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Background The female gender is a well known risk factor of acute kidney injury that is included in many score widely used by cardiologists for assessment of the risk of contrast-induced acute kidney injury (CI-AKI). The exact influence of gender in patients with chronic coronary syndromes requiring intraarterial contrast media administration remains to be established. Purpose The aim of our study was to assess the influence of gender on the risk of the development of CI-AKI in patients with chronic coronary syndromes, receiving optimal medical treatment and with indications for percutaneous coronary interventions (PCI). Methods 1023 patients with chronic coronary syndromes and indications to PCI were included in the prospective cohort clinical study. The CI-AKI was defined as a rise in serum creatinine equal to or more than 25% from baseline. Preventive measures included the administration of 0,9% saline with intravenous infusion speed of 1 ml/kg/h (0,5 ml/kg/h for patients with heart failure) before and after the procedure. The contrast media used were either iodixanol or iopromide, which are both known to cause less adverse events than high-osmolar contrast media. Results The CI-AKI developed in 132 patients (12,9%). The number of male patients was higher than the female ones (741 and 282, 72,4% and 27,6% respectively). The 95% confidence interval of the means was −0,004 to 0,0088. The F test was performed to compare variances: F was 1,297, DFn 281, Dfd 740, the p value was statistically significant. The CI-AKI developed in 45 females (16% of all the female patients) and 87 males (11,7% of all the male patients). Female patients were more likely to be enrolled in the study in older age (presented in population pyramid). This fact is likely to be due to the menopause and natural history of chronic coronary syndromes in female gender. Conclusion The female gender is a significant risk factor of the CI-AKI development in patients with chronic coronary syndromes undergoing percutaneous interventions. Women need to be screened and monitored more closely before any contrast media administration in catheterisation laboratory. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Sechenov University

Background and Aims Contrast-induced acute kidney injury (CI-AKI) remains one of the major obstacles to perform percutaneous coronary interventions (PCI), especially in older patients and in patients with comorbidities. The number of cases of stable coronary artery disease (CAD) requiring such kind of interventions, in spite of optimal medical treatment received, remains high. Diabetes, hyperuricemia and other components of metabolic syndrome, as well as heart failure, are well known risk factors predisposing to the development of CI-AKI after contrast exposure. Anaemia is diagnosed in a number of patients without underlying chronic kidney disease (CKD), when they seek for medical help due to CAD. The aim of our study was to assess the prevalence of CI-AKI (primary outcome) and the prognostic significance of anaemia as a its possible risk factor (secondary outcome) in different groups of patients with stable CAD requiring PCI using the contrast media. Method We conducted a single-centre prospective observational cohort study. 561 patients aged 18-89 with stable CAD undergoing PCI were enrolled from June 2012 until October 2013. The CI-AKI was defined as a rise in serum creatinine of ≥0,5 mg/dl (≥44μmol/l) or a 25% increase from baseline value, assessed at 48-72 hours after PCI. Anaemia was defined according to the WHO definition – haemoglobin level <12,0 g/dl in women and <13,0 g/dl in men. The contrast media used was either iodixanol (iso-osmolar contrast) or iopromide (low-osmolar contrast), which are both known to cause less adverse events than high-osmolar types of contrast. Nephrotoxic drugs were stopped 48 hours before PCI. The 5-year prognosis including all-cause and cardiovascular mortality, myocardial infarction, stroke, gastrointestinal bleeding, decompensation of chronic heart failure, repeat revascularizations (PCI and coronary artery bypass grafting), end-stage renal disease (ESRD) development, was assessed via phone calls and appointments according to the clinical situation and severity of the condition. Results The prevalence of CI-AKI in this group of patients was 104 cases (18,5%) (primary outcome). The number of patients with anaemia was higher in the group of patients who developed CI-AKI after PCI (6% [7/104] vs 4,4% [20/457]). The female patients with anaemia were more likely to develop CI-AKI (71% [5/7] vs 35% [7/20]). The number of patients who suffered from MI having anaemia at the inclusion date was 2 (28,6%) vs 6 (30%) in patients with and without CI-AKI respectively. Acute heart failure decompensation in patients with anaemia was significantly higher in patients with CI-AKI (43% [3/7] vs 10% [2/20]). This fact needs further evaluation in larger studies but anaemia may be one of the prognostic factors, worsening the kidney damage and leading to worse cardiorenal outcomes. Conclusion Patients with stable CAD suffering from anaemia are more likely to develop CI-AKI even without underlying CKD or ESRD. Female patients with anaemia and stable CAD have higher risk of development of CI-AKI. The combination of CI-AKI and anaemia may lead to a higher 5-year risk of acute heart failure decompensation.

History of the discovery of fibrillation and defibrillation, stages of the development of the concept of defibrillation are described in the article. The differences in mechanisms of different types of defibrillation are given here. The modern state of defibrillation and future trends are discussed in our article.

The article describes the main methods of assessment of physiological significance of coronary artery stenoses, their use in clinical practice and future perspectives. New diagnostic methods that are currently under research are discussed.

The article discusses the stages of formation and development of ultrasound diagnostics, including those with contrast enhancement. The main types of contrast agents and their mechanism of action are presented. Examples of the use of contrast-enhanced ultrasound in various fields of medicine are given. The prospects of the method and its place in clinical practice are discussed.

Aim. The main aim of our study was to assess the role of risk factors in patients with previous contrast induced acute kidney injury (CI-AKI) on a probability of a development of the new coronavirus infection. Materials and methods. Our study includes 65 patients with the history of CI-AKI after coronary angiography from 2013 to 2017 years; 10 of them had a new coronavirus infection, which had developed before November 2020. CI-AKI was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dl or more in serum creatinine from baseline value, assessed at 48 hours following the administration of the contrast. The primary endpoint was the development of a new coronavirus infection. Results. We found statistically significant difference in the prevalence of the allergic reaction to iodine (р=0.0178) between non-COVID and COVID-patients group. Also, there were statistically significant differences in the secondary endpoints: renal replacement therapy (р=0.0178) and repeated percutaneous coronary intervention in the last year (р=0.0112) were more common among patients with coronavirus. The difference in the prevalence of arterial hypertension was near to statistical significance (р=0.0882). Conclusion. COVID-patients with CI-AKI had more allergic reactions to iodine than non-COVID patients. The trend of more common arterial hypertension between COVID-patients was found in our research. There were not any statistical significant differences in other risk factors. There were statistically significant difference in the secondary endpoints such as repeated percutaneous coronary intervention and renal replacement therapy. Other endpoints didnt show a statistically significant difference.

Tumors in the heart are rare and difficult to diagnose pathologies. There are primary and secondary tumors, the letter tumors include metastases of other tumors. In this work is presented clinical case of metastatic lesion of the right atrium with renal cell carcinoma. Modern methods of diagnostics of patients with intracardiac formations are discussed.