PULMONARY CIRCULATION IN YOUNG AND MIDDLE-AGED MEN WITH ACUTE KIDNEY INJURY DURING MYOCARDIAL INFARCTION

Relevance. Hemodynamics changes of the pulmonary circulation in myocardial infarction complicated by acute kidney injury are not well understood. Aim. To evaluate the characteristics of pulmonary circulation in men under 60 years old with acute kidney injury in myocardial infarction to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of pulmonary circulation parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of the risks of developing acute kidney damage and chronic heart failure in the selected groups were performed. Results. The study group differed in a lower heart rate (HR1) (66.3±12.2 from the control group (75.8±18.8; p=0.003). It showed a tendency towards lower the mean pulmonary artery pressure (MPAP) and total pulmonary resistance (TPR) at both points of the study. In both groups, there was a similar dynamic of decrease in the MPAP and TPR levels, more pronounced in the control group (MPAPII: -14.3%; MPAPI: -6.1 %; TPRII: -29.9%; TPRI: -21.8%; p<0.0001) and multidirectional - for HR: in the study group, an increase in HR was noted by 0.9% (p<0.0001), and in the control - its decrease by 8.4% (p<0.0001). Risk markers of the acute kidney injury developing were MPAP1˂30.4 mm Hg, HR1˂67 per minute and TPR1˂622.8 dyne•s•cm-5, the presence of chronic heart failure and cardiac asthma among the disease complication. The predictors of chronic heart failure in the study group were MPAP1≥26.9 mm Hg and HR1≥62 min. Conclusions. In case of acute kidney injury, lower levels of pulmonary circulation indicators are noted, their lower dynamics during the observation period, and a greater frequency of observation of chronic heart failure in comparison with the control group. The above listed values of the pulmonary circulation parameters have been assessed as a risk marker of the acute kidney injury and chronic heart failure development.

THE PULMONARY CIRCULATION PECULIARITIES IN YOUNG AND MIDDLE-AGED MEN WITH MYOCARDIAL INFARCTION AND RECURRENT EPISODES OF ISCHEMIA

Relevance. The pulmonary hypertension (PH) and heart failure (HF) development during myocardial infarction (MI) in men with recurrent ischemic events (RIE) has not been adequately studied. Aim. To evaluate changes in pulmonary circulation parameters (PCP) in men under 60 years old (y.o.) in acute and subacute MI periods with RIS to improve understanding of PH and HF developmental options and to search for possible ways to improve prevention. Material and methods. The study included men aged 19-60 years old with type I of MI. Patients are divided into two age-comparable groups: I - the study group, with RIS - 110 patients; II - control, without it - 555 patients. A comparative assessment of PCP in the first 48 hours and the end of the subacute period of MI in these groups was performed. Results. In the first hours of MI the higher values of total pulmonary resistance (TPR) and mean pulmonary artery pressure (MPAP) were noted in the study group. When considering their dynamics at the end of the third MI week the MPAP decreased in both groups (I: by 8.7%; p˂0.0001; II: by 15.0%; p˂0.0001). TPR decreased in both groups (I: by 30.6%; II: by 29.6%; p˂0.0001) too. The heart rate - I: by 6.2%; p=0.03; II: 8.4%; p˂0.0001). At the end of the third MI week, MPAP remained elevated in the study group (I: 30.6 ± 12.7; II: 27.2 ± 7.7; p = 0.03).

Development of an electrode system for continuous measurement of the volume of an AHV

Mechanical circulatory assistance devices are vital for the patients with end-stage heart failure, who require heart transplantation but are in a waiting list due to the shortage of donor organs. This makes the development of the advanced MCS devices and artificial heart ventricles a crucial task. The systems for the dynamic and adaptive control of circulation parameters are required. AHV liquid volume measurement units must be developed to create such systems. Objective – Determination of the optimal electrode system for the AHV liquid volume measurement unit based on the electrical impedance measurements. The most significant geometrical parameters of the electrode systems for the impedance based AHV liquid volume measurement are determined. The optimal values of the geometrical parameters were found for the system of dynamic AHV liquid volume measurement. Results were confirmed by the numerical and experimental studies. The obtained values of the optimal geometrical parameters of electrode systems will be used in development of biotechnical system of adaptive AHV control.

Basic principles of infusion therapy: fundamentals of fluid and electrolyte balance

