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The problem of resuscitating a man whose respiration and heart were arrested under strong cooling is urgent for the reanimation practice. The aim of this work was to study the influence of Slavinorm (a polypeptide complex of the vessels) on the heart work activation and the regeneration of their inherent respiration in the Wistar rats with the help of artificial ventilation of lungs (ALV) and warming the sternum region under deep hypothermia. The animals narcotized with urethan were cooled in water (9,2±0,5ºС) up to the arrest of respiration. The experimental group of rats 1 h before cooling were injected intraperitoneally with Slavinorm (15,6 mg/kg of weight) and the control rats were injected with physiological solution. In control rats the arrest of respiration was observed at the rectal temperature (Тr) 16,0±0,3ºС, in the esophagus (Te) 19,1±0,3ºС. The artificial lung ventilation (ALV) and heating the breast region resulted in the initiation of natural respiration in 29,2±0,4 min from the beginning of ALV at Tr 13,8±0,2ºС, Тe 16,1±0,2ºС. The conclusion: Slavinorm increases the resistance of an organism to cold, assists the prolongation of the process of cooling up to the arrest of respiration, decreases the temperature thresholds of the heart activation and resuscitation of natural respiration.

Purpose of the study. Studying the features of microcirculation, functional state and anatomy of the heart using the “Holiday Heart” syndrome model in rats we developed.Materials and methods. Experiments were carried out on white outbred male rats. The “Holiday Heart” syndrome was modeled as follows: animals received a 10 % aqueous ethanol solution as the only source of fluid for the first 10 days, then tap water for 10 days, and again a 10 % aqueous ethanol solution for the next 10 days. One day after the end of the repeated intake of alcohol, the animals were taken into the experiment. Animals that received free access to tap water served as control. Some rats in the experimental group (n = 10) had an echocardiogram recorded before the start of the experiment, and on the 31st day of the experiment, after which the level of microcirculation of blood and lymph in the brain and heart was measured using laser Doppler flowmetry. In the remaining animals (n = 10), microcirculation of blood and lymph in the brain and heart was assessed on the 3rd day of alcohol deprivation.Results. Analysis of the obtained data showed that in the conditions of the “Holiday Heart” syndrome model, significant changes occur in the anatomy, functional activity and geometry of the heart: there is a significant thinning of the anterior wall of the left ventricle heart (LV), an increase in systolic and diastolic volumes and sizes of the LV and a significant (p = 0.0018) decrease in its inotropic function. These changes occur against the background of a significant (p = 0.0081) decrease in the level of blood microcirculation in the myocardium, however, on the 3rd day of deprivation, blood flow in the microvessels of the heart increases statistically significantly (p = 0.0285).Conclusion. In model experiments reproducing the “Holiday Heart” syndrome, it was shown for the first time that ethanol causes significant changes in the microcirculation, anatomy, functional activity and geometry of the left ventricle of the heart, which, apparently, can play a key role in the formation of myocardial electrical instability pathognomonic for this syndrome.

Purpose of the study. Studying the blood microcirculation characteristics in the brain and heart of rats with ACM.Materials and methods. The study was carried out on white outbred male rats. The animals were randomized into 2 groups: 1st (n = 7) — control (intact) rats that received a normal diet and free access to water; 2nd (n = 6) — animals that received a normal diet and a 10 % ethanol solution as the only source of liquid. After 24 weeks of alcoholization in animals, the size and inotropic function of the heart were assessed using echocardiography. The next day, in anesthetized rats (urethane 1300 mg/kg i.p.), blood microcirculation in the heart and brain was recorded using a computerized laser analyzer “LAZMA-D” (manufactured by NPP “Lazma”, Russia) using the LDF 3.0.2.396 program. Using spectral wavelet analysis, the amplitudes of endothelial, neurogenic, myogenic, pulse and respiratory oscillations of microblood flow and the shunting index were determined.Results. According to echocardiography data, in rats that consumed a 10 % ethanol solution for 24 weeks, ACM is formed, which is accompanied by a decrease in blood microcirculation in the brain and myocardium. Thus, if in control animals the indicator of blood microcirculation in the myocardium was 36.60±2.19 perf. u., then in rats with ACM it was equal to 26.88±1.50 perf. u. units (p = 0.004). In the myocardium of rats with ACM, compared with control animals, the amplitude of both active and passive oscillations of microblood flow was significantly greater.Conclusion. In rats with ACM, the level of blood microcirculation in the heart muscle is significantly reduced, which, according to the results of spectral wavelet analysis, is prognostically unfavorable.

The aim of this study was to determine the sources of superoxide anion radical (O₂⁻•) in rat heart homogenate under conditions of surgical trauma inflicted against the background of an experimental model of posttraumatic stress disorder (PTSD). Materials and methods. The experiments were conducted on 42 white Wistar rats weighing (220±10) g, divided into 6 groups: Group 1 – intact animals; Group 2 – rodents with PTSD modeled by reproducing single prolonged stress (SPS); Group 3 – rats that underwent a sham operation; Group 4 – animals that underwent laparotomy; Group 5 – rats that underwent a sham operation after SPS modeling; Group 6 – animals that underwent laparotomy after reproducing SPS. The rate of O₂⁻• generation in the heart homogenate was studied using a spectrophotometric test with nitroblue tetrazolium. Results. The modeling of PTSD (SPS) and surgical trauma leads to a significant increase in oxidative stress in the rat heart, evidenced by an elevated rate of O₂⁻• generation involving NADPH-dependent electron transport chains (ETC) in microsomes, NO synthase, the mitochondrial respiratory chain, and leukocyte NADPH oxidase. In the post-laparotomy period following SPS, the oxidative stress enhanced significantly and was manifested through increased O₂⁻• generation by NADPH-dependent microsomal and NO synthase ETC by 72.3%, by NADH-dependent mitochondrial ETC by 72.9%, and leukocyte NADPH oxidase by 80.9% compared to intact control. When compared to group 2, these indicators rose by 29.6%, 24.4%, and 26.8%, respectively. Group 4 demonstrated an even more pronounced increase in O₂⁻• generation, reaching 54.0%, 54.6%, and 62.9% respectively. Furthermore, O₂⁻• production rates from all sources in group 4 were likely higher than those in group 5 by 29.8%, 21.2%, and 21.5% , respectively. Conclusions. The combined effect of laparotomy and experimental PTSD synergistically enhances O₂⁻• production in the heart homogenate from various sources, significantly exceeding the levels observed with either laparotomy or SPS alone.

Background. The mechanisms underlying the development of the heart contractile apparatus and the distribution of myofibrils in cardiomyocytes following intrauterine ethanol intoxication continue to be a topic of significant debate. The aim of this paper is to determine the dynamics of postnatal changes in the ultrastructure of ventricular contractile cardiomyocytes in the rat heart after chronic alcoholization of the maternal organism. Methods. The study focused on the hearts of rat offspring from birth to adulthood. Transmission electron microscopy was utilized to examine the ultrastructure of cardiomyocytes in various zones of the ventricular myocardium. Results. It has been observed that prenatal alcohol exposure induces cardiomyocyte heteromorphism, characterized by varying degrees of damage throughout postnatal ontogenesis in rat offspring. Specifically, cells exhibiting critical signs of destruction in the myocardium of intramural and subepicardial zones of both ventricles aggregate into clusters surrounded by morphologically intact cardiomyocytes, while irreversibly damaged cells with subendocardial localization appear isolated. Following birth, there is a progressive accumulation of mitochondria exhibiting signs of limited functional activity. These polymorphic organelles, featuring a matrix of moderate or low electron density with sporadically developed cristae, primarily concentrate in paranuclear regions and are dispersed along the interstices of myofibril dissociation. Conclusion. Maternal chronic alcohol intoxication results in enduring harm to the contractile apparatus of ventricular cardiomyocytes in rat offspring. This damage manifests as sarcomere structure disorganization, myofibril fragmentation and misalignment, notable suppression of sarcomerogenesis, and reduced myofibril content, all closely linked to mitochondrial alterations.

