Capabilities of photoplethysmography as a method for screening of cardiovascular system pathology

Currently, vegetative dysfunction considered to be one of principal mechanisms in the pathogenesis of cardiovascular pathology, which causes a cascade of events leading to changes in the properties and a structure of vascular wall. This review article contains literature from various databases (Russian science citation index, PubMed, Google Shcolar, Scopus). It presents the methods for assessing vegetative imbalance. In particular, the method of photoplethysmography (PPGV) is considered for recording periodic fluctuations at various frequencies in the distal vascular bed which characterize physiological processes (cardiac activity, respiratory influences, neurogenic, myogenic and endothelial activity). In addition, other diagnostic capabilities of PPGV such as heart rate (HR) assessment, determining the properties of vascular wall and the level of blood saturation are elucidated. This paper demonstrates a wide range of PPGV applications. The simplicity of PPGV reproduction and its cost-effectiveness make it feasible both in routine clinical practice for the purposes of screening for cardiovascular pathology, and for individual health monitoring incorporated in smart devices.

The potential of cardioscreening in oil and gas refinery

Aim: to compare the results of examination conducted among oil and gas refinery employees, obtained during yearly periodic medical examination with the results obtained during cardioscreening. Material and Methods – 47 employees (64% - men, mean age 52 ± 8 yrs) of large oil and gas refinery were examined by cardiologist in 2018. Six months before the cardioscreening all employees underwent yearly periodic medical examination. The data of anamnesis, laboratory and instrumental findings (blood glucose, lipids, ECG) of examinees were analyzed. Revealed risk factors, the levels of risk SCORE, diagnosis and recommendations made during periodic medical examination and during cardioscreening were compared. Results – In the studied group dyslipidemia was observed in 39 employees (83%). Elevated blood glucose was revealed in 30 examinees (64%). Left ventricle hypertrophy on ECG was determined in 6 patients (13%). Hypertension was diagnosed in 35 subjects (75%) by cardiologist vs 26 subjects (55%) by therapeutist, diabetes mellitus was diagnosed in 8 (15%) vs 4 (8,5%) subjects by cardiologist and therapeutist correspondingly, smoking – in 20 (43%) and 16 (34%) of employees correspondingly (p < 0,001). Mean systolic BP was 152±20 mm Hg during cardioscreening versus 133±24 mm Hg during periodic medical examination (p < 0,001). High and very high risk SCORE have had 26 subjects (55%) according the data of cardiologist and 15 subjects (32%) according the data of therapeutist (p < 0,001). Conclusion – In the companies with abusive working conditions it is necessary to distinguish high and very high cardiovascular risk groups by means of cardioscreening.

Effect of angiotensin/neprilysin inhibition on ventricular repolarization and clinical arrhythmogenesis

Background: The most common reason for sudden cardiac death in heart failure is malign ventricular arrhythmias. LCZ 696 improves hospitalization and sudden cardiac death outcomes in heart failure, however mechanisms in preventing sudden cardiac death are still unknown. There is little information available assessing effect of LCZ 696 on Tp-e interval and related calculations. In this study, we aimed to investigate the impact of Sacubitril/valsartan therapy on Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in heart failure patients and its reflections on clinical arrhythmogenesis. Methods: The study was designed as a prospective observational fashion. 265 patients with implantable cardioverter-defibrillator (ICD), who were on regular follow up at Samsun Training and Research Hospital Outpatient Heart Failure Clinic, were validated for the study. Clinical, echocardiographic, electrocardiogram and device data before initiation and six months after dose optimizing were obtained. Results: Stroke volume, cardiac output and ejection fraction significantly improved after LCZ 696 treatment. T wave related parameters, QT and QTC intervals significantly diminished. Furthermore, there was a negative correlation between baseline Tp-e interval duration and the absolute percentile increase of stroke volume(r:-0.234, p: 0.042) and cardiac output (r: -0.240, p: 0.037). Conclusion: In our study, switching Renin-Angiotensin-Aldosterone-System inhibitor with Angiotensin receptor/neprilysin inhibitor was associated with increase in left ventricle performance and decrease of sustained ventricular arrhythmias that required ICD shocks. These positive findings were accompanied by improvements in surface electrocaridogram changes such as Tp-e and related indices.