Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. Low-grade chronic inflammation plays a major role in the progression of CVD. The review examines the role of interleukin-1 (IL-1) family cytokines in the development of CVD. IL-1 family cytokines play an important role in the progression of atherosclerosis, the development of myocardial infarction (MI), and chronic heart failure (CHF). The review presents data on the mechanisms of IL-1 action and the effectiveness of anti-IL-1 drugs in the prevention of CVD. Also, in this review, we consider the possibility of using changes in the composition of intestinal microbiota as a method of influencing the level of IL-1.

Introduction. Health problems, the high prevalence of cardiovascular risk factors, «early sports specialization» and frequent borderline changes in the cardiovascular system in young athletes are of particular interest to specialists. The problem of using specialized food products (SFP) for athletes of young age has not been resolved either. Objective. Assessment of the state of the brachial artery (BA) endothelium, eye sclera microvessels, blood parameters and performance of young athletes before and after a course of SFP based on apiculture components. Materials and methods. In 40 Olympic reserve athletes (16.1±0.4 years) were tested for reactive hyperemia and hyperventilation to assess flow-dependent vasodilatation (FDVD), constriction (FDVC), biomicroscopy of the sclera, spiroergometry, general and biochemical blood tests. Results. All athletes were found to have endothelial dysfunction (ED) of BA in the form of a violation of the FDVD, FDVC, an increase in the neurovegetative tension index (TI), cortisol and microcirculation spasm. After a course of SFP (honey bar), FDVD increased by 96% (p=0.0001), FDVC decreased by 2 times (p=0.0001), TI decreased by 40% (p=0.0001), and microvascular spasm by 65% (p=0.0001). Protein, red blood cells, hemoglobin, minerals and performance increased, while total cholesterol, triglycerides, cortisol and urea decreased. Conclusion. A decrease in FDVD, an increase in FDVC, high TI, increased cortisol and microcirculation spasm are manifestations of the overexertion syndrome in young athletes, which forms a spastic type of regional blood circulation, limiting performance and creating preconditions for the development of arterial hypertension. SFP in the form of a honey bar eliminates ED, microcirculation spasm, replenishes daily losses of nutrients, provides an increase in protein and minerals necessary for a growing body. Non-invasive methods for assessing BA and microcirculation are relevant and in demand in children’s sports.

Objective. Analyze sensitivity and specificity of perfusion computed tomography in diagnostics of occlusive disease of the supplying gluteal muscles arteries. Material and methods. In 138 patients with aortoiliac aneurysmatic and/or occlusive disease, lower extremity arterial disease and long-term period after reconstructive interventions follow up, computed tomographic angiography with perfusion assessment was performed. Results. Mean blood flow velocity indices in 276 gluteal muscles were divided into 3 groups: Group 1 (n = 82) – with arterial stenosis >50% or occlusion, leading to blood flow reduction in both gluteal artery and deep femoral artery basins; Group 2 (n = 105) – with blood flow reduction only in the gluteal arteries; Group 3 (n = 89) – without blood flow disorders in the gluteal arteries. The median of the mean blood flow velocity in the gluteus maximus and medius in the Group 1 was 7.5 and 6.1 ml/100 g/min, in Group was 8.1 and 5.7 ml/100 g/min, and in Group 3 was 10.0 and 7.9 ml/100 g/min, respectively. The mean blood flow velocity was statistically significantly lower in the gluteal muscles of Group 1 and 2 in comparison to Group 3, as well as in the gluteus maximus with the presence of symptoms of proximal claudication in comparison with its absence (8.0 vs 8.3 ml/100 g/min, respectively). The sensitivity and specificity of the method in diagnosing occlusive disease of the supplying arteries were 73% and 53%, respectively, at the level of the mean gluteus maximus blood flow velocity ≤ 9.8 mL/100 g/min. Conclusion. Perfusion computed tomography allows us to assess the severity of regional hypoperfusion of the gluteal muscles at rest.

