Influence of physical loads of different orientation on indicators of physical working capacity and level of the maximum oxygen consumption at the qualified athletes depending on the period of training process

Objective: to assess the impact of physical activity of different orientation and intensity on the physical performance and maximum oxygen consumption (MOC) in qualified athletes, depending on the period of the training process. Materials and methods: 136 male athletes were examined, 116 of them were qualified athletes (age 22.1±4.1 years). I group – wrestling (n=30), II – cross-country skiing, biathlon (n=27), III – powerlifting (n=33), IV – volleyball (n=26). V – control (n=20), sports training less than 3 years. Bicycle ergometry (VEM) with the assessment of physical performance on the PWC170 test in the preparatory and competitive periods of training was conducted. STATISTICA 10.0 program was used for statistical processing. Data were presented as: median (Me), lower and upper quartiles (25% and 75%). Results: the highest rates of PWC170 – 1508.0 KGM/min and IPC – 65.37 ml/min/kg in the preparatory period and, respectively, PWC170 – 1560.0 KGM/min and IPC – 68.00 ml/min/kg in the competitive period were achieved by athletes in group II. Athletes in group III had the lowest rates of PWC170 – 1100.0 KGM/min and IPC – 40.60 ml/min/kg in both the preparatory and competitive periods – 1120.0 KGM/min and 42.04 ml/min/kg. Conclusions: high level of physical performance and MOC indicated the effectiveness of the cardiovascular system in athletes of highly dynamic sports, training for endurance (crosscountry skiing, biathlon). In powerlifters with high intensity of static loads, physical performance and MOC remained at a low level. The results can be used to make timely adjustments to the training and competitive process of athletes

Structural and functional indicators of the heart of patients with ischemic heart disease and type 2 diabetes mellitus. Rhythmoinotropic response isolated myocardium at different levels of glycated hemoglobin

BACKGROUND: Adequate glycemic control can significantly reduce the risk of developing cardiovascular events. However, until now, glycaemic targets in aged patients remain a subject of discussion, especially in the conditions of the combined development of Type 2 Diabetes Mellitus (T2DM) and ischemic heart disease (IHD).AIMS: To examine the structural and functional heart parameters in patients with IHD associated with T2DM and the rhythmoinotropic responses of their isolated myocardium depending on glycated hemoglobin level.MATERIALS AND METHODS: The study included 44 patients with a diagnosis of "chronic IHD associated with T2DM", of which 2 groups were formed. Patients with glycated hemoglobin level (HbA1c) <8% were included in the 1st group, and patients with HbA1c ≥8% were included in the 2nd group. The structural and functional heart parameters obtained with ultrasonography, and the rhythmoinotropic responses of myocardium in patients ex vivo were analyzed using the right atrial appendage fragments obtained during elective coronary artery bypass graft. The inotropic response of muscle strips at a basic stimulation frequency of 0,5 Hz to testing influences was assessed. An extrasystolic test and post-rest test were performed.RESULTS: It was found that extrasystolic contractions of isolated myocardial strips in patients of the 2nd group appeared at shorter extrasystolic intervals, which indicates a greater excitability of the myocardium in patients of this group. Postextrasystolic muscle contractions in patients of the 2nd group had significant potentiation. The amplitude of the muscle strips contractions in patients of both groups was potentiative after short rest periods. However, with an increase in the rest duration, potentiation of contractions was observed only in the group with a higher HbA1c level. According to the ultrasonography data, it was found that the values of the endsystolic and diastolic volumes, the interventricular septum thickness and the left ventricular (LV) myocardium mass were significantly lower in the patients of the 1st group compared with the corresponding indicators in the patients of the 2nd group. The early LV filling velocity (peak E) was significantly lower in the patients of the 1st group, which indicates a slower LV relaxation. At the same time, the rapid LV filling velocity did not have a significant intergroup difference, but this indicator exceeded the reference values in both groups.CONCLUSIONS: With a moderately increased glycemic level (9,2 [8,0; 10,3]%), the structural and functional heart parameters are preserved both at the level of the isolated myocardial tissue and at the level of the whole heart