Microvascular obstruction (MVO) of coronary arteries promotes an increase in mortality and major adverse cardiac events in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). Intramyocardial hemorrhage (IMH) is observed in 41–50 % of patients with ST-segment elevation myocardial infarction and PCI and is accompanied by inflammation. There is evidence that microthrombi are not involved in the development of MVO, which is associated with infarct size, the duration of ischemia, and myocardial edema. However, there is no conclusive evidence that the latter plays an important role in the development of MVO. There is evidence that platelets, inflammation, Ca2+ overload, neuropeptide Y, and endothelin-1 could be involved in the pathogenesis of MVO. The role of endothelial cell dysfunction in MVO formation in patients with AMI and PCI remains under question. It is unclear whether nitric oxide production is decreased in patients with MVO. It was obtained only indirect evidence on the involvement of inflammation in the development of MVO. The role of reactive oxygen species, necroptosis and pyroptosis in the pathogenesis of MVO is also not studied. The participation of thromboxane A2, vasopressin, and prostacyclin in the formation of MVO is unknown. It was not obtained conclusive evidence on the involvement of coronary artery spasm in the development of MVO. Dual antiplatelet therapy improves the efficacy of PCI in prevention of MVO. It is unknown whether epinephrine or L-type Ca2+-channel blockers improves coronary blood flow in patients with MVO.

The article presents a case of immunoglobulin light chain amyloidosis with cardiac involvement without typical noncardiac manifestations. A complex diagnostic search for the cause of newly diagnosed pulmonary hypertension is described. Aspects of differential diagnosis in invasive hemodynamic assessment of pulmonary circulation and echocardiographic data are discussed. A special case feature is involvement of the hearing organ, which is very rare.

Experimental medicine provides the scientific community with a plethora of information on therapeutic efficacy of probiotic strains. However, from the point of view of evidence-based medicine, the list of disorders controlled by probiotics is limited to antibiotic-associated diarrhea in adults and children, Clostridium difficile-associated diarrhea, acute infectious diarrhea in children and adults, eradication therapy, ulcerative colitis and irritable bowel syndrome. Recently, these indications are also amended by well-validated clinical guidelines for the usage of probiotic preparations, in order to modulate immunity. Given the permeability of gastrointestinal and immune system barriers for pathogenic and opportunistic microbiota, it seems logical to assume the effectiveness of probiotics as potential symbiotic regulators of nervous and cardiovascular systems. It should also be taken into account that metabolic disorders, e.g., obesity, with a low-intensity inflammatory response and characteristic cytokine pattern, are acquired as a gain of human civilization. In this regard, we propose a scientific hypothesis about the effectiveness of probiotic microbial strains in increasing myocardial resistance to ischemic-reperfusion injury, due to their ability to block individual links of the cytokine cascade during the development of inflammatory response, for its subsequent translation into clinical practice.The development and validation of a new experimental model of systemic inflammatory response syndrome (SIRS) in male Wistar rats, including obesity, acute inflammatory process of the colon, and antibiotic-induced dysbiosis, became basic to the study of efficacy of probiotic drugs in terms of myocardial resistance to ischemicreperfusion injury (IRI). Rats with SIRS showed a significantly increased size of the infarction area (+28%) upon experiments with isolated perfused heart under global ischemia-reperfusion conditions. Significant changes in the leukocyte formula and immunological parameters associated with SIRS were corrected by introduction of a mixture of probiotic strains L. acidophilus (LA-5) and B. animalis subsp. lactis (BB-12), and the isolated strain L. delbrueckii TS1-06. In both groups with probiotic correction, there was a decrease in the infarction area compared to the SIRS group. General and specific changes in IL-2, transforming growth factor-b (TGF-b) and tumor necrosis factor-a (TNFa) were noted. The reduction of myocardial infarction by probiotics may be related to the blocking of first-order cytokines, which leads to a «break» of proinflammatory cascade. A need for in-depth study of cardioprotective mechanisms mediated by probiotics was confirmed due to their potential usage as a symbiotic alternative to biological drugs which block the main pro-inflammatory cytokines.

The aim of this study was to assess the production of reactive nitrogen species in the hearts of rats subjected to surgical trauma simulated against the background of post-traumatic stress disorder (PTSD). Materials and methods.The study was conducted on 42 white Wistar rats weighing 210-230 g, then divided into 6 groups: Group 1 consisted of intact animals, Group 2 included animals exposed to the induction of the PTSD model through single-prolonged stress (SPS), Group 3 – rats subjected to a sham operation, Group 4 – animals undergoing laparotomy, Group 5 – rats undergoing a sham surgical operation following SPS, and Group 6 – animals undergoing laparotomy under modeled SPS. NO synthase activity in the heart homogenate was determined spectrophotometrically. Results. The formation of peroxynitrite was assessed by the content of peroxynitrite of alkaline and alkaline-earth metals. SPS exposure significantly increases the production of reactive nitrogen species in the hearts of rats, in particular, it enhances NO synthase activity by activating the inducible isoform and reduces the activity of constitutive NO synthases, which is accompanied by the growth in the concentration of peroxynitrites. On the 7th day after laparotomy against the background of the experimental PTSD model, the indicators of nitrosative stress in the hearts of rats (total and inducible NO synthase activity and peroxynitrite concentration) significantly exceeded their values in the groups subjected to a single laparotomy and to a sham operation against the background of simulated SPS.

The object of the research is the socio-philosophical discussions of Russian philosophers of the turn of the XIX-XX centuries, the subject of our research is the anthropodicy of I.A. Ilyin. The author examines the categories of good, good and evil, the meaning of life, asceticism in the context of the concept of active resistance to evil and the teachings about the heart of I. Ilyin. These concepts were considered as a reflection of reality, as the foundation for building a state and society. Ilyin cites three qualities necessary for an active struggle against evil: spiritual character, willpower and a living conscience. According to the presence of these qualities, Ilyin accordingly divides people into three categories. Only a strong and conscientious person is able to fulfill “God’s work” on earth. The author of the article comes to the conclusion that I. Ilyin’s concept of the imposition of will on the internal or external composition of a person contains axiological and didactic potential. Russian Russian philosophical thought at the beginning of the 20th century came to realize the Russian idea, that is, to comprehend the self-existence of the Russian, Russian people. Ilyin’s ontology and axiology, despite negative criticism, enriched Russian philosophical thought, his ethical views allowed us to approach the understanding of the philosophical awareness of the meaning of human existence and set the vector of development of society and the state. Concepts and. Ilyina in our time, serious external existential challenges for Russia look more relevant than ever and require a comprehensive study. For the first time it was revealed that the teachings of I. Ilyin trace the intentions of asceticism characteristic of Russian spiritual culture. The practical value of the work is determined by the fact that the results of the research can be used in the development of courses “Philosophy”, “History of Philosophy”, “Ethics”, “Cultural Studies”, “Fundamentals of Russian statehood”.

Introduction and purpose: Ethanol is still one of the most frequently consumed drugs worldwide and is a strong risk factor for more than 60 illnesses including alcoholic cardiomyopathy which is a specific heart muscle disease caused by long-term excessive alcohol consumption. The review aims to gather available data and summarize it to give better understanding of the disease, to help select patients with the condition to implement proper treatment, and to present possible future directions as the incidence of the disease is projected to persist in the future. Brief description of the state of knowledge: Alcoholic cardiomyopathy (ACM) is characterized by dilation, increased mass of the left ventricle, and reduced ejection fraction leading to end-stage heart failure. It is caused by ethanol’s direct toxicity on myocytes disturbing many different metabolic pathways. The result is a decrease in both systolic and diastolic function of the heart. The ACM development depends on factors such as genetics, gender, dietary factors and the dosage of ethanol consumption. The goal of the treatment is total alcohol abstinence, but the reduction of ethanol intake may also be beneficial. Patients should obtain a complete pharmacological treatment for heart failure. Summary: Ethanol overconsumption remains an unresolved problem, with the incidence of ACM projected to persist in the future, especially among patients with alcohol use disorder (AUD). Efforts for prevention, early detection, and effective treatment of ACM need to be established. A primary focus should be on treating AUD because it is the most effective way to halt the progression of the disease. Further research should focus on both asymptomatic and symptomatic patients with AUD to better define clinical manifestations, diagnostic approaches, and the most effective treatments for ACM.

Background: Patients referred for cardiac surgery usually also have other comorbidities. These include thyroid disease, which is relatively common in patients with heart problems. Objective: The aim of the study was to evaluate the feasibility of combined cardiac surgery and thyroidectomy. Material and methods: Six patients (age range: 54-74 years) qualified for elective, simultaneous surgeries on the heart and the thyroid were included in the study. In preparation for thyroidectomy, three patients were diagnosed with diseases requiring cardiac surgery. Two patients, initially referred for coronary artery bypass surgery in one case, and surgery for recurrent fluid in the pericardial sac with concomitant mitral and tricuspid valve regurgitation and atrial fibrillation in the other, were diagnosed in large hyperactive goitre. The last patient with a history of oncology (lung tumour), admitted to the Department of Cardiology due to a heart attack, had a CT scan of the chest, which revealed retrosternal goitre narrowing the lumen of the trachea to 9 mm. All patients underwent combined heart and thyroid operation and were discharged home 8-27 days after surgery. Conclusions: Although preoperative qualification requires a very cautious and individual approach, simultaneous surgeries in patients requiring thyroid and heart interventions are expedient and should be promoted.

