Microvascular obstruction (MVO) of coronary arteries promotes an increase in mortality and major adverse cardiac events in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). Intramyocardial hemorrhage (IMH) is observed in 41–50 % of patients with ST-segment elevation myocardial infarction and PCI and is accompanied by inflammation. There is evidence that microthrombi are not involved in the development of MVO, which is associated with infarct size, the duration of ischemia, and myocardial edema. However, there is no conclusive evidence that the latter plays an important role in the development of MVO. There is evidence that platelets, inflammation, Ca2+ overload, neuropeptide Y, and endothelin-1 could be involved in the pathogenesis of MVO. The role of endothelial cell dysfunction in MVO formation in patients with AMI and PCI remains under question. It is unclear whether nitric oxide production is decreased in patients with MVO. It was obtained only indirect evidence on the involvement of inflammation in the development of MVO. The role of reactive oxygen species, necroptosis and pyroptosis in the pathogenesis of MVO is also not studied. The participation of thromboxane A2, vasopressin, and prostacyclin in the formation of MVO is unknown. It was not obtained conclusive evidence on the involvement of coronary artery spasm in the development of MVO. Dual antiplatelet therapy improves the efficacy of PCI in prevention of MVO. It is unknown whether epinephrine or L-type Ca2+-channel blockers improves coronary blood flow in patients with MVO.

Aim. To evaluate the heart morphological features and the significance of the non-ischemic myocardial contrast pattern in medium-term prognosis of continued left ventricular (LV) remodeling after surgery in patients with ischemic cardiomyopathy.Material and methods. The results of paramagnetic contrast-enhanced cardiac magnetic resonance imaging (MRI) were analyzed in 31 patients with ischemic cardiomyopathy with an average age of 58,4±7,6 years before complex surgical treatment. The heart morphological features and non-ischemic contrast pattern in the myocardial segments remote from the infarction area according to contrast-enhanced MRI were assessed.Results. Patients with a non-ischemic contrast pattern had higher left atrial volume index (p=0,02), LV end-systolic index (p=0,03), and right ventricular sizes (p=0,01). A relationship was found between the left atrial volume index and cardiac remodeling in the postoperative period (p<0,005, correlation coefficient r=0,53).Conclusion. Non-ischemic myocardial contrast pattern is accompanied by an increase in the left atrial volume, which in turn is a predictor of continued LV remodeling in patients with ischemic cardiomyopathy in the postoperative period.

BACKGROUND:In the progression of atherosclerotic lesions of the brachiocephalic arteries, disturbances occur interdependently in the venous system, its extra- and intracranial sections. Therefore, an adequate assessment of the venous component of cerebral hemodynamics should be an important addition to the study of the arterial bed. The most common diagnostic method for detecting pathological changes in cerebral vessels today is ultrasound. However, there is still not enough information about which parameters clinically most valuable reflect venous remodeling and outflow disturbance. Changes in the structural and functional parameters of the internal jugular veins with varying degrees of stenosis of the carotid arteries were studied in fragments. AIM:To study the venous outflow through the internal jugular veins at different degrees of the internal carotid arteries stenosis. MATERIAL AND METHODS:The study included 91 patients who underwent ultrasound examination of the carotid arteries and internal jugular veins. According to the ultrasound results, patients were initially divided into three groups: group 1 (main) - 26 patients with hemodynamically significant stenosis of the internal carotid arteries of 70% or more by area (stenosis of 'high' degree), group 2 (comparison) - 31 patients with stenosis of the ICA 50-60%, which we defined as 'borderline', group 3 (control) - 34 patients with stenosis of the ICA less than 30% ('small' stenoses). In 9 patients, a comprehensive MR-tomographic and MR-angiographic examination of the brain was performed. RESULTS:In the group with 'high' degree stenoses, the venous peripheral and central venous pressure were statistically significantly lower, the area of the internal jugular vein were larger, and the linear velocity and volumetric flow rate on the side of the stenosis were higher than in the groups with 'borderline' and 'small' stenoses. The indicators in the group of 'borderline' stenoses were statistically significantly different from the group with 'high' degree stenosis and did not differ from the indicators of the control group, the division of this group into two subgroups: with stenoses up to 55% and more than 55% showed a statistically significant difference in linear velocity and volumetric flow rate as between subgroups and between the subgroup with stenoses greater than 55% and the control group. CONCLUSION:Evaluation of the geometric and hemodynamic parameters of the internal jugular veins during a comprehensive ultrasound examination in patients with various degrees of stenosis allows clarifying the hemodynamic significance of stenotic lesions of the internal carotid arteries and then confirming the significant nature of the stenosis on MRA. Quantitative assessment of venous blood flow should be included in the complex ultrasound examination in patients with carotid atherosclerosis.