ОЖИРЕНИЕ КАК ФАКТОР РИСКА ТРОМБОЭМБОЛИИ ЛЕГОЧНОЙ АРТЕРИИ

The aim of the study. Based on the data of the Register of new cases of hospital pulmonary embolism (PE) in hospitals in Tomsk (2003–2012), to explore the contribution of obesity to the development of venous thromboembolism.Material and Methods. Study were subjected to medical history and records of autopsies of patients treated in hospitals in Tomsk in 2003–2012, who at patologoanatomic and/or instrumental study revealed pulmonary embolism. The degree of obesity was assessed according to WHO criteria (1997). Statistical processing of the results was carried out using the software package for PC Statistica 8.0 for Windows. To test the normality of the distribution of quantitative traits using the Shapiro–Wilk test and the Kolmogorov–Smirnov with the adjusted Lillieforsa. Check the equality of the population variance was performed using Fisher's exact test and Cochran. Was considered statistically significant level of p < 0.05.The results of the study. In Western Siberia, Tomsk, a register of hospital pulmonary embolism (2003–2012). In the register included 720 patients with in vivo and/or post mortem revealed pulmonary embolism (PE). Analyzed data from medical records and autopsy reports. Revealed statistically significant differences in BMI (p = 0.033) and the presence of obesity (p = 0.002) in patients with pulmonary embolism, holding medical and surgical beds. As of medical, surgical and among patients with thromboembolism, obesity is significantly more common in women than men (p = 0.050 and p = 0.041 respectively). According to the study, obesity grade 1 or 2 alone (at the isolated presence of the patient) is not significantly increased the odds of a massive thromboembolism. However, grade 3 obesity increased the odds of a massive pulmonary embolism by more than 2.7 times (OR = 2.708, CI: 1,461–5,020).Цель исследования. На основании данных Регистра новых случаев госпитальной тромбоэмболии легочной артерии (ТЭЛА) в стационарах г. Томска (2003–2012 гг.), изучить вклад ожирения в развитие тромбоэмболии.Материал и методы. Исследованию были подвергнуты истории болезни и протоколы вскрытий пациентов, лечившихся в стационарах г. Томска в 2003–2012 гг., у которых при патологоанатомическом и (или) инструментальном исследовании выявлена ТЭЛА. Степень ожирения оценивали согласно критериям ВОЗ (1997). Статистическая обработка полученных результатов проводилась с помощью пакета прикладных программ Statistica 8.0 for Windows. Для проверки нормальности распределения количественных признаков использовали критерий Шапиро–Уилка и критерий Колмогорова–Смирнова с поправкой Лиллиефорса. Проверку равенства генеральных дисперсий осуществляли с помощью критериев Фишера и Кохрэна. Статистически значимым считали уровень p < 0,05.Результаты и обсуждение. В среднеурбанизированном городе Западной Сибири, Томске, создан Регистр госпитальной тромбоэмболии легочной артерии (2003–2012 гг.). В Регистр были включены 720 пациентов, у которых прижизненно и (или) посмертно выявлена ТЭЛА. Проанализированы данные историй болезни и протоколов патологоанатомического вскрытия. Выявились статистически значимые различия в отношении индекса массы тела (р = 0,033) и наличия ожирения (р = 0,002) у пациентов с ТЭЛА, занимающих терапевтические и хирургические койки. Как среди терапевтических, так и среди хирургических пациентов с тромбоэмболией значимо чаще ожирение встречалось у женщин по сравнению с мужчинами (р = 0,050 и р = 0,041 соответственно).Согласно полученным данным, ожирение 1-й или 2-й степени самостоятельно (при изолированном присутствии у пациента) существенно не повышало шансы развития массивной тромбоэмболии. Однако ожирение 3-й степени увеличивало шансы развития массивной ТЭЛА более чем в 2,7 раза (ОШ = 2,708; ДИ: 1,461–5,020)

