠΎΡΡΠ΅ΠΊΡΡΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ±Ρ ΠΡΡΠ΄ΠΎΠ½Π°; p<0,00006) ΠΈ ΠΊΡΠ°ΡΠΊΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ°ΠΌΡΡΠΈ (Ρ = 0,03) Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄ΠΎ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎ ΡΡΠ΅Π½ΠΎΠ·Π°ΠΌΠΈ ΠΌΠ΅Π½Π΅Π΅ 50% Π½Π°ΡΡΠ΄Ρ Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΊΡΠ°ΡΠΊΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ°ΠΌΡΡΠΈ ΡΠ½ΠΈΠΆΠ°Π»ΠΈΡΡ (Ρ<0,05), Π° Π² Π³ΡΡΠΏΠΏΠ΅ ΡΠΎ ΡΡΠ΅Π½ΠΎΠ·Π°ΠΌΠΈ Π±ΠΎΠ»Π΅Π΅ 50% ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΠΊΠ°ΠΊ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ, ΡΠ°ΠΊ ΠΈ ΠΊΡΠ°ΡΠΊΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ°ΠΌΡΡΠΈ (Ρ<0,05). ΠΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ° ΠΏΡΠΈ ΡΡΠ΅Π½ΠΎΠ·Π΅ Π‘Π Π²ΡΡΡΡΠΏΠ°ΡΡ Π»ΠΈΡΠ½ΠΎΡΡΠ½Π°Ρ ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎΡΡΡ, ΡΠ²ΡΠ·Π°Π½Π½Π°Ρ Ρ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°ΠΌΡΡΠΈ, ΠΈ Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΠΠΠ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΡΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ»ΠΎΠΆΠ½ΠΎΠΉ Π·ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ-ΠΌΠΎΡΠΎΡΠ½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Π·Π½ΠΎΠΉ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΡΡ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠ² Π‘Π ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΈ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠ΅Π½ΠΎΠ·Π° ΡΠ»ΡΠΆΠΈΡ ΡΠ°ΠΊΡΠΎΡΠΎΠΌ Π·Π°ΠΌΠ΅Π΄Π»Π΅Π½ΠΈΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΠ²Π΅ΡΠ° Π² ΡΠ°Π·Π½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ. ΠΠ»Ρ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°ΡΠΈΠΈ Π³ΡΡΠΏΠΏ Π±ΠΎΠ»ΡΠ½ΡΡ
Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΡΡΠ΅Π½ΠΎΠ·Π° Π² ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΡΠ°ΡΠΊΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ, ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ°Π΅ΡΡΡ Π² Π³ΡΡΠΏΠΏΠ΅ Π±Π΅Π· ΡΡΠ΅Π½ΠΎΠ·Π°, Π½ΠΎ ΡΠ½ΠΈΠΆΠ°Π΅ΡΡΡ Π² Π³ΡΡΠΏΠΏΠ΅ Ρ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΌ ΡΡΠ΅Π½ΠΎΠ·ΠΎΠΌ
Profibrotic genetic polymorphisms as possible risk factors for the development of diastolic dysfunction in patients with epicardial adiposity
Aim. To determine the associations of variable sites of fibrogenesis genes with the risk of left ventricular (LV) diastolic dysfunction (DD) in patients with epicardial adiposity (EA).Material and methods. The study included 101 men with general obesity (Altai Territory) without cardiovascular diseases, diabetes and documented LVDD, of which, after determining the epicardial fat thickness (EFT), 2 groups were formed: group 1 β with EA (EA+), EFT β₯7 mm or more (n=70); group 2 β without EA (EA-), EFT <7 mm (n=31). The control group was formed from Kemerovo region residents of the corresponding sex and age and without a history of cardiovascular diseases and general obesity. Polymorphisms of the MMP9 rs17576, TGFB1 rs1800469, MMP3 rs6796620, MMP3 rs626750, MMP1 rs514921, LOC101927143 rs4290029, TIMP2 rs2277698 genes were determined in all patients using the polymerase chain reaction. After 4,7Β±0,3 years, all patients with general obesity underwent repeated echocardiography to assess LVDD.Results. We found that in the group with EA for rs626750 MMP3, the carriage of the