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[Focus ultrasound for cardiology practice. Russian consensus document]. KARDIOLOGIIA 2021; 61:4-23. [PMID: 34882074 DOI: 10.18087/cardio.2021.11.n1812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
This document is a consensus document of Russian Specialists in Heart Failure, Russian Society of Cardiology, Russian Association of Specialists in Ultrasound Diagnostics in Medicine and Russian Society for the Prevention of Noncommunicable Diseases. In the document a definition of focus ultrasound is stated and discussed when it can be used in cardiology practice in Russian Federation.
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Anticoagulant Therapy in Patients with Non-valvular Atrial Fibrillation in Real Clinical Practice: in Appropriate Dose Reductions. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-03-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the frequency of administration of direct oral anticoagulant (DOACs) in doses recommended and not recommended by the instructions of the drugs in non-valve atrial fibrillation (AF) patients.Material and methods. 10663 case histories of patients hospitalized for 5 years (2014-2018) were studied, 1307/10663 (12,3%) case histories of patients with AF were selected. In patients with AF, the risk of stroke and systemic embolism, the risk of bleeding, the anticoagulant therapy (ACT) recommended at the prehospital stage and its adequacy was evaluated.Results. 1 261/1 307 (96,5%) patients had a non-valve AF. The risk of stroke and systemic embolism was 4,7±1,5 (CHA2DS2-VASс), 97,5% of patients with non-valve AF (1229/1261) needed ACT. Only 665/1229 (54.1%) patients with AF received ACT at the time of hospitalization and 578/1229 (47,0%) of patients did not receive ACT. Before hospitalization 281/665 (42,3%) patients received vitamin K antagonist (warfarin). The international normalized ratio in the target range (2,0-3,0) was in 111/281 (39,5%) patients. 57,7% (384/665) outpatients with AF received NOAC: rivaroxaban - 180/384 (46,9%) patients, dabigatran etexilate - 110/384 (28,6%) patients, apixaban - 94/384 (24,5%) patients. Inappropriate reduced doses of DOAC were revealed in 68/384 (17,7%) patients: apixaban - 23,4%, dabigatran - 16,4% and rivaroxaban - 15,6% (p>0,05).Conclusion. In real clinical practice 42,3% AF patients used warfarin, only 39,5% of them had INR in target values. DOAC in inappropriate reduced doses used 17,7% patients.
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[Prevention of thromboembolic complications during cardioversion and catheter ablation in patients with atrial fibrillation: review of key randomized trials]. ACTA ACUST UNITED AC 2020; 60:99-106. [PMID: 33228512 DOI: 10.18087/cardio.2020.10.n1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022]
Abstract
This review focuses on the relevance of sinus rhythm control in patients with atrial fibrillation in real-life clinical practice and specific clinical features of patients with this arrhythmia. The authors presented current guidelines on prevention of thromboembolic complications and a review of results from major clinical studies of direct oral anticoagulants. The search for literature and selection of clinical studies for 2009-2020 were performed on websites of the European and Russian Societies of Cardiology, the All-Russian Scientific Society of Arrhythmologists, and in online databases PubMed, EMBASE, eLibrary, and Google Scholar using the key words atrial fibrillation, anticoagulants, ablation, cardioversion, and efficacy and safety.
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P3757Profibrogenic biomarkers and severity of left atrial fibrosis in patients with atrial fibrillation and metabolic syndrome: is it possible to predict the effectiveness of therapy? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Galectin-3 (Gal-3) and transforming growth factor-beta1 (TGFbeta1) – biomarkers of fibrosis are increased in patients with atrial fibrillation (AFib) and metabolic syndrome (MetS). We propose that both can impact on progression of the arrhythmia.
Purpose
Objective of the study was to evaluate the role of Gal-3 and TGFbeta1 in predicting the effect of antiarrhythmic pharmacotherapy (APT) and radiofrequency ablation therapy (RAT) in patients with AFib and MetS.
Methods
539 AFib patients hospitalized in cardiology department (2015–2016 years) were examined. 204 AFib patients with paroxysmal (n=156) and persistent (n=48) forms 35–60 years old were included in prospective study: 110 had ≥3 components of MetS (IDF, 2005) and 94 without MetS. Serum GAL-3, TGF-beta1 (Enzyme immunoassay) were performed. Antiarrhythmics were applied during 12 months. Antiarrhythmic effect of pharmacotherapy was established if no episodes of AFib were registered during follow-up. 73 patients without effect of APT were treated with RAT with pulmonary veins isolation. Ablation procedure was performed with the system of electroanatomical mapping CARTO3. In the “offline” mode we evaluated areas of low voltage in the amplitude spectrum of 0,2–1,0 mV and divided all patients into groups: I – minimal (<10% of LAarea, n=18), II – mild (10–19% of LAarea,n=26), III – moderate (20–29% of LAarea, n=17) and IV - severe low voltage area (≥30% of LAarea,n=12). After ablation, we analyzed the clinical data and the effectiveness of RAT during 12 months.