Aim. To study changes in the size and linear velocities of the blood flow of internal jugular veins in patients with high degree stenosis of the extracranial carotid artery. Methods. The study included 28 patients: 14 patients with high degree stenoses of the internal carotid arteries (70% and more by NASCET criteria) constituted group 1, 14 patients with “small” stenoses of the ICA (less than 30%) – group 2. The state of blood flow in the extracranial sections of the main arteries of the head were evaluated using ultrasound. Results. When studying the features of venous blood flow, the following was found: in the group with unilateral hemodynamically significant stenosis, in contrast to the group of patients with “small” stenoses, the venous pressure measured on the arm was statistically significantly lower, and therefore the calculated central venous pressure, while the linear velocities of the peaks S and T were statistically significantly higher by 1 the group on the side of hemodynamically significant stenosis. On the side of contralateral stenosis in group 1, there was statistically significantly less area of VAV, and the ratio S 1 /S 2 , than in patients of group 2. Intra-group analysis revealed a statistically significant difference in almost all indicators in patients with hemodynamically significant stenosis compared with the contralateral side: the diameters of the vein and its area were larger, and the linear rates of the A, S and T peaks were higher. Whereas there were no statistically significant differences in the group of “small” stenoses. Conclusion. Changes in venous blood flow in the jugular veins are interrelated with the development of high degree carotid stenosis and have diagnostic significance, can be used as an additional sign of the hemodynamic significance of carotid stenosis.

HighlightsWe have analyzed the parameters of cerebral hemodynamics and left ventricular functional capacity in patients with occlusion and stenosis of the contralateral internal carotid artery during vascular surgery. Considering the importance of the left ventricular functional capacity and treatment options to ensure the stability of cerebral circulation in patients with occlusion and hemodynamically significant stenosis of the contralateral carotid artery, its detailed study at all stages of vascular surgery remains necessary. AbstractAim. To study cerebral hemodynamics and left ventricular functional capacity in patients with occlusion and stenosis of the contralateral internal carotid artery (ICA) to optimize treatment at the preoperative phase.Methods. The study compared the hemodynamic parameters of the blood flow of the ICA, vertebral arteries and left ventricular functional capacity in patients with ICA occlusion and contralateral ICA stenosis, which formed the 1 group (12 patients), and patients with unilateral hemodynamically significant stenosis, which formed the 2 group (52 patients). The blood flow in the extracranial portions of the major arteries of the head and heart was assessed using ultrasound, and the arterial vascular system and brain structure was assessed using MRI and MRA.Results. Before surgery, statistically significant differences in velocity parameters in the vertebral arteries on the occlusion side were found; on the contralateral occlusion side, velocity parameters in ICA were significantly different from the corresponding indicators in the group with unilateral stenosis; after surgery, statistically significant differences were found in the common carotid and vertebral arteries on the occlusion side; on the contralateral occlusion side, differences in velocity parameters in the common carotid, internal, and vertebral arteries were revealed in comparison with the group with unilateral stenosis. Of the indicators of the left ventricular functional capacity, only left ventricular ejection fraction differed significantly when comparing the group of patients with occlusion and stenosis of ICA and the group of patients with unilateral stenosis. Moreover, when evaluating pre- and postoperative outcomes in the group of patients with occlusion, significant differences were obtained only regarding the vertebral artery on the side of occlusion – the peak systolic blood flow velocity and the volumetric blood flow velocity significantly decreased. There were no significant differences between the common carotid, internal carotid arteries on the contralateral occlusion side, and middle cerebral arteries.Conclusion. Carrying out a comprehensive ultrasound examination of the main arteries of the head in combination with magnetic resonance imaging of the brain is a reliable and adequate way to assess cerebral hemodynamics, changes in the vascular bed and structure of the brain. Given the extreme importance of the left ventricular functional capacity to ensure the stability of cerebral circulation in patients with occlusion of the internal carotid artery and contralateral hemodynamically significant stenosis, its detailed study before carotid endarterectomy is necessary to adjust therapeutic measures.

