Non-compaction and dilated cardiomyopathy: genotypic, phenotypic and prognostic differences

Aim. To study and compare genotypic and phenotypic signs in patients with non-compaction cardiomyopathy (NCM) and dilated cardiomyopathy (DCM), to conduct a comparative analysis of clinical outcomes and 5-year cumulative survival of patients with NCM and DCM.Material and methods. The study included 144 unrelated patients with cardiomyopathy: NCM (n=74) and DCM (n=70). Mean age was 39 [30; 49] years (men, 96 (66,7%); left ventricular ejection fraction (LVEF) was 30,5 [24; 46]%. A comprehensive clinical examination included electrocardiography, Holter monitoring, echocardiography, cardiac magnetic resonance imaging, coronary angiography, DNA diagnostics (NGS+Sanger), cascade screening, and cosegregation analysis. To assess clinical outcomes, the NCM group was divided into 2 subtypes according to baseline LV systolic function (NCM/DCM phenotype — 50 individuals with LVEF ≤49%; and isolated NCM — 24 patients with LVEF ≥50%). The following adverse events were assessed as the composite endpoint: cardiovascular death, heart transplantation (HT), sustained ventricular tachycardia, ventricular fibrillation, successful cardiopulmonary resuscitation, cerebral thromboembolism. The follow-up period was 62 months.Results. Among patients with LVEF ≤49% at a 5-year follow-up, 37 (74,0%) of 50 patients with the NCM/DCM phenotype and 41 (58,6%) of 70 patients with DCM achieved composite endpoint. Out of 24 patients with NCM with LVEF ≥50% (median LVEF, 56 [51; 61]%), 2 (8,3%) patients achieved composite endpoint (χ2=28,8; p=0,001). In the NCM/DCM group with LVEF ≤49%, a higher level of pathogenic genetic variants (64% vs 41,4%/DCM vs 29,2%/NCM; χ2=11,4; p=0,003), cerebral thromboembolism (χ2=11,8; p=0,003) and HT (χ2=10,6; p=0,005). The results of the 5-year survival analysis (Kaplan-Meier) showed a worse prognosis for NCM with LVEF ≤49% compared with DCM (log rang: χ2=11,5; p=0,001) and isolated NCM (log rang: χ2=17,02; p=0,0001). In the overall cohort (n=144), gene-positivity was also associated with worse prognosis (log rang: χ2=5,38; p=0,02).Conclusion. In the present study, patients with dilated subtype of NCM showed a worse prognosis compared with DCM and isolated NCM. Heart failure progression and cerebral thromboembolism were the most common complications in patients with NCM/DCM

Genetic risk factors for dilated cardiomyopathy

Aim. To study the diagnostic significance of genetic testing in patients with dilated cardiomyopathy (DCM), identify predictors of life-threatening ventricular tachyarrhythmias (VTAs) and assess adverse clinical outcomes in different genetic groups.Material and methods. The study included 126 unrelated patients with verified DCM as follows: 70 (55,6%) probands with criteria for familial DCM and 56 (44,4%) individuals with a probable hereditary component. All patients (age, 43,1±11,3 years; men, 92 (73%); left ventricular ejection fraction, 30,6±8,43%; left ventricular enddiastolic diameter, 68,3±8,36 mm; follow-up period — median, 49 months) receive a complex of diagnostic investigations, including genetic screening using nextgeneration sequencing, followed by verification of variants by the Sanger method.Results. Pathogenic and likely pathogenic genetic variants were found in 61 (48,4%) of 126 patients with DCM. The dominant mutations were titin-truncating variants (TTNtvs), identified in 16 individuals (12,7%), and variants of lamin A/C (LMNA), identified in 13 probands (10,3%). Mutations in the other 19 genes were found in 32 (25,4%) patients. The following primary endpoints were assessed: sudden cardiac death (SCD), episodes of VTA (sustained ventricular tachycardia/ventricular fibrillation) and appropriate shocks of implanted cardiac resynchronization therapy (CRT)/cardioverter defibrillators (CVD) devices. As a result of ROC analysis, the following independent risk factors for SCD were identified: mutations in the LMNA gene (AUC, 0,760; p=0,0001) and non-sustained ventricular tachycardia (cut-off heart rate ≥161 bpm: AUC, 0,788; p=0,0001). When comparing the phenotypes and genotypes of DCM, TTNtv genotype was associated with a lower prevalence of complete left bundle branch block (χ2=7,46; p=0,024), a lower need for CRT/CVD implantation (χ2=5,70; p=0,017) and more rare episodes of sustained ventricular tachycardia/ventricular fibrillation (χ2=30,1; p=0,0001) compared with LMNA carriers. Kaplan-Meier analysis showed the worst prognosis in carriers of LMNA mutations both in relation to life-threatening VTA (log rang χ2=88,5; p=0,0001) and in achieving all unfavorable outcomes (χ2=27,8; p=0,0001) compared with groups of genenegative individuals, carriers of TTNtv and other genotypes.Conclusion. The phenotypes of DCM with TTNtv did not significantly differ in the incidence of VTAs and adverse outcomes compared with the gene-negative group and other genotypes (with the exception of LMNA). The contribution of the associations of LMNA mutations with VTAs on prognosis was confirmed, which shows the important role of LMNA genotype diagnosis for SCD risk stratification in patients with DCM

