The effect of empagliflozin on the development of chronic heart failure after myocardial infarction according to a 12-month prospective study

BACKGROUND: Although the positive cardiovascular effect of empagliflozin has been established, its influence on the formation of heart failure (HF) in patients with type 2 diabetes mellitus (T2D) after myocardial infarction (MI) remains unknown. AIM: To study the effect of empagliflozin on the formation of chronic HF after MI in patients having diabetes mellitus of type 2 (DM 2), according to 12-month follow-up data. MATERIALS AND METHODS: 47 patients with MI and DM 2 were included; 21 received standard therapy for MI and diabetes (group 1); 26 patients, in addition, received empagliflozin (group 2). The patients were investigated in 3 and 12 months, to assess the dynamics of glycemic control, 6-minute walk test, echocardiography. RESULTS: During postinfarction period, the 6-minute walk distance was increasing in group 1 in a lesser degree (p = 0.18) than in group 2 (49.5%, p = 0.0004). The ejection fraction got better particularly in group 2 (p = 0.002). At baseline, the proportions of patients having HF with reduced and mid-range ejection fraction were 85.7% and 82.4% in groups 1 and 2 (p = 0.56) but in 12 months decreased to 71.4% and 29.4% (p = 0.012). In empagliflozin group diastolic function was improved in a third of the patients (p = 0.041). The pulmonary artery systolic pressure was increasing in group 1 (by 10,4%, p = 0.041) but decreasing in group 2 (by 24,0%, p = 0.019). Glycemic control was better in group 2 than in group 1. CONCLUSION: According to 12-month follow-up data, empagliflozin has a positive effect on HF formation and symptoms in patients having MI and DM 2. This effect may be based on the ability of empagliflozin to improve the state of the heart including the delay of postinfarction remodeling, the improvement of pulmonary artery hemodynamics, systolic and diastolic function, the reduction of risk of chronic HF with reduced and mid-range ejection fraction

ВЛИЯНИЕ ЭНДОВАСКУЛЯРНОЙ РЕТРОПЕРФУЗИИ МИОКАРДА НА ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ ЛЕВОГО ЖЕЛУДОЧКА У БОЛЬНЫХ С ОСТРЫМ КОРОНАРНЫМ СИНДРОМОМ И СЛОЖНЫМИ ФОРМАМИ ПОРАЖЕНИЯ ВЕНЕЧНЫХ АРТЕРИЙ СЕРДЦА

Myocardial retroperfusion in patients with acute coronary syndrome (ACS) is an actual scientific problem. Objective: To assess left ventricular (LV) function in patients with ACS in the medium term after the intervention with myocardial retroperfusion. The study included 24 patients with ACS: Group 1 consisted of 12 (50%) patients with ACS who has ST segment elevation, Group 2 - 12 (50%) patients with ACS who had no ST segment elevation. Both groups were divided in two subgroups: subgroup A - patients with retroperfusion; subgroup B - patients without retroperfusion. Results: In group 1 postoperative normalization of LV function was observed in 6 patients in the subgroup of A and in 1 patient in the subgroup B in the medium term; in group 2 postoperative normalization of LV function was observed in 4 patients in subgroup A and in 2 patients in the subgroup B. Conclusion: It is advisable to apply a retroperfusion support of myocardial blood supply technique during the intervention in patients with ACS.Ретроперфузия миокарда у больных с острым коронарным синдромом (ОКС) является актуальной научной проблемой. Цель: провести оценку функции левого желудочка (ЛЖ) у больных с ОКС в средние сроки после интервенции с ретроперфузией миокарда. Обследованы 24 пациента с ОКС: 1-ю группу составили 12 (50%) больных ОКС с подъемом сегмента ST, 2-ю группу - 12 (50%) больных ОКС без подъема сегмента ST. Обе группы были разделены на две подгруппы: подгруппа А - пациенты с ретроперфузией; подгруппа В - больные без ретроперфузии. Результаты: в 1-й группе в средние сроки после операции нормализация функции ЛЖ наблюдалась у 6 больных в подгруппе А и у 1 больного в подгруппе B; во 2-й группе - у 4 больных в подгруппе А и у 2 больных в подгруппе В. Заключение: во время интервенционного вмешательства у пациентов с ОКС целесообразно применять методику ретроперфузионной поддержки кровоснабжения миокарда

Crystallographic growth of cavities in zirconium.

No abstract provide

PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN ATRIAL FIBRILLATION - RAT POISON OR NEW ORAL ANTICOAGULANTS: DO WE HAVE A CHOICE, AND SHOULD WE BE AFRAID TO MAKE IT? FIRST CLINICAL EXPERIENCE WITH RIVAROXABAN IN NIZHNY NOVGOROD

Adequate primary and secondary prevention of thromboembolic complications is one of the main goals of management of patients with atrial fibrillation. Many years of practice and experience of warfarin use, unfortunately, did not lead to wider and more efficient use of anticoagulation therapy. New oral anticoagulants devoid of drawbacks of warfarin, which prevented its prescription and long-term use, have appeared in the past few years. One of them, the most studied, with the largest list of indications for use, and very attractive, is rivaroxaban.</p