Fundamental and practical aspects of coronary artery calcification

Барбараш, О. Л.; Кашталап, В. В.; Shibanova, I. A.; Коков, А. Н.

doi:10.15829/1560-4071-2020-4005

Cited by 11 publications

(10 citation statements)

References 51 publications

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“…В последние годы подобный подход стал применяться и для новых диагностических технологий или в случае изменения показаний к применению известной диагностической технологии. ОРИГИНАЛЬНЫЕ СТАТЬИ § В частности, анализируются не только диагностические возможности методов, но и способность на основании их данных стратифицировать риск развития ССО и определять тактику лечения (консервативное или инвазивное) [2,3].…”

Section: Discussionunclassified

“…Она включает разные клинические варианты, которые связаны с различным риском развития сердечно-сосудистых осложнений (ССО) [1]. Стратификация риска развития ССО позволяет прогнозировать течение заболевания, определяет оптимальную тактику его лечения и рекомендована всем пациентам с подозрением на ИБС, а также лицам с установленным диагнозом заболевания при прогрессировании симптомов [2,3]. Основными факторами, на основании которых проводят стратификацию риска развития ССО при стабильной ИБС, выступают фракция выброса (ФВ) левого желудочка (ЛЖ) <50 %, стеноз коронарных артерий (КА) ≥50 % и наличие распространенной зоны ишемии миокарда [1].…”

Section: автор для перепискиunclassified

“…В амбулаторной практике при первичном осмотре оцениваются факторы риска (ФР) и претестовая вероятность (ПТВ) ИБС [2,3], которые позволяют провести первичную оценку риска развития ССО и отбор пациентов для специфической неинвазивной диагностики ИБС. Однако использование ПТВ ИБС в прогнозировании и стратификации риска в популяции и отдельных когортах в Российской Федерации изучено недостаточно.…”

Section: автор для перепискиunclassified

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Stress Echocardiography by the ABCDE Protocol ln the Assessment of Prognosis of Stable Coronary Heart Disease

Zhuravleva,

Ryabova,

Vrublevsky

et al. 2024

Kardiologiia

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Aim. To assess the role of clinical indicators and parameters of stress echocardiography performed according to an extended protocol as predictors for the occurrence of a composite cardiovascular endpoint (CCVEP) in IHD.Material and methods. The study included 186 patients (60.2% men, mean age 60.6±9.9 years) with an established (n=73; 39.2%) and suspected (60.8%) diagnosis of IHD. Stress EchoCG with adenosine triphosphate (38.2%), transesophageal pacing (15.1%), dobutamine (2.6%), and bicycle ergometry on a recumbent ergometer (44.1%) was performed. The stress EchoCG protocol included assessment of regional wall motion abnormalities (WMA), B-lines, LV contractile reserve (CTR), coronary reserve (CR), and heart rate reserve. The median follow-up period was 13 [9; 20] months. The composite CCVEP included death from cardiovascular diseases and their complications, acute coronary syndrome, and revascularization and was defined at the first of these events. Statistical analysis was performed with the Statistica 16.0 and SPSS Statistics 23.0 software packages. Differences were considered statistically significant at p<0.05.Results. Invasive or noninvasive coronary angiography was performed in 90.3% of patients; obstructive coronary disease (stenosis ≥50%) was detected in 67.9% of cases. During the follow-up period, 58 (31.2%) patients had cardiovascular complications. The risk of developing CCVEP was associated with the pretest probability (PTP) of ischemic heart disease (odds ratio, OR, 1.05; 95% confidence interval, CI, 1.02-1.08), dyslipidemia (DLP) (OR 0.40; 95% CI 0.20-0.82), carotid atherosclerosis (OR 0.39; 95% CI 0.18-0.86), LV ejection fraction (OR 0.96; 95% CI 0.93-0.99), appearance at peak stress of new significant (2 LV segments or more) regional WMAs (OR 0.32; 95% CI 0.18-6.55), decreased LV CTR (OR 0.46; 95% CI 0.27-0.79) and CR (OR 0.33; 95% CI 0.18-0.61); p<0.05 for all. In a multivariate analysis with Cox regression, the model with clinical indicators included PTP of IHD (OR 1.04; 95% CI 1.01-1.07; p=0.01) and DLP (OR 0.14; 95% CI 0.02-1.01; p=0.05) as predictors. The model with stress EchoCG parameters included the appearance of new significant WMAs (OR 0.33, 95% CI 0.16-0.65; p=0.001) and reduced <2.0 CR (OR 0.44; 95% CI 0.24-0.82; p=0.01). A comparative analysis of Kaplan-Meier curves confirmed statistically significant differences in the dynamics of the CCVEP occurrence depending on the absence or presence of hemodynamically significant WMAs and/or reduced CR during stress EchoCG (p<0.01).Conclusion. Reduced LV CR and WMA during stress EchoCG in patients with suspected or confirmed IHD are significant independent predictors for the CCVEP occurrence. Among clinical indicators, PTP of IHD and DLP are of the greatest importance for prognosis.

