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The relationship between government and university medicine in the context of the development of the Asian "colonial" periphery of Russia in the late imperial period are studied. It is concluded that these relationship, the manifestations of which were most pronounced in the period of the fight against epidemics, are not quite standard from the point of view of model of the classical relationship between power and knowledge in the colonial context of European maritime empires. This is connected mainly with the social portrait of the university intelligentsia, with the peculiarities of their professional socialization, which led to the fact that in Siberia they broadcast the experience of the European metropolises, rather than the colonies.

Aim: To study interconnections between epicardial adipose tissue thickness (EATt), parameters of glucose metabolism/insulin, C-reactive protein (hsCRP), serum adipokines and severity of coronary artery disease (CAD) depending on the presence of diabetes mellitus type 2 (DM 2); to determine significant markers of CAD severity in patients with DM 2., Materials and Methods: The study involved 106 patients with CAD (m/f 64/42, 60.96.8 years), including patients with DM 2 (group 1, n=35) and non-diabetic patients (group 2, n=71). Severity of CAD was evaluated according to angiography data with calculation of Gensini Score (GS). EATt was assessed via echocardiography. Serum levels of glucose/insulin metabolism parameters, lipid fractions, hsCRP and adipokines were evaluated. Clinical parameters, including GS, did not differ between groups., Results: EAT thickness median was elevated in gr.1 (5.1 mm vs. 4.4 mm in group 2), while adiponectin levels were decreased (6.55 g/ml vs. 7.71 g/ml). Linear regression of body mass index and resistin levels on EATt was revealed in gr.1; in gr.2 EATt linearly increased with waist circumference increment when EATt6 mm. Linear regression of EATt on GS was revealed in gr.1 when EATt8 mm, while linear regression in the whole GS range was obtained for HDL-C and hsCRP levels., Conclusion: Study results demonstrate differences in mechanisms of deposition and functioning of epicardial and abdominal adipose tissue depending on the presence or absence of diabetic status. Patients with DM2 are characterized by the excessive EAT deposition and decrease of serum adiponectin levels compared to non-diabetic patients in the equal conditions. Independent markers of CAD severity in DM 2 are decreased HDL-C and increased hsCRP levels, but not EATt.

Rupture of the interventricular septum (MVP) as a complication of acute myocardial infarction is a rare event and associated with high mortality without timely surgical treatment. We present a case of a 68-year-old patient who had an acute myocardial infarc‑ tion with ST-segment elevation complicated by a rupture of MVP. In this article we discusse the difficulties of patient management with this pathology and the problem of choice of treatment tactics.

An antagonist of central cannabinoid CB1 receptors rimonabant causes weight loss in patients with obesity and metabolic syndrome, improves blood lipid parameters, increases the adiponectin level, decreases the rate of glucose and glycosylated hemoglobin in patients with diabetes mellitus type-2. However, rimonabant adverse effects include depression, anxiety, nausea, and dizziness which are apparently due to the blockade of central CB1 receptors. In mice with a high-calorie diet, we defined that the blockade of peripheral CB1 receptors prevents obesity, steatosis of the liver, improves lipid and carbohydrate metabolism. Experimental studies suggest that peripheral CB2 receptor agonists have antiatherogenic effect. To validate the expediency of clinical research of CB2 receptor agonists in patients with atherosclerosis the comparative analysis of antiatherogenic properties of cannabinoids should be performed. In addition, experiments are needed on the combination use of cannabinoids with well-known antiatherogenic agents, such as statins.

