OBJECTIVE:The aim of this study is to evaluate the cost-effectiveness, diagnostic accuracy, clinical outcomes, and radiation exposure associated with rubidium-82 chloride perfusion PET. METHODS:A comprehensive literature search up to October 2024 was conducted to identify key studies assessing the use of rubidium-82 chloride perfusion PET/CT in ischemic heart disease (IHD). These studies included economic analyses, evaluations of diagnostic accuracy, and comparisons with other imaging modalities such as single-photon emission computed tomography (SPECT), stress echocardiography, and invasive coronary angiography. RESULTS:The reviewed studies demonstrate that rubidium-82 chloride perfusion PET/CT has high sensitivity and specificity in detecting IHD (90% and 91%, respectively) accompanied by significant coronary artery stenosis. Economic analyses show that this method is cost-effective due to a reduction in the use of downstream invasive procedures, leading to overall cost savings. Additionally, the economic impact on healthcare is enhanced by a lower level of radiation exposure compared to traditional perfusion SPECT imaging, reducing associated future radiation risks. The cost-effectiveness and minimum patient throughput required for implementing this modality In Russia were evaluated. CONCLUSION:The presented data confirm the cost-effectiveness of rubidium-82 chloride perfusion PET/CT by reducing costs for subsequent diagnostic and therapeutic interventions while maintaining a sufficient patient flow.

Cardiovascular disease is one of the most frequent cause of death globally. The greatest part is occupied by ischemic heart disease. HIV patients are composed to a higher risk of coronary heart disease. The purpose of this work is to evaluate the possibility of using molecular imaging methods in a comprehensive examination of patients with HIV infection and ischemic heart disease. Materials and methods. The survey group includes 32 patients with HIV infection. The comparison group consists of 25 age-matched patients with coronary heart disease and without HIV Infection. All patients were underwent myocardial perfusion scintigraphy using single photon emission computed tomography. Positron emission tomography with FDG were performed if necessary to assess the viability of the myocardium. The patients of the main group undergo diagnostic coronary angiography and standard set of laboratory and institutional diagnostic methods. Results. The results of which confirm the high efficiency of radionuclide diagnostic methods for detecting perfusion disorders, contractility and myocardial viability in patients with HIV infection even at an early stage. They can be recommended for using in a comprehensive examination of patients with HIV infection.

ВИЧ-ассоциированные заболевания внутренних органов достаточно многообразны, среди них именно патология сердечно-сосудистой системы является одной из непосредственных причин гибели пациентов с ВИЧ-инфекцией. Наблюдательные исследования показали, что ВИЧ-инфицированные лица имеют высокий риск неблагоприятных сердечно-сосудистых событий по сравнению с остальной популяцией. Сердечно-сосудистые заболевания, обусловленные атеросклерозом, в том числе инфаркт миокарда и инсульт, представляют одну из основных причин смертности среди ВИЧ-положительных больных. Ряд исследований указывают на ускорение процессов атерогенеза вследствие ВИЧ-инфекции. В качестве возможных причин обсуждаются как прямое воздействие ВИЧ, так и другие факторы, которые имеют место у данной категории лиц: побочные эффекты антиретровирусной терапии, злоупотребление наркотическими средствами, сопутствующие заболевания, связанные с ВИЧ. Помимо специфических факторов риска у пациентов с ВИЧ-инфекцией могут присутствовать и традиционные — курение, гиподинамия, ожирение, гиперхолестеринемия. Результаты различных исследований показывают, что существует большой научный и практический интерес к проблеме атеросклероза у пациентов с ВИЧ-инфекцией.

Novel biological markers, such as fibrosis marker galectin-3, peptide hormone adrenomedullin, soluble ST2, chemokine CX3CL1, surrogate marker of vasopressin, and others, are every year one step closer to being introduced into health practice. Over the past decades, significant progress has been made in the study of cardiovascular biomarkers. A key moment was the introduction of deter mining the concentration of natriuretic peptides used as markers for the diagnostic and prognostic evaluation of patients with heart failure. Currently, in order to search for novel markers for early diagnosis and risk stratification, studies have been conducted on the analysis of promising inflammatory marker tenascin-C (TNC) in cardiovascular patients. Data have been obtained that allow us to consider TNC as a tool for risk stratification and assessment of cardiovascular disease prognosis. The combination of TNC with other biological markers, in particular brain natriuretic peptide, may improve prognostic power. Nevertheless, serial testing to assess the prognosis and effectiveness of ongoing treatment, including in the conditions of a multimarker model, requires further research.