Diagnosis of myocarditis remains one of the most difficult clinical problems in cardiology. In connection with the coronavirus infection COVID-19 caused by the acute respiratory virus SARS-CoV-2, non-invasive diagnosis of myocarditis is an urgent task. The most informative method for diagnosing myocarditis is magnetic resonance imaging [1,2]. The arsenal of MRI includes a number of pulse sequences that make it possible to identify and evaluate the process of inflammation in its various phases. Various pulse sequences (T2-weighted images or T2-mapping, delayed contrast, T1-mapping) allow not only to diagnose the disease, but also to determine the stages of damage. The ability of MRI to differentiate ischemic and non-ischemic lesions [3] is used in emergency cardiology for various myocardial injuries.The peculiarity of this clinical case is the use of MRI diagnostics in a patient with a typical clinical picture of acute coronary syndrome in the emergency department of cardiology. The data of the contrast MRI of the heart allowed the patient to make the correct diagnosis.

Abstract. Taking into account the conflicting data on the effect of the systemic inflammatory response on the structural and functional changes in the myocardium in clinical forms of tuberculosis, we conducted an echocardiographic study and an assessment of pro- and anti-inflammatory cytokines in the blood serum.The purpose: to study the relationship of structural and functional changes in the myocardium with markers of systemic inflammation IL-6, IL-10, VEGF-A in patients with various forms of pulmonary tuberculosis.Materials and methods. The study included 77 patients with a confirmed diagnosis of pulmonary tuberculosis, who are on inpatient treatment in a tuberculosis dispensary. During the study, patients were randomized into 3 groups, cavernous form of pulmonary tuberculosis, (n = 15). The mean age of the patients was 44.2 ± 5.3 years and had no statistically significant differences between the groups. The control group consisted of 10 healthy individuals. The mean age of the control group was 42.4 ± 2.3 years. The concentration of IL-6, IL-10 and VEGF-A in blood serum was assessed by ELISA and В-mode echocardiography.The results obtained. The severity of systemic inflammation was associated with the clinical form of pulmonary tuberculosis: the maximum value of IL-6 was observed in the infiltrative form, and the minimum, but significantly higher value compared to the control group, in the fibrous-cavernous form of pulmonary tuberculosis (25, 7 ± 16.5 vs 10.3 ± 4.24). High levels of interleukin IL-6 were accompanied by higher levels of VEGF in blood serum, regardless of the form of pulmonary tuberculosis, while the highest concentration of both was observed in patients with infiltrative form of tuberculosis . A significant increase in the structural and functional values of the myocardium of the right and left parts of the heart was established both in relation to the control group and in comparison with the group of patients with an infiltrative form of pulmonary tuberculosis, despite lower levels of VEGF-A (391.43 ± 241.0 vs 274.50 ± 158.30).Conclusions. Pulmonary tuberculosis is accompanied by varying severity of systemic inflammation associated with the clinical form of the disease. Structural and functional changes in the myocardium of the right and left parts of the heart in pulmonary tuberculosis are associated with the clinical form of pulmonary tuberculosis. The most pronounced changes are observed in the fibrous-cavernous form, the minimum - in the infiltrative form. There is no direct relationship between the severity of the systemic inflammatory response and structural and functional changes in the heart.

BACKGROUND: Myocarditis is among the most common complications arising from coronavirus infection (COVID-19). AIM: This study aims to find the differences in the patterns of myocardial injury between patients who had COVID-19 and those from the pre-pandemic period, as determined by contrast-enhanced cardiac magnetic resonance imaging. MATERIALS AND METHODS: The study encompassed a retrospective analysis of 47 patients who underwent contrast-enhanced cardiac magnetic resonance imaging to rule out acute myocarditis. Group 1 comprised 34 patients with a confirmed history of COVID-19 through PCR testing (nasal and/or throat swabs), while Group 2 comprised 13 individuals who underwent contrast-enhanced cardiac magnetic resonance imaging in 2017 prior to the onset of the COVID-19 pandemic. All patients enrolled in the study had clinical manifestation of cardiac injury without signs of coronary artery disease as an underlying cause of condition. RESULTS: The mean time from the onset of heart symptoms to the administration of contrast-enhanced cardiac magnetic resonance imaging was 166 days. In group 1, a decrease in exercise tolerance was observed in 77% of patients, and 14 (42%), 30 (88%), and 28 (85%) of patients complained of chest pain, shortness of breath, and heart palpitations, respectively. In group 2, four patients (30%) had dyspnea, nine patients (69%) complained of chest pain, and six patients (46%) had heart palpitations and/or feeling of arrhythmia. Myocardial injury in group 1 was more generalized. The third of them had displayed preserved increased pulmonary vascularity and pleural effusion. Within group 1, men had significantly lower left ventricular ejection fraction, lower values of global longitudinal deformation, and higher values of left atrial function compared with the corresponding parameters in women. Differences in women were found only in the number of the affected segments in the left ventricular myocardium. CONCLUSION: SARS-CoV-2 virus caused extended myocardial injury, affecting a significant number of myocardial segments. Men had more frequent postinflammatory complications, characterized by abnormal function of the left ventricle and left atrium. Obtained results require continuous efforts for further assessment of long-term consequences of previous COVID-19 to the cardiovascular system. In this regard, contrast-enhanced cardiac magnetic resonance imaging may represent a sensitive imaging tool for the assessment of cardiac injury severity.

Diabetic cardiomyopathy is a serious complication of diabetes mellitus (DM). Aim. Therefore, we aimed to study myocardial changes in adult rats with streptozotocin (STZ)-induced DM exposed to chronic immobilization stress (CIS). Materials and methods. A total of 26 adult albino male rats weighing 180–200 g were examined. All the animals were divided into three groups: Group I included 10 rats with STZ-induced DM exposed to CIS; Group II comprised 10 rats with STZ-induced DM; Group III included 6 intact animals. The samples were collected on the 14th and 56th days of the experiment. Histological, histochemical, electron microscopy, and biochemical methods were used. Results. On the 14th day of the experiment, in Group I and Group II, increased blood flow was observed in the capillaries, venules, and veins, while an arteriolar spasm in the microcirculation was found. In addition, cardiomyocyte surface area in different myocardial regions reduced due to low glycogen content as confirmed by histochemical and ultrastructural studies. On the 56th day of the experiment, in Group I and Group II, hyperemia occurred due to red blood cell aggregation and microthrombi. The surface area of all microcirculatory vessels increased as compared to that of intact animals, as evidenced by an increase in their wall surface area leading to an increase in their wall-to-lumen ratio. Such morphometric changes in the microcirculatory vessels were indicative of decreased vascular permeability and impaired myocardial blood flow. At the histological level, in Group I and Group II, focal cardiomyocyte lysis, moderate to diffuse stromal edema, lymphohistiocytic infiltration were seen. Such changes pointed to sterile inflammation, probably due to myocardial infraction secondary to diabetic microangiopathy. In cardiomyocytes, karyolysis, vacuolar degeneration, apical ballooning, subsarcolemmic edema, fibrosis and lysis of myofibrils, colliquative necrosis were observed. Conclusions. STZ-induced DM and stress resulted in pronounced destructive changes in the myocardium of rats, including interstitial edema, focal cardiosclerosis, myolysis. Such changes occurred on the background developing diabetic microangiopathy. The most pronounced myocardial changes were recorded in animals with a comorbidity.

Background. Mortality from acute myocardial infarction with ST-segment elevation in cardiac hospitals ranges from 4.5 to 7 %, and these data has not decreased in recent years. The most common cause of death in patients is cardiogenic shock, the likelihood of which directly depends on infarct size. It is quite clear that there is an urgent need to create drugs to limit the size of infarction and prevent the occurrence of cardiogenic shock.The aim. To evaluate the role of reactive oxygen species and redox-sensitive protein kinases in the infarction-limiting effect of opioid peptide deltorphin II in cardiac reperfusion in rats.Materials and methods. Coronary occlusion (45 min) and reperfusion (120 min) were performed in rats anesthetized with α-chloralose. The selective δ2-opioid receptor agonist deltorphin II, a hydroxyl radical scavenger 2-mercaptoprpionyl glycine (2-MPG), a superoxide radical scavenger tempol, the protein kinase Cδ (PKCδ) inhibitor rottlerin, the PI3-kinase inhibitor wortmannin, the inhibitor of ERK1/2 kinase PD98059 were injected before of reperfusion of the heart.Results. Deltorphin II contributed to a two-fold decrease in infarction size. Injection of 2-MPG, tempol, rottlerin, wortmannin, PD98059 alone had no effect on infarction size in rats. 2-MPG and tempol did not affect the infarction-reducing effect of deltorphin II. Rottlerin, wortmannin, and PD98059 eliminated the cardioprotective effect of deltorphin II.Conclusion. The infarction-reducing effect of deltorphin II does not depend on the production of superoxide radical and hydroxyl radical. Superoxide radical and hydroxyl radical do not play a significant role in reperfusion injury of the heart after coronary occlusion (45 min). PKCδ, PI3-kinase, and ERK1/2 kinase are involved in the infarction-limiting effect of deltorphin II in myocardial reperfusion.

