Diagnostic utility of long-term remote ECG monitoring in compare with 24 hour Holter monitoring in patients with atrial fibrillation after catheter radiofrequency ablation in the early postoperative period.

AIM: To evaluate the diagnostic utility of long-term remote monitoring of ECG compared with 24 hour Holter monitoring for the detection of cardiac arrhythmias and conduction disturbance in patients with atrial fibrillation (AF) after catheter radiofrequency ablation (RFA; isolation) of the pulmonary veins. MATERIALS AND METHODS: The study included 62 patients aged 58.5±11.1 years, with paroxysmal or persistent AF, after catheter RFA (pulmonary veins isolation). Patients underwent long-term remote ECG monitoring, 24 hour Holter monitoring and transthoracic echocardiogram. RESULTS: After 24 hour Holter monitoring of 62 patients with AF after RFA in 21 of them (33.9%) was detected early recurrence of AF. Remote ECG monitoring of 18 patients, detected AF in 7 patients (39%), 2 of them were asymptomatic AF recurrence. 24 hour Holter monitoring of the same 18 patients AF recurrence was not detected at all (0%). CONCLUSION: Both of devices, long-term remote monitoring of ECG and 24 hour Holter monitoring detected 45.2% of recurrence of AF. Over the wearing of both devises 24 hour Holter and long-term remote monitor the last detected more events among 18 patients (33% vs 0%). Two evens of AF recurrence were asymptomatic.

Pre-treatment condition effects on blood pressure and heart rate variability change in patients with arterial hypertension on therapy.

AIM: To study the relationship of the initial clinical and functional state of patients with arterial hypertension (AH) with the dynamics of daily indices of blood pressure (BP) and sinus rhythm on antihypertensive therapy. MATERIALS AND METHODS: 38 patients were examined (general clinical examination, electrocardiography, echocardiography, daily bifunctional monitoring with the determination of weighted average rhythmogram variations - WARV, clinical and biochemical analysis of blood, glycated hemoglobin, thyroid hormones) and distribyted according to the use of hypotensive drugs of main classes and combined therapy AH. Dynamic monitoring of the effectiveness of treatment was carried out (after 2-4 weeks, then every 1-2 months), clinically and with bifunctional monitoring, correction of therapy. The observation period was 8 months. RESULTS: By the end of the study, 27 patients had target blood pressure, significant decrease in systolic / diastolic blood pressure (10/5 mm Hg and more) occurred in 30 patients. A correlation was found between the effectiveness of antihypertensive treatment and the initial clinical and instrumental parameters of patients: age, heart size (including left ventricular hypertrophy - LVH), thyroid stimulating blood hormone (TSH) level and fasting blood glucose (within normal limits). The level of WARV also correlated with these indicators and was significantly higher in patients who achieved a significant reduction in blood pressure. No significant dynamics of WARV was detected. No relationship between baseline blood pressure with WARV and their changes were identified. The connection of the myocardial mass index with the level of TSH and glycated hemoglobin was demostrated. CONCLUSION: The WARV reflects the severity of organic heart changes associated with age, disease duration, metabolic profile, LVH - heart damage as a target organ in AH, but is not suitable for analyzing its functional changes within one stage of the disease.

Effect of twelve-month physical exercise program on patients with osteoporotic vertebral fractures: a randomized, controlled trial.

UNLABELLED: We performed a randomized clinical trial to evaluate the effect of a 12-month physical exercise program on quality of life, balance, and functional mobility in postmenopausal women with osteoporotic vertebral fractures. All three outcomes improved in the intervention group and were better than in the controls. INTRODUCTION: Th aim of this study was to evaluate the effectiveness of a structured physical exercise intervention on quality of life, functional mobility, and balance in patients with osteoporotic vertebral fractures and back pain. METHODS: Seventy-eight postmenopausal women with vertebral fractures were randomized into an exercise group (n = 40) and a control group (n = 38). The mean age was 69.2 ± 7.7 years. All women had at least one osteoporotic vertebral fracture and suffered from chronic back pain. Patients with a history of vertebral and non-vertebral fracture within the past 6 months were excluded. The 40-min exercise program was conducted twice weekly for 1 year. Participants in the control group were instructed to continue their usual daily activities. Participants were assessed at baseline and at 12 months using the Quality of Life Questionnaire (QUALEFFO-41). Balance was measured with the Balance Master® System NeuroCom® and functional mobility was measured with the "timed up and go" test and "sit-to-stand" test. RESULTS: Total QUALEFFO-41 score after 12 months was significantly better in the exercise group (44.2 ± 7.5) compared to the control group (56.6 ± 9.4), p < 0.0001. Quality of life improved in domains: "Pain", "Physical function: Jobs around the house", "Physical function: Mobility", "Social function", "General health perception" in the exercise group as compared to the control group. After 12 months, balance as assessed by "Tandem Walk and Sway" became significantly better in the exercise group as compared to the control group (p = 0.02). A significant improvement in the "timed up and go" test (p = 0.02) and the "sit-to-stand" test (p = 0.01) was shown in the exercise group compared to the control group. CONCLUSIONS: This is the first 12 month-randomized clinical trial of exercise in osteoporotic women with a vertebral fracture that demonstrates improvement of three key outcome measures: quality of life, functional mobility, and balance.