Introduction. Ultrasound (US) is the first step in diagnosing soft tissue tumors (STT). However, standard US might not provide enough information to determine the nature of STT, particularly for rare or deep tumors. Malignant tumors are characterized by new blood vessel growth (neoangiogenesis), so technologies that can detect microcirculation and blood flow are crucial for diagnosing them. One of these technologies is contrast-enhanced ultrasound (CEUS). CEUS allows us to visualize the smallest blood vessels and evaluate their structure, making it a promising method for diagnosing changes in soft tissues. However, currently, there are no Russian studies published that explore its effectiveness. Objective. To determine the diagnostic effectiveness of CEUS in differentiating between benign and malignant STT and to compare its results with a study without contrast. Materials and methods. This retrospective study examined the results of scans from patients with STT who underwent multiparametric ultrasound examinations (mpUS). The mpUS used standard modes (Bmode, color Doppler mapping, sonoelastography) and contrast-enhanced ultrasound (CEUS). A crucial requirement was the availability of the pathology report, which acted as a reference standard. Results. Based on the results of the analysis of visualization and histological examination data, differential diagnostics of benign and malignant SST was performed; ultrasound without contrast enhancement (CE) had a sensitivity of 82% (CI 69–91 %), specificity of 61 % (CI 48–73 %), accuracy of 70 % (CI 61–78 %), positive predictive value of 63 % (CI 50–75 %), negative predictive value of 80 % (CI 66–90 %), and the area under the curve was 0.72 (good quality of the model). Adding the information obtained with CEUS significantly increased all the parameters: sensitivity – 94 % (CI 83–98%), specificity – 88 % (CI 78–95 %), accuracy – 91 % (CI 84–95%), positive predictive value – 87 % (CI 75–94 %), negative predictive value – 94 % (CI 85–98 %), and area under the curve – 0.91 (excellent quality of the model). Conclusions. The study revealed that ultrasound using only standard modes was significantly less accurate than CEUS. CEUS demonstrated a much higher ability to differentiate between benign and malignant STT. This makes CEUS a valuable tool for diagnosticians and oncologists. However, further research is needed to better understand the potential of CEUS and incorporate it into the diagnostic process for detecting soft tissue lesions, as well as in the program of control observations of the scar area after excision of sarcoma.

Introduction. Due to the necessity of quantitative measurement and representation of orbital volumes for objective assessment of changes in their bone walls, the development of specialized image processing methods, in particular the usage of multispiral computed tomography (MSCT), is of great importance at present. This information enables the physician to choose patient’s treatment tactics, plan the course of surgical intervention and evaluate the results of the surgical treatment, which in turn improves the efficiency, quality of treatment and patients’ rehabilitation. Purpose. Demonstration of the clinical application of multislice computed tomography data for assessment of orbital volumes in patients with various pathological changes in the orbital bone walls to obtain additional diagnostic information and select treatment tactics. Materials and methods. From 2018 to 2024, CT data was processed at the Radiology Department No. 2 of the University Clinical Hospital № 1 of Sechenov University to quantitatively calculate orbital volumes in 201 patients (100%). Additionally, orbital volumes were calculated in 50 people without orbital pathology as a control group. MSCT was performed on the Aquilion One 640 (Canon, Japan) in volume mode with a slice thickness of 0.5 mm in the bone and soft tissue reconstruction mode; the Vitrea workstation and the standard Sculpt tool were used for subsequent calculation of orbital volumes. Results. Orbital volumes were calculated in 100% of patients. 147 patients (73%) out of 201 patients (100%) had posttraumatic changes of the orbital bone walls; orbital volume calculations in these cases were performed to determine individual wall parameters in order to plan the restoration of bone boundaries and replenishment of soft tissue deficiency; in 19 cases (9%) orbital wall deformations were combined with anophthalmic syndrome. In 11 patients (6%) with congenital anophthalmia, volume calculations were performed to quantify the degree of underdevelopment of the orbital bone walls. In 43 patients (21%), the technique was used after globe removal in order to plan further globe endoprosthetics. Conclusions. The technique of quantitative measuring of orbital volumes provided objective reliable data on changes of orbital bony boundaries within various nosologies, which made it possible to obtain additional diagnostic information about the patients’ condition and to implement a personalized approach to preoperative planning, which directly correlates with the quality of treatment and patients’ rehabilitation.

Purpose. To evaluate the efficacy and safety of using a dynamic inversion table to improve vasomotor function of the microvasculature and increase functional reserves in patients with post-COVID syndrome. Materials and methods. The study involved 70 patients aged 18 to 75 years (35 in the main group and 35 in the control groups) with a history of COVID-19 (confirmed), with persistent complaints of a decrease in quality of life for more than 12 weeks after suffering the disease. The main and control groups were formed by randomization. Patients of the control group received a ten-day rehabilitation course according to temporary methodological recommendations, patients of the control group received a ten-day course of using a dynamic inversion table (tested medical equipment). To assess the functional status, stress cardiorespiratory testing was performed, the state of microcirculation was assessed by the results of occlusive test performed by laser Doppler flowmetry. Results. It was revealed that at the end of the rehabilitation course in the main group there was a significant increase in the amount of work performed during cardiorespiratory stress testing (+13.31 W). The main group also showed a significant increase in the metabolic equivalent of the work performed after the rehabilitation course and amounted to +0.6 MET, an increase in the relative maximum oxygen consumption at the load height (+2.43 ml/min/kg). In addition, a significant increase in post-occlusive blood flow was detected in the main group based on the results of post-occlusive sample analysis (+80.42 %) after the rehabilitation course, while there was a slight decrease of the indicator in the control group. Conclusions. The method of improving vasomotor function of microvasculature using dynamic inversion table can be effective for patients with reduced reserves for improvement of physical quality of life. This method may be promising for the rehabilitation of patients with microcirculation dysfunction.

