BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of periphe...BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease(CHD).METHODS The study included a total of 218 patients(63±10.9 years of age;54%male)with CHD subjected to coronary angiography and routine diagnostic assessment,including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions.Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.RESULTS We demonstrated for the first time that the presence of atherosclerotic plaque with≥70%stenosis in femoral arteries was associated with significant coronary stenosis,with 93%sensitivity and 90%specificity,and thus can be used as an additional diagnostic marker for coronary stenosis.The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries,with a high correlation coefficient r=0.8(P<0.05).The presence of an atherosclerotic plaque in the femoral arteries with≥30% or≥70%stenosis was associated with a 30-or 70-fold higher odds ratio of coronary stenosis,respectively.CONCLUSION For resource-limited clinics,our findings suggest skipping carotids-femoral ultrasound alone may suffice to rule out severe CHD.Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.展开更多
Fatigue is among the most common,albeit underestimated,symptoms in patients with metabolic dysfunction-associated steatotic liver disease.It affects quality of life and reduces the effectiveness of non-pharmacological...Fatigue is among the most common,albeit underestimated,symptoms in patients with metabolic dysfunction-associated steatotic liver disease.It affects quality of life and reduces the effectiveness of non-pharmacological interventions,thereby negatively affecting the prognosis.This review discusses the clinical problems associated with increased fatigue,explores diagnostic methods,considers key pathogenetic mechanisms of this symptom development(including neuroinflammation,hyperammonemia,mitochondrial and muscle dysfunction,sleep disorders,changes in the composition of gut microbiota),and describes the role of interorgan communication(the liver-brain and gut-brain axes)in the formation of the central link of fatigue.The presented data emphasize the need for an integrated approach to the diagnosis and correction of fatigue,which would include not only the impact on metabolic disorders,but also on neurophysiological and behavioral factors.Early assessment of fatigue and targeted interventions on key pathogenetic links can increase the effectiveness of non-pharmacological intervention(which currently form the basis of metabolic dysfunction-associated steatotic liver disease therapy)and improve the prognosis of patients with this chronic liver disease.展开更多
BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve o...BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve of patients with chronic heart failure(CHF).At the same time,the significance of these parameters in patients taking beta-blockers for CHF is insufficiently studied,taking into account the negative chronotropic effect of drugs.In this regard,it is relevant to identify factors that can characterize the compensatory capabilities of a patient with CHF during 6MWT,not related to the calculation of heart rate.AIM To identify hemodynamic indicators of the adaptive capabilities of patients with CHF during paired 6MWT depending on their intake of beta-blockers.METHODS Seventy-four patients with compensated CHF due to coronary heart disease and/or hypertension formed the main group,comprising 46 individuals who were taking beta-blockers,and a comparison group comprising 28 individuals who had not been taking beta-blockers for at least one month before 6MWT.All participants underwent Doppler echocardiography(DECG),paired 6MWT,with assessment of hemodynamic parameters before and after both the first and second test.AI,THRR,blood pressure variability(BPV)were calculated.Multivariate,correlation analyses,univariate analysis of variance were used.RESULTS There were no significant associations between adaptation characteristics and DECG parameters or functional class(FC)of CHF in patients of the main group.In the comparison group,the indicators of compensatory reserve were significantly and directly associated with left ventricular ejection fraction(LVEF),and inversely with FC CHF and cardiac cavity size.In both groups,a greater difference in systolic blood pressure between the end of the first and the beginning of the second 6MWT was significantly associated with a higher index of right ventricular systolic dysfunction(Tricuspid annular plane systolic excursion)and LVEF,as well as a smaller left ventricular size and mass,and a lower pulmonary artery systolic pressure in patients in the main group.CONCLUSION Systolic BPV,measured immediately after 6MWT and 20 minutes after its completion,can indirectly characterize the compensatory reserve in patients with CHF,regardless of their beta-blocker intake.展开更多
The article presents an original method for the automatic assessment of the quality of event-related potentials(ERPs),based on the calculation of the coefficientε,which describes the compliance of recorded ERPs with ...The article presents an original method for the automatic assessment of the quality of event-related potentials(ERPs),based on the calculation of the coefficientε,which describes the compliance of recorded ERPs with some statistically significant parameters.This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines.The frequency of migraine attacks was correlated with the spatial distribution of the coefficientsε,calculated for EEG channels.More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region.Patients with infrequent migraines exhibited maximum quality in the frontal areas.The automatic analysis of spatial maps of the coefficientεdemonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.展开更多
文摘BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease(CHD).METHODS The study included a total of 218 patients(63±10.9 years of age;54%male)with CHD subjected to coronary angiography and routine diagnostic assessment,including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions.Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.RESULTS We demonstrated for the first time that the presence of atherosclerotic plaque with≥70%stenosis in femoral arteries was associated with significant coronary stenosis,with 93%sensitivity and 90%specificity,and thus can be used as an additional diagnostic marker for coronary stenosis.The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries,with a high correlation coefficient r=0.8(P<0.05).The presence of an atherosclerotic plaque in the femoral arteries with≥30% or≥70%stenosis was associated with a 30-or 70-fold higher odds ratio of coronary stenosis,respectively.CONCLUSION For resource-limited clinics,our findings suggest skipping carotids-femoral ultrasound alone may suffice to rule out severe CHD.Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.