Transthoracic echocardiography (TTE) has been described as an accurate technique for noninvasive evaluation of coronary flow reserve (CFR) of the left anterior descending artery (LAD) and posterior descending artery (PDA). Aim of this study was to find out whether serial measurement of CFR in LAD and PDA using TTE allows detection of stenosis elimination after intracoronary intervention and is a marker of successful procedure., Methods: The study group comprised 14 patients with single-vessel coronary disease (stenosis 82+/-14%) of the LAD (9 patients) or right coronary artery (RCA, 5 patients) scheduled for stent implantation. All patients underwent dipyridamole stress echo with CFR evaluation of either distal LAD or PDA 1 day before and 6-9 days after successful stent implantation. CFR was calculated as the ratio of hyperemic to basal peak diastolic velocity. A CFR value of <2.0 was considered abnormal., Results: Adequate Doppler signals to measure CFR were obtained in 13 patients (93%). Abnormal pre-procedure CFR value was revealed in 12 assessed patients (92%). Significant increase of CFR due to a decrease of coronary flow velocity at rest and its more pronounced hyperemic rise was found in all patients after stent implantation (CFR: 1.28+/-0.52 before and 2.53+/-0.37 after stenting; p<0.001). Using a cut-off value of CFR more or equal 2.0 to identify absence of significant coronary artery disease, TTE detected successful stent implantation with a sensitivity of 91.7% and specificity of 100% for both LAD and RCA. CFR was still abnormal in only 1 patient with pre-procedure>90% LAD stenosis., Conclusion: TTE is a feasible technique for serial CFR evaluation in LAD and PDA. Cut-off CFR value more or equal 2.0 is a sensitive and specific criterion of successful stent implantation in LAD and RCA.

The study was aimed at identification of relations between perfusion and electrophysiological changes in left ventricular (LV) myocardium in patients with ischemic heart disease (IHD) with postinfarction LV aneurysm and ventricular tachycardia. The study enrolled 23 patients with the aforementioned disease. Preoperatively, apart from standard clinical examination of cardiosurgical patients, intracardiac electrophysiological study and perfusion single-photon emission computed tomography of myocardium with 99mTc-Technetril were performed. The patients were subjected to coronary artery bypass grafting and left ventricular reconstruction. Assessment of the outcomes showed that electrophysiological condition of left ventricle was dependent on myocardial perfusion. Electrophysologically normal myocardium with electric potential >1.5 mV, transient zone (0.5-1.5 mV) and zones with the potential <0.5 mV differed significantly by the percentage of perfusion: 61, 45, and 35%, respectively. Zones of delayed conduction and those of double potential were located mostly in transient zone of electrical potential conduction with the current amplitude of 0.5-1.5 mV and myocardial perfusion from 35 to 61%. Double potential zone was formed in the area of myocardium with better perfusion (perfusion defect of 55% with preserved metabolism) as opposed to the zone of delayed conduction, where perfusion defect was 40% with low level of metabolic activity. The obtained data has proven the presence of correlation between electrophysiology and perfusion of myocardium. This provides an opportunity to identify electrically unstable myocardial zones with the help of specific computer tomography of myocardium.

Aim: to assess additive diagnostic value of simultaneous evaluation of coronary flow reserve (CFR) in the left anterior descending (LAD) artery and posterior descending artery (PDA) during dipyridamole stress echocardiography (stress-Echo) for detection of LAD and PDA stenoses >50%., Methods: 108 in-patients (mean age 50+/-11 years) with cardiac chest pain underwent dipyridamole stress-Echo with ECG-analysis, wall motion analysis by 2-dimentional imaging (2D) and coronary flow reserve (CFR) evaluation in both LAD and PDA by pulse-wave Doppler. The 2D test was considered positive when more or equal 2 segments demonstrated wall motion abnormalities. CFR was calculated as ratio of hyperemic to basal peak diastolic blood flow velocity. CFR <2.0 was considered reduced. Coronary angiography was performed within one week after stress-Echo., Results: 34 of 97 patients with CFR in the LAD and wall motion in the LAD territory had LAD stenosis >50%, and 22 of 90 patients with evaluated CFR in the PDA and wall motion in the RCA territory had RCA stenosis >50%. Thus stenosis >50% was detected in 56 of 187 evaluated LAD and RCA. The 2D test and ECG results were positive for 35 arterial territories, reduced CFR - for 48 arteries. With combined evaluation of ECG, 2D test and CFR, accuracy was not significantly higher (80% for ECG+2D test, 82% for CFR and 80% for combined test) but sensitivity and negative predictive value increased (sensitivity: 63% for ECG+2D test, 86% for CFR and 91% for combined test; negative predictive value: 85% for ECG+2D test, 93% for CFR and 95% for combined test)., Conclusion: Assessment of CFR in both LAD and PDA is feasible for majority of patients and can increase sensitivity and negative predictive value of dipyridamole stress-Echo for the detection.

