Цель. Выявление электрокардиографических (ЭКГ) признаков стенотического поражения ствола левой коронарной артерии (СЛКА) при нагрузочном тестировании пациентов с хронической ишемической болезнью сердца (ИБС) с множественным поражением коронарных артерий.

Цель. В настоящее время очевидна гиперкоагуляция и высокая частота тромбозов в острую фазу COVID-19. Однако динамика этих изменений остается малоизученной. Целью нашей работы была оценка различных звеньев гемостаза через несколько месяцев после перенесенного COVID-19.

Цель. Оценка взаимосвязи тяжести течения COVID-19 у пациентов без исходной сердечно-сосудистой патологии с различными эхокардиографическими параметрами дисфункции миокарда обоих желудочков.

Несмотря на то, что 13–15% пациентов поступают в стационар позднее 48 ч от начала симптомов острого инфаркта миокарда с подъемом сегмента ST (ОИМпST), оптимальная тактика лечения в этих случаях до сих пор неясна.

Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease worldwide, especially in patients with type 2 diabetes mellitus and obesity. Thirty-four patients with NAFLD were enrolled and administered empagliflozin 10 mg or dapagliflozin 10 mg once a day. Body weight and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), triglycerides (TG), glycated haemoglobin (HbA1C) decreased significantly after 24 weeks of empagliflozin and dapagliflozin treatment. The ALT level decreased from 41.6±8.6 to 26.8±8.3 u/l (p=0.002), the AST level decreased from 35.3±6.8 to 21.9±7.1 U/l (p=0.0029). The risk of fibrosis was mild and reached statistical significance only when assessed with FIB-4 index, when comparing the initial values and after 24 weeks of treatment - 1.35±0.48 and 1.15±0.35, respectively (p=0.025). This fact can be explained by the minimal degree of fibrosis at the baseline. Conclusion. There were comparable effects of empagliflozin and dapagliflozin on estimated parameters at the end of the study. Further studies on big cohorts of patients with different stages of NAFLD are required to unambiguously answer the question about the effect of iSGLT2 on the progress of this disease.

Васильева Елена Юрьевна, доктор мед. наук, профессор кафедры кардиологии; e-mail: vasilievahelena@gmail.com; Рязанкина Надежда Борисовна, аспирант кафедры кардиологии; Манчуров Владимир Николаевич, аспирант кафедры кардиологии; Хмара Татьяна Николаевна, аспирант кафедры кардиологии; Скрыпник Дмитрий Владимирович, кандидат мед. наук, доцент кафедры кардиологии; Резцов Роман Юрьевич, кандидат мед. наук, ассистент кафедры кардиологии; Шпектор Александр Вадимович, доктор мед. наук, профессор, заведующий кафедрой кардиологии

The infections very often complicate the course of autoimmune rheumatic diseases. In diagnostic of septic complications in rheumatic patients the new biomarkers of infections can have a decisive importance. The procalciotonine test is one of them. The issue was to evaluate the diagnostic informativity of this test. The sample included 93 patients. The examination was applied to 65 patients with rheumatic diseases. Among them, 13 patients had bacterial infections. The group consisted of 33 patients with rheumatoid arthritis, 11 patients with systemic lupus erythematous, 6 patients with systemic angiitis, and 15 patients with other rheumatic diseases. The comparative group included 27 patients of cardio-therapeutic profile and 8 of these patients had bacterial infections. The procalcitonine test was applied with quantitative electrochemiluminescent technique. In patients with rheumatoid arthritis the mean levels of procalciotonine test consisted 0.10 +/- 0.13 ng/ml; with systemic lupus erythematous--0.08 +/- 0.06 ng/ml; with systemic angiitis--0.22 +/- 0.2 ng/ml; with other rheumatic diseases--0.12 +/- 0.15 ng/ml; of cardio-therapeutic profile without infections--0.08 +/- 0.06 ng/vl/ With threshold of procalcitonine test higher than 0.5/ml the sensitivity to diagnostic of infections consisted of 58%, specificity--94% in the group with rheumatic diseases. The procalciotonine test in case of no infection process with values higher than 0.5 ng/ml was detected in three patients. The evaluation of dependence of sensitivity and specificity for procalciotonine test and C-reactive protein the area under curve of procalcitonine test was larger in patients with rheumatic diseases (0.85 against 0.79) and in patients of cardio-therapeutic profile (0.92 against 0.90). The quantitative procalcitonine test is the best technique to detect septic complications in rheumatic patients.