The review presents the contemporary literature data and the results of our own research concerning the impact of particulate matter of polluted air on the cardiovascular system. The short-term and long-term effects of air pollution are discussed in the context of a particle size, chemical composition, and a source of origin.

Aim. The aim of the study was to determine the effects of interventional treatment for atrial fibrillation (AF) on the dynamic changes in the system of extracellular matrix proteolysis. Material and methods. A total of 50 patients were included in the study: 27 patients (18 males) had persistent AF (mean age of 62.1±9.4 years); 23 patients (14 males) had long-lasting persistent AF (mean age of 64±11 years). All patients received radiofrequency antral pulmonary veins isolation and linear lesions on the back wall of the left atrium and the mitral isthmus with CARTO system (Biosense Webster, USA). Blood serum changes in the parameters of extracellular matrix proteolysis and concentrations of growth factors including matrix metalloproteinase (MMP)-1, MMP-3, MMP-9, tissue growth factor β1 (TGF-β1), tissue inhibitor of matrix metalloproteinases 1 (TIMP-1), and fibroblast growth factor (FGF) were determined before the Maze procedure, immediately after the procedure, after 1 day, 3 months, and 6 months. Results. The concentrations of all MMPs immediately after the Maze procedure dramatically decreased most likely due to significant thermal damage of the left atrium. On the next day after the procedure, the MMP-1 concentration restored to the initial level, the MMP-3 concentration remained at the same level, whereas the MMP-9 concentration drastically increased to the level exceeding the initial value. After 3 months, the concentrations of MMP-1 and MMP-3 were near the initial levels, whereas MMP-9 concentration dropped to the level recorded immediately after the procedure. After 6 months of observation, the MMP-1 concentration demonstrated downward trend and was lower than the initial value; the MMP-1 level also did not reach the initial level; and the MMP-9 concentration returned to the initial level. The TGF-β1 concentration also dramatically dropped right after the procedure and slowly recovered during 6 months of follow-up. The decrease in the TGF-β1 concentration immediately after the procedure can be explained by massive cell death in the atrial myocardium. One day after the procedure, the TGF-β1 concentration increased and reached the initial level, but it decreased after 3 and 6 months. Conclusion. The reductions in the concentrations of MMPs and growth factors in the absence of AF after the Maze procedure resulted from the arrest and perhaps the reversal of the structural remodeling.

Aim: to evaluate the associations between polymorphisms of the APOA1 (rs670), APOA5 (rs662799) and ACE (rs4646994) genes and traditional risk factors for CHD in patients with ST-segment elevation myocardial infarction. Materials and Methods: A total of 58 STEMI patients, admitted in the Kemerovo Cardiology Clinic for diagnosis and treatment, were included in the study. Blood samples for genotyping were collected at days 2-14. Clinical and demographic data, laboratory and instrumental findings were assessed. Data analysis was performed using the STATISTICA software (version 8.0; StatSoft, Tulsa, Oklahoma) and the genetic calculators (GeneXpert) with the construction of different inheritance models. Results: Carriership of the T allele of the T-1131C APOA5 polymorphism was associated with the presence of myocardial infarction in anamnesis (OR=1.75, 95% CI=1.05-2.92, p=0.04), acute cerebrovascular events (cerebral vascular accidents) in history (OR=3.4, 95% CI=1.16-11.38, p=0.02), and diabetes mellitus (DM) (OR=2.29, 95% CI=1.03-5.11, p=0.04). The A allele of the APOA1 gene had a protective effect against the presence of chronic heart failure (OR=0.32; 95% CI=0.14-0.73; p=0.01). Carriership of the I allele of the ACE gene was associated with the presence of angina in history (OR=1.56, 95% CI=1.08-2.26, p=0.02). Conclusion: Certain polymorphic variants of genes, involved in lipid metabolism and arterial hypertension ( APOA1, APOA5, ACE ), are associated with traditional cardiovascular risk factors that can be used in further evaluation of the clinical severity of patients with STEMI.

