One of the manifestations of ischemic cardiomyopathy is remodeling of left ventricular (LV), which can manifest itself both globally and as a result of an aneurysm. In the vast majority of cases, LV aneurysm location is the apex and the anterior septal region; very rarely, aneurysms are localized in the area of the posterior LV wall and are large. Due to the relative rarity of the given localization surgical treatment tactics of this pathology is not well-established and standardized. The work presents a clinical case of surgical treatment of an aneurysm of the LV posterior wall, demonstrates the stages of diagnosis, and also identifies the features of surgical intervention with the results of treatment in 6 months after surgery.

Aim: To access frailty and its impact on 10-year survival in patients with implanted devices for cardiac resynchronization therapy (CRT).

Methods: 77 patients with congestive heart failure (74% men, 26% women; mean age of 58.7 ± 10.7 years) with NYHA class II–IV were enrolled. Frailty Index was calculated using 31 parameters (the ability to perform daily activities, clinical status, laboratory markers, comorbidities). Based on the frailty index patients were identified as not frail (< 0.375; n = 41; 53%), and frail (≥ 0.375; n = 36; 47%).

Results: The mean follow-up period was 49.0 ± 34.2 months. Survival at 10-year follow-up was 87.5% for non-frail patients, compared to 47.2% for frail patients (log-rank test p < 0.001). In univariate analysis, frailty associated with 10-year mortality (OR 7.824; 95% CI 2.495 – 24.533; p < 0.001). After adjustment for age, gender, rhythm, NYHA class, left ventricular ejection fraction, left bundle branch block, and QRS width, frailty remained a significant prognostic factor associated with 10-year mortality (OR 9.528; 95% CI 2.720 – 33.368; p < 0.001). Also, according to logistic regression, the presence of frailty reduced the chance of superresponse (decrease of left-ventricular end -systolic volume ≥ 30%) to CRT (OR 0.278; 95% CI 0.100–0.770; p = 0.014).

Conclusion: Frailty is widespread in patients with heart failure and implanted devices for CRT. In these patients frailty is associated with a more than seven-fold increased risk of death during 10-year follow-up and with a lower chance of superresponse to CRT.

Background. Aortic dissection remains one of the most challenging cardiovascular pathologies for radical surgical treatment. The frozen elephant trunk (FET) procedure allows simultaneous reconstruction of the aortic arch and descending thoracic aorta. However, long-term outcomes are largely determined by postoperative aortic remodeling.

Aim: To compare aortic remodeling after implantation of dissection-specific versus conventional hybrid prostheses using a standardized protocol and to assess the incidence of specific complications – distal stent graft-induced new entry (dSINE) and endoleaks.

Material and Methods. This prospective single-center study included 106 patients with aortic dissection who underwent FET between 2014 and 2025. Patients were divided into two groups: Group 1 (n = 56) – “Soft Elephant Trunk” hybrid prosthesis (MedInzh, Russia); Group 2 (n = 50) – conventional hybrid prostheses (E-Vita Open Plus, Thoraflex Hybrid, Medtronic Valiant). Remodeling was assessed according to a patented protocol (RU 2841599 C1), including planimetry (area, perimeter) at 7 aortic levels and volumetry in 3 segments using CT before surgery, postoperatively, at 6 months, and annually up to 5 years. Remodeling was classified according to Dohle DS criteria as positive (PR), negative (NR), or stable (SR).

Results. At critical stent graft implantation levels (2–4), Group 1 showed a consistent decrease in NR and an increase in PR, whereas Group 2 demonstrated an irregular pattern with frequent NR episodes. Volumetric assessment revealed stable remodeling in Group 1, while Group 2 showed NR progression at 4–5 years. The 5-year incidence of dSINE was significantly lower in Group 1 (8.9% vs. 42.9%; p = 0.001). Use of a dissection-specific hybrid prosthesis was associated with a reduced risk of dSINE (OR 0.10; 95% CI 0.02–0.36; p = 0.001), while type B dissection increased the risk (OR 10.46; 95% CI 2.37–62.68; p = 0.004). Late (>5 years) type 1b endoleaks occurred more frequently in Group 2 (31.4% vs. 7.1%; p = 0.009).

 Conclusions. The use of dissection-specific hybrid prostheses in aortic dissection surgery provides more stable positive remodeling and reduces the incidence of dSINE and late endoleaks compared with conventional prostheses. The standardized planimetric and volumetric protocol allows reliable monitoring of remodeling and timely identification of indications for reintervention.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, had a profound impact on global health, and society and become one of the deadliest in history. Knowledge of risk factors for mortality is critically important in the formation of organizational, methodological and clinical decisions to limit disease progression and reduce the number of fatal outcomes. However, it is still unclear whether generally accepted risk factors can be equally useful in identifying risk groups in a diverse population of patients in small cities.