Aim: To study diagnostic value of myocardial-arterial stiffness (MAS) as a determinant of N-terminal pro-brain natriuretic peptide (NT-proBNP) expression in patients with chronic heart failure (CHF) with ischemic or postinfarction left ventricular (LV) dysfunction., Material and Methods: We analyzed 6 months prognosis of 54 patients (mean age 61.7+/-8.6 years) with II-III NYHA class CHF divided into 2 groups: (I, n=18) with class II CHF and preserved LV ejection fraction (EF) (55+/-10.4%), (II, n=36) with class III CHF and low LF EF (30.4+/-6.8%). MAS was measured by echocardiography as ratio of arterial elasticity (Ea) and end-systolic elasticity of LV myocardium (Es). Serum NT-proBNP was measured by immunoenzyme assay., Results: During 6 months follow-up one group II patient with initial NT-proBNP level 2020 rg/ml died. NT-proBNP level in group I was significantly lower than in group II (313 and 647 rg/ml, respectively). Ea/Es ratio was significantly higher (p=0.001) in group II. Multifactorial analysis demonstrated moderate correlation of NT-proBNP with Ea/Es ratio (r=0.50, p=0.0001) and negative correlation with LVEF (r=-0.45, =0.003) among patients with II-III class CHF., Conclusion: As correlation between symptoms and severity of clinical manifestations of ischemic or postinfarction cardiac dysfunction at development of CHF was not high it appears rational to consider MAS estimated by Ea/Es ratio as independent predictor of cardiovascular complications. Sufficiently close correlation between NT-proBNP and Ea/Es ratio allows to improve stratification of risk and to assess objectively prognosis of the disease using easier obtainable parameter Ea/Es in cases when possibility to measure NT-proBNP is not available.

Objective: This open randomized study compares the effects of 24-week-long treatment with rosuvastatin and with atorvastatin coadministered with ezetimibe on the parameters of carbohydrate metabolism and the plasma levels of adipokynes in patients with coronary artery disease and type 2 diabetes mellitus or impaired glucose tolerance (IGT)., Method: A total of 31 patients with coronary artery disease and type 2 diabetes mellitus or IGT were recruited in the study. Patients were randomized into two groups: group 1 included patients who received rosuvastatin therapy in an average dose of 12.5 mg/day (n=16); group 2 included patients who received combination treatment with atorvastatin in an average dose of 13.3 mg/day and ezetimibe (10 mg) (n=15). Plasma levels of lipids, apoB, apoA1, glucose, insulin, leptin, and adiponectin were evaluated; HOMA-IR index (an empty stomach insulin, mu/l x fasting glucose, mmol/l) / 22.5) was calculated., Results: During the therapy, the LDL-C and apoB levels decreased by 51.7% and 42.3% in group1 and by 51.8% and 44.9% in group 2, respectively. Reduction in the triglyceride levels was significantly more pronounced in group 2 than in group 1: 43.2% vs 17.4% (p<0.02), whereas we did not observed significant changes of HDL-C and apoA1 in either group. The increases in basal glycemia, basal insulinemia, HbA1c levels (from 6.47% [6.10-7.02%] to 6.98% [6.23-8.18%]), and HOMA-IR (from 2.14 [1.68-3.51] to 4.30 [2.31-5.77]) were found only in group 2 (p<0.05 for all). These changes were observed in 75% of patients of group 2 independently of the presence of diabetic state or IGT, but the changes were more pronounced in patients with disturbed carbohydrate metabolism. Changes of leptin levels during the therapy were diverse: 73% patients of group 1 demonstrated decrease in the leptin levels, whereas 67% of patients in group 2 experienced 57%-increase in the leptin concentrations. Degree of increased basal glycemia was associated with increase in the leptin levels (r=0.37, p=0.04) in the entire group of patients (n=31). Furthermore, changes in leptin levels were negatively associated with decreased adiponectin levels (r=-0.57, p=0.034)., Conclusions: In case of equivalent degree of the decrease in LDL-C levels, 24-week combination therapy with atorvastatin and ezetimibe, unlike rosuvastatin treatment, induced increases in basal glycemia, insulinemia, HbA1c, and HOMA-IR index irrespective of the presence of carbohydrate metabolism disturbances before treatment. Our data suggest that adiponectin and leptin are involved in the mechanisms of adverse metabolic effects of the combination of atorvastatin and ezetimibe.

