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In case of antitumour anthracyclines therapy of patients with non-Hodgkin lymphomas the possibility of using speckle-tracking echocardiography is being considered. It was found that patients with non-Hodgkin lymphomas have early violations of the left ventricular myocardium during the course of antitumor chemotherapy using anthracyclines. They are characterized by reducing of longitudinal deformation of the myocardium with a gradual spread from the apical to the basal segments of the left ventricle. A statistically significant reduction in global and segmental systolic deformation after the 4th course of chemotherapy (cumulative dose of doxorubicin 333.5 88.5 mg/m2) is the earliest marker of left ventricular mechanical dysfunction, appearing before the development of diastolic dysfunction and ejection fraction reduction of the left ventricular. Early violations of myocardial mechanics in the dynamics of the course of antitumour therapy with anthracyclines are identified in the apical area of the left ventricle, it can be connected with circulatory failure in this area. Violations of myocardial mechanics in the apical area of the left ventricle can be an erly predictor of ischemia of this area with possible progression to global contractile muscle dysfunction of the left ventricular. The global longitudinall deformation of the left ventricular myocardium in contrast to ejection fraction of the left ventricular is more sensitive to myocardial damages against the backdrop of chemotherapy using anthracyclines. So, it can be used as an early preclinical marker of myocardial damage, that takes echocardiography closer to the most advanced methods of myocardial visualization.

Summary Background We developed a heterologous COVID-19 vaccine consisting of two components, a recombinant adenovirus type 26 (rAd26) vector and a recombinant adenovirus type 5 (rAd5) vector, both carrying the gene for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein (rAd26-S and rAd5-S). We aimed to assess the safety and immunogenicity of two formulations (frozen and lyophilised) of this vaccine. Methods We did two open, non-randomised phase 1/2 studies at two hospitals in Russia. We enrolled healthy adult volunteers (men and women) aged 18–60 years to both studies. In phase 1 of each study, we administered intramuscularly on day 0 either one dose of rAd26-S or one dose of rAd5-S and assessed the safety of the two components for 28 days. In phase 2 of the study, which began no earlier than 5 days after phase 1 vaccination, we administered intramuscularly a prime-boost vaccination, with rAd26-S given on day 0 and rAd5-S on day 21. Primary outcome measures were antigen-specific humoral immunity (SARS-CoV-2-specific antibodies measured by ELISA on days 0, 14, 21, 28, and 42) and safety (number of participants with adverse events monitored throughout the study). Secondary outcome measures were antigen-specific cellular immunity (T-cell responses and interferon-γ concentration) and change in neutralising antibodies (detected with a SARS-CoV-2 neutralisation assay). These trials are registered with ClinicalTrials.gov, NCT04436471 and NCT04437875. Findings Between June 18 and Aug 3, 2020, we enrolled 76 participants to the two studies (38 in each study). In each study, nine volunteers received rAd26-S in phase 1, nine received rAd5-S in phase 1, and 20 received rAd26-S and rAd5-S in phase 2. Both vaccine formulations were safe and well tolerated. The most common adverse events were pain at injection site (44 [58%]), hyperthermia (38 [50%]), headache (32 [42%]), asthenia (21 [28%]), and muscle and joint pain (18 [24%]). Most adverse events were mild and no serious adverse events were detected. All participants produced antibodies to SARS-CoV-2 glycoprotein. At day 42, receptor binding domain-specific IgG titres were 14 703 with the frozen formulation and 11 143 with the lyophilised formulation, and neutralising antibodies were 49·25 with the frozen formulation and 45·95 with the lyophilised formulation, with a seroconversion rate of 100%. Cell-mediated responses were detected in all participants at day 28, with median cell proliferation of 2·5% CD4+ and 1·3% CD8+ with the frozen formulation, and a median cell proliferation of 1·3% CD4+ and 1·1% CD8+ with the lyophilised formulation. Interpretation The heterologous rAd26 and rAd5 vector-based COVID-19 vaccine has a good safety profile and induced strong humoral and cellular immune responses in participants. Further investigation is needed of the effectiveness of this vaccine for prevention of COVID-19. Funding Ministry of Health of the Russian Federation.