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We studied the relationship of inotropic responses of the isolated myocardium to stimulation of β 1 -and β 2 -adrenergic receptors (β-AR) with echocardiography parameters in 28 patients with coronary heart disease (CHD). Myocardial fragments (trabeculae of the right atrial appendage) were obtained during coronary artery bypass surgery. The inotropic response of the trabeculae was assessed in an isometric mode. Stimulation of β 1 -and β 2 -AR with agonists was performed against the background of preliminary α-AR blockade. In case of preserved ejection fraction, significant inotropic response of the trabeculae (135 (112; 154)% from the initial contraction amplitude) was observed after β 1 -AR stimulation, while in reduced ejection fraction, its significant increase was observed after β 1 -AR stimulation (126 (112; 170)% from the initial contraction amplitude). In patients with preserved and reduced ejection fraction, the correlations between the inotropic responses of the trabeculae to β 1 -and β 2 -AR stimulation and echocardiography parameters were different. The revealed differences reflect the degree of cardiac remodeling under condition of the studied pathology., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature.)

Performing cardiac surgery under cardiopulmonary bypass (CPB) and circulatory arrest (CA) provokes the development of complications caused by tissue metabolism, microcirculatory disorders, and endogenous nitric oxide (NO) deficiency. This study aimed to investigate the potential mechanisms for systemic organoprotective effects of exogenous NO during CPB and CA based on the assessment of dynamic changes in glycocalyx degradation markers, deformation properties of erythrocytes, and tissue metabolism in the experiment. A single-center prospective randomized controlled study was conducted on sheep, n = 24, comprising four groups of six in each. In two groups, NO was delivered at a dose of 80 ppm during CPB ("CPB + NO" group) or CPB and CA ("CPB + CA + NO"). In the "CPB" and "CPB + CA" groups, NO supply was not carried out. NO therapy prevented the deterioration of erythrocyte deformability. It was associated with improved tissue metabolism, lower lactate levels, and higher ATP levels in myocardial and lung tissues. The degree of glycocalyx degradation and endothelial dysfunction, assessed by the concentration of heparan sulfate proteoglycan and asymmetric dimethylarginine, did not change when exogenous NO was supplied. Intraoperative delivery of NO provides systemic organoprotection, which results in reducing the damaging effects of CPB on erythrocyte deformability and maintaining normal functioning of tissue metabolism.

We compared the expression of Са 2+ -ATPase (SERCA2a), calsequestrin (CASQ2), ryanodine receptors (RyR2) proteins and their genes (ATP2A2, CASQ2, and RYR2) in coronary heart disease (CHD) patients with and without comorbid type 2 diabetes mellitus. All studies were performed on the right atrial appendages resected during coronary bypass surgeries. Expression of SERCA2a and RyR2 proteins and their ATP2A2 (p=0.046) and RYR2 genes in comorbid pathology was significantly (p=0.042) higher (by 1.2 and 2 times; p=0.025). The expression of CASQ2 protein and its gene did not differ significantly between the groups (p=0.82 and p=0.066, respectively). It was concluded that the expression of SERCA2a and RyR2 proteins and their genes (but not CASQ2 and its gene) is elevated in CHD associated with type 2 diabetes mellitus. Expression of the studied proteins correlated with the expression of their genes. Increased expression of CASQ2 protein and its gene can probably prevent imbalance of the Ca 2+ -transporting systems in cardiomyocytes and contractile dysfunction of the myocardium, even in CHD associated with type 2 diabetes mellitus., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

We compared the capability of human fibroblasts to populate porous polycaprolactone (PCL) scaffolds modified during fabrication with surface-active agents Triton Х-100 (type 1 scaffold) and polyvinylpyrrolidone (type 2 scaffold). The mean fiber diameter in both scaffolds was almost the same: 3.90±2.19 and 2.46±2.15 μ, respectively. Type 1 scaffold had higher surface density and hydrophilicity, when type 2 scaffold was 1.6 times thicker. The cells were seeded on the scaffolds by the dynamic seeding technique and then cultured in Petri dishes with nutrient medium in a humid atmosphere. During 3-day culturing, no cell release from the matrix was noted. DAPI staining proved the presence of cells in both scaffolds. However, in type 1 scaffold the cells populated the whole thickness, while in type 2 scaffold, the cells were present only in the superficial layer. These findings suggest that PCL scaffolds modified with Triton Х-100 or polyvinylpyrrolidone are not cytotoxic, but the structure of the scaffold treated with Triton Х-100 is more favorable for population with cells.

We examined a total of 246 patients subjected to coronary artery bypass grafting with the use of the great saphenous vein (GSV). The patients were subdivided into two groups. Group One (n=121) patients endured procurement of the great saphenous vein by a new endoscopic technique in an open system with the help of the equipment Karl Storz and electric dissector Ligasure. In Group Two (n=125) patients the vein was harvested by means of the traditional open method. In all patients we evaluated complications in the early postoperative period 13±2.5 days after the operation. The rate of relapsing angina pectoris in both Groups turned out to be low and did not differ (1.65% in Group One and 1.6% in Group Two). Patients of the both groups differed significantly by the incidence of postoperative complications on the lower limbs in the zone of procurement of the GSV (9.09% in Group One and 26.4% in Group Two, p=0.131). Group Two patients (open method of procurement of the GSV) were considerably more often found to have developed cases of lymphorrhoea, haematomas, disjunction of the sutures (21.6%) compared with Group One (endoscopic method) patients (3.3%) (p=0.167), which in 10.4% of cases required secondary surgical debridement of wounds in patients after the open harvest of the GSV. Eventually, the length of hospital stay for Group Two patients increased significantly (15 ± 4.5 days) compared with Group One patients (8±1.1 days) (p=0.361). Hence, the endoscopic method of harvesting the GSV in the open CO2 system makes it possible to obtain a good cosmetic effect on the lower limbs after the operation, to considerably decrease the complications rate, thus reducing the length of hospital stay.