Non-communicable diseases, coronary heart disease has ranked first among the causes of morbidity and mortality according to WHO over the past decade and a half in most developed countries. Molecular imaging techniques make it possible to detect this disease at an early stage, determine the prognosis, risks and the need for intervention. Radionuclide diagnostics can be widely used in patients with cardiac diseases to assess the viability of cardiomyocytes and myocardial perfusion and to detect the presence and extent of perfusion defects, stress-induced ischemia, and post-infarction changes using single photon emission computed tomography and positron emission tomography. Compared with foreign countries, radionuclide imaging methods are not currently widely used in cardiology practice in Russia. This review highlights the physical foundations of single-photon emission tomography and positron emission tomography, the physiological and pathophysiological basis of radiopharmaceutical uptake in myocardial tissue, the mechanisms and procedures for performing functional pharmacological and physical stress tests, and recent data in the field of radionuclide imaging of myocardial pathology. This review aims to acquaint the reader with the world practices of using positron-emitting radionuclides in diagnostic procedures, highlighting both their basic principles and the latest achievements in this area. The review focuses on the practice of using 82Rb in the assessment of myocardial perfusion, including in comparison with other positron-emitting radionuclides, as one of the promising areas of development in the diagnosis of coronary heart disease.

Purpose: to determine the role of nuclear medicine methods in the diagnosis and quality control of treatment and rehabilitation of patients with complications after coronavirus diseasr (COVID-19) The article provides a brief analysis of the incidence of COVID-19 and highlights the role of diagnosis, treatment and rehabilitation of patients suffering from the consequences of coronavirus diseasr after the end of the pandemic. The most common clinical manifestation of coronavirus diseasr is bilateral interstitial pneumonia, one of the complications of which is the development of acute respiratory distress syndrome, its pathogenesis is highlighted. It is also noted that the leading link in the development of the disease is a systemic lesion of the endothelial vascular wall, which is the cause of thrombosis and its complications, primarily pulmonary embolism, ischemic brain infarctions and cardiovascular catastrophes. Specific methods of radionuclide diagnostics are described for individual organs and systems: respiratory, cardiovascular, brain, and others. The need to diagnose and control the quality of treatment and rehabilitation of patients with post-inflammatory changes in the parenchyma of internal organs and a decrease in their functional ability due to sclerotic changes, patients with changes in the state due to the transition of inflammation to the chronic stage, as well as with an overactive immune response to inflammatory changes. Conclusion: at the stage of diagnosis and treatment of the consequences of a previous coronavirus diseasr and subsequent rehabilitation, molecular imaging methods are essential in a complex of studies.

Abstract. This article provides a historical overview of the use of radionuclide methods for the diagnosis of HIV infection and its complications. Molecular imaging methods have been effectively used for a long period of time for the qualitative and quantitative assessment of lymphadenopathy and for the study of the biodistribution of a radiopharmaceutical, on the basis of which it is possible to indirectly track the dynamics of the patient's condition. Also, radionuclide diagnostic methods, in particular PET / CT, can detect malignant neoplasms, which are a frequent complication of HIV infection in the late stages. The works devoted to the determination of the possibilities of nuclear medicine in the diagnosis of HIV have had a significant impact on the development of modern radiation diagnostics of infectious diseases.

Objective. To prove the safety and efficacy of distal radial artery (DRA) puncture for endovascular interventions versus the traditional forearm radial artery (RA) puncture site by comparing immediate and long-term results. Methods. In 2017, a multicenter, open, randomized (1:1) study TENDERA (Comparison between Traditional Entry Point and Distal Puncture of Radial Artery) was started. During 2 years, 520 patients were included, mean age 63.4±10.0 years. The observation group (DRA puncture) included 271 patients, the comparison group (RA puncture) - 249 patients. The study included both stable patients and those with NSTEMI: the observation group - 39 (14.4%), the comparison group - 34 (13.7%), p=0.809. The primary endpoint is immediate (hospital) or late radial thrombosis. Secondary endpoints are: 1 - composite point, complications from the access artery; 2 - puncture parameters. Results. The average difference in the diameters of the RA and DRA was 0.3 mm and 0.4 mm, in some patients the DRA diameter corresponded to the RA or even exceeded it. The diameter of RA and DRA in men and women significantly differs, 2.65±0.44 mm and 2.36±0.36 mm (p=0.001), 2.31±0.39 mm and 2.13±0.38 mm (p=0.001). Technical success of DRA access requre the number of attempts. 94.1% - the percentage of successful cardiac catheterization performed through the distal radial artery approach, which is significantly less than via RA - 100% (p<0.001). In the observation group, significantly fewer rebleedings and rehemostasis were occured. In the long-term period, there were registered outstandingly more hematomas in the observation group at the time of discharge and after 1 week. Conclusion. Intermediate analysis of the results of the TENDERA study shows that there is no significant difference in the primary endpoint, but the number of complications in the observation group associated with the puncture markedly - hematoma more than 5 cm to the day of discharge and after 7 days. What this paper adds Intermediate results of the first multicenter open randomized (1:1) study devoted to the comparison of distal puncture of the radial artery versus the traditional entry point of puncture of the radial artery on the forearm during the endovascular interventions have been presented. A significant reduction of the number of local complications has been revealed in the group of distal puncture of the radial artery and the absence of differences according to the primary endpoint: early and late radial artery thrombosis.