Aim: To evaluate the utility of demographic, clinical, and laboratory characteristics in the prediction of negative outcome of patients with COVID-19 admitted to the intensive care unit (ICU) of the multidisciplinary COVID-19 hospital in the city of Saransk.

Material and Methods. Medical records of 153 patients (including 134 recovered and 19 dead) with laboratory-confirmed SARS-CoV-2 infection treated in the intensive care unit of the S.V. Katkov Republican Clinical Hospital between March and December of 2020 were included in this retrospective, single-center, clinical trial. Demographic, clinical, and laboratory characteristics, complications and therapeutic interventions were compared between deceased and recovered patients. The primary endpoint was in-hospital all-cause mortality. Risk factors for mortality were analyzed using logistic regression.

Results. Multivariate regression analysis showed that in the population studied, included both therapeutic and surgical patients, a history of coronary artery disease, chronic non-specific lung disease, acute surgical conditions, plasma creatinine at ICU admission ≥ 106 µmol/L had a negative effect on in-hospital mortality, whereas fever at admission had a protective effect. Patients who died had lower oxygen saturation upon the admission to ICU and were more likely to receive invasive mechanical ventilation and higher doses of dexamethasone in treatment.

Conclusion. The present study identified predictors to mortality of patients with COVID-19, treated in the ICU of a Mordovia Republic hospital (Russia), which were somewhat different from those previously reported for larger cities and indicate a large contribution of concomitant diseases to the negative outcome. We did not identify a significant contribution of many proposed laboratory markers to predicting mortality. These findings may help authorities and clinicians optimize organizational, methodological, and clinical approaches to medical care of patients to reduce the risk of a negative outcome from COVID-19.

A review of domestic and foreign scientific publications from 2018 to 2023 was conducted. The search was carried out using the Pubmed biomedical research database and the Russian Science Citation Index. 1673 articles were found, using keywords. Various etiological and pathogenetic variants of gastroduodenitis (GD) are considered. One of the most common pathogens of gastroduodenal pathology is Helicobacter pylori (Hp), which, due to its virulence factors, can persist for a long time on the mucous membrane of the stomach and duodenum, thereby causing its inflammation, subsequently leading to gross damage to the mucosa and complications of gastrointestinal tract. Today, despite the prevalence of Hp, many new etiological agents are found: cytomegalovirus, Epstein - Barr viruses, Lamblia intestinalis, Blastocystis spp., Entamoeba spp. and various factors contributing to the development of this disease. For example, such as human constitution, environment, gender differences, age, genetics, drug exposure, stress, the relationship of perinatal brain lesions, endothelial dysfunction and immunity with the detection of GD has also been described. Every year the range of etiological agents expands, which leads to changes in the pathogenesis of GD.

Introduction. The relevance of this work is due to the high incidence of pacemaker-induced cardiomyopathy (PICM) associated with chronic right ventricular pacing, reaching up to 30% in the pediatric population. Current evidence suggests the benefits of left ventricular (LV) pacing in preserving contractile function and intraventricular synchrony. This study presents the immediate and long-term results of epicardial LV pacemaker lead implantation in children.

Aim: To retrospectively assess epicardial left ventricular (LV) pacing in children with atrioventricular blocks (AVB).

Material and methods. This single-center retrospective study included patients with clinically significant atrioventricular (AV) block who underwent implantation of an epicardial pacing system with the ventricular lead localized in the LV apex. In the early and late postoperative periods, all patients underwent a comprehensive examination, including: 12-channel electrocardiography (ECG) with assessment of the QRS complex width, pacemaker function control, 24-hour Holter monitoring, echocardiography (EchoCG) according to a standard protocol with determination of LV contractile function parameters, chest X-ray in the frontal and lateral views. To minimize the influence of anthropometric variability in childhood, such EchoCG parameters as LV end-diastolic volume, as well as the sizes of the left and right atria were expressed as a percentage of the expected values, taking into account weight and height characteristics. Additionally, intraventricular dyssynchrony (IVD) was assessed using tissue Doppler ultrasonography and global longitudinal strain (GLS) of the LV using Speckle-tracking echocardiography.

Results. From 2013 to 2024, 36 patients underwent primary implantation of an epicardial pacemaker system with the ventricular lead localized at the apex of the LV (33 dual-chamber systems in DDD mode, 3 single-chamber systems in VVI mode). The age of patients at the time of surgery was 4 [1;7] years, from 14 days to 14 years. There were no clinical signs of heart failure and echocardiographic markers of PICMP in the entire group in the early postoperative period and during long-term follow-up (up to 9 years). During long-term follow-up (up to 9 years), all patients had no clinical signs of heart failure and echocardiographic markers of PICMP, including IVD and increased LV GLS.