Results
Gal-3 in patients with recurrent paroxysms and without the effect of APT was higher than in patients without recurrent paroxysms (1312,1 [750,2; 2494,3] and 500,2 [410,3; 723,4] pg/ml, p<0,001). TGF-beta1 was also higher in patients without the effect of APT (11521,2 [2950,2; 17642,2] and 2999,5 [1767,4; 5490,2] pg/ml, p<0,001). Patients from IV group had greater low voltage area of LA, than in I group (33,4±2,1 and 6,6±2,4%, p<0,001), but also higher levels of Gal-3 (1201,1 [950,2; 2140,3] and 490,2 [310,3; 523,4] pg/ml, p=0,027) and TGF-beta1 (9497,2 [1257,2; 14672,2] and 3491,5 [1767,4; 8470,2] pg/ml, p=0,04). The multivariate regression analysis demonstrated that Gal-3 is an independent predictor of non-effective antiarrhythmic pharmacotherapy of AFib (OR=2,38, 95% CI: 1,12–5,04, p=0,024). In patients with AFib and MetS who had Gal-3 above 770,5 pg/ml (cut-off point on ROC-curve) the risk of non-effective APT was in 3,6-fold higher during follow-up (RR=3,6, 95% CI: 1,6–7,9, p=0,002). Binomial regression analysis was found that greater % of LA fibrosis corresponds to higher probability of recurrence of AFib after RAT (OR=1,1, 95% CI: 1,03–1,12, p=0,002).
Conclusions
Galectin-3 and TGF-beta1 in AFib and MetS patients with left atrium severe fibrosis are higher than in patients with minimal fibrosis. We suppose that profibrogenic substances can impact on progression of AFib and non-effectiveness antiarrhythmic pharmacotherapy.
Acknowledgement/Funding
Governmental grant 17-75-30052
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P2878Transforming growth factor beta-1, galectin 3 and left atrium fibrosis in patients with paroxysmal atrial fibrillation and metabolic syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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HIT Poster session 2P486The effect of short term aerobic exercise and ACE polymorphism on cardiovascular remodeling in healthy sedentary postmenopausal womenP487Are there predictors of malignant progression of aortic stenosis severity?P488Quantitative und semiquantitative parameters in the classification of aortic insufficiency: a 3D-echocardiography and magnet resonance imaging studyP489Vascular indicies surrogate markers for left ventricular dysfunctionP490Left ventricular systolic strain data does not require indexation to cavity size in mitral valve diseasesP491Impact of EACVI grant programme on career progression of grant winnersP492Early predictor of atrial fibrillation recurrence after electrical cardioversion: diastolic parameters come firstP493Echocardiographic diagnosis of arrhythmias in the fetusP4943D echocardiography is a fast-learning and a more reliable method compared with 2D echocardiography for the assessment of left ventricular volumes and ejection fraction in patients with heart failureP495Right ventricular mechanics in functional ischemic mitral regurgitation in acute inferior myocardial infarctionP496Added value of two dimentional strain in assessement of left ventricular systolic function in rheumatic mitral stenosis patients with normal ejection fractionP497Left ventricular myocardial deformation in arterial hypertension with different types of glucose metabolism disordersP498Epicardial to pericardial adipose tissue ratio: predicting myocardial ischemia in patients referred for exercise stress echocardiographyP499Echocardiographic evaluation of the patients with asd after percutaneous closureP500Screening for carotid artery stenosis with the use of pocket-size imaging device equipped with linear probeP501LAD correlates poorly with LAVIP502Predictors associated with the diastolic dysfunction formation in patients with moderate hypertensionP503Assessment of left atrial function by speckle tracking analysis in transthoracic echocardiography for predicting the presence of left atrial appendage thrombus in patients with atrial fibrillationP504can echocardiography detect subclinical myocardial damage in the layers of myocardial wall? (The first study in a large population with known inflammatory disease)P505Epicardial fat thickness and galectin 3 in patients with atrial fibrillation and metabolic syndromeP506Left ventricular reverse remodeling in heart failure: a new obesity paradox?P507Epicardial adipose tissue and carotid intima media thickness in hemodialysis patients; single center experienceP508Echocardiographic parameters of mitral valve remodeling associated with poor clinical outcome in high risk patients with functional mitral regurgitation after Mitraclip implantationP509Prevalence of valve disease in a community population over the age of 60P510Discordance between mitral valve area and mean transmitral pressure gradient in mitral stenosis: Is mean gradient marker of the severity or parameter of tolerance in severe mitral stenosis?P511Ischemic mitral regurgitation is associated with impaired radial and circumferential myocardial deformation in acute inferoposterior myocardial infarctionP512The importance of early left atrial functional changes in predicting long term left ventricular remodeling in patients surviving a ST elevation myocardial infarctionP513Remodeling of myocardial deformation after mitral valve surgeryP514Global longitudinal peak systolic strain is reduced shortly after heart transplantationP515Detailed transthoracic and transesophageal echocardiographic analysis of mitral leaflets in patient undergoing mitral valve repair. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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