[Right ventricle free wall rupture during transcatheter occluder implantation in a patient with postinfarction rupture of the interventricular septum and COVID-19-associated myocarditis. Case report].

Intraventricular septum rupture is a rare mechanic complication of myocardial infarction associated with high mortality. This case describes STEMI in recovered patient after COVID 19 associated pneumonia, which was complicated by ventricular septum rupture followed by cardiogenic shock. It was managed by percutaneous occluder implantation. The procedure was complicated by right ventricular wall rupture. Postmortem examination of myocardium showed the signs of inflammation infiltrate and myocyte necrosis, according to histopathological Dallas criteria diagnosis of COVID-19 associated myocarditis was established. The COVID-19 pandemic has contributed to increasing cardiovascular mortality. This is typically attributed to diminishing resources for timely and appropriate medical care, and patients' late presentations for fear of contracting the infection. Cardiovascular complication of COVID-19 may be another contributing factor. Further research is needed to improve our understanding of the mechanisms and long-term sequelae of myocardium damage in COVID-19, to optimize treatment strategy and subsequent follow-up in such patients.

[Therapeutic Hypothermia in a Cardiac Arrest: Complicated Questions and Unsolved Problems].

The article aims to review the main trials, meta-analyses and guidelines regarding to various practical aspects and unsolved questions of an appliance of the therapeutic hypothermia in out-of-hospital and in-hospital cardiac arrest.

[Experience with Prasugrel in the Treatment of Patients with Acute Coronary Syndrome].

BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin and one of inhibitors of P2Y12 receptors (clopidogrel, ticagrelor, prasugrel) is an international standard of receptors (clopidogrel, ticagrelor, prasugrel) is an international standard of is an international standard of treatment strategy in patients with acute coronary syndrome (ACS). PURPOSE: to analyze experience of prasugrel use in the National Medical Cardiology Research Center in comparison to similar groups of patients treated with other P2Y12 inhibitors for determination of optimal place of DAPT with prasugrel in ACS patients. Materials and methods. We included in this retrospective study 40 patients who received therapy with prasugrel, ticagrelor, or clopidogrel in connection with urgent percutaneous coronary intervention (PCI) performed in the Department of Urgent Cardiology from May to December 2018. We analyzed specific characteristics of prasugrel treated patients including disease history, features of clinical presentation and coronary anatomy, use of strategies of escalation and de-escalation, as well as inhospital mortality, development of complications and side effects. Results. New P2Y12 inhibitors were more effective in patients with higher risk of atherothrombosis compared with risk of bleeding. Median of implanted stents in ticagrelor and clopidogrel groups was equal to 1, in the prasugrel group - 2 stents per PCI. When multivascular stenting was performed the choice usually was made in favor of prasugrel or ticagrelor, excluding cases with presence of limiting factors - use of oral anticoagulants (OAC) (n=4) and prehospital thrombolytic therapy (n=5). Of note was close to statistical significance high number of side effects related to ticagrelor use (n=3, 23.08%, p=0.057). There were no significant differences between groups in rates of unfavorable outcomes and complications. Conclusion. Administration of prasugrel can be considered in patients with high risk of atherothrombosis: with diabetes, with large number of implantable stents. The choice between ticagrelor and prasugrel can be made with consideration of the potential for side effects that significantly impair the quality of life of patients. Main limitations for application of both prasugrel and ticagrelor are the need to permanent use of OAC, prehospital thrombolytic therapy, and higher cost compared to clopidogrel.

[RESTORATION OF SYMPATHO-PARASYMPATHETIC BALANCE IN HEART RATE VARIABILITY IN THE DEVELOPMENT OF PSYCHOEMOTIONAL STRESS AGAINST THE BACKGROUND OF TAURINE IN EXPERIMENT].

In this fragment of the study, the change in the ratio of low (LF) and high frequency (HF) waves to the heart rhythmogram during prolonged immobilization (5 hours) of sexually mature white non-linear rats was studied by spectral analysis of heart rate variability, which causes psychoemotional stress and the accompanying vegetative equilibrium shift, indicating on the dysregulation of the sympatho-parasympathetic balance without and against the background of daily intraperitoneal injection of taurine (50 mg/kg) and its participation in the mechanisms of adaptive processes in the early poststress period (from 1 to 14 days). Spectral analysis of both absolute and relative indices of the I-th group (stress without taurine) revealed significant shifts in the frequency spectrum. On the first day after immobilization, the total power of the spectrum decreased by 4.3%, the HF component by 33.3%, and the level of VLF and LF-components increased by 25.5% and 25%, respectively, compared to the norm. On the 14th day after the immobilization, there is a decrease in tension, but the LF component is still above the norm by 5%. Calculations of the percentage ratios of the absolute values of the spectrum at different times of the post-stress period against the background of taurine injection showed that in the initial stage (immediately and on the first day after stress) a strong shift of activity toward sympathization occurs, and the absolute value of LF and VLF in the spectrum increased by 23,1% and 10.9% respectively. However, the complete restoration of the vago-sympathetic balance with the daily application of taurine occurs already on the 7th day after immobilization. The beneficial effect of taurine on the cardiovascular system was revealed when examining the scatterogram of the regression dependence of the heart rate, which revealed a smaller variation in heart rate and its stabilization on the 7th day after immobilization. Thus, the use of taurine immediately after stressful reactions is necessary to accelerate adaptive processes in the early post-stress period to prevent the development of stress pathology.