APPLICATION OF BALLOON ANGIOPLASTY OF ARTERIES FOR TREATMENT OF DIABETIC FOOT SYNDROME IN PATIENTS IN BURYAT REPUBLIC

The report describes experience of treatment of diabetic foot syndrome over the period of 2009-2011. It demonstrates statistic analysis of lesions of arteries of lower extremities, and also frequency of surgical correction of purulent-necrotic lesions of extremities

Study of the adjuvant properties of preparations containing recombinant human granulocyte-macrophage colony stimulating factor

The relevance of the search for new vaccine adjuvants is growing along with the increase in the number of current vaccine preparations, especially those developed on the basis of proteins. Some cytokines are known to exert adjuvant properties. The present work is devoted to the study of adjuvant activity of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) and constructs based on it. Earlier, we developed a technology for isolation and purification of GM-CSF from the E. coli SG20050/p280_2GM producer strain, as well as a technology for conjugating polyglucin:spermidine complexes with rhGM-CSF. Double-stranded RNA was used to obtain molecular constructs on the basis of rhGM-CSF conjugate. To assemble constructs, the ratio of the components was calculated for one dose of the preparation to contain 5-40 mg of rhGM-CSF and 100 mg of double-stranded RNA. The effectiveness of the formation of molecular constructs was evaluated by dsRNA electrophoretic mobility shift in a 1% agarose gel. The effectiveness of the resulting adjuvants was determined in ELISA assays by measuring the titers of specific antibodies in mouse sera against ovalbumin or recombinant receptor-binding domain of the surface S protein of the severe acute respiratory syndrome coronavirus 2 (Delta variant (B.1.617.2). The experiments were carried out in 100 male BALB/c mice weighing 16-18 g. Mice were immunized twice, with a 14-day interval, by intramuscular injection of 200 mL per animal. Recombinant receptor-binding domain of the surface protein of SARS-CoV-2 was administered at a dose of 50 mg/animal, ovalbumin – at two doses – 1 mg or 5 mg/animal. Corresponding antigen was used as a positive control, a saline solution – as a negative control. It was shown that the maximum effect was achieved by immunization with a construct based on double-stranded RNA and rhGM-CSF conjugated to polyglucin-spermidine. The use of a conjugate without double-stranded RNA as an adjuvant also improved humoral response. The use of native rhGM-CSF did not increase the titers of specific antibodies. Thus, it was found that rhGM-CSF being a part of a polysaccharide conjugate or a molecular construct exerted an ability to enhance the humoral immune response to protein antigens

Physical properties of thermoelectric zinc antimonide using first-principles calculations

