Improved survival of children born with low, extremely low and very low body weight in modern conditions due to increased nursing capabilities, optimization of treatment and increased efficiency of resuscitation measures has led to the need for greater understanding of the importance of assessing the cardiovascular system’s state beyond the neonatal period. With approximately 10% of infants worldwide being born preterm, there is an increasing need for further research into optimal regimens, lifestyle and clinical interventions that can benefit and modify cardiovascular morphology and function in this growing population. Modern theoretical postulates on the physiology and pathophysiology of the child’s heart include ideas about the key process of cardiac biomechanics — diastole, during which the earliest disturbances, that precede the formation of systolic dysfunction, occur. Assessment of the pumping properties of the left ventricle in systole and diastole is a fundamental methodological technique for an in-depth understanding of the pathophysiological mechanisms of cardiovascular system’s emerging diseases, their early diagnosis and assessment of the complex therapy’s effectiveness. However, despite the widespread use of standard echocardiography to assess systolic and diastolic function, its traditional parameters have limitations in terms of diagnostic accuracy and effectiveness in practice. Expanding knowledge about new pathogenetic mechanisms of the cardiac dysfunction formation in conditions of prematurity at the current stage of cardiology development using the “trace spot” technology (two-dimensional speckle tracking echocardiography) will be very useful for scientists studying the mechanics formation of the child’s heart after premature birth, and for doctors of various specialties in early diagnosis of heart diseases.

This review addresses the capabilities of stress EchoCG as a simple, non-invasive, non-radiation method for diagnosing occult disorders of coronary blood flow in patients with non-ST-elevation acute coronary syndrome on a low-risk electrocardiogram. The capabilities of the enhanced stress EchoCG protocol are based on supplementing the standard detection of transient disturbances of local contractility, generally associated with coronary artery obstruction, with an assessment of the heart rate reserve, coronary reserve and other parameters. This approach is considered promising for a more complete characterization of heart function during exercise and an accurate prognosis of the clinical case, which allows determining the tactics for patient management not limited to selection for myocardial revascularization.

Russian Society of Cardiology (RSC)With the participation of: the National Society for the Study of Atherosclerosis (NOA), the Atherothrombosis National Society, the Russian Association of Cardiovascular Surgeons, the Russian Society of Cardiosomatic Rehabilitation and Secondary Prevention (RosOKR), the Russian Society of Radiologists and Radiologists (RSRR), the Russian Association of Ultrasound Diagnostics Specialists in Medicine (RASUDM), the Russian Scientific Society for X-ray Endovascular Diagnosis and Treatment

Aim: To study the state of cardiac tissue homeostasis in the process of ontogenesis in prematurity in the light of modern fundamental knowledge on the biology of cardiac stem cells, the structure of cardiomyocytes, paracrine regulation mechanisms and other pathogenetic mechanisms affecting the growth, development and remodeling of the cardiovascular system in childhood and in follow-up.Literature search strategy. A search for studies and analytical literature reviews was conducted in databases Cochrane library, MEDLINE, Google Academy, PubMed and other databases mainly from the beginning of 2018 to December 2023. Publications/ studies reflecting various aspects of the physiology of the infant heart in premature infants (clinical and experimental aspects) were independently selected for inclusion. Preference was given to randomized controlled trials.Results. Based on modern concepts of pre- and post-implantation (postnatal) development and growth of the infant heart, the analysis of the processes of postnatal growth and development of the heart of children born healthy full-term and premature with spontaneous natural conception is given. The analysis of the main pathogenetic mechanisms influencing the processes of growth and development of the child’s heart in the intrauterine and postnatal period is carried out.Conclusion. Experimental and clinical data reasonably require a conscious revision of the fundamental theoretical postulates about the regenerative capabilities of the myocardium in various periods of childhood, including the clinical group of premature babies, and practical guidelines for pregnancy management with the threat of abortion and infertility (preimplantation measures using assisted reproductive technologies), combined/intensive (including, respiratory) therapy in the neonatal period, longterm outpatient follow-up of children and adults born prematurely with low, very low and extremely low body weight in order to prevent, screen and treat potential effects on the health of the cardiovascular system throughout life. The information provided is very useful for a wide range of readers – biologists, embryologists, reproductive doctors, obstetricians, gynecologists, neonatologists, pediatricians, internists, cardiologists, surgeons.