Aim: To study the impact of a polymorphic variant of the matrix metalloproteinase-3 (MMP-3) gene on the development and course of chronic heart failure (CHF) in patients with coronary heart disease., Subjects and Methods: A total of 277 patients with New York Heart Association (NYHA) Functional Class (FC) II-IV CHF were examined. MMP-3 -1171 5A/6A genetic polymorphism was studied by polymerase chain reaction. A control group included 136 patients (mean age 53.6 ± 4.8 years) with no signs of cardiovascular diseases, as evidenced by the examination., Results: The frequency of the 5A allele and the 5A/5A genotype of the 1171 5A/6A polymorphic locus in the MMP-3 gene proved to be higher in the patients with CHF than that in the control group. Thus, the variability of the 5A allele (odds ratio (OR), 1.39; 95% confidence interval (CI): 1.033 to 1.869; p = 0.03) and the 5A/5A genotype (OR, 2.15; 95% CI: 1.131 to 4.070; p = 0.02) was associated with increased risk for CHF. There were significant differences in the frequency of MMP-3 alleles and genotypes in relation to FC of CHF. The frequency of the 5A/5A genotype was substantially higher in the patients with NYHA FC IV CHF than that in those with NYHA FC II CHF (32.8% versus 15.2%; p = 0.039). The frequency of the 5A allele was significantly higher in the patients with NYHA FC IV CHF than that in those with NYHA FC II CHF (55.5% and 39.3%; respectively; p = 0.019). Thus, the carriage of the 5A allele and the 5A/5A genotype of the 1171 5A/6A polymorphic locus in the MMP-3 gene is a risk factor of severe CHF., Conclusion: The determination of MMP-3 -1171 5A/6A polymorphism may be recommended for the early prediction of a risk for the development and severe course of CHF.

Objective: This open randomized study compares the effects of 24-week-long treatment with rosuvastatin and with atorvastatin coadministered with ezetimibe on the parameters of carbohydrate metabolism and the plasma levels of adipokynes in patients with coronary artery disease and type 2 diabetes mellitus or impaired glucose tolerance (IGT)., Method: A total of 31 patients with coronary artery disease and type 2 diabetes mellitus or IGT were recruited in the study. Patients were randomized into two groups: group 1 included patients who received rosuvastatin therapy in an average dose of 12.5 mg/day (n = 16); group 2 included patients who received combination treatment with atorvastatin in an average dose of 13.3 mg/day and ezetimibe (10 mg) (n = 15). Plasma levels of lipids, apoB, apoA1, glucose, insulin, leptin, and adiponectin were evaluated; HOMA-IR index (an empty stomach insulin, mu/l x fasting glucose, mmol/l)/22.5) was calculated., Results: During the therapy, the LDL-C and apoB levels decreased by 51.7% and 42.3% in group 1 and by 51.8% and 44.9% in group 2, respectively. Reduction in the triglyceride levels was significantly more pronounced in group 2 than in group 1: 43.2% vs 17.4% (p < 0.02), whereas we did not observed significant changes of HDL-C and apoA1 in either group. The increases in basal glycemia, basal insulinemia, HbA1c levels (from 6.47% [6.10-7.02%] to 6.98% 16.23-8.18%]), and HOMA-IR (from 2.14 [1.68-3.51] to 4.30 [2.31-5.77]) were found only in group 2 (p < 0.05 for all). These changes were observed in 75% of patients of group 2 independently of the presence of diabetic state or IGT, but the changes were more pronounced in patients with disturbed carbohydrate metabolism. Changes of leptin levels during the therapy were diverse: 73% patients of group 1 demonstrated decrease in the leptin levels, whereas 67% of patients in group 2 experienced 57%-increase in the leptin concentrations. Degree of increased basal glycemia was associated with increase in the leptin levels (r = 0.37, p = 0.04) in the entire group of patients (n = 31). Furthermore, changes in leptin levels were negatively associated with decreased adiponectin levels (r = -0.57, p = 0.034)., Conclusions: In case of equivalent degree of the decrease in LDL-C levels, 24-week combination therapy with atorvastatin and ezetimibe, unlike rosuvastatin treatment, induced increases in basal glycemia, insulinemia, HbA1c, and HOMA-IR index irrespective of the presence of carbohydrate metabolism disturbances before treatment. Our data suggest that adiponectin and leptin are involved in the mechanisms of adverse metabolic effects of the combination of atorvastatin and ezetimibe.