Введение. Проблема атеросклеротических поражений артериальных сосудов общепризнанно сегодня является важнейшей причиной смертности трудоспособного населения во всех индустриальных странах, в том числе и в России [1]. При этом все большее внимание уделяется не только изолированной диагностике патологии коронарных и каротидных артерий, но и ранней диагностике атеросклеротических поражений аорты, поскольку именно состояние аорты понимается сегодня как ключевой фактор для прогноза жизни пациента и тесно связано с поражением артерий жизненно важных органов, прежде всего сердца, мозга и почек [2–4]. Целью нашей работы стала оценка взаимосвязи атеросклеротического поражения аорты и крупных артериальных сосудов по данным МРТ.

цель: выявление по данным МРТ характерных фенотипов структурных изменений головного мозга (ГМ) у больных резистентной артериальной гипертензией (РАГ) по данным МРТ и возможности их коррекции через год после ренальной денервации (РДН).

A study of foreign and domestic literature devoted to the application of texture analysis of magnetic resonance images of the heart was performed. The analysis included publications selected by key words and their combinations: cardiac magnetic resonance imaging (MRI), myocarditis, myocardial infarction, cardiomyopathy, radiomics, and texture analysis. Radiomics and texture analysis, as a new and rapidly developing direction of in-depth analysis of digital medical images, is developing, the number of publications on this topic is growing every year and the topic is not losing its relevance. Radiomics is a promising method of image analysis that aims to improve the diagnosis and prognosis of diseases by extracting a large number of quantitative features that can be missed by the human eye in the visual analysis of images. Radiomics biomarkers derived by extracting data from magnetic resonance images of the heart could be a valuable tool for assessing myocardial viability, myocardial lesions in myocarditis and cardiomyopathies.

BACKGROUND:The number of published studies exploring risk factors for the development of early postoperative complications predicted based on the findings of magnetic resonance imaging in patients with left ventricular dysfunction is limited. OBJECTIVE:Our study was aimed at searching for predictors of a complicated course of the postoperative period in patients with ischemic cardiomyopathy. PATIENTS AND METHODS:In a total of 44 patients prior to comprehensive surgical treatment of ischemic cardiomyopathy, we analyzed volumetric and linear parameters of the left ventricular myocardium by means of contrast-enhanced cardiac magnetic resonance imaging. For prognostic purposes, we proposed volumetric-myocardial indices: the ratio of the end-diastolic volume to the viable myocardium mass (DVM) and the ratio of the end-systolic volume to the viable myocardium mass (SVM). RESULTS:It was found that the ratio of the end-systolic volume to the viable myocardium mass was the only independent risk factor for the development of postoperative complications and that an increase of the SVM index by one unit increased the risk of developing complications in the early postoperative period 6.68-fold. CONCLUSION:The assessment of the proposed index at the preoperative stage may contribute to optimization of selection of patients for surgery.

Aim. Pathological accumulation of contrast-paramagnetic by the aortic wall interrelated with volume of ischemic myocardial infarction damage and left ventricular ejection fraction (EFLV) were studied in patients with acute myocardial infarction (AMI). Materials and Methods. By contrast-enhanced MRI (CE-MRI) and quantitative methods of image processing left ventricular mass (ММLV) and mass of myocardial damage (МDAMI) were calculated. 25 patients having AMI within 2–4,5 weeks (19 male, 6 female, age 60.6±3.8 years), 12 patients with stable angina without AMI (7 male, 5 female, age 57.6±3.3 years) and 11 practically healthy people without heart disease (6 male, 5 female, age 63.1±3.2 years) were studied. Results. Paramagnetic contrast enhancement of the aortic wall was found to be significantly correlated with severity of infarction damage (the index (МDAMI/ММLV))). Enhancement index T1-WI of the aortic wall less than 1.18–1.20 means that only 2 of 10 patients had myocardial damage higher 20 % (i. e., (МDAMI/ММLV)>0.2); the index greater than 1.20 means 10 of 15 patients had the damage (p<0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.><0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.