Purpose. To study the haemodynamic characteristics in the lacrimal artery (LA) and lacrimal vein (LV) in healthy adults and children of different ages. Materials and methods. 360 healthy individuals (720 eyes), including 180 children (group 1) and 180 adults (group 2), underwent ultrasound examination with color Doppler imaging (CDI) and pulse wave Doppler to assess blood flow in LA and LV. All subjects were divided into subgroups depending on their age. The 1A subgroup included 60 children aged 1-7 years, 1Б subgroup included 60 children aged 7–13 years and 1В subgroup included 60 children aged 13–17 years. The 2A subgroup included 60 adults aged 18–40 years, 2Б subgroup included 60 subjects aged 40–60 years and 2B subgroup included 60 subjects aged 60–90 years. The maximum systolic velocity (Vsyst), the end diastolic velocity (Vdiast) and resistance index (RI) of LA and Vsyst of LV were registered in all subgroups. Results. The minimum mean values of Vsyst were determined in 1A and 2B subgroups. Similar changes of V diast in LA were registered. On the other hand, the minimal highest mean values of Vsyst in LV were identified in 1A subgroup, which were significantly different from those in 1B and 1B subgroups (p<0.05). The minimum mean values of Vsyst in SV were determined in individuals of 2B subgroup. Conclusions. The normative values of blood flow in LA and LV can be used as echographic criteria for diagnostics of lacrimal gland diseases.

Introduction. Infusion therapy, despite all its advantages, is not fully understood regarding its impact on the cardiovascular system when large volumes of fluid are used. Objective. To assess the response of the cardiovascular system to massive infusion load in 5 healthy individuals. Materials and Methods. The study included 5 healthy volunteers (2 men and 3 women), with a mean age of 31.6±5.3 years, mean weight of 73.25±15.8 kg, and mean body surface area of 1.83±0.2 m². The study protocol involved the administration of 0.9 % sodium chloride solution through a peripheral catheter for ≈10 hours during the daytime over 2 days, at a volume of 2.2 L/m² body surface area per day. Before the start of the experiment, as well as 48 hours (2 days) and 168 hours (7 days) after the start, all participants underwent measurements of body weight, blood pressure (BP), heart rate (HR), blood tests for NT-proBNP levels, and transthoracic echocardiography. Results. The study found no significant changes in BP, HR, and body weight. A significant increase in NT-proBNP level was noted, rising from 29.3±17.67 ng/ml to 295.4±136.1 ng/ml (p=0.018) after 48 hours of infusion, followed by a decrease (38.0±20.94 ng/ml, p=0.020) and normalization after 7 days. Additionally, after 48 hours, there was an increase in the volume of the left atrium (from 39.2±9.0 ml to 58.2±10.7 ml; p=0.003), basal size of the right ventricle (from 3.44±0.18 cm to 3.66±0.26 cm; p=0.020), and vertical size of the right atrium (from 4.12±0.24 cm to 4.56±0.37 cm; p=0.032), as well as an increase in the amplitude of tricuspid annulus systolic excursion (TAPSE) – from 2.5±0.27 cm to 2.94±0.25 cm; p=0.034) and the E/e’ index (from 3.87±0.52 to 4.83±0.35; p=0.015. Conclusion. Intravenous administration of large volumes of 0.9 %NaCL is associated with an enlargement of the right heart chambers, with enhanced contractility of the right ventricle, increased volume of the left atrium, elevated left ventricular filling pressure, and a marked increase in NT-proBNP. NT-proBNP level should be estimated outside of infusion therapy.