Aim: to study natural dynamics of mean levels of systolic and diastolic arterial pressure (SAP, DAP), body mass index (BMI), total cholesterol (TC), high density lipoprotein cholesterol (HDLC), and triglycerides (TG) in elderly people using data of 17-year cohort prospective observation., Material and Methods: Primary examination of a random sample of population was carried out in 1988-1991, reexamination in 2002-2005. Here we present results of examination of 1046 persons including 136 of older age group (mean age at reexamination 69.3 ± 3.2 years)., Results: During the period of observation mean values of SAP in the elder group increased from 140.66 ± 23.61 to 164.58 ± 31.80 mm Hg (+17.0%; p<0,001). Values of DAP in women also rose from 87.82 ± 13.12 to 90.58 ± 13.69 mm Hg (+3.2%; p=0.029) while they did not change in the same age men. IMT values decreased from 28.78 ± 4.91 to 28.22 ± 5.17 kg/m² (-1.9%; p = 0.049). There was no dynamics of mean TC levels, while mean HDLC level lowered from 1.44 ± 0.35 to 1.29+0.34 mmol/l (-7.7%; p<0.001). Mean TG levels rose from 1.40 ± 0.78 to 1.73+1.0 mmol/I (+23.6%; p=0.002)., Conclusion: The following changes occurred between 2 examinations of elderly persons performed with interval of 17 years: elevation of SAP, elevation of DAP in women, lowering of HDLC and BMI, elevation TG. There were no changes of TC.

Veins of lower extremities are classic sources of pulmonary artery thromboembolism (PATE). But one should not underestimate presence of thrombi in other potential sources - veins of small pelvis, superior vena cava, and chambers of the heart. We analyzed 652 case histories and autopsy data of patients in whom PATE had been revealed at pathological anatomical investigation and selected 157 cases in which right heart chambers were sources of emboli (right atrium in 83.5% and right ventricle - in 13.7% of cases). According to autopsy data average mass of the heart was 512.5+/-36.1 g. In most patients it exceeded norm. Thrombi in both right and left cardiac chambers were found in 52.3% of cases. Eighty three patients had history of myocardial infarction or were treated for MI during last hospitalization; 52.3% of patients had atrial fibrillation. After detailed study of all anamnestic, clinical, instrumental, and pathologic-anatomic data we selected 69 factors which according to contemporary views could facilitate formation of thrombus in the right cardiac chambers. Using these factors and method of logistic regression we created a mathematical model for assessment of probability of the presence of thrombi in right cardiac chambers.

