Cardiovascular disease for many years occupied a leading position in the structure of mortality in the world, and the level of morbidity and mortality in this disease remains high. This represents an important medical and social problem even in developed countries with modern health care system, causing damage to the economy and demography of states. In half of the cause of death the reason is coronary heart disease, the main manifestations of which may be occlusion or stenosis of the coronary arteries and heart rhythm abnormalities. Modern radiologic diagnosis are used in clinical practice for the study of cardiac patients. They allow to visualize the coronary arteries and to assess some of the morphometric parameters, but do not provide information about changes in the microvessels and the level of metabolism in the muscle cells of myocardium and cardiac conduction system. Thus, the necessity of a comprehensive scientific study, which will determine the existence of correlation between the structural and functional organization of morphometric parameters of various diameter vessels of the heart and metabolic processes in the myocardium. The results of this research will enable the development and widespread use in clinical practice, effective noninvasive diagnostic severity of heart failure, to expand the arsenal of interpretations used in clinical practice, methods of examination of patients with cardiac disease. This will facilitate early diagnosis, improve the prevention and therapy of cardiovascular diseases, and, in general, improve outcomes in these patients.

Treatment of heart valves pathology is an actual problem of modern medicine. Aortic valve pathology is widely spread in population on a stable high level. Aortic valve pathology is a common disease in elderly patients with no possibility or high-risk of open surgical treatment. Modern hybrid methods of treatment, such as transcatheter aortic valve implantation are now being actively proposed and modified. MSCT angiography before transcatheter aortic valve implantation is a method of choice. Data obtained by MSCT is extremely necessary to define the possibility and the access path of transcatheter aortic valve implantation. MSCT allows to select the size and type of aortic valve prosthesis. Appearance of modern MSCT scanners with 320-640 row of detectors will increase the leading role of MSCT in preoperative inquiry of patients with planned transcatheter aortic valve implantation.

The purpose of this work was to evaluate of viability of a myocardium and assessment prognostic value of myocardial contrast delayed enhancement with 64-slice multidetector computed tomography after ST-elevation acute myocardial infarction (AMI). Methods. In study were included 117 patients with first AMI. Multidetector computed tomography (MDCT) with contrast enhancement was performed in all patients in 3-5 days and at 12 month after AMI. In arterial phase were evaluation myocardial perfusion defect, end-systolic, end-diastolic volume and ejection fraction of LV. In delay phase we detected 3 types of contrast enhancement of infarct zone: subendocardial residual defect (RD) (viable myocardium - type 1), transmural myocardial contrast delayed enhancement (DE) with or without RD (nonviable myocardium - 1and 2 types). LV remodelling was defined as an increase in LVEDV of >20 % at 12 months after infarction compared with that based on measurements in individual patients. Results. Myocardial perfusion defect was less in patients with viable myocardium 1 [0.4-2.4] versus 7.3 [5.3-10.0] and 6.3 [5.0-15.0] in patients with DE and with or without RD, respectively, p<0.001. During the 12-month period, LV remodelling was observed in 19.3 % patients with non-viable myocardium. Multivariable Cox proportional hazards regression analysis indicated that the number of LV segments with transmural DE (infarct size) was a significant independent predictor for the prediction of LV remodelling. Conclusions. The number of LV segments with transmural DE on MDCT may provide promising information for predicting LV remodelling and cardiac events in patients with AMI.

Evaluate the patency of aorto-coronary and mammarno-coronary bypass grafts by MSCT in patients with high surgical risk, in the early and late periods after CABG surgery. The study included 85 patients who underwent CABG surgery. All patients underwent MSCT in 1.5-3 months after surgery (1 point) and after 9-12 months (2 point). According to the MSCT at early postoperative period 21.7 % of occluded venous bypass grafts, 0.3 % of mammary grafts and 16 % of significant stenoses of venous bypasses were found. At the 2 control point 7 % of occluded vein grafts and 0.4 % of significant stenoses of the venous grafts was determined, stenotic changes in mammary grafts were not detected.

To evaluate the possibility of magnetic resonance imaging (MRI) in determining the stability of atherosclerotic plaques in patients with multifocal atherosclerosis, comparing with the data of histological examination. Using magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were examined 37 patients with carotid stenosis of more than 70 %. The study was conducted at 3T scanner using 16-channel neurovascular and carotid specialized 8-channel coils. The study protocol consisted of a standard time-of-flight angiography in 3D, T1-, T2-and proton-weighted (PD) sequence in axial projection, with a slice thickness of 1-2mm. Further, most of the patients was performed carotid endarterectomy, with subsequent histological processing and evaluation of the resulting material structure atheroma. In 23 cases the patients had signs of instability, such as hemorrhage into the plaque and/or thrombosis, a large (>40 %), lipid/necrotic core. Which was confirmed by histological findings of the study. This paper gives an indication of the high efficiency of this method in determining the stability of atherosclerotic plaques.

The aim of the study was to assess effectiveness of MRI and contrast-enhanced MRI in studies patients with chronic myocardial infarction. 97 pts with CMI were studied with contrast-enhanced cardiac MRI before and 50 - after surgery. All pts were examined with cine-MRI (for function analysis) and contrast late enhancement MRI. A total of 1649 segments were analysed before and 850 after operation. Wall motion improvement was demonstrated in 62.5 % segments with 0-50 % late inhancement and only 6.2 % segments with severe contrast enhancement (>50 %).