Conclusion. Epicardial LV pacing in children with AVB demonstrates favorable long-term results, including preservation of systolic function, intraventricular synchrony, and absence of signs of PICMP. The data obtained confirm the advisability of choosing the LV apex as the optimal implantation point in this category of patients.

Introduction. Radionuclide imaging of somatostatin receptor type 2 (SSTR-2) shows great promise as a novel marker of cardiovascular inflammation. However, it is still unclear whether local inflammation and high levels of macrophages in the infarct area that overexpress SSTR-2 are positive or negative factors for myocardial healing.

Aim. To evaluate the relationship between inflammatory biomarkers as indicators of the systemic response to ischemic injury and the local inflammatory response in the myocardium, as measured by SSTR-2-targeted imaging, during the early post- infarction period.

Material and methods. Twenty-three patients with acute primary anterior wall myocardial infarction and ST-segment elevation myocardial infarction (STEMI) were included in the study. On the first day (before PCI) and on the fifth day after AMI, venous blood was collected from all patients to determine hsCRP and IL-6 levels. Five to six days after the acute coronary event, all patients underwent SPECT/CT with ^99mTc-Tektrotyd. Seven days after the acute coronary event, they underwent myocardial perfusion scintigraphy with ^99mTc-MIBI at rest.

Results. The results of the study indicated a negative correlation between hs-CRP and IL-6 levels on days 1 and 5 with left ventricular ejection fraction (LVEF) and a positive correlation with the summed rest score (SRS). Concurrently, SUVmax exhibited no correlation with hsCRP and IL-6 levels. Concurrently, SUVmax exhibited a moderate correlation with SRS (r = 0.517, p = 0.011). In the context of univariate linear regression, SUVmax demonstrated no statistically significant impact on hs-CRP and IL-6 levels. Concurrently, the total resting perfusion defect score (SRS) exerted an influence on the alteration in the levels of inflammatory biomarkers. It is also noteworthy that no regression relationship was identified between SUVmax and SRS.

Conclusion. The findings indicated that the intensity of accumulation of somatostatin analog ^99mTc-Tectrotyd in the left ventricular myocardium during the early postinfarction period is not associated with the levels of inflammatory biomarkers. Our findings indicate the activation of cellular and biochemical pathways of the inflammatory cascade. Conversely, the study identified a potential anti-inflammatory function of somatostatin receptor type 2 hyperexpression.

Introduction. Today, one of the urgent health problems is the increasing antibiotic resistance of pathogenic microorganisms. In this regard, there is an increasing need to find new antimicrobial agents for medical use. Benzophenazine derivatives may be an example of promising antimicrobial agents. This article presents a study of the antimicrobial properties of newly synthesized compounds of the benzophenazine group.

Aim: To evaluate the antibacterial and antifungal potential of benzophenazine derivatives under experimental conditions in vitro.

Material and Methods. The antimicrobial activity of a panel of benzophenazine derivatives – unsubstituted benzophenazin-5-ol (VN-13), o-methylated benzophenazin-5-ol (VN-16-3), 4,5-difluorobenzophenazin-5-ol (VN-11), and o-methylated 4,5-difluorobenzophenazin-5-ol (VN-35-3) – was assessed by titration in sterile 96-well plates, followed by plating on solid media. The antimicrobial activity of the compounds was evaluated against pathogens of infectious diseases such as Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, Streptococcus agalactiae, Pseudomonas aeruginosa, MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant Enterococcus), CRAB (carbapenem-resistant Acinetobacter baumannii), Burkholderia cenocepacia, Candida albicans. The antibacterial and antifungal potential of the compounds was assessed by the presence or absence of microbial colony growth at various concentrations of the benzophenazines (from 2000 μg/ml to 0.016 μg/ml).

Results. The study results demonstrated that all tested benzophenazine derivatives exhibited antibacterial activity against Streptococcus agalactiae and Burkholderia cenocepacia. Against other tested strains, including multidrug-resistant ones, only unsubstituted benzophenazine-5-ol (VN-13) showed activity. Pseudomonas aeruginosa and Escherichia coli ATCC 25922 were resistant to all studied compounds.

Conclusion. Benzophenazine derivatives demonstrate bactericidal or bacteriostatic activity against a number of bacteria, including polyresistant strains, as well as fungi of the genus Candida. Based on the results obtained, it is possible to assume the relevance of further research in the direction of studying the efficacy and safety of benzophenazines as promising antimicrobial agents.