The prospects for NT-pro BNP level determining in physical activity conditions in patients during the rehabilitation period after the myocardial infarction, complicated with decompensated heart failure

The aim of the study was to determine the futility of NT-pro BNP level analysis during dosed physical exercise for diagnosing decompensated HF in the postinfarction period and the possibility to determine the HF functional class. Materials and methods. 160 patients with previous MI were examined, patients’ average age was (56.67±5.72) years. The patients were randomized in 2 groups dependently on the presence of the signs of II А-B according to V. Kh. Vasylenko and M. D. Strazhesko classification and FC III-IV (according to NYHA) decompensated chronic HF. Group I consisted of 120 patients with Q-QS and non-Q MI; group II (the control one) had 40 patients with MI without signs of decompensated HF; 20 healthy people made up a norm group. Results. Signs of coronary insufficiency such as dizziness and signs of poor peripheral perfusion (cyanosis/paleness) occurred in 104 (86.7 %) and 79 (65.8 %) cases that differ from the same values in the second group 4 (10.0 %) and 14 (35.0 %) respectively. 88 (73.3 %) patients with the signs of decompensated HF felt general weakness, fatigue, and expressed a request to stop the test. The HR in the postinfarction patients with the signs of decompensated HF was before the exercise (88.2±3.18) bpm (p≤0.05); in the patients with past MI without the signs of decompensated HF, it was (75.32±3.41) bpm (p≤0.05); and in the practically healthy people, it was (77.73±3.02) bpm. We found out a reverse moderate correlation between the distances that had been covered by a patient during the 6MWT NT-proBNP level in blood serum of examined patients. Conclusions. Inadequate response to dosed physical exercises and increased immunological parameters as quantitative HF markers could be useful not only for diagnostics, but also for the risk stratification for decompensated HF that had occurred in patients on different rehabilitation stages after an acute MI.

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BODY IMMUNOLOGICAL REACTIVITY IN OPIOMANIA

Medical Immunology (Russia) ◽

10.15789/1563-0625-bir-2289 ◽

2021 ◽

Vol 23 (4) ◽

pp. 781-784

Author(s):

K. K. Kulmukanova ◽

A. U. Baiduissenova ◽

E. A. Akhmediyarova ◽

A. A. Yktiyarov ◽

G. A. Bekniyazova ◽

...

Keyword(s):

Relative Number ◽

Neurological Status ◽

The Body ◽

Control Group ◽

Immunological Reactivity ◽

Immunological Parameters ◽

Group I ◽

Opioid Drugs ◽

Therapeutic Measures ◽

Opium Addiction

Due to the general trend of changes in reactivity in many exogenous and endogenous diseases, more and more attention is currently being paid to changes in immunological reactivity in drug addiction. The expediency of assessing the state of immune mechanisms in opioid addiction is determined by the need to predict their course and outcome. The aim of the study was to study the immunological reactivity of the body in patients with opium addiction in a stage of abstinence. For this purpose, clinical and immunological studies were conducted in 80 patients who use opioid drugs. The duration of the disease ranged from 0.5-19 years. Of these, the disease duration is up to 3 years – 28 patients (group I), and over 3 years – 52 patients (group II). The number of subjects in the control group was n = 50. Authors carried out the assessment of the mental, narcological, somatic, and neurological status. In addition, they have studied the general clinical, biochemical and immunological parameters As a result of this study, it was found, that patients of group I had more pronounced T-lymphocytopenia. A persistent increase in the value of serum IgM was revealed both in the dynamics of abstinence and depending on the duration of the disease, which may indicate a strain on the humoral link of immunity in opium addiction. In addition, as the duration of chronic narcotization increases, there is a tendency to increase the relative number of B-lymphocytes. Thus, at the patients with opium addiction in a state of abstinence develop T-lymphocytopenia. Moreover, with an increase in the duration of the disease, an increase in the level of IgM by 2-2.6 times. The revealed changes in the immunological reactivity of the organism suggest the need to include immunocorrective therapy in the complex of therapeutic measures for opium addiction.

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INFLUENCE OF OZONE THERAPY ON THE DYNAMICS OF HUMORAL IMMUNITY INDEXESIN OBSERVATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Farmaciâ Kazahstana ◽

10.53511/pharmkaz.2021.58.80.013 ◽

2021 ◽

pp. 60-64

Author(s):

А. М. ЖУКЕМБАЕВА ◽

К.С. ЛАТКИНА ◽

К. М. КАПАРОВА ◽

А.К. КУАТ ◽

Ж. К. АТХАН ◽

...