We assessed effect of enhancement of parasympathetic activity by indirect vagal stimulation via sensitive n. vagus-r. auricularis terminals on dynamics of clinical conditions, ejection fraction and global longitudinal left ventricle deformation in patients with chronic cardiac insufficiency (CCI). This comparative placebo-controlled parallel study 3 months in duration included 70 patients with chronic coronary heart disease, signs of IIl-IV FC CCI, and sinus rhythm. Auricular electric vagal stimulation (AEVS) was performed using a device for electric stimulation of sensitive vagus terminals (patent No 2327492 of 27.06.2008). The complex of clinical and instrumental studies included 6 min walk test, echocardiography, and speckle tracking imaging before, immediately and 3 months after AEVS. A course of AEVS improved clinical conditions in 58 (92.06%) of the 63 patients due to one-grade or greater decrease of CCI FC and increase of the walking distance. This effect persisted till month 3. It was absent in 5 (8.33%) patients. Improvement of clinical conditions with the decrease of CCI FC was accompanied by increase of left ventricular ejection fraction due to diminished end-systolic volume. The ejection fraction did not change in 4 patients with HR over 80/min. All patients with lowered HR after AEVS showed improved LV contractility in the longitudinal direction.

Aim: To study the impact of angiotensinogen (AGT) and angiotensin II receptor type 1 (AGTR1) gene polymorphisms on the development and course of chronic heart failure (CHF) in patients with coronary heart disease (CHD)., Subjects and Methods: Two hundred and twenty-six patients (149 men and 77 women; mean age 55.9 +/- 5.8 years) with CHF were examined. Genotypes were identified by the restriction fragment length polymorphism analysis of polymerase chain reaction products. A control group comprised 136 subjects (63 men and 73 women; mean age 53.6 +/- 4.8 years) without signs of cardiovascular diseases, as evidenced by the examination., Results: The T allele of the M235T polymorphism in the AGT gene was found to be associated with the development and unfavorable course of CHF in patients with CHD. At the same time, carriage of the M allele of the M235T polymorphism in the AGT gene reflected the favorable course of this disease. That of the C allele and A/C genotype of the A1166C polymorphism in the AGTR1 gene was associated with the development of CHF and the A allele and A/A genotype manifested themselves as protective factors. According to the severity of CHF and the nature of its course, the distribution of frequencies of the genotypes and alleles of the A1166C polymorphism in the AGTR1 gene showed no significant differences between the patient groups., Conclusion: There were associations of the polymorphisms of the AGT gene (the M235T polymorphic marker) and the AGTR1 gene (the A1166C polymorphic marker) with the development of CHF in patients with CHD.

Aim of investigation - to study effect of angiotensin-converting enzyme (ACE) gene polymorphism as a dominant risk factor of development of chronic heart failure (CHF) and target for effective therapy with ACE inhibitor enalapril in patients with ischemic heart disease. We followed 226 patients with CHF on stable permanent basic therapy comprising -adrenoblocker, diuretic, aldosterone antagonist, digoxin, and ACE inhibitor. Seventy eight patients received enalapril (starting dose 2.5 mg twice daily with subsequent titration up to 10-20 mg twice daily). Control group comprised 136 patients without cardiovascular abnormalities. Allele D of polymorphic locus I/D of ACE gene in homozygous state was associated with high risk of development and severity of clinical manifestations of CHF. In patients with D/D genotype of ACE gene at the background of therapy with enelapril we noted more pronounced lowering of CHF functional class and augmentation of left ventricular ejection fraction compared with patients having I/I and I/D genotypes. We revealed associative interrelationships of ACE gene polymorphism (polymorphic locus I/D) with development and severity of CHF as well as effectiveness of therapy with an ACE inhibitor enalapril.

