Review. Рубрика в журнале - Cardiometry
Spotlight on management of hypertrophic cardiomyopathy
Статья обзорная
Hypertrophic cardiomyopathy (HCM) is the commonest inherited cardio-myopathy. Prevalence 1/500 individuals. The disease has variable expressivity and penetrance, which leads to a diverse phenotypical expression. The aim of this review paper is to shed light on management of HCM.
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Статья научная
Topicality. Most of the inhabitants on the planet have directly experienced certain manifestations of pain, and in the case of chronic pain sensations, some significant changes may occur not only in the psycho-emotional sphere of a human individual, but also some functional alterations in the life maintenance systems. There are two global problems of medicine which are associated with oncology and cardiovascular pathology, and, taking into account the prevalence of pain symptoms of various etiologies, a pathological triangle is formed, each side of which affects the overall configuration thereof. There is a need to understand these pathological relationships in order to determine the real possibilities of breaking them and correcting such common complex life situations. Any attempt to create a concept and visually verify the real pathological changes in the heart, when modeling a combination of chronic neurogenic pain and a malignant process, is relevant that is the aim of this research work. We targeted the morphological picture of the heart in female mice with chronic neurogenic pain (CNP) and the growth of B16 melanoma and found a rather tough scenario of unfolded events. Materials and methods. We used female mice of the C57BL/6 line with a normal genotype. Chronic neurogenic pain (CNP) was produced by bilateral ligation of the sciatic nerve. Against that background, all animals were subcutaneously transplanted with melanoma B16/F10. After decapitation, the isolated heart preparations were carried out according to the stages of morphological preparation for staining sections with hematoxylin-eosin, followed by morphological examination of the structure with the Leica DM LS2 microscope furnished with an Olympus optical.C-5050 Zoom video camera and Morfotest software. Photographing was conducted with magnifications x10, x40, x100. Results. A pronounced pro-oncogenic effect of pain stimulation of the neurogenic nature was revealed, which consisted in an earlier manifestation of the tumor growth, large-scale metastasizing even to atypical target organs, and the formation of a pre-terminal state at an earlier time. At the same time, morphological correlates of prolonged damage to the heart at the level of the valves and the ventricular wall were determined, the key elements of which were ischemia, total longitudinal splitting of muscle fiber bundles, blood filling of large vessels, hemorrhages, deep cell dystrophy of cardiomyocytes, myolysis, macrofocal necrosis (myomalacia), an accumulation of necrotic masses, fibrosis and eosinophilic infiltration. Visualization of the nuclei of cardiomyocytes indirectly indicated the switch of the death program to the non-apoptotic pathway, i.e. necrosis as a result from the “tumor-caused” depletion of the energy reserves of cardiomyocytes. Conclusion. The simulated hypertrophied manifestations of myocardial catastrophe in the experiment expand the concept of a prolonged infarction and provide a basis for predicting and preventing a negative course of events in difficult patients with persistent pain syndromes and comorbid pathology against the background of the development of a malignant process.
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Succinate as a mobilization cue
Статья обзорная
Succinic acid, being a metabolite of the Krebs cycle and the end product of anaerobic transformations in mitochondria, functions outside mitochondria and cells as a regulatory signal. In the cytosol, micromolar amounts of succinate stabilize the transcriptional hypoxia-inducible factor HIF, which triggers the genes responsible for adaptation to hypoxia. Outside the cells, succinate activates the SUCNR1 receptor, which increases the concentration of intracellular calcium. The effect of short bursts of endogenous succinate accumulation and signaling after hypoxia/ischemia, or extreme glucose use from physical exercise should be distinguished from the effect of a permanently increased level of endogenous succinate under pathology (obesity, diabetes mellitus, chronic ischemia, succinate dehydrogenase damage). A short succinate signal triggers an adaptive response by an organism. Prolonged rise and highly elevated levels of endogenous succinate is a pro-inflammatory, damaging factor that can contribute to the progression of neoplasms. Use of succinate-containing compositions at a dose of 0.5-5 millimole can only provide a short signal. This is due to the positive effect of a number of succinate-containing agents.
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Статья обзорная
Design of an effective succinate-based agent for the use in sports has required a profound analysis of the main action mechanisms of the agent in question. Our paper reflects basic principles, which are decisive for the design of the offered succinate-based agent to increase the organism performance and the rate of recovery after intensive physical loading. We have treated a special role of the metabolic conversions of succinate in energy exchange of mithochondria: high energy efficiency, possibility of beneficial oxidation under oxygen deprivation, anaerobic formation and possible consequences of the above phenomenon. The listed key factors have determined the applications of succinate in practice in order to maintain the energy exchange as well as design a number of anti-hypoxia means. It is assumed that the treated peculiarities of the succinate metabolism can provide the basis for formation of a signal, regulatory role of this molecule in the organism environment.
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Статья обзорная
The aim of this article is a comprehensive review of the publications during the last decade in order to evaluate current indications for cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and atrial fibrillation (AF). Clinical studies show that CRT not only improves HF symptoms and quality of life but also reduces morbidity in New York Heart Association (NYHA) class III or IV patients with reduced left ventricular ejection fraction (LVEF) and wide QRS. The loss of atrioventricular synchrony and difficulty to ensure an adequate biventricular pacing worsens these patients response to CRT. According to the latest guidelines CRT should be considered for patients to reduce all-cause mortality in patients with chronic HF, QRS ≥ 120 ms and LVEF ≤ 35% who remain in NYHA functional class III/ambualtory class IV despite at least 3 months of optimal pharmacological theraphy who are expected to survive at least 1 year with good functional status, provided that biventricular pacing as close as possible to 100% can be achieved (class IIa, level B). Despite the fact that there is a general agreement on the indication for CRT in AF patients, their optimal management strategy still remains a matter of discussion.
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Use of Laser Technologies in Oncourology
Статья научная
Due to the increasing use of laser technologies in oncourology, we consider it relevant to publish a review of domestic and foreign articles for 2015-2021. The range of application of various lasers in oncourology is very wide (holmium (Ho): YAG, thulium (Tm): YAG, etc.). In comparison with traditional surgical interventions, the greatest effectiveness of laser technologies in combination with endoscopy is clearly traced, the risks of intra – and postoperative complications are minimized, the period of inpatient stay for patients changes.
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