Background. The purpose of the study is to determine the dynamics of growth and differentiation of cortical and perimedullary nephrons in children with pathology of the cardiovascular system. Materials and methods. We researched the histological material of the kidneys painted by hematoxylin-eosin and obtained from postmortem, from pediatric patients with congenital heart disease (open foramen ovale, ventricular septal defect and without pathology this patients has age range from 0 to 12 months) patients divided into three age groups (0‒2, 4‒6, 10‒12 months). During microscopy, the number of nephrons in the field of view in the subcortical zone and separately in the perimedullary zone of the cortical substance was counted, the data obtained were subjected to statistical processing. Results. In patients without pathology of the cardiovascular system, the differentiation of subcortical nephrons during the first year of life occurs linearly. There is a clear trend towards a decrease in the number of nephrons per unit area with age. The development of pericerebral nephrons in the same group up to 6 months is similar, but by the age of 10‒12 months, the number of bodies of perimedullary nephrons per conventional unit of area increases to values determined at 2 months of age. Conclusions. In patients with pathology of the cardiovascular system, the dynamics of differentiation of nephrons in the subcapsular zone differs from those found in the first group and repeats the dynamics of differentiation of perimedullary nephrons. The presence of congenital malformations of the cardiovascular system during the first year of a child's life leads to changes in the differentiation of the renal parenchyma. In children without pathology of the cardiovascular system, there is a decrease in the number of nephrons per conventional unit of area during the first year of life. Changes in the differentiation of nephrons in the subcapsular zone of the kidneys in the presence of congenital malformations of the cardiovascular system can become one of the pathogenetic stages in the development of arterial hypertension.

Evolution of concepts of pathogenesis and treatment of heart and kidney involvement as integrated continuum are described

This work is a scientific and educational analytical review intended for practicing cardiologists. The purpose of the review is to draw physicians’ attention to the role of myocardial contractility in the regulation of coronary circulation. We consider the fundamental phenomenon of arterial compression (squeezing) in the left ventricular (LV) wall, creating an obstruction to blood flow during cardiac systole. This phenomenon formally resembles functional coronary artery stenosis. Based on a review of the literature, the positive role of arterial compression in coronary hemodynamics is interpreted. Understanding the mechanical relationship between the contractile and coronary systems in the cardiac wall may be useful for practicing physicians when choosing treatment tactics for patients, optimizing LV bypass during heart surgeries, and improving the efficiency of adaptation of the transplanted heart.

The influence of sports activity on the cardiovascular system is accompanied by physiological adaptation of the organism. Intense physical activity, far exceeding the body’s capabilities, can lead to structural changes or remodeling of the athlete’s myocardium. The review is devoted to the study of myocardial heterogeneity and is aimed at attracting attention of physicians, physiologists, biologists, researchers and developers of ECG computer analysis programs to prognostically significant indicators. Based on the mechanisms of electrical heterogeneity of the ventricular myocardium, the review considers the results of clinical studies by Russian and foreign specialists. The high predictive capabilities of indicators for the detection of fatal and non-fatal cardiovascular events and sudden cardiac death are discussed. It was found that the speed indicators of the electrical activity of the heart are the earliest marker of cardiac arrhythmias and conduction disorders. Risk factors - arterial hypertension, smoking, hypercholesterolemia and overweight - are associated with a decrease in the rate of electrical activity of the heart and an increase in myocardial heterogeneity. The data presented allow us to conclude that myocardial electrical heterogeneity is a prognostically significant indicator for the detection of fatal and non-fatal cardiovascular events; it is widely discussed in foreign literature, but is not used by domestic specialists.

Relevance. In conditions of ever-increasing volume of training loads, the frequency of cases of chronic physical overstrain (CPO) among athletes is increasing. It determines the importance of early diagnosis of the formed pathology of the cardiovascular system in order to prevent its further development. The aim of the study was to study the dynamics of autoantibodies to cardiomyocyte proteins using an experimental model of CPO and to determine the prospects of a laboratory method for the determination of autoantibodies for early diagnosis of pathomorphological changes in the heart. Materials and Methods. The study was conducted on male white rats. A treadmill was used to model CPO. In animals, the heart rate was measured, electrical phenomena in the heart were recorded. The content of hemoglobin and erythrocytes was determined in the blood. The level of cardiospecific autoantibodies (auto-AB) to troponin I, to alpha-actin 1, and to the heavy chain of beta-myosin 7B was measured. Heart mass was measured and histomorphological assessment of the state of cardiomyocytes was carried out. Results and Discussion. While modeling CPO, a decrease in body weight of the animals, the development of anemia, and cardiac hypertrophy were recorded. A decrease in body weight by more than 30 % was recorded from days 25 to 35 of the modeled CPO. A decrease in the number of erythrocytes in the blood was noted on day 25 with a peak fall on days 30-35. The mass of heart of animals in the dynamics of 0-15-35 days was 0.39±0.003; 0.41±0.001; 0.44±0.005 g/100 g, respectively. On day 25, sinus tachycardia was recorded in 2 % of the animals. On days 30 and 35, in 10 % of the studied rats, a violation of the processes of repolarization of the left ventricle by the type of subepicardial ischemia was recorded. On the 25th day, fibrosis of the perivascular region was visualized, passing into the interstitial field between the myofibrils. Reticulate structures of connective tissue fibers between cardiomyocytes were found. The period of 30-35 days was characterized by even greater severity of pathomorphological changes: myocardial hypertrophy, moderate myocardial dystrophy, interstitial and perivascular fibrosis. An increase in the number of detectable auto-ABs to cardiomyocyte proteins was noted on the 10th day of the experiment. A multiple increase in autoantibodies to cardiomyocyte proteins was recorded earlier than functional disorders in the heart and morphological changes in cardiomyocytes were detected. Conclusion. The laboratory method for determining auto-ABs to myocardial proteins can be the earliest of the complex methods for diagnosing disorders that are formed in the body in conditions of adaptation to intense and prolonged physical exertion.

The COVID-19 pandemic is a global health emergency. The relevance of this problem in immunoinflammatory rheumatic diseases is due to the increased risk of infection with SARS-CoV-2 and its severe course. The paper describes the clinical features and morphological changes in organs in a patient with rheumatoid arthritis and secondary amyloidosis of the heart and kidneys, who died from an infection caused by SARS-CoV-2.

Primary cardiac tumors are very rare in the population. About 20% of it are malignant. The most common type of cardiac malignant tumor is angiosarcoma. This tumor has the ability to infiltrate surrounding tissues and form distant metastases. Angiosarcoma is most often located in the right atrium and it mostly attacks men. This neoplasm is difficult to diagnose, because it has no specific symptoms. Patients with this tumor may complain of a chest pain, cardiac arrhythmias, suffocation and distal oedema. The rarity of occurrence and the lack of specyfic symptoms contribute to late diagnosis of the disease and worse prognosis of patients. Angiosarcoma can also be misdiagnosed as pneumonia or more common cardiovascular disease for example coronary artery disease. In advanced stage, this tumor can even lead to myocardial rupture. Various imaging methods are used in the diagnostics of this neoplasm for example: CT, MRI, PET-CT or Echocardiography. Histopathological examinations are less frequently used due to the risk of serious complications like hemothorax. Due to the very uncommon occurrence of the angiosarcoma, guidelines describing treatment of patients with this neoplasm, have not been developed yet. Currently, surgical removal of the tumor (if it is possible), chemiotherapy and radiotherapy are used. Reaserches on the genetic mutations which cause angiosarcoma and the development of appropriate drugs may give patients a chance for more effective treatment in the future

The article is dedicated to the comparison of anthropological models of the Hebrew Bible and the Greek Bible (Septuagint). Through lexical and theological analysis, the article reveals the correlation of typical anthropological ideas of the Hebrew Bible and the Septuagint. Based on this analysis, the main tendencies, innovations and changes in the field of the anthropology of the Septuagint are identified. In this article a comparative analysis of the vocabulary of the Hebrew Bible and the Septuagint, which describes a person and his inner world, is carried out. The concepts of “spirit”, “soul”, “body”, “flesh”, “heart”, etc. are considered. The article discusses the features of the translation of the key anthropological vocabulary of the Hebrew Bible into Greek. The question of the use of dichotomous and trichotomous approaches to the interpretation of anthropological vocabulary in the Septuagint is considered. The influence of dualistic anthropology on the interpretation of the main anthropological concepts used in the texts of the Septuagint is investigated. Examples, in which there is a tendency to “spiritualization” of the Bible, are considered. The nature of the use of Greek vocabulary associated with the ideas of the resurrection from the dead and eternal life in the books from the complete corpus of the Septuagint, the works of Philo and the Greek translation of the First Book of Enoch is investigated. The use of vocabulary related to the theme of the individual Adam and “man” as a generic concept is considered. The problem of discrepancies in the use of the name Adam in the Greek Bible and the Hebrew Bible is investigated. The reasons for the fact that the “personalization” of the first person (Adam) in the story of the creation of humankind in the Septuagint is indicated earlier than in the Hebrew Bible are described. The features of the interpretation of the expression “image of God” (Gen 1:27) in the writings of Philo of Alexandria are considered.