homozygous T allele is 2 times more common (recessive inheritance, p=0,0022). After 4,7Β±0,3 years, LVDD was registered in 18 patients in the EA+ group and in 2 patients in the EA- group. When analyzing inheritance patterns, as well as comparing genotypes in groups of patients with EA with developed LVDD (n=20) and without LVDD (n=78), we found that patients with EA and LVDD are 3,4 times more likely to be a carrier of the homozygous T allele (recessive inheritance, p=0,02) for rs1800469 TGFB1.Conclusion. In patients with EA and LVDD, the carriage of the T rs1800469 TGFB1 allele is more common, which probably contributes to cardiac fibrosis and LVDD according to a recessive inheritance
Π£ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ ΡΠΎΠ±ΡΡΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΌΡΠ»ΡΡΠΈΡΠΎΠΊΠ°Π»ΡΠ½ΡΠΌ Π°ΡΠ΅ΡΠΎΡΠΊΠ»Π΅ΡΠΎΠ·ΠΎΠΌ ΠΈ ΡΠ°Ρ Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ 2-Π³ΠΎ ΡΠΈΠΏΠ°
The review article presents current positions about prevalence of multifocal atherosclerosis and type 2 diabetes mellitus in patients with coronary artery disease (CAD). Existing approaches to the assessment and management of high risk of ischemic events in such patients are identified. Based on the results of clinical trials, the main positions have been identified on risk prevention of cardiovascular complications in patients with combination of multifocal atherosclerosis and type 2 diabetes mellitus. The results of the COMPASS study on the use of a combination of rivaroxaban 2.5 mg twice a day and a low dose of acetylsalicylic acid in patients with CAD and/or multifocal atherosclerosis are presented, which is accompanied by a significant reduction in the risk of cardiovascular events. This approach demonstrated a increase in the risk of massive bleedings, but mainly in the first year of treatment and without significant subsequent increase. At the same time, in the group of combination therapy rivaroxaban and acetylsalicylic acid there was no increase in the frequency of the most severe bleeding - fatal, intracranial and into the critical organs, compared to the group of monotherapy of acetylsalicylic acid. These two facts show a perfectly acceptable level of hemorrhagic risk for translation into real clinical practice. Hemorrhagic risk management capabilities were considered in a CoMPASS study by prescribing proton pump inhibitors to patients. The data on the COMPASS sub-analysis on evaluation of effectiveness and safety of combined antithrombotic therapy in patients with CAD and/or multifocal atherosclerosis and type 2 diabetes mellitus are presented. They showed the possibility of usage such approach in patient management in routine clinical practice. Patients with very high risk of ischemic events: ischemic heart disease and multifocal atherosclerosis, as well as type 2 diabetes mellitus, particularly need to improve approaches to antithrombotic therapy.Π ΠΎΠ±Π·ΠΎΡΠ½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΌΡΠ»ΡΡΠΈΡΠΎΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π°ΡΠ΅ΡΠΎΡΠΊΠ»Π΅ΡΠΎΠ·Π° (ΠΠ€Π), ΡΠ°Ρ
