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Kardiologiia Feb 2021This thematic review focuses on recently proposed classification of stages in pronounced aortic stenosis based on the prevalence of extravalvular cardiac damage and its...
This thematic review focuses on recently proposed classification of stages in pronounced aortic stenosis based on the prevalence of extravalvular cardiac damage and its modified variant designed for asymptomatic patients. The review presents studies, which analyzed the predictive significance of the proposed classification. The use of this classification allows predicting the course of disease in patients with pronounced aortic stenosis in valve replacement. The classification is based on routinely used structural and functional echocardiographic signs with already proven predictive values with respect of adverse events in patients after aortic valve replacement. The review discusses limitations of the classification for pronounced aortic stenosis stages based on the prevalence of extravalvular cardiac damage.
Topics: Aortic Valve; Aortic Valve Stenosis; Heart Injuries; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Prevalence; Severity of Illness Index
PubMed: 33706692
DOI: 10.18087/cardio.2021.1.n1024 -
Kardiologiia Jan 2021Echocardiography allows evaluating left ventricular (LV) myocardial contractility; however, the visual assessment of contractility is subjective and requires... (Review)
Review
Echocardiography allows evaluating left ventricular (LV) myocardial contractility; however, the visual assessment of contractility is subjective and requires considerable experience. Modern technologies for assessment of LV myocardial contractility, such as tissue Doppler and speckle-tracking echocardiography, provide quantitative estimation of various parameters of myocardial strain, including the LV postsystolic shortening. Several studies have demonstrated the value of postsystolic shortening for evaluation of myocardial ischemia and "ischemic memory" in patients with cardiovascular diseases. This review analyzes experimental and clinical studies that addressed LV postsystolic shortening.
Topics: Echocardiography; Heart; Heart Ventricles; Humans; Myocardial Contraction; Myocardium; Systole; Ventricular Function, Left
PubMed: 33522475
DOI: 10.18087/cardio.2020.12.n1087 -
Kardiologiia Jan 2021Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular...
[The role of diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation. Expert consensus developed under the auspices of the National Medical Research Center of Cardiology,...
Diagnosis of heart failure with preserved ejection fraction (HFpEF) is associated with certain difficulties since many patients with HFpEF have a slight left ventricular diastolic dysfunction and normal filling pressure at rest. Diagnosis of HFpEF is improved by using diastolic transthoracic stress-echocardiography with dosed exercise (or diastolic stress test), which allows detection of increased filling pressure during the exercise. The present expert consensus explains the requirement for using the diastolic stress test in diagnosing HFpEF from clinical and pathophysiological standpoints; defines indications for the test with a description of its methodological aspects; and addresses issues of using the test in special patient groups.
Topics: Biomedical Research; Cardiology; Consensus; Echocardiography; Echocardiography, Stress; Exercise Test; Heart Failure; Humans; Russia; Stroke Volume; Ventricular Function, Left; Workload
PubMed: 33522468
DOI: 10.18087/cardio.2020.12.n1219 -
Nano Letters Nov 2020We present a new approach to femtosecond direct laser writing lithography to pattern nanocavities in ferromagnetic thin films. To demonstrate the concept, we irradiated...
We present a new approach to femtosecond direct laser writing lithography to pattern nanocavities in ferromagnetic thin films. To demonstrate the concept, we irradiated 300 nm thin nickel films by single intense femtosecond laser pulses through glass substrate. Using a fluence above the ablation threshold, the process is destructive, leading to the formation of an ablation crater. By progressively lowering the laser fluence, the formation of closed spallation cavities below the ablation threshold is achieved. Systematic studies by the electron and optical interferometric microscopies, supported by molecular dynamics simulations, enabled us to gain an understanding of the thermo-mechanical spallation mechanism at the solid-molten interface. We achieved the fabrication of periodic arrangements of closed spallation nanocavities. Due to their topology, closed magnetic nanocavities can support unique couplings of multiple excitations (magnetic, optical, acoustic, spintronic). Thereby, they offer a unique physics playground for emerging fields in magnetism, magneto-photonic, and magneto-acoustic applications.
PubMed: 33074002
DOI: 10.1021/acs.nanolett.0c02574 -
Kardiologiia Mar 2020This review focuses on a new method for noninvasive, complex evaluation of left ventricular (LV) systolic function using an echocardiography-based technology of... (Review)
Review
This review focuses on a new method for noninvasive, complex evaluation of left ventricular (LV) systolic function using an echocardiography-based technology of computing indexes of myocardial performance by construction of pressure-deformation curves. Since this new method accounts for the effect of afterload on myocardial contractility, the article presents data demonstrating advantages of the evaluation of LV myocardial performance over the speckle-tracking echocardiography and other methods in diagnostics of several diseases. The review provides a description of this method and its advantages and limitations. The authors analyzed results of major studies on evaluation of LV performance. Prospects of implementation and practical use of the method are discussed in the aspects of diagnostics of cardiovascular diseases and risk stratification for different groups of patients.