Assess the state of myocardial energy metabolism in patients with arterial hypertension (AH) and left ventricular hypertrophy (LVH) according to 31P magnetic resonance spectroscopy (31P MRS) compared with healthy individuals. The study included 46 people, 30 healthy volunteers (group I) who do not have cardiovascular disease (CVD) and 16 hypertensive patients with LVH (group II). All persons included in the study was performed MRI and MRS of the heart on high field MRI Achieva 3T TX (Philips, The Netherlands). We used the ISIS localization, adiabatic impulse with iterative shimming. To assess myocardial energy metabolism in patients with hypertension and LVH we used two energy indexs: PCr/ATP (the ratio of the concentrations of phosphocreatine to adenosine triphosphate), and Pi/PCr (the ratio of the concentration of inorganic phosphate to phosphocreatine). Index value of PCr/ATP in the group I was 2.08±0.35, in group II - 1.66±0.11, (p <0.05). The value of Pi/PCr in group I was 8.87±3.14, in group II - 13.5±3.3 (p<0.05). 31P MRS can be used to determine the status of myocardial energy metabolism in patients with hypertension and LVH.

To determine the diagnostic value of stress-echocardiography with combined agents in diagnosis of late coronary stent restenosis. 67 patients with symptoms of cardialgia aged from 38 to 56, who underwent coronary balloon angioplasty and stent implantation from 4 to 8 years ago, were included in the study. To determine coronary stent restenosis all patients underwent stress-echocardiography (stress-echoCG) in the protocol dobutamine/ transesophageal atrial pacing (TEAP) and follow up coronary angiography (CAG). The results of stress-echoCG from 62 patients can suggest the presence of restenosis of stent-implanted artery, in 5 cases - stenosis of noninvolved coronary arteries, that was confirmed during CAG. Opinion of coronary stent restenosis was based on detection of local contractility impairment zones in vascular depended region of stent-implanted artery. CAG revealed restenosis of coronary stent >70.0 % in 28 patients, from 40.0 % to 70.0 % in 28 patients. In 6 cases de novo segmental stenosis in stent-implanted artery were observed, which localized distal or proximal to intact stent. In 3 patients zones of local contractility impairment revealed by stress-echoCG corresponds with stenosis of noninvolved circumflex arteries in 2 patients, in 3 patients - left anterior descending artery stenosis. Accuracy, sensitivity and specificity of stress-echoCG in diagnosis of coronary stents restenosis as well as noninvolved coronary arteries stenosis appeared to be correspondently 91.0 %, 90.3 % and 100 %. Stress-echoCG is a high informative method of early topical diagnosis of coronary stents restenosis as well as noninvolved coronary arteries stenosis. Early diagnosis of coronary stents restenosis permit to produce low invasive endovascular intervention.

The article deals with possibilities of radiological methods in determination of microcirculatory disorders, metabolism and assessment of the the activity of pathological process in patients with sarcoidosis.

The article deals with modern abilities of radiologic assessment (computed tomography with angiography, single photon emission computed tomography SPECT) of rare interstitial lung diseases.

Radiologic diagnosis of exacerbations of chronic obstructive pulmonary disease (COPD) of unclear etiology is still an issue in patients with severe chronic obstructive pulmonary disease. Severe exacerbations of COPD are often caused by infectious factors, however, circulatory disorders in this group of patients may play a significant role in the development of life-threatening conditions, and their timely diagnosis is important in the prognosis of the disease, and quality of life.

The aim of this study was to identify the early echocardiographic marks of the myocardial dysfunction in patients with essential hypertension and atrial fibrillation. Forty-eight patients with essential hypertension including 24 patients with atrial fibrillation and were examined. Twelve healthy men were the control group. Clinical examination, echocardiography and tissue Doppler imaging were applied. It was shown that the early echocardiographic marks of the myocardial dysfunction in patients with hypertonic disease and paroxysmal form of atrial fibrillation are early diastolic and systolic longitudinal myocardial velocities of the left ventricle, as well as the reduction of the left atrium diastolic contribution. These patients have remodeling of the left atrium and more advanced systolic and diastolic dysfunction, compared with persons suffering from arterial hypertension without an arrhythmia.

Possibilities of the finger blood flow spectrum restoration through the analysis of the temperature oscillations have been investigated. Temperature measurements have been performed by dynamic thermography method; blood flow has been estimated from the envelope of the photoplethysmography pulse waves. Model, established the blood flow and the temperature oscillations relationships, has been used to restoration of the blood flow oscillations spectrum. Time-frequency spectral decomposition was carried out by means of the wavelet analysis, using the Morlet wavelet function. As a result of investigation, it was established that viewed method of the blood flow spectrum restoration allows to monitor of the blood flow oscillations in endothelial (0.005-0.02 Hz) as well as in neurogenic (0.02-0.05 Hz) frequency band. Velocity of propagation of the temperature signal in a biotissue increased with the frequency, i.e. it is appears dispersion of the thermal wave. Presented results create the basis of the non-contact temperature methods of the skin blood flow estimation.