HTML Кодзова М.М., Юрпольская Л.А., Макаренко В.Н., Бокерия Л.А. Т1-картирование в оценке структурно-функциональных изменений миокарда у пациентов с дилатационной кардиомиопатией и низкой фракцией выброса левого желудочка. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им.А.Н. Бакулева РАМН.2020; 21 (2): 181–7. DOI: 10.24022/1810-06942020-21-2-181-187

Цель исследования – изучение нативного и постконтрастного значений Т1-релаксации миокарда для дифференцировки здорового и диффузно пораженного миокарда у пациентов с неишемической дилатационной кардиомиопатией и низкой фракцией выброса.

HTML Шляппо М.А., Александрова С.А., Макаренко В.Н. Диагностические находки подклапанных аневризм левого желудочка неишемического генеза. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2020; 21 (2): 188–92. DOI: 10.24022/ 1810-0694-2020-21-2-188-192

OBJECTIVE To assess the capabilities of multislice spiral computed tomography coronary angiography (MSCT-CA) to visualize the anatomy of the sinus node artery (SNA). MATERIAL AND METHODS The retrospective analysis of coronary artery examinations covered 46 patients with the referral diagnosis of coronary heart disease. MSCT-CA showed no evidence of coronary artery stenosis. This sample included 23 (50%) men and 23 (50%) women; the mean age of the patients was 52.4 +/- 9.1 years; the mean height was 170 +/- 6.67 cm; the mean weight was 80.7 +/- 12.1 kg. X-ray computed tomography was carried out using a SOMATOM Definition AS+ 128-slice computed tomography scanner with retrospective ECG synchronization, reconstructed slice thicknesses of 1 and 3-mm. The Spearman correlation test was used for statistical data analysis. RESULTS The SNA was visualized in 83% of the patients. It originated from the right coronary artery (RCA) and the circumflex branch of the left coronary artery in 84 and 16% of cases, respectively. No significant association was found between the type of heart blood supply and that of sinus node one (r = 0.06). In 18% of cases, the SNA was visualized only at the level of the ostium, allowing the assessment of the origin of the artery, and at the level of its mid-third in 32%; the distal SNA bed was visualized up to its division; in 10% of them the artery could be visualized all the way, including the division (the dissipation site). Unclear visualization of the proximal SNA was observed among 17% of the patients in whom the SNA could not be visualized with a heart rate (HR) of more than 80 beats/min in 62.5% of the patients, less than 41 beats/min in 12.5%, and 60-61 beats/min in 25%. HR was not found to be associated with the quality of SNA visualization (r = 0.09). CONCLUSION MSCT can assess the anatomy of SNA up to the distal bed and dissipation site. In the overwhelming majority of the patients, the SNA originated from the RCA (84%) regardless of the type of heart blood supply. The best SNA visualization was noted with a HR of 50 to 80 beats per minute. There was no statistical relationship of the quality of visualization to HR.

The results of assessment and management of a patient with dislocation of ventricular electrode of cardiac pacemaker into the pulmonary vein are given; the data on medical, biological, and technical complications of cardiac pacing are analyzed, the treatment strategy of the above complications is discussed.

10-year experience of use of spiral computed tomography (CT) with bolus intravascular contrasting allowed the authors to determine the advantages of this method in aortic aneurysm diagnostics and to show the importance of its application in dynamic monitoring. The article also covers drawbacks of the method, which are not so significant as the advantages, because the CT method answers practically all surgeon's questions, including the length, localization of aneurism, presence of congenital vascular anomalies, fistulas, hemorrhages or prosthesis infection in postoperative period. CT meets all the diagnostic requirements and bears minimal risk while quickly giving enough information about anomalies of bloodstream and surrounding tissues in a certain patient.

In this article are highlighted factors, predicting sinus rhythm restoration in patients with chronic atrial fibrillation, which complicated mitral valve diseases after surgical correction of mitral valve pathology. It has been elaborated diagnostic algorithm for selecting patients eligible to «aggressive approach» in the treatment of atrial fibrillation.

The paper analyzes clinical experience of positron emission tomography for the diagnosis of breast cancer. A total of 47 PET were performed including 36 in patients with verified breast cancer, 2 in suspicion of breast cancer, 5 in suspicion of generalized disease and 4 at different stages of anticancer treatment. Positron emission tomography was performed in a whole body mode with 18fluorodeoxyglucose. The method diagnosed breast cancer at a 93% accuracy, 94% sensitivity and 75% specificity. Positron emission tomography findings led to alteration in the treatment strategy in 30% of patients studied.