Highlights The relationship between the rotational mechanics of the basal left ventricular segments and the geometric model of the mitral valve in patients with hypertrophic cardiomyopathy depending on the gradient of obstruction in the left ventricular outflow tract is presented in the research. Abstract Background . Hypertrophic cardiomyopathy is a common genetically determined disease of the heart muscle. Outflow tract obstruction and mitral regurgitation are the principal features of the disease. Previously, it was believed that these phenomena were primarily caused by the static component of obstruction-interventricular septum hypertrophy. Recently, however, attention has been paid to its dynamic component – SAM syndrome, namely, the role of the mitral valve apparatus in the pathogenesis of the obstructive form of hypertrophic cardiomyopathy. The features of one of the components of the mitral valve apparatus – the basal segments of the left ventricle adjacent to the mitral valve fibrous ring – has not been sufficiently studied. Aim . To evaluate the relationship between rotation and deformation of the basal segments of the left ventricle and 3D morpho functional parameters of the mitral valve in hypertrophic cardiomyopathy. Methods . The study involved 106 patients aged 23 to 78 years: 65 patients with obstructive form of hypertrophic cardiomyopathy, 13 patients with non-obstructive form of the disease, 18 patients with arterial hypertension and left ventricular hypertrophy, and 10 patients without left ventricular hypertrophy and mitral valve lesions. The complex of clinical and instrumental research methods consisted of medical interview, physical examination, standard transthoracic echocardiography (expert-level ultrasound system Vivid E9 (GE Healthcare)), Speckle Tracking Imaging (2D strain) technology to assess the deformation and rotation of the basal segments of the left ventricle, transesophageal echocardiography and real-time three-dimensional visualization of the mitral valve from the transesophageal access followed by post-processing three-dimensional quantitative reconstruction of the mitral valve. Results. Global strain and strain rate of the LV at the level of the basal segments, rotation and rotation rate in patients with hypertrophic cardiomyopathy, arterial hypertension with left ventricular hypertrophy and persons with an unchanged mitral valve did not differ significantly. In patients with the obstructive form of hypertrophic cardiomyopathy, global circumferential strain at the level of the basal segments of the left ventricle correlated with features of mitral valve annulus geometry (namely, anterolateral-posteromedial, commissural diameters and sphericity index of the mitral valve annulus) and the angle of the anterior mitral valve leaflet. Rotation at the level of the basal segments correlated with the anteroposterior diameter, height, sphericity index and area of the mitral valve annulus, as well as the length and area of the anterior leaflet, and the area of the posterior leaflet. Conclusion. Rotation and deformation of the basal segments of the left ventricle correlate with indicators of the geometry of the mitral valve fibrous ring as assessed by three-dimensional quantitative reconstruction.

Highlights. The hypothesis of the evolution of LV twisting types is proposed, which is based on the gradual transformation of LV twisting types as a prerequisite for postnatal growth and development of heart chambers in healthy children and adolescents. In the future, the transition of one type of LV twist to another will enable us to diagnose the predominance of growth and maturation of the fibrous skeleton, apex, vortex cordis, trabecular apparatus, as well as creating projections of the individual development and growth of the heart in childhood and adolescence. Abstract. Modern data on the nature of the mechanics of the left ventricle (LV) in postnatal ontogenesis in healthy children and adolescents born full-term are fundamental, since they allow not only to determine ontogenetically conditioned variants of individual development of contractile-rotational mechanisms of LV in the process of growth and development, but also, if necessary, make it possible to identify subclinical dysfunction in the early stages, monitor the effectiveness of complex therapeutic and rehabilitation measures. The article analyzes newly established fact of the absence of static character of the selected various forms of LV twisting into a systole and the ability of their transformation in the process of growth and development. This fact forms the basis of the author's original hypothesis of “the evolution of LV twisting models”, which provides the optimal ontogenetic growth of the child and adolescent heart in the postnatal period. The hypothesis of “evolution of left ventricular twisting types” is based on modern knowledge about multifaceted processes at the tissue level, the mechanics of LV in the individual rate of development and growth of the heart in childhood and adolescence.