Early postnatal ablation of the microRNA-processing enzyme, Drosha, causes chondrocyte death and impairs the structural integrity of the articular cartilage.

OBJECTIVE: In growth plate chondrocytes, loss of Dicer, a microRNA (miRNA)-processing enzyme, causes defects in proliferation and differentiation, leading to a lethal skeletal dysplasia. However roles of miRNAs in articular chondrocytes have not been defined in vivo. To investigate the role of miRNAs in articular chondrocytes and to explore the possibility of generating a novel mouse osteoarthritis (OA) model caused by intrinsic cellular dysfunction, we ablated Drosha, another essential enzyme for miRNA biogenesis, exclusively in articular chondrocytes of postnatal mice. DESIGN: First, to confirm that the essential role of miRNAs in skeletal development, we ablated the miRNA biogenesis pathway by deleting Drosha or DGCR8 in growth plate chondrocytes. Next, to investigate the role of miRNAs in articular cartilage, we deleted Drosha using Prg4-CreER(T) transgenic mice expressing a tamoxifen-activated Cre recombinase (CreER(T)) exclusively in articular chondrocytes. Tamoxifen was injected at postnatal days, 7, 14, 21, and 28 to ablate Drosha. RESULTS: Deletion of Drosha or DGCR8 in growth plate chondrocytes caused a lethal skeletal defect similar to that of Dicer deletion, confirming the essential role of miRNAs in normal skeletogenesis. Early postnatal Drosha deletion in articular chondrocytes significantly increased cell death and decreased Safranin-O staining. Mild OA-like changes, including surface erosion and cleft formation, were found in male mice at 6 months of age; however such changes in females were not observed even at 9 months of age. CONCLUSIONS: Early postnatal Drosha deficiency induces articular chondrocyte death and can cause a mild OA-like pathology.

Changes of decartograms under gravitational acceleration and microgravity.

The Decarto technique was used to study the orthogonal ECGs recorded in 23 subjects during parabolic flights (44 records). A parameter of the instantaneous decartograms, namely the activation area (AA), which is the total area of the depolarization front projection on the image sphere, was analyzed. We compared the values of AA during the periods of horizontal flight, upward parts of all parabolas, and the initial 10 s of microgravity of all parabolas. According to the characteristics of the vectorcardiograms and AA, all subjects were subdivided into 3 groups: with increased electric activity of the right ventricle (I), the left ventricle (II) and both ventricles (III). Changes of AA with change of gravitational levels in these groups showed some differences. In groups I and II, the AA of the initial part of the QRS complex increased during microgravity and decreased during hypergravity. In group III it decreased during microgravity and changed variously during hypergravity. The AA of the middle part of the QRS complex decreased during microgravity and increased during hypergravity, and these changes were more pronounced in group III. The changes of AA in groups I and II may be explained by the Brody effect. In group III, AA seems to be influenced by some additional factors, possibly by changes in the intramyocardial or intraventricular blood volume. The AA of the last part of the QRS complex increased during microgravity and decreased during hypergravity in all groups. This may be explained by an effect of mutual neutralization of depolarization fronts related to the changes of the QRS duration.(Fig. 3, Ref. 4)

Two-year dynamics of vectorcardiography parameters in patients with primary pulmonary hypertension.

VCG data (McFee--Parungao system) were obtained from 12 patients with primary pulmonary hypertension (PPH). During 2 years, VCG investigations were repeated from 2 to 5 times. Various VCG-parameters were analyzed. Space and horizontal QRS areas, projection of integra QRS vector to axis y and the sum of Rx and Sx were diagnostically most significant. Their values proved abnormal at the beginning of survey. In the course of observation, states of the right heart chambers together with VCG-parameter dynamics were investigated in every patient. States of the right cardiac chambers improved in 4 patients. In all of them the parameter turned to normal values. In two patients, during the monitoring time monotonous increase of parameters was observed, with the state of the right heart chambers declining. In 6 patients, state of right heart chambers appeared relatively stable. In these patients, values of all the parameters were either stable or insignificantly changeable around some mean values. Thus, the dynamics of VCG-parameters makes it possible to estimate adequately the states of the right cardiac chambers in PPH patients. (Tab. 1, Fig. 4, Ref. 4)

Decarto technique in long-term observation of patients treated for primary pulmonary hypertension.

Techniques for noninvasive observation of heart states play an important part in experimental and therapeutic cardiology. The objective of this work is to describe a new method for intelligible pictorial representation of data acquired by an orthogonal electrocardiographic lead system and demonstration of possibilities of this method in estimating the results of longterm treatment for a cardiac disease. The method used, dipole electrocardiotopography (DECARTO), provides a set of maps (decartograms) that depict in an explicit form the instantaneous, as well as integral electrophysiological properties of the heart during the excitation cycle. The observed group of patients contained 10 females and 2 males with primary pulmonary hypertension. It was found that in all but one cases tested, the features of the maps strongly correlated with the results of the other diagnostical methods and clinical findings. The trends to improvement (6 cases), stabilization (4 cases), or deterioration (1 case) of the heart state were clearly indicated. In one case, however, the interpretation of the decartograms was ambiguous. The advantage of the DECARTO technique lays in clearness of data representation for visual analysis and facilitation of electrophysiological and anatomical interpretation of the data. (Fig. 6, Ref. 2)