We report first principles calculations of the structural, electronic, elastic and vibrational properties of the semiconducting orthorhombic ZnSb compound. We study also the intrinsic point defects in order to eventually improve the thermoelectric properties of this already very promising thermoelectric material. Concerning the electronic properties, in addition to the band structure, we show that the Zn (Sb) crystallographically equivalent atoms are not exactly equivalent from the electronic point of view. Lattice dynamics, elastic and thermodynamic properties are found to be in good agreement with experiments and they confirm the non equivalency of the zinc and antimony atoms from the vibrational point of view. The calculated elastic properties show a relatively weak anisotropy and the hardest direction is the y direction. We observe the presence of low energy modes involving both Zn and Sb atoms at about 5-6 meV, similarly to what has been found in Zn4Sb3 and we suggest that the interactions of these modes with acoustic phonons could explain the relatively low thermal conductivity of ZnSb. Zinc vacancies are the most stable defects and this explains the intrinsic p-type conductivity of ZnSb.Comment: 33 pages, 8 figure

Başkortostan Cumhuriyeti Toratau Jeoparki bal arısı (apis mellifera) popülasyonunda tergit rengi değişimi

A phenetic analysis of the honey bee population of the Toratau Geopark (Russia) was performed. Over 1,000 worker and drone bee samples were collected from 250 colonies in 59 apiaries on the territory of the Toratau Geopark (Gafuriysky, Ishimbaysky, Meleuzovsky, and Sterlitamaksky districts of the Republic of Bashkortostan). Six phenes in worker bees and four phenes in drone bees were recognized. The phenes E, 1R, 2R, and 3R in workers and Is, I, and O-gray in drones were predominant in the honey bee population of the Toratau Geopark, which were associated with subspecies of the Clineage. These phenes can be used as indicators of introgressive hybridization in the local dark European honey bee population. The phenes allow for quick evaluation of certain honey bee colonies hybridization states.Toratau Jeoparkı'ndaki (Rusya) bal arısı popülasyonunun fenetik analizi yapılmıştır. Toratau Jeoparkı topraklarındaki (Başkurdistan Cumhuriyeti'nin Gafuriysky, Ishimbaysky, Meleuzovsky ve Sterlitamaksky bölgeleri) 59 arılıktaki 250 koloniden 1.000'den fazla işçi ve erkek arı örneği toplanmıştır. İşçi arılarda altı fen ve erkek arılarda dört tergit rengi tespit edilmiştir. İşçilerde E, 1R, 2R ve 3R ve erkek arılarda Is, I ve O-gri fenleri Toratau Jeoparkı'ndaki bal arısı popülasyonunda baskındı ve bunlar C soyunun alt türleriyle ilişkiliydi. Bu tergit rengi, yerel koyu Avrupa bal arısı popülasyonunda içsel melezleşmenin göstergeleri olarak kullanılabilir. Bu tergit renkleri, belirli bal arısı kolonilerinin melezleşme durumlarının hızlı bir şekilde değerlendirilmesine olanak sağlamaktadır.The article was prepared with supporting the grant of the head of the Republic of Bashkortostan Radiy Khabirov, grant title "Study of the Bashkir bee population on the territory of the Toratau Geopark

Initial and severe cases of influenza in 2020-2022 and population immunity prior to epidemic season

The purpose of the present work was to evaluate population immunity to influenza and molecular genetic analysis of influenza viruses detected in the Russian Federation over 2020-2022. In this study, 1344 samples of blood serum collected prior to the 2021-2022 flu season in Siberian, Southern, Far Eastern, Volga and Ural Federal Districts were studied. Seropositivity to the A/Victoria/2570/2019 vaccine strain (H1N1) pdm09 was detected in 25% to 31% of samples from the four federal districts, and in 8% of samples from the Far Eastern Federal District. Seropositivity to the A/Cambodia/e0826360/2020 strain (H3N2) was detected in 24% to 37% of the samples. The lowest population immunity was revealed to the influenza B/Washington/02/2019 vaccine strain (Victoria lineage), with < 10% of serum samples reactive to the studied strain. Since March 2020, the worldwide turnover of all seasonal respiratory viruses has sharply decreased, except of rhinoviruses. From March 2020 to June 2021, we have identified six B/Victoria influenza viruses from sporadic cases of influenza. From June 2021 to the end February 2022, the State Research Center “Vector” received 901 samples positive for influenza A(H3N2) virus RNA, two specimens positive for A(H1N1) pdm09 virus RNA, and 17 samples positive for influenza B. All studied A(H3N2) viruses belonged to the 3C.2a1b.2a2 subclade (Bangladesh group). The two verified A(H1N1) pdm09 influenza viruses belonged to the 6B.1A.5a clade. All studied influenza B viruses were assigned to the B/Victoria genetic lineage, and to 1A.3a2 subclade. The genomes of all identified viruses did not contain mutations of the NA gene responsible for drug resistance to neuraminidase inhibitors, or mutations in РA gene responsible for baloxavir resistance. All viruses tested by fluorescence assay were sensitive to oseltamivir and zanamivir. The worldwide frequency of influenza isolates resistant to antineuraminidase drugs does not exceed 1-2% of cases. Hence, oseltamivir and zanamivir provide effective treatment for seasonal influenza