The relationship between government and university medicine in the context of the development of the Asian "colonial" periphery of Russia in the late imperial period are studied. It is concluded that these relationship, the manifestations of which were most pronounced in the period of the fight against epidemics, are not quite standard from the point of view of model of the classical relationship between power and knowledge in the colonial context of European maritime empires. This is connected mainly with the social portrait of the university intelligentsia, with the peculiarities of their professional socialization, which led to the fact that in Siberia they broadcast the experience of the European metropolises, rather than the colonies.

Purpose. The study assessed left ventricle longitudinal strain of the endocardial, middle, and epicardial layers in children from one to five years old, born with low, very low, and extremely low body weight.Material and methods. The study was performed in 204 children aged from one to five years; of these, 53 children were prematurely born late in pregnancy, 103 children were born very preterm, and 48 children were born healthy and full-term. The left ventricle longitudinal strain of the endocardial, middle, and epicardial layers was assessed off-line using the Speckle Tracking Imaging-2D Strain technology.Results. Disturbance of the transmural gradient strain of left ventricle wall were detected in 11.32% of prematurely born late in pregnancy children and in 16.5% of very preterm children. A decrease of left ventricle segments strain was registered in 33.96% of children prematurely born late in pregnancy and in 18.44% very preterm children. In children of the same age, born healthy and full-term, transmural wall gradient disturbances and decrease of strain in left ventricle segments were not observed. In children prematurely born late in pregnancy, the disturbance of the transmural strain gradient of left ventricle and the decrease of strain in left ventricle segments are not associated with left ventricle remodeling.Conclusion. The development of the cardiovascular system in children of early and preschool age, born prematurely with low, very low, and extremely low body weight, is characterized by disturbances in the transmural strain gradient of left ventricle wall, due to the processes of postnatal growth and development of the child’s heart, which requires monitoring on an outpatient basis in polyclinic in childhood — by a pediatric cardiologist and a pediatrician, and in adulthood — by a cardiologist and therapist.

Высокие риски неблагоприятных событий со стороны сердечно-сосудистой системы в группе взрослых, рожденных недоношенными, требуют усиленного изучения вопросов физиологии и патофизиологии детского сердца при наличии информации о преждевременных родах в анамнезе, являющихся по современным представлениям хроническим состоянием. Истоки заболеваний сердца и сосудов во взрослом возрасте берут начало в патологии антенатального и раннего неонатального периодов развития и определяют в известной степени качество жизни взрослых пациентов в отдаленные временные промежутки. Использование современных неинвазивных ультразвуковых технологий исследования сердечно-сосудистой системы у детей, рожденных недоношенными с низкой, очень низкой и экстремально низкой массой тела, позволило получить новые данные фундаментального характера, а также существенно расширить традиционные представления о природе торсионных механизмов и вкладе потокогенной составляющей в процессы постнатального онтогенеза. Развитие различных моделей контрактильно-ротационных процессов и формирование нескольких вариантов вихревых диастолических потоков левого желудочка у детей в возрасте от одного года до пяти лет, рожденных недоношенными, является неотъемлемой частью процесса постнатального онтогенеза детского сердца при условии наличия фактора преждевременных родов в анамнезе. High risks of adverse cardiovascular events in the group of adults born prematurely require an intensified study of the physiology and pathophysiology of the child heart given the history of preterm birth, which is considered as chronic condition under modern concepts. The origins of heart and vascular disease in adulthood originate in the pathology of antenatal and early neonatal periods, determining to a certain extent the quality of life of adult patients in remote time intervals. The use of modern non-invasive ultrasound technologies for studying the cardiovascular system in children born prematurely with low, very low and extremely low body weight allowed to obtain new fundamental data as well as to expand significantly conventional conceptions of the nature of torsion mechanisms and the contribution of the flow-generating component in postnatal ontogenesis. The development of various models of contractile-rotational processes and the formation of several variants of left ventricular vortex diastolic flows in preterm-born children aged one to five years is an integral part of the process of postnatal ontogenesis of the child heart given a history of preterm birth.

