Objective. To assess the density of the calcified substrate of atherosclerotic plaques of the carotid arteries using data from the computed tomography of patients with multifocal atherosclerosis. Material and methods. In 251 patients with verified atherosclerosis of the coronary and carotid arteries, with a high prevalence of angina pectoris, a history of myocardial infarction and modifiable cardiovascular risk factors, multislice computed tomography (MSCT) of the carotid arteries was performed to assess the calcium index and determine the equivalent density of calcium deposits (EDCD). A morphological sub-study of the material from the removed atherosclerotic plaques was carried out using scanning electron microscopy (SEM) in 12 patients. Results. According to the MSCT data, we identified 5 main types of calcium deposit location in the thickness of the atherosclerotic plaque. We noted that totally calcified plaques were associated with carotid artery stenosis by more than 30 %. According to the SEM data, we identified 2 leading patterns: diffuse and compact types of microcalcification. There was a statistically significant association of a low level of EDCD with a diffuse type of calcification both in vivo (p=0.010) and ex vivo (p=0.008). Patients, having carotid artery EDCD less than 0.21 mg/mm3, reported a significantly higher incidence of type 2 diabetes mellitus (p=0.0001) and a history of stroke (p=0.021). When comparing the MSCT data on the calcium deposit density and their localization in the atherosclerotic plaque, we noted a statistically significant predominance of low EDCD with superficial calcification of the plaque (p=0.002). Conclusion. The use of a calculated indicator of the equivalent density of calcium deposits of the atherosclerotic substrate allows us to non-invasively obtain new data on the structure of plaques. The observed association of the superficial distribution of calcification with low calcification density according to the MSCT data may indicate potential plaque instability.

Highlights. Patients with coronary artery disease and age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) who underwent elective on-pump coronary artery bypass grafting are at higher risk of developing cardiovascular complications, non-infectious complications, and death.Musculoskeletal disorders (sarcopenia, osteopenic syndrome, osteosarcopenia) in combination with traditional predictors (age, diabetes mellitus, prior myocardial infarction and stroke, cancer) are risk factors for unfavorable prognosis of postoperative period of coronary artery bypass grafting. Aim. To assess risk factors for unfavorable prognosis in patients with coronary artery disease (CAD) undergoing elective on-pump coronary artery bypass grafting, taking into account age-related disorders (sarcopenia, osteopenic syndrome, osteosarcopenia).Methods. This single-center study included 387 CAD patients admitted for elective coronary artery bypass grafting. Taking into account the diagnosed age-related disorders, four groups of patients were formed. The first group consisted of 52 (13.4%) patients with sarcopenia, the second group was comprised of 28 (7.2%) patients with osteopenia (osteopenia/osteoporosis), the third group included 25 (6.5%) patients with osteosarcopenia, and the fourth group consisted of 282 (72.9%) participants with coronary artery disease and without musculoskeletal disorders (MSD). Risk factors for a composite endpoint (myocardial infarction, stroke, paroxysmal atrial fibrillation, cardiac rhythm disturbances) and death, and noninfectious complications (resternotomy for bleeding, pneumothorax aspiration and thoracentesis) were assessed.Results. The composite endpoint occurred more frequently in patients with osteopenia (group I – 9.6%, group II – 32.1%, group III – 12%, group IV – 12.8%; p = 0.029), and non-infectious complications occurred more frequently in patients with sarcopenia and osteosarcopenia (group I – 17.3%, group II – 7.1%, group III – 12%, group IV – 5.3%; p = 0.002). MSD were associated with the risk of composite endpoint (odds ratio (OR) 1.73, p = 0.035), and osteopenia increased it three-fold (OR 3.01, p = 0.046). Moreover, MSD were associated with higher risk of non-infectious complications (OR 1.71, p = 0.026), especially in patients with sarcopenia (OR 2.02, p = 0.034). The assessment of risk factors for unfavorable prognosis highlighted the presence of osteopenic syndrome (100 CU), prior stroke (88 CU) and myocardial infarction (85 CU). The risk of non-infectious complications was associated with prior ischemic events (ranking level for myocardial infarction – 100 CU, stroke – 75 CU), and MSD (89 CU) and its types (osteosarcopenia – 77 CU, osteopenia – 69 CU, sarcopenia – 52 CU).Conclusion. Age-related disorders in combination with MSD increase the risk of a composite endpoint and non-infectious complications by one to three times.

