Liver transplant is known to be the only radical treatment for patients with end-stage liver diseases. It is known that cardiovascular diseases rank third among patients, who underwent liver transplant. Due to the current generally accepted policy of aggressive treatment of hypercholesterolemia, mortality from cardiovascular diseases has been significantly reduced in general population. Statin therapy has also demonstrated a decreasing effect on mortality among patients with chronic liver failure. Recently published research results have shown the increasing occurrence of non-communicable diseases among liver recipients, including diseases that determine cardiovascular mortality (arterial hypertension, chronic coronary syndrome, chronic heart failure, chronic kidney failure). This evidence demonstrates that in post-operative period doctors should do their best to identify not only traditional risk factors of acute transplant rejection, but also pay attention to cardiovascular risks and their timely treatment. Based on the data about a number of differences in the incidence of cardiovascular risk factors and on the specifics of confirmation and treatment of chronic coronary heart disease in liver transplant recipients in comparison with the general population, we believe that in transplant centers it is necessary to develop a specialized algorithm of dispensary follow-up of recipients (checklist) for adequate prevention of diseases of the circulatory system.

Angina pectoris is one of the most common symptoms of ischemic heart disease (IHD). Coronary angiography in a significant part of patients with angina pectoris and signs of myocardial ischemia does not reveal obstructive atherosclerotic changes in the coronary arteries. Independent or additional mechanisms of ischemia can be microvascular dysfunction and epicardial coronary vasospasm. The clinical form of ischemic heart disease, which is based on ischemia caused by dysfunction of the coronary vessels in the absence of obstructive changes, has recently received the definition of INOCA (Ischaemia with No Obstructive Coronary Artery Disease). The concept of INOCA comprises two types of angina pectoris – microvascular and vasospastic. The underlying INOCA coronary vasomotor disorders have both different pathophysiological mechanisms and localization in the vascular system of the coronary circulation itself. Clinically the most important vasomotor disorders are epicardial and microvascular vasospasm, impaired microvascular vasodilation. The article provides a brief overview of the mechanisms of regulation of coronary blood flow under physiological conditions and vascular dysfunction in non-obstructive atherosclerotic lesions.

Objective: To study the results of surgical treatment of patients with ascending aorta dilatation and aortic valve disease. Methods: Echocardiographic examination was performed in all patients before surgery, within 1 month after surgery, and in the long-term period - once a year. Computed tomography was performed in patients from the main group as a control research method within 1 month after surgery and in the long-term period – once a year. Results: The results of surgical treatment of 255 patients with aortic valve disease and ascending aorta dilatation from 40 to 55 mm in the early postoperative and long-term periods with an average follow-up period of 3 years were analyzed. The wrapping method of the ascending aorta, performed in 93 patients, led to a significant decrease in the ascending aorta diameter from 45.47±2.96 mm to 35.98±3.88 mm, preventing the progression of its dilatation and aneurysm formation. The method showed a lower risk of complications in the early postoperative period compared to ascending aorta replacement. In the long-term follow-up, the frequency of major cardiovascular events and overall survival after aorta wrapping and aorta replacement in combination with correction of the aortic valve pathology did not differ significantly. After aorta wrapping, according to computed tomography, during the observation period, there were no complications from the ascending aorta in the form of dissection, intimal defects, wrap dislocation, aorta kinking; there was no significant calcification of the xenopericardial wrap. Conclusion: Ascending aorta wrapping can be performed as an alternative method of surgical treatment of the ascending aorta dilatation in aortic valve surgery in a certain cohort of patients with good results in the early postoperative and long-term follow-up periods.

The aim of the study was to assess the clinical significance of determining the level of lipocalin associated with neutrophil gelatinase in urine (uNGAL) at the time of hospital admission in patients with acute ST-elevation myocardial infarction (STEMI) and acute ischemic kidney injury. Conclusion. Acute ischemic kidney injury is a frequent complication of STEMI. Based on the findings of the study uNGAL can be applied as an early marker of acute ischemic kidney injury and a predictor of post-discharge CKD in patients with MI.

The article describes current approaches to the interventional treatment of patients with arrhythmogenic cardiomyopathy (ACM) complicated with paroxysmal sustained ventricular tachycardia (VT). The advantages and disadvantages of two competing methods for mapping and ablation – activation mapping vs substrate mapping – are analyzed. The rationale for the proposed method of VT substrate mapping in ACM and the authors’ own results are presented. The results obtained by the authors make it possible to recommend substrate ablation according to the proposed technique as an invasive first-line therapy for patients with persistent monomorphic VT and ACM

Aim. To develop a multifactor response prediction model to CRT in patients with CHF complicated by AF taking into consideration myocardium dyssinchrony parameters, clinical, functional, and laboratory predictors of a positive response to interventional treatment. The linear model developed to assess the dynamics of LV ESV allows individualizing the patient selection for interventional treatment in case of predicting an unstable early response to CRT.