Aim: To study contractility of the left ventricle (LV) in prematurely born children of early and preschool age who received treatment in intensive care units, neonatal intensive care units and pathology of newborns in the neonatal period.Material and Methods. The study included 155 children, of which 108 children aged from one to five years old, born with very low body weight and extremely low body weight; and 47 children of the same age, born full-term and healthy. Study design: pilot, cross-sectional, retrospective, case-control study. EchoCG was performed using the Vivid E9 ultrasound system (GE, Healthcare) with M5S matrix probe (1.5–4.6 MHz). The LV global circumferential (GCSMV, GCSPM, GCSApex), and longitudinal strain, as well as the global strain of the endocardial, middle and epicardial layers of the LV were assessed. in the systole “clockwise”) was found in 33.33% of children with a history of bronchopulmonary dysplasia, and in 28.13% of children who received mechanical ventilation during the neonatal period. In 25 (69.44%) of 36 children with signs of anemia in the neonatal period, there was a decrease in deformation along the circumference of the LV epicardial layer. In 13 (86.67%) of 15 clinical observations with signs of transient hypothyroidism in the anamnesis, a decrease in deformation along the circumference of the epicardial layer was revealed.Conclusion. Factors “body weight at birth”, “fetal growth retardation”, “anemia, use of mechanical ventilation in the neonatal period”, “transient hypothyroidism”, “development of bronchopulmonary dysplasia” in children of early and preschool age born prematurely with very low and extremely low body weight, adversely affect the formation of LV contractility and rotational mechanics in the postnatal period, exacerbating the disorders caused by the immaturity of the child’s heart tissue and the implementation of other pathogenetic mechanisms in prematurity, which requires medical supervision of this clinical group in polyclinic conditions.

Aim. To study the prognostic significance of cardiovascular risk factors (RFs) in the formation of all-cause and cardiovascular mortality based on the results of a 27-year prospective cohort study of Tomsk population of both sexes aged 20-59 years.Material and methods. The object of study was random house-to-house sample of Tomsk population. In total, 1546 people (630 men and 916 women) aged 20-59 were examined. In 1988-1991, the prevalence of following cardiovascular RFs was studied: hypertension (HTN), overweight, smoking, alcohol consumption, hypercholesterolemia (HCE), low high-density lipoprotein cholesterol levels (hypo-HDL-emia), hypertriglyceridemia (HTG). All examination methods used were strictly standardized. To determine the RF, the criteria generally accepted in epidemiological studies were used. Over 27 years of follow-up, 330 deaths were recorded, including 142 due to cardiovascular disease.Results. In the multivariate Cox proportional hazard model, the following va­riables were studied: HTN, overweight, smoking, alcohol consumption, HCE, hypo-HDL-emia, HTG, coronary artery disease (CAD) (according to epi­demio­logical criteria), and age. The strongest predictor of of all-cause death was frequent alcohol use (relative risk (RR) 2,75). Smoking increased the risk of death by 2,72 times. Among former smokers, the risk of all-cause death was 1,9 times higher compared to non-smokers. HTN increases the death risk by 1,61 times. Each year of life lived increases the death risk by 1,06 times. The most significant risk factor for death from CVD was frequent alcohol consumption (RR 3,01). Smoking increases the cardiovascular death risk by 2,28 times. Among former smokers, the RR of cardiovascular death was 1,91. HTN increases the risk of cardiovascular mortality by 1,84 times compared with people with normal blood pressure. Each year of life lived increases the risk of cardiovascular death by 1,1 times. In multivariate analysis, overweight, HCE, hypo-HDL-emia, HTG did not have a significant independent effect on the all-cause and cardiovascular death risk.Conclusion. In a 27-year cohort prospective study, independent predictors of all-cause and cardiovascular mortality, along with hypertension and age, were lifestyle risk factors, such as smoking and frequent alcohol consumption.

