[Cerebrovascular complications in patients with moderate and small stenosis of the carotid arteries in the hospital period of coronary artery bypass grafting using cardiopulmonary bypass]. / Tserebrovaskulyarnye oslozhneniya u patsientov s gemodinamicheski neznachimymi stenozami sonnykh arterii v gospital'nom periode koronarnogo shuntirovaniya s ispol'zovaniem iskusstvennogo krovoobrashcheniya.

OBJECTIVE: Assessment of the incidence of acute cerebral circulatory disorder (ACCD) and decompensation of chronic cerebral ischemia (CCI) in the hospital period of coronary artery bypass graft performed using artificial circulation in patients with- and without moderate and minor carotid artery stenosis. MATERIAL AND METHODS: One hundred and twenty-eight patients were examined. Neurological and neuropsychological examinations, neuroimaging were performed, concentrations of S100ß protein in blood serum were determined. RESULTS: In the group with stenosis, 3.5% of patients were diagnosed with ACCD, while patients without carotid artery damage did not have this complication. The frequency of decompensation of CCI in patients with stenosis was significantly higher (52%) compared with the group without stenosis (34%). Early postoperative cognitive dysfunction (POCD) with an equally high frequency was diagnosed in both groups: 63% with stenosis and 65% without carotid artery stenosis. A decrease in the strength and mobility of nervous processes, deterioration of memory, workability and increased exhaustion of attention were revealed. CONCLUSION: Patients with moderate and minor stenoses are more susceptible to the development of cerebrovascular complications than patients who do not have atherosclerotic lesions of the carotid arteries and need more thorough preoperative preparation.

[Stenosis of the carotid artery in women with ischemic stroke and markers of inflammation]. / Stenozy karotidnykh arterii u zhenshchin s ishemicheskim insul'tom i markery vospaleniia.

AIM: To assess the relationship between the severity of stenosis of the carotid arteries, the level of female sex hormones and markers of subclinical inflammation in women with ischemic stroke (IS). MATERIAL AND METHODS: Two hundred and eleven women (mean age 68.9±9.23 years) were examined. A history of cardiovascular disease, previous cardiovascular events, type and subtype of stroke were recorded. Neurological status was assessed using neurological scales. Atherosclerosis was diagnosed by color duplex scanning of brachiocephalic arteries and laboratory testing (estradiol, markers of subclinical inflammation). RESULTS: Carotid artery stenosis of ≥50% was found in 13.3% of patients, less severe stenosis in 36.0%. Stenosis of ≥50% was positively correlated with the level of IL-18, TNF-alpha, and negatively correlated with the level of IL-6, IL-4, and MMSE score. In dynamics, there was a decrease in the level of TNF-alpha in all groups of patients, and an increase in the IL-4 level in women with carotid artery stenosis of ≥50%. CONCLUSION: Study of the influence of markers of subclinical inflammation on the atherosclerosis progression and recurrent disorders of cerebral circulation in women with IS should be continued.

[The possibility of application of stimulant growth factor (ST2) for verifying postinfarction remodeling of myocardium.]

PURPOSE OF STUDY: To detect level ST2 in blood serum of patients with myocardium infarction in dynamics of hospital period and their relationship with remodeling of myocardium. MATERIALS AND METHODS: The study sampling included 87 patients (65 males and 22 females) with myocardium infarction and the ST-segment elevation and average age of 59 years. All patients were allocated in two groups: with adaptive alternative of remodeling of myocardium (67 patients) and deadaptive alternative (20 patients). The control group consisted of 30 individuals. At the first and twelfth days after myocardium infarction in blood serum content of ST2 and NT-proBNP were detected using immune-enzyme technique with application of test-systems produced by Critical Diagnostics (USA) and Biomedica (Slovakia) correspondingly. The data statistical analysis was processed using non-parametric criteria. THE RESULTS: He content of ST2 and NT-proBNP at the first day of myocardium infarction increased in 2.4 and 4.5 times correspondingly as compared with control group. The patients with deadaptive remodeling were characterized by in 1.5 times higher content of ST2 at the first day than in group of adaptive remodeling and in 5.3 times higher that in control group. In the end of hospital period (twelfth day) in both groups decreasing of level of ST2 was observed. The concentration of NT-proBNP at the first day was increased in 1.8 times in patients of both groups and decreased at twelfth day. At that there were no differences between both groups. The high level of ST2 at the first day increases the risk of development of deadaptive remodeling in 4.5 times, NT-proBNP only in 2.3 times. CONCLUSION: The high level of stimulant growth factor ST2 at the first day of myocardium infarction was associated with deadaptive alternative of post-infarction remodeling that permits using ST2 as prognostic marker with high sensitivity and specificity.