Search

Background. The results of numerous studies have demonstrated a strong relationship between cardiovascular mortality and cardiac biomarker levels. However, a significant number of these studies were devoted to assessing the prediction of cardiovascular events during the acute period of COVID-19. Therefore, the search for markers for predicting the unfavorable course of chronic heart failure in patients with type 2 diabetes mellitus (SD2) and CKD who have undergone COVID-19 is relevant.Objective. Purpose of the study was to prediction of the unfavorable course of chronic heart failure in comorbid patients who have undergone COVID-19.Materials and methods. The study included 181 patients with verified cardiovascular pathology and chronic heart failure with preserved ejection fraction of NYHA functional class 1-3, suffering from type 2 DM and CKD, which were divided into two groups: group 1 included 135 patients who had suffered COVID-19 not earlier than 3-6 months ago, in group 2 (n = 46) COVID there was no history of-19. The duration of the study was 18 months. Quality of life was determined using the Kansas and Minnesota Questionnaire, ECHOCG hemodynamics, glomerular filtration rate, cardiac dysfunction biomarkers NT-proBNP and sST2.Results. The results of the study showed that the reduced clinical and functional status of patients who had recovered from COVID-19 was confirmed by the results of TSC (p = 0.0004) and the total SJC score (p < 0.001). Low indicators of the physical component of health affected the summary assessment of quality of life in patients undergoing COVID-19 according to the results of the KCCQ questionnaires (55.81 points versus 62.86 points in the comparison group, p < 0.001) and MLHFQ (43.0 points versus 38.0 points in the comparison group, p = 0.002). In the first group, more significant adverse changes in the indicators of remodeling of the left heart and hemodynamic disorders were identified, which corresponded to significantly higher concentrations of markers of myocardial dysfunction. Using multivariate logistic regression analysis, a basic statistical model 1 was built to predict the probability of HF decompensation and cardiovascular death (CVD) in patients with chronic heart failure, diabetes mellitus type II and chronic kidney disease who underwent COVID-19. According to the obtained results, the most significant parameters for assessing the probability of CCT of Model 1 were the number of points on the clinical assessment scale, stroke volume, left ventricular mass index, NT-proBNP concentration. This model, sensitivity and specificity of which was 85.6%, 79.2% respectively, had a fairly high prognostic potential (AUC – 0.856; 95% CI: 0.717-0.994; p < 0.001). The inclusion of sST2 in the original model resulted in an increase in the area under the ROC curve (AUC – 0.91; 95% CI: 0,812-0,992; р < 0,001). Thus compared to the baseline model including NT-proBNP concentration, the addition of sST2 increases the predictive power of the model with respect to the risk of CCT in patients with CHFsEF with diabetes mellitus and chronic kidney desease who have had COVID-19. The results of the calculations confirm the high quality of the model with a sensitivity of 93.3%, specificity of 78.9% and accuracy of 86.1%. Comorbid patients with chronic heart failure who underwent COVID-19 have more severe clinical manifestations, structural and functional disorders of the heart and kidneys, higher concentrations of biomarkers of cardiac dysfunction NT-proBNP and sST2. Soluble ST2 outperforms NT-proBNP in predictive properties and is a priority for assessing the risk of heart failure decompensation and mortality in patients with comorbid pathology who underwent COVID-19.

Aim. To evaluate the relationship between the level of galectin-3 (Gal-3) and left ventricular (LV) structural and functional characteristics in coronary artery disease (CAD) with NYHA class I-III heart failure (HF) with and without type 2 diabetes (T2D) and chronic kidney disease (CKD).Material and methods. We examined 120 patients (men — 68,3%) with coronary artery disease and class I-III HF, divided into 3 groups: group 1 — patients without T2D and CKD (n=40), group 2 — with CKD without T2D (n=40), group 3 — with T2D and CKD (n=40). The Gal-3 level was determined using the enzyme immunoassay, and LV global longitudinal strain (GLS) was determined using the speckle tracking method.Results. In patients with coronary artery disease and CKD, including T2D, Gal-3 was higher (p=0,048) (in group 1 — 12,55 [10,60;23,05], in group 2 — 16,60 [11,75;23,95], in group 3 — 16,90 [11,90;25,15] ng/ ml) and more closely correlated with volume parameters, LV ejection fraction and the ratio of early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e'). Grade 2 diastolic dysfunction (DD) in group 1 was in 10%, in group 2 — in 47,5%, in group 3 — in 60% of patients. The groups did not differ in GLS (p=0,087).Conclusion. An increase in Gal-3 concentration with worsening HF and correlations between the biomarker level and volume parameters, LV mass index, LV ejection fraction, GLS and diastolic dysfunction indicate its important role in the development of myocardial remodeling and fibrosis.