The study of changes in electrocardiograms under the influence of stress on the body is relevant. The catecholamines released in this case cause disorders of the work of the heart and contribute to the development of cardiovascular pathology. Stress also causes suppression of testosterone synthesis and spermatogenesis. The aim of the study was - to analyze changes in electrocardiogram indicators in rats that have undergone castration and stress during the development of epinephrine heart damage (EHD). Material and methods of investigation. The study was performed on 240 white Wistar male rats, which were kept in one room on a standard diet and a vivarium regime. All animals were divided into four series: 1 – control, 2 – stress, 3 – castration, 4 – castration and stress. To simulated EHD, rats were injected once intramuscularly with a 0.18% solution of adrenaline hydrotartrate at the rate of 0.5 mg/kg of rat’s weight. Such a dose of adrenaline causes reliable regulatory changes in the functioning of the cardiovascular system under any environmental conditions already 1 hour after injection of the drug, without causing lethality among animals. Stress was induced in rats from 1.5 to 3 months of age. The animals were constantly kept in cages with the limitation of living space by two times for 1.5 months. Experimental modeling of the decrease in the level of sex hormones in rats was carried out using castration under sodium thiopental anesthesia (40 mg/kg). Autopsy of the anterior abdominal wall was made according to Ya.D. Kirshenblatt method. At the time of the beginning of EHD simulation, all animals were 4 months old. Electrocardiography (ECG) was made after 1, 3, 7, 14 and 28 days after injection of epinephrine hydrotartrate in volumes corresponding to body weight. ECG was made under thiopental-sodium anesthesia. For analysis, we took the durations of the PQ and QT intervals, the status of the ST segment from the isoline, and the amplitude of the T wave. The significance of the obtained differences between the results (minimum level of significance p

Background. Currently, the poultry industry is developing quite intensively, this is why the use of various additives that accelerate growth and improve the quality of products is associated with this. The biologically active additive «Kovelos-Sorb» has similar properties – an enterosorbent based on particles of amorphous silicon dioxide. Purpose. To study the features of morphological adaptation of heart structures and biochemical blood parameters of Ross-308 broiler chickens when introducing the «Kovelos-Sorb» sorbent into the main diet. Materials and methods. Two groups of Ross-308 broiler chickens were studied from 1 day to 40 days, with a total number of 160 heads from 8 age groups of 10 individuals each. The experimental group of chickens was injected with the sorbent «Kovelos-Sorb» in the amount of 0.1% by weight of feed to the main diet. The study of morphological and biochemical parameters of the broiler organism was carried out according to generally accepted methods. Results. The analysis of the dynamics of changes in the morphological structures of the heart (linear measurements – longitudinal size, transverse size, girth, thickness of the epicardium, myocardium, endocardium, thickness of muscle fibers), the volume of cardiomyocyte nuclei, biochemical blood parameters of Ross-308 broiler chickens when added to the main diet of the enterosorbent «Kovelos-Sorb». Conclusion. It was found that the silicon-containing sorbent «Kovelos-Sorb» has a positive effect on the qualitative morphological characteristics of the heart of Ross-308 broiler chickens, manifested by stabilization of shell structures, in an increase in the thickness of the muscle fibers of the atria and ventricles of the heart.

New data on the features of development of visceral organs in embryos of egg cross chickens Lohmann Brown under red and green monochromatic LED lighting were obtained. The effect of two continuous LED lighting modes has been studied: experimental modes - r ed and green light, control - d arkness. The absolute values of weight dimensions and specific growth rate (according to the Schmalhausen-Brody formula) of heart, muscular stomach, liver of chicken embryos were estimated using morphometric methods. The studies proved that red and green LED lighting has a stimulating effect on the embryonic development of visceral organs (heart, muscular stomach, liver) in Lohmann Brown egg cross compared to the control (darkness). Under red and green LED stimulation, chicken embryos prevailed in the heart mass from the 14th to the 20th day of embryogenesis. The muscular stomach and liver of chicken embryos developed more intensively under red illumination on the 18th and 20th days, and under green illumination - a similar effect on the muscular stomach was noted on the 19th and 20th days, on the liver - o n the 20th day. It has been established that in the early ontogenesis of Lohmann Brown chickens there were several critical stages (phases). They fall on different days of development and characterize the features of rhythmicity in growth processes of visceral organs in chicken embryogenesis under LED stimulation of red and green spectrum. Chicken embryos under red and green illumination had the highest growth rate of heart on the 17th and 20th day, respectively; muscular stomach under red illumination - o n the 17th and 20th days, liver - on the 16th and 17th day under red and green illumination. By the hatching period on the 20th day, there were no differences in the development of visceral organs of chicken embryos depending on red and green light spectrum. The hatching of Lohmann Brown chicken embryos exposed to red and green light occurred on the 20th day of incubation - a day earlier than under control conditions (darkness). The proposed biological causes underlying the effect of monochromatic light of different color spectrum on embryogenesis of chicken embryo and organs are discussed.

Relevance. Early diagnosis of chronic overstress among athletes remains an important problem for coaches and specialists in the field of sports physiology and medicine. The goal is to study in an animal model the dynamics of autoimmune response to physical activity of different duration and intensity and to establish the prospects of the method of determining autoantibodies to cardiomyocyte proteins as an indicator of the morphofunctional state of the heart in the conditions of adaptation to muscle loads. Materials and Methods. The study was conducted in male white rats. Animals were subjected to 9 weeks of training simulated with treadban. The intensity of the load changed the angle of inclination and the speed of the tape. The amount of cardiospecific autoantibodies (auto-AB) to troponin I, to alpha-actin 1, to the human cardiac beta-myosin heavy chain MYH7 was determined in the blood by enzyme immunoassay. The relative heart mass was measured. Histomorphological assessment of cardiomyocyte condition was carried out. Statistical processing was carried out using the Student and Mann-Whitney criteria. Results and Discussion. Animal training was accompanied by moderate cardiac hypertrophy of pathological changes in cardiomyocytes. Heart weight increased by 6.9 %; 10.6 %; 12.9 % in the dynamics of 6-8-9 weeks of training. Concentrations of auto-AB to troponin I and to alpha-actin 1 were characterized by cyclicity, manifested by an increase in week 2 and a decrease by the 8th and 9th weeks of training. In the dynamics of 0-2-8-9 weeks of the experiment, the amount of auto-AB to troponin I was: 3.10.3; 4.20.9; 2.10.2; 2.00.04 ng/ml. For auto-AB to actin: 26.71.2; 31.31.4; 13.71.8; 12.11.6 ng/ml, respectively. The level of auto-AB to beta-myosin was manifested by a decrease in the dynamics of 0-6-9 weeks of training and amounted to: 16.30.9; 10.91.5; 8.20.8; 9.6 0.9 ng/ml. Conclusion. The results of determining cardiospecific auto-AB demonstrate a clear response of the immune system to the processes taking place in cardiomyocytes, which makes it possible to recommend further study of the method of determining auto-AB to cardiomyocyte proteins as a diagnostic test of the functional state of the heart muscle during the period of adaptation to physical activity.

