Treatment Of Cardiovascular System Diseases Research Articles

Reconstruction of central arterial pressure waveform based on CBi-SAN network from radial pressure waveform

The central arterial pressure (CAP) is an important physiological indicator of the human cardiovascular system which represents one of the greatest threats to human health. Accurate non-invasive detection and reconstruction of CAP waveforms are crucial for the reliable treatment of cardiovascular system diseases. However, the traditional methods are reconstructed with relatively low accuracy, and some deep learning neural network models also have difficulty in extracting features, as a result, these methods have potential for further advancement. In this study, we proposed a novel model (CBi-SAN) to implement an end-to-end relationship from radial artery pressure (RAP) waveform to CAP waveform, which consisted of the convolutional neural network (CNN), the bidirectional long-short-time memory network (BiLSTM), and the self-attention mechanism to improve the performance of CAP reconstruction. The data on invasive measurements of CAP and RAP waveform were used in 62 patients before and after medication to develop and validate the performance of CBi-SAN model for reconstructing CAP waveform. We compared it with traditional methods and deep learning models in mean absolute error (MAE), root mean square error (RMSE), and Spearman correlation coefficient (SCC). Study results indicated the CBi-SAN model performed great performance on CAP waveform reconstruction (MAE: 2.23 ± 0.11 mmHg, RMSE: 2.21 ± 0.07 mmHg), concurrently, the best reconstruction effect was obtained in the central artery systolic pressure (CASP) and the central artery diastolic pressure(CADP) (RMSECASP: 2.94 ± 0.48 mmHg, RMSECADP: 1.96 ± 0.06 mmHg). These results implied the performance of the CAP reconstruction based on CBi-SAN model was superior to the existing methods, hopped to be effectively applied to clinical practice in the future.

Analysis of Potentially Inappropriate Drug Prescribing in Hospitalized Elderly Patients

Abstract The study was conducted at the Clinical Centre Kragujevac, during the period March-May 2016. The study population consisted of patients older than 65 that were treated at different departments of the Clinic for Internal Medicine. Data were collected from hospital medical records of patients and anonymous semi-structured questionnaires. STOPP (screening tool of older people's prescriptions)/ START (screening tool to alert to right treatment) criteria from 2014 were used to monitor the outcome of interest. Based on the outcome PIM (potentially inappropriate drugs)/PPO (potential prescribing omissions), respondents were divided into groups of cases - patients to whom at least one potentially inappropriate drug determined by STOPP criteria was prescribed and those with at least one potential prescribing omission determined by START criteria. Control groups were patients without these outcomes. Most commonly, PIM was detected in the treatment of cardiovascular system diseases (27.12%), followed by the use of drugs that predispose falls in elderly (20.34%). The most important risk factors for the occurrence of PIM were female gender (OR=3.27; 95% CI 1.01-10.64), polypharmacy (5-8 drugs used simultaneously) (OR=3.10; 95% CI 1.11-12.04) and with whom the patient lives (OR=11.26; 95% CI 1.46-86.68). The use of STOPP/START criteria is proved to be efficient in the detection of PIM/PPO at the secondary level of health care. Full attention should always be paid to patients who are at the highest risk for inappropriate drug prescription. Doctors should make their decisions conscientiously and in line with clinical evidence, not blindly believing the pharmaceutical representatives.

Reconstruction of central arterial pressure waveform based on CNN-BILSTM

Central arterial pressure is an important physiological indicator of the human cardiovascular system. Its noninvasive, continuous and accurate reconstruction and monitoring are essential to the evaluation, prevention and treatment of cardiovascular system diseases. However, it is difficult to improve the accuracy of noninvasive central arterial pressure reconstruction by traditional methods, which limits its clinical application and promotion. In this study, a model for reconstructing central artery pressure from radial arterial pressure waveforms based on a convolutional neural network and bi-directional long short-term memory (CNN-BiLSTM) was proposed. Central aortic pressure waveforms and radial arterial pressure waveforms were measured invasively before and after medication in 62 patients to evaluate the CNN-BiLSTM model for reconstructing central artery pressure. The CNN-BiLSTM model was compared with two traditional methods (autoregressive exogenous (ARX) and N-point moving average method (NPMA)) and four deep learning models (LSTM, BiLSTM, LSTM-BiLSTM and CNN-LSTM) in the mean absolute error (MAE), root mean square error (RMSE) and Spearman correlation coefficient (SCC). Experimental results showed that the proposed model achieved the best results on waveform reconstruction (MAE: 2.18 ± 0.13 mmHg, RMSE: 2.95 ± 0.16 mmHg). At the same time, a good reconstruction effect was obtained in the central arterial systolic pressure (RMSE: 3.34 ± 0.91 mmHg) and diastolic blood pressure (RMSE: 2.41 ± 0.18 mmHg). Therefore, the reconstruction model based on CNN-BILSTM is a potential method for noninvasive continuous monitoring of central arterial pressure.

