NON-INVASIVE CORONARY ARTERIES ATHEROSCLEROSIS CT-VISUALIZATION: UP-TO-DATE STANDARDS AND OWN CLINICAL EXPERIENCE STUDY. / NEINVAZYVNA KT-VIZUALIZATsIIa ATEROSKLEROTYChNYKh URAZhEN' KORONARNYKh ARTERII: SUChASNYI STAN PROBLEMY TA REZUL'TATY VLASNOGO DOSVIDU ZASTOSUVANNIa.

Non-invasive coronary arteries (CA) visualization experiences fast progress recently. Existing evidence-based dataand trials show that there is a great need in non-invasive technologies able to trustworthy and accurately identifyCA high risk atherosclerotic plaques (AP) and provide more insights into atherosclerosis pathophysiology in individ-ual patents, being accurate qualitative and quantitative methods of primary diagnosis and answer to therapeuticintervention indicators in patients with coronary artery (CAD). Until now in Ukraine there were no studies evaluat-ing accuracy of last generation 640-sliced computed tomography coronary angiography (CTCA) in diagnosing of dif-ferent CAD forms.Objective of the study was to study diagnostic accuracy of CTCA compared to invasive coronary angiography (iCAG)in the patients with different forms of chronic CAD before surgeon revascularization.Materials and methods. From I.2019 to V.2021 we prospectively studied 201 patients with different chronic CADforms (76.6 % men and 23.4 % women) aged (61.8 ± 9.2) years hospitalized to our center for diagnostic work-upand decision about primary or secondary revascularization (coronary aortic bypass (CABG) or percutaneous (PCI)intervention). All patients underwent planned CTCA and iCAG.Results and conclusions. There were no significant complication duing procedures performed. Totally 2412 coro-nary segments were visualized and studied. Coronary calcium index (CI) highly significantly correlated with overallburden and severity of atherosclerotic process (r = 0,73, р < 0.0001). CTCA compared to iCAG showed no false-nega-tive results and only 6 (2.99 %) false positive results in cases of insignificant lesions. There was no significant dif-ference in diagnostic accuracy for significant stenoses with very high accuracy for overall vessels lesions quantityand burden (r = 0.95, р < 0.0001) with very high prognostic method accuracy (AUC 0.99; OR >>1000, р < 0.0001),making high multi-sliced CTCA safe and extremely accurate method for qualitative and quantitative diagnosis of ath-erosclerotic CA lesions absolutely comparable to iCAG, including hemodynamic significance evaluation.

[Assessment of results of transesophageal echocardiography in patients with atrial flutter].

We performed 89 transesophageal electric cardiac stimulation procedures (TEECS) in order to restore sinus rhythm in 75 (84.3%) men and 14 (15.7%) women with type I atrial flutter (AF) due to coronary heart disease (n=59, 66.3%) and cardiosclerosis after myocarditis (n=30, 33.7%). Before cardioversion all patients underwent transthoracic and transesophageal echocardiography. All patients were divided into two groups: in group I (n=39) mean left atrium appendage ejection velocity was less or equal 40 cm/s, in group 2 (n=50) - > 40 cm/s. Patients of group I had significantly longer duration of AF episode, more often had concomitant hypertension and atrial fibrillation. Cardioversion in group I was less effective with frequent relapses and transformation into constant form. Patients of group 2 had no spontaneous contrast phenomenon grade II-IV and intra-atrial hemodynamics of type II-III, while at TEECS cardioversion straight into sinus rhythm without episode of transient fibrillation was observed significantly more frequently, suggesting possibility of shortening of anticoagulant preparation period before the procedure.

Left ventricle diastolic function in the patients after coronary arteries bypass graft combined with left ventricle aneurismectomy according to tissue doppler imaging: one year follow-up.

AIM: To evaluate left ventricle (LV) diastolic function dynamics in patients after acute myocardial infarction (AMI) after combined operation of coronary artery bypass graft with LV aneurismectomy (CABG + AE) according to the results of tissue Doppler imaging (TDI). METHODS: Forty patients after AMI underwent Doppler echocardiography (EchoCG) with TDI and M-mode colour-flow imaging before and in 3 and 12 months after CABG + AE. Mitral annulus (MA) TDI with velocity indices was performed in 4 segments of LV. RESULTS: Conventional transmitral diastolic Doppler indices before and after CABG + AE remained unchanged. TDI showed significant improvement of LV systolic (systolic movement velocity S: 6.1+/-0.8, 7.4+/-1.2 and 6.9+/-1.3 cm/sec. before and in 3 and 12 months after the operation, respectively, p<0.01) and diastolic function after the operation (MA early diastolic movement velocity (e'): 7.3 +/- 2.1, 8.4 +/- 1.5 and 8.9 +/- 1.8 cm/s.; ratio of transmitral early-flow velocity (E) to MA early-diastolic movement velocity (E/e'): 18.4 +/- 2.2, 12.3 +/- 1.8 and 11.5 +/- 2.3; ratio of E diastolic flow propagation velocity (Vp) 3.1 +/- 0.45, 2.2 +/- 0.38 and 1.8 +/- 0.16 before and in 3 and 12 months after the operation, respectively, p<0.01). CONCLUSIONS: Results of the study demonstrate significant improvement of LV diastolic function in the patient after CABG + AE according to TDI, regardless of transmitral flow pattern. TDI is more sensitive and preload independent method of LV myocardial function evaluation.

[Prospective study on the survival of patients with liver cirrhosis: state of the cardiovascular system].

Study of survival of patients with the help of disease severity Child-Pugh index which is a reliable marker of the liver cirrhosis forecast and control for efficiency of therapy. The determination of points in classes of disease severity differentiated by Child-Pugh index allows predicting the course of liver cirrhosis and decrease in points may suggest improvement of the disease. It is revealed, that one third of patients from a class C dies during two years as a result of the development of systolic heart failure.