[Cell therapy of critical lower limb ischemia (problems and prospects)].

Critical limb ischemia is a syndrome that combines several peripheral artery diseases with different ethiology and pathogenesis but with similar prognosis, high morbidity and mortality. Possibility of surgical and conservative treatment of critical limb ischemia almost completely exhausted. Some hopes have arisen due to progress in cell technology. The article provides a critical analysis of pathogenic prerequisites of stem/progenitor cells for the treatment of patients with a critical limb ischemia in detail the basic results of preclinical and clinical studies on the safety and efficacy of cell technology. Unsolved problems and prospects of practical application are also discussed.

[Novel method of analysis of risk of development of ischemic heart disease with the use of genomic and computer technologies].

AIM: to assess effectiveness of the use of modern methods of prognostication for assessment of risk of development of ischemic heart disease (IHD). MATERIAL AND METHODS: We examined 131 patients with diagnosis of IHD verified by coronary angiography and 159 subjects of control group. Initial information on each patient included the following parameters: traditional risk factors, laboratory parameters, results of instrumental examination, genetic markers. We studied 29 polymorphisms in 27 genes which according to international databases were associated with IHD. Genotype was assessed as 2 models: dominant and recessive. For each patient we calculated individual genetic index as sum of present polymorphic markers with addition of data of familial anamnesis. The data obtained were analyzed with the "RECOGNITION" system which used for solution of prognostication problems main approaches and algorithms of the theory of recognition by precedents. RESULTS: Accuracy of recognition varied from 70 to 75% with small number of traits and up to 90% on informative trait subsystems. The method "linear machine" showed the highest accuracy. The voting algorithm showed maximal accuracy of prognosis relative to some algorithms. In IHD prognostication most information systems comprised genetic markers, most significant of which was the genetic index representing sum of available polymorphic markers with addition of data of familial anamnesis. CONCLUSION: Analysis with the use of methods of recognition by precedents is a perspective technique for stratification of IHD risk and support of optimal decision making on prevention. The use of collectives of different methods of prognostication allows to increase accuracy of prognosis.

[The role of genetic predisposition in the development of cardiovascular diseases (myocardial infarction, ischemic stroke, unstable stenocardia) and its interaction with conventional risk factors].

To assess the risk of cardiovascular events, the diagnostic effectiveness of molecular-genetic markers (polymorphisms in APOE, ACE (I/D) and MTHFR (C677T) genes) in combination with conventional risk factors has been studied. The prognostic effectiveness of common algorithms (the Framingham scale) is not sufficient for evaluation of risk factors for cardiovascular diseases. The combination of results of molecular-genetic testing with conventional risk factors allows to increase the predictability of cardiovascular risks.

[Evaluation of the severity of aortic stenosis using 2-dimensional Doppler echocardiography]. / Otsenka stepeni vyrazhennosti stenoza ust'ia aorty s pomoshch'iu dvukhmernoi dopplerékhokardiografii.

Hemodynamic evaluation of aortic ostial stenosis (AOS) was made in 89 patients at Doppler echocardiography. Maximal circulation rate (MCR) through the aortic valve averaged 3.47 +/- 0.073 m/s, maximal transaortic pressure gradient (TPG) made up 49.97 +/- 2.11 mm Hg, the aortic ostium area (AOA) amounted to 0.85 +/- 0.031 sm2. It was established that AOA evaluation is most reasonable, as MCR and TPG vary with cardiac output. Especially desirable this measurement is believed in patients with TPG under 64 mm Hg and small left ventricular ejection. Mitral regurgitation is a frequent finding in AOS patients. Unless calcinosis of the mitral ring, mitral valve affection would be absent. In mitral regurgitation the disease took a more severe course, the patients having reduced AOA and left ventricular ejection, though larger end-diastolic diameter and end-diastolic volume. The emergence of mitral regurgitation in AOS is a result of left ventricular hypertrophy and dilatation suggesting a low compensatory reserve of the myocardium.

[The assessment of left ventricular diastolic function in patients with aortic defects]. / Otsenka diastolicheskoi funktsii levogo zheludochka u bol'nykh s aortal'nymi porokami.

Thirty patients with aortic heart disease and 10 healthy persons were examined for diastolic function of the left ventricle using two-dimensional Doppler echocardiography. The decline of the rate and volume of early diastolic filling, the rise of the filling during the atrial systole were revealed in 60% of the patients with aortal disease. The decrease of the ejection fraction of the left ventricle was noted in 23.3% of the patients. All the patients with aortic disease were distributed into 2 groups depending on the presence (group II) or lack (group I) of mitral regurgitation. Addition of mitral regurgitation in patients with aortic disease masked the deranged filling of the left ventricle and interfered with the diagnosis of diastolic dysfunction. A reverse moderately pronounced relationship (r = -0.56) has been discovered between the myocardial mass and impairment of the diastolic filling.