[Possibilities of "E-vita open plus" hybrid stent graft in surgery of thoracic aorta]. / Vozmozhnosti gibridnogo stent-grafta «E-vita open plus¼ v khirurgii grudnoi aorty.

BACKGROUND: The variety of pathology of the thoracic aorta supposes different approaches of surgical management, including the use of hybrid technologies. OBJECTIVE: To broaden a possible spectrum of indications for implantation of the "E-vita open plus" hybrid stent graft. RESULTS: Surgical treatment of thoracic aorta with the help of the "E-vita open plus" hybrid stent graft according to the "frozen elephant trunk" technique demonstrated satisfactory results in patients with various pathology: type A and B acute and chronic dissection according to the Stanford classification, as well as rare diseases (post-traumatic false aneurysm, complicated atherosclerosis of the thoracic aorta). CONCLUSION: The technology of "frosted elephant trunk" with implantation of the "E-vita open plus" hybrid stent graft in not limited by cases of acute aortic dissection, aortic aneurysmatic transformation and has wider indications for application. The use of this technology in cases of rare pathology of the thoracic aorta ("shaggy aorta" syndrome, posttraumatic false aneurysm) makes it possible to obtain satisfactory clinical results.

[Capabilities of radiodiagnostic techniques for evaluating myocardial hemodynamics and contractility in ventricular arrhythmias].

As of now, the study of ventricular arrhythmias (VA) is of topical interest for modern arrhythmology and cardiology. These arrhythmias constitute about 30% of all the arrhythmias and have a diverse etiopathogenetic basis. Having no noticeable impact on a patient's quality of life, VA may cause ventricular fibrillation, severe circulatory disorders, and sudden cardiac death. Objective of this study--to compare the capabilities of radiation techniques for evaluating ventricular hemodynamics and contractility in patients with VA. A multitude of current radiodiagnostic methods, among which the most preferential technique cannot be set aside to reveal the causes of and to study hemodynamic disorders, is now used to evaluate ventricular hemodynamics and contractility in patients with VA. Each procedure has its usage features in a contingent of patients with arrhythmias.

[Capabilities of radionuclide imaging study in the evaluation of pulmonary hemodynamics and right ventricular function in chronic obstructive pulmonary disease].

OBJECTIVE: To assess the capabilities of radionuclide imaging studies in the evaluation of pulmonary hemodynamics and right ventricular function in chronic obstructive pulmonary disease (COPD). SUBJECT AND METHODS: Twenty-one patients aged 55.8 +/- 9.7 years with COPD (forced expiratory volume in one second (FEV1), 37.43 +/- 15.46%; BODE index, 6.30 +/- 2.66) were examined. A comparison group included 15 patients aged 56.3 +/- 8.3 years without cardiorespiratory pathology. All the patients underwent radionuclide angiopulmonography (RAPG), equilibrium radionuclide tomoventriculography (ERTVG), external respiratory function testing, and determination of the plasma levels of endothelin-1 and stable nitric oxide metabolites. RESULTS: Analysis of the results of ERTVG and RAPG in the study and comparison groups has shown that the chanrades in the lesser circucr moderate. r index and smoking intensity have demonstrated the statistically significant association with the indicators of pulmonary circulation. The plasma level of endothelin-1 was higher1in the patients with COPD than in those in the comparison group. CONCLUSION: Right dysfunction is moderate in COPD as this process is preceded by structural changes in the bronchi, parenchyma, and lung vessels. To identify lesser circulatory dysfunction in COPD, one should orient to the indicators of RAPG that can verify pulmonary hemodynamic disorders and to the data of ERTVG that shows right ventricular systolic and diastolic function and right atrial dimensions.

[Assessment of the functional state of the right ventricle by radionuclide tomoventriculography].