Introduction. Type 2 diabetes is the most common form of endocrine disease. Diabetes is a well-established risk factor for stroke. Carotid endarterectomy (CEE) is the main method of preventing a serious complication of stroke in patients with carotid stenosis. Consequently, the assess of type 2 diabetes on the results of CEE is an urgent problem of angiosurgery. Aim: To assess effect of type 2 diabetes on cerebrovascular reserve capacity and brain structure in patients with carotid atherosclerosis by ultrasound and magnetic resonance diagnostic. Material and Methods. 44 patients with hemodynamically significant stenosis of the internal carotid arteries (ICA), who underwent ultrasound and magnetic resonance examinations of the carotid arteries at the pre- and postoperative stages were included in this study. Two groups were formed: group I ( n =15) – with a verified diagnosis of type 2 diabetes, group II ( n = 29) – without diabetes. To assess the cerebrovascular reserve, functional hypercapnic and hyperoxic tests were performed. Results. The analysis of the results showed statistically significant differences in the ICA blood flow in both groups. Intergroup comparison before surgery in the middle cerebral artery on the side of hemodynamically significant stenosis revealed a statistically significant difference in pulsation and peripheral resistance index. In the common carotid arteries on both sides, significant intergroup differences were found in the velocity parameters of blood flow after the CEE operation. The reactivity index in patients with surgical stenosis with type 2 diabetes in the hyperoxic test was statistically significantly different on the side of the stenosis compared to the same indicator in the group without diabetes. There were no statistically significant differences in the hypercapnic test. The value of reactivity index indicates a negative or paradoxical reaction. Conclusion. The use of simple and accessible functional tests to assess cerebrovascular reserve, plaque structure and changes in the brain in patients with type 2 diabetes at the stage of preoperative preparation according to ultrasound and MRI studies allows us to correct the treatment and subsequent protection of the brain at the stage of surgery to prevent possible complications.

Purpose. The objective of the study was to elucidate the impact of COVID-19 pandemic on cardiac magnetic resonance imaging (CMR)-derived portrait of a patient in one specialized cardiovascular center.Material and Methods. The study comprised 987 patients who underwent CMR with paramagnetic contrast enhancement in cardiovascular center from 01.01.2019 to 01.06.2022. Data were obtained from electronic medical records stored in the electronic module keeping track of instrumental studies. Data contained information on type and characteristics of protocol, referring department, clinical and demographic patient characteristics, and diagnosis. Gender, age, type of visit (ambulatory, in-hospital), instrumental data, and unstructured text were analyzed. Contrast-enhanced CMR was performed according to standard method using 1.5-Tesla MRI system Vantage Titan 1.5T (Toshiba Medical Systems) with ECG-synchronization.Results. Proportion of CMR among all MRI studies increased during the study period. Maximum number of cardiac diseases was detected in 2021. Incidence of fibrosis-dystrophic myocardial changes increased from 67.17% in 2019 to 84.14% in 2022 potentially due to the past cardiac inflammation. Patient numbers in each age group peaked in 2021, and the highest incidence rate was observed in the group of 60-69-year-old patients with high risk for severe COVID-19 course and complications. In 2020, the incidence of acute myocarditis significantly decreased to 10% in men and 13% in women and then gradually increased in 2021. The rate of ambulatory visits significantly increased in 2020, but returned to the pre-pandemic level in 2021.Conclusion. COVID-19 pandemic increased the need for CMR. Patients with history of COVID-19 had persistent and newly occurring symptoms of myocardial damage suggesting chronic cardiac involvement. Regional myocardial fibrosis was the main COVID-19-associated presentation on contrast-enhanced CMR. Continuous follow-up of patients is required to assess their risk for the left ventricular remodeling.

The article presents a methodology for assessing the level of social tension according to the data of electronic social networks. The calculation of the level of social tension according to the specified method is carried out automatically using software tools and requires the participation of the researcher only at the level of an analytical conclusion. An approach to identifying the dissatisfaction of the population at the level of the simplest actions of social network accounts has been described in detail. The necessity of identifying certain spheres of public life for the identification of population discontent has been substantiated, the indicated spheres have been highlighted and described. An indicator has been developed that makes it possible to calculate the level of social tension within each of the identified spheres of public life, taking into account the level of negative messages (posts and comments) and the discussion of each topic. A generalising indicator of the level of social tension has been developed, combining individual indicators of tension by topic. The calculation of the generalising indicator makes it possible to identify the level of social tension in a region or other territorial entity and track its dynamics in any perspective, including retrospectively.The proposed methodology for assessing social tension based on data from electronic social networks differs significantly from existing sociological and statistical approaches. Its main advantage lies in the minimal time lag between the dynamics of social tension, reflected in the social network, and its identification, which expands the possibilities of a prompt response to the growth of negative moods in society. Another difference of the proposed approach is the possibility of multiple repetitions of calculations with minimal, in contrast to the sociological method, the cost of additional resources for each subsequent iteration of the calculation of the indicator value.

