Condition of the Right Heart in Patients With COVID-19­Associated Pneumonia: Follow-Up During Hospitalization.

Aim      Dynamic assessment of the right heart in patients with COVID-19-associated pneumonia of different severity during regression of the systemic inflammatory response (SIR).Material an methods    This single-center prospective study included 46 patients with the novel coronavirus infection COVID-19 and viral pneumonia according to chest multispiral computed tomography (CT). Laboratory and echocardiographic examinations of patients were performed.Results Based on the results of evaluation with the Clinical Condition Scale (CCS-COVID), patients were divided into two groups: group A, patients with a score from 6 to 9 and group B, patients with a score from 10 to 14. The study results of both groups were evaluated twice: on day 10±2.5 from the onset of symptoms (groups A10 and B10, respectively) and again on day 17±1.8 (groups A17 and B17, respectively). Patients of group B10 had more pronounced SIR (C-reactive protein, 111.38±52.5 mg / l) and a larger volume of ground-glass opacity (38.3±9.6 %). At the first stage, higher values of right ventricular global longitudinal strain (RV GLS) were detected in group B10 compared to group A10 (23.2±4.8 % vs. 19.9±3.5 %, р=0.048). During the regression of SIR intensity and the positive dynamics of CT, lower values of Е / А were observed in group B17 (1.0 [0.98; 1.2]) vs. group А17 (1.4 [1.18; 1.5, p=0.015), and е' / a' in group B17 (0.66 [0.58; 0.85]) vs. 0.95 [0.79; 1.12] in group B17 (p=0.010). Е / А and е' / a' ratios were correlated with total lactate dehydrogenase fraction (r= -0.452 and p=0.006; r= -0.334 and p=0.050, respectively).Conclusion      In patients with severe COVID-19-associated pneumonia during regression of SIR intensity, changes in the parameters that reflected RV diastolic dysfunction were observed.

[No Effect of the p.Arg230His Variant Of The VCL Protein on the Course of the Hypertrophic Cardiomyopathy In Russian Family Carrying The p.Gln1233Ter Pathogenic Variant In The MYBPC3 Gene].

Aim      To determine specific clinical characteristics caused by a combination of the rs397516037 pathogenic variant in the myosin-binding protein C (MTBPC3) and the rs749628307 polymorphic variant in the vinculin (VCL) gene in a Russian family of carriers and to evaluate the contribution of the rs749628307 polymorphic variant in the VCL gene to the development of hypertrophic cardiomyopathy (HCMP).Material and methods  The family under study included one healthy person and 3 patients with HCMP. A targeted analysis of proband's exome was performed. A structural alignment for both forms of the VCL protein, the canonical form and the form with p.Arg230His substitution, was performed.Results The pathogenic rs397516037 variant and the potentially pathogenic rs749628307 variant were detected in the proband and several family members. A possibly damaging variant rs749628307 was detected in the proband and several family members evaluated in this study. The structural alignment confirmed that the rs749628307 variant did not alter the protein structure significantly and could not cause an impairment or loss of the protein function.Conclusion      This study demonstrated that apparently the rs749628307 variant in the VCL gene does not affect the protein structure in a pathogenetically significant way, neither does it affect the severity and form of the clinical manifestations of HCMP; therefore, it cannot be considered as pathogenic.

[Myocardial ischemia in patients with hypertrophic cardiomyopathy].

Authors present is comprehensive clinical and instrumental evaluation of patients with HCM with myocardial ischemia. 104 patients (38.4% of men) with HCM were examined, mean age 58.2±14.7. The examination included risk factors assessment for CAD, ECG, Echo, stress ECG test, 24-hour ECG monitoring. In the presence of myocardial ischemia, CAG (n=66) and MSCT of the coronary arteries (CA) (n=4) were performed. All patients were split up on 2 groups: I - 70 HCM patients with myocardial ischemia, 67.3%, and II (the control group) - 34 HCM patients without myocardial ischemia, 32.7%. The group I was divided on 2 subgroups: 1 - 29 patients with coronary atherosclerosis (41.4%), 2 - 41 patient without coronary atherosclerosis (58.6%). Age (p=0.046), family history (p=0.037), higher systolic and diastolic arterial pressure, long-term arterial hypertension (p<0.05) were determined as significant risk factors for CAD. Smaller diameter of LAD (p=0.008), higher LV mass index, greater LV diastolic function disorder (p<0.05) were detected in group 2 compared to group II. The decrease in myocardial perfusion (MBG scale) was associated with high LV mass index and cardiac arrhythmias. The frequency of concomitant coronary atherosclerosis among HCM patients with myocardial ischemia was determined as 41.4%. Analysis of traditional risk factors for CAD in patients with HCM revealed the strong relation to age, aggravated by a family history of CAD, blood pressure level and duration of hypertension. Smaller diameter of LAD, higher LV mass index, greater LV diastolic function disorder were observed in HCM patients with myocardial ischemia without CAD.