The aim of this work was to evaluate the potential of radionuclide tomoventriculography (RTVG) for the study of the functional state of right ventricle (RV) in patients with thromboembolism of branches of the pulmonary artery (TEPA) or ventricular arrhythmias. A total of 96 patients were admitted for examination to the clinics of Research Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences in 2006-2008. They were divided into 3 groups. Group 1 (n = 40) included patients of mean age 62 +/- 11 years with non-massive TEPA, group 2 (n = 15) patients with coronary heart disease NYHA class I-II (50 +/- 9 years), group 3 (n = 4) children and adolescents 13.2 +/- 3.7 years with ventricular extrasystole and/or monomorphic ventricular tachycardia. All patients were examined by ECG-synchronized RTVG. The study showed that this method can be used to efficaciously determine volume characteristics of right ventricle, ejection fraction, relationship between fast and slow filling phases, and intreventricular dyssynchronism. The functional ability of the right side of the heart in patients with minor lesions in the pulmonary vasculature should be regarded as a sign of acute thromboembolism and marked systole-diastolic dysfunction of right ventricle (under similar conditions) as a manifestation of chronic post-thromboembolic hypertension. The number of areas of asynchronous myocardial contractions and the degree of intraventricular dyssynchronism detected by RTVG positively correlate with the degree of contractile dysfunction of right ventricle. Scintiographic signs of intraventricular dyssynchronism suggest predominance of contractile heterogeneity of right ventricle over physiological one.

[Parameters of perfusion pulmonoscintigraphy and radionuclide tomoventriculography in non-massive thromboembolism of pulmonary-artery branches].

OBJECTIVE: The present work was aimed at identifying the most informative parameters of perfusion pulmonoscintigraphy and radionuclide tomoventriculography in non-massive thromboembolism of the pulmonary-artery branches. MATERIALS AND METHODS: We examined a total of fifty-five patients. The Study Group was composed of 40 subjects (mean age 60.3 +/- 10.4 years) presenting with non-massive pulmonary artery thromboembolism (PATE). The Comparison Group comprised 15 patients with coronary heart disease (CAD) (average age 59.0 +/- 9.0 years, NYHA functional class I-IT circulatory insufficiency). All patients were subjected to perfusion-ventilatory pulmonoscintigraphy and radionuclide equilibrium tomoventriculography. The basic systolic and diastolic parameters of the right ventricle (RV) were determined using the obtained RESULTS: The Group of patients with non-massive PATE (i. e., damage to the pulmonary vascular bed up to 50%) turned out hypertension. quite heterogeneous by the severity degree of the RV contractility dysfunction. This Group included the patients with and without signs of RV contractility dysfunction. Taking into consideration small extension of the lesion, normal values of functional capability of the right portions of the heart may be interpreted as a sign of acute PATE, whereas the presence of pronounced systolicdiastolic dysfunction of the right ventricle should be regarded as apathognomonic sign of chronicpost-thromboembolic pulmonary hypertension. CONCLUSIONS: The most informative scintigraphic signs of right-ventricular dysfunction in thromboembolism of the pulmonary-artery branches are as follows: a decrease in the RV stroke volume, peak ejection rate and filling rate which are revealed even in insignificant embolisation of the lesser-circulation vessels. The preserved functional ability of the right portions of the heart in patients with a small scope of damage to the vascular bed of the lungs may be regarded as a sign of acute thromboembolism, while systolic-diastolic dysfunction of the right ventricle as one of the indices of chronic post-thromboembolic pulmonary hypertension.

[Anti-ischemic effects of trimetazidine in patients with post-infarction heart failure]. / Anti-ishemicheskaia éffektivnost' trimetazidina u bol'nykh s postinfarktnoi serdechnoi nedostatochnost'iu.

The antiishemic efficiency of course monotherapy with trimethazidine and its impact on myocardial perfusion were studied in patients with postinfarct dysfunction of the left ventricle (LV), which was associated with moderate heart failure (HF). This prospective controlled clinical study included 47 patients who had experienced myocardial infarction. The patients had also angina pectoris on exertion and NYHA Functional Classes (FC) II-III HF. The patients were randomized into 2 groups: Group 1 comprised patients with more than 50-W exercise tolerance (ET), FC II angina, and FC II HF; Group 2 consisted of those with 50-W or less ET, FC II-III angina, and FC II-III HF. Four-week course therapy with trimethazidine in a dose of 60 mg/day was found to exert a pronounced antiischemic effect in patients with reversible LV ischemia associated with HF. The tolerance of the drug during its 4-week course therapy was good and the drug caused no adverse reactions.