ABSTRACT
Background@#Lower extremity arterial diseases are chronic stenosis of the artery and occlusive arterial diseases, which are commonly caused by atherosclerosis. Prevalence of lower extremity arterial diseases has positive proportional relationship with age of the patients. Furthermore, prevalence of lower extremity arterial disease is 16% among the males over the age of 60, whereas prevalence among same aged woman is 13%. Among the age group of 38 to 59 age, 60 to 69 age and 70-82 age group, prevalence of lower extremity arterial disease was 5.6%, 15.9%, and 33.8%, respectively.@*Goal@#Identifying lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions.@*Obiective@#</br> 1. To identify age and sex of the patients with lower extremity arterial occlusive disease and chronic stenosis of arteries.</br> 2. To identify lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions.@*Material and methods@#Study sample consisted of 237 patients, who were diagnosed with lower extremity arterial occlusive disease and chronic stenosis of arteries from 2019 to 2020 at reference centre on Diagnostic Imaging na after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital. Computed angiogram images of lower extremity arteries were examined. Contrast agent “Ultravist” was pumped by automatic syringe. Lower extremity arterial occlusive disease and chronic stenosis of arteries are categorized by CTA-TASC classification of аorta-iliac and femoral popliteal lesions. The youngest participant was 20 years old and the oldest participant was 76 years old. Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test.@*Results@#We have found following results: 185(78.1%±3.0) cases out of 237 diagnosed patients with lower extremity arterial occlusive disease and chronic stenosis of arteries are males and 52(21.9%±3.0) cases are female. Distribution of lower extremity arterial occlusive disease and chronic stenosis of arteries by the age group of patients are: up to 20 years of age is 3 (1.3%±0.7), 21 to 40 years of age is 14(5.9%±1.5), 41 to 60 years of age is 86(36.3%±3.1) and over the age of 61 is 134(56.5%±3.2). It is statistically highly significant that experiencing lower extremity arterial occlusive disease and chronic stenosis of arteries among the age group of over 61(P<0.001). </br> The result of lower extremity arterial occlusive disease and chronic stenosis of arteries by the CTA-TASC classification of aorta-iliac and femoral popliteal lesions are: CTA-TASS аorta-iliac lesions A-16(6.8%±1.8), B-8(3.4%±1.2), C-12(5.1%±1.4), D-41(17.3%±2.5), CTA-TASS femoral popliteal A-41(17.29%±2.5), B-53(22.36%±3.6), C-47(19.83%±2.6), D-96(40.5%±3.2), respectively.@*Conclusions@#</br> 1. Lower extremity arterial occlusive disease and chronic stenosis of arteries occurs 46.5% over the age of 60 and 78.1% of the patients are males.</br> 2. Following two categories have identified more than the rest, 17.3% CTA-TASC classification of аorta-iliac lesions, type D and 23.3% CTA-TASC classification of femoral popliteal lesions, type D.
ABSTRACT
Background@#The American Heart Association estimates that more than 1 million people die each year from acute coronary heart disease and half a million from acute coronary syndrome, and that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health Organization, 2013].@*Goal@#In this study we aimed to using coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease.@*Material and methods@#From 2018 to 2021, we performed a coronary computed tomography angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT) device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital.</br> Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. @*Result@#In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease that coronary artery diameters more widening to compared healthy artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18 (38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5).@*Conclusion@#We detect that computed tomography angiography (CCTA)’s specific signs of unstable plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes and rupture of intima.
ABSTRACT
@#BACKGROUND. The aim of this study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI) and risk factors of stent restenosis. MATERIAL AND METHODS. We conducted a retrospective cohort study based on the Angiographic diagnostic and treatment Department of 3rd State Central Hospital of Mongolia. Patients who had undergone coronary stenting between 2000 and 2017 were recruited and monitored until the end of 2010. RESULTS. Among a total of 4520 selected patients with a mean age of 58±7 years, 2125 subjects had BMS and 2395 subjects had DES. The incidence of stent restenosis and stent thrombosis were significantly lower in the DES (37; 1,5%) group as compared with the BMS (201; 9,4%) group. Patients who have stent restenosis presented comorbidities, such as diabetes 214(47,8%), hypertension 54(22,6%), prior PCI 21(8,2%), re-infarction 12(5,04%), chronic kidney disease 16(6,7%), hyperlipidemia 21(8,2%). СONCLUSION. Implantation of DES was related to better outcomes than for BMS, in terms of reducing restenosis and stent thrombosis after PCI. STEMI patients who have co morbidities have greater risk of stent stenosis and thrombosis
ABSTRACT
Introduction@#Coronary atherosclerosis is the leading cause of morbidity and mortality in the world. Hypogonadism is not considered a traditional risk factor for coronary artery disease (CAD). Higher CVD mortality may be partially attributed to behavioral and physical characteristics of males, including increased smoking, drinking, endocrine and metabolic factor like fat distribution, and low male engagement in preventive care. In the last decades, many studies have suggested that low testosterone levels are associated with increased prevalence of risk factors for CVD, including dyslipidemia and diabetes. For the reason, this research focused on identifying any association between testosterone deficiency and risk factors of coronary heart disease.@*Goal@#This study aimed to identify any association between testosterone deficiency and risk factors of coronary heart disease in Mongolian men.@*Material and methods@#In this case control study, we determined plasma total testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol, apolipoprotein – ApoA1, Apo B and glucose in 287 subjects, among them 125 patients with ACS and 162 healthy subjects. Statistical analysis was performed using SPSS 22.0 of IBM. @*Results@#Mean age of the participants was 55.19±6.99 years old. It was found that, mean plasma TT levels in patients with ACS (4.17 ng/ml) was significantly lower than in the healthy subjects (4.70 ng/ml). There was a negative association between plasma TT level and glucose level (r=-0.185; p=0.002) and ApoB/ApoA1 (r=-0.132, p=0.026).@*Conclusion@#The results in the present study suggest that low plasma TT level may be a risk factor for CHD in men, which may relate to the influence of plasma lipoprotein and glucose metabolism by endogenous testosterone.