[THE ROLE OF TAURINE THE PROCESS OF ADAPTATION OF VISCERAL SYSTEMS UNDER PSYCHO-EMOTIONAL STRESS IN RAT].

In recent years the identification of regulatory mechanisms of the general adaptation syndrome, manifesting itself as the response of an organism to drastic changes in the environment and leading to emotional stress, acquires a special significance. The control over visceral functions plays a particular role in stress reactions because of emerging threat of violation of neurodynamic balance of sympathetic-para- sympathetic relationships with their most sensitive element - the heart. Quick adaptation to stress helps to restore not only the sympathetic-parasympathetic homeostasis but also the energy metabolism. One of the essential components, activating metabolic processes, is taurine. This paper considers the descending influence of the paraventricular nucleus (PVN) on neuronal reactions of the solitary tract nucleus (NTS), the first linking pathways of visceral sensitivity, the mechanisms of central control over visceral reactions by mathematical model analysis of heart rate variability (MMA HRV) as well as morpho-histochemical changes in brain structures integrating and regulating the visceral sphere (PVN of the hypothalamus and the amygdala) under psycho-emotional stress without and with intraperitoneal injection of taurine (50 mg/kg). Acute and semichronic experiments were conducted on white nonlinear rats under 5-hour- long immobilization psycho-emotional stress. A highly defined centralization of vegetative HRV parame- ters (HR, IVR, INRS) was revealed, these parameters being normalized on days 7 and 14 at the background of taurine injections. The interaction and interdependence of the central regulatory mechanisms of cardiovascular reactions are shown as well as a considerable protective effect of taurine on promoting early restoration of adaptive properties of the central and peripheral segments of visceral sensitivity under development of long-term psycho-emotional stress.

Observation of the naive-T-odd Sivers effect in deep-inelastic scattering.

Azimuthal single-spin asymmetries of leptoproduced pions and charged kaons were measured on a transversely polarized hydrogen target. Evidence for a naive-T-odd, transverse-momentum-dependent parton distribution function is deduced from nonvanishing Sivers effects for pi(+), pi(0), and K(+/-), as well as in the difference of the pi(+) and pi(-) cross sections.

The role of the septal nuclei in controlling the activity of vagosensitive neurons in the solitary tract nucleus in cats.

Studies on cats anesthetized with a mixture of Nembutal and chloralose were performed to study the descending influences of single, paired, and frequent stimulation of the lateral septal nucleus (LSN) and bed nucleus of the stria terminalis (BNST) on the activity of viscerosensory neurons in the solitary tract nucleus, identified by stimulation of the cervical part of the vagus nerve. Of 70 units recorded in the solitary tract nucleus, 50 were identified as primary and secondary input vagus neurons. Single stimuli applied to the septal nuclei induced initial excitation in 30% (15 units) of vagus neurons. The latent period of these responses was 5-25 msec. Presentation of paired stimuli showed that loss of the ability to respond to the second stimulus occurred at interstimulus intervals of 10-200 and sometimes 300 msec. A total of 34% (17 units) of solitary tract nucleus neurons showed tonic changes in spontaneous activity in response to rhythmic stimulation. Increasing the stimulation frequency to 10-20 Hz led to very different changes in the spontaneous rhythm, i.e., wave-like changes (decreases and increases in frequency, secondary suppression) or complete inhibition, sometimes lasting up to 10 sec after stimulation ended. A small number of units (five) showed a blocking effect of septal discharges on the visceral afferent input in conditions of paired stimulation. These results lead to the conclusion that the LSN and BNST are involved in modulating the activity of bulbar viscerosensory neurons, though their influences are mediated mainly via oligo- and polysynaptic pathways via other limbic structures (hypothalamus, amygdala).

Spontaneous and evoked hypothalamic unit activity in kittens during development.

Spontaneous and evoked hypothalamic unit activity in response to sensory stimuli was studied in acute experiments on anesthetized kittens. After the second day of postnatal development, spontaneous unit activity can be recorded in the posterior hypothalamus. Evoked responses to sciatic nerve stimulation were recorded on the fourth to fifth day after birth. In the early stages of development phasic and tonic types of unit responses are present in the hypothalamus, with some predominance of phasic. At the end of the third week responses of hypothalamic neurons in kittens have still not reached their definitive formation.