Aim. The aim of the study was to elucidate the effects of inotropic myocardial support with Levosimendan on spectral and temporal parameters of heart rate variability (HRV) in patients with myocardial infarction (MI) complicated by heart failure (HF). Material and methods. A total of 153 patients with Q wave-positive MI complicated by heart failure (Killip II-III) aged from 34 to 84 years (mean age of 60 (54; 69) years) were assigned to two comparable groups: Group 1 (n=104) received Levosimendan in addition to standard therapy; Group 2 (n=49) did not receive Levosimendan. Twenty four-hour Holter monitoring with HRV evaluation was performed twice: at day 1 or 2 (before administration of Levosimendan in Group 1) and at day 5 or 6 after MI. Results. Patients of both groups did not differ in the frequency of registration and in the forms of arrhythmias in subacute period of MI. The initial parameters of HRV were comparable in both groups. Significant rank reduction for some temporal (SDNN, r-MSSD, pNN50) and spectral (TP, LF, HF) parameters was observed on day 1 and day 2 of MI in both groups. In subacute period of MI, HRV increased in both groups. However, in the presence of Levosimendan, an improvement in the temporal indexes (SDNN, r-MSSD, and pNN50) was more significant; the power of low frequency (LF) spectrum characterizing sympathetic tone increased; the power of high frequency (HF) spectrum characterizing the effects of parasympathetic tone on heart rate also increased. These data indirectly suggested an abolition of an imbalance in the autonomic nervous system. The number of patients with SDNN index lower than 50 ms, a significant predictor of poor prognosis, decreased by two times in Group 1 and did not change in Group 2. Conclusion. Abolition of autonomic nervous system imbalance and correction of hypersympathicotonia can represent the mechanisms of favorable clinical and, possibly, prognostic effects of Levosimendan in patients with MI complicated by heart failure.

The following research paper introduces the results of prospective randomized study comprising 72 patients with chronic total occlusion of the right coronary artery (RCA CTO). Participants were divided in 2 groups. All patients underwent cardiac magnetic resonance imaging (CMRI) with pharmacological stress-test for the evaluation of myocardial perfusion. Group 1 received endovascular recanalization of RCA CTO; group 2 received standard medical treatment. The follow-up examinations were performed at 2 and 12 months. All participants were evaluated as myocardium ischemia high risk patients (≥2 segments affected). After 2-month post randomization, statistically significant decrease in the number of segments with perfusion defects (-2.05 segments ranging from -2.58 to -1.52, 95% CI, р<0.001) and reduction in the number of high risk patients (from 39 (100.0%) to 29 (74.4%), р<0.001), were detected in group 1 compared with group 2. Neither of parameters in group 2 changed significantly at 1 year follow up. Therefore, according to CMRI data, PCI in patients with CTO RCA significantly reduced risk of myocardium ischemia; myocardial perfusion characteristics in patients without PCI remained unchanged.

The open, prospective, randomized comparative study included 68 patients who underwent successful elective endovascular intervention for atherosclerosis-related coronary artery stenosis. At baseline, all patients were taking statins as the standard lipid-lowering therapy long-term. Group 1 included 33 patients who received a loading dose of atorvastatin 80 mg 12 hours before the intervention and the same dose for 2 days with consequent reduction to the standard dose. Average total dose per patient was 320 (260-400) mg for 7 days of hospital stay. Group 2 included 35 patients treated with rosuvastatin 40 mg/day or 260 (240-280) mg for 7 days of hospital stay. The levels of cardiac biomarkers TnI and CK MB were determined at baseline, 12, 24, 48, and 72 hours after PCI. The study demonstrated that the use of high loading doses of potent statins (atorvastatin and rosuvastatin) with planned endovascular interventions on the coronary arteries had a similar impact on the dynamics of cardiac bio-markers during 72 hours after PCI. The use of a loading dose of rosuvastatin had an advantage due to significantly smaller increases in CK MB and TnI (26.7% and 27.1%, respectively) during the first 12 hours after the procedure, 24.3%-decrease in the number of patients with more than 1 x ULN TnI level, and due to 12.1%-decrease in the number of patients with increased CPK MB more than 3 x ULN after the procedure. These observations suggest less acute myocardial damage during the intervention in patients receiving a loading dose of rosuvastatin compared with those receiving a loading dose of atorvastatin.