Introduction. Approaches to the introduction of negative feedback in pulse control systems regulating the parameters of electricity flow with pulse-width modulation (PWM) continue to attract research attention in the field of switch power amplifiers (SPA) and switch voltage converters (SVC). Evaluation of the potential of compensation methods is of importance when selecting power electronics devices for various purposes.Aim. To review compensation methods for parameter regulation and to investigate conditions for the operational stability of SVC with feedback on output voltage and current.Materials and methods. The research methodology included the theory of pulsed automatic control systems, the method of harmonic linearization with stability assessment according to Nyquist criteria, and the generating filter method based on multiple frequencies.Results. An analysis of operational stability conditions was carried out. Analytical dependences and graphical representation of the limit feedback values from the modulation parameters and the switch transformation scheme were proposed.Conclusion. The conducted study of the feedback depth in SVC, limited by the penetration of high-frequency components into the path of a width-modulated signal and its delay, due to the peculiarities of the terminal stage of the SPA, demonstrates that the limit value of the voltage feedback depth at typical circuit parameters does not exceed 12 dB, while the depth of the current feedback of the filter choke of the low frequencies can be fundamentally (more than 20 dB) higher. At the same time, the implementation of voltage stabilization and output current limitation modes for maintaining reliable operation in start-up and overload modes is possible only with the use of combined feedback.

Impaired kidney function has a negative impact on the course of heart failure in both patients with and without diabetes mellitus. Therefore, the development and study of the effectiveness of methods for the treatment of chronic heart failure, especially in patients with diabetes mellitus and chronic kidney disease, in order to improve the prognosis and reduce the risk of cardiorenal complications, is a priority for modern medicine. Inhibitors of the sodium glucose co-transporter type 2 today have a strong evidence base, not only as hypoglycemic drugs. Representatives from this group demonstrated cardiovascular safety and high efficacy in patients with chronic heart failure, both with reduced (EMPEROR reduced, DAPA-HF studies) and preserved left ventricular ejection fraction (EMPEROR-Preserved, DELIVER studies), regardless of the presence of sugar diabetes. An additional analysis of the conducted studies and specially planned projects showed the nephroprotective properties of the drugs. Long-term use of inhibitors of the sodium glucose co-transporter type 2 reduced the risk of progression of renal failure to the end stage and the severity of albuminuria in patients with chronic kidney disease. The proven cardiorenoprotective effects of gliflozins have expanded the boundaries of their clinical application. However, not all representatives of this group registered in our country can be recommended for patients with chronic heart failure and chronic kidney disease. From the standpoint of evidence-based medicine, dapagliflozin, empagliflozin, and canagliflozin have indications for use in various clinical situations. The article presents the results of randomized clinical trials on the use of sodium-glucose co-transporter type 2 inhibitors in patients with cardiovascular diseases, chronic heart failure, chronic kidney disease with and without type 2 diabetes mellitus. The effect of gliflozins on the course of chronic heart failure and renal outcomes was analyzed. The data of the latest studies CREDENCE, Dapa-CKD, EMPEROR-Preserved, VERTIS CV, STELLA-LONG TERM are covered in more detail. Keywords: chronic heart failure, chronic kidney disease, diabetes mellitus, type 2 sodium-glucose co-transporter inhibitor, empagliflozin, dapagliflozin, kanagliflozin, ertugliflozin, ipragliflozin.

The nanodisperse Al2O3 powders formation with carbon in a DC electric arc under the influence of an arc discharge between an D16T aluminum alloy electrode and a carbon electrode in the air atmosphere are studied. The effect of the arc current on the plasma-arc synthesis of an aluminum-carbon material, a precursor for production of hollow Al2O3 nanoparticles, was studied. It is found that with an increase in the arc current from 4 to 14 A, the amount of product increases by almost an order of magnitude, despite competing dissociation processes with an increase in temperature from 5000 to 5500 К.