Прогрессивный взгляд на биологию лактации и физиологию грудного вскармливания позволяет рассматривать грудное молоко кормящей женщины в качестве «живой системы и иммунного органа». Обнаружение в составе грудного молока различных пулов клеток, включая стволовые клетки грудного молока, а также экзосом, содержащих микроРНК, делает возможным понимание и объяснение на новом уровне особенностей развития сердечно-сосудистой системы у взрослых и детей, рожденных недоношенными и получавших в течение первого года жизни различные варианты вскармливания. Отсутствие при вскармливании детей первого года жизни грудного молока приводит к более выраженным изменениям морфологии (ремоделированию) и функциональных характеристик сердца, преобладанию особых («реверсивных») форм вращения левого желудочка, что свидетельствует о специфичных закономерностях формирования механики, роста и развития детского сердца у рожденных преждевременно в постнатальный период. Междисциплинарный подход, изучение грудного молока с точки зрения сложной биосистемы, а не только как источника питательных веществ помогут установить влияние характера вскармливания детей до года на процессы постнатального роста и развития детского сердца при условии наличия фактора недоношенности в анамнезе. Дальнейшее исследование влияния на организм недоношенного ребенка компонентов грудного молока призвано революционно изменить традиционные представления о биологии лактации и физиологии грудного вскармливания, а также существенно скорректировать теоретические фундаментальные постулаты по физиологии/патофизиологии постнатального роста, развития и функции сердечно-сосудистой системы. A progressive outlook on the biology of lactation and the physiology of breastfeeding allows the breast milk of a nursing woman to be considered as a "living system and immune organ." Discovering of various cell pools in breast milk, including breast milk stem cells and exosomes containing microRNAs, makes it possible to understand and explain at one new level features of cardiovascular system development in adults and prematurely born children received various feeding options during the first year of life. The absence of breast milk during feeding of children in the first year of life leads to more pronounced changes in morphology (remodeling) and functional characteristics of the heart and the prevalence of special ("reversible") forms of left ventricular rotation, indicating specific patterns in formation of mechanics, growth and development of heart in children born prematurely in postnatal period. An interdisciplinary approach and the study of breast milk in terms of a complex biosystem and not only as a source of nutrients would help to establish the impact of the nature of feeding children under one year of age on processes of postnatal growth and development of child heart, under condition of prematurity factor in the history. Further investigation of breast milk components’ impact on premature infant’s organism is intended to breakthrough conventional conceptions of lactation biology and breastfeeding physiology as well as to adjust in substantial way theoretical fundamental postulates on the physiology/pathophysiology of postnatal growth, development and function of the cardiovascular system.

An increase in the birth rate of premature and low birth weight children at the current level of medical development requires the development of fundamental ideas about the physiology of the cardiovascular system in a history of preterm birth from the point of view of pre- and postnatal ontogenesis. For practicing neonatologists, pediatricians, therapists, cardiologists, reproductologists, etc., it is necessary to improve the traditional ideas about the mechanisms of damage to the cardiovascular system in this category of patients. Because it is established that this clinical subgroup is characterized by increased risks of early onset of pathology of the heart and blood vessels, as well as a high mortality rate in adulthood. Pathological changes of the cardiovascular system in conditions of prematurity can occur at various levels of integration of the body (molecular, subcellular, cellular, organ, functional systems, organismal). The use of modern noninvasive technology of “spot tracing” makes it possible to study the features of segmental deformation and the variety of forms of left ventricle (LV) torsion mechanics during postnatal growth and development in prematurely born children. Optimization of research and diagnostic processes in the field of mechanics of the infant heart in the prenatal and postnatal periods from the point of view of progressive data on anatomy, histology, and clinical biochemistry allows us to study the nature of various contractile–rotational models, as well as reasonably assume the contribution of the fibrous skeleton of the infant heart to the formation of “childhood types” of left ventricular twisting. The search and development of informative criteria for the early diagnosis of latent subclinical heart dysfunction in childhood, taking into account the possibilities of non-invasive ultrasound technology of spot tracing (analysis of types of rotational movement, determination of areas of reduced longitudinal deformation of the LV), based on the current provisions of evidence-based medicine, have become quite possible in modern conditions and are demonstrated by the authors in this review. The information offered to the readers will allow them to expand the understanding of the physiology and pathophysiology of the infant heart with a history of premature birth, bearing in mind the fact that prematurity is considered a chronic condition.

