Female and Male Phenotypes of Iron Deficiency in CHF. Additional analysis of the «The Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)¼ study.

Aim    To evaluate the incidence of iron deficiency (ID) in men and women with chronic heart failure (CHF) and to compare clinical and functional indexes in patient with and without ID depending on the gender.Material and methods    An additional analysis of the study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)" was performed. The study included 498 (198 women, 300 men) patients with CHF, in whom, in addition to iron metabolism, the quality of life and exercise tolerance (ET) were studied. 97 % of patients were enrolled during their stay in a hospital. ID was defined in consistency with the European Society of Cardiology (ESC) Guidelines. Also, and additional analysis was performed according to ID criteria validated by the morphological picture of the bone marrow.Results    ID was detected in 174 (87.9 %) women and 239 (79.8 %) men (p=0.028) according to the ESC criteria, and in 154 (77.8 %) women and 217 (72.3 %) men (p=0.208) according to the criteria validated by the morphological picture of the bone marrow. Men with ID were older and had more severe CHF. They more frequently had HF functional class (FC) III and IV (63.4 % vs. 43.3 % in men without ID); higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower ET. HF FC III increased the probability of ID presence 3.4 times (p=0.02) and the probability of HF FC IV 13.7 times (p=0.003). This clinical picture was characteristic of men when either method of determining ID was used. In women, ID was not associated with more severe CHF.Conclusion    Based on the presented analysis, it is possible to characterize the male and female ID phenotypes. The male ID phenotype is associated with more severe CHF, low ET, and poor quality of life. In females of the study cohort, ID was not associated with either the severity of CHF or with ET.

[The possibility of clinical diagnosis of non-massive pulmonary thromboembolism under conditions of limited availability of instrumental diagnostic tools].

The study included 105 patients with local segmental microcirculatory disturbances in the lungs and X-ray detectable pathologic changes of different localization or without them. The control group comprised 71 patients in whom perfusion scintiography revealed normal pulmonary circulation. Data on the patients' history, clinical and physical characteristics, results of laboratory analysis, functional-diagnostic, ultrasound and X-ray studies are presented. Discriminative analysis revealed significant differences between selected parameters that were used together with relevant canonical discrimination function coefficients to calculate "integral indices" characterizing clinical condition of individual patients. Their comparison in the affected and control patients allows to predict the probability of local segmental microcirculatory disturbances in the lungs and to enhance efficiency of diagnosis of non-massive thromboembolism of pulmonary artery.

[The effect of positive end-expiratory pressure on respiratory biomechanics in bronchial asthma]. / Vliianie polozhitel'nogo davleniia v kontse vykhoda na biomekhaniku dykhaniia pri bronkhial'noi astme.

The influence of PEEP breathing has been studied in 43 patients with exacerbation of bronchial asthma (BA) during 20 min in resistance of 5, 7 or 9 sm. Sputum expectoration and inspiration were found improved after PEEP breathing. Moreover, in some patients mild BA attacks relieved. Lung hyperinflation, bronchial obstruction reduced. A positive effect was observed in moderate asthma in PEEP breathing of 7 and 9 sm more frequently. This, PEEP breathing can be applied in the treatment of BA.