Ischemic Etiology and Clinical Outcomes Following Cardiac Resynchronization Therapy

Optimal patient selection for cardiac resynchronization therapy is crucial. There are several concerns that allow to better clarify the association between the ischemic etiology of heart failure and the response to cardiac resynchronization therapy. The type of ischemic coronary disease has an impact on the responses to cardiac resynchronization therapy. The prognostic impact of cardiac resynchronization therapy on cardiac death including heart transplantation and durable ventricular assist device implantation is another concern.

The changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease

Introduction: Exercise-based cardiac rehabilitation improves endothelialBackground/Aim. Exercise-based cardiac rehabilitation improves endothelial function, reduces cardiac mortality and anginal symptoms in patients with established cardiovascular disease. We evaluated the changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease (IHD) participating in a cardiovascular rehabilitation exercise program. Methods. Thirty-five patients with stable IHD engaged in cardiovascular rehabilitation program with the regular aerobic physical activity during 6 weeks were consecutively included together with 37 control, age and sex-matched, IHD patients with a sedentary lifestyle. Clinical data about anthropometric and cardiovascular parameters and laboratory data: serum cell adhesion molecules intracellular (sICAM-1) and vascular (sVCAM-1), reactive carbonyl derivatives (RCD), lipid peroxidation products malondialdehyde (MDA) and nitric oxide (NO) concentration were determined at the beginning and after 6 weeks of aerobic training (45 minutes of continuous exercise up to 80% of maximal heart rate, 3 times a week). Results. The baseline characteristics of examined groups were similar according to age, gender, and cardiovascular risk profiles. The regular aerobic physical activity induced significant reduction of body mass index, blood pressure, heart rate, triglycerides, RCD (1.27 ? 0.48 ?mol/g proteins vs. 1.04 ? 0.22 ?mol/g proteins), sVCAM-1 [100.4, interquartile range (IQR)(78.4?118.3) ng/mL vs. 80.0 IQR(68.5?97.2 ng/mL)] and increasing of NO (64.72 ? 16.06 nmol/mg proteins vs. 74.38 ? 18.57 nmol/mg proteins) and HDL cholesterol (p < 0.05), which was not seen in sedentary control RCD (1.16 ? 0.25 interquartile range vs. 1.12 ? 0.14 interquartile range), sVCAM-1 [92.2 IQR (73.6?106.8 ng/mL) vs. 91.3 IQR (73.0?105.3 ng/mL) and NO (68.5 ? 17.9 nmol/mg vs. 65.7 ? 19.6). The values of sICAM-1 were lower in exercise training group baseline without significant changes during observation [80.74 IQR (54.92?97.3) vs. 80.36 IQR (68.1?95.3)] compared to the control

HYBRID REVASCULIZATION AS METHOD OF SURGICAL TREATMENT OF ISCHEMIC CORONARY DISEASE IN NUMEROUS LESIONS OF CORONARY BED

Hybrid revasculization of myocardium combined the advantages of mammary-coronary bypass surgery and coronary arteries stenting. It presented itself as a perspective direction in treatment of ischemic coronary disease. The article provides the results of comparison of usage of hybrid revasculization of myocardium and aortocoronary bypass in 71 patients with multivessel coronary artery disease. The data obtained indicated, that hybrid approach allowed complete revasculization of the myocardium (as in case of aortocoronary bypass), fast recovery of the patient, shortening a hospital stay due to decrease of intra- and postoperative complications.