No abstract

Aim      To study time-related changes in bone remodeling markers in patients with ischemic heart disease (IHD) associated with type 2 diabetes mellitus (DM) and disorders of carbohydrate metabolism (CM). Also, a possibility was studied of using these markers for evaluation of breast bone reparative regeneration in early and late postoperative periods following coronary bypass (CB).Materials and methods           This study included 28 patients with IHD and functional class II-III exertional angina after CB. Patients were divided into 2 groups based on the presence (group 1) and absence (group 2) of CM disorders. Contents of osteocalcin (OC), C-terminal telopeptide (CTTP) of type 1 collagen, deoxypyridinoline (DPD), and alkaline phosphatase bone isoenzyme (ALPBI) were measured by enzyme immunoassay on admission (Т1) and at early (Т2) and late (Т3) postoperative stages. Sternal scintigraphy with a radiopharmaceutical (RP) was performed at stage 3 following sternotomy.Results The content of OC and CTTP was reduced in group 1 compared to the values in the group without CM disorders (р<0.005) at stages Т1 and Т2. There were no significant intergroup differences in concentrations of ALPBI and DPD throughout the study. Time-related changes in OC, CTTP, and DPD had some intergroup differences: the increase in biomarkers was observed in group 1 considerably later, at stage Т3 (р<0.005), while in group 2, it was observed at stage T2 after sternotomy. Scintigraphy revealed significant intergroup differences in the intensity of RP accumulation in sternal tissue.Conclusion      The intergroup differences in the content of biomarkers evidenced a disbalance among processes of formation and resorption of bone tissue and delayed remodeling processes in patients with IHD associated with type 2 DM and CM disorders. The study confirmed significance of comprehensive evaluation of time-related changes in markers for bone tissue metabolism and sternal scintigraphy for diagnosis and evaluation of sternal reparative regeneration following sternotomy in patients with IHD associated with type 2 DM and disorders of CM metabolism.

Background The aim of the study was to evaluate the impact of idiopathic ventricular tachycardia and premature ventricular beats on cardiac function and dyssynchrony and to elucidate relationships between data of scintigraphic and intracardiac electrophysiology studies (EPSs). Methods The study comprised 64 patients with idiopathic ventricular arrhythmias (VAs; median age of 14 years ranging from 8 to 18 years). The control group comprised 20 patients (median age of 12 ranging from 7 to 16 years) without cardiac arrhythmias. EPS and radiofrequency ablation (RFA) procedure for VA were performed in 21 children according to indications. The functional state of both ventricles was assessed by gated blood pool single photon emission computer tomography (GBP‐SPECT) before and after RFA in all patients. Results Patients with VA had local areas of asynchronous myocardial contraction (AMC). Compared with the control group, VA patients had significantly higher values of end‐diastolic volume, end‐systolic volume, and lower contractility indices. Negative association was found between total numbers of AMC areas and cardiac contractility indices. Ectopic foci localization, determined based on EPS data, was associated with AMC areas topography based on GBP‐SPECT. RFA procedure significantly improved cardiac contractility indices; AMC areas completely disappeared or decreased compared with the preoperative conditions. Conclusion In VA patients, AMC areas were localized mostly in the right ventricle. Comparison of the results of GBP‐SPECT and EPS studies showed a relationship between AMC localizations and ectopic foci topography. The fact that AMC areas disappeared after RFA supports the hypothesis stating that the presence of AMC areas is a scintigraphic symptom of ectopic focus.

This clinical case demonstrates a successful simultaneous approach for Type B aortic dissection in association with Kommerell's diverticulum using an E-vita OPEN PLUS Hybrid prosthesis. Computed tomography in the early postoperative period and after a 6-month follow-up showed favourable surgical outcomes.

шемическая кардиомиопатия-выраженная сократительная дисфункция и расширение полостей желудочков сердца, имеющие в своей основе обструктивное поражение коронарных артерий. Успех хирургического лечения ишемической кардиомиопатии зависит, помимо прочих факторов, от объема дисфункционального, но жизнеспособного миокарда, способного восстановить свою сократительную функцию после коронарного шунтирования. Если его количество незначительно, риск от операции превышает таковой от медикаментозной терапии. Наиболее доступным радионуклидным методом идентификации жизнеспособного миокарда является перфузионная сцинтиграфия миокарда с радиофармацевтическими препаратами на основе 201Tl и 99mTc. В обзоре представлены сведения о возможностях применения данного метода в аспекте прогноза восстановления функции миокарда левого желудочка сердца после оперативного лечения больных с ишемической кардиомиопатией. Приведены сведения о диагностической эффективности таких сцинтиграфических симптомов, как сегментарное накопление радиофармпрепарата, анализ подвижности и систолического утолщения стенки левого желудочка сердца, его индекса эксцентричности и механической диссинхронии. Приведен анализ результатов выполнения перфузионной сцинтиграфии миокарда в сочетании с фармакологическими пробами с вазодилататорами и инотропными агентами-добутамином и нитроглицерином. В заключительной части обзора проанализированы крупнейшие на данный момент исследования, посвященные изучению зависимости между наличием жизнеспособного миокарда и прогнозом развития неблагоприятных сердечных событий в данной группе больных. Ключевые слова: ишемическая кардиомиопатия, ишемическая болезнь сердца, жизнеспособность, ОФЭКТ, диссинхрония, левый желудочек, реваскуляризация.

No abstract

No abstract

This case report describes simultaneous approach that enables to replace the ascending aortic aneurysm complicated with atherosclerotic lesions of the descending aorta (the “shaggy aorta” syndrome) using frozen elephant trunk technique.