Topography of the left atrial appendage is of importance for supraventricular arrhythmias surgery and sealing of the appendage orifice to prevent thromboembolism in cryptogenic strokes. The aim was to explore the common position of the appendage and delineate variants of its adjacent anatomy in human adults by means cadaveric morphometrics. Material and methods. We studied 54 silicone-filled heart specimens of 200–400 g. With the caliper, we measured the distances from the base of the left atrial appendage to the cardiac apex, to the structures of the atrial complex, nearest large blood vessels, as well as to the left coronary artery. Results. The base of the appendage was 87 ± 13.1 mm from the cardiac apex and 49.7 ± 7.0 mm from the right appendage. The distance from the appendage to the superior caval vein (36.4 ± 8.1 mm) was 16 % longer than the distance to the ascending aorta (30.4 ± 6.4 mm), 1.25 times less than the distance to the oval fossa (45.2 ± 6.0 mm), 1.5 times less than the distance to the inferior caval vein (55.5 ± 8.7). The smallest median value (9.6 mm) and the largest variation (1.4–15.2 mm) were found for the distance to the pulmonary trunk. Four pulmonary veins inflowed to the atrium at different distances from the appendage opening. In 59.6 %, we revealed the left upper pulmonary vein to be closest to the auricle. The mouth of that was 43 % higher and 57 % at the same level with the appendage opening (p = 0.07). The left coronary artery ran 2.63–18.74 mm inferiorly to the appendage. Interrelations of average strength were found for the parameters of atrial complex. The study showed the length of the ventricular complex as being an unpredictable parameter for determining the adjacent anatomy of left atrial appendage. Conclusions. The morphometric parameters and their interrelations are proposed to use as reference values and criteria for determining the normal atrial complex.

Heart transplantation is a recognized and effective method of treating end-stage heart failure. Complicated heart transplant surgery carries a high surgical risk as well as complications that are dangerous to life and health. Transplantation is a life-saving opportunity for patients who have run out of alternative treatments. Patients with heart transplants face many physical and psychological problems every day. The aim of the work was to discuss the care problems of a patient 3.5 years after the heart transplantation procedure. Material and methods: The study used a research method - an individual case study, in which the interview technique, observation, analysis of medical documentation and measurement of vital parameters were used. Results: After the interview, observation and analysis of medical records and as a result of the measurements made, the patient was diagnosed with nursing problems, including such as: increased susceptibility to infections that may pose a serious threat to the life and health of the patient caused by the weakening of the immune system by immunosuppression, anxiety and fear related to the risk of rejection of a transplanted organ and mood instability resulting from uncertain health situation and the effects of immunosuppressive drugs, physical limitations related to with previous operations. Conclusions: Despite the passage of time, the patient after heart transplantation still feels the fear of a sudden deterioration of his health, the occurrence of side effects of the implemented treatment, and to the greatest extent his organism rejects the transplanted organ. Educating the patient, caring for it and keeping track of his health condition makes him feel more confident and at ease. The quality of life of the patient after transplantation can be significantly improved thanks to discipline and properly conducted self-care and self-care.

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Systemic inflammation is known to be a key component of infection and non-infection diseases progression and may lead to multiorgan failure, persistent inflammation, immunosuppression, catabolism syndrome or even indolent death. This importance dictates the need for relevant in vivo models of inflammation to investigate the pathogenesis of numerous diseases and to perform drug screening. Danio rerio (zebrafish) became one of the most important models to explore biological processes in vivo. The aim of the study was to generate a lipopolysaccharide (LPS) model of systemic inflammation in vivo using zebrafish and to identify organspecific proinflammatory genes activity after intraperitoneal LPS infusion. We performed organ specific analysis of main proinflammatory genes expression in zebrafish after LPS stimulation. Comparing 18s, eef1a1l1, gapdh, and actb as potential housekeeping genes, we came to conclusion that eef1a1l1 with 99% effectiveness is the most promising for further normalization in this model. The genes activity was the most pronounced in the heart where the expression of IL6, CXCL8a, and CXCL18β was increased up to 100-fold. Moreover, the kidneys were the most involved in the inflammatory process since the highest number of analysed genes were up-regulated there: expression levels of CXCL18β, CXCL8a, IL1β, IL6, Mpeg1.2, and TNFa were significantly increased. This was probably related to the kidney activity as an immune and hematopoietic organ. The lowest reactivity was detected in the muscles. Immune reactions could be dose-dependent, for instance the infusion of 20 µg LPS led to decrease of expression of IFNy, Mpeg 1.2, and Mpeg 1.1 in the liver and to increase of Mpeg 1.2 expression in the kidney comparing with 10 µg dosage. Thus, due to the high degree of the similarity and other unique properties, Danio rerio has the advantage of being relevant model of inflammation. Our model demonstrated that the investigation of isolated zebrafish organs could be useful and informative for the investigation of inflammatory processes.

Results from recent large randomized trials investigating the use of high PEEP in patients without ARDS all suggest that high levels may increase mortality due to hypotension and bradycardia. A careful assessment of cardiac function — with particular focus on the right ventricle — should be performed before planning our ventilation strategy in any setting, including COVID-19 and ARDS in general. Mechanical ventilation should be respectful in regards of heart function, and tolerant with moderate hypoxia and hypercapnia, noninvasive (whenever possible) and synchronized.

Purpose of the study. An analysis of indices of free radical oxidation and respiration of mitochondria of heart cells in a malignant process in presence of diabetes mellitus and chronic neurogenic pain in experimental animals.Materials and methods. The study included outbred female rats (n=32) and С57ВL/6 female mice (n=84). Experimental groups of rats were: intact group 1 (n=8), control group 1 (n=8) with diabetes mellitus (DM), comparison group 1 (n=8) with standard subcutaneous transplantation of Guerin’s carcinoma, main group 1 (n=8) with Guerin’s carcinoma transplanted after 1 week of persistent hyperglycemia. Experimental groups of mice were: intact group 2 (n=21), control group 2 (n=21) with a model of chronic neurogenic pain (CNP), comparison group 2 (n=21) with standard subcutaneous transplantation of melanoma (B16/F10), main group 2 (n=21) (CNP+B16/F10) with melanoma transplanted 3 weeks after the CNP model creation. Heart mitochondria were isolated by differential centrifugation. Levels of cytochrome C (ng/mg of protein), 8-hydroxy-2'-deoxyguanosine (8-OHdG) (ng/mg of protein), and malondialdehyde (MDA) (μmol/g of protein) were measured in mitochondrial samples by ELISA. Statistical analysis was performed using the Statistica 10.0 program.Results. DM in rats upregulated 8-OHdG by 6.3 times and MDA by 1.9 times (р=0.0000) and downregulated cytochrome C by 1.5 times (р=0.0053) in heart cell mitochondria, compared to intact values. DM+Guerin’s carcinoma in rats increased 8-OHdG by 14.0 times and MDA by 1.7 times (р=0.0000) and decreased cytochrome C by 1.5 times (р=0.0000), compared to intact values. CNP in mice did not affect the studied parameters in mitochondria of the heart. CNP+B16/F10 in mice increased 8-OHdG by 7.1 times and MDA by 1.6 times (р=0.0000) and decreased cytochrome C by 1.6 times (р=0.0008).Conclusions. Comorbidity (diabetes mellitus, chronic neurogenic pain) together with malignant pathology aggravates mitochondrial dysfunction of heart cells with destabilization of the respiratory chain mediated by free radical oxidation processes.

Cytomorphological changes of a cat’s cadaver’s parenchymal organs in the early postmortem period were established in the aspect of forensic veterinary examination. The aim of this work was to clarify the processes of necrobiosis at the cellular level under aerobic environment on the first day after the animal’s death as a cytomorphological criterion in the aspect of forensic veterinary examination when deciding time of death in the early postmortem period in conditions of its non-obviousness. It has been proven that the most dynamic cytomorphological changes were found in the spleen tissue, pancreas and heart; cytoarchitectonics of liver and lung tissue changed less intensively. Intense cytomorphological changes in kidney tissue and brain were not observed. It was revealed that it is impossible to determine the histological topography of cells during the cytological examination of samples from parenchymal organs after the first day of the postmortem period. It was found that for solving the forensic veterinary examination problems, the dynamics of the kidney and brain tissue cytoarchitectonics was not informative, the necrobiosis of liver and lung cells had average information content, and the changes in the cytomorphological picture in the spleen tissue, pancreas, and in heart were highly informative. The intensity of the dynamics of cytomorphological changes and their informativeness for solving the question of the time of death were in direct correlation. It is recommended to use the express cytological method as an additional one in the practice of forensic veterinary examination to resolve the issue of the time since death of animal in terms of its non-obviousness before the appearance of late cadaveric phenomena.