Highlights. Early atherosclerotic changes in the abdominal aortic wall and common iliac arteries in patients without clinical manifestations of critical atherosclerotic stenosis of the lower extremity arteries were studied using contrast enhanced magnetic resonance imaging. A method for quantitative characterization of the accumulation of paramagnetic contrast in the abdominal aortic wall and common iliac arteries is presented.Aim. To study the pattern of early atherosclerotic lesions of the abdominal aortic wall and common iliac arteries in patients without clinical manifestations of critical atherosclerotic stenosis of the lower extremity arteries using paramagnetic contrast enhancement (CE-) MRI.Methods. The retrospective study included 36 patients (25 men, 11 women) who underwent MRI of the lumbar spine with CE, without signs of atherosclerosis of the lower extremities. Subsequently, 2.5 and 4 years after CE-MRI, two patients developed acute leg ischemia and required vascular surgeries. At the time of the study, both had higher levels of C-reactive protein in the blood (6.3 mg/L and 5.9 mg/L, while the other patients had <4.2 mg/L). MRI included T2 – and T1-weighted spin-echo scans (T2-w and T1-w) in the axial and sagittal planes, before and in 10-15 minutes after contrast injection. The index of enhancement (IE) of T1-w was calculated based on the ratio of mean intensities of the region of arterial wall over aorta and iliac arteries in CE-MRI and pre-contrast MRI: IE = Int.T1–w. CE / Int. T1–w pre-contrast.Results. Depending on the IE of the abdominal aortic wall in CE-MRI, patients were divided into three groups: group 1 (n = 11) with IE ≤1.05; group 2 (n = 16) with 1.05 1.15. The aortic IE in all three groups was 1,03 (1,01;1,03); 1,10 (1,09;1,15); 1,36 (1,16;1,40) respectively (p<0.001). The thickness of the abdominal aortic wall progressively increased moving up the group 1, while statistically significant differences were found only between the groups 1 and 3, and the groups 2 and 3 (p<0.001). There were no differences in the wall thickness of the common iliac arteries and the diameter of all vessels studied between the groups. Two patients from the group 3 later presented with acute limb ischemia.Conclusion. The state of the abdominal aortic wall and common iliac arteries should be evaluated, and IE of T1-w should be calculated when performing CE-MRI examination of the area of the descending aorta to assess pathological neoangiogenesis as the most important component of atherogenesis.

OBJECTIVE:The study was aimed at investigating the clinical significance of the gradient of luminal narrowing of atherosclerotically altered internal carotid arteries as a risk factor for ischemic cerebral damage by means of ultrasonographic techniques and magnetic resonance imaging. PATIENTS AND METHODS:The study enrolled a total of 20 patients, mean age 62.4±1.3 years. Based on the findings of cerebral magnetic resonance imaging, they were subdivided into two groups: those without ischemic cerebral damage (13 subjects) and with ischemic lesion (7 patients). The vessels of carotid basin were assessed by means of ultrasonographic techniques, calculating the gradient of narrowing of the lumen of atherosclerotically altered arteries using 2 methods: A - as the ratio of the percentage of the internal carotid artery stenosis to the distance between near-to-stenosis distal/proximal segment of the non-stenotic artery and the site of maximal narrowing; B - as the ratio of the difference of the cross-sectional areas of the internal carotid artery in the place of stenosis and the nearest maximal non-stenotic distal/proximal portion to the distance between them. RESULTS:In the group of confirmed foci of ischemic lesion of the brain as compared with the group having no ischemic lesions according to the A method, we revealed a statistically significant difference in the parameters of the gradient of luminal narrowing on the distal portion of the internal carotid artery, with no statistically significant differences in the examined parameters revealed on the proximal portion. There were no statistically significant differences in the gradient of luminal narrowing calculated according to the B method on either distal or proximal portion. CONCLUSION:The gradient of narrowing of arterial lumen characterizes the degree of incrementing luminal narrowing from the 'normal' (without stenosis) proximal portion of the artery to the area of maximal stenosis and further to free distal lumen, which is an important diagnostic criterion for stenosis severity and prediction of ischemic cerebral lesion. There is yet no sufficient experience in using this index in clinical practice, since it was proposed relatively recently. However, this parameter appears to possess an advantage, primarily a prognostic one, as compared with the classical methods of measuring stenosis by the ECST and NASCET methods. The most preferable should be recognized calculation of the luminal narrowing according to the A method supposing measuring the ratio of the percentage of stenosis (according to the ECST method) of the internal carotid artery to the distance between the near-to-stenosis distal/proximal region without stenosis and the site of maximal narrowing.