This article presents a literature review dedicated to modern methods of noninvasive evaluation of efficacy of thrombolytic therapy in patients with ST-segment elevation in myocardial infarction. D-dimer as a probable marker of myocardial reperfusion and its role in thrombolytic therapy efficacy evaluation is under discussion.

The application of the diffraction method for backscattered electrons allows us to take a fresh look at the structural changes in the material as a whole and on the processes of destruction of metal structures in particular. The aim of this work was to apply the method of diffraction of backscattered electrons to reveal the characteristic distinctive features of the structure of the material in areas under the fracture and away from it.The diffraction of backscattered electrons is a method that allows one to determine the orientation of individual grains, the local texture, and also to identify the phases in the sample under research. This method can determine local and general deformations, the number of recrystallized and deformed grains, the size and misorientation of grains, etc.The results of a study of the mast fragment of the unit for drilling and repairing wells with a carrying capacity of 200 tons (APC-200) are presented with the establishment of characteristic structural differences between the sites under the fracture and away from it.The appearance and development of a subgrain structure at the site under the slope is established. It is shown that the material of the mast was made of rolled metal, for which no additional heat treatment was carried out, and destruction could occur at almost any point.

Aim. To evaluate the influence of carvedilol (Talliton, Egis, Hungary) on daily profile of blood pressure (BP), anatomical and functional conditions of left ventricle (LV) and cerebral circulation in patients with arterial hypertension (AH), stage II-III. Material and methods. 30 patients (10 men, 20 women, average age 51,9±7,9 y.o.) with AH II-III stage ( RSSC,2004) and with initially affected daily profile of BP, cerebral circulation, anatomical and functional disorders of LV took carvedilol 25-75 mg/d during 6 months. Hemodynamics was estimated by ambulatory BP monitoring, Doppler Echocardiography, and ultrasound Dopplerography of extra cranial vessels. Results. A normalizing effect of carvedilol on abnormal daily profile of BP and cerebral circulation was determined. The treatment resulted in the regress of LV hypertrophy with predominant reduction of interventricular septum thickness and also the transformation of concentrical LV hypertrophy in excentrical one. Conclusion. Long-term therapy with carvedilol in patients with AH II-III stage provides a stable BP control and cardioprotective effect, improves cerebral circulation.

It is demonstrated in the paper the process of transition from the interdisciplinarity (relationships between scientific theories as logical systems) to the dialogue and intersubjectivity (relationships between creators, authors of theories) and, further, to the convergence, such type of thinking, when science builds qualitatively new technosphere, which will become an organic part of nature.

The article is dedicated to the new economical technology of coatings on the base of titanium carbide by means of electro-spark processing of the details with SVS-reagents. The structures, phase and chemical compositions, micro-hardness, wear resistance of coatings are determined.

Functional properties of wear resistant combined coatings based on Ti are investigated in the paper. The coatings have been obtained with the help of combined technology that used electro arc evaporation and ionic nitriding methods. Wear resistance of the combined coating is five-fold higher than a standard TiN coating. The high-wear resistance is attributed to a secondary structure, which appears in the friction zone on the surface of the combined coating.

The paper proposes a technology of wear resistant coating formation on the basis of Ti. The combined technology includes electro arc evaporation in vacuum and ionic nitriding. Every technological stage of coating application has an influence on tiie structure formation of the combined coating.

In total, 30 patients with Stage II arterial hypertension, AH (ESH/ESC 2003; Society of Cardiology of the Russian Federation 2004), mean age 51. 93 ± 7.96years. For 6 months, participants received carvedilol (Talliton, Hungary, Egis) in daily dose 25-75 mg. Microcirculation, hemorheology, and lipid profile were assessed at baseline and after treatment, by conjunctival biomicroscopy and laboratory tests. Carvedilol corrected microcirculation due to its effects on vessels and capillaries, long-term carvedilol treatment didn't affected blood lipid profile, and beneficially influenced hemorheology