The aim of the study was to assess the incidence of high residual platelet reactivity in patients with myocardial infarction (MI), depending on the age and reperfusion therapy at different times from the onset of MI. Conclusion. The study revealed a high percentage of patients with MI with an insufficient response to acetylsalicylic acid and clopidogrel at different times from the onset of MI. There were no differences in the indicators of the aggregatogram depending on the age of the patients. There were no differences in the indicators of the aggregatogram depending on the type of reperfusion therapy performed (only TLT or TLT + PCI). There were no differences in the indicators of the aggregatogram depending on the type of implanted stents.

The article discusses the impact of donor left ventricular (LV) hypertrophy on the survival of recipients after heart transplantation.

Anumber of respiratory infections can result in pulmonary fibrosis as an outcome. SARS-CoV2, along with other coronaviruses, is no exception. The factors contributing to the formation of fibrosis are insufficiently studied. Nor are the methods for determining the activity of the process and the degree of fibrosis in the lung are well developed. Among the instrumental methods, along with computed tomography of the chest, an alternative option for dynamic monitoring can be the method of ultrasound examination of the lungs. Among laboratory parameters, C-reactive protein and fibrinogen are of interest

The article discusses the prevalence of polymorphic variants of the MTNR1B gene and the C6310T locus of the CYP1A1 gene in patients with obstructive sleep apnea syndrome (OSAS) and analyzes their association with melatonin levels and the risk of developing OSAS.

The article is devoted to a comparative analysis of morphological changes in the tissues of the reproductive system of women under the influence of a neodymium laser and bipolar coagulation during laparoscopic operations. The results of assessing the reliability of dif ferences in morphometric indicators of tissue damage (sections of the fallopian tubes, fragments of ovarian tissue, membranes of benign cystic formations of the ovaries, leiomyomatous nodes of the body of the uterus) under the influence of electromagnetic radiation of various wavelengths are presented. The recorded changes directly depend both on the applied heat or light energy, and on the histological structure of the tissue under study. Fundamental differences in artifactual changes in tissues of the reproductive system were revealed when using bipolar coagulation and laser radiation in surgical practice, and the dependence of morphological changes on the wavelength of a neodymium laser was established for the first time.

Investigation of the microcirculatory bed (MVB) has induced heightened interest both theoretical and practical in the medical world of the XX–XXI century. Evaluation of the MVB state has been widely used for revealing pathogenesis and developing an efficient treatment plan in cardiology, diabetology, oncology, dermatovenereology, dentistry, surgery, nephrology, urology, resuscitation and other branches of medicine. It’s worth noticing that evaluation of the microcirculatory parameters should be included into COVID-19 management for optimal medication of the patients especially in severe cases. The ar ticle provides a description of the microcirculator y bed, its structure, functions, mechanisms of regulation, causes of damage, and methods for diagnosing disorders. Proper consideration is given to the current techniques used to improve microcirculatory readings. Non-invasive techniques applied in the Republic of Belarus for improving the microcirculatory readings include the method of enhanced external counterpulsation and gravity therapy.

Varicocele is found in 8–40% of young men between the ages of 15 and 40. In 25.4% of cases, it is combined with a violation of reproductive function and in 40% of cases it causes pain syndrome in the scrotum. The etiology and pathogenesis of the disease are associated with various disorders in venous hemodynamics of the upstream vascular network. The peculiarity of venous blood outflow from the organs of the scrotum is the presence of a developed network of anastomoses and collaterals at the level of the scrotum, the inguinal region and the retroperitoneal space.

The frequency of recurrence after surgical treatment of varicocele reaches 29%. This circumstance encourages the medical community to search for the optimal surgical aid to prevent pathological reflux of blood into the venous plexuses of the testicle from the overlying parts of the vascular network. The operation is indicated in case of presence of the clinical symptoms, the development of orchopathy and disorders of spermatogenesis, regardless of the degree of development of varicocele (WHO classification 2010). Operations aimed at eliminating varicocele are divided into 2 large groups: the first group – preserving the renocaval shunt or shunting operations and the second group – not preserving the renocaval shunt or occlusive operations. Shunting operations include the creation of intervenous anastomoses: proximal, distal and bidirectional. Proximal anastomoses are aimed at eliminating renal venous hypertension as the direct cause of the disease. The imposition of bidirectional and distal anastomoses is considered inappropriate, since in the first case, the time of surgical intervention increases, and in the second case, renal hypertension is not eliminated. Occlusive operations are indicated for primary varicocele and the absence of pronounced venous hypertension. According to the level of vein ligation, they are divided into supra-inguinal and sub-inguinal, by selectivity into selective and non-selective, and by operative access into open, laparoscopic and endovascular. The lowest number of relapses and postoperative complications is observed in sub-inguinal selective and endovascular techniques. They are the most universal ones and eliminate all hemodynamic types of varicocele. Supra-inguinal selective techniques show their high effectiveness in the renospermatic type of varicocele and, unlike sub-inguinal operations, there is no risk of damage to the testicular artery during the operation. Thus, a differentiated approach to choosing the type of surgery reduces the risk of postoperative complications and prevents recurrence of the disease.