САХАРНЫЙ ДИАБЕТ И ТРОМБОЭМБОЛИЯ ЛЕГОЧНОЙ АРТЕРИИ

Purpose. The aim of the study is to analyze characteristics and the clinical course of pulmonary embolism in patients with diabetes on the basis of the Pulmonary Embolism Register (PE) of deaths inTomskhospitals between 2003 and 2011.Materials and methods. We studied the autopsy reports and medical records of all patients (712 cases) diagnosed with pulmonary embolism anteand/or postmortem, died between 2003 and 2010. Diabetes mellitus was diagnosed in 141 patients and all of them had moderately severe course of the disease or were sub-or decompensated. 28.57% had a high body mass as well: 31,59 + 8,36 kg/m2 . The ratio of medical to surgical patients was 2.1 : 1.Results. All patients with diabetes were hospitalized on an emergency basis. 31 patients (21,6 %) stayed in hospital less than a day, so blood clots – the sources of thromboembolism, were formed at home, outside of hospital. The major source of thromboembolism was inferior vena cava branches. At the same time, 31,4 % diabetic patients had thrombi in the right chambers of the heart. Anticoagulants were used in 16,4 % of cases to prevent thromboembolism.Conclusion. The importance of type 2 diabetes mellitus as a risk factor for thromboembolic complications has been until now underestimated both at the outpatient and hospital stages. Цель. По данным госпитального Регистра тромбоэмболии легочной артерии (ТЭЛА) проанализировать варианты ее течения у пациентов с сахарным диабетом.Материалы и методы. Изучены протоколы вскрытий и историй болезни пациентов (712 случаев) с диагностированной прижизненно и/или посмертно ТЭЛА среди умерших в стационарах Томска. Сахарный диабет выявлен у 141 больного и у всех имел среднетяжелое или тяжелое течение, находился в стадии субили декомпенсации, у 28,57 % сопровождался повышенной массой тела. Соотношение «терапевтических» и «хирургических» пациентов составило 2,2 : 1.Результаты. Все пациенты с диабетом госпитализировались в экстренном порядке; 31 пациент (21,6 %) находился в стационаре менее суток, т. е. тромбообразование в местах – источниках тромбоэмболии у них происходило в домашних условиях вне стационара. Ведущим источником тромбоэмболии были ветви нижней полой вены, в том числе вены культи нижней конечности. В 31,4 % местом первичного тромбообразования у пациентов с сахарным диабетом были правые камеры сердца. Профилактические мероприятия в отношении ТЭЛА в виде применения антикоагулянтов использовались в 16,4 % случаев.Заключение. Значимость сахарного диабета 2-го типа как фактора риска развития тромбоэмболических осложнений до настоящего времени недооценивается как на амбулаторном, так и госпитальном этапе.