[A Case of Apical Hypertrophic Cardiomyopathy With Rare Anomaly of Coronary Arteries Origin].

A clinical case of apical hypertrophic cardiomyopathy (HCM) in 44­years old man is presented. In this patient exercise ECG testing and 24­hour ECG monitoring revealed exercise-induced ST depression in the angiographically confirmed absence of coronary atherosclerosis. The uncommonness of this observation was the combination of HCM with a rare anomaly of coronary arteries origin.

[Hypertrophic cardiomyopathy and ischemic heart disease: the problem of pathology combination].

Hypertrophic cardiomyopathy (HCM) is a disease with left ventricular hypertrophy caused by mutations in the genes of myocardial contractile proteins, whose frequency is about 0.5 %. Due to the high incidence of anginal pain and marked changes in ECG with HCM, the problem of diagnosing the combination of HCM and coronary artery disease (CAD) presents a rather difficult task for the clinician. The complexity of this diagnosis is due to the ability of standard methods of instrumental examination (ECG, a test with physical activity, stress tests in conjunction with visualization of the myocardium) to detect myocardial ischemia in both СAD and HCM. In such cases, the coronary angiography, or multispiral computed tomography of coronary arteries (in patients with low СAD risk) remains the gold standard for detecting atherosclerotic lesions of the coronary arteries. The possibility of combining HCM and СAD in patients of older age groups raises the question of the features of the course of diseases and the prognosis of such patients.

[Tissue Doppler imaging and ultrasonic methods for evaluating myocardial deformation in the diagnosis of hypertrophic cardiomyopathy].

Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disease caused by mutations in genes that encode components of the sarcomere. Standard echocardiography is not always capable to identify regional systolic dysfunction of the left ventricle (LV), and to detect the disease on its preclinical stage. Genetic testing allows identifying sarcomere gene mutations in less than 50% of patients due to difficulty of screening all genes responsible for hypertrophic cardiomyopathy. Modern innovative methods of echocardiography - tissue Doppler, strain and strain rate, speckle tracking have been widely used for quantification of regional ventricular motion. Work of recent decades has proven the ability of these techniques to detect regional systolic and diastolic dysfunction of the LV, to diagnose HCM early, to differentiate it from other pathological and physiological hypertrophies. These modes can be used for prediction of cardiovascular complications in patients with HCM. In clinical practice the use of innovative technologies in combination with standard echocardiography allows to obtain more accurate and extensive information on the severity and prognosis of the disease.

Separation of ions from explosives in differential mobility spectrometry by vapor-modified drift gas.

Differential mobility spectrometry (DMS) of nitro-organic explosives and related compounds exhibited the expected product ions of M- or M x NO2- from atmospheric pressure chemical ionization reactions in purified air at 100 degrees C. Peaks in the differential mobility spectra for these ions were confined to a narrow range of compensation voltages between -1 to +3 V which arose through a low dependence of mobility for the ions in electric fields at E/N values between 0 and 120 Td (1 Td = 10(-17) V cm2). The field dependence of ions, described as an alpha parameter, ranged from -0.005 to 0.02 at a separation field of 100 Td. The alpha parameter could be controlled through the addition of organic vapors into the drift gas and was increased to 0.08-0.24 with 1000 ppm of methylene chloride in the drift gas. This modification of the drift gas resulted in compensation voltages of +3 to +21 V for peaks. The improved separation of peaks was consistent with a model of ion characterization by DeltaK or Kl - Kh, where Kl is the mobility coefficient of ions clustered with vapor neutrals during the low-field portion of the separation field waveform and Kh is for the same core ion when heated and declustered during the high-field portion of waveform.

[The determination of ampicillin in the blood and urine of patients by microcolumn high-performance liquid chromatography]. / Opredelenie ampitsillina v krovi i moche bol'nykh metodom mikrokolonochnoi vysokoéffektivnoi zhidkostnoi khromatografii.

The method of the quantitative determination of ampicillin in the blood serum and urine on the Soviet-made chromatograph "Milichrom" with an ultraviolet detector and 2 x 62 cm column is described. The conditions of chromatography were as follows: wavelength-210 nm; elution rate-100 microliters/min; analysis time-12 min. The conditions of chromatographic analysis were selected on sorbents Lichrosorb RP-18, Nucleosil S-18 and Silosorb S-18. The given method of ampicillin determination--is characterized by a high specificity, accuracy, the use of small volumes of the blood taken from a finger, the rapidity of making analyses and may be recommended for introduction in the clinical practice for optimization of treating patients with ampicillin.