Background. Cardiovascular disease, including coronary artery disease (CAD), remains a leading cause of mortality. The results of recent studies demonstrate that microRNA engages in pathogenesis of different pathological states, including coronary atherosclerosis and its clinical manifestation — CAD.

Objective. To evaluate microRNA-27а, microRNA-133а and microRNA-203 expression in cardiomyocytes and blood serum of CAD patients with different degrees of coronary artery lesion.

Design and methods. 100 patients were included in the study, they formed 3 groups: 40 patients with CAD and significant atherosclerosis of 1-2 coronary arteries; 40 patients with multi arterial coronary disease and 20 persons without CAD and significant comorbidity. The microRNA-27a, microRNA-133а and microRNA-203 expression was determined in cardiomyocytes and blood serum of these patients by real-time polymerase chain reaction.

Results. Level of microRNA-27a, microRNA-133а and microRNA-203 expression in left atrium cardiomyocytes of CAD patients with significant stenosis of 3 or more coronary arteries was higher, then their expression in the patients with 1-2-vessel and in group without coronary atherosclerosis. Examination of the microRNA expression level in blood serum and in left atrium cardiomyocytes revealed a significant difference. The expression of microRNA-27a and microRNA-133а in cardiomyocytes is above than in blood serum, while the expression of microRNA-203 in the myocardium is lower, than in the blood serum. Level of microRNA-27a, microRNA-133а and microRNA-203 expression in blood serum in CAD patients with significant stenosis of 3 or more coronary arteries was significantly higher, than in patients with 1-2 stenosis of coronary arteries. Furthermore, classification tree method established that risk of atherosclerotic heart disease increases five-fold if microRNA-203 expression in blood serum is more than 100 REU.

Conclusion. MicroRNA-27а and microRNA-133а expression in cardiomyocytes of left atrium is higher than in blood serum in CAD patients. MicroRNA-203 expression level in blood serum may be a new predictive marker of coronary artery degree atherosclerotic stenosis in CAD patients.

Previously, it was believed that mutations in filamin C are able to cause only skeletal myopathies, cardiac tissues have not been studied. However mutations in FLNC have been recently found that lead to both joint damage to the skeletal and cardiac musculature and to isolated cardiac tissue damage. Moreover, had known that mutations in FLNC are associated with all known types of cardiomyopathies (HCM, DCM, RCM, arrhythmogenic) аt present. The article presents our own clinical observations of an adult and children’s cases of isolated phylaminic RCM based on our institution. The study of this problem will allow us to include the known mutations in the genetic screening panels, which will lead to early diagnosis of cardiomyopathies associated with mutations in FLNC and the ability to prevent rapid disease progression and more later cardiac transplantation in the future.

Background. According to the recommendations of the European Society of Cardiology, ultrasound examination of the lung can be used to assess congestive changes, however, this method has so far a low recommendation class IIb and a level of evidence C, which can be regarded as a consequence of its insufficient knowledge.

The aim of the research. To study ultrasound characteristics of the lung tissue in patients with intermediate left ventricular function after resolving of acute decompensation of heart failure.

Materials and methods. The ultrasound profile of the lung tissue was studied in 71 patients after resolution of acute heart failure decompensation under intermediate left ventricular function. The average age of patients studied was 65.2 ± 3.6 years. 64.3% of them were males ,25.7%-females. Using the ultrasonic method, B-lines were studied, the distance between them being 3 mm and 7 mm in a semi-quantitative manner, according to the method of E. Picano in 2016. The results were statistically processed

Results. In persons after the acute decompensation of the heart failure residual congestion persisted with interstitial component dominated in both lungs. Appearance of interstitial lung edema to be considered as prognostic factor of re-hospitalizations rate increasing.

Conclusion. Interstitial congestion in the pulmonary parenchyma considered as a factor in the deterioration of the clinical course of heart failure sign of its acute decompensation. In this connection, it is interesting to identify interstitial pulmonary edema at the early stage to prevent real clinical presentation of acute decompensation of the heart failure.