Keyword(s):

Personal Data ◽

Chronic Obstructive ◽

Ozone Therapy ◽

Immunological Parameters ◽

Study Program ◽

Obstructive Pulmonary Disease ◽

Copd Exacerbations ◽

Group I ◽

Group Ii ◽

Exacerbation Of Copd

Проведен анализ результатов изменений иммунологических показателей на фоне проводимого лечения обострения ХОБЛ, проведенного у 55 больных. Все больные, рассматриваемые в нашей работе, подписали письменное информированное согласие на участие в программе исследований и неразглашении личных данных. Установлено, что через 7 суток после начала лечения уровень IgM в сыворотке крови во II группе, где проводилась озонотерапия, был достоверно меньше, чем в I, что свидетельствовало о более быстрой регрессии воспалительного процесса во II группе (P< 0,05). При этом показатели HCT-индуцированного фагоцитоза, на фоне проводимой озонотерапии во II группе, были достоверно больше, чем в I, где озонотерапия не проводилась (P<0,05). То есть, резервы кислород зависимой фагоцитарной активности нейтрофилов во II группе на фоне проведения озонотерапии были более функционально активны. Особого внимания заслуживает то, что во II группе элиминация ЦИК происходила достоверно быстрее, чем в I (P< 0,05). Это свидетельствовало об эффективности применения озонотерапии при лечении обострения ХОБЛ. Таким образом, положительное влияние инфузионной озонотерапии на различные звенья воспаления при обострении ХОБЛ свидетельствуют о перспективности дальнейших исследований в этом направлении. The analysis of the results of changes in immunological parameters in the treatment of complications of COPD in 55 patients. All patients considered in our study signed a written informed consent to participate in the study program and not to disclose their personal data. Serum IgM levels in group II treated with ozone therapy 7 days after the start of treatment were significantly lower than in group I, indicating a more rapid regression of the inflammatory process in group II (P <0.05). At the same time, the incidence of HCT-induced phagocytosis in group II ozone therapy was significantly higher than in group I without ozone therapy (P <0.05). That is, in the context of ozone therapy, the reserves of oxygen-dependent phagocytic activity of neutrophils of group II were functionally active. Particular attention should be paid to the fact that the elimination of AIC in group II was faster than in group I (P <0.05). This demonstrated the effectiveness of ozone therapy in the treatment of COPD exacerbations. Thus, the positive effect of infusion ozone therapy at different stages of inflammation during the exacerbation of COPD indicates the prospects for further research in this area.

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Immunomodulator in combination treatment of patients with ovarian cancer and its influence on DNA cytometric and immunological parameters.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e18079 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e18079-e18079

Author(s):

Anna Yu. Ardzha ◽

Ekaterina V. Verenikina ◽

Elena Yu. Zlatnik ◽

Vera P. Nikitina ◽

Oksana E. Zhenilo ◽

...

Keyword(s):