Changes in the antigenic and genetic structure of influenza viruses: analysis of surveillance data of influenza A and B in Russia in 2006-2013

The goal of this research project was to study the natural variability of human influenza A and B viruses based on the analysis of the population structure of influenza viruses, circulating in Russia in 2006-2013, in order to determine the direction of their genetic and antigenic drift by comparison to the WHO reference strains. Our results proved that during that period significant changes occurred in the genetic structure of influenza viruses, their phylogenetic affiliation, as well as their sensitivity to antiviral drugs. According to the surveillance data, the percentage of influenza A(H1N1) viruses among patients with influenza-like illness or acute respiratory infection gradually decreased from 42% of the total number of influenza viruses in 2006-2007 to 19% in 2008- 2009. Influenza A(H1N1) viruses are characterized by «silent» variability that manifests in the gradual accumulation of amino acid substitutions in the minor undetectable group of viruses.The share of influenza A(H3N2) viruses varied from 10% in the 1st post pandemic year to approx. 60% in 2008-2009 and 2011- 2012 epidemic seasons. All of the influenza A strains isolated during the last years of the period, covered in this study, were found to be susceptible to neuraminidase inhibitors and resistant to adamantane antivirals.Influenza B viruses of both Yamagata and Victoria lineages circulated in Russia in the period from 2006 to 2013. The vast majority of these influenza B viruses belonged to the Victoria lineage. Phylogenetic and antigenic analyses of influenza B viruses have demonstrated a gradual drift of Russian isolates from the reference strains. No changes leading to resistance to oseltamivir or zanamivir were found in influenza B strains isolated until 2013.The goal of this research project was to study the natural variability of human influenza A and B viruses based on the analysis of the population structure of influenza viruses, circulating in Russia in 2006-2013, in order to determine the direction of their genetic and antigenic drift by comparison to the WHO reference strains. Our results proved that during that period significant changes occurred in the genetic structure of influenza viruses, their phylogenetic affiliation, as well as their sensitivity to antiviral drugs. According to the surveillance data, the percentage of influenza A(H1N1) viruses among patients with influenza-like illness or acute respiratory infection gradually decreased from 42% of the total number of influenza viruses in 2006-2007 to 19% in 2008- 2009. Influenza A(H1N1) viruses are characterized by «silent» variability that manifests in the gradual accumulation of amino acid substitutions in the minor undetectable group of viruses. The share of influenza A(H3N2) viruses varied from 10% in the 1st post pandemic year to approx. 60% in 2008-2009 and 2011- 2012 epidemic seasons. All of the influenza A strains isolated during the last years of the period, covered in this study, were found to be susceptible to neuraminidase inhibitors and resistant to adamantane antivirals. Influenza B viruses of both Yamagata and Victoria lineages circulated in Russia in the period from 2006 to 2013. The vast majority of these influenza B viruses belonged to the Victoria lineage. Phylogenetic and antigenic analyses of influenza B viruses have demonstrated a gradual drift of Russian isolates from the reference strains. No changes leading to resistance to oseltamivir or zanamivir were found in influenza B strains isolated until 2013