The aim of the study was to investigate the long-term changes in arterial blood pressure after sympathetic denervation of the renal arteries. The analysis included a total of 54 patients with resistant hypertension who underwent renal denervation and was monitored for 12 month. Arterial blood pressure within 6 months after the intervention was significantly lower compared with the initial values in these patients. After 12 months, there was a downward tendency in arterial blood pressure values. In addition, the number of responders to the sympathetic renal denervation increased by 11% by the end of the first year of the follow-up.

Here we present the method for protecting the cells from peroxidation by simultaneous stimulation the pro- and anti-oxidant systems with 1.4-dithioerythritol 3.0 mM and ascorbic acid 0.1 mM.

The dynamics of composition, quantitative parameters and morphological characteristics of white blood cells and platelets, and endothelial vasodilatory function was studied in spontaneously hypertensive rats (SHR) from 5^th to 12^th week of life. Sequence of the changes in the study indicators was elucidated. Simultaneously with an increase in arterial blood pressure, relative lymphocyte count and platelet anisocytosis index increased in SHR compared to WKY rats at 6 weeks of age. Disturbance of endothelial vasodilatory function in SHR developed at 8 weeks of age after the development of sustained arterial hypertension and the occurrence of a number of changes in leukocyte and platelet parameters. Perhaps the change in the properties of white blood cells and platelets is one of the factors in the formation of endothelial dysfunction in hypertension.

The article presents the results of the study of ultrastructural changes of the kidneys in the dynamics of total non-fatal hypothermia in the experiment. Data showed minimal ultrastructural changes in the kidneys in the presence of systemic hypothermia at -10 °С and more pronounced changes at -18 °С. The ultrastructural changes in the kidneys suggested the decline in functional activity of the renal tubular apparatus in the presence of hypothermia.

The aim of this study was to elucidate the effects of long term therapy with verapamil and its combinations with diuretics on blood pressure and lipid metabolism in hypertensive patients. We studied 26 hypertensive patients. The following parameters were estimated: 24-hours ambulatory blood pressure monitoring (ABPM), plasma levels of the lipids and glucose. All parameters were evaluated before and after 6-month therapy. Goal BP was achieved in 54% of patients with monotherapy by verapamil and in 96% of patients treated by combination of verapamil and diuretics. Moreover, after 6 month, there was a decrease in LDL levels both in patients with monotherapy and with combination of verapamil and diuretics. According to our data, therapy with verapamil in hypertensive patients demonstrated good profile of tolerance, significant antihypertensive effect, and improved lipid metabolism even after diuretic adding.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome (BWGS) occur in 0.45-0.24% of all congenital heart disease (CHD) cases. 80-90% patients die without operation during their first year of life. There are two types of ALCAPA syndrome: the infant type and the adult type. Aim. Objective of the study was to evaluate the ultrasound diagnostic signs of BWGS in children and causes of errors. Methods. Total database comprised 6912 cases; 19 BWGS patients aged 12 days to 10 years were examined. Echocardiography, ECG, and coronarography were performed. Results and discussion. Isolated ALCAPA was diagnosed in 16 patients (0.23%); combination of ALCAPA with other CHD was diagnosed in 3 patients (0.04%). The ultrasound signs of BWGS were releases of the left coronary artery (LCA) from the pulmonary trunk, reverse flow from the lateral wall of PA, collateral flows between the RCA and LCA, LV remodeling with myocardial dysfunction, and mitral regurgitation. Diagnostic difficulties were due to the fact that BWGS “wears masks” of other diseases such as: myocarditis, dilated cardiomyopathy, mitral insufficiency, and myocardial infarction. Left ventricular remodeling can be associated with endocardial fibroelastosis. Direct visualization of the LCA arising from the pulmonary artery is not 100%-specific diagnostic sign which remain undetected by sonographer. The presence of reverse blood flow in the pulmonary trunk depends on pathophysiological phase, pulmonary pressure, and the development of collateral circulation. Therefore, it cannot be detected in some patients. In some patients, only collateral flows were present. Sometimes, mitral regurgitation due to ischemic genesis is underestimated and its causes are not determined. Thus, differential diagnosis is required for children with signs of LV remodeling and heart failure in the presence of mitral regurgitation and BWGS; the evaluation of coronary arteries should be included in the Echo algorithm.