Ovarian Cancer ◽

Interferon Gamma ◽

Complete Response ◽

Cd4 Cells ◽

Cytological Examination ◽

Immunological Parameters ◽

Dna Index ◽

Group Iii ◽

Group I ◽

Direct Results

e18079 Background: Immunotherapy in oncology has now proven effective, but standard approaches have not yet been defined. Ways to optimize and increase the effectiveness of treatment with immunomodulators, in particular interferon-gamma preparations, in such patients remain an urgent problem of gynecological oncology. The purpose of the study was to improve direct results of ovarian cancer treatment. Methods: The study included patients aged 50-77 years with inoperable ascitic ovarian cancer (verified by cytological examination of ascitic fluid), stage IIIC-IV, receiving neoadjuvant chemotherapy (CT) in combination with immunotherapy with interferon-gamma (IFNγ). Group I – 26 patients, CT with carboplatin (AUC-6), paclitaxel (175 mg/m2); group II – 22 patients, chemoimmunotherapy and intramuscular IFNγ (ingaron) - 500 000 IU on day 1, 1 million IU on days 2,3,5, a similar CT on day 4; group III – 24 patients, chemoimmunotherapy and intraperitoneal IFNγ (ingaron) - 500 000 IU on day 1, 1 million IU on days 2,3,5, a similar CT on day 4. Patients received on average 2-3 therapy cycles. Results: Progression was registered only in group I in 3.8%; complete response in patients without IFNγ – 7.8%, with intramuscular and intraperitoneal IFNγ – 27.3% and 37.5% (p≤0.05) respectively. Surgical treatment followed in all patients, with total surgeries in 87.5% of patients with intraperitoneal IFNγ. DNA cytometry showed the minimal number of aneuploid tumors in patients with intraperitoneal IFNγ (16.6%), while in patients without immunotherapy 38.4%. The DNA index statistically significantly decreased by 1.3 times in patients with intraperitoneal IFNγ compared with patients without IFNγ (1.11±0.01% vs. 1.4±0.05% respectively) (p≤0.05). Levels of CD3+CD4+ cells elevated by 1.2 times (from 36.2±1.6 to 44.9±3.78%, p≤0.05) in patients with intramuscular IFNγ; intraperitoneal IFNγ caused an increase in CD3+ lymphocytes by 1.3 times (from 62.1±2.8 to 77.9±2.94%, p < 0.05) and CD3+CD4+ by 1.4 times (from 36.2±1.6 to 50.6±5.9%, p≤0.05). Conclusions: Interferon-gamma (ingaron) in combination with CT improves direct results of the treatment; intraperitoneal injections of interferon-gamma demonstrated better outcomes and tolerance confirmed by immunological and DNA cytometric parameters.

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Demographic and clinical differences between idiopathic and scleroderma-related pulmonary arterial hypertension: Russian National Registry analysis

Systemic Hypertension ◽

10.26442/sg29142 ◽

2016 ◽

Vol 13 (2) ◽

pp. 65-72

Author(s):

N N Yudkina ◽

E G Valeeva ◽

I N Taran ◽

E V Nikolaeva ◽

V M Paramonov ◽

...

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

National Registry ◽

Functional Class ◽

Current Therapy ◽

Group I ◽

Pulmonary Arterial ◽

The Moment ◽

Registry Analysis

Pulmonary arterial hypertension associated with systemic sclerosis (SSc-PAH) and idiopathic pulmonary arterial hypertension (IPAH) belong to group I in the clinical classification of PH, but there is evidence for significant differences in their survival due to current therapy. Objective: the objective of this report is to compare pts with (SSc-PAH) and (IPAH) based on data of Russian National Registry. Patients and methods: in the study we included 52 pts with IPAH and 50 with SSc-PAH. There were no differences in functional class (FC). Diagnosis was based on RHC. Results. At the moment of diagnosis average age of patients with SSc-PAH was 15 year higher (p

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The influence of genetic and immunologic factors on indicators of innate immunity daughters

Rossiiskaia selskokhoziaistvennaia nauka ◽

10.31857/s2500-26272019563-66 ◽

2019 ◽

pp. 63-66

Author(s):

M. A. Eryomina ◽

I. Yu. Ezdakova

Keyword(s):

Animal Health ◽

Immunological Parameters ◽

Significant Relationships ◽

Group I ◽

Reference Type ◽

Immunological Factors ◽

Milking Frequency ◽

Group Ii ◽

Negative Relationships ◽

Type Parameter

The aim of the research is to study the influence of genetic and immunological factors of bulls on the immunological parameters of daughters at razdoe (from the first lactation to the second). The object of research was cows-daughters of bulls, previously evaluated by genetic and immunological indicators. It was revealed based on the survey findings that in the cows in group II in the period of the second lactation, the lymphocyte and basophil concentrations decreased by 9.23% (р0.05) and 1.54% (р0.05), respectivley, while the monocyte concentration increased by 6.23% (р0.001). It may be related with an increase in the animal body compensatory responses at the reference-type parameter of the neutrophils phagocytic activity reduced by 10.7% (р0.05) and 14.6% (р0.05) for the animals in group I and group II, respectively. With respect to the animals in group II, the negative relationships between the lymphcyte and monocyte counts in the first lactation and the neutrophil and eosinophil counts in the second lactation, comprising -0.501 (р0.05) and -0.567 (р0.05), respectively, were ascertained. The less quantity of the significant relationships in group I can indicate the less intense state of the immune system in the daughters of the bull sires, which are characterized with the steady-state genetic and immunological parameters, in the period of increasing the milking frequency early in lactation (from the first to second lactations), what can serve as an additional criterion, given the consolidation in the offspring of sires stable indicators of animal health.