Th e aim of the research. To analyse the structure of complications in patients with coronary artery disease and different musculoskeletal disorders (MSD) undergoing elective coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass. Material and methods. From 2019 to 2020, a single-centre cohort study was conducted on 387 stable coronary artery disease patients aged over 50 before elective CABG. The following MSD were assessed: sarcopenia, osteopenia, and osteosarcopenia. Patients were divided into four groups according to the MSD type: group I included 52 (13.4 %) patients with sarcopenia, group II included 28 (7.2 %) patients with osteopenia, group III was composed of 25 (6.5 %) patients with osteosarcopenia, and group IV included 282 (72.9 %) patients without MSD. Patients underwent CABG using cardiopulmonary bypass. Cardiovascular, infectious and non-infectious complications, death, a composite endpoint including cardiovascular complications and death, as well as the total number of complications were analysed. Results. Infectious complications were revealed in 23 (5.9 %) patients. Th e highest frequency of infectious complications was noted in patients with osteosarcopenia while the lowest frequency was found in patients without MSD (24 % vs 5.8 % in group I, 7.1 % in group II, 4.3 % in group IV). The highest number of surgical complications was noted in patients with sarcopenia and osteosarcopenia (17.3 % in group I, 7.1 % in group II, 12 % in group III, 5.3 % in group IV; p = 0.002). The composite endpoint was significantly more prevalent in patients with osteopenia (32.1 vs. 9.6 % in group I, 12 % in group III, and 12.8 % in group IV). Th ere were no statistically signifi cant diff erences in the total number of complications between the groups of patients with MSD. Th e complications were 2-fold more likely to occur in patients with osteopenia and osteosarcopenia compared to patients without MSD. Moreover, MSD increased the risk of the composite endpoint by 1.7 times (odds ratio (OR) 1.73, 95 % confi dence interval (CI) 1.04-2.89; p = 0.035); osteopenia increased the risk of the combined endpoint by 3 times (OR 3.01, 95 % CI 1.02-8.9; p = 0.046). Surgical complications were associated with baseline MSD (OR 1.71, 95 % CI 1.06-2.76; p = 0.026); sarcopenia increased the risk of surgical complications by 2 times (OR 2.02, 95 % CI 1.05-3.88; p = 0.034). Conclusion. The frequency of complications in patients with MSD was 1.79-fold higher compared with patients without MSD. Cardiovascular and infectious complications as well as complications associated with surgical treatment were more common in patients with MSD. MSD can be used as a risk factor for the development of in-hospital complications because the presence of these disorders increases the risk of cardiovascular complications, non-infectious complications and death by 1.7 times. Moreover, osteopenia was associated with a threefold increase in the composite endpoint risk, while sarcopenia doubled the risk of non-infectious complications.

Highlights. Taking into account the connection between the increase in the volume of myocardial adipose tissue and vessels with massive calcification of the coronary arteries in coronary heart disease, morphometry of epicardial and perivascular adipose tissue during routine tomographic examinations can be considered as a non-invasive technique for determining a surrogate marker of severe coronary lesion.Aim. To evaluate the relationship of coronary artery calcification (CA) and morphometric parameters of local fat depots in patients with coronary heart disease (CHD).Methods. 125 patients with stable coronary artery disease aged 59±8.9 years were examined. Visualization of local fat depots, abdominal fat depots, and coronary calcification (CC) was performed using multislice computed tomography with subsequent post-processing of images on the Siemens Leonardo workstation (Germany). Non-contrast magnetic resonance imaging of the heart was used to determine the EAT thickness.Results. Coronary calcification was detected in 95.2% of the examined patients with coronary artery disease (n = 119). There were higher indices of the EAT thickness of the right and left ventricles in case of massive CC, the thickness of the pericardial adipose tissue at the level of the trunk of the left coronary, anterior descending, circumflex arteries, and increased morphometry indices of the abdominal fat depot in comparison with the patients who had moderate and medium CC.Conclusion. An increase in the volume of adipose tissue of the myocardium and vessels in CAD is associated with massive calcification, which is reflected in the pathogenetic “adipovascular” continuum, characterized by the stimulation of adipogenesis against the background of atherocalcinosis of the coronary arteries. Morphometry of epicardial and perivascular adipose tissue during routine tomographic studies is a non-invasive technique for determining a surrogate marker of severe coronary lesions.

