Effectiveness of neoton in patients with chronic heart failure depending on the left ventricular ejection fraction. Sub-analysis of the BYHEART study

Aim. To study the effectiveness of exogenous phosphocreatine (EPCr) therapy in patients with heart failure (HF) with reduced and mildly reduce dejection fraction (EF).Material and methods. The all-Russian prospective observational study BYHEART included 842 patients who underwent aEPCr therapy course. Before and after the course of EPCr therapy, the following studies were carried out: a questionnaire on the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the clinical assessment scale (CAS), transthoracic echocardiography with an assessment of the left ventricular EF, a 6-minute walk test, N-terminal pro-brain natriuretic peptide (NT-proBNP). All patients before the EPCr course received long-term optimal therapy for HF.Results. Data analysis was carried out for patients in groups with heart failure with reduced ejection fraction (HFrEF) and with mildly reduced ejection fraction (HFmrEF) within the group depending on the course of EPCr treatment: subgroup A — patients who received EPCr therapy less than 20 g/course and subgroup B — patients who received EPCr therapy ≥20 g/course. The results obtained demonstrate an increase in the quality of life and exercise tolerance, an improvement according to the CAS, a decrease in NT-proBNP levels, and an improvement in left ventricular systolic function in patients with both HFrEF and HFmrEF during the course of intravenous EPCr therapy.Conclusion. The use of EPCr is a promising tool in addition to optimal therapy in patients with HFrEF and HFmrEF

The role of the CNTNAP2 gene in the development of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder in which genetic and environmental factors interact in its development. Research suggests that the contactin associated protein 2 (CNTNAP2) gene may play a role in ASD pathophysiology, yet more studies involving human participants and animal models of autism are needed. One such model may be the use of prenatal valproic acid (VPA) model to induce autism-like behaviors in offspring rats. The aim of this study was twofold: (1) to examine the association of the CNTNAP2 gene rs2710102 variant with ASD in children; and (2) to examine the effect of prenatal exposure to VPA on Cntnap2 gene expression in the rat brain. The study included 167 children of European ancestry—81 diagnosed with ASD (20 girls, 61 boys; age 4.9±1.4 years) and 86 controls (44 girls, 42 boys; 5.1±1.2 years). In vivo experiments were conducted in 80 rats (40 with the VPA model of autism), with Cntnap2 gene expression analysis in the amygdala, hippocampus, prefrontal cortex, and cerebellum. Results demonstrated that the frequency of the CNTNAP2 gene rs2710102 GG genotype was significantly higher in children with ASD when compared with controls (33.3 vs 19.8%; OR=2.03, 95%CI [1.004, 4.102], p = 0.035), although, potentially due to bias in cohort selection, in the ASD children this polymorphism did not meet Hardy-Weinberg expectations (χ2 =5.40, p = 0.02). In addition, Cntnap2 gene expression was significantly lower (p < 0.01) in the amygdala and hippocampus of VPA rats when compared with controls, regardless of sex. These results support previous research and provide evidence for the CNTNAP2 gene as a risk factor for AS

Relationship of depressive disorders with hypertension, its control and other metabolic risk factors in the Tyumen Oblast population of men and women. Data from the study “Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation” (ESSE-RF)

Aim. To study the association between depression and metabolic cardiovascular risk factors, hypertension (HTN) and its control in a random sample of Tyumen Oblast population of men and women aged 25-64 years.Material and methods. The study object was a random sample of the population of the Tyumen and the Tyumen Oblast aged 25-64 years, examined as part of the ESSE-RF epidemiological study. The study included 1658 participants. Among them, 30,3% (n=503) were men, while 69,7% (n=1155) — women. Mean age was 48,9±11,4 years. The prevalence of metabolic risk factors (hyperlipidemia, carbohydrate metabolism disorder, obesity), hypertension and the likelihood of its control in men and women with different levels of depressive disorders diagnosed using the HADS scale were assessed.Results. Compared with participants without depression, persons with psychological disorders were significantly more likely to have HTN (55,5% vs 47,6%, p&lt;0,01), elevated levels of total cholesterol (TC) (63,9% vs 54,0%, p&lt;0,01) and low-density lipoproteins (LDL) (66,7% vs 60,3%, p&lt;0,05), carbohydrate metabolism disorders (8,3% vs 5,2% p&lt;0,05), obesity (49,2% vs 37,7%, p&lt;0,01). Significantly more often hypertensive subjects without depression took antihypertensive drugs effectively (odds ratio (OR) — 1,747, 95% confidence interval (CI), 1,001-3,053) and controlled blood pressure (OR — 1,533, 95% CI, 1,05-2,36). There was no association between the use of antihypertensives and the level of depressive disorders. Among women with depression (HADS&gt;7), dyslipidemia (65,5% vs 57,4% for TC, p&lt;0,05; 71,0% vs 62,9% for LDL, p&lt;0,05), carbohydrate metabolism disorders (10,1% vs 5,2%, p&lt;0,01), obesity (53,3% vs 43,2%, p&lt;0,01), HTN (60,6% vs 45,6%, p&lt;0,01) were more common. Men with clinical depression were more likely to have HTN (69,0% vs 47,7%, p&lt;0,05), with a high level of depression — hyperlipidemia (58,9% vs 46,7% for TC, p&lt;0,05; 67,1% vs 53,9% for LDL, p&lt;0,05). Women with elevated depression levels were less likely to take antihypertensive drugs (30% vs 49,4%, p&lt;0,01) and control hypertension (13,8% vs 21,2%, p&lt;0,05).Conclusion. The data obtained confirm the association of depressive disorders with metabolic risk factors and the likelihood of HTN control, which is especially significant among women

