Aim. To identify the nature of changes in the hemostasis system in patients with chronic and acute ischemic heart disease. Methods. The first group was comprised of 46 patients with stable angina of the II-III functional class, the second group was comprised of 42 patients with acute coronary syndrome, the control group included 28 healthy individuals. In all of the examined individuals determined were the number of platelets, the amount of antithrombin III, activated partial thromboplastin time, international normalized ratio, fibrinogen content, soluble fibrin monomer-complexes, von Willebrand factor, protein C and S in blood plasma. Results. In patients with stable angina of the II-III functional class originally noted was an increase in the level of the von Willebrand factor in plasma by 43%, while in patients with acute coronary syndrome - by 67% compared with the control figures, the content of fibrinogen in blood plasma exceeded the control values by 18.8% and 68.8%, respectively. In patients with acute coronary syndrome the concensoluble fibrin monomer-complexes was initially increased. In the evaluation of plasma hemostasis in patients of both groups revealed was a significant decrease of the international normalized ratio and activated partial thromboplastin time values, which was more pronounced during acute coronary syndrome than in the control group. Conclusion. In patients with ischemic heart disease present was a thrombogenic shift of the hemostasis indices toward hypercoagulation, which is most evident in acute coronary syndrome, suggesting the presence of chronic intravascular blood coagulation.

Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 20132022 was used.

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

Transesophageal echocardiography is widely used in clinical practice in patients with atrial fibrillation and it is mainly applied to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, as well as to determine the tactics for surgical interventions. Transesophageal echocardiography has an advantage over transthoracic echocardiography in visualizing the left atrium and left atrial appendage, common sites of thrombus formation in patients with atrial fibrillation. Due to the anatomical proximity of the esophagus to the heart, the transesophageal access avoids signal fading and incorrect interpretation of the study results. The possibilities of transesophageal echocardiography in patients with atrial fibrillation have expanded with the development of medical technology, and three-dimensional transesophageal echocardiography has become widespread. In recent years, the studies on the use of the transesophageal echocardiography in patients with atrial fibrillation during the coronavirus pandemic have been published. The review presents the results of studies, meta-analyzes of pooled samples, as well as clinical cases, demonstrating capabilities of transesophageal echocardiography in patients with atrial fibrillation. A brief history of the development of the method, work on the study of the technology features and capabilities of transesophageal echocardiography for pulmonary vein ablation, cardioversion, occlusion of the left atrial appendage in patients with atrial fibrillation, as well as studies on disadvantages of the transesophageal echocardiography and possible options for their elimination are presented. Comparison of the transesophageal echocardiography with transthoracic and intracardial echocardiography is also highlighted. In preparing the review, the literature search method in PubMed databases for the period 20122021 was used, as well as data from an earlier period to indicate the history of the method development.