Highlights The differences in the postnatal ontogenesis of the heart in children from one to five years old born prematurely and with low, very low, and extremely low birth weight were revealed. The coexistence of different models in contractile-rotational processes of the left ventricle was demonstrated. Abstract Aim . To expand the traditional ideas about the left ventricle (LV) mechanics formation processes in children born with low, very low and extremely low body weight in the postnatal period during the process of growth and development. Methods. The study was conducted in 237 children aged from one to five years old: 51 children born healthy and full-term (FT), 68 children born with low body weight (LBW) and 118 children born with very low (VLBW) and extremely low body weight (ELBW). The analysis of clinical, anamnestic data, indicators of standard echocardiography and LV mechanics was performed using discriminant analysis. To demonstrate the assessment of remoteness or proximity between clinical groups, the Mahalanobis distance was used. Visualization of the structure distribution of groups in a multidimensional feature space was carried out in the coordinates of the first two discriminant functions (canonical roots, canonical variables) of discriminant analysis. The evaluation of the discriminant functions significance was verified by Wilks statistics. Statistical analysis was performed on a personal computer using the Statistica program (version 12). Results . The most informative criteria for F (8.462) = 100,84 are “body weight at birth” (p = 0.000000), “character of feeding up to a year” (p = 0.000000) and direction of apex rotation (p = 0.0098). Conclusion . The use of discriminant analysis makes it possible to establish a change in the degree of the selected criteria influence on the level of differences between clinical groups, demonstrating fundamentally new aspects of a child's heart mechanics formation in the history of prematurity.

The active use of assisted reproductive technologies has allowed us to achieve very impressive results, which allows us to consider this method as one of the effective approaches to infertility treatment. More than eight million children have been born worldwide with the help of assisted reproduction to date. At the same time, assisted reproductive technologies are an important risk factor, since long-term consequences for the morphology and function of the child’s heart can predispose to premature cardiovascular morbidity and mortality. These facts require a revision of traditional ideas about the long-term safety of their use, the formation of special registers. The creation of registers of the use of assisted reproductive technologies optimizes the process of long-term monitoring of children born with their use. The analysis of experimental and clinical studies presented in the review creates a theoretical basis for understanding the subtle mechanisms of the formation of postnatal health in children born prematurely and in the process of using inflammatory reproductive technologies. This review of the literature will allow doctors of various specialties (embryologists, reproductologists – obstetricians-gynecologists, neonatologists, pediatricians, therapists, cardiologists) and producers of culture media to significantly expand traditional ideas about the impact of assisted reproductive technologies on the health of the cardiovascular system in childhood, since even small changes in the conditions of cultivation and the composition of the culture medium for the embryo, the peculiarities of the course of pregnancy can have significant delayed effects on the health of children, born with the use of assisted reproductive technologies. Therefore, it is obvious the importance of monitoring children of this clinical group in order to further clarify possible long-term health consequences, a deeper understanding of the fundamental patterns of postnatal development and early diagnosis of subclinical disorders of the cardiovascular system.

The Russian Society of Cardiology (RKO) With the participation of: The National Society for the Study of Atherosclerosis (NOA), the Russian Association of Endocrinologists (RAE), the Russian Society of Cardiosomatic Rehabilitation and Secondary Prevention (RosOKR), the Russian Scientific Medical Society of Therapists (RNMOT), the Eurasian Association of Cardiologists, the Eurasian Association of Therapists (EAT), the Russian Association of Gerontologists and Geriatricians

Objective – to investigate cerebrovascular reactivity (CVR) depending on rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) positivity in hypertensive patients with rheumatoid arthritis (RA).Subjects and methods. A single cross-sectional study included 61 patients (mean age 59.8±7.7 years; 6 men and 55 women) with combined RA and grade 1–2 hypertension (HTN). The duration of RA was 11.2±7.4 years. The duration of HTN was 12.1±8.6 years. All patients were treated with methotrexate. RA patients were categorized into RF/ACPA seronegative and RF/ACPA seropositive subgroups. CVR was evaluated by bilateral transcranial Doppler sonography of the middle cerebral arteries (MCA) in a hyperoxic test (O2 CVR) and in a hypercapnic test (CO2 CVR). We measured MCA mean blood flow velocity (Vmn), time average maximal blood flow velocity (TAMX), peak systolic velocity (Vps) at baseline, within 2 minutes of 100% oxygen inhalation and within 3 minutes of recovery phase (hyperoxic test). We calculated the following indicators for assessing CVR: index changes of flow velocity mean (IFVm), speed modification of velocity (SMFVm) and normalized answer of reserve (NAR). Then, according to the same scheme, we performed a hypercapnic test with the inhalation of a 4% mixture of carbon dioxide with air. Values are presented as Me [Q1 ; Q3 ].Results and discussion. Hypertensive patients with RA had a decrease in response power of MCA blood flow to hyperoxia. RF-seropositive RA patients had a more pronounced decrease in the power of the response to hyperoxia compared with RF-seronegative RA patients. The values of IFVm in the hyperoxic test were –13.4 [–19.9; –0.9] versus –16.2 [–22.7; –13.4]% (р=0.0453), respectively. ACPA-seropositive RA patients had not only a more pronounced decrease in the power of the response of MCA blood flow to hyperoxia, but also a more pronounced slowdown in the response velocity of MCA blood flow to hyperoxia compared with ACPA-seronegative RA patients. The values of IFVm in the hyperoxic test were –9.74 [–15.9; 2.84] versus –20.9 [–25.0; –14.7]% (р=0.0062), the values of SMFVm were –0.05 [–0.09; 0.02] versus –0.09 [–0.20; –0.05] sm/s2 (р=0.0488) respectively. Combined RA and HTN patients had a decrease in response power of MCA blood flow to hypercapnia. However, no statistical differences were found in the state of CO2 CVR between patients with seropositive RA and seronegative RA.Conclusion. Hypertensive patients with seropositive RA have a more pronounced O2 CVR disorder in compared to seronegative RA patients.