Study aim was investigation of blood pressure levels (BP) in spouses and assessment of the role of arterial hypertension (AH) in a spouse as risk factor (RF) of AH in a 17-years prospective study. Primary study based on a random sample of citizens of Tomsk (1546 men and women aged 20-59 years) was carried out in 1988-1991. At repeat study which was carried out in 2002-2005 we obtained data on AH and end points from 81.2% of initial population. Cohort family study comprised 427 family couples. Relative risk (RR) of AH development in men in case of AH of a female spouse was 1.63 (95% confidence interval [CI] 1.14 to 2.33). RR of AH development in a women in this situation was 1.5 (95%CI 1.13 to 1.99). Husbands AH was associated with 5.2% elevation of systolic BP (SBP) (&lt;0.001), 4.8% elevation of diastolic BP (DBP) (=0.001) in his wife. AH of a wife was associated with 5.5% elevation of SBP (&lt;0.001) and 5% elevation of DBP (=0.003) in a husband. Coefficient of correlation (r) of SBP levels between spouses was 0.09 in age group 20-39 years (=0.041) and 0.16 in age group 40-59 years (=0.002). For DBP in age group 20-39 years r=0.14 (=0.002), in age group 40-59 years r=0.10 (=0.042). In a prospective study in men and women we found higher SBP when AH was detected in a spouse during follow-up compared with individuals whose BP had been and remained normal (by 5.4%, =0.015) or those whose BP during this period decreased to normal level (by 17.5%; =0.006). Detection of new cases of AH in men - spouses of women with AH was higher than in man - cohabitants of wives without AH (53.8 and 37.3%, respectively, =0.028). Thus we found concordance of BP levels in spouses, which was conditioned by marital assortment as well as common environment and way of life.

The aim of this work was to study dynamics of new cases of hospital thromboembolism of pulmonary artery branches (TEPA) based on the registry data of Tomsk hospitals for 2003-2010 and to estimate applicability of recommendations of European Society of Cardiologists (2008) on diagnostics and treatment of TEPA. Case records and autopsy protocols were available for analysis. The data were treated using Statistica for Windows 6.0 package. 5.04% of the deceased patients had TEPA according to autopsy data. The discrepancy between clinical and pathoanatomical findings averaged 57.6%. In 2010, TEPA was not diagnosed in 35.6% patients. The number of new cases of submassive TEPA and TEPA of small branches with the fatal outcome decreased to 40.7 and 48% since 2007 while the incidence of lethal massive thromboembolism amounted to 68%. Its increase was especially notable among men after 2008. In 2003, 73.3% of the patients who died from TEPA were women while it was the cause of death in 54.8% of men in 2010. The duration of hospital stay was 0-16 (mean 8/1 +- 7.8) bed-days. Most patients (60.3%) had 3 or more risk factors. The frequency of TRPA relapses correlated with the presence of pericardial fluid (p = 0.039) and acute myocardial infarction (p = 0.023). In 24.2% of the cases. TEPA originated in heart chambers.

Aim of the Study: The study aimed to reveal the sign of coronary atherosclerosis absence using the factor analysis in patients referred for the coronary angiography., Patients and Methods: 9409 patients suspected stable coronary artery disease (CAD) or with confirmed diagnosis of CAD from the "Registry of provided coronary angiography" were included in the study., Results of the Study: Principal factor described about 59% of the variation and included the burdens of 4 parameters (gender, smoking, significant coronary atherosclerosis and hypothyroidism) and was interpreted as factor of coronary atherosclerosis., Conclusions: It was found that the absence of coronary stenosis was associated with female gender, non-smoking status and hypothyroidism.

Aim: To reveal possible predictors of thrombosis in the right cardiac chambers and to build a mathematical model to estimate the probability of thrombi in them in patients with thromboembolism of the pulmonary artery branches., Materials and Methods: The data of autopsy protocols and case histories were analyzed in'157 patients in whom the source of thromboembolism had been right cardiac chambers according to postmortem evidence. A logistic regression method was used to create a probability model., Results: The findings were used to select 69 indicators--possible provokers of thrombosis and accordingly predictors of thrombi in the right cardiac chambers. A mathematical model--a formula to estimate the probability of thrombi in the right cardiac chambers--was made. It comprised 8 indicators: weight, height, pericardial fluid, right atrial dilatation, right ventricular wall thickness, a left or right ventricular apical scar, a concomitant inflammatory process, and concurrent diabetes mellitus. CONCLUSION; The application of the developed formula may assist in identifying a group of patients who have the highest probability of thrombi in the right cardiac chambers and accordingly must undergo a more in-depth examination.