Topics: Echocardiography; Heart Ventricles; Humans; Stroke Volume; Systole; Ventricular Dysfunction, Left; Ventricular Function, Left
PubMed: 32375619
DOI: 10.18087/cardio.2020.3.n925 -
Kardiologiia Mar 2020To assess possibilities of contrast echocardiography with quantitative evaluation of myocardial perfusion in patients with previous Q-wave myocardial infarction.
OBJECTIVE
To assess possibilities of contrast echocardiography with quantitative evaluation of myocardial perfusion in patients with previous Q-wave myocardial infarction.
MATERIALS AND METHODS
We examined 15 men (42-72 years) with coronary artery disease and previous myocardial infarction, and pathological Q-wave in 2 or more ECG leads. Quantification of left ventricular (LV) myocardial perfusion was performed by calculating of the ultrasound signal tissue intensity from the LV myocardial segments during intravenous administration of the ultrasound contrast agent (SonoVue). The Tissue intensive curve (TIC) analysis was done in the end-diastolic period before and on the fourth cardiac cycle after applying the "flash". Changes in the intensity of myocardial perfusion (A4, dB) was estimated as the difference between the intensity values of the ultrasound signal in the myocardial segment during the period of filling the contrast bubbles on 4-th cardiac cycle and before applying the «flash». Measurements were performed in 16 segments of the LV. A contrast cardiac magnetic resonance imaging (contrast MRI) was performed in order to verify the LV scar. Fibrotic changes of 50% of myocardial wall or more were considered as signs of post-infarction scar.
RESULTS
The dynamics of perfusion and scar presence in 240 myocardial segments were evaluated. The median A4 was 1 dB (range, -20 to 10 dB). MRI revealed 82 of 240 segments with the large-focal scar. The effectiveness of the diagnostic test (quantitative contrast perfusion echocardiography with A4 assessment) to detect myocardial scar was investigated. ROC curve analysis showed good model quality, AUC=0,787 (0,730-0,837); sensitivity 82.9%; specificity 75.3%; p<0.01. The cut-off point for A4 was -1.
CONCLUSION
A new approach to quantitative contrast assessment of perfusion allows to identify perfusion disorders with high efficiency in patients with previous Q-wave myocardial infarction.
Topics: Adult; Aged; Contrast Media; Coronary Disease; Echocardiography; Humans; Male; Middle Aged; Myocardial Infarction; Myocardium; Sensitivity and Specificity
PubMed: 32345194
DOI: 10.18087/cardio.2020.2.n817 -
Angiologiia I Sosudistaia Khirurgiia =... 2020The back of the foot is a standard region for measuring transcutaneous oxygen tension (tcpO2) with a reliably determined threshold of ischaemia, but such measurement...
The back of the foot is a standard region for measuring transcutaneous oxygen tension (tcpO2) with a reliably determined threshold of ischaemia, but such measurement reflects blood supply of only a portion of angiosomes of the foot. Determining the reference values of tcpO2 in other regions of the lower extremity is of current importance. However, measuring the tcpO2 level on the plantar surface and in some other regions not uncommonly reveal a phenomenon of its steady decrease instead of formation of a plateau. The purpose of the present study was to analyse the frequency of the phenomenon of a steady decrease in ptcO2 level while performing transcutaneous oximetry in various zones of the lower extremity. We retrospectively analysed the results of a total of 160 measurements of tcpO2 in 35 patients with diabetes mellitus. The patients' mean age amounted to 68 (47-87) years, with the duration of diabetes mellitus averaging 14 (1-24) years. The male-to-female ratio was 60:40. Seventy-seven percent of patients had foot ulcers/wounds, 34% of patients had a history of previously endured revascularization. The examination was carried out in the dorsal, plantar, medial plantar regions of the foot, on the medial surface of the crus and in the subclavian region, using the TCM 400 monitoring device (Radiometer, Denmark). The measurements were performed by an experienced operator in strict accordance with the manufacturer's recommendations. We evaluated the average value of tcpO2 between the 15th and 19th minutes of measurement and the peculiarities of the tpcO2 curve (plateau/increase/decrease of the value) within this time interval. The mean tcpO2 value in the medial plantar region was significantly higher than that on the back of the foot: 34 (3-70) versus 22 (1-59) mm Hg, p=0.003. A portion of measurements demonstrated a steady decrease in the tpcO2 during the measurement up to the 40th minute. Complying with the stable plateau phase criteria we had developed were 92% of measurements in the subclavian region, 100% - in the middle third of the crus, 76% - on the back of the foot, 77% - in the medial plantar region and 43% - on the plantar surface of the foot. CONCLUSIONS: 1) the revealed phenomenon of a steady decrease of tcpO2 in some patients needs to be taken into consideration in clinical practice and deserves further study; 2) the nature of this phenomenon is unclear, with a possible effect of skin creams on the results of the measurements; 3) it is advisable to include into the functions of the devices for transcutaneous oximetry an algorithm for confirmation of the true phase of the plateau and calculation of the mean tcpO2 value for a chosen period; 4) despite the need for measurement of tcpO2 in the 'alternative zones' it is necessary to thoroughly study the reliability of the data in these zones and to determine the normal values of the parameter separately for each of them.