See “Inflammaging in the pathogenesis of chronic non-communicable diseases”, Kim O. T. in Opinion of invited editor, pp. 54-55. The study of osteosarcopenic obesity (OSO) in patients with cardiovascular diseases (CVDs) in recent years has caused a dis-cussion on common pathogenesis of atherosclerosis, obesity, progressive loss of skeletal and muscle mass. Are these processes independent age-related conditions or comorbidities with common links of pathogenesis? The aim of this review was to analyze studies on OSO in patients with CVDs. We used following electronic databases: PubMed, Clinical Trials, Google Scholar, www.elibrary.ru. Based on this analysis, modern ideas on the etiology, epidemiology and pathogenesis of OSO in elderly and senile patients with atherosclerosis were described. The authors concluded that absence of standards for OSO diagnosis and inadequate clinical suspicion of specialists during routine examination is one of the main causes of its insufficient detection in elderly patients with CVDs. The results of analyzed studies allow us to consider the OSO and atherosclerotic changes as a single link of cardiovascular continuum. Eliminating the negative effect of chronic inflammation on human body should be considered as a key mechanism in the treatment of OSO and atherosclerosis. However, more research is needed in this area.

Aim. To determine the most significant predictors of an unfavorable progress of osteoporosis (OP) in men with coronary artery disease after coronary artery bypass grafting (CABG) according to long-term (5 years) follow-up data.Methods. The prospective study included 393 patients (men) hospitalized for CABG. All patients underwent multispiral computed tomography of the coronary and carotid arteries to assess the calcium score (CS) and determine the equivalent density of calcium deposits (EDCD), coronary angiography, and dual-energy X-ray absorptiometry. After 5 years (average 59 months) of follow-up, the prognosis (status alive/dead) was assessed in 335 patients. Mortality during follow-up in patients after CABG was 10.7% (36 patients died). 257 patients underwent repeated osteodensitometry, quantitative assessment of coronary and carotid calcification, assessment of the “end points” of bone status (osteoporotic fractures, osteoporosis).Results. During the five-year follow-up an increase in the prevalence of OP was noted from 76.1% to 90.7%, while in 43.6% of cases, the progression of OP was recorded. Fractures occurred in 39 patients (15.2%), and in 34 (13.2%) osteoporosis developed for the first time. OP progression is associated with smoking (OR 5.3, 95% CI 3.1–9.4), 30% or more carotid artery stenosis (OR 5.6, 95% CI 2.9–10.7), baseline severe (more than 400) calcification of the coronary arteries (OR 2.7 at 95% CI 1.3–9.8), low density of (EDCD less than 0.19 g/mm3 ) coronary (OR 1.7 at 95% CI 1.1–8.2) and carotid (OR 2.4, 95% CI 1.4–10.3) calcium deposits. Linear regression analysis made it possible to establish that the reliable predictors of an unfavorable course of OP are coronary CS, EDCD of the carotid arteries, and the absence of statin therapy.Conclusion. OP progression in patients in the long-term period (5 years) after CABG was noted in 43.6%. The predictors of OP progression and the complications are a high level of coronary artery calcification, a low EDCD in the carotid arteries, and 30% or more stenosis of the carotid arteries. Patients receiving statins were associated with a lower risk of osteoporosis.