Background. Infusion therapy (IT) is a method of managing the functions of the organism by influencing purposefully the morphological composition and physiological properties of blood through parenteral administration of organic and inorganic solutions. The main feature of IT is that the drug completely enters the bloodstream. Objective. To describe the main characteristics of fluid and electrolyte balance and the IT principles. Materials and methods. Analysis of the literature sources on this topic. Results and discussion. Fluid comprises about 60 % of the human body (in children – 70-80 %, in adults – 60 %, in elderly – 50-55 %). Total fluid includes intracellular and extracellular. The latter, in turn, is divided into intravascular, interstitial and transcellular. Water balance involves the balance of fluid entering the body and the fluid being excreted. The main sources of water are beverages and food, however, about 300 ml per day is formed endogenously during oxidation processes. The main ways of the fluid excretion are its excretion in urine and stool, and perspiration losses. To calculate the physiological need of water for an adult, the body weight should be multiplied by the coefficient of 30 (up to 65 years), 25 (65-75 years) or 20 (more than 75 years). IT should also take into account the pathological losses of water from fever, vomiting, diarrhea, the presence of large wounds or burns, as well as reduction of the need in water in renal or heart failure. Thus, physiological needs, fluid deficiency, fluid volume as a result of pathological loss should be added, and the oral rehydration subtracted from this sum to calculate IT volume. There are 3 degrees of dehydration severity: I degree – deficiency of 1-2 liters, thirst, oliguria; II degree – deficiency of 4-5 liters, thirst, oliguria, dry skin, mucous membranes and tongue, general weakness; III degree – deficiency of 7-8 liters, consciousness disorders, decrease in arterial pressure, shock. The first degree can be overcome by oral rehydration, the second degree – by 50 % of oral rehydration and 50 % of IT, the third degree – by 70-100 % of IT. IT solutions are divided into crystalloids, colloids, polyatomic alcohols and special drugs. Preparations of polyatomic alcohols include, in particular, Reosorbilact, Sorbilact, Xylate (“Yuria-Pharm”). Complications of IT are divided into complications associated with the violation of the technique of entering the bloodstream (injuries of blood vessels and adjacent organs, hematomas, foreign bodies in the vessels and heart, the solution misplacement out of the vascular space); complications associated with the violation of the technique of drug administration (thromboembolism, air and fat embolism); complications associated with the wrong rate of solutions’ administration (heart overload, hypervolemia, pulmonary edema, cerebral edema); complications associated with the characteristics of infusion solutions (partial hemolysis of blood cells, acid-base imbalance, disorders of blood osmolarity, local cooling of the heart); complications associated with the IT method; complications due to individual intolerance; infectious complications in case of violation of asepsis and antiseptics; infectious diseases. Criteria for IT security include the knowledge of the drug composition and understanding of the instructions for its use; multicomponentity; use of the minimum effective doses; monitoring of the excreted urine and other fluids and infused solutions; strict control of fluid balance and blood circulation parameters. Conclusions. 1. IT is an important tool in treatment of many diseases, which performs a wide range of tasks. 2. The IT solution should be chosen depending on the individual needs of the patient. 3. Criteria for IT safety include the knowledge of drug composition and instructions for its use; multicomponentity; use of the minimum effective doses; monitoring of excreted urine and infused solutions; control of fluid balance and blood circulation parameters.

Regional features of ice cover in the West Kamchatka fishing subzone with considering яof the thermobaric conditions (according to the satellite data)

Aiming to develop the biological resources of the Okhotsk Sea shelf zone, a remote study of regional features of the ice processes dynamics in fishing areas is important. One of the main fishing areas of the Okhotsk Sea is the West Kamchatka subzone — the northeastern sector of the water area to the east of 153°30′ E, bounded from the south by latitude 54° N. Dynamics of seasonal changes in ice cover is inherent in every region of the sea, regardless of the total area of ice. Geophysical processes affect the ice cover through a complicated mediated correlation that includes changes of the atmospheric circulation parameters. Critical, anomalous states of the ice cover in the West Kamchatka fishing subzone and also the cause-effect relations of its formation are revealed during the pollock seasons in 2006–2017. The mechanism of influence of thermobaric conditions, confirming the influence of the Okhotsk tropospheric cyclone (OTC) and the Pacific tropospheric crest on the formation of abnormal ice conditions in the Okhotsk Sea both in general and in certain local areas is presented.

Comparison of vascular parameters between normal cynomolgus macaques and healthy humans by optical coherence tomography angiography

Background The metabolic activity of retina is higher than other human tissues and is crucial to the vision. Cynomolgus macaques is widely used in ophthalmic disease research. The evaluation and comparison of macular and optic disc vascular circulation parameters between normal adult cynomolgus macaques and healthy adult humans using OCT-A can promote better use of nonhuman primate models in studies of ophthalmic vascular disease. Methods Twelve normal adult cynomolgus macaques with a mean age of 4.91 ± 0.43 years were studied for data collection. The macula of 28 adult healthy humans (14 males and 14 females), with a mean age of 25.11 ± 6.21 years and the optic discs of 9 adult healthy humans (4 males and 5 females) with a mean age of 28.56 ± 6.78 years were measured. The vessel density (VD) was measured using an RTVue XR with AngioVue. The scan sizes of the macular and optic discs were 3 × 3 mm and 4.5 × 4.5 mm, respectively. Results OCT-A can image the superficial and deep capillary plexuses and radial peripapillary capillary network. In RPC layer of the optic disc, the VD in the nasal quadrant was lower than the VD in the inferior temporal quadrant. Similarities and significant differences in VD between healthy humans and cynomolgus macaques were obtained using OCT-A. Conclusions This study provides normal vascular parameters for adult cynomolgus macaques using OCT-A to help establish an optical parameter database for cynomolgus macaques and compare VD between healthy humans and cynomolgus macaques to promote choroid-retinopathy research. Trial registration Current Controlled Trials NCT03692169, retrospectively registered on 26 sept 2018.

Age-related changes in retrobulbar circulation: a literature review

Introduction The advances in research methods used in ophthalmology allow for an increasingly accurate examination of the eyes, as well as the morphology and function of the vessels. Colour Doppler imaging is still the first-line method for the analysis of parameters of retrobulbar circulation. Therefore, the aim of this work was to present the current state of knowledge about anatomical and functional age-related changes in retrobulbar arteries. Methods A literature search was performed mainly based on the PubMed database. Results The anatomy of retrobulbar arteries, histological background of age-related vascular changes, age-related changes in retrobulbar blood flow in the ophthalmic artery, central retinal artery, short posterior ciliary arteries, and the reference values for the age-dependent retrobulbar circulation parameters measured by colour Doppler imaging are discussed in this review. Conclusion The age of the subject should always be taken into account when interpreting the parameters of retrobulbar blood flow measured by colour Doppler imaging.