基金Supported by Russian Science Foundation,No.23-45-10030.
文摘Fatigue is among the most common,albeit underestimated,symptoms in patients with metabolic dysfunction-associated steatotic liver disease.It affects quality of life and reduces the effectiveness of non-pharmacological interventions,thereby negatively affecting the prognosis.This review discusses the clinical problems associated with increased fatigue,explores diagnostic methods,considers key pathogenetic mechanisms of this symptom development(including neuroinflammation,hyperammonemia,mitochondrial and muscle dysfunction,sleep disorders,changes in the composition of gut microbiota),and describes the role of interorgan communication(the liver-brain and gut-brain axes)in the formation of the central link of fatigue.The presented data emphasize the need for an integrated approach to the diagnosis and correction of fatigue,which would include not only the impact on metabolic disorders,but also on neurophysiological and behavioral factors.Early assessment of fatigue and targeted interventions on key pathogenetic links can increase the effectiveness of non-pharmacological intervention(which currently form the basis of metabolic dysfunction-associated steatotic liver disease therapy)and improve the prognosis of patients with this chronic liver disease.
基金Supported by Ministry of Health of the Russian Federation titled Development of a Hardware-Software Complex for the Non-Invasive Monitoring and Prediction of Circulatory Decompensation in Patients with Chronic Heart Failure,No.125030703255-7.
文摘BACKGROUND The six-minute walk test(6MWT)allows to determine,in addition to the main parameters,the time of heart rate recovery(THRR),cardiac function,adaptation index(AI),which characterize the compensatory reserve of patients with chronic heart failure(CHF).At the same time,the significance of these parameters in patients taking beta-blockers for CHF is insufficiently studied,taking into account the negative chronotropic effect of drugs.In this regard,it is relevant to identify factors that can characterize the compensatory capabilities of a patient with CHF during 6MWT,not related to the calculation of heart rate.AIM To identify hemodynamic indicators of the adaptive capabilities of patients with CHF during paired 6MWT depending on their intake of beta-blockers.METHODS Seventy-four patients with compensated CHF due to coronary heart disease and/or hypertension formed the main group,comprising 46 individuals who were taking beta-blockers,and a comparison group comprising 28 individuals who had not been taking beta-blockers for at least one month before 6MWT.All participants underwent Doppler echocardiography(DECG),paired 6MWT,with assessment of hemodynamic parameters before and after both the first and second test.AI,THRR,blood pressure variability(BPV)were calculated.Multivariate,correlation analyses,univariate analysis of variance were used.RESULTS There were no significant associations between adaptation characteristics and DECG parameters or functional class(FC)of CHF in patients of the main group.In the comparison group,the indicators of compensatory reserve were significantly and directly associated with left ventricular ejection fraction(LVEF),and inversely with FC CHF and cardiac cavity size.In both groups,a greater difference in systolic blood pressure between the end of the first and the beginning of the second 6MWT was significantly associated with a higher index of right ventricular systolic dysfunction(Tricuspid annular plane systolic excursion)and LVEF,as well as a smaller left ventricular size and mass,and a lower pulmonary artery systolic pressure in patients in the main group.CONCLUSION Systolic BPV,measured immediately after 6MWT and 20 minutes after its completion,can indirectly characterize the compensatory reserve in patients with CHF,regardless of their beta-blocker intake.
基金partially supported by the Russian Federation Government Grant No.075-15-2022-1094(clinical data processing)supported by the Ministry of Science and Higher Education of the Russian Federation in the framework of the state assignment(FSRR-2020-0003)partially supported by the Russian Foundation for Basic Research(20-02-00752).
文摘The article presents an original method for the automatic assessment of the quality of event-related potentials(ERPs),based on the calculation of the coefficientε,which describes the compliance of recorded ERPs with some statistically significant parameters.This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines.The frequency of migraine attacks was correlated with the spatial distribution of the coefficientsε,calculated for EEG channels.More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region.Patients with infrequent migraines exhibited maximum quality in the frontal areas.The automatic analysis of spatial maps of the coefficientεdemonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.
