CURRENT ISSUES OF MODELING HEART FAILURE AND MYOCARDIAL FIBROSIS IN RATS

Complex Issues of Cardiovascular Diseases, Journal Year: 2025, Volume and Issue: 13(4), P. 126 - 137

Published: Jan. 11, 2025

Highlights Methods for modeling heart failure in rats are classified into models requiring surgical intervention, toxic, genetic and autoimmune models, based on the effects of physical factors, use special dietary regimens. It is impossible to single out a ideal model, since development multifactorial process, it preferable combination several methods. The correctness choice model its compliance with tasks future research must be confirmed by combining diagnostic methods verifying myocardial fibrosis - laboratory, histological, instrumental. Annotation Detailed study mechanisms main pathogenetic factor, fibrosis, required developing new effective treatment strategies. an appropriate key reliable experimental study. aim review systematize current data rats. advantages these animals high genetic, biochemical physiological similarity humans, ease breeding, availability maintenance, small size, while allowing surgery. This article classifies currently available rat failure, discusses their pathophysiological basis, timing formation clinical features, disadvantages each model. authors have paid particular attention developed domestic scientists. assessing influence drugs considered. requires animal assess biochemical, functional, morphological changes damaged myocardium, controlled testing drugs. Should necessity arise, specialists should simultaneously, whereas strategy depends

Language: Английский

Clinical and anamnestic predictors of poor long-term prognosis in patients with chronic heart failure and implanted cardioverter-defibrillator

Terapevticheskii arkhiv, Journal Year: 2025, Volume and Issue: 97(1), P. 21 - 28

Published: Feb. 20, 2025

Aim. Identification of a complex clinical and anamnestic predictors an unfavorable long-term prognosis in patients with heart failure low left ventricular ejection fraction implanted cardioverter-defibrillator (ICD). Materials methods. In 260 ICD included the ”Kuzbass Register Patients ICD”, data were obtained on status alive/dead, causes death cardiovascular events during 4-year follow-up period. The clinical-instrumental socio-demographic parameters entered into register before implantation used to compile prognostic regression model. Results. A total 348 (endpoints) recorded, which 54 deaths. main cause 48 (88.9%) was acute decompensated failure. According multivariate analysis, factors that increase risk outcome model were: level systolic pressure pulmonary artery, thickness interventricular septum, social status, presence chronic obstructive disease, ventricle absence renin-blocker angiotensin-aldosterone system (model sensitivity – 70%, specificity 75.9%, AUC=0.8). Conclusion. use predictive practice will make it possible personalize approaches making decision need for further monitoring order improve their survival.

Language: Английский

Sudden cardiac death and decompensation of heart failure: how to reduce the risks. A review

Terapevticheskii arkhiv, Journal Year: 2025, Volume and Issue: 97(1), P. 80 - 85

Published: Feb. 20, 2025

The main causes of death in patients with heart failure (HF) are sudden cardiac and decompensation HF, especially a low left ventricular ejection fraction. prediction prevention risk factors for the development these conditions important goals both guideline-directed medical therapy electrophysiological treatment methods. article presents an overview clinical studies devoted to study implantable cardioverter defibrillators death, highlights issues monitoring course HF. Special attention is paid multisensory devices equipped unique set sensors early diagnosis HF decompensation. It expected that practical use such will reduce number exacerbations hospitalizations by detecting signs threatening blood circulation before appearance active symptoms, as result mortality this category patients.

Language: Английский

Clusters of patients with chronic heart failure based on the analysis of body composition parameters and palliative status

Bulletin of the Medical Institute REAVIZ (REHABILITATION DOCTOR AND HEALTH), Journal Year: 2025, Volume and Issue: 15(1), P. 72 - 78

Published: March 20, 2025

The aim of the study : to divide a heterogeneous group patients with chronic heart failure, taking into account parameters body composition and severity painful symptoms. Object methods . involved 298 CHF. was assessed: presence sarcopenia obesity (with calculation muscle mass index), functional class, left ventricular ejection fraction, markers galectin-3, hsCRP sodium uretic peptide, Bartel index. A 10-point Edmont scale used assess two-stage cluster analysis performed. Results Three clusters were identified in patient structure: share first overall structure 23.2%, second – 61.1%, third 15.8%. It determined that includes sarcopenic obesity. They are characterized by maximum galectin level fraction sample. have low walking speed, dynamometry, NТ-proBNP. intermediate position is occupied (patients isolated disorder or without it). high dynamometry indicators, 6-minute test value, Barthel Patients people weight sarcopenia. Sarcopenia Fast questionnaire T6W indicators significantly reduced fractions NТ-proBNP level. most pronounced pain fatigue lowest depression. In cluster, pain, fatigue, drowsiness, nausea, shortness breath, anxiety, well-being expressed much less than other clusters. And highest appetite disorders, depression, deterioration well-being. Conclusions distressing symptoms varies depending on and, accordingly, patient's composition, which can be constructing algorithms for providing palliative care

