[Clinical guidelines for the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (Part 2)].

The paper gives current approaches to treating chronic thromboembolic pulmonary hypertension (CTEPH) from the document «Federal Guidelines for the Diagnosis and Treatment of CTEPH» approved at the Third Russian Congress on Pulmonary Hypertension on December 11, 2015. The guidelines had been elaborated to optimize the treatment of patients with CTEPH on the basis of an analysis of the data of the present-day registries and multicenter randomized clinical trials, national and international guidelines and consensus documents, and documents published in recent years. CTEPH is a unique form of pulmonary hypertension since it is potentially curable by surgical treatment.

[Clinical guidelines for the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (Part 1)].

Chronic thromboembolic pulmonary hypertension (CTEPH) is precapillary pulmonary hypertension, in which chronic obstruction of large and middle branches of pulmonary arteries (PAs) and secondary changes in the lung microcirculatory bed result in a progressive increase in pulmonary vascular resistance and PA pressure with the development of severe right cardiac dysfunction and heart failure. CTEPH is a unique form of pulmonary hypertension since it is potentially curable by surgical treatment. The diagnostic criteria for CTEPH are a mean PA pressure of ≥25 mm Hg, as evidenced by right heart catheterization; a PA wedge pressure of ≤15 mm Hg; a pulmonary vascular resistance of >2 Wood units; the presence of chronic/organized thrombi/emboli in the elastic PAs (pulmonary trunk, lobular, segmental, subsegmental PAs); effective anticoagulant therapy at therapeutic dosages over at least 3 months.

[Atrial fibrillation and prolonged nocturnal cardiac arrests in a patient with obstructive sleep apnea syndrome. Successful correction of disorders by CPAP therapy].

The case history of a 46-year-old patient with obstructive sleep apnea syndrome was analyzed. The examination revealed fourth-degree obesity, prior myocardial infarction, persistent atrial fibrillation with nocturnal asystoles lasting as long as 14.3 sec.

[A clinical case of hemangioma of the face and tongue concurrent with severe obstructive sleep apnea syndrome complicated by cardiac arrhythmias and conduction disturbances].

The paper describes a clinical case of a female patient with severe obstructive sleep apnea syndrome in the presence of congenital hemangioma of the face, soft palate, and tongue concurrent with paroxysmal atrial fibrillation and atrial flutter, paroxysmal supraventricular tachycardia, and sinoatrial block (maximally up to 3.9 sec). Continuous positive airway pressure therapy could reduce the number of paroxysms of atrial fibrillation and atrial flutter, supraventricular tachycardia and eliminate sinoatrial block.

[Adhesion molecules and mononuclear cell subpopulations in the coronary and pulmonary arteries of patients with coronary heart disease].

Unlabelled: Atherosclerosis is a multifactor disease, in which dysfunction of the endothelium leads to the emergence of its adhesion molecules.

Objective: to investigate the expression of the endothelial adhesion molecules PECAM (CD31), ICAM, and VCAM, as well as adherent endothelial T cells and monocytes. The material examined was en face pulmonary and coronary artery samples taken during autopsies (10 men), and en face specimens obtained from the coronary artery fragments taken from coronary heart disease patients during endarterectomy (37 men).

[Heat and cardiovascular diseases: A review of epidemiological surveys].

The review summarizes epidemiologic data on the effects of heat on cardiovascular morbidity and mortality. Patients with heart failure and cardiac arrhythmias are most susceptible to negative heat exposure. At the same time, measures aimed at preserving the health of the population lead to a considerable reduction in losses associated with an abnormal rise in air temperature.

[Mineralocorticoid receptor antagonists in the treatment of patients with chronic heart failure. Positions in 2015].

Mineralocorticoid receptor antagonists (MCRA) are part of standard medical therapy for heart failure (HF). The clinical efficacy of MCRA in patients with systolic HF has been proven by randomized clinical trials. The efficacy of this drug group in patients with chronic HF with preserved left ventricular systolic function and the advent and practical introductions of safer new-generation MCRA remain to be answered.