Possibilities of carboxytherapy for diseases of the cardiovascular system

The aim of the study was to analyze the mechanisms of action and pharmacodynamics of carboxytherapy in diseases of the cardiovascular system (CVS). Materials and methods. An analysis of domestic and foreign experience in the use of carboxytherapy for diseases of CVS. Results and discussions. The mechanism of action of carboxytherapy is based on the principle of the introduction of carbon dioxide (CO2) in the patient's body, due to which many pathological disorders can be eliminated. Inhalation and non-inhalation introduction of CO2 into the body has been used for medicinal purposes for many decades. The empirical (off label) use of this therapy in course of time has gained a wide clinical evidence base. There is a large amount of clinical evidence in the world of the effective use of carboxytherapy in many fields of medicine, including those with CVS diseases. It is proved that CO2 introduced into the body penetrates freely through cell membranes and has antihypoxic, vasodilating, antioxidant, anti-ischemic, antispasmodic and other positive effects. Therefore, carboxytherapy contributes to a complex of pharmacological effects inherent of traditional antianginal, hypotensive, antispasmodic and other drugs that are widely used in the treatment of CVS diseases. Conclusions. An analysis of domestic and foreign experience in carboxytherapy shows that the effects of CO2 in diseases of the CVS are achieved by improving oxygenation and microcirculation, anti-anginal, anti-inflammatory, antihypertensive, antispasmodic, anti-oxidant, and analgesic effects of this gas. Carboxytherapy is an alternative, promising and safe method of treating diseases of the cardiovascular system.

ZnO nanorods functionalized with chitosan hydrogels crosslinked with azelaic acid for transdermal drug delivery

The growing number of people suffering from civilization diseases increases the amount of medication taken. Thus, novel methods for drug delivery must be developed which will constitute an alternative to oral administration. A new hope for patients bring transdermal drug delivery systems. To overcome skin barrier function, they must be prepared from materials which increase cell membrane permeability for the medication. Therefore, there is an increasing need for novel, advanced transdermal systems capable of controlled active substance release under specific stimuli. The aim of this research was to obtain novel hydrogel-based transdermal delivery systems through crosslinking process of chitosan using azelaic acid followed by doping with ZnO nanorods to enhance its drug sorption properties. Ready materials were investigated over their structure, morphology and durability. Drug loading capacity, controlled drug release ability and its kinetics were determined on medication used in treatment of cardiovascular system diseases - acetylsalicylic acid. Finally, lack of cytotoxicity was confirmed by XTT assay and cell morphology study carried out on L929 mouse fibroblasts. Obtained results show a great potential of the developed transdermal delivery systems in active substances administration through skin tissue and may help to protect digestive tract of the patients in the future.

Structural and molecular basis of angiotensin-converting enzyme by computational modeling: Insights into the mechanisms of different inhibitors.

Angiotensin-I converting enzyme (ACE) is a two-domain dipeptidylcarboxypeptidase involved in regulating blood pressure via the kallikrein-kininand renin-angiotensin-aldosterone complex. Therefore, ACE is a key drug target for the treatment of cardiovascular system diseases. At present many works are focus on searching for new inhibitory peptides of ACE to control the blood pressure. In order to exploit the interactions between ACE and its inhibitors, molecular dynamics simulations were used. The results showed that (a) the secondary structures of the three inhibitor-protein complexes did not change significantly; (b) root-mean-square deviation (RMSD), radius of gyration (Rg), and solvent-accessible surface area (SASA) values of Leu-Ile-Val-Thr (LIVT)-ACE complexes were significantly higher than that of other systems; (c) the backbone movement of LIVT was vigorous in Asp300-Val350, compared with that in Tyr-Leu-Val-Pro-His (YLVPH) and Tyr-Leu-Val-Arg(YLVR), as shown by the center-of-mass distance; and (d) the backbone movement of Asp300-Val350 may contribute to the interaction between ACE and its inhibitors. Our theoretical results will be helpful to further the design of specific inhibitors of ACE.

Analiza zmian patologicznych w badaniu endoskopowym górnego odcinka przewodu pokarmowego u pacjentów przygotowywanych do planowej operacji kardiochirurgicznej

Wstęp: Współczesne leczenie chorób sercowo-naczyniowych w znacznym stopniu opiera się na hamowaniu czynności układu krzepnięcia krwi mającego na celu zmniejszenie ryzyka wystąpienia incydentów zatorowo-zakrzepowych. Leczenie to w warunkach ambulatoryjnych opiera się na podawaniu leków hamujących czynność płytek krwi lub stosowaniu antykoagulantów doustnych. Obecnie coraz większą popularnością cieszą się leki z grupy nowoczesnych antykoagulantów doustnych. W okresie przed- i okołooperacyjnym używane sąheparyny drobnocząsteczkowe, a w czasie samej operacji kardiochirurgicznej praktycznie zawsze stosowana jest heparyna. Obecność nadżerek lub wrzodów w górnym odcinku przewodu pokarmowego (GOPP) u operowanych pacjentów może zwiększać ryzyko okołooperacyjnego krwawienia z GOPP.Celem pracy była analiza częstości występowania zmian patologicznych w GOPP u chorych przygotowywanych do planowych operacji kardiochirurgicznych.Wnioski: W badaniu endoskopowym zmiany patologiczne w GOPP stwierdzono u ponad 50% chorych przygotowywanych do planowych operacji kardiochirurgicznych. Przedoperacyjna diagnostyka i protokół ochrony farmakologicznej redukują ryzyko krwawienia z GOPP.