Language: Английский

Comorbid conditions in patients with chronic heart failure (according to the registry of chronic heart failure in the Tyumen region)

Consilium Medicum, Journal Year: 2024, Volume and Issue: 25(10), P. 685 - 692

Published: Jan. 31, 2024

Background. Comorbidity in patients with chronic heart failure (CHF) makes a major impact to the course of both underlying and concomitant diseases, significantly worsens prognosis increases mortality from cardiovascular diseases. Improving specialized treatment within framework three-tier model providing medical care CHF is healthcare priority. Aim. Analysis frequency comorbid conditions included registry Tyumen region. Materials methods. The study was conducted using register method, which has been operating region since January 2020. Medical data outpatient cards discharge reports were entered by doctors 9 polyclinics an attached population, 1 consultative polyclinic, hospitals, on basis there are rooms structure city Tobolsk, Zavodoukovsk, with. Nizhnyaya Tavda, Yalutorovsk, Region, Ural Federal District. 5741 I–IV functional classes (FC). Gender, clinical-instrumental laboratory data, non-cardiac cardiac diseases according International Classification Diseases 10th revision into single map registry. Results. In sample CHF, whose average age 70.0±9.7 years, 2331 (40.6%) men 3410 (59.4%) women. most common were: coronary artery disease – 55.4%, HD 22.5% HRT 13.5% cases. Among reasons, diabetes mellitus often noted 31.5% cases, kidney 31.1% obstructive pulmonary 10% Concomitant more III–IV. Conclusion. Maintaining analyzing it possible assess required volume care, plan necessary time, material, economic organizational resources take account difficulties diagnosis, monitoring.

Language: Английский

EPIDEMIOLOGICAL ANALYSIS OF COMORBID DISEASES DETERMINING THE PROGNOSIS OF AN ELDERLY PATIENT WITH TYPE 2 DIABETES MELLITUS

Успехи геронтологии, Journal Year: 2024, Volume and Issue: 37(4), P. 363 - 372

Published: Oct. 1, 2024

Language: Русский

EPOCH-CHF As A Mirror of the Current Problems in Cardiovascular Diseases Treatment in Real Clinical Practice

Kardiologiia, Journal Year: 2024, Volume and Issue: 64(11), P. 48 - 61

Published: Nov. 30, 2024

Aim To analyze the main reasons for impairment of life prognosis patients with chronic heart failure (CHF) in real clinical practice Russian Federation. Material and methods Representative samples population Nizhny Novgorod region (1998, n=1,922) European part Russia followed from 2002 through 2017 (n=19,276), as well randomly selected medical records outpatients under dispensary monitoring CHF 19 therapeutic preventive institutions three constituent entities Federation (n=177, 2022) were analyzed adherence to therapy effectiveness treatment. In addition, prevalence, etiology, acute decompensated (ADHF) determined a EPOCH study. Results The EPOCH-CHF study first time true prevalence (8.2% by soft criteria) 3.1% (by strict criteria). Furthermore, reduced ejection fraction (EF) was 0.8%, moderately EF 0.9%, preserved 1.4% all studied whom HF defined criteria. EPOCH-Hospital Stage studies confirmed that long-term exposure body arterial hypertension ischemic disease significantly influenced development CHF. At same time, myocardial infarction, diabetes mellitus uncorrected defects can induce severe within short period. both after ADHF stable is very poor. Within 4 years, 55.2% die; no patient III-IV FC survives longer than 10 years; I-II are at 75% risk die 16 years follow-up. This related an ineffective use basic drugs uncoordinated follow-up patients. Conclusion analysis showed high level coverage but low compliance national guidelines, which reflected doses drugs, lack effective hemodynamic control and, consequence, poor CHF, regardless its course or decompensation.