The study was focused on clinical equivalence of two amlodipine medications (cardilopin and norvasc) in patients with Stage I-III arterial hypertension (AH). Forty-two patients (mean age 52.1±3.9years) were divided into two groups, according to cardilopin or norvasc administration. At baseline and 6 months later, echocardiography (EchoCG), Doppler cardiac and vessel sonography were performed. Monthly blood pressure (BP) control demonstrated that BP target level was achieved by the end of Month One and sustained till the study's end, at similar doses of norvasc and cardilopin (5-10 mg/d). By the end of the study, left ventricular (LV) myocardial mass reduced, and prevalence of normal LV geometry increased, with significant improvement in LV diastolic function in both groups. Initially decreased linear blood flow parameters and pulse index, as well as increased extracranial vascular resistance, normalized by 6 months. Hemodynamic parameters were similar in both groups. According to its beneficial influence on initially disturbed hemodynamics, LV geometry and cerebral blood flow in AH patients, cardilopin is as effective as norvasc.

The possibilities of testing Centre of State national University of powder metallurgy in using of different methods and devices at analytical control of production are shown. On the basis of long-term working experience of testing Centre there are given recommendations to the works laboratories on using of spectral methods on definition of elementary composition of different classes materials.

In the article there are described the possibilities of the' program Autoscan Objects, intended for stereological analysis of the structured components of different materials. The principles of program creation and carrying out of analysis are shown. There is offered the program Autoscan Areas, intended for measurements of the surfaces, engaged by different phases, and also porosity of the examined materials.

The capabilities of the atomic-emission analysis in the foundry industry are shown when the composition of the starting raw material and final production are controlled. Both the operation principle and basic characteristics of a new atomic-emission spectrometer "EMAS-200", with a linear photodiode emission detector employed in its spectra recording system, are described. Also the applicability of this \^evice for production quality control in metallurgy is shown.

Aim. To access the effect of lisinopril (diroton) on cerebral circulation and blood rheology in patients with arterial hypertension stage II. Material and methods. The trial included 37 patients (16 males, 21 females) with a mean arterial hypertension (AH) history 15.9 ± 5.6 years. Diroton was given in a dose 10-40mg/dayfor 6 months. Cerebral circulation (total cerebral circulation and venous outflow - TCC and VOF) was accessed by means of doppler ultrasonography. Blood and plasm rheology was determined using a rotational viscozymeter ACP-2. Instrumental tests were performed at baseline and at the end of the study. Results. Rheology tests showed that diroton-treated patients achieved a significant decrease in blood viscosity in high, moderate and low shear stress and plasma viscosity, a decrease in platelet aggregation index and an increase in the index of erythrocytic deformability. All these changes were accompanied with a significant fall in fibrinogen and hematocrit. Doppler ultrasound revealed an insignificant increase in TCC and VOF. Conclusion. Diroton significantly improved impaired blood rheology and viscosity in AH patients as well as cerebral hemodynamics in patients with subnormal cerebral circulation and venous outflow at baseline.

Cerebral blood flow, blood rheology and viscosity during 6-month rilmenidin therapy (Albarel, Egis) were measured in 50 patients with arterial hypertension (JNC VII, 2003). Rilmenidin was administered once a day, in the dose of 1-2 mg/d. Total cerebral blood flow and venous drainage, assessed with Doppler ultrasonography, were initially reduced. By the end of the study, they increased significantly, by 16 % and 12,5 %, respectively. Rheology and viscosity parameters improved substantially, too.

Aim. To assess ramipril effects on microcirculation (MC) and cerebral blood flow (CBF) in patients with Stage II-III arterial hypertension (AH). Material and methods. In total, 37 patients with Stage II-III AH were examined. Thirty patients completed the study, receiving ramipril (2,5-20 mg/d) and hydrochlorothiazide (12,5 mg/d) for 6 months. At baseline, after one and six months, clinical examination, Doppler ultrasound of extracranial vessels, and MC assessment by conjunctival biomicroscopy were performed. Results. By the end of the study, target blood pressure level was achieved in 86% of the participants. Main parameters of MC and CBF correlated with each other. Ramipril therapy was associated with normalization of CBF and MC, primary due to the beneficial effects on capillary and intravascular MC. Conclusion. Inter-correlation between MC and CBF parameters support the interrelation between pathological processes in patients with AH and target organ damage, and also facilitate the assessment of ramipril protective effects on CBF. Long-term ramipril and hypothiazide therapy improved both MC and CBF in patients with Stage II-III AH.