Aim. Based on the autopsy data, to analyze mortality patterns of the Zabaykalsky Krai population over a three-year period in the group of out-of-hospital sudden cardiac death (SCD).Material and methods. The protocols of deceased persons without evidence for violent death were analyzed with distribution into groups depending on age, sex and cause of death. Descriptive statistics were used for statistical processing.Results. The leading positions (58% of cases) in mortality patterns are occupied by various types of coronary artery disease (CAD). Chronic coronary syndromes were detected in 21%, cardiomyopathy — in 11%, decompensated heart failure — in 7%, myocarditis — in 1% of cases. Acute types of CAD were found in 68,4% in men and 31,6% in women. Among men, the number of such cases increases from 31 to 70 years of age and decreases over 70 years old. Among women, there is an increase in the SCD prevalence in the group over 70 years old.Chronic coronary syndromes were found in 46,4% in men and 53,6% in women. In both groups the number of cases increases with age. The maximum sex differences are observed in the group over 70 years old. The mean age for men is 72,2±8,8 years, for women — 77,2±10,4 years. Blood alcohol was detected in 10,2% of cases. The mean age of the deceased in all age groups of persons with identified blood alcohol was 66,2±12 years.In 1,89% of cases, I46 code (ICD-10) was established. The largest number of deaths among persons of both sexes was registered in the group of 31-40 years old, accounting for 36,8% among men and 13,2% among women. The mean age of the deceased was 35,8±8,4 years. In 28,6% of cases, ethyl alcohol was found in the biological media of the deceased in this group.Conclusion. Acute and chronic types of CAD make a significant contribution to out-of-hospital mortality. The number of SCD in men is higher than in women and is directly proportional to the age increase, reaching a maximum in the group over 70 years old. Ethyl alcohol, an important trigger of SCD, was detected in 10,8% of SCD cases in 2017, and in 15% in 2018 and 2019.

Aim. To study the structural and functional cardiac changes and arrhythmias in patients with type 1 diabetes (T1D) complicated with ketoacidosis.Material and methods. We analyzed 24-hour Holter monitoring data in 112 patients with T1D complicated with diabetic ketoacidosis (DKA). To assess the left ventricular (LV) diastolic function, all patients underwent echocardiography.Results. In patients with T1D complicated with DKA, the following cardiac arrhythmias were recorded: supraventricular arrhythmias — 60,7%, premature ventricular contractions — 26,2%, premature ventricular and supraventricular contractions — 13,1%. In 30% of patients with T1D complicated with DKA, premature ventricular contractions were classified as class 4A, in 10% — class 4B. With severe DKA, 5% of patients had short runs of unstable ventricular tachycardia. As the severity of ketosis increases, myocardial remodeling and LV diastolic dysfunction are recorded, as well as the spectral and temporal parameters of heart rate variability decrease.Conclusion. In patients with T1D complicated with DKA, structural and functional LV abnormalities, the development of LV diastolic dysfunction and cardiac arrhythmias are more often recorded. The most pronounced changes were found in the group of patients with T1D with moderate and severe DKA.

Background. The coronavirus pandemic has caused a rapid increase in the number of cases and high deaths worldwide. A new coronavirus infection in the presence of an initial cardiac pathology can provoke decompensation of chronic heart failure. Aim. To study the clinical features of postinfarction chronic heart failure occurring against the background of a new coronavirus infection. Material and methods. The study included 80 patients with decompensated chronic heart failure. Three groups have been formed. In patients of the first group (n=40), who underwent inpatient treatment for a new coronavirus infection, the cause of chronic heart failure was a previous Q-myocardial infarction. In patients of the second group (n=20), who did not tolerate COVID-19 earlier and at the time of the current hospitalization, the cause of chronic heart failure was a previous Q-myocardial infarction. The third group (n=20) consisted of patients with chronic heart failure of ischemic etiology without postinfarction cardiosclerosis, not previously and at the time of examination infected with the SARS-Cov-2 virus. Statistical analysis was carried out using the IBM SPSS Statistics V26 program. The KolmogorovSmirnov, KruskalWallis, and Pearson 2 tests were used. Results. Symptoms of left and right ventricular heart failure were equally common in all groups. Patients of the studied groups had a history of paroxysmal and permanent forms of atrial fibrillation, while the latter variant was more common in patients of the first group with chronic heart failure with postinfarction cardiosclerosis and coronavirus infection. According to echocardiography, the most pronounced structural and functional changes in the myocardium were also found in patients of the first group with postinfarction heart failure and a new coronavirus infection. Thus, statistically significant differences related to the size of the left atrium, end diastolic volume and end systolic volume of the left ventricle, systolic pressure in the pulmonary artery. An increase in the end systolic volume of the left ventricle by 94.6% was registered in the first group compared with the third group of patients (p=0.001). Systolic pressure in the pulmonary artery in the first group was 14.2% higher than the normal values (p 0.001), while in patients of the second and third groups this indicator was within the normal range. Conclusion. In patients with postinfarction cardiosclerosis suffering from a new coronavirus infection, symptoms of chronic heart failure are more pronounced, characterized by a significant decrease in exercise tolerance; cardiac arrhythmias are more often recorded, and structural and functional changes in the myocardium are of a maladaptive nature.

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Aim. To assess the patterns of microcirculation disorders and its effect on the left ventricular (LV) structure and function in patients with type 1 diabetes (T1D) complicated by diabetic ketoacidosis (DKA).Material and methods. The study included 128 patients with T1D complicated by DKA. Echocardiography was performed according to the standard technique. To study the microcirculation and vascular tone regulation, we used a laser Doppler flowmetry (LDF) using the LAKK-02 machine (Lazma, Russia).Results. In patients with T1D complicated by DKA, there was an increase in thepassive blood flow modulation with a depression of active factors. The most pronounced changes are recorded in 1-5 days of the disease. Along with this, a spectral redistribution in favour of respiratory and cardiac microcirculation ranges was demonstrated. With DKA, the myocardial remodelling is recorded: an increase in left atrial (LA) size by 5,6%, LV end systolic and diastolic dimension and volume by 5,3% and 6,7%, respectively, LV mass by 17,3% and LV mass index by 17,8%. Decreased LV ejection fraction (EF) in comparison with healthy individuals was obtained. Significant unidirectional changes in these parameters were revealed in comparison with the T1D patients without DKA.Conclusion. In patients with T1D complicated by DKA, the microcirculation decreases, as a result of which the adequate tissue supply is limited, vascular resistance and hemodynamic load increases, which leads to LV structural and functional changes.