ABSTRACT
Background @#The frequency of tetralogy of Fallot among newborns and infants is 5.6-14.0% of all congenital heart defects [5, 14, 17] The most frequent complication of the early postoperative period is right ventricular failure, which is formed when the anatomy of the right ventricle and the progressive pulmonary regurgitation are disturbed [1, 3, 12]. With the development of new minimally invasive methods of examination and their introduction into clinical practice, the understanding of hemodynamic parameters after surgical correction, pathophysiological mechanisms of development of right ventricular dysfunction has improved. </br> One of these methods is transpulmonary thermodilution and pulse waveform analysis, which allows in the early hours after operation to determine preload, heart function and postload parameters [9, 20]. </br> In the long-term period, many patients after radical correction have right ventricular dysfunction due to many years of massive pulmonary regurgitation. With the introduction of MRI improved understanding of the pathophysiological mechanisms of development of right ventricular dysfunction.. Recent reports indicate that the global functional assessment of the right ventricle after surgical correction does not reflect its present function [7, 10].@*Aim@#The aim of the study was to estimate the early postoperative indices of hemodynamics in different types of the right ventricular output plastics after radical correction of Fallot’s tetralogy and to access the functional state of the right ventricle in the long- term postoperative period.@*Materials and Methods@#On the basis of cardiovascular surgery department of the Shastin P.N. hospital, a prospective cohort study of 52 patients (28 boys, 24 girls), underwent radical correction of Fallot’s tetralogy, was conducted. </br> Patients were divided into 2 groups by the type of reconstruction of the right ventricular outlow tructs: group I included patients with transannular plasty of the output part (group I, 26 patients), group II-patients with preserved fibrous ring of the pulmonary artery (group II, 26 patients). The postoperative hemodynamic status was assessed with transpulmonary thermodilution. The right ventricular function in the long-term period was estimated by means of US and MRI.@*Results@#During the first postoperative hours, hemodynamic indices according transpulmonary thermodilution technique were significantly lower in group I and reliable differed from group II. However, later (12.24,48 hour after), restoration of hemodynamic indices in group I, which did not significantly differ from group II, was observed. In the long-term period, ejection of the right ventricle was reliable higher in group II, while terminal diastolic volume of the right ventricle was significantly higher in group I. Pulmonary regurgitation was also significantly higher in group I-36.7 (32,44) versus 13,2 (3;14) (p<0,01).@*Conclusions@#Preservation of pulmonary artery fibrous ring provides better parameters of hemodynamics in the early postoperative period including systolic and diastolic functions. In the long-term period, this group of patients is less subjected to the right ventricular function.
ABSTRACT
@#The study of indices of heart remodeling was performed in children with secondary atrial septal defects (ASDs) after either endovascular or surgical repair of the defects. The data analysis showed that serious ASDs lead to diastolic left ventricular (LV) dysfunction. Recovery of LV function occurred during the first day following endovascular repair or after six months following surgical correction. Maximum reduction of dilatation of the right heart chambers after ASD repair is recorded in the early postoperative period and keeps during follow up, regardless of the method for the defect repair. We found a significant depression in mechanical activity of left atrium after surgical repair with the recovery one year after the procedure.
ABSTRACT
@#Article deals with age-related hypogonadism in men as an interdisciplinary problem. Current definition, prevalence, analyzes the relationship between age and the incidents of hypogonadism were shown. The detailed overview of clinical studies, meta analysis of causal link of androgen deficiency and erectile dysfunction, ischemic heart disease, arterial hypertension, dyslipidemia, and diabetes mellitus was presented. To date was found the relationship between metabolic syndrome and androgen deficiency. Low level of testosterone is closely connected with low libido as well as insulin resistance, abdominal obesity, dyslipidemia. Insulin resistance and hyperinsulinemia are noticed in patients with hypogonadism in comparison with obese and normal-weight patients. Therefore, metabolic risk factors are the connecting link of cardiovascular diseases and androgen deficiency. Meta-analysis of clinical trials of the effects of testosterone replacement therapy and safety of long term use was presented in the article. The article discusses the importance of a unified approach to the diagnosis and treatment of androgen-deficient conditions and cardiovascular disease.
ABSTRACT
Introduction: The paper presents lateresults of surgical correction of the patientswith acquired heart disease.Materials and method: Two hundredfifty one patients had surgical defectcorrection from 2000 to 2016 years. Lateresults were observed in 134 patients. It wasrevealed that subgroup with aortic, mitral andmitral-aortic stenosis and in the subgroupwith aortic insufficiency, systolic functionof the left ventricular was significantlyincreased and heart cavities were positivelyremodeled.Results: Five-year survival rate in subgroupwith initial aortic stenosis and insufficiencywas 100% , in subgroup with initial mitralstenosis - 78.4%, with mitral insufficiency- 75.0%, with mitral-aortic stenosis - 94.1%and with mitral-aortic insufficiency - 49.1%.Conclusion: Risk factors of late mortalityof the patients with valve pathology andsystolic dysfunction of left ventricular aftersurgical correction are: IV NYHA, chronicheart failure, the heart-lung coefficientmore than 65%, high lung hypertension(systolic pressure in pulmonary artery morethan 60 mm.Hg), size of the left ventricularmore than 60 mm and index of end-diastolicvolume of left ventricular more than 110 ml/m2.