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Section: Discussionunclassified

Section: автор для перепискиunclassified

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Stress Echocardiography by the ABCDE Protocol ln the Assessment of Prognosis of Stable Coronary Heart Disease

Zhuravleva,

Ryabova,

Vrublevsky

et al. 2024

Kardiologiia

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“…Метод STE применен у 273 (71,8%) из 380 больных (с высоким качеством визуализации при ЭхоКГ), включенных в "Проспективный регистр лиц, перенесших COVID-19-ассоциированную пневмонию", свидетельство о государственной регистрации базы данных № 2021622535. Впоследствии исключены больные с подтвержденной ишемической болезнью сердца [11] и артериальной гипертонией (АГ) с увеличенной массой миокарда ЛЖ по данным ЭхоКГ [12]; таким образом, в исследование включено 216 (56,8%) пациентов.…”

Section: материал и методыunclassified

Relationship between latent left ventricular contractile dysfunction and signs of immune inflammation in patients with COVID-19 pneumonia

Shirokov

Yaroslavskaya

Krinochkin

et al. 2023

Cardiovasc Ther Prev

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Aim. To investigate the relationship between echocardiographic parameters and laboratory immune inflammation signs in patients after coronavirus disease 2019 (COVID-19) pneumonia depending on the left ventricular (LV) involvement according to speckle tracking echocardiography (STE).Material and methods. The study included 216 patients (men, 51,1%, mean age, 50,1±11,1 years). The examination was carried out in patients 3 months after COVID-19 pneumonia. Patients were divided in 3 groups: group I (n=41) — diffuse decrease (≥4 segments the same LV level) of longitudinal strain (LS) according to STE; group II (n=67) — patients with regional decrease (LS reduction ≥3 segments corresponding to systems of the anterior, circumflex or right coronary arteries); group III — patients without visual left ventricle involvement (n=108).Results. There were no significant differences in LV ejection fraction — 68,9±4,1% in group I, 68,5±4,4% in group II and 68,6±4,3 in group III (p=0,934). A decrease in the global longitudinal left ventricle strain was detected significantly more often in groups I and II compared with group III (-17,8±2,0, -18,5±2,0 and -20,8±1,8%, respectively; p<0,001). At the same time, LS depression of LV basal level (-14,9±1,5, -16,8±1,2% and -19,1±1,7%; p<0,001), as well as a decrease in LS of LV inferior-posterior segments in group with diffuse involvement was detected significantly more often than in groups II and III. In addition, we revealed a significant difference in interleukin-6 concentration — 3,1 [2,5;4,0], 3,1 [2,4;3,8] and 2,5 [3,8;1,7] pg/ml, (p=0,033), C-reactive protein — 4,0 [2,2;7,9], 5,7 [3,2;7,9] and 2,4 [1,1;4,7] mg/l, (p<0,001), tumor necrosis factor-a — 5,9±1,9, 6,2±1,9 and 5,2±2,0 pg/ml, (p=0,004) and ferritin — 130,7 [56,5;220,0], 92,2 [26,0;129,4] and 51,0 [23,2;158,9] pg/l, respectively (p=0,025).Conclusion. A relationship was found between diffuse and regional left ventricular involvement according to STE and signs of immune inflammation in patients 3 months after COVID-19 pneumonia.

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“…Не вызывает сомнений ассоциация кальцификации коронарных артерий с ССЗ [6,7]. В Многоэтническом проспективном когортном исследовании измеренный с помощью мультиспиральной компьютерной томографии кальций в коронарных артериях (CAC >0) ассоциируется с почти двукратным повышением риска эпизодов сердечно-сосудистых событий независимо от статинотерапии [8].…”

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Calcification markers and long-term outcomes of coronary artery bypass grafting

et al. 2021

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Aim. To assess the long-term outcomes of coronary artery bypass grafting (CABG) and their association with calcification biomarkers.Material and methods. The study included 129 men (mean age, 61,5±7,5 years) with coronary atherosclerosis who were admitted for CABG surgery. Patients were divided into 2 groups: with favorable and unfavorable (death, myocardial infarction, stroke, surgery) 5-year prognosis after surgery. Before the surgery, the blood concentrations of calcification biomarkers (osteoprotegerin, osteopontin, osteonectin and osteocalcin) were determined in all patients.Results. Long-term outcomes of myocardial revascularization were studied in 92 patients (71%). An unfavorable long-term 5-year period was identified in 28 men (30,4%). In men with an unfavorable 5-year prognosis, the blood osteocalcin level before CABG was 1,2 times higher than in men with a favorable one. Multivariate linear regression showed that the risk of a 5-year unfavorable prognosis for coronary atherosclerosis after myocardial revascularization was associated with the blood osteocalcin concentration, determined before CABG (B=0,018, R2=0,285, p=0,008).Conclusion. The data obtained indicate the relevance of continuing studies on osteocalcin, including with respect to its contribution to coronary atherosclerosis and calcification.

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Fundamental and practical aspects of coronary artery calcification

Cited by 11 publications

References 51 publications

Stress Echocardiography by the ABCDE Protocol ln the Assessment of Prognosis of Stable Coronary Heart Disease

Stress Echocardiography by the ABCDE Protocol ln the Assessment of Prognosis of Stable Coronary Heart Disease

Relationship between latent left ventricular contractile dysfunction and signs of immune inflammation in patients with COVID-19 pneumonia

Calcification markers and long-term outcomes of coronary artery bypass grafting

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