Vol 14, No 1 (2023)

BACKGROUND: The activation of the patient from the day after an acquired mitral valve (MV) defect with standard cardiorehabilitation surgery and further physical training at an early uncomplicated inpatient stage of the postoperative period appears promising to improve not only the functional status but also the quality of life (QL).

AIM: Our aim was to examine the effect of early physical rehabilitation on the dynamics of anxiety, depression, and QL in patients after surgical correction of the MV defect.

MATERIALS AND METHODS: The study included 80 patients (median age 60.8 [47.5; 69.0] years) who underwent surgical correction of an acquired MV defect. Starting from the 7th day after the surgery, patients were assessed for functional status, and the intensity of the training load was selected, and this was done again on the 24th day after the surgery. Moreover, the QL parameters on the SF-36 scale and levels of anxiety and depression on the Hospital Anxiety and Depression Scale (HADS) were evaluated. The control group (n=47) underwent a standard cardiac rehabilitation program from 1st day after surgery. In the main group (n=33), based on the results of the cardiopulmonary exercise testing, physical training on a treadmill was initiated for 14 days, from the 8th day after the surgery, in addition to a personalized training program.

RESULTS: In addition to improving the functional state, early physical training improved the dynamics of QL indicators in the main group. After 14 days of treadmill training, the physical health component increased from a median of 35.1 to 64.4 (p=0.03), and the mental health component from a median of 49.1 to 82.1 (p=0.03). In addition, after the early physical rehabilitation program in the main group, the number of people without anxiety and depression, according to the HADS scale, significantly increased from 9% to 27.3% (p=0.04), whereas the dynamics of the QL, anxiety, and depression levels in the control group were not significant.

CONCLUSION: Early physical rehabilitation, including moderate-intensity workouts with an individual calculation of the speed / angle of the treadmill, starting from 8 days after surgical correction of the acquired MV defect demonstrated efficacy in improving the QL and reducing anxiety and depression levels 24 days after surgery.

BACKGROUND: Cardiorenal relationships are one of the key problems in cardiology and nephrology. Microalbuminuria is a symptom of kidney pathologies and cardiovascular diseases. Studying the causes of microalbuminuria will help in solving the issue of pathological cardiorenal relationships.

AIM: To study the causes of the origin of microalbuminuria on the group of locomotive crews employees of the Trans-Baikal Railway.

MATERIALS AND METHODS: Predictors of microalbuminuria were established using data from a 6-year prospective follow-up of 22 clinical and anamnestic items in a natural cohort group of initially healthy 7,959 men (workers of locomotive crews) aged 18–66 years. A confusion matrix, multivariate regression model, and relative risk assessment were used for this purpose.

RESULTS: Microalbuminuria was found to be caused by excessive alcohol consumption, arterial hypertension, dyslipidemia, family history of early cardiovascular disease, grade I–II retinopathy, and smoking. The established predictors of microalbuminuria showed statistical heterogeneity in different analyses, referring to the significance of their assessment in the models used.

CONCLUSION: The statistical heterogeneity of microalbuminuria predictors of is probably determined by and related to their qualitative characteristics and the unique implementation of their damaging effect in the formation and progression of microalbuminuria at the cellular level. The results of the study showed the need to continue the examination of predictors of microalbuminuria using other statistical analysis tools until their unique specific characteristics are known and the effects of damage on the formation of this pathological symptom are clarified.

Advanced glycation end products (AGEs) are represented by heterogeneous molecular structures and their accumulation in organs and tissues reflects the intensity of oxidative stress and glycemia. As a physiological process, aging is associated with AGE accumulation and changing the morphology and functions of the vascular wall. Accelerated AGE accumulation initiates inflammation, contributing to the development of cardiovascular diseases, such as arterial hypertension, coronary heart diseases, and atherosclerosis of peripheral arteries; conditions associated with high cardiovascular risks such as prediabetes, diabetes mellitus type 2, and chronic kidney diseases are also characterized by the accelerated AGEs accumulation. The ability of AGEs to fluorescence underlies noninvasively in blood serum, tissues, and skin using a well-proven technique of autofluorescence, which is little known to domestic specialists. This review presents the possibilities of autofluorescence to reflect arterial wall remodeling, which includes stiffness, vascular endothelial function, atherosclerotic plaque formation, and instability, using modern materials. The review emphasizes the evidence base regarding the ability of this method to predict mortality and cardiovascular events in a large population from low to high risk.

The Wolf–Parkinson–White (WPW) syndrome is a condition with early excitation of the heart ventricles due to the conduction of an electrical pulse along the atrioventricular pathway, such as the Kent, James bundle, and Mahaim fibers; the pulse is usually accompanied by supraventricular tachycardia, atrioventricular reciprocal tachycardia in 95% of cases, and fibrillation, atrial flutter, and other supraventricular tachycardia in other cases. WPW syndrome can be observed in patients of any age, approximately 1–30 per 10,000 people, with male predominance. The disease affects 0.15–0.25% of the population. Sudden cardiac death occurs in one patient per 1000 annually, and sometimes this is the first "business card" of the disease. This is mainly due to the lightning-fast formation of life-threatening arrhythmias, for example, with the transformation of atrial fibrillation into ventricular fibrillation. The morphological substrate is an additional atrioventricular connection. Currently, transcatheter radiofrequency ablation is the standard of the interventional treatment of WPW syndrome. WPW syndrome has a diverse etiology. Numerous studies reported that genetics play a significant role in the development of WPW syndrome. Several genetic predictors of WPW syndrome are presented in the modern literature, which may be relevant in predicting and diagnosing hidden forms of this syndrome, such as course, development of symptoms and manifestations, and reduction of the risks of sudden cardiac death.