[Impact of a cold wave on disease course, hemodynamics, carbohydrate metabolism, and blood rheological properties in cardiac patents].

Aim: To study the impact of cold waves on disease course, hemodynamics, lipid and carbohydrate metabolisms, oxidative stress, and blood rheological properties in patients with cardiovascular diseases (CVD).

Subjects And Methods: 24 men and 36 women (their mean age was 62.9±9.

Atrial appendage transcriptional profile in patients with atrial fibrillation with structural heart diseases.

During the last few years DNA microarray studies of gene expression changes in human atrial tissues from patients with and without atrial fibrillation (AF) have been performed. For this purpose, tissue samples are usually collected from AF patients undergoing open heart surgery. These investigations have limitations associated with the unavoidable heterogeneity of compared groups which is due to the presence of various structural changes accompanying different sets of underlying heart diseases in both groups.

[Dynamics of Fatty Acid binding protein and pro-brain natriuretic Peptide levels in patients with ischemic heart disease at the background of stress test and balloon coronary angioplasty.].

Dynamics of fatty acid binding protein (FABP) and pro-brain natriuretic peptide (pro-BNP) levels was studied in patients with ischemic heart disease at rest, during transitory myocardial ischemia, and before and after balloon angioplasty. Forty patients were included: 25 patients with stable angina comprised the study group and 15 patients with acute myocardial infarction (AMI) comprised control group. No significant elevation of FABP was revealed after myocardial revascularization, a tendency was noted to elevation of FABP after transitory ischemia.

[Effect of Type 2 Diabetes on Results of Endovascular Treatment of Ischemic Heart Disease With Drug Covered Stents (Results of 1 Year Follow-up).].

Aim of the study was to determine the impact of sirolimus-eluting stents (SES) on clinical outcomes in patients with type 2 diabetes mellitus (DM) undergoing coronary revascularisation. The study enrolled 99 diabetic patients with de novo lesions in native coronary arteries. Medically treated DM was present in 61 patients (62%), 7 (7%) of whom required insulin.

Erythrocyte membrane fluidity and haemoglobin haemoporphyrin conformation: features revealed in patients with heart failure.

This study examined the possible involvement of abnormal erythrocyte oxygen (O(2)) transport in the pathogenesis of heart failure. Haemoglobin (Hb) haemoporphyrin conformation was assessed by Raman spectroscopy (RS) of blood samples, whereas membrane fluidity was estimated at depths of 0.6-0.

[Homocysteine: why is it harmful?].

This paper discusses the potential pathogenetic mechanisms by which the damaging action of hyperhomocysteinemia on the vessels is realized, namely a negative effect on the structure and function of the vessel wall, on proliferation of smooth muscle cells and endothelium-dependent vasodilatation; on the processes of blood cell interaction with the vessel wall (adhesion of monocytes, platelet adhesion and aggregation, etc): prothrombogenic action on the coagulation system, and effect of homocysteine on adenosine concentration in plasma and tissues.

[Clinical, hemodynamic and neurohumoral effects of long-term therapy of patients with severe chronic heart failure with beta-adrenoblocker bisoprolol].

Unlabelled: The use of beta-adrenoblockers in conjunction with angiotensin converting enzyme inhibitors improves quality of life and prognosis of patients with chronic heart failure. However basic mechanisms of these positive effects in severe heart failure remain to be elucidated.

Methods: Patients (n=54) with NYHA class III-IV heart failure and left ventricular ejection fraction < or =35% were randomized either to treatment with bisoprolol (1.

Potential of phosphorus nuclear magnetic resonance spectroscopy in studies of the energy metabolism of skeletal muscles.

The aim of the present study was to investigate the possibility of phosphorus magnetic resonance spectroscopy (MR spectroscopy) in the diagnosis of metabolic lesions of skeletal musculature in patients with intermittent claudication syndrome, chronic cardiac failure, and varicose diseases of the lower limbs. Studies included 50 males: 20 patients with intermittent claudication, 10 patients with chronic cardiac failure, and 10 patients with varicose veins. The control group consisted of 10 healthy volunteers.

