АГ-артериальная гипертензия, АД-артериальное давление, ДАД-диастолическое артериальное давление, ЗПА-заболевание периферических артерий, ИБС-ишемическая болезнь сердца, ИСАГизолированная систолическая артериальная гипертензия, кфСПВ-каротидно-феморальная скорость пульсовой волны, ЛЖ-левый желудочек, ЛПИ-лодыжечно-плечевой индекс, МРТ-магнитно-резонансная томография, ПАД-пульсовое артериальное давление, плСПВ-плече-лодыжечная скорость пульсовой волны, ППИ-пальце-плечевой индекс, РА-ревматоидный артрит, САД-систолическое артериальное давление, СД-сахарный диабет, СКФ-скорость клубочковой фильтрации, СПВ-скорость пульсовой волны, ССЗ-сердечно-сосудистые заболевания, ССО-сердечно-сосудистые осложнения, ССР-сердечно-сосудистый риск, УЗИ-ультразвуковое исследование, ФВ-фракция выброса, ХБП-хроническая болезнь почек, ХПН-хроническая почечная недостаточность, ХСН-хроническая сердечная недостаточность, ЦАД-центральное аортальное давление, AIx-индекс аугментации, CAVI-сердечно-лодыжечный сосудистый индекс, D-путь, пройденный волной, Δt-время запаздывания. Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved.

АГ-артериальная гипертензия, АД-артериальное давление, ДАД-диастолическое артериальное давление, ЗПА-заболевание периферических артерий, ИБС-ишемическая болезнь сердца, ИСАГизолированная систолическая артериальная гипертензия, кфСПВ-каротидно-феморальная скорость пульсовой волны, ЛЖ-левый желудочек, ЛПИ-лодыжечно-плечевой индекс, МРТ-магнитно-резонансная томография, ПАД-пульсовое артериальное давление, плСПВ-плече-лодыжечная скорость пульсовой волны, ППИ-пальце-плечевой индекс, РА-ревматоидный артрит, САД-систолическое артериальное давление, СД-сахарный диабет, СКФ-скорость клубочковой фильтрации, СПВ-скорость пульсовой волны, ССЗ-сердечно-сосудистые заболевания, ССО-сердечно-сосудистые осложнения, ССР-сердечно-сосудистый риск, УЗИ-ультразвуковое исследование, ФВ-фракция выброса, ХБП-хроническая болезнь почек, ХПН-хроническая почечная недостаточность, ХСН-хроническая сердечная недостаточность, ЦАД-центральное аортальное давление, AIx-индекс аугментации, CAVI-сердечно-лодыжечный сосудистый индекс, D-путь, пройденный волной, Δt-время запаздывания. Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved.

Background. In order to provide personalized medicine and improve cardiovascular outcomes, a method for predicting adverse left ventricular remodeling (ALVR) after ST-segment elevation myocardial infarction (STEMI) is needed. Methods. A total of 125 STEMI patients, mean age 51.2 (95% CI 49.6; 52.7) years were prospectively enrolled. The clinical, laboratory, and instrumental examinations were performed between the 7th and 9th day, and after 24 and 48 weeks, including plasma analysis of brain natriuretic peptide (BNP), transthoracic echocardiography, analysis of left ventricular-arterial coupling, applanation tonometry, ultrasound examination of the common carotid arteries with RF signal amplification. Results. Patients were divided into 2 groups according to echocardiography: “ALVR” (n = 63)—end-diastolic volume index (EDVI) >20% and/or end-systolic volume index (ESVI) >15% after 24 weeks compared with initial values; “non-ALVR” (n = 62)—EDVI <20% and ESVI <15%. In the ALVR group, hard endpoints (recurrent myocardial infarction, unstable angina, hospitalization for decompensated heart failure, ventricular arrhythmias, cardiac surgery, cardiovascular death) were detected in 19 people (30%). In the non-ALVR group, hard endpoints were noted in 3 patients (5%). The odds ratio of developing an adverse outcome in ALVR vs. non-ALVR group was 8.5 (95% CI 2.4–30.5) (p = 0.0004). According to the multivariate analysis, the contribution of each of the indicators to the relative risk (RR) of adverse cardiac remodeling: waist circumference, RR = 1.02 (95% CI 1.001–1.05) (p = 0.042), plasma BNP—RR = 1.81 (95% CI 1.05–3.13) (p = 0.033), arterial elastance to left ventricular end-systolic elastance (Ea/Ees)—RR = 1.96 (95% CI 1.11–3.46) (p = 0.020). Conclusion. Determining ALVR status in early stages of the disease can accurately predict and stratify the risk of adverse outcomes in STEMI patients.

The aim of the study was to evaluate the diagnostic significance of ST-segment re-elevation episodes registered with telemetric ECG monitoring in patients with ST-segment elevation myocardial infarction (STEMI) treated with thrombolytic therapy (TLT). The study included 117 patients with STEMI following effective TLT. The elective coronary angiography followed by percutaneous coronary interventions was performed in the interval from 3 to 24 hours after a successful systemic TLT. Before and after cardiac catheterization, the telemetric ECG monitoring was performed using AstroCard Telemetry system (Meditec, Russia). During the study, two groups of patients were formed. Group 1 included 85 patients (72.6%) without new ST-segment deviations on telemetry. 77 patients (90.6%) had no recurrent coronary artery thrombosis at angiography. Eight patients (9.4%) from group 1 were diagnosed with thrombosis of the infarct-related coronary artery. Group 2 included 32 patients (27.4%) who underwent TLT and then had ST-segment re-elevation episodes of 1 mV or more in the infarct-related leads, lasting for at least 1 minute. In group 2, in 27 of 32 patients (84.4%), thrombosis of the infarct-related coronary artery was confirmed (p<0.01 compared with group 1). In 71.9% cases, the recurrent ischemic episodes were asymptomatic (‘painless myocardial ischemia’) (p<0.01). Thus, in patients with STEMI and successful TLT, re-elevation of ST-segment during remote ECG monitoring is strongly related to angiographically documented coronary artery thrombotic reocclusion. The absence of chest pain during recurrent myocardial ischemia requires continuous ECG telemetry to select patients for the rescue percutaneous coronary interventions at an earlier stage.

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