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EFFECT OF LEVOSIMENDAN ON SHORT TERM AND LONG TERM CLINICAL COURSE OF PATIENTS WITH ACUTELY DECOMPENSATED HEART FAILURE IN INDIAN POPULATION

International Journal of Advanced Research ◽

10.21474/ijar01/11799 ◽

2020 ◽

Vol 8 (9) ◽

pp. 1378-1379

Author(s):

Seshi Vardhan Janjirala ◽

Keyword(s):

Heart Failure ◽

Placebo Group ◽

Symptomatic Relief ◽

Cardiac Contractility ◽

Decompensated Heart Failure ◽

Functional Class ◽

Treatment Groups ◽

Acutely Decompensated Heart Failure ◽

All Cause Mortality ◽

And Function

We evaluated the efficacy of levosimendan, a positive inodilator, given intravenously to patients with acutely decompensated heart failure (ADHF). Methods: Patients admitted with ADHF received placebo or IV levosimendan for 24 hr in addition to standard treatment. The primary endpoint was a composite that evaluated changes in clinical and laboratory status at 30th day and at 180th day.secondary end point is all cause mortality. Results: In the 125-patient trial, more levosimendan than placebo patients were improved at discharge, whereas fewer levosimendan patients experienced clinical worsening at 6 months. The functional class, cardiac contractility ( FS,EF) were better in simenda group at 3rd month both neumerically and statistically.All-cause mortality at 180 days occurred in 5% patients in the levosimendan group and 28%patients in the placebo group. The levosimendan group had greater decreases in Brain Natriuretric peptide level at 24 hours. There were no statistical differences between treatment groups for the other secondary end points (all-cause mortality at 31 days, number of days alive and out of the hospital, patient global assessment, patient assessment of dyspnea at 24 hours, and cardiovascular mortality at 180 days). There was a higher incidence of cardiac failure in the placebo group. There were higher incidences of atrial fibrillation, hypokalemia, and headache in the levosimendan group Conclusions: In patients with ADHF, intravenous levosimendan provided rapid and durable symptomatic relief and levosimendan improved haemodynamic performance more effectively than placebo. 6MHWD, quality of life, worsening of heart failure, cardiac structure and function were statistically and numerically improved in simenda group for first 3monthsHowever the results were not consistent for 180 days.This benefit was accompanied by lower mortality in the levosimendan group than in the placebo group for up to 180 days.

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P4504Pulmonary circulatory-right ventricular uncoupling in acute decompensated heart failure: a key mediator of congestion

European Heart Journal ◽

10.1093/eurheartj/ehz745.0897 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Losito ◽

M Barki ◽

V Labate ◽

A Giammarresi ◽

M Caracciolo ◽

...

Keyword(s):

Heart Failure ◽

Right Ventricular ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Right Atrial ◽