The analysis of the results of immunomodulatory drug-based treatment of multiple sclerosis (MS) with calculation of the volume of tissue damage and the use of magnetic resonance imaging (MRI) at control stages is presented. The article describes the diagnostic MRI criteria of loci of brain tissue damage and their temporal changes in MS during the follow-up period for as long as up to 2 years. The contrast-enhanced study with paramagnetic agent not always enables detection of the presence of MS progression whereas the changes in the number and area of hot spots as well as their migration may be more indicative of worsening of the disease compared with the results of the contrast-enhanced study.

The article focuses on the role of the Department of faculty therapy of Siberian State Medical University, Alma Mater of Siberian therapeutic school, establishment and development of cardiology in Siberia and the Institute of Cardiology, the team of which celebrated its 35th anniversary.

The article presents the biography of the famous Russian surgeon Nikolay A. Rogovich and his contribution to the development of Russian surgeries. The author gives a brief review of his scientific, educational, medical, and social activities.

This study aims to examine the regional features of mortality from external causes in the Sakha Republic (Yakutia) in the period of 1990-2012. As sources, we used the data of the Federal Statistics Service, Territorial Department in the Sakha Republic (Yakutia); medical certificates of death (form No. 106/у-02); forensic examination reports; certificates of death of the Civil Registry Office in the SR(Y) for the given period. The study was conducted using the statistical, analytical, and mathematical methods, and the methods of comparative analysis. It has revealed the negative impact of human losses from accidents in children and working-age people on the demographic situation in the republic. In the children aged from 1 to 14 years, those dying of external causes made 65% of the total deaths in this age group, 91% in children aged 15-17 years, and 37% in able-bodied persons. The structure of external causes of death was dominated by homicides (16.0%) and suicides (22.3%), with all road accidents accounting for 12.0%. According to the 2012 data, the mortality rate from suicide (40.1 per 100 thousand people) was by 48% higher than the average rate (20.8) in the Russian Federation and by 23% higher than the corresponding rate in the Far Eastern Federal District (30.8). The mortality rate from homicide in Yakutia (28.0 per 100 thousand people) was by 61% higher than the average rate (10.8) the Russian Federation and by 22% higher than in the Far Eastern Federal District (21.7). In addition, the suicide rate in Yakutia exceeded by almost 2.5 times the critical parameters defined by WHO experts (20 suicides per 100 thousand people). The study has also revealed the intra-regional differentiation of mortality from external causes. The most unfavorable situation was observed in the Arctic group of regions with a relatively low level of social and economic development. Lower death rates from external causes, including violence, were recorded in the industrial regions with more favorable social and economic environment, better infrastructure, and a developed network of health institutions.

We studied the role of malignant tumors in the formation of the loss of public health of the industrial city in the period of 1970-2010. The study included population living in the proximity of the nuclear industry enterprises. Data showed that malignant tumors were one of the main causes of deaths among the adult population (19.4%), deaths among people of working age (22.8%), life potential loss (9.2%), labor potential loss (46.4%), economic loss (10.0%), and primary disability cases among working age population (20%). Studying the role and prevalence of risk factors for the development of malignancies including the factors of long-term professional exposure to technogenic radiation is required.