Language: Английский

Heart failure and netosis: a modern view of pathophysiology and treatment methods

HERALD of North-Western State Medical University named after I I Mechnikov, Journal Year: 2024, Volume and Issue: 16(4), P. 5 - 18

Published: Dec. 20, 2024

Over the past 20 years, prevalence of chronic cardiac insufficiency in Russian Federation has increased from 6.1 to 8.2%. Chronic, mild inflammation is also one main factors affecting development and progression insufficiency. The purpose review analyze literature data on role netosis pathogenesis insufficiency, as well consider new potential possibilities therapy. As a result research search, 3366 publications were extracted PubMed 2223 found using Google Scholar. search queries included following keywords their combinations: “netosis”, “neutrophil extracellular traps”, “NET”, “heart failure”, “myocardial infarction”, “atrial fibrillation”, “coronary heart disease”, “myocarditis”. mechanisms neutrophil traps formation contribution certainly require further study. In particular, direct fibrosis, hypertrophy dysfunction left ventricle still unknown. However, recent genetic pharmacological studies show that inhibitors myeloperoxidase, elastase peptidylargine deiminase can be effective, at least conditions unfavorable remodeling after myocardial infarction, valve diseases decompensated ventricular hypertrophy, deterioration which leads These results are important for understanding pathophysiology developing methods its treatment.

Language: Английский

Phenotypic clusters and biomarkers profile in patients with chronic heart failure with preserved and mildly reduced left ventricular ejection fraction

Terapevticheskii arkhiv, Journal Year: 2024, Volume and Issue: 96(12), P. 1137 - 1143

Published: Dec. 27, 2024

Aim. To study the profile of cardiac biomarkers (NT-proBNP – N-terminal pro-brain natriuretic peptide, sST2 soluble growth stimulation expressed gene 2, galectin-3, copeptin) in clusters patients with chronic heart failure preserved (CHFpEF) and mildly reduced (CHFmrEF) left ventricular (LV) ejection fraction (EF). Materials methods. The included 135 CHF LV EF40%. All signed informed consent. Results. Patients were senior age 76 [65; 82] years; 56% are women. most common comorbid diseases hypertension ischemic disease, including previous AMI, CKD, obesity AF. During cluster analysis, 4 identified: 1 “ischemic”, which men aged 64 [57.5; 76.3] years old coronary artery disease myocardial infarction COPD. 2 “hypertensive”, represented by elderly women 80.0 [74.3; 85.5] arterial hypertension. 3 “maladaptive multiple organ disorders” AF, signs pulmonary hypertension, lower EF (48 [43; 54]%) CKD. “cardiometabolic” female 71 [60.0; 78.0] old, type diabetes, CKD In there higher concentrations NT-proBNP (1640 [746; 2218] pg/ml; p=0.0015), (25.2 [17.0; 54.5] ng/ml) galectin-3 11.8 [9.5; 14.3] ng/ml highest one-year mortality rate 33.3%. Conclusion. Four distinct EF40% identified that differed clinical characteristics, prognosis: ischemic, hypertensive, cardiometabolic maladaptive dysfunction. These results confirm heterogeneity CHFpEF CHFmrEF create prerequisites for development personalized approaches to therapy.

Language: Английский

Associations of the left ventricle myocardial deformation parametrs with cardiovascular risk in patients with an implanted cardioverter-defibrillator

Journal of Arrhythmology, Journal Year: 2024, Volume and Issue: 31(1), P. 39 - 46

Published: Jan. 23, 2024

Aim . To study the impact of left ventricle (LV) deformation parameters by two-dimensional strain method to assess intended use cardioverter defibrillator implantation for primary prevention sudden cardiac death. Methods The included 133 patients with congestive heart failure NYHA 3-4 functional class a LV ejection fraction ≤35%, taking optimal drug therapy. speckle-tracking echocardiography estimation indicators (segmental strains, global longitudinal and circular [GLS GCS, respectively]) was carried out, after which purpose death performed. enrolled in were observed prospectively two years operation (visits clinic 3, 6, 12, 18, 24 months) registration first-time ventricular tachyarrhythmias (VT) paroxysms assessment one-year cardiovascular mortality. Results arrhythmic endpoint appeared 27 (20%), 19 (14%) died due acute decompensation failure. Comparative analysis studied did not reveal statistically significant differences groups survivors deceased patients. Patients VT had worst characteristics. It found that at absolute values GLS<6% risk first manifestation during observation period increased almost threefold (odds ratio (OR)=2.59; 95% confidence interval (CI): 1.07-6.26; p=0.031). second independent predictor point anterior wall (OR=1.28; 95%CI: 1.14-1.45; p=0.0001 univariate OR=1.55; 1.18-2.04; p=0.002 multivariate analysis). Based on multifactor analysis, myocardial deformation, age, sex, ischemic disease, predictive model obtained predict 71% sensitivity 97% specificity. area under curve 0.916 (95%CI: 0.850-0.981; p=0.0001). Conclusion do help mortality, but may be useful stratification risk. achieve this GLS value as well segmental map regional strains can used.

Language: Английский