Maximum Diameter ◽

Group Iii ◽

Non Invasive ◽

Group I ◽

Group Ii

Abstract Background The degree of congestion in patients hospitalized for acute decompensated heart failure (ADHF) is estimated using traditional non-invasive markers such as echo-derived inferior vena cava diameter (IVCD) and NT-proBNP levels. The deterioration of right ventricular (RV) function and its uncoupling to pulmonary circulation (Pc) represents a turning point in terms of prognosis and clinical outcome in patients affected by heart failure. However, how RV-to-Pc uncoupling correlates with markers of decompensation and congestion in ADHF patients has never been explored. Purpose To investigate, in a cohort of ADHF patients, the association between the degree of RV-to-Pc uncoupling, assessed by the ratio between tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), IVCD and right atrial pressure (RAP) estimated at echocardiography. Methods Fourty-six ADHF patients both with reduced and preserved EF (mean age 73.15±10.85 years, 60.8% males) admitted to the Cardiology Department were prospectively enrolled within 24–48 hours from admission. In the acute phase all patients underwent transthoracic echocardiography and laboratory blood tests. Patients were then stratified in tertiles according to TAPSE/PASP ratio (group I: <0.4 mm/mmHg; group II: 0.4 to 0.6 mm/mmHg and group III: >0.6 mm/mmHg) correlating the degree of RV-to-Pc with non-invasive markers of congestion such as NT-proBNP, IVC maximum diameter and RAP. Other echocardiographic parameters including left ventricular (LV) systolic function and LV filling pressures were considered. Results An exponential inverse relationship was found between NT-pro-BNP levels at admission with levels decreasing progressively with the increment of the ratio (Group I: 12828±10600 ng/l; Group II 5549±5383 ng/l; Group III 3695±3870 ng/l; p=0.004) (Figure 1a). An analogous correlation was observed when considering the IVC maximum diameter (Group I: 20.87±5.37 mm; Group II 18.08±4.35 mm; Group III 10.9±3.36 mm; p<0.001) (Figure 1b) and the RAP estimated at echocardiography (Group I: 12.875±5.25 mmHg; Group II 9.157±4.82 mmHg; Group III 4±1.61 mmHg; p<0.001) (Figure 1c). In addition, progressively increasing values of LVEF (Group I: 28±11.3%; Group II 42±17.3%; Group III 49±11.8%; p=0.001) were detected from the lowest to the highest TAPSE/PASP tertiles. No correlation was observed in the three groups for E/E' values at admission (Group I: 17.17±6.7; Group II 19.42±8.36; Group III 15.92±5.7; p=0.5). Figure 1 Conclusions In ADHF, the association between RV to Pc uncoupling, echo-derived measures of congestion and natriuretic peptide levels is here described for the first time. The extent of RV dysfunction in ADHF deserves attention and seems to represent a critical and quite underestimated key mechanism between congestion resolution and in-hospital worsening HF.

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Platelet Aggregability In Healthy And Ischemic Heart Disease (IHD) Donors: A Unique Aggregometry Parameter Practically Independent Of Platelet Count Or Drugs Such As Acetylsaly- Cilic Acid

10.1055/s-0038-1653340 ◽

1981 ◽

Author(s):

M M Frojmovic ◽

J Milton ◽

W Yung ◽

J Brandwejn ◽

T Wong ◽

...

Keyword(s):

Platelet Count ◽

Coronary Artery ◽

Platelet Aggregation ◽

Light Transmission ◽

Myocardial Infarct ◽

Maximal Velocity ◽

Coronary Insufficiency ◽

Group I ◽

Group Ii ◽

Induced Aggregation

We report on a uniquely useful parameter of platelet aggregation derived from aggregometry tracings for adenosine diphosphate (ADP)-induced aggregation in citrated platelet- rich plasma, pH 7.4, 37°C., for 13 healthy and 13 IHD donors (6 post-myocardial infarct (2-16 days), and 1 acute coronary insufficiency (7 days) (group I) and 6 angiographically characterized coronary artery disease (group II). A double reciprocal (L-B) plot of [ADP] (1-100 µM) against the velocity of light transmission increase associated with platelet aggregation obtained for the initial velocity (V) or for the maximal velocity (V*) was usually linear only at high ADP (≥ 5 µM), from which a Vmax value could be extrapolated. We then derived [ADP]l/2:- [ADP] yielding V=l/2 Vmax, from a Hill-type plot ((log (V/Vmax-V) vs log [ADP]). Only [ADP] 1/2 values derived from V* allowed a highly significant (P≥ 0.001) distinction to be made between healthy and IHD donors (2.4 ± 0.4 µM (n=13) vs 1.3 ± 0.3 µM (n=7, group 7, group I; n=4/6, group II)). Other parameters such as extent of primary or maximal aggregation did not distinguish IHD from normal donors, and could not be normalized for varying platelet counts. 2/6 donors in group II (coronary artery occlusions) and 4 donors with normal angiographs had “normal” [ADP] 1/2 = 2.5 ± 0.4 µM. One recall of a 7 day postmyocardial infarct donor after 7 weeks still exhibited “abnormal” [ADP] 1/2 = 1.0 vs 1.4 µM. This new parameter appears independent of normal hematocrit-citrate/platelet count variations, or of drug type including aspirin, and promises to be useful for classification of diseases according to platelet aggregabilit.

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Circulating Platelet Aggregates In Thrombotic Pathologies

10.1055/s-0038-1653299 ◽

1981 ◽

Author(s):

J J Rodzynek ◽

P L Schoenfeld ◽

T Martin ◽

P Léautaud ◽

P Wettendorff ◽

...