Differentiation between amiodarone-induced thyrotoxicosis type 1 (AmIT1) and type 2 (AmIT2) is a diagnostic challenge. The current diagnostic tests are often unable to differentiate these two types of thyrotoxic syndrome. Several studies had shown that the serum T4 level and T3/T4 ratio are significantly different in patients with destructive thyroiditis, and those with Graves` disease. These studies showed that the serum T4 concentration is significantly higher, and the T3/T4 ratio is significantly lower in patients with destructive forms of thyroiditis compared to their values  in Graves’ disease. Since AmIT1 is known to develop in patients with latent Graves` disease, and AmIT2 is a destructive thyroiditis, the purpose of our study was to evaluate the serum FТ4 level and FT4/FT3 ratio in AmIT1 and AmIT2 as an additional diagnostic test for differentiating these types of thyrotoxicosis. 45 patients with thyrotoxicosis (33 with AmIT1 and 12 AmIT2) were included in the study. The diagnosis of thyrotoxicosis type (AmIT1 or AmIT2) was established on the basis of clinical data, color flow Doppler sonography (CFDS), the presence of TSH receptor autoantibody in patients with AmIT1, as well as the effect of treatment. There was no difference in FT3 levels in patients with AmIT1 and AmIT2, while the FT4 values were significantly higher in patients with AmIT2 (36,2±19,1 mmol/L) than in those with AmIT1 (17,8±3,7 mmol/L, p= 0,002). Also, a difference in the FT4/FT3 ratio was found between AmIT1 (2,7±0,8) and AmIT2 (6,1±5,7, p=0,048). Moreover, 75% of patients with AmIT1 had FT4/FT3ratio < 3,10, while 75% of patients with AmIT2 had FT4/FT3 ratio > 3,65. The FT4/FT3 ratio can be used as an additional test in the differential diagnosis AmIT1 and AmIT2.

Complexity of epilepsy and a seizure as clinical and pathophysiological entities is reflected in a large number of experimental models of epilepsy. They could be stratified into acute and chronic, chemical and electric. The present review describes some most typical non-genetic models of different kinds used on laboratory rats. Also, the results of application of these models for research of vagus nerve stimulation as a novel treatment of drug resistant epilepsy are summarized.

The review considers methods for selecting chemo- and biopreparations, their combinations using 2D and 3D cell culture models to predict a personified response of patients with malignant neoplasms (ovarian, stomach, intestine, lung, lacteal, pancreas, head and neck cancer) to chemotherapy. Performance indicators (sensitivity, specificity, prolongation of total and disease-free survival) of chemosensitivity assessment methods in cultures of tumor cells are analyzed on the basis of their comparison with the effectiveness of chemotherapy of patients. The article highlights the advantages and disadvantages of the methods described, the prospects for their further application in clinical practice.

Recurrence of twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC) of placental anastomoses is unfavorable complication. Multiparous woman 34 years old in TTTS stage 2 was performed FLC of 8 arteriovenous anastomoses of the placenta followed by amnioreduction of 1000 ml on the gestational age of 22 weeks and 2 days. At gestational age of 24 weeks 6 days was revealed a recurrence of the TTTS, with considerable polyhydramnion of recipient and anhydramnion of the donor, a repeated FLC of 5 residual placental anastomoses was performed and amnioreduction of 2000 ml at 25 weeks 1 day of gestation. On the fifth day was normalized the amount of amniotic fluid of both fetuses. At 32 weeks of gestation spontaneously was began the birth, the weights of newborns were 1560 and 1600 g, both had Apgar score 8/9. Respiratory therapy continued for 7 hours at the second newborn and for 13 hours at the first newborn girl after transferring to the ICU. The signs of the respiratory failure were not observed. There were no differences between complete blood counts. This clinical case confirms the possibility of effective correction of recurrence TTTS with the help of repeated FLC of placental anastomoses.