Cardiac manifestations in COVID-19, including myocardial injury with elevated troponin levels, are common. Myocarditis has been reported as a possible complication in coronavirus patients, but direct evidence for SARS-CoV-2 myocarditis remains limited. The described series of histopathological confirmations of myocarditis in COVID-19 differ in severity and interpretation. Clinical manifestations of non-ischemic myocardial injury are nonspecific, differential diagnosis is even more difficult due to the complications after viral pneumonia. Cardiac Magnetic Resonance Imaging (CMRI) is a powerful tool for studying structural and functional changes in myocardial injury. New pulse sequences of parametric mapping with determination of the T1 and T2 relaxation times of the myocardium are a unique method for quantitative assessment of the myocardium tissue. Within 6 months in 2021, we retrospectively analyzed the CMRI results of 45 patients with COVID-19 at the Republican Scientific and Practical Center “Cardiology”. The percentage of patients with positive criteria for Lake Louise myocarditis was 18% (n = 8). The elevated reference values of T2 ≥ 2σ up to 33% was the most frequent pathological change in myocardial tissue characteristics. There is significant variability in the published data collection as to the prevalence of myocarditis associated with different research methodologies in studies and discrepancies in the interpretation of MRI-mapping data. This brief review is aimed at revising and summarizing current knowledge on myocarditis in COVID-19 patients and highlight the problems of CMRI diagnostics.

Cardiac manifestations in COVID-19, including myocardial injury with elevated troponin levels, are common. Myocarditis has been reported as a possible complication in coronavirus patients, but direct evidence for SARS-CoV-2 myocarditis remains limited. The described series of histopathological confirmations of myocarditis in COVID-19 differ in severity and interpretation. Clinical manifestations of non-ischemic myocardial injury are nonspecific, differential diagnosis is even more difficult due to the complications after viral pneumonia. Cardiac Magnetic Resonance Imaging (CMRI) is a powerful tool for studying structural and functional changes in myocardial injury. New pulse sequences of parametric mapping with determination of the T1 and T2 relaxation times of the myocardium are a unique method for quantitative assessment of the myocardium tissue. Within 6 months in 2021, we retrospectively analyzed the CMRI results of 45 patients with COVID-19 at the Republican Scientific and Practical Center “Cardiology”. The percentage of patients with positive criteria for Lake Louise myocarditis was 18% (n = 8). The elevated reference values of T2 ≥ 2σ up to 33% was the most frequent pathological change in myocardial tissue characteristics. There is significant variability in the published data collection as to the prevalence of myocarditis associated with different research methodologies in studies and discrepancies in the interpretation of MRI-mapping data. This brief review is aimed at revising and summarizing current knowledge on myocarditis in COVID-19 patients and highlight the problems of CMRI diagnostics.

An increased number of elderly people in the medical terms means the predominance of pathology in the morbidity structure, which is determined by comorbidity, systemic lesions and an unfavorable prognosis. Comorbid patients are the most vulnerable group with a particularly high risk of adverse outcomes. In the presented review, the problem of management of acute coronary syndrome (ACS) in elderly patients in the context of the COVID-19 pandemic is addressed. The review demonstrates results of randomized clinical trials and registries of recent years, which purposefully included patients with ACS aged ≥ 75 years. Particular attention is paid to the need for a geriatric assessment of patients, the presence and severity of senile asthenia and its influence on the choice of treatment tactics and prognosis. The problem of choosing a method of myocardial revascularization and drug therapy schemes in elderly patients is considered under pandemic conditions. Issues related to drug interactions between drugs for the treatment of acute forms of coronary heart disease and drugs for the treatment of COVID-19 are reflected. In this situation, taking into account the risks of possible drug-drug interactions is of particular importance, which is especially challenging in elderly comorbid patients. Based on the available data, we have analyzed the main trends in the choice of treatment tactics for elderly patients with ACS during the COVID-19 pandemic.

The article presents data on clinically significant heart impairment in patients with rheumatoid arthritis (RA), as well as features of the development of ischemic and non-ischemic heart disease with a significant increase in the risk of adverse cardiovascular events. Patients with RA are characterized by an increased risk of developing myocardial infarction, heart failure, rhythm disturbances, sudden cardiac death, and general cardiovascular death. The paper emphasizes the possibility of a fairly rapid development of myocardial dysfunction in patients with RA from the moment of manifestation of the disease, the development and progression of atherosclerosis of the coronary arteries. Besides, in case of the development of a coronary artery disease in RA patients, the worst survival rate after a heart attack was established. The available findings suggest that rheumatoid arthritis is a disease that makes a significant contribution to cardiovascular morbidity and mortality.