Objective: The aim of this study was to evaluate cognitive function, as measured by serial neuropsychological testing, and cerebral perfusion, as measured by brain SPECT scanning in patients with coronary artery diseases (CAD) following off-pump and on-pump coronary artery bypass graft surgery. Besides, the relationship between cerebral blood flow, cognitive functions, surgery parameters, and cardiac function in these patients were estimated. Also, brain-protective effects of instenon were studied., Methods: Brain SPECT and comprehensive neuropsychological testing were performed 1 day before, 10-14 days and 6 months after coronary artery bypass graft surgery (CABG). The study involved 65 patients (62 males and 3 females, mean age 55+/-2) who underwent CABG with cardiopulmonary bypass (CPB) (43 pts) and off-pump coronary revascularization (OPCAB) using the Octopus stabilization system (22 pts). In 21 cases employing CPB, for prevention of the impairments of cerebral perfusion and cognitive deficit instenon was administered., Results: CABG with the use of extracorporeal circulation is complicated by short-term and long-term neurocognitive dysfunction (in 96 and 55% cases, correspondingly). Also, in the early period after CABG, in 68% patients, decrease in regional cerebral blood flow (rCBF) was found, and after 6 months brain perfusion was lower than the baseline in 55% cases. Relationship between postoperative rCBF changes and the dynamics of cognitive function was found in early period and after 6 months following CABG., Conclusion: The coronary revascularization on beating heart or preventive administration of instenon in CPB patients helps significantly to diminish the risk of cerebrovascular complication.

Background: Twenty two patients with congestive cardiac failure treated surgically by dynamic cardiomyoplasty (CMP) with m. latissimus dorsi were examined. Myocardial perfusion was assessed with (199)TlCl scintigraphy combined with dipyridamole stress-test. In order to obtain direct evidence of myocardial perfusion from muscular flap we also injected a bolus of (99m)Tc into a. thoracodorsalis, with simultaneous blood sampling from coronary sinus. Haemodynamic parameters were assessed using radionuclide angiography., Methods: In a year of follow-up all the patients were assigned to one of two groups: eleven patients demonstrated improvement in clinical status (first group) and in another group comprising eleven persons no positive effect or deterioration were obvious (second group). The patients of the first group before operation revealed two times less persistent defect size than patients of the second group. Analysis of integral index of persistent defect revealed more expressive differences between groups. Before the surgical treatment the patients with improvement in clinical status after cardiomyoplasty demonstrated greater size of reversible defect in comparison with patients of the second group. In the second group coronary fraction of thallium accumulation was 1.4 times higher in comparison to the first group, as the result of myocardial hypertrophy in patients with bad prognosis. There were no significant differences between the two groups in Il/m level before cardiomyoplasty. Before the surgical treatment the patients with improvement in clinical status after cardiomyoplasty demonstrated greater ejection fraction in comparison with patients of the second group., Results: Cardiomyoplasty led to a decrease in the mean size of reversible defects due to indirect revascularisation. This hypothesis was testified to by the fact that in patients after cardiomyoplasty nuclide appeared in coronary sinus at 10-12th seconds after injection into artery thoracodorsalis through anastomoses between the latissimus dorsi muscle and the myocardium. The time of appearance of the second wave of rise gamma-counting in blood samples from coronary sinus reflects the repeated entry of radiopharmaceutical in myocardium after recirculation.

Thirty-five cardiomyoplasty procedures were performed in five patients with dilated and 30 patients with ischemic cardiomyopathies. Russian-made cardiomyostimulators (CMS) were implanted in these patients. Twenty-one patients underwent a one-step procedure using a left thoracotomy for cardiomyoplasty, while in 14 patients, a two-step procedure that included a mid-line sternotomy was carried out. During the average follow-up period of 9 +/- 2.1 months, studies were carried out that showed in survivors improved clinical functional status and decreased heart failure symptoms. Evidence of revascularization of the ischemic myocardium from the latissimus dorsi muscle (LDM) wrap was obtained by angiography and radioactive scintigraphy. In five patients, the CMS had to be removed due to complications, and in all these patients, their clinical functional status deteriorated following the cessation of cardiomyostimulation.

The pulmonary haemodynamics and thyroid hormone level were investigated in 21 patients with EKS-222 (VVI) pacemaker, implanted after successful transvenous electrical endocardial His-bundle fulguration (TEF). Triiodthyronine (T3) and thyroxine (T4) were determined by radioimmunoassay, pulmonary circulation parameters were estimated by means of radiocardiography and radionuclide ventriculography using an Omega 500 gamma-camera and a "Scintron MX" computer system. Patients with atrial fibrillation (AF) during VVI pacing had higher level of T3 and T4 and better pulmonary circulation parameters than those with persistent sinus node activity during paced rhythm.