Aim. To study the prevalence of musculoskeletal disorders in patients with stable coronary artery disease (CAD). Material and methods. Patients with stable CAD (n=387) were included in the study. The subjects were admitted to the hospital for planned myocardial revascularization (ages of 50-82). The median age was 65 [59;69] years. Most of the sample consisted of males - 283 (73.1%). 323 (83.5%) patients had arterial hypertension (AH), 57.1% - history of myocardial infarction, and a quarter of the patients had type 2 diabetes mellitus (DM). The study of musculoskeletal system included the identification of sarcopenia in accordance with The European Working Group on Sarcopenia in Older People (EWGSOP, 2019); verification of osteopenia/osteoporosis according to the WHO criteria (2008); diagnosing osteosarcopenia in case of sarcopenia and osteopenia/osteoporosis coexistence. Results. At the initial screening of sarcopenia in accordance with EWGSOP, clinical signs (according to the Strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire) were detected in 41.3% of cases, but further examination (dynamometry, quantitative assessment of skeletal muscle) confirmed this diagnosis only in 19.9% of patients with CAD. Among the examined patients with CAD a low T-score according to DEXA was found in 53 (13.7%) of cases, and osteopenia was diagnosed 10 times more often than osteoporosis (90.6% vs. 9.4%). Furthermore, due to combination of low bone density (osteopenia/osteoporosis) and reduced muscle mass and strength (sarcopenia), osteosarcopenia was verified in one patient. Thus, the study revealed the prevalence of particular types of musculoskeletal disorders in 105 (27.1%) patients with stable CAD. The most common type of musculoskeletal disorder was sarcopenia - 52 cases (13.4%); osteopenia/osteoporosis was detected in 28 patients (7.2%), osteosarcopenia in 25 (6.5%). The most pronounced clinical manifestation of sarcopenia and osteopenia/osteoporosis, reflected by a higher score on the SARC-F questionnaire, low handgrip strength, small area of muscle tissue, low musculoskeletal index, as well as low values of bone mineral density, were observed in patients with osteosarcopenia. Patients with osteopenia/osteoporosis did not differ significantly from patients without musculoskeletal conditions in most parameters, with the exception of the T-score, the average SARC-F score, and muscle strength in men. The conducted correlation analysis revealed not only the relationship between the parameters of musculoskeletal function, but also their association with age, duration of AH, CAD, and type 2 DM. Conclusion. Several types of musculoskeletal disorders were found in a third of patients with CAD. Sarcopenia was revealed to be the most frequent type of musculoskeletal disorder.

Abstract Background The aging of the population increases the number of elderly patients undergoing cardiac surgery. Despite the proven effectiveness of coronary bypass graft (CABG) surgery, it can lead to postoperative complications, similar to any other medical intervention. The early postoperative complications are associated directly with the clinical status of the patient. Most recent studies have focused on the effect of patient's musculoskeletal conditions on quality of life, disability and mortality. However, there are few studies devoted to assessment of the impact of musculoskeletal conditions on the course of the postoperative period in patients treated with CABG. Aim To evaluate the impact of musculoskeletal conditions on the early postoperative period in CABG patients with stable coronary artery disease (CAD). Materials and methods 387 patients aged 65 (59; 69) years with stable CAD, scheduled for CABG were enrolled in the study. Before enrollment all patients signed an informed consent form. For the assessment of the musculoskeletal function, sarcopenia was defined in accordance with the European Working Group on Sarcopenia in Older People (EWGSOP, 2019) and osteopenic syndrome (osteopenia/osteoporosis) was defined in accordance with the World Health Organization (WHO,2008). Osteosarcopenia was diagnosed in cases of co-existent sarcopenia and osteopenia/osteoporosis. The patients were divided into two groups according to the presence of musculoskeletal disorders. The 1st group included 105 (27.1%) patients: 52 (49.5%) with sarcopenia; 28 (26.7%) with osteopenic syndrome (osteopenia/osteoporosis) and 25 (23.8%) with osteosarcopenia. The 2nd group included 282 (72.9%) patients without musculoskeletal conditions. The analyzed groups were comparable in age, gender and comorbidities. CABG was performed via a midline sternotomy incision with the cardiopulmonary bypass. In the postoperative period, the total number of developed complications (cardiovascular, surgical, pulmonary) in patients with CAD was taken into account. Statistical analysis was performed using the Statistica software. Results In the early postoperative period, the total number of complications was statistically higher among patients who initially had musculoskeletal disorder. The prevalence of complications was higher in the 1st group of patients - 80 out of 105 (76.2%), while patients without musculoskeletal conditions demonstrated a 1.17 times lower prevalence - 183 out of 282 (64.99%), p=0.034. The incidence and the strength of association was estimated by the odds ratio (OR) and 95% confidence interval (CI). The presence of the initial musculoskeletal disorder was found associated with the 1.7 times increased risk of complications after CABG (OR =1.73, 95% CI: 1.03–2.89, p=0.035). Conclusions The presence of the musculoskeletal condition in CABG patients with CAD is a predictor of early adverse effects in the postoperative period. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The study was supported by Federal State Budgetary Institution of Higher Education “Kemerovo State University” (Contract No. 1327/2020/223, under the Agreement No. 075-15-2020-766 made as of 14th of December, 2020, entitled “Patient-centered care for patients with coronary artery disease and osteosarcopenia who underwent coronary artery bypass graft surgery”).