Background. The state of the aorta is a key factor in the prognosis of the patient’s life, since the distension of the ascending aorta in systole determines the blood supply to the myocardium in diastole. Paramagnetic contrast-enhanced MRI provides a reliable assessment of pathological neoangiogenesis, however, in fact, studies of the aorta are performed descriptively, without calculating mechanical strength and extensibility. Objective. To develop and clinically test on the patients with atherosclerotic lesions and myocarditis a method for quantitative assessment of extensibility and mechanical elasticity of the aortic wall.Design and methods. Were examined 12 patients with acute myocardial infarction with ST segment elevation, as a control group 11 patients without clinical and instrumental signs of atherosclerosis of large arteries and aorta. All underwent MRI of the chest and heart with paramagnetic contrast enhancement (PMCE) and ECG synchronization. The indices of aortic distensibility, distensibility normalized to pulse BP, Young’s modulus of the aortic wall, systolic distension of the ascending aorta (mL), index of strengthening of the aortic wall in PMCE were calculated.Results. Ascending aortic distensibility decreased in patients with myocarditis and acute infarction. Young’s modulus and distensibility of the ascending aorta significantly correlated with the value of the aortic wall enhancement index in PMCE. Myocardial damage in acute infarction and myocarditis was noted with a decrease in systolic expansion of the ascending aorta below 10 ml due to its reduced elasticity.Conclusion. There is a relationship between pathological accumulation of a paramagnet in the wall of the ascending aorta, a decrease in its elasticity, a decrease in the volume of systolic aortic dilation, and the development of hypoperfusion myocardial damage. Magnetic resonance elastometry of the aortic wall makes it possible to assess violations of aortic distensibility and predict the development of ischemic damage in the myocardium of the left ventricle.

Aim To study the effect of type 2 diabetes mellitus on changes of intracardiac haemodynamics and myocardial morphology in patients with ischaemic heart disease and a postinfarction aneurysm of the left ventricle before and after corrective operations on the heart. Patients and methods The study included 79 patients with ischaemic heart disease and a chronic aneurysm of the left ventricle (Group I - patients with type 2 diabetes mellitus (n=27), mean age 57.5±3.9 years, average number of shunts 2.9±0.6; Group II - patients without diabetes mellitus (n=52), mean age 55,3 ±7.1 years, average number of shunts - 2.7±0.3). In the preoperative period all patients were examined taking into account the functional class of angina pectoris, with the assessment of the left ventricular ejection fraction, end-diastolic index, end-systolic index, sphericity index. All patients underwent coronary artery bypass grafting and surgical restoration of the normal geometry of the left ventricle according to the Menicanty technique with the target end-systolic index of 60 ml/m2, during which 39 patients from both groups were subjected to intraoperative biopsy of the left ventricular myocardium and right atrial auricle. Results The intergroup analysis revealed no statistically significant differences in age, angina pectoris class, level of arterial pressure between the groups. Neither were there statistically significant differences in the echocardiographic parameters at the preoperative stage. In the postoperative period, we detected a significant decrease in the end-systolic and end-diastolic volumes of the left ventricle in both groups, with a statistically significant increase of the left ventricular ejection fraction observed only in non-diabetic patients. One year after the operation, such patients still continued to demonstrate more favourable parameters of the systolic and diastolic functions of the left ventricle. A detailed analysis with determining the delta of the alterations in the parameters revealed more significant positive dynamics in the postoperative period in patients with ischaemic heart disease not associated with type 2 diabetes mellitus. Conclusion The obtained findings are indicative of negative dynamics of the course of chronic ischaemic heart disease aggravated by type 2 diabetes mellitus after reconstruction of the left ventricle. Macro- and microangiopathy in type 2 diabetes mellitus significantly deteriorated the myocardial trophism. Subsequent bleedings draw phagocytic cells into the myocardial stroma, thus adversely affecting the further prognosis and course of the disease, since we demonstrated that the presence of inflammatory infiltrate in the myocardial stroma is a key factor of unfavourable outcomes of surgical treatment of patients with ischaemic cardiomyopathy.