Long-Term Monitoring of Liver Fibrosis and Steatosis in Patients with Chronic Hepatitis C after Achieving a Sustained Virologic Response to Antiviral Therapy

Aim: to analyze the dynamics of fibrosis and steatosis of the liver according to fibroelastometry in patients with chronic hep-atitis C (CHC) after ≥ 6 months from transient elastometry (TE) achieving a sustained virologic response (SVR) to antiviral therapy.Materials and methods. At baseline, a prospective observational study included 628 CHC patients with known stage of liver fibrosis (F) before AVT, some of whom were phased out due to non-compliance with the inclusion criteria. The final analysis included 297 patients who had transient elastometry (TE) data with CAP™ technology on the severity of liver fibrosis (± steatosis) before treatment and after ≥ 6 months after reaching SVR (67 % – interferonfree regimens of therapy). Median follow-up from the moment SVR was confirmed was 3 years [2; 6].Results. At the end of the study, the average age of patients was 49 ± 12 years, of which 53 % were men. In the long-term period after reaching SVR, regression of liver fibrosis was diagnosed in 80 % of cases (including in patients with cirrhosis), and the progression of fibrosis was in 3 % of patient. At the same time, regression of liver steatosis was detected only in 31 % of the patient, worsening of the results was in 23 % (26 % of them had the appearance of steatosis (S) of the liver of 1–3 degrees in persons with no fatty liver before the start of AVT). In the group of patients with liver steatosis, the proportion of men was significantly higher (p = 0.004). Clinically significant stages of fibrosis F3–F4 were significantly more often recorded in patients with hepatic steatosis, both before treatment (46 % S1–S3 and 22 % S0, p &lt; 0.001) and after ≥ 6 months after reaching SVR (19 % S1–S3 and 9 % S0, p = 0.023).Conclusion. In patients with chronic hepatitis C with SVR achieved in the long term, despite a significant regression of liver fibrosis, a high prevalence of hepatic steatosis remains. The data obtained indicate the feasibility of routine diagnosis of both fibrosis and steatosis of the liver in the management of patients with chronic HCV infection before and after successful antiviral therapy

Recommendations for the prevention and correction of thrombotic complications in COVID-19

The new coronavirus infection caused by the SARSCoV2 virus (COVID19) is characterized by a high frequency of thrombotic complications varying from venous or, more rarely, arterial thrombosis to the development of disseminated intravascular coagulation (DIC) and/or diffuse pulmonary vascular microthrombosis, which aggravates the disease and becomes one of the leading causes of deaths. Timely and personalized anticoagulant thromboprophylaxis with lowmolecularweight heparins may prevent a severe course of the disease and improve outcomes. This applies to outpatients, hospitalized patients and patients in the early post hospital period. In the future, to develop comprehensive and evidencebased guidelines on the management of patients with COVID19, it is necessary to conduct comprehensive systematic studies and comparative clinical trials of prophylaxis and treatment of hemostatic disorders in patients with COVID-19

INFLUENCE OF ANTHROPOGENIC IMPACTS ON THE WORK OF SOLAR ELECTRICITY AND HEATING PLANTS

The modeling of complex systems, radiant heat transfer in anthropogenically disturbed the atmosphere, solar electric and thermal power plantsare considered. The structural diagram of the simulation of solar radiation on the tributaries heat perceptive surface and solar thermal power plants is discussed. Calculations of the spectral intensities and flux of solar radiation are carried out taking into account the selectivity of the molecular absorption of the ingredients of the radiation of the gas phase of the atmosphere, scattering and absorption of radiation by atmospheric aerosols and clouds in view statistics of their distribution according to the station's location and time of year

NUCLEAR IMAGING IN THE DIAGNOSIS OF CARDIAC AMYLOIDOSIS

Histological analysis of endomyocardial tissue is still the gold standard for the diagnosis of cardiac amyloidosis but has its limitations. Accordingly, there is a need for noninvasive techniques to cardiac amyloidosis diagnostics. Echocardiography and magnetic resonance imaging can show characteristics which may not be very specific for cardiac amyloid. Recently, new opportunities of nuclear imaging in risk stratification and assessment of prognosis for patients with cardiac amyloidosis have appeared. During the last two decades different classes of radiopharmaceuticals have been developed based on compounds tropic to the components of amyloid infiltrates. In this paper we describe the current possibilities and perspectives of nuclear medicine techniques in patients with cardiac amyloidosis, including osteotropic and neurotropic scintigraphy, single-photon and positron emission tomograph