METABOLITHOTROPIC ASPECTS OF CARDIOPROTECTIVE ACTION OF NEW COMBINED MEDICINE BASED ON L-ARGININE AND THIOTRIAZOLIN AT MODELING OF MYOCARDIAL INFARCTION

Objectives: The actual problem of modern medicine is the development of medications in treatment of cardiovascular system diseases. Different combinations of L-arginine with thiotriazolin in acute myocardial ischemia were examined as part of study and the optimal combination has been established - 4:1, named “Argitryl.” The aim is to study the antioxidant, energotropic, and nitric oxide (NO)-modulating mechanisms of the cardioprotective effects of L-arginine with thiotriazolin (4:1) (Argitryl) drug candidate compared to 4.2% solution for injections “Tivortin” (TOV “Yuriya-Farm,” Ukraine) on the model of pituitrin-isadrin infarction of myocardium in laboratory rats.Methods: The study was conducted in accordance with Guidelines of State Expert Center of the Ministry of Health of Ukraine. All manipulations were carried out in accordance with the “European Convention for the protection of vertebrate animals used for experimental and other scientific purposes.” The experiments were performed on 40 white outbred rats weighing 170–180 g. The antioxidant activity of the drugs was assessed by reduction of biochemical marker oxidative stress and an increase in the activity of the antioxidant system of the myocardium.Results: The study of energy metabolism has shown that the modeling of myocardial infarction leads to typical ischemic injuries - decrease in ATP, discoordination of the Krebs cycle, activation of anaerobic glycolysis in the cytosolic fraction of the heart of rats from the control group. Administration of Tivortin to animals does not lead to a significant decrease in ischemic injuries in the energy metabolism of the myocardium. The brightest anti-ischemic effect was observed with the appointment of “Argitryl.”Conclusion: The ascertained braking reaction of oxidative stress compared to the control group was found as a result of administration of Argitryl and Tivortin to animals with pituitrin-isadrin myocardial infarction. It was also found that the administration of Argitryl and Tivortin has a positive effect on the indices of the energy metabolism of the ischemic myocardium and leads to the normalization in conjugated NO system/renewed thiols. Argitryl significantly exceeds Tivortin on the influence of antioxidant, energy-tropic, and NO-modulating mechanisms of cardioprotective and anti-ischemic action on the studied indicators

Monitoring the quality consistency of Fufang Danshen Pills using micellar electrokinetic chromatography fingerprint coupled with prediction of antioxidant activity and chemometrics.

A fast micellar electrokinetic chromatography fingerprint method combined with quantification was developed and validated to evaluate the quality of Fufang Danshen Pills, a traditional Chinese Medicine, which has been used in the treatment of cardiovascular system diseases, in which the tetrahedron optimization method was first used to optimize the background electrolyte solution. Subsequently, the index of the fingerprint information amount of I was performed as an excellent objective indictor to investigate the experimental conditions. In addition, a systematical quantified fingerprint method was constructed for evaluating the quality consistency of 20 batches of test samples obtained from the same drug manufacturer. The fingerprint analysis combined with quantitative determination of two components showed that the quality consistency of the test samples was quite good within the same commercial brand. Furthermore, the partial least squares model analysis was used to explore the fingerprint-efficacy relationship between active components and antioxidant activity in vitro, which can be applied for the assessment of anti-oxidant activity of Fufang Danshen pills and provide valuable medicinal information for quality control. The result illustrated that the present study provided a reliable and reasonable method for monitoring the quality consistency of Fufang Danshen pills.

Effects of vitexin-2″-O-rhamnoside and vitexin-4″-O-glucoside on growth and oxidative stress-induced cell apoptosis of human adipose-derived stem cells

Vitexin-2"-O-rhamnoside (VOR) and vitexin-4"-O-glucoside (VOG) are the two main flavonoid glycosides of the leaves of Cratagus pinnatifida Bge. var. major N. E. Br. that has been widely used for the treatment of cardiovascular system diseases. In this study, we simultaneously investigated the influence of VOR and VOG on human adipose-derived stem cells (hADSCs) injury induced by hydrogen peroxide (H2 O2 ) to further characterize their anti-oxidative and anti-apoptotic activity. hADSCs were isolated, cultured in vitro and pretreated with 62.5 μm VOR or 120 μm VOG for 24 h and then exposed to 500 μm H2 O2 for an additional 4 h. Pretreatment of hADSCs with VOR and VOG was demonstrated to significantly ameliorate the toxicity and apoptosis effects, such as morphological distortion, nuclear condensation, decreased intracellular caspase-3 activity and percentage of cells in apoptosis/necrosis by using morphological assay, immunocytochemistry and flow cytometric evaluation. In addition, VOR and VOG caused no cytotoxic effect on hADSCs at concentrations up to 250 and 480 μm, respectively. Our results indicated that both VOR and VOG contribute to the protection against H2 O2 -mediated oxidative stress damage and could be safely used for a wide range of concentrations.