Abstract Aim To value the possible relationship between the intensity of neoangiogenesis in the aortic wall in patients with resistant arterial hypertension and the subsequent development of ischemic cerebral disorders in them over a three-year follow-up. Materials and methods This study comprised 36 patients with resistant hypertension, in whom the renal denervation was carried out. MRI of the brain and also with contrast enhancement of the aorta and kidneys were examined. MRI studies included T2 and T1 spin-echo MRI, and also coronal slices, with suppression of the signal from adipose tissue (TR=150 ms, TE = 4 ms), before and in 12–15 minutes after contrast-enhanced. The diameter and thickness of the wall of the descending aorta were measured. Index of the enhancement of the aortic wall was calculated as the ratio of intensities of the wall after, and before contrast-enhanced. 9 according to MRI data - developed an acute ischemic stroke during this period, and 27 had no cerebral circulation disorders. The control group consisted of individuals without hypertension (n=12). Results After renal denervation, the systolic blood pressure significantly decreased in all patients for more than 15 mm Hg. In groups of patients with ischemic stroke, and without it, the diameter of the aortic lumen at the level above the renal arteries was 22,1±2,4 mm and 22,8±2,7 mm, respectively; the aortic wall thickness was 3,9±0,7 mm and 3,7±0,8 mm. In control subjects without hypertension, the wall thickness was less than 2,7 mm (on average 2,2±0,4 mm), with an aortic diameter of 21,3±0,9. As to the index of enhancement (as a marker of neoangiogenesis intensity) in the control group, in everybody, the IE was <1,12. In patients with stroke within 3 years after renal denervation, IE = 2,12±0,31, and in patients without stroke IE = 1,66±0,19. The value of IE = 1,82 was the best for separating groups with and without stroke in the three years endpoint, as from the ROC analysis. Conclusion Contrast enhancement of the aortic wall in MRI is associated with the risk of brain ischemic stroke in patients with resistant arterial hypertension, even when blood pressure control is achieved by renal denervation. This makes it possible to predict the risk of stroke in these patients more reliably and encourages the inclusion of agents that reduce the activity of inflammation and pathological neoangiogenesis in the aortic wall, to the spectrum of antihypertensive therapy. Funding Acknowledgement Type of funding sources: None. Brain MRI T2WIMRI of the kidneys and aorta, T1WI

The article reflects the results of a study of the impact of migration on regional labour markets amidst a decline in the working-age population in Russia. After substantiating the relevance of the issues under consideration, the authors propose a methodological analysis toolkit, the author’s own methodology for calculating the coefficients of permanent long-term external and internal labour migration in regional labour markets, and the coefficient of total migration burden. In addition, the authors provide an overview of the information and statistical base of the study. According to current migration records, data of Rosstat sample surveys on Russian labour migrants leaving for employment in other regions, regional labour resources balance sheets based on the calculated coefficients of labour market pressures, the authors analyzed the impact of migration on the Russian regional labour markets over the past decade. It revealed an increasing role of internal labour migration in many regions, primarily in the largest economic agglomerations and oil and gas territories. At the same time, the role of external labour migration remains stable and minimum indicators of the contribution of permanent migration to the formation of regional labour markets continue to decrease. It has been established that irrational counter flows of external and internal labour migration have developed, which indicates not only an imbalance in labour demand and supply but also a discrepancy between the qualitative composition of migrants and the needs of the economy. It is concluded that the state does not effectively regulate certain types of migration, considering its impact on the labour market. The authors justified the need for conducting regular household sample surveys according to specific programs to collect information about labour migrants and the conditions for using their labour. In addition to the current migration records, using interregional analysis, this information allows making more informed decisions at the federal and regional levels to correct the negative situation that has developed in the regional labour markets even before the coronavirus pandemic had struck.

МР-ТОМОГРАФИЧЕСКАЯ КОНТРАСТ-УСИЛЕННАЯ ВИЗУАЛИЗАЦИЯ СТЕНКИ АОРТЫ КАК ПОКАЗАТЕЛЬ РИСКА РАЗВИТИЯ ОСТРЫХ ИШЕМИЧЕСКИХ ПОВРЕЖДЕНИЙ ГОЛОВНОГО МОЗГА У ПАЦИЕНТОВ С