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Main causes of secondary hypertrophic cardiomyopathy include acromegalic cardiomyopathy. Heart damage in patients with the acromegaly is mediated both by the direct action of growth hormone and insulin-like growth factor-1, and increased deposition of collagen and lymphomononuclear cells in the myocardium, which leads to architectural changes, disturbances in fluid and electrolyte balance, severe left ventricular myocardial hypertrophy, diastolic and systolic left ventricular dysfunction and chronic heart failure. This article presents the world's first described observation demonstrating the possibility of successful transfemoral aortic valve repair to a comorbid patient with severe aortic stenosis according to the potential risks caused by the active form of the acromegaly.

Aim. To study myocardial perfusion in patients with coronary artery disease (CAD) with and without type 2 diabetes mellitus (DM) using volumetric computed tomography (VCT) of the heart with a pharmacological test with adenosine triphosphate (ATP). Materials and methods. The study included 93 patients, of which 18 had CAD with DM, and 50 had CAD without DM. All patients underwent one of the stress tests, cardiac VCT with ATP test, invasive coronary angiography, or CT coronary angiography. Left ventricle (LV) myocardial perfusion was evaluated for hypoperfusion zones and the calculation of semi-quantitative indices: decrease of LV myocardial density, LV myocardial perfusion index, transmural perfusion coefficient, and our proposed new indicator myocardial perfusion reserve (MPR). Results. The MPR index value in the hypoperfusion zones in patients with CAD and DM was 0.64 [0.620.66], in patients with CAD without diabetes 0.65 [0.630.66]; p=0.4; the value of the transmural perfusion coefficient in the areas of abnormal LV myocardial perfusion in patients with CAD and DM was 0.81 [0.800.86] versus 0.83 [0.800.85] in patients with CAD without DM (p=0.6). More hypoperfusion segments were observed in patients with CAD and DM (33.3%) compared to those without DM (14%; p=0.029). The MPR index in the hypoperfusion zones in patients with CAD with intact coronary arteries (CA) and DM was 0.56 [0.540.60] versus 0.55 [0.540.62] in patients with CAD with intact CA without DM; p=0.2. Conclusion. In patients with CAD and type 2 DM, according to the VCT with ATP test, more foci hypoperfusion areas were detected, regardless of the severity of coronary artery involvement, compared with patients with CAD without DM, which may be due to the microangiopathy in the myocardium. The similarity of the MPR parameters in the hypoperfusion zones associated with hemodynamic stenosis of the CA and with intact CAs indicates the ischemic genesis of these zones. For citation: Soboleva GN, Minasyan AA, Gaman SA, Rogoza AN, Molina LP, Soboleva TV, Shariya MA, Ternovoy SK, Karpov YuA. Type 2 diabetes mellitus and coronary artery disease: features of perfusion volume computed tomography of the heart in a pharmacological test with adenosine triphosphate. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(4):309315. DOI: 10.26442/00403660.2023.04.202158

An approach to testing artificial neural networks is described. The model of neural network is based on graph theory, and operations that are used in theoretical works devoted to graphs, trees, paths, cycles, and circuits. The methods are implemented in a C++ program in the form of a set of data structures and algorithms for their processing. C++ classes are used as data structures for implementing the processing of such objects as a graph vertex, edge, oriented and undirected graph, spanning tree, circuit. Lists of standard methods (constructors and destructors, different assigning operations) are given for all classes. Additional operations are represented in details, and among them – adding one graph to another graph, adding an edge to a graph, removing edges and vertices from graph, normalizing graph, and some more. Many different searching operations are offered. Variants of graph sorting operations are also included into graph model, some of them are similar to array sorting algorithms, and some are more specific. Above these low-level operations several more complex operations are considered as graph model components. These operations include building spanning tree for arbitrary graph, building cograph for spanning tree of a graph, discovering circuits in a graph, evaluating of circuit sign, and so on. Examples of the interfaces of the most important overloaded operations on the objects used are given. An example is given of implementation of one of testing procedures where overloaded operations of graph model objects are used.