Kardiologiya
-
Review
[Pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery].
More than 230 million surgical operations are performed yearly in the world and this number is continually growing. Thirty days mortality in moderate and high risk non-cardiac surgery is about 2% and exceeds 5% in patients with high cardiac risk. ⋯ This allows to avoid unjustified investigations and drug therapy in operations with low cardiac risk and stresses significance of perioperative medical treatment. This review contains an analysis questioning some statements of the novel ESC guidelines such as reduction of preoperative cardiac tests and prophylactic revascularization of coronary arteries before operations with intermediate and high risk of cardiac complications.
-
Aim of the study was determination of physiological limits of QT-intervals and its derivative values in healthy children and adolescents during graded exercise tests. We examined 100 healthy boys and girls aged 11-15 years (mean age 13.4+/-2.1 years) and performed electrocardiography at rest and standard veloergometry (VEM) in all of them. We analyzed corrected intervals according to Bazett (QTc=QT/RR) and Fredericia (FQTc/3RR) formulas. ⋯ Maximal QTc lengthening in the process of test did not exceed 50 ms in any of the examined persons. Hysteresis of QTc interval was equal to 21+/-6 (15-25) ms. The conclusion was made that algorithm of assessment of QT interval changes during exercise test should include initial values of QTc calculated according to the Bazett formula, maximal QTc value, level of exercise at which it was registered, maximal increase of QTc during exercise, and QTc interval hysteresis.
-
Comparative Study
[Assessment of the prognostic value of the CRUSADE score in patients with acute coronary syndromes hospitalized in a noninvasive hospital].
Background. The CRUSADE score was created for assessment of bleeding risk in patients with acute coronary syndrome (ACS). However its accuracy was not confirmed in populations of patients treated in Russian hospitals, in noninvasively managed patients, in patients without myocardial infarction (MI). ⋯ Conclusions. In noninvasively treated ACS patients high risk of bleeding by CRUSADE score was closely associated with occurrence of total as well as major and moderate bleedings. Prognostic accuracy of the CRUSADE score for prediction of major or moderate bleeding during hospitalization was higher in CRUSADE-specific group (patients satisfying criteria of the CRUSADE derivation cohort).
-
Tobacco smoking is a major risk factor of the development of atherosclerosis and thrombosis. Components of tobacco smoke induce changes in the function of thrombocytes, endothelium, macrophages and smooth muscle cells of blood vessels. ⋯ The compounds of tobacco smoke also promote atherogenesis by affecting gene expression. Aim of the present article is to review published data about molecular mechanisms underlying harmful effects of ingredients of tobacco smoke such as nicotine and tar on the progression of atherosclerosis.
-
The aim of this work was to investigate prognostic value of creatine kinase MB-fraction and troponin T increase in patients after coronary bypass grafting (during 3-year prospective observation). Parameters were studied in 6, 12, 48 and 72 hours after surgical myocardial revascularization. It was revealed that increase of myocardial necrosis markers is associated with significant more frequent development of cardiovascular complications during 3-year prospective observation.