The review presents an analysis of the scientific literature on comorbidity of coronary artery disease (CAD) and assessment of its impact on the results of coronary artery bypass grafting (CABG). Arterial hypertension (AH), chronic obstructive pulmonary disease (COPD), metabolic syndrome (MS), and diabetes mellitus (DM) have been shown to be the most common comorbidities in CAD patients. Clinical manifestations of cardiovascular comorbidities also include atrial fibrillation, acute cerebral ischemia, atherosclerosis of carotid and lower limb arteries, and chronic heart failure.Concomitant COPD doubles the risk of postoperative complications after CABG and reduces the 10-year survival rate in patients to 30%. In CAD patients with MS, the risk of postoperative mortality increases by 1.4 times, and the 5-year survival rate decreases by 3 times. Diabetes significantly worsens the long-term survival of patients after CABG and is an independent predictor of acute cardiovascular events after revascularization in the long term. The presence of various comorbidities in CAD patients requires a personalized approach to managing the risks of adverse outcomes after CABG and introduction of modern artificial intelligence (AI) technologies into clinical practice, which significantly increase the accuracy of prognosis.

This literature review analyzes current data on the main stages of child’s heart contractility development from prenatal to postnatal period. The presented information will expand the conventional ideas on the age-related cardiovascular physiology in children, supplementing with relevant knowledge about the patterns of left ventricular mechanics, and the mechanisms affecting child’s heart morphology. In addition, we consider the evolutionary feasibility of the simultaneous existence of various left ventricular mechanics models, which ensure the effective cardiac function in the postnatal period. This is very important for the work of neonatologists, pediatricians, pediatric cardiologists and therapists.

Aim. To study the interdependence of spousal body mass and influence of spouse overweight on the death risk according to the 27-year cohort prospective study.Material and methods. We examined a random household sample (n=1546; married couples, 427). Overweight frequency among spouses was studied on the first stage of the study (1988-1991). In 2002-2005 (stage II), the examination was repeated and overweight dynamics were studied. In 2015 (stage III), we analyze mortality rates and significance of overweight and spousal overweight for the mortality risk formation. Overweight was detected in people with body mass index ≥25 kg/m2. Two hundred deaths were recorded during 27-year follow-up. Vital status was established for 97% of observed persons.Results. Overweight was detected in 61,1% of men who lived with overweight wife and in 45% of men whose wife had normal body mass (p<0,01). Overweight was diagnosed more often in women whose husband also had overweight comparing with women who lived with normal weight husband (76,2% vs 61,7%; p<0,001). The risk of overweight formation among individuals whose spouse’s body mass increased from norm to overweight was in 3,04 times higher than in persons whose spouse had a stable normal body mass and in 2,2 times higher than in participants whose spouse had overweight on study stages I and II. Relative risk of mortality in men who lived with overweight wife was 2,07.Conclusion. 1) We found the body mass concordance in spouses. 2) The average body mass index in men and women who lived with overweight spouse is higher than in men and women whose spouse had a normal body mass. 3) Interdependence of spousal body mass was revealed in dynamics. 4) Spousal overweight is an independent predictor of premature mortality in men.