To assess the prevalence of frailty in the preoperative period and to evaluate its effect on the risk of complications and adverse outcomes in patients undergoing coronary artery bypass grafting (CABG). 303 patients undergoing preoperative management for elective primary CABG were recruited in the study. The study cohort was divided into three groups depending on the PRISMA-7 scores suggesting the presence or absence of frailty and the presence of prefrailty. Statistical analysis was performed using the commercially available software package STATISTICA 8.0.360.0 for Windows (StatSoft, Inc., USA) and SPSS Statistics v. 17.0.0. 46 (15%) patients had frailty, while 49 (16%) patients were diagnosed with prefrailty. 208 (69%) patients did not have any signs of frailty. All three groups had significant age differences, therefore only elderly patients aged of 67.0±6.5 years with frailty were allocated for subsequent analysis (prefrailty group - 62.3±7.4 years old, patients without frailty - 60.0±7.7 years, p=0.003). Patients with frailty or prefrailty more often suffered from diabetes mellitus (patients without frailty - 19.2%, prefrailty group - 30.6% and frailty group - 28.3%, p=0.05), arterial hypertension (69.2%, 93.9% and 95.7%, respectively, p<0.001), atrial fibrillation or flutter (7.2%, 14.3% and 19.6%, respectively, p=0.03), chronic heart failure class 3–4 (7.2%, 10.2% and 8.7%, respectively, p=0.002), and peripheral arterial disease (22.6%, 38.8% and 58.7%, respectively, p<0.001). Three groups were comparable in main clinical and demographic parameters. There were no significant differences found in the incidence of postoperative atrial fibrillation or flutter (15.9%, 8.2% and 6.5%, respectively, p=0.07) and infections (1.9%, 0% and 4.3%, respectively, p=0.640). The incidence of myocardial infarction in the intra- and early postoperative period after CABG did not differ significantly between the groups (0.5%, 2% and 0%, respectively, p=0.328) as well as the incidence of stroke (2.4%, 2% and 0%, respectively, p=0.640). Patients with frailty and prefrailty had significantly higher cerebrovascular and cardiovascular mortality compared to those without frailty (8.2%, 2.2% and 0.5%, respectively, p=0.001). Almost 15% of patients referred to CABG suffered from frailty. The presence of prefrailty or frailty increases the risk of death in the early postoperative period after CABG. Type of funding source: None

Objective: to assess the relationship between bone mineral density (BMD) and the muscular apparatus in male patients with coronary heart disease (CHD).Patients and methods. The investigation enrolled 79 male patients (median age, 63 [57; 66] years) with an established diagnosis of CHD verified by coronary angiography.Muscle mass was assessed by multispiral computed tomography, by determining the axial muscle tissue area (cm2 ) at the level of LIII. Muscle strength was measured with a wrist dynamometer. Muscle function was examined using the tests of the Short Physical Performance Battery (SPPB). BMD at the neck and proximal femur as a whole and at the lumbar spine was measured by dual energy X-ray absorptiometry.For comparative analysis, the patients were divided into three groups (EWGSOP, 2010). Group 1 included 31 patients without sarcopenia; Group 2 consisted of 21 patients with presarcopenia; and Group 3 comprised 27 patients with sarcopenia.Results and discussion. Osteopenic syndrome was diagnosed in 34 (43%) patients: osteopenia and osteoporosis in 31 (39%) and 3 (4%) patients, respectively. Normal BMD values were observed in 45 (57%) men. The prevalence of osteopenic syndrome was significantly higher in the patients with sarcopenia than in those with presarcopenia (p=0.050) and was comparable to that in men without sarcopenia (p>0.050). BMD at the neck and proximal femur as a whole was significantly lower in the patients with sarcopenia than in those without sarcopenia or with presarcopenia (p<0.050). There was a direct correlation between BMD and the characteristics of muscle mass and muscle strength. Regression analysis showed that the total skeletal muscle area at the level of LIII had a significant direct impact on BMD at the neck and proximal femur as a whole, and the reverse – walking speed.Conclusion. The relationship between the characteristics of the muscular apparatus and BMD requires further investigation.