Objective: to monitor the current trends and developments in organ donation and transplantation in the Russian Federation based on the 2020 data.Materials and methods. Heads of organ transplant centers were surveyed through questionnaires. Data control was done using the information accounting system of the Russian Ministry of Health. Between separate federal subjects of the Russian Federation and between transplantation centers, comparative analysis of data obtained over years was performed.Results. Based on data retrieved from the 2020 Registry, 44 kidney, 29 liver and 16 heart transplantation programs were functioning in the Russian Federation in 2020. The kidney transplant waitlist in 2020 included about 11.5% of the total 60,000 patients receiving dialysis. Organ donation activity in 2020 was 3.9 per million population, with a 74.6% multi-organ procurement rate and an average of 2.9 organs being procured from one effective donor. In 2020, there were 7.7 kidney transplants per million population, 3.8 liver transplants per million population and 1.7 heart transplants per million population. Same year, the number of transplant surgeries performed in the Russian Federation fell by 19.2% to 13.4 per million population against the background of the outbreak caused by the new coronavirus disease COVID-19. The city of Moscow and the Moscow region in 2020 accounted for 13 out of the 14 functioning organ transplantation centers, performing 66.3% of all kidney transplants and 72.4% of all extrarenal transplants in the country. The number of organ recipients in the Russian Federation have exceeded 130 per million population.Conclusion. In 2020, despite the new coronavirus disease COVID-19 pandemic and accompanying restrictive measures, transplant centers continued to perform organ transplants, run a waiting list and monitor organ recipients. However, the number of effective donors (–22.9%) and organ transplants (–19.2%) decreased, tentatively to the 2017 levels. In 2021, transplant centers with support from health authorities will have to restore the volume of transplant care with consideration to the real needs of the population and the donor resource. The COVID-19 factor, including vaccination of the population, as well as financial support to transplantation programs, will be decisive in shaping the trend of transplantation care and organ donation in the federal subjects of the Russian Federation in the coming 1–2 years.

Cardiac myxoma is the most common primary benign cardiac tumor (up to 50% of all primary cardiac neoplasms). The implementation of the modern imaging techniques into the clinical practice, particularly, 2D echocardiography, computed tomography and magnetic resonance tomography (MRI) results to the prompt diagnosis of the myxoma. However, the absence of specific clinical features, insufficient awareness of this condition among the physicians along with a rare prevalence, may lead to a misdiagnosis. This case report is notable for the relatively late diagnosis of a giant left atrial myxoma due to a number of circumstances but with successful surgical treatment.

Purpose. The aim of this work is to show the capabilities of late gadolinium enhancement cardiac magnetic resonance imaging (MRI) in the diagnosis of a rare disease such as cardiac amyloidosis. Materials and methods. Demonstration of clinical cases detecting cardiac amyloidosis using MRI. Results. Contrast-enhanced cardiac MRI revealed patterns characteristic of cardiac amyloidosis. Conclusion. Cardiac MRI with late gadloinium enhancement is the method of choice in the diagnosis of cardiac amyloidosis.

Alcoholic liver disease is associated with liver injury ranging from steatosis to steatohepatitis, fibrosis and cirrhosis. One of the mechanisms of organs damage is cytokines influences. The intensity of injury depends on individual reactivety.The aim of the study was to evaluate changes in the blood of interleukins in the heart of high- and low-emotional (HE, LE) male rats with ethanol hepatosis, hepatitis, fibrosis and cirrhosis of the liver and to determine the degree of liver and heart damage.Material and methods of investigation. The experiments were performed on 72 HE and LE outbred male rats aged 4 months ((control 1, glucose 7 days, acute ethanol hepatitis – EH) and 120 HE and LE autbred male rats aged 5.5-6.5 months (control 2, glucose 67 days, ethanol hepatosis – EHs, ethanol fibrosis – EF, ethanol cirrhosis – EC). The emotionality was determined by "open field" method.Determined in the blood serum Tumor Necrosis Factor Alpha (TNF-α), Interleukin 1 Beta (IL-1β), Interleukin 4 (IL-4), Interleukin 10 (IL-10), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP). All animals underwent histological examination of the liver and heart, right and left ventricles (RV, LV), and ventricular septum (VS) square.Results. In EH increase IL-1β, IL-10 and decrease TNF-α in LE rats. In EHs, EF and EC were decrease of IL-1β, IL-4 and IL-10 in HE rats and decrease of TNF-α, IL-4 and IL-10 in LE rats. In EH decrease ALT (more in LE), AST (more in HE) and increase AP. In HE rats in EHs, EF and EC decreased ALT, in EC increased AST. AP in HE rats increased in EHs; decreased in EF and EC. In LE rats ALT was increased in EHs, and decreased in EC; AST was increased in EC; AP was increased in EHs. In both groups of animals at ethanol damage of a liver remodeling of heart is observed. The earlier and bigger is observed in HE rats.Conclusion. The degree of ethanol damage to the liver and heart depends on the emotionality of the animals and the severity of the simulated pathology, which is more pronounced in highly emotional rats. In the mechanisms of ethanol damage of organism of different emotionality rats take plase cytokines changes. In hepatitis increase IL-1β, IL-10 and decrease TNF-α in low emotions rats. In hepatosis, firosis and cirrhosis were decrease of IL-1β, IL-4 and IL-10 in high emotional rats and decrease of TNF-α, IL-4 and IL-10 in low emotional rats.

Objective: To examine the acid-base balance, blood gases and echocardiographic changes in bronchial asthma in children. Methods: The results of the examination of 60 children suffering from bronchial asthma (BA), aged from 5 to 14 years are presented. The patients were divided into 2 groups depending on their age. The first group consisted of 28 children from 5 to 10 years old, the second – 32 children aged 11 to 14 years. The control group included 20 healthy children, identical to the surveyed groups in terms of gender and age. Echocardiography was performed on a Vivad 3 apparatus (GE, USA), the acid-base balance and blood gases were studied on an ABL 800 Flex apparatus (Radiometer Medical, Denmark). Results: Studies have shown that children with asthma had significant changes in the ventilation capacity of the lungs in the form of perfusion and diffusion disorders, which undoubtedly influenced the severity of their condition. In children of both groups, there was a significant lack of bases (p

Cardiac paragangliomas are an extremely rare cause of cardiac masses. We present a case of a cardiac paraganglioma presenting as a highly vascular mass on coronary angiography in a patient with angina, we discuss the challenges in its diagnostic evaluation and management.

Background. Malignant neoplasms of the mammary gland represent the most numerous groups in terms of morbidity and mortality among women of the Republic of Belarus. The most formidable complication of radiation therapy for breast cancer is heart complications. Aim of the study is to compare the dose loads on the heart when creating radiation treatment plans for left breast cancer with the inclusion of regional lymph nodes using two 3D planning methods in a standard position on the back with free breathing. Material and methods. The research included dosimetric plans for the treatment of left breast cancer in 20 patients after radical mastectomy with lymph node dissection. The tangential planning method with separation of radiation volumes in the isocenter was compared with the planning method without separation of radiation volumes, including the fields in the projection of which the heart is located. Results. The best indices for the heart in terms of average (Dmean) and minimum (Dmin) doses were obtained using the tangential planning method with separation of radiation volumes in the isocenter (4.26 Gy, 0.6 Gy, respectively). Conclusion. Irradiation of left breast cancer by tangential planning with separation of radiation volumes in the isocenter contributed to a statistically significant decrease in dosimetric parameters: Dmean and Dmin.

Introduction. The number of surgically treated cases of heart failure by means of orthotopic heart transplantation is increasing every year. At the same time, there is a shortage of optimal donors for heart transplantation, being a factor that leads to a primary graft dysfunction in the intra- and immediate postoperative period. In order to reduce the risk of complications and increase patient survival rates in primary heart graft dysfunction, a number of transplant centers resort to the choice of the treatment by means of mechanical circulatory support, such as extracorporeal membrane oxygenation. Clinical case. In the early postoperative period after heart transplantation, the patient was diagnosed with developing primary graft dysfunction. The clinical response to medication support of hemodynamics was unsatisfactory. Venoarterial extracorporeal membrane oxygenation was performed. On the 4th day, the regional contractility of the left ventricle restored, the ejection fraction of both ventricles increased, their systolic function improved. The patient was discharged on the 21st day in a satisfactory condition. Conclusion. Mechanical circulatory support modalities, such as venoarterial extracorporeal membrane oxygenation, can compensate for the emerging primary myocardial dysfunction in recipients. The efficiency of the extracorporeal membrane oxygenation is achieved not only by knowledge of current clinical recommendations, but also depends on the implementation of other clinics' experience as well as technical readiness of the center and medical personnel' qualification.