Keyword(s):

Myocardial Necrosis ◽

Group Iv ◽

Group V ◽

Coronary Insufficiency ◽

Group Iii ◽

Group I ◽

Acute Coronary Insufficiency ◽

Circulating Platelet Aggregates ◽

Platelet Aggregates ◽

Normal Controls

The dosage of circulating platelet aggregates following Wu and Hoak (CPA) was performed in 52 healthy volunteers acting as normal controls (N), in 205 consecutive patients admitted in a general hospital for pathologies other than thrombotic or cardiac ischaemia (group I), in 59 consecutive admissions for deep venous thrombosis (group II), in 45 consecutive admissions for pulmonary thromboembolism (group III), in 35 consecutive admissions for acute coronary insufficiency (group IV) and in 73 consecutive admissions for acute myocardial infarction demonstrated by electrocardiogram and specific enzymes (group V). The percentage of positive tests (CPA 0.80) in those various groups appeared as follows: In conclusion: The positivity of CPA is not a specific indicator of a thrombotic disease neither of acute coronary insufficiency (36.5% false positive tests). CPA is not sensitive for the diagnosis of thrombotic conditions.In the setting of ischaemic heart disease, CPA positivity appears with higher frequency when myocardial necrosis is demonstrated, However the two groups don’t differ significantly on a statistical basis (P non significant).

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P539Comparative analysis of patients with cardiac resynchronization therapy depending on septal flash

EP Europace ◽

10.1093/europace/euaa162.272 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

N Shirokov ◽

V Kuznetsov ◽

A Soldatova ◽

L Malishevskii ◽

D Krinochkin

Keyword(s):

Cardiac Resynchronization Therapy ◽

Interventricular Septum ◽

Functional Class ◽

Doppler Imaging ◽

Cardiac Resynchronization ◽

Resynchronization Therapy ◽

Basal Segment ◽

Group I ◽

Functional Features ◽

Septal Flash

Abstract Background Mechanical dyssynchrony (MD) and superresponse (SR) to cardiac resynchronisation therapy (CRT) relationship is still debated. Aim To assess clinical and morpho-functional features of the heart in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) depending on septal flash (SF). Materials and methods The study enrolled 60 patients (92.0% men, 8.0% women; mean age 54.5 ± 10.4 years; 70.0% had left bundle branch block (LBBB) with II-IV NYHA functional class CHF. SF (mechanical anomaly of interventricular septum (IVS) movement) is determined according to speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI). Patients were divided into two groups: with SF (I group, n = 10) and without SF (II group, n = 50). Results At baseline the groups did not differ in main clinical characteristics including QRS width and LBBB. Mechanical interventricular delay was higher in group I (65.5 ms [53.5;95.5] vs 31.0 ms [15.0;64.5]; р=0.026). Basal segment of IVS longitudinal strain (LS) delay by STE (257.5 ms [156.3;293.8] vs 323.5 ms [262.5;377.8]; р=0.024) and LS delay by TDI (204.0 ms [170.8;260.3] vs 434.0 ms [370.0;489.0]; р<0.001) were significantly lower in group with SF. According to logistic regression a combination of LS apical segment of IVS by STE (HR 0.607; 95% Cl 0.369 – 0.989; р=0,048) and LS delay basal segment of IVS by TDI (HR 0.969; 95% Cl 0.0945 – 0.993; р=0.011) had a relationship with SF. According to ROC analysis sensitivity and specificity of this model in SF definition in patients with CRT were 87.5% and 86.5% (AUC = 0.939; p < 0.01). Mean changes in LV ESV (52.0 ml [32.5;72.8] vs 19,0 ml [1.3;40.0]; р=0.002) and LV ejection fraction (EF) (13.0% [5.5;18.8] vs 4.0% [2.0;9.0]; р=0.002) were significantly higher in patients with SF. All patients in group I had a super-response to CRT (ESV LV decrease ≥30%); 42.0% patients in group II were superresponders (р<0.001). Conclusion SF could be determined by STE and TDI. SF is associated with severe mechanical interventricular dyssynchrony and superresponse to CRT. Patients with SF have significantly better LV EF dynamics after CRT. Abstract Figure. Septal Flash in patient with SR to CRT

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