Histological assessment of calcification patterns in different sites of ascending aorta in patients with thoracic aortic aneurysm has been performed using alizarin red S staining. Biopsy specimens from 67 patients (47 males, 20 females, mean age 56,9 +/- 11,1 years) with thoracic aortic aneurysm from three different sites of ascending aorta were taken intraoperatively. Calcium content in aorta was calculated as the percentage of positively stained area using FiJi. Statistical data processing was performed using JASP 0.17.2.1. Calcific precipitates were diffusely distributed mainly in the tunica media of the vessel. The mean calcium percentage was: for the sinotubular junction (zone 1) - 7.85 [2.2; 15.4]%, mid-ascending aorta (zone 2) - 10.45 [3.83; 22.35]%, proximal aortic arch (zone 3) - 10.95 [4.65; 18.63]% (p=0.216). Patients with maximum calcification level in zone 3 were younger (53 [41; 62] years) than patients in whom the maximum calcification was detected in zone 2 (60 [55.25; 65] years) and zone 1 (64 [58; 68] years, p=0.035).

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.

The concentration of matrix metalloproteinase (ММР-1, 3, 9), tissue inhibitor ММР-1 (TIMP-1), atrial (proANP) and brain NT-(proВNP) natriuretic peptide have been studied by the method of enzymelinked immunosorbent assay in blood serum and plasma in 53 patients with ischemic cardiomyopathy and in 17 healthy volunteers. The groups were of the comparable age. In 37 patients from the group with ischemic cardiomyopathy there was performed identification of circulating antibodies to myocardium in blood serum by the method based on the reaction of indirect immune fluorescence. In one year after surgical treatment 27 patients (50,9%) were examined, in 6 of them there was noticed negative dynamics of the late postoperative period. Statistical analysis of the obtained data showed that concentration of ММР-3 and ММР-9 in blood serum of the patients with postoperative remodeling was significantly higher than that in patients with favourable late postoperative period (p=0,03); this fact allows ММР-3 and ММР-9 identification as molecular markers of postoperative remodeling of left ventricle.

Morphofunctional condition and features of ultrastructural organization of right atrium auricle and left ventricular myocardial cardiomyocytes were studied in 40 patients with ischemic cardiomyopathy and chronic heart failure. Results of electron-microscopic study of patients myocardium were compared with clinical results of their operative treatment for the first time. New data about pathogenous mechanisms of repeated left ventricular remodeling at ultrastructural level were obtained. Presence of plastic insufficiency of cardiomyocytes of both left ventricle and right atrium auricle was shown to play key role in heart failure advancing in late postoperative period.

Some cases of nanobacteria detection using ultrastructural examination of left ventricular myocardium in patients having acquired valvular disease of both rheumatic and infectious nature are described.

We performed morphological examination of intact and atherosclerotic aortic regions after laser irradiation with various characteristics (wavelength and energy). Particular attention was given to the type of damages to the vascular wall around craters formed by the laser beam. Combined irradiation with UV and visible lights produced least pronounced damages to surrounding tissues in the aortic wall.

The results of treatment of 161 patients with atherosclerotic small degree stenoses of carotid arteries (up to 50% of diameter) were analyzed. From them 67 patients underwent operations for chronic cerebro-vascular failure and 11 patients--for acute cerebro-vascular failure. 31 patients, who had contraindications for surgery or refused it, plasmapheresis procedures were carried on, 52 patients with asymptomatic carotid arteries' disease underwent conservative treatment. On the base of the results of examination and late results of treatment it is shown valid to recommend carotid endarterectomy as a prophylactic measure in acute cerebrovascular failure in asymptomatic patients who have morphologically unstable plaques of carotid arteries. If there are general contraindications for carotid endarterectomy, with the aim of prophylaxis of cerebrovascular failure the procedures of plasmapheresis for alteration of morphologic structure of plaques are advisable.