Aim: To study the structural and functional parameters of echocardiography in healthy representatives of the urban Shor population, including men and women.Material and Methods. The study included 96 indigenous and 66 non-indigenous urbanized residents of Gornaya Shoria, matched by age and divided according to ethnic and gender characteristics into 4 groups: indigenous men (n=40), indigenous women (n=56), non-indigenous men (n=32), and non-indigenous women (n=34). All individuals underwent echocardiographic study. Body surface area-indexed left and right heart structural parameters, pulse wave Doppler data, data on propagation atrioventricular flow rates, and spectral Doppler tissue data were studied.Results. According to the results of anthropometry, men and women of Shor nationality had a lower body mass and body surface area compared with the corresponding values in men and women of non-indigenous nationality (p<0.0001 in all cases). However, the indices of the thickness of the interventricular septum, the posterior wall of the left ventricle, left ventricular mass and stroke volume, the diameter of the aorta, and the anterior-posterior dimension of the right ventricle were significantly higher in the group of indigenous women compared to non-indigenous ethnic groups. (p<0.01 in all cases). The values of the left ventricular end-diastolic volume, left atrial volume, pulmonary artery diameter were significantly higher in both men and women of indigenous nationality relative to the corresponding female and male comparison groups (p<0.01 in both cases). The tricuspid flow propagation velocity in male Shors was significantly higher than that in non-indigenous men (p<0.01). The Shor nationality was associated with a decrease in body surface area and increases in aortic diameter indices, pulmonary artery, left ventricular posterior wall, left ventricular myocardial mass index, pulmonary artery index, right atrial area index, and tricuspid flow propagation velocity; only a decrease in body surface area was associated with the female sex.Conclusion. In healthy representatives of the indigenous population of Gornaya Shoria, ethnic differences in the structural and functional parameters of echocardiography prevailed over gender-related differences.
Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Research Institute for Complex Issues of Cardiovascular Diseases Aim To evaluate the effects of neuromuscular electrostimulation in the prehabilitation and prevention of muscle weakness in patients awaiting cardiac surgery. Materials and methods 122 patients waiting for elective cardiac surgery were included. Exclusion criteria: age less than 25 and more than 80 years; emergency and urgent surgical interventions; arthropathies; low pain threshold; rhabdomyolysis and other myopathies; cognitive dysfunction. Routine laboratory and instrumental examinations were performed in all patients upon admission to the hospital, as part of a standard examination. 62 patients were randomly selected for the preoperative NMES group, in addition to the standard preoperative preparation and treatment program. The standard program included 60 control patients. Patients of the NMES group underwent quadriceps stimulation for at least 5 sessions, lasting 90 minutes, daily before surgery. Results. The groups were comparable and did not have significant differences in gender and age characteristics, according to the main clinical and anamnestic data and types of operations. Initially, there were no differences in the state of the muscles of the lower extremities, the distance of the six-minute walking test (6MWT), and the strength of the hand grip. After NMES, there was an increase in muscle strength relative to the control group, both stimulated muscle groups and unstimulated antagonist muscles, as well as a greater 6MWT distance and hand compression force. All the differences were significant. Conclusions The course of pre-rehabilitation of NMES before surgery, allowed to maintain, and in some cases improve the condition of the muscle frame of the lower extremities. A positive effect was observed not only in stimulated muscle groups, but also in antagonist muscles Indicators of muscle status NMES (n = 62) Control group (n = 60) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 24,4 [18,3; 31,4] 30,4 [23,8; 36,2]* 24,7 [20,1; 33,2] 22,25 [18,9; 30,4] <0,001 Left knee extensors strength (kg) 23,8 [19,3; 31,3] 29,2 [23,6; 35,4]* 25,75 [19,2; 31,3] 22,9 [18,9; 27,8] <0,001 Right knee flexors strength (kg) 18,9 [13,3; 24,0] 21,7 [16,6; 25,1] 19,55 [13,1; 26,0] 16,7 [12,1; 23,3] 0,006 Left knee flexors strength (kg) 19,3 [14,3; 24,5] 21,9 [17,3; 26,7] 19,5 [13,0; 24,3] 18,2 [13,4; 22,2] 0,005 6-MWT (m) 300,0 [261,0; 371,0] 331,0 [280,0; 375,0] 304,5 [253,0; 380,0] 285,5 [246,0; 342,0] 0,006 Right handgrip strength (kg) 28,5 [20,5; 34,0] 31,5 [22,0; 34,0] 29,0 [19,0; 34,0] 27,0 [19,0; 33,0] 0,054 Left handgrip strength (kg) 25,0 [18,0; 31,0] 25,0 [18,0; 32,0] 24,0 [15,0; 31,0] 22,0 [14,0; 28,0] 0,062 * - p-level from baseline data < 0,05 Abstract Figure. dynamics of stimulated muscles
Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases Introduction The purpose was to evaluate the effectiveness of NMES in patients with complications after cardiac surgery. Methods This study was 37 patients who had significant postoperative complications after cardiovascular surgery. Participants were randomly - NMES group, n = 18; control, n = 19. It was not possible to blind the investigator. Analyzed basic clinical data. The dynamometry of the muscles upper and lower extremities was carried out, as well as a 6-minute walk test (6MWT). Also, the thickness of the quadriceps was measured using ultrasound.The patients underwent NMES on the quadriceps femoris muscle, daily from the third postoperative day, until discharge. The duration session was 90 minutes. Outcomes No differences were found in the baseline characteristics of the groups, including the results of laboratory and instrumental studies. Groups were comparable in the surgery and perioperative parameteres. The initial strength indicators also had no significant differences in the groups. At discharge knee extensors strength (KES) was significantly higher in the NMES group. The knee flexor strength (KFS) and handgrip strength (HF) increased the same in both groups. The quadriceps crosssectional area (CSA) muscle increased more in the NEMS group than in the control to the time of discharge. Average KES increased to a greater extent in the NMES group. At the same time, average and maximum KFS increased equally in both groups. A 6MWT before discharge did not show a difference between groups (P=.166). The NMES course did not affect the duration of hospitalisation (P=.429). Discussion This pilot study show beneficial effects of NMES on muscle strength in patients with complications after cardiovascular surgery. Physical tests initially and in dynamics NEMS Group (n = 18) Control group (n = 19) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 20,3 [17,9; 26,1] 28,05 [23,8; 36,2] * 20,1 [18,6; 25,4] 22,3 [20,1; 27,1] * 0,004 Left knee extensors strength (kg) 17,75 [15,5; 27,0] 27,45 [22,3; 33,1] * 20,8 [17,5; 24,2] 22,5 [20,1; 25,9] * 0,017 Right knee flexors strength (kg) 14,85 [11,7; 19,5] 17,5 [14,1; 23,4] * 16,9 [13,1; 23,8] 19,2 [12,5; 26,4] * 0,971 Left knee flexors strength (kg) 14,7 [12,6; 19,6] 19,75 [15,9; 24,2] * 16,2, [10,4; 25,1] 18,8 [13,1; 27,7] * 0,889 6-MWT (m) 148,5 [108,5; 174,0] 288,0 [242,0; 319,0] * 169,0 [115,0; 217,0] 315,0 [277,0; 400,0] * 0,166 Right handgrip strength (kg) 24,5 [15,0; 33,0] 25,5 [19,0; 36,0] * 27,0 [18,0; 32,0] 30,0 [20,0; 35,0] * 0,795 Left handgrip strength (kg) 17,0 [12,0; 27,0] 21,0 [15,0; 31,0] * 19,0 [14,0; 29,0] 23,0 [16,0; 30,0] * 0,541 * - p-level from baseline data < 0,05 ** - p-level from baseline data ≥ 0,05
Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” Purpose To study the preoperative status and assess the rate of in-hospital complications in patients with newly diagnosed type 2 diabetes mellitus (DM) undergoing coronary artery bypass grafting compared to patients with previously diagnosed DM and normoglycemia. Materials and Methods. 708 consecutive patients who underwent coronary artery bypass grafting (CABG) between 2011 to 2012 at the Research Institute for Complex Issues of Cardiovascular Diseases were included in the study. All patients without positive history of diabetes underwent an oral glucose tolerance test (ОGTT). The lab findings were interpreted in accordance with the recommended diagnostic criteria for diabetes and other glycemic disorders. Results. DM screening before coronary artery bypass grafting allowed to diagnose type 2 diabetes in 8.9% (n = 63) and prediabetes in 10.4% (n = 74) of the study population. The preoperative screening increased the number of patients with DM from 15.2% (n = 108) to 24.1% (n = 171), and with prediabetes from 3.0% (n = 21) to 13.4% (n = 95). The total number of patients with carbohydrate metabolism disorders increased from 18.2% (n = 129) to 37.5% (n = 266). The study groups did not differ in the rate of in-hospital complications due to a relatively low number of occurred events. However, a trend towards higher rate of in-hospital complications after CABG was defined among patients with newly diagnosed and previously diagnosed DM. The regression analysis demonstrated the presence of the relationships between the previously diagnosed DM2 and the total number of significant complications (odds ratio (OR) - 1.350, 95% confidence interval (CI): 1.057-1.723, p = 0.020) and prolonged in-hospital stay (OR 1.609, 95% CI: 1.202-2.1555, p = 0.001). The significance of the mentioned above relationships increased with the addition of newly diagnosed diabetes to the regression model as a probable predictor (for in-hospital complications: OR = 1.731, 95% CI: 1.131-2.626, p = 0.012; for prolonged in-hospital stay: OR 2.229, 95% CI: 1.412-3.519, p <0.001). Moreover, additional associations between DM and the risk of developing multiple organ dysfunction (OR 2.911, 95% CI 1.072-7.901, p = 0.039), urgent lower extremity surgery (OR 1.638, 95% CI 1.009-15.213, p = 0.020) and the need for extracorporeal correction of hemostasis (OR 3.472, 95% CI: 1.042-11.556, p = 0.044) have been defined. Importantly, the presence of these associations would not have been identified without including newly diagnosed DM in the regression model. Conclusion The newly diagnosed diabetes mellitus affects the prognosis of CABG as well as the previously diagnosed DM. The obtained results suggest the importance of active preoperative DM screening.
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