The aim was to determine the pathogenetic features of the NO system in the myocardium of the left ventricle in the rats with endocrine-salt hypertension.Material and methods. The experiment was conducted on 20 male rats 220-290 g weight, 6–10 months old which were divided into 2 experimental groups: 1st – the control group (10 intact normotensive male Wistar rats); 2nd – 10 male Wistar rats with endocrine-salt arterial hypertension. Systolic and diastolic BP levels were measured in all the rats using a system of non-invasive arterial pressure measurement BP-2000. The objects of study in the experimental animals were blood plasma in which the nitrotyrosine level was measured, and the fragment of left ventricle, which was divided into two parts, one of which was homogenized using a Silent Crusher S homogenizer (Heidolph, Germany), in which nitrites level was determined. Concentration of immunoreactive material to NOS isoforms was detected with immunofluorescence method. The study of NOS mRNA isoforms expression in the left ventricular myocardium homogenates was carried out using a real-time polymerase chain reactionResults. In the experiment, an increase in all 3 isoforms and their mRNA was obtained. In the study, a decrease in nitrites concentration and a significant increase in nitrotyrosine levels, indicates the development of nitroso-oxidative stress.Conclusions. The development of experimental endocrine-salt hypertension in the Wistar rats leads to a stable increase in mean blood pressure by 65 % compared to control. Endocrine-salt arterial hypertension in Wistar rats is characterized by an increased mRNA content of all three isoforms of nNOS, eNOS and iNOS by 2.7, 2.8 and 5.7 times, respectively, compared to the control; increased expression of immunoreactive material to isoforms in transverse fibers by 14.3 %, 16.2 % and 18.5 %, respectively; in longitudinal fibers IRM to nNOS was higher by 8.3 %, to iNOS - by 8. 5%, but to eNOS it was lower by 7.6 %. At the same time, nitrites level decreased by 11.7 % and nitrotyrosine concentration was significantly higher, exceeding the control value by 88.5 %.

Alcohol is one of the leading causes of death worldwide, annually taking 3 million lives. Alcohol abuse to a greater degree negatively affects the functioning of the cardiovascular system. Aim. Studying the severity of pathomorphological changes in the heart of deceased patients with alcoholism. Materials and methods. The heart sections of 35 deceased alcoholic patients (38–60 years old) were taken for histo-morphometric analysis. As a comparison group, the material of deceased patients (n = 15), suffering from ischemic heart disease (IHD) and hypertension disease (HD) was studied. Results. In conditions of alcoholism in 100 % of cases myocardium showed marked microcirculatory disorders, increased vascular permeability. In all cases sclerotic changes similar in topography to the comparison group were noted, however, sclerosis of large arterioles was 1.9 times less pronounced than in IHD group. In the myocardium of alcoholics, edema, atrophy of cardiomyocytes bundles and areas of fatty stroma are common. In 20 % of cases, there were mosaic necrosis of individual cardiomyocytes and small focal necrosis of small groups of cells, fibrinoid necrosis of small branches of coronary arteries. Compared with IHD group the number of fatty degenerated cardiomyocytes increased by 1.23 times, fuchsinophilic cardiomyocytes – by 1.38 times with simultaneous reducing severity of sclerotic changes in vessels by 1.9 times. Sclerotic changes in stroma are significantly higher in relation to IHD and HD groups (by 1.88 and 6.94 times, respectively). Conclusions. The morphogenesis of heart damage during alcoholism consists of combination of dystrophic, necrotic, atrophic and sclerotic changes – morphological substrate of alcoholic cardiomyopathy. These signs, based on quantitative analysis, are important criteria necessary for the thanatogenetic analysis in cases of death on the background of alcoholism.

Objective: to monitor current trends and developments in organ donation and transplantation in the Russian Federation based on the 2019 data. Materials and methods. Heads of organ transplant centers were surveyed. Data obtained over years from federal subjects of the Russian Federation and from organ transplant centers in the country were analyzed and compared. Results. Based on data retrieved from the 2019 Registry, only 46 kidney, 31 liver and 17 heart transplant centers were functioning in Russia. In 2019, there were 6,878 potential recipients in the kidney transplant waitlist. This represents 13.7% of the 50,000 dialysis patients in the country. Donation activity in 2019 reached 5.0 per million population; multi-organ procurement rate was 71.6%; 2.9 organs on average were procured from one effective donor. In 2019, there were 10.0 kidney transplants per million population, 4.0 liver transplants per million population and 2.3 heart transplants per million people. Same year, the number of transplant surgeries performed in Russia rose 10.7% from the previous year. Moscow and Moscow Oblast alone have 13 functioning organ transplantation centers. They account for half of all kidney transplant surgeries and 70% of all liver and heart transplants performed in the country. Organ recipients in the Russian Federation have exceeded 16,000 in number. Conclusion. Organ transplantations in Russia keep on increasing – 10–15% per year. Donor and transplant programs are also becoming more effective and efficient. However, the demand for organ transplants far exceeds the current supply of available organs in the Russian Federation. Peculiarities of the development of organ donation and organ transplantation in Russia in 2019 were associated with some factors, such as structure and geographical location of transplant centers, waitlisting of patients, funding sources and amount, and management of donor and transplant programs. The national transplantation registry will be developed taking into account new monitoring and analysis challenges.

Introduction and purpose: Coronary artery disease (CAD) is a leading cardiological problem in modern society. A special form of CAD is the Chronic Total Occlusion (CTO), which affects about 20% of visible coronary artery lesions. The aim of the study is to present the role of myocardial perfusion scintigraphy performed on patients with CTO, and scintigraphic findings in these patients.Material and method: It was a retrospective study. We analized studies in patients with CTO reported in medical history. We included studies performed between 2016 and 2019. 119 cases were found with the majority of men (M = 95, W = 24). The patients’ mean age was 65 years (M = 65, W = 66). In order to assess ischemia in these patients, the stress test was applied by means of physical exercise (cycloerometer) or pharmacological test. If patient's clinical condition did not allow a stress test, only a rest test was performed.Results: In the analyzed group the most common occluded vessel was the right coronary artery (59%). In this case, mean ischaemia was found to cover 18% of the myocardium. The second most frequent obstructed vessel was the circumflex (16%) with ischaemia of 15%. The next artery was left anterior descending artery with ischaemia of 30% and other vessel - 7%. 9 patients had more than one vessel closed.Conclusions: Myocardial perfusion imaging helps to choose optimal treatment in patients with CTO.

Physical and chemical factors, obesity, lipid metabolism disorder, diabetes affect the state of the vascular endothelium, the processes of thrombus formation, fibrinolysis and increase the risk of developing cardiovascular diseases. It can be assumed that the development and course of pathological processes in the cardiovascular system, caused by vibration disease with the onset of diabetes, will undergo changes. The purpose of the study was to assess the state of heart condition according to the level of specific autoantibodies with the combined effect of vibration disease and type 2 diabetes mellitus. Patients with vibration disease (group I), patients with type 2 diabetes (group II) and persons with vibration disease in combination with type 2 diabetes (group III) were examined. Individuals do not have a history of coronary heart disease, stroke, and myocardial infarction have been included in obsledrovanie. Serum levels of specific autoantibodies characterizing the state of the heart have been studied. It was revealed that the content of autoantibodies to 1-adrenoreceptors in patients of group I was higher than in individuals of group II. The relative content of autoantibodies to the components of the membrane and cytoplasm of myocardial cells in patients of groups I-III did not differ. It was found that elevated levels of autoantibodies to components of the membrane and cytoplasm of myocardial cells, cardiomyosin, 1-adrenoreceptors were observed more often in patients with vibration disease combined with diabetes and in persons with vibration disease than in people with diabetes. Persons with a reduced content of autoantibodies to 1-adrenergic receptors were not detected among patients of groups I and III. Changes in the levels of specific autoantibodies in persons with vibration disease may indicate the development of functional metabolic and structural changes in the heart, disorders of its electrical activity that have not yet been manifested in the form of a pathological process. Lower levels of 1-adrenoceptor autoantibodies in patients with type 2 diabetes without vibration disease can be caused by increased levels of catecholamines, which is characteristic of diabetics. Further research, including clinical data and indicators of functional diagnostics is necessary to confirm our assumptions.

Among the large number of benign tumors of the heart myxoma most frequently diagnosed neoplasm intracavitary (occurs in 50%). The clinical picture of a myxoma is extremely various. Often it is diagnosed as a casual find. Usually the diagnosis is established according to an echocardiography. Magnetic resonance imaging is used for inspection of patients with suspicion on myxoma in cases when information of echocardiography is not enough and before surgical treatment. We present clinical follow-up 58 years old patients with left atrial myxoma, which before surgical treatment has executed a heart MRI.