Aim. To assess the prevalence of frailty and describe clinical features of frail patients with stable coronary artery disease (CAD). Methods. 387 patients admitted to the hospital for elective primary coronary artery bypass grafting (CABG) were recruited in the study. Clinical data, demographic data, and the results of the instrumental examinations were collected for each subject. The primary screening of prefrailty and frailty in patients before the surgery was performed using the ’Age is not a hindrance’ questionnaire. The results were processed using the IBM SPSS Statistics 26.0.0 software package. A value of p ≤ 0.050 was considered statistically significant. Results. Frailty was found in 19% of patients with coronary artery disease and multivessel coronary artery disease before open myocardial revascularization, while 58% of patients had prefrailty. The presence of frailty and prefrailty was associated with older and advanced age (p = 0.003), female sex (p = 0.001), type 2 diabetes mellitus (p = 0.006), as well as with comorbidities, including cerebral atherosclerosis (p = 0.020), and heart rhythm disturbances (p = 0.050). Conclusion. The results obtained in this study are consistent with other studies reporting higher levels of comorbidities among frail patients.

HTML Сердечно-сосудистые заболевания (ССЗ) с прогрессирующим течением атеросклероза у пожилых пациентов отягощаются целым рядом возрастассоциированных состояний, одним из которых является саркопения – прогрессирующее снижение количества и качества поперечно-полосатой мускулатуры. Изучение проблемы саркопении у больных ССЗ вызывает в научном сообществе дискуссию, касающуюся вопросов общности патогенеза атеросклеротического поражения и прогрессирующей потери мышечной массы с позиции коморбидности, объединяемой общими звеньями патогенеза этих двух процессов. С использованием современных данных литературы в обзоре проведен анализ основных модифицируемых факторов риска атеросклероза и саркопении с точки зрения патофизиологических механизмов их влияния на артериальное русло и мышечную ткань, проанализированы исторические аспекты и современные исследования, посвященные изучению общих звеньев атерогенеза и протеолиза. Определено, что рассматриваемые в данном обзоре факторы риска, такие как курение, ожирение, нарушение углеводного обмена, артериальная гипертония, безусловно, имеют самостоятельные патогенетические пути реализации неблагоприятного влияния, но единым связующим звеном для них является воспалительная реакция, определяющая взаимное потенцирование и коморбидность саркопении и атеросклероза.

Objective of the study was to investigate the characteristics of lipid metabolism in male patients with coronary artery disease (CAD) depending on the state of muscle mass, strength and function. Material and methods. The investigation enrolled 79 male patients with a reliable diagnosis of CAD, verified by coronary angiography (median age 63 (57; 66) years). Diagnosis of sarcopenia was based on the recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP, 2010) with the examining of muscle strength, muscle mass and muscle function. Total cholesterol, triglycerides (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) content was determined in fasting blood serum by spectrophotometric method. Patients were divided into 3 groups (according to the definition of EWGSOP, 2010): 1st–31 patients without sarcopenia, 2nd–21 patients with presarcopenia, and 3rd–27 patients with sarcopenia. Results and discussion. There was an inverse correlation between the level of total cholesterol in patients and the musculoskeletal index (r = –0.315; p = 0.005) and the total skeletal muscle area at level LIII (r = –0.277; p = 0.013). Comparative analysis in the group of patients with coronary artery disease and sarcopenia showed significant higher levels of total cholesterol compared with those in patients with coronary artery disease without sarcopenia (5.20 (3.75; 6.00) mmol/l vs 3.90 (3.40; 4.60) mmol/l; p = 0.03). According to the results of regression analysis, a direct relationship was found between the value of total cholesterol and the risk of decreasing of the musculoskeletal index (odds ratio 1.914, 95 % confidence interval 1.166– 3.141). The receiver operating characteristic (ROC) curve analysis provided the critical value of total cholesterol as 4.7 mmol/l. Conclusion. The presence of sarcopenia in patients with CAD was associated with severe proatherogenic disorders of the lipid profile of the blood. Hypercholesterolemia is an additional predictive factor in reducing muscle mass.