МЕТАБОЛИЧЕСКИЕ НАРУШЕНИЯ И ТРОМБОЭМБОЛИЯ ЛЕГОЧНОЙ АРТЕРИИ

The purpose of the study. To examine the contribution of diabetes and obesity in the development of pulmonary embolism on the based data of the Register of new hospital of pulmonary embolism (PE) in hospitals inTomsk(2003–2012). Material and Methods. The medical history and records of autopsies of patients treated in hospitals in the city ofTomsk, 2003–2012, and anatomopathological and/or instrumental examination revealed pulmonary embolism have been subjected to studies. We used the classification of diabetes mellitus proposed by the WHO in1999 inour work, because the register including data (2003–2012). The degree of obesity was assessed according to WHO classification (1997). Statistical analysis of the results was carried out with the help of software for computer Statistica for Windows, version 8.0. The Shapiro–Wilk and Kolmogorov–Smirnov tests was used to determine the nature of the distribution of the data. The ho mogeneity of the population variance was assessed using Fisher's exact test andLeuventest. The Mann– Whitney test was used when comparing two independent samples to determine the significance of differences. The analysis was conducted by means of qualitative characteristics contingency tables using Pearson χ 2 . The odds ratio was calculated to assess the association between a specific outcome and the risk. Data are presented as M ± SD factor. The significance level of p for all procedures used by the statistical analysis was taken to be 0.05. It was considered statistically significant level of p < 0.05. The results of the study. In intermediate urbanized city ofWestern Siberia,Tomsk, established register of hospital pulmonary embolism (2003–2012). The register included 751patients whose in vivo and / or postmortem revealed pulmonary embolism (PE). The data histories and autopsy reports was analyze. The type 2diabetes was diagnosed in 205 patients. The type 2 diabetes moderate had 29%. Diabetes severe suffer 82 patients (40%). In the group body mass index (BMI) was (29.24 ± 7.87) kg/m2 . Obesity diagnosed in 157patients (20.9%). It occurs in24.7% of cases for women andin 15.2% of cases for men. If a patient had obesity grade 3 was found to increase the risk of a massive thromboembolism in 3.27 times (OR = 3.27; 95% confidence interval [1.60–6.69]; p = 0.001) and an increase in the risk of fatal thromboembolism 3.56 times(OR = 3.56; 95% CI [1.73–7.43]; p = 0.001). It does not detect the influence of obesity 1 and 2 degrees on the development of a massive pulmonary embolism, or PE, which would cause the patient's death. Significant effect of type 2 diabetes was found on the development of the heavy flow of fatal pulmonary embolism. Цель исследования – на основании данных Регистра новых случаев госпитальной тромбоэмболии легочной артерии (ТЭЛА) в стационарах г. Томска (2003–2012 гг.) изучить вклад сахарного диабета (СД) и ожирения в развитие легочной эмболии.Материал и методы. Исследованию были подвергнуты истории болезни и протоколы вскрытий пациентов, лечившихся в стационарах г. Томска в 2003–2012 гг., у которых при патологоанантомическом и (или) инструментальном исследовании выявлена ТЭЛА. Учитывая сроки создания Регистра (2003–2012 гг.), в нашей работе использовалась классификация СД, предложенная ВОЗ в 1999 г. с соответствующими критериями. Степень ожирения оценивали согласно критериям ВОЗ (1997).Результаты и обсуждение. В среднеурбанизированном городе Западной Сибири – Томске – создан Регистр госпитальной ТЭЛА (2003–2012 гг.). В Регистр был включен 751 пациент, у которого прижизненно и (или) посмертно выявлена ТЭЛА. Проанализированы данные историй болезни и протоколов патологоанатомических вскрытий. Сахарный диабет 2-го типа (СД-2) выявлен у 205 больных, из них 60 (29%) имели СД-2 средней степени тяжести. Диабетом тяжелой степени страдали 82 пациента (40%). Индекс массы тела (ИМТ) в группе лиц, страдающих СД, составил (29,24 ± 7,87) кг/м2. Ожирение зафиксировано у 157 пациентов (20,9%). У женщин оно встречалось в 24,7% случаев, у мужчин – в 15,2%. При наличии у пациентов ожирения 3-й степени обнаружено увеличение риска развития массивной тромбоэмболии в 3,27 раза (ОШ = 3,27; 95%-й ДИ [1,60–6,69]; р = 0,001) и увеличение риска развития летальной тромбоэмболии в 3,56 раза (ОШ = 3,56; 95%-й ДИ [1,73–7,43]; p = 0,001). При этом не обнаружено влияния ожирения 1-й и 2-й степени на развитие массивной ТЭЛА, или ТЭЛА, которая стала бы причиной смерти пациента. Выявлено статистически значимое (р £ 0,001) влияние СД-2 тяжелого течения на летальный исход ТЭЛА