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Aim: To evaluate the efficacy of cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) associated with cardiac dyssynchrony and to identify the factors that influence the CRT efficacy., Material and Methods: This retrospective study included 155 patients after implantation of CRT devices. The CRT devices with a built-in cardioverter-defibrillator (CRT-D) and without it (CRT-P) were implanted in 139 (89.7%) and 16 (10.3%) patients, respectively. The follow-up period was 52.37±35.94 months. Based on the study results, two groups of patients were formed depending on the presence of a clinical response to CRT, responders and non-responders. The factors that influenced the clinical response to CRT were studied. The effect of the baseline state of patients on the effect of therapy was assessed. The need for CRT optimization and a possibility of using electrocardiographic criteria for that purpose were studied. Modern devices and leads for CRT, their functional capabilities and their influence on the CRT efficacy were characterized. Statistical analysis was performed with an IBM SPSS Statistics 21.0 (Chicago, USA) package., Results: CRT implantation with the left ventricular lead placement according to the traditional technique, through the coronary sinus, was successful in 130 (87.9%) patients. Difficulties with the left ventricular lead placement were noted in 13 (8.3%) patients when other techniques were used. After 6 months, a hemodynamic and clinical response was observed in 112 (72.2%) patients, and no positive response in 43 (27.8%). The increase in left ventricular ejection fraction in the responder group was more than 21.8±3.7%, which was associated with an improvement of the 6-minute walk test results. Th clinical response was significantly influenced by the possibility of stimulation from the basal parts of the heart; the use of more modern devices for CRT and quadripolar left ventricular leads; timely CRT optimization; and persistent dyssynchrony in non-responders. During the follow-up period, 34 (21.9%) patients died. The death rate in the non-responder group was significantly higher than in the responder group, 18 (41.3%) vs. 16 (14.3%), p=0.001. The main cause of death in the group of non-responders was CHF. Heart transplantation was performed in 3 (1.9%) patients., Conclusion: CRT increases the life span and improves the quality of life in patients with CHF and cardiac dyssynchrony. There was a group of patients with no benefit from CRT in this study. Modern devices allow increasing the number of patients who benefit from CRT. Periodic optimization of CRT is necessary. When optimizing CRT, it is possible to use electrocardiographic criteria of effectiveness: duration of the QRS complex and changes in the position of the electrical axis of the heart.

Visual Question Answering systems target answering open-ended textual questions given input images. They are a testbed for learning high-level reasoning with a primary use in HCI, for instance assistance for the visually impaired. Recent research has shown that state-of-the-art models tend to produce answers exploiting biases and shortcuts in the training data, and sometimes do not even look at the input image, instead of performing the required reasoning steps. We present VisQA, a visual analytics tool that explores this question of reasoning vs. bias exploitation. It exposes the key element of state-of-the-art neural models - attention maps in transformers. Our working hypothesis is that reasoning steps leading to model predictions are observable from attention distributions, which are particularly useful for visualization. The design process of VisQA was motivated by well-known bias examples from the fields of deep learning and vision-language reasoning and evaluated in two ways. First, as a result of a collaboration of three fields, machine learning, vision and language reasoning, and data analytics, the work lead to a better understanding of bias exploitation of neural models for VQA, which eventually resulted in an impact on its design and training through the proposition of a method for the transfer of reasoning patterns from an oracle model. Second, we also report on the design of VisQA, and a goal-oriented evaluation of VisQA targeting the analysis of a model decision process from multiple experts, providing evidence that it makes the inner workings of models accessible to users.

The main place among cardiovascular diseases takes coronary heart disease. The number of coronary artery bypass surgery increases every year. The large number of coronary artery bypass grafting (CABG) performed worldwide. The need for assessment of grafts patency is enormous., Objective: We are performed analyze of graft patency results, after CABG surgery in our clinic., Materials and Methods: This paper presents the results of a retrospective analysis of angiographic graft patency data depends of TIMI flow, Syntax score, diameter and degree of vascular lesions, as well as the surgery type., Results: According angiographic data of 142 patients, we found that 74 (52.1 %) had no graft dysfunction. In the 68 (47.9 %) patients had various types graft dysfunction which is 3.0 % of the total number of operated patients in our center for coronary heart disease. 31 (46 %) patients were operated under Off pump, 19 (28 %) - On pump and 18 (26 %) - in a parallel bypass technic. According to our data parameters such as Syntax score, the diameter of the vessel and the percentage of lesion, its did not significantly affect the grafts patency in terms of up to 12,7±6,5 months. Preoperative coronary blood flow (assessed by TIMI scale) the significantly affects the grafts patency., Conclusions: In the graft patency for perioperative period and follow-up, significantly affected preoperative coronary blood flow assessed by TIMI. The results of beating heart (off pump and using a parallel IR) and On pump surgery similar in the immediate postoperative period. But there is tend to increase graft dysfunction in up to 30 months in patients after off pump surgery. We don't found relation between Syntax score, the diameter of the coronary arteries, the percentage of stenosis and graft patency after 12 months follow-up.

Spontaneous rupture of the left ventricular posterior wall after mitral valve replacement is a severe complication and is associated with high mortality rate. This complication was first described in 1967 by Roberts and Morrow, which describe the results of autopsy of two patients. In leading clinics around the world left ventricular wall ruptures after mitral valve replacement account for up to 20% of causes of hospital mortality. Currently there is no clear-cut strategy of treatment of this complication. In this article we present analysis of both traditional and non-traditional methods of treatment of this complication as well as own small positive and negative experience.