Π°ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π±Π΅ΡΠ° (Π‘Π) 2-Π³ΠΎ ΡΠΈΠΏΠ° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΡΠ΅ΡΠ΄ΡΠ° (ΠΠΠ‘). ΠΠ±ΠΎΠ·Π½Π°ΡΠ΅Π½Ρ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ ΠΊ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΈ ΡΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ±ΡΡΠΈΠΉ Ρ ΡΠ°ΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π²ΡΠ΄Π΅Π»Π΅Π½Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΏΠΎΠ·ΠΈΡΠΈΠΈ ΠΏΠΎ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ ΡΠΈΡΠΊΠ° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ΠΌ ΠΠ€Π ΠΈ Π‘Π 2-Π³ΠΎ ΡΠΈΠΏΠ°. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ COMPASS ΠΏΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ ΡΠΈΠ²Π°ΡΠΎΠΊΡΠ°Π±Π°Π½Π° 2,5 ΠΌΠ³ Π΄Π²Π° ΡΠ°Π·Π° Π² Π΄Π΅Π½Ρ ΠΈ Π½ΠΈΠ·ΠΊΠΎΠΉ Π΄ΠΎΠ·Ρ Π°ΡΠ΅ΡΠΈΠ»ΡΠ°Π»ΠΈΡΠΈΠ»ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ‘ ΠΈ/ΠΈΠ»ΠΈ ΠΠ€Π, ΡΡΠΎ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ Π·Π½Π°ΡΠΈΠΌΡΠΌ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠΊΠ° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
ΡΠΎΠ±ΡΡΠΈΠΉ. Π’Π°ΠΊΠΎΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π» Π·Π°ΠΊΠΎΠ½ΠΎΠΌΠ΅ΡΠ½ΠΎΠ΅ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° Π±ΠΎΠ»ΡΡΠΈΡ
ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ, Π½ΠΎ Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌ Π² ΠΏΠ΅ΡΠ²ΡΠΉ Π³ΠΎΠ΄ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ Π±Π΅Π· Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠ΅Π³ΠΎ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ. ΠΡΠΈ ΡΡΠΎΠΌ Π² Π³ΡΡΠΏΠΏΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΈΠ²Π°ΡΠΎΠΊΡΠ°Π±Π°Π½ΠΎΠΌ ΠΈ ΠΠ‘Π Π½Π΅ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΎΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠΎΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΡ
ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ - ΡΠ°ΡΠ°Π»ΡΠ½ΡΡ
, Π²Π½ΡΡΡΠΈΡΠ΅ΡΠ΅ΠΏΠ½ΡΡ
ΠΈ Π² ΠΊΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈ Π²Π°ΠΆΠ½ΡΠ΅ ΠΎΡΠ³Π°Π½Ρ, Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π³ΡΡΠΏΠΏΠΎΠΉ ΠΌΠΎΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΠ‘Π. ΠΡΠΈ Π΄Π²Π° ΡΠ°ΠΊΡΠ° ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΡΡ ΠΎ Π²ΠΏΠΎΠ»Π½Π΅ ΠΏΡΠΈΠ΅ΠΌΠ»Π΅ΠΌΠΎΠΌ ΡΡΠΎΠ²Π½Π΅ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° Π΄Π»Ρ ΡΡΠ°Π½ΡΠ»ΡΡΠΈΠΈ Π² ΡΠ΅Π°Π»ΡΠ½ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΠΏΡΠ°ΠΊΡΠΈΠΊΡ. ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π»ΠΈΡΡ Π² Ρ
ΠΎΠ΄Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ COMPASS ΠΏΡΡΠ΅ΠΌ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠΎΠ² ΠΏΡΠΎΡΠΎΠ½ΠΎΠ²ΠΎΠΉ ΠΏΠΎΠΌΠΏΡ (ΠΠΠ) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΡΡΠ±Π°Π½Π°Π»ΠΈΠ·Π° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ COMPASS ΠΏΠΎ ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ‘ ΠΈ/ΠΈΠ»ΠΈ ΠΠ€Π ΠΈ Π‘Π 2-Π³ΠΎ ΡΠΈΠΏΠ°, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°ΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΊ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΡΡΡΠΈΠ½Π½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. ΠΠΎΠ»ΡΠ½ΡΠ΅ Ρ ΠΎΡΠ΅Π½Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΠ±ΡΡΠΈΠΉ - Ρ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΡΠ΅ΡΠ΄ΡΠ° ΠΈ ΠΌΡΠ»ΡΡΠΈΡΠΎΠΊΠ°Π»ΡΠ½ΡΠΌ Π°ΡΠ΅ΡΠΎΡΠΊΠ»Π΅ΡΠΎΠ·ΠΎΠΌ, Π° ΡΠ°ΠΊΠΆΠ΅ Ρ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ 2-Π³ΠΎ ΡΠΈΠΏΠ° - ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π½ΡΠΆΠ΄Π°ΡΡΡΡ Π² ΡΠ»ΡΡΡΠ΅Π½ΠΈΠΈ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ² ΠΊ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
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