The review presents an analysis of literature data on the use of exercise stress tests in patients with disorders of heart rhythm and conduction, such as sinus node dysfunction, atrioventricular blockade, WPW-phenomenon, atrial fi brillation, canalopathy. The value of clinical and electrocardiographic parameters registered during the exercise stress tests for verifi cation of the diagnosis and determination of the patient management tactics is shown. Clinical examples from own practice are given.

Background. Percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) is followed often by myocardial injury. Up to now there is no mutual agreement to the infl uence of the perioperative myocardial injury on the long-term prognosis of the IHD patients.

Objective. The aim of study was to assess the risk factors for the development of cardiac events in the long-term period in patients with stable coronary artery disease with myocardial damage after PCI.

Materials and methods. The study included 113 patients with stable coronary artery disease who underwent planned PCI. Serum troponin levels were determined before and 24 hours after the intervention. Re-examination of patients was carried out after 12–18 months (average 15 months).

Results. The post PCI Tn I level over a reference one was registered in 25 patients (22,2 %). During the follow-up period the cardiovascular events took place in 25,6 % patients: acute myocardial infarction (MI) in 3 (2,6 %), angina occurred in 23 %. One-way ANOVA revealed a signifi cant value for cardiac risk events of the patient age, number of stenosed arteries, summary degree of stenosis, and their complicity, number of implanted stents. The fi rst three of them were included in the fi nal combination of the stepwise discriminant analysis. The general linear model of the latter detected additionally statistical signifi cance of the variables “MI in the past” (before PCI) and “number of postdilatations“.

Conclusion. In patients with stable ischemic heart disease, included in the study, the determining risk factors for the development of cardiac events were the prevalence and nature of the obstructive lesion of the coronary bed, age, previous myocardial infarction, and especially the performance of PCI. Myocardial damage was not identifi ed as a risk factor for recurrent angina or myocardial infarction.

Objective. To assess the expression of the leptin gene (LEP) in the epicardial (EAT) and subcutaneous (SAT) adipose tissue in coronary artery disease (CAD) patients.

Methods. 107 people were examined: 87 with CAD (57 men, 30 women), 20 without CAD (10 men, 10 women). Biopsy of EAT, SAT, coronary angiography, heart computed tomography, blood leptin levels were estimate, mRNA expression of the LEP gene evaluated by PCR.

Results. In CAD patients with multivessel coronary artery lesion, the level of blood leptin is the highest. The expression of the LEP gene in EAT is higher in men than in women, in men with CAD higher than in non-coronary artery disease patients, and with a multivascular coronary lesion higher than in a 1–2 vascular lesion. Expression of the LEP gene in EAT in women with CAD is higher than with no CAD, and does not depend on the severity of coronary atherosclerosis. In SAT, LEP gene expression in men with CAD is higher than without CAD; women with CAD are lower than without CAD. Expression of the LEP gene in SAT is higher in men with a multivascular lesion than in 1–2 vascular lesion, and lower in women with a multivascular damage.

Conclusions. The expression of the leptin gene in women is higher in SAT, and in men in EAT. Expression of the leptin gene in EAT with CAD is higher than without CAD. The expression of the leptin gene in SAT in men with CAD, especially with multivessel lesions, is higher than without coronary artery disease.

Background. Studying the possibilities of ultrasound diagnosis of atherosclerotic lesions of the carotid arteries to determine the treatment tactics of patients with various types of atherosclerotic plaques.

Objective. Assessment of the possibilities of ultrasonic triplex research in identifying signs of instability of atherosclerotic plaques of the carotid arteries.

Design and methods. The study included 360 patients aged from 28 to 95 years old who were admitted to the St. Petersburg State Budgetary Health Institution “Mariinskaya Hospital” with diagnoses of transient ischemic attack and acute cerebrovascular accident. All patients underwent an ultrasound visualization of the brachiocephalic arteries.

Results. Most patients had atherosclerotic plaques of the carotid arteries with a stenosis of up to 75 % and had signs of instability with varying degrees of severity (according to triplex ultrasound). However, it was not possible to reliably assess the presence of hemorrhage in the plaque using a single imaging method.

Conclusion. The data obtained indicate the complexity and ambiguity of the studied question. Further detailed examination of the signs of atherosclerotic plaque instability is required using various diagnostic imaging techniques.

Background. E-cadherin is known as one of the endometrial receptivity biomarkers.

Objective: to conduct a comparative analysis of the endometrial E-cadherin expression in healthy fertile women and patients with reproductive dysfunctions with the ovulatory menstrual cycle.

Design and methods. The main group consisted of patients with infertility (n = 81) and early pregnancy loss (n = 40), the control group — of 16 healthy fertile women. All subjects underwent endometrial biopsy and venipuncture to receive peripheral blood sample (to determine estradiol and progesterone levels) at 6–8 days after ovulation. Endometrial specimens were assessed by histological and immunohistochemical (evaluation of e-cadherin expression) methods.

Results. In patients with reproductive failure, the frequency of apparent E-cadherin expression in the luminal (89 %, n = 84 out of 94) and glandular (74 %, n = 89 out of 121) epithelium did not differ from the corresponding indicators in fertile women (luminal epithelium — 94 %, n = 15 out of 16, gland — 88 %, n = 14 out of 16) (p > 0.05 for all indicators). The frequency of reduced E-cadherin endometrial expression was similar in patients of the main group with complete secretory transformation of the endometrium (1), incomplete secretory transformations (2) and in healthy women (3): respectively in the luminal epithelium — 7 % (n = 3 out of 43) (1), 14 % (n = 7 out of 52) (2), 6 % (n = 1 out of 16) (p > 0.05); in the glands — 20 % (n = 10 out of 51) (1), 31 % (n = 22 out of 70) (2), 13 % (n = 2 out of 16) (3) (p > 0.05).

Conclusion. In patients with the history of reproductive disfunctions freaquency of lower/higher E-cadherin expression was similar to those in healthy fertile women.

When using the method of low-volume hemoperfusion (MOG) in the clinic, the therapeutic effect of which is to implement the mechanisms of hemomodulation and activation of the sorption procedure, it is important to take into account the activation properties of solid-phase granular drugs. Blood-contact interaction was carried out in bench conditions with the use of donated blood in rotary mode. Blood samples were taken before the experiment and after 5, 20, 40 and 60 minutes. Changes in blood cell and subcellular populations were evaluated using the Sysmex XT 1800i hematological analyzer (26 parameters), which made it possible to indirectly judge the activation of blood cells. 20 experiments were conducted. To analyze the activation functions of the hemocontact preparation SCT 6A HP, the speed-time adhesive profi le of blood cells on the sorbent was used. The maximum rate of adhesion was noted in the period of “5 min” from the beginning of contact. The rate of adhesion of granulocytes in all time intervals was signifi cantly higher than that of agranulocytes. The adhesion process can be an indicator of the activation of blood cells in contact with foreign surfaces, and serve as an evaluation criterion for the activation capabilities of these surfaces.