Aim.To evaluate the effectiveness of the mathematical model for determining the probability of osteopenic syndrome in patients with multifocal atherosclerosis.Materials and methods. The study included 251 male patients with verified atherosclerosis of the coronary and carotid arteries. The average age of the patients was 60,56±8,7 years. All patients included in the study performed multispiral computed tomography of coronary and carotid arteries with a quantitative evaluation of calcification by the method of Agatston (calcium index and equivalent weight of calcium deposits), color duplex scanning of carotid arteries, densitometry. The obtained data were used to calculate the probability of having an osteopenic syndrome (р) using a mathematical model. Criterion for the risk of osteopenic syndrome in the patient is the value р>0,688. The results of the analysis were compared with the densitometry data chosen as the reference method.Results. According to the quantitative assessment of coronary artery calcification in patients with osteopenia and osteoporosis, significantly higher values of the calcium index and equivalent weight of calcium deposits were observed than in patients with normal bone mineral density. Regardless of the presence of bone mineralization, more than half of the respondents (66,7% of patients with normal bone mineral density and 59,6% of patients with osteopenic syndrome) had coronary artery stenoses up to 50%. Calcification and presence of stenosis more than 30% of carotid arteries prevailed in the group of patients with osteopenic syndrome. The results of calculating the probability of having an osteopenic syndrome using a mathematical model indicate that it is highly prevalent in the sample (69,3%) and does not differ significantly from the densitometry data (70,1%). The sensitivity of the mathematical model was 89,8%, the specificity was 78,7%, the prognostic value of the positive result was 90,8%, the prognostic value of the negative result was 76,6%.Conclusion. The mathematical model for assessing the probability of osteopenic syndrome is highly diagnostic in men with multifocal atherosclerosis.

Purpose of the study. A comprehensive quantification of ectopic fat depots using modern methods of radiation diagnosis in patients with ischemic heart disease. Patients and methods. The study included 76 patients with a verified diagnosis of ischemic heart disease (IHD). The control group consisted of 32 people without clinical manifestations of IHD. All patients to assess the area and volume of visceral adipose tissue, as well as measuring the volume of paraaortic adipose tissue at the level of the abdominal aorta were performed multispiral computed tomography (MSCT) at the level of L3–L5 vertebrae. In order to visualize and morphometry pericoronary and paraaortic adipose tissue at the level of the thoracic aorta, patients in both groups were performed MSCT angiography of the coronary arteries with ECG synchronization. To visualize the epicardial fat depot with an assessment of the thickness of the adipose tissue layer, magnetic resonance imaging (MRI) of the heart was performed. Results. During the comparative analysis, significantly higher values of quantitative indicators of the main ectopic fat depots were noted in patients with coronary artery disease. Estimation of the prevalence of obesity according to BMI data in the compared groups showed no significant differences. Considering the standard values of the area and volume of visceral adipose tissue, the prevalence of obesity was significantly higher in the group of patients with IHD. Conducted correlation analysis showed the relationship of quantitative indicators of ectopic visceral, para-aortic and epicardial fat depots. Moreover, in the group of patients with IHD, stronger correlations were found between the fat depots of different localization (r = 0,71, p = 0,013 in group with IHD and r = 0,59, p = 0,039 in group without IND). Conclusion. Modern tomographic methods allow for a comprehensive quantification of ectopic fat depots. Significantly higher morphometry indices of the studied fat depots in patients with coronary artery disease demonstrate the need to develop a unified diagnostic algorithm for reliable stratification of cardiometabolic risk.

Increase in life expectancy is among the most significant achievements of modern medicine. Currently, the majority of patients are elderly, being characterised by multimorbidity and frailty. Sarcopenia, a progressive and generalized loss of skeletal muscle mass and strength, is associated with a reduced quality of life and high risk of adverse outcomes including disability and death in these patients. Age-related neuromuscular degeneration, decline of circulating anabolic hormones, chronic inflammation and oxidative stress considerably affect the development of sarcopenia. In addition, low intake of proteins and carbohydrates along with a decrease in physical activity also affect muscular homeostasis. Being combined with obesity, osteopenia/osteoporosis, and vitamin D deficiency, sarcopenia worsens the prognosis of the patient in terms of life expectancy. In this review, we discuss the current advances in epidemiology, pathophysiology, and diagnosis of sarcopenia.

