[State of the art mathematical methods of the coronary blood flow modelling: background and clinical value].

X-ray computed tomography coronary angiography (CTCA) is a current method for diagnosing ischemic heart disease. Although this method has a high specificity and a negative predictive value in diagnosing coronary obstructions, there are limitations in determining the hemodynamic significance of the stenosis. Extensive use of noninvasive methods for evaluation of coronary hemodynamics, specifically evaluation of the fractional flow reserve (FFR) is limited due to its high cost and risks of complications. Mathematical modeling of coronary circulation and its reserve based on CTCA data is an up-to-date method that has been experimentally confirmed and clinically validated. This method showed a high diagnostic efficacy in several large studies that used the invasive determination of FFR as a "gold standard". This review addresses the current state of studies on mathematical modeling for fractional coronary reserve in patients with ischemic heart disease, as well as the limitations and prospects of this method.

[123 I-MIBG scintigraphy in the assessment of heart failure prognosis and effectiveness of cardiac resynchronization therapy].

Cardiac resynchronization therapy (CRT) is one of the methods of treating patients with chronic heart failure, which can reduce the mortality rate of this group. Scintigraphic assessment of sympathetic myocardial innervation allows us to evaluate the heart failure prognosis and the effectiveness of interventional treatment. The method is based on use of the radiopharmaceutical 123 I-methiodiobenzylguanidine (123 I-MIBG), which is a structural analogue of norepinephrine and is able to selectively accumulate in the sympathetic nerve endings. This review includes a brief description of norepinephrine metabolism and pharmacokinetics of 123 I-MIBG in the sympathetic nerve ending, a brief description of the study methodology and the clinical significance of this method in patients with heart failure. Particular attention is paid to the possibilities of using this method in patients with severe chronic heart failure before and after CRT.

[Perfusion-Metabolic Myocardial Scintigraphy in Prognosis of Left Ventricular Remodeling After Complex Surgical Treatment of Ischemic Cardiomyopathy].

PURPOSE: To study capabilities of perfusion-metabolic myocardial scintigraphy for prediction of the left ventricular (LV) reverse remodeling after comprehensive surgical treatment of ischemic cardiomyopathy (ICMP). METHODS: The study included ICMP patients aged 56±7 years (n=32) who underwent surgical correction of LV dysfunction (myocardial revascularization, LV reconstruction, and mitral valve restoration). Inclusion criteria were significant coronary artery disease; myocardial infarction; New York Heart Association (NYHA) class III-IV heart failure; LV ejection fraction (EF) ≤45%; LV end-systolic index (ESI) >60 mL/m2; and LV akinesia or dyskinesia according to echocardiography. Before surgery all patients were subjected to scintigraphy with 99mTc-MIBI (to assess perfusion) and with 123I-BMIPP (to assess myocardial metabolism). Scintigraphy results were expressed as median and lower; upper quartile (Me [lQ; hQ]). The clinical status and ventricular volume indicators were evaluated before surgery, in the early post-operative period (up to 4 weeks), and in the late post-operative period (12 months). RESULTS: At 12 months after intervention patients were divided into two groups: group 1 comprised patients (n=18) with beneficial outcome of the operation that stopped LV remodeling (ESI decreased, remained unchanged, or increased by.