Topics: Aged; Aged, 80 and over; Blood Gas Monitoring, Transcutaneous; Diabetes Mellitus; Female; Foot; Humans; Male; Reproducibility of Results; Retrospective Studies
PubMed: 32240131
DOI: 10.33529/ANGIO2020119 -
Journal of Tissue Engineering and... May 2020According to experimental studies, mesh implants may reduce in size up to 50.8% during their integration into soft tissues. This results in impaired mobility of the... (Clinical Trial)
Clinical Trial
BACKGROUND
According to experimental studies, mesh implants may reduce in size up to 50.8% during their integration into soft tissues. This results in impaired mobility of the anterior abdominal wall and hernia recurrences, as well as affects patients' quality of life. Due to unsatisfactory radiographic contrast of polymeric mesh implants, changes in their size can be rarely confirmed using imaging methods. Medical devices made of metal alloys have the best radiographic contrast.
OBJECTIVE
The purpose of this study was to evaluate the radiographic contrast of mesh implants made of titanium filaments and to determine the sizes and locations of the implants after the anterior abdominal wall hernia repair.
MATERIALS & METHODS
The study included 40 patients with inguinal, umbilical, and postoperative ventral hernias. Surgical hernia repair was performed using a mash implant made of titanium filaments, "titanium silk". Multislice spiral computed tomography (MSCT) was performed on Days 3 and 90 after surgery, followed by an assessment of the size and location of the mesh implant.
RESULTS
90 days after the anterior abdominal wall hernia repair, the locations of the titanium silk mesh implants in the tissues corresponded to their intraoperative setting. There were no statistically significant changes in the sizes of mesh implants on Day 90, compared with Day 3.
CONCLUSION
The titanium silk mesh implants have satisfactory radiographic contrast, which allows imaging of their location and size in the tissues using MSCT and comprehensive evaluation of hernia repair outcomes using instrumental methods of examination.
Topics: Adult; Female; Hernia, Ventral; Herniorrhaphy; Humans; Male; Middle Aged; Surgical Mesh; Titanium; Tomography, X-Ray Computed
PubMed: 32187850
DOI: 10.1002/term.3029 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2020Sleep-disordered breathing is associated with sleep fragmentation and reduced blood oxygenation due to apnea and hypopnea episodes. Multiple studies indicate that... (Review)
Review
Sleep-disordered breathing is associated with sleep fragmentation and reduced blood oxygenation due to apnea and hypopnea episodes. Multiple studies indicate that obstructive sleep apnea syndrome (OSAS) can have negative impact on cognitive functioning, primarily executive functions, attention, and episodic memory. The attention is also focused on cognition in patients with neurologic and psychiatric comorbidities. There are different explanatory models, which show the mechanisms of OSAS influence on cognition. However, it is still unclear how the initial severity of the disease and clinical outcomes interrelate, and which factors play role in the compensation of cognitive dysfunction. Better understanding of these issues is crucial for the prevention of cognitive impairment and rehabilitation of cognitive functioning.
Topics: Cognitive Dysfunction; Executive Function; Humans; Sleep Apnea, Obstructive
PubMed: 32105275
DOI: 10.17116/jnevro202012001190 -
Annals of Parasitology 2020The review provides data on species composition of nematodes in 50 species of birds from Armenia (South of Lesser Caucasus). Most of the studied birds belong to...
The review provides data on species composition of nematodes in 50 species of birds from Armenia (South of Lesser Caucasus). Most of the studied birds belong to Passeriformes and Charadriiformes orders. One of the studied species of birds (Larus armenicus) is an endemic. The taxonomy and host-specificity of nematodes reported in original papers are discussed with a regard to current knowledge about this point. In total, 52 nematode species parasitizing birds in Armenia are reported. Most of the reported species of nematodes are quite common in birds outside of Armenia. One species (Desmidocercella incognita from great cormorant) was first identified in Armenia. Great snipe was recorded as a new host for Hystrichis tricolor. Zoonotic nematode Trichinella pseudospiralis was reported in Armenia from Eurasian blackbird.
Topics: Animals; Armenia; Nematoda; Passeriformes
PubMed: 33646734
DOI: 10.17420/ap6604.285