Purpose of the study. A comprehensive quantification of ectopic fat depots using modern methods of radiation diagnosis in patients with ischemic heart disease.Patients and methods. The study included 76 patients with a verified diagnosis of ischemic heart disease (IHD). The control group consisted of 32 people without clinical manifestations of IHD. All patients to assess the area and volume of visceral adipose tissue, as well as measuring the volume of paraaortic adipose tissue at the level of the abdominal aorta were performed multispiral computed tomography (MSCT) at the level of L3–L5 vertebrae. In order to visualize and morphometry pericoronary and paraaortic adipose tissue at the level of the thoracic aorta, patients in both groups were performed MSCT angiography of the coronary arteries with ECG synchronization. To visualize the epicardial fat depot with an assessment of the thickness of the adipose tissue layer, magnetic resonance imaging (MRI) of the heart was performed.Results. During the comparative analysis, significantly higher values of quantitative indicators of the main ectopic fat depots were noted in patients with coronary artery disease. Estimation of the prevalence of obesity according to BMI data in the compared groups showed no significant differences. Considering the standard values of the area and volume of visceral adipose tissue, the prevalence of obesity was significantly higher in the group of patients with IHD. Conducted correlation analysis showed the relationship of quantitative indicators of ectopic visceral, para-aortic and epicardial fat depots. Moreover, in the group of patients with IHD, stronger correlations were found between the fat depots of different localization (r = 0,71, p = 0,013 in group with IHD and r = 0,59, p = 0,039 in group without IND).Conclusion. Modern tomographic methods allow for a comprehensive quantification of ectopic fat depots. Significantly higher morphometry indices of the studied fat depots in patients with coronary artery disease demonstrate the need to develop a unified diagnostic algorithm for reliable stratification of cardiometabolic risk.

Objective. To estimate the density of calcium deposits of atherosclerotic plaques of coronary and carotid arteries in patients with diabetes mellitus (DM) type 2 using multislice computed tomography (MSCT).Material and methods. 251 patients with multifocal atherosclerosis (MA) were examined using MSCT. Determined equivalent density of calcium deposits (EDCD) atherosclerotic plaque of coronary and carotid arteries.Results. According to the data of MSCT in patients with MA irrespective of concomitant diabetes was a high incidence of calcification of the coronary and carotid arteries. In Group 1 EDCD coronary arteries was 0.235 (0.214; 0.254) mg/mm3, in the group 2 - 0,219 (0,192; 0,242) mg/mm3. EDCD of carotid arteries in patients with diabetes was 0.183 (0.171; 0.193) mg/mm3, in patients without diabetes - 0.226 (0.199; 0.247) mg/mm3. There was a significant difference in the groups EDCD values for coronary (p = 0.017), and the carotid (p = 0.000003) artery.Conclusion. Using index EDCD obtained on the basis of routine MSCT coronary and carotid arteries in patients with MA with DM compared with those without diabetes had significantly higher density calcifications in projection of coronary and low density of calcium deposits carotid arteries without regard to the degree of Agatston calcification scale.

One of the processes that accompany the aging of the body and the decline in the quality of life of older people is sarcopenia or loss of muscle tissue and the associated restriction of mobility. The identification of this condition in patients at the stage when there is only an initial decrease in muscle mass without a decrease in muscle strength is of great importance for determining the cause of the disease and the timely start of treatment. This review describes the capabilities of the methods of radiation diagnosis in assessing the quantity and quality of muscle tissue and their shortcomings from the standpoint of verification and dynamic observation of sarcopenia. The lack of a unified standard for the instrumental diagnosis of this pathology and the alertness of specialists regarding sarcopenia during routine examination is one of the main reasons for the insufficient detection of muscle loss in the cohort of elderly patients. This review is of interest to a wide range of clinical physicians and radiologists, who are found in their practice with patients of older age groups.

Poster: ECR 2019 / C-0082 / Quantitative assessment of the pericoronary fat depots using multislice computed tomography by: A. Kokov , Y. Dyleva, N. Brel, O. Gruzdeva, V. L. Masenko, E. Belik, E. Uchasova, O. Barbarash; Kemerovo/RU