[Radionuclide diagnosis of right ventricular myocardial infarction].

The diagnostic capacities of 99mTc-pyrophosphate plane myocardial scintigraphy versus 99mTc-pyrophosphate single photon emission computed tomography (SPECT) were compared. Recording right precordial ECG leads showed that 26 patients had right ventricular myocardial infarction (MI)-typical changes as ST-segment evaluation, followed by abnormal Q wave. Plane scintigraphy indicated a characteristic inclusion of 99mTc-pyrophosphate into the right ventricular myocardium in 18.

Ultrastructure of rabbit myocardium in the late period of immobilization stress.

Ultrastructure of working myocardium was studied in rabbits subjected to 70-day immobilization in narrow cages excluding active movements. The structure of working cardiomyocytes, nervous apparatus, and microvascular bed in auricles were studied. Particular attention was focused on intercalated disks in muscle fibers, where separation of fasciae adherents was observed, while desmosomes in the lateral area of these contacts were preserved.

[Comparative ultrastructural analysis of capillaries in the conducting and contracting myocardium of the heart sino-auricular region in suddenly died patients with coronary artery disease and alcoholic cardiomyopathy].

The EM study of capillaries in the sinus node (SN) and adjacent working myocardium has been performed in 12 patients who ceased a sudden coronal cardiac death at the age 34-69 years and in 8 patients with alcoholic cardiomyopathy who suddenly died at the age 32-60 years. Quantitative evaluation of the density of the capillaries and their diameters in the myocardium of this region was made. Acute and chronic changes were observed in the capillaries of SN and working myocardium.

[Ultrastructure of the contacts between conducting and also between working myocytes in the sino-auricular region of the heart of the intact rat].

Ultrastructural investigation of cellular contacts of sinus node (SN), conducting myocytes of types I and II and working myocytes of right atrium (RA) perinodular myocardium was performed in rat heart. Lateral contacts between myocytes and intercalated discs are the basic in this area. Desmosomes and nexuses were found in lateral contacts apart from regions of simple abutment of plasmalemma.

[Status of the adrenal medulla in various forms of cardiomyopathy].

Adrenal medulla was studied quantitatively by a histofluorescent method and by that of Wood in 20 persons who had died at the age 35-50 years. The autopsy material was obtained from 11 dead bodies (control group--accident death) and those who had dilated and alcoholic cardiomyopathy (DCMP and ACMP, respectively). Catecholamine luminescence intensity (CLI) was higher in ACMP compared to control.

[Hyperplastic changes and aldosterone content in the adrenal cortex in essential hypertension and primary aldosteronism].

Autopsy and operative material (adrenalectomy for hyperaldosteronism) was studied to elucidate morphology, incidence of nodules, aldosterone content in the adrenal of patients with essential hypertension (EH). It was established than nodular masses in the adrenals in the form of micro and macronodules are present in 80% of EH patients. Aldosterone content in the adrenals in both nodules and in the adjacent cortex is significantly higher than in the adrenals of patients without EH.

[An ultrastructural analysis of the postmortem changes in the sinoauricular area of the canine heart].

The EM study of all tissues and myocyte components in the sinus node (SN) and adjacent working myocardium of the right atrium was performed in normal dogs and in dogs 1, 2, and 3 hours after death. A quantitative evaluation of the myocyte density, connective tissue components, vessels and nerve fibers in the SN and working myocardium of this region was performed. Destructive changes having mosaic appearance were observed in the conducting and working myocytes, myelinated and non-myelinated, nerve fibers, in vessels and partly in components of connective tissue of both SN and working myocardium.

[The morphology of the myocardium in the Wolff-Parkinson-White syndrome].

Myocardium of the right atrium from 5 patients with the above syndrome was studied at the light and EM level. Apoptotic degeneration of myocytes was demonstrated for the first time. The alterations observed may be secondary and due mainly to microcirculatory disturbances produced by tachyarrhythmia which appear during the excitation waves circulation.