Introduction. In 2003, at the Annual Congress of the American Heart Association in Orlando, L. Menicanti and M. Di Donato proposed an original morphofunctional classification of postinfarction left ventricular aneurysms based on the silhouette and segmental contractility of the LV wall. According to this classification, 4 types of aneurysms are distinguished. Type 4 is akinesis of the anterolateral, apical and posterobasal segments, the presence of residual contractility of the anterobasal and inferoapical segments («double scar»). The combination of anterior and posterior LV aneurysms is one of the rarest complications, and the incidence rate of less than 1 % is due to high mortality in the acute period of MI [2–4]. Objective. To evaluate the results of surgical treatment of patients with post-infarction left ventricular aneurysm type IV according to the classification of L. Menicanti. Materials and methods. In this retrospective single-center study, we examined the medical records of 37 patients who underwent simultaneous reconstruction of the anterior and posterior LV aneurysm, coronary artery bypass grafting and mitral valve plastic surgery from 2010 to 2024 at the Federal Center for Cardiovascular Surgery in Penza. The main inclusion criteria were: coronary heart disease and the presence of an aneurysm type IV (a combination of anterior and posterior aneurysms) according to the classification of L. Menicanti. Results. In the period from January 2010 to 2024, 37 operations were performed, which consisted of geometric remodeling of post-infarction LV aneurysm type IV. The follow-up period was up to 120 months. The long-term results of patients were assessed. An increase and preservation of LV contractility was revealed, despite the reverse LV remodeling in the long-term period (p=0.01). According to the univariate Cox regression analysis, it was revealed that MV plastic surgery reduces the likelihood of fatal outcome in the long-term period (HR=0.306, p=0.027). Conclusions. 1. Combined correction of anterior and posterior aneurysms is not associated with perioperative risk of death. 2. Combined correction of anterior and posterior aneurysms is accompanied by a significant increase and preservation of LV contractility both in the early and late follow-up periods. 3. MV plastic surgery reduces the likelihood of death in the late period (HR=0.306, p=0.027).

Introduction. The use of factor Xa inhibitors in deep vein thrombosis is effective and associated with lower hemorrhagic risk compared with low molecular weight heparins and warfarin. For «fragile» patients with increased tissue bleeding, the tactics are not prescribed in the recommendations. The possibility of using sulodexide in prolonged therapy has been noted. Aim. To determine the tactics of prolonged anticoagulant therapy of recurrent deep vein thrombosis in «fragile» patients using microcirculation parameters. Materials and methods. Microcirculation parameters were recorded using a 25 MHz high-frequency ultrasound Doppler sensor on the nail bed of the 1st finger of the upper limb. A 7 MHz sensor were used for control color duplex scan after 21 days and 2, 3, and 6 months of treatment. Based on the parameters of microcirculation and hemorrhagic risk, treatment tactics were changed, 44 patients with increased tissue bleeding after 3 months received rivaroxaban 10 mg per day, 14 patients with a hemorrhagic history received sulodexide 500 LSU 2 times a day for 3 months, then 250 LSU 2 times a day, 39 patients received the standard treatment regimen. Results. There were no hemorrhagic complications or relapses. Recanalization was faster with full-dose rivaroxoban therapy: Qam 0.638±0.22 / 1.258±0.32(0.06); slower when the dose was reduced: Qam 0.772±0.31/2.418± 0.57 (0.02) and the use of sulodexide Qam 0.725±0.44/1.258±0.32(0.06); after 6 months, there was practically no difference in the groups and full recanalization was achieved. Conclusion. A reduced dosage of rivaroxaban was effective in increased tissue bleeding. The use of sudodexide in patients with hemorrhagic history allowed to obtain a good result without new hemorrhagic complications and significant deviations in microcirculation parameters. Monitoring of the latter made it possible to change tactics in a timely manner and avoid hemorrhagic complications in patients with increased tissue bleeding and microcirculatory reactivity, which can be proposed for wider use in daily clinical practice.

An osteochondroma of the sternum is of clinical interest due to the rarity of its localization. This article presents a clinical case with dynamic observation of a patient with a sternal body mass. Computed tomography allowed evaluating the structural changes of the bone, topographic relationships with mediastinal organs, vessels of the anterior chest wall, and lack of response to radiation therapy in dynamics. Based on the obtained data, a preliminary diagnosis was made, which was further histologically confirmed. At present, the patient is preparing for surgical treatment.

Different variants of the vertebral artery structure occur with an incidence of no more than 15 %. It is important to note that variant vertebral artery anatomy is usually an incidental finding during instrumental diagnosis, as it is clinically asymptomatic in most cases. However, these variants may be of practical importance either before surgical treatment in the neck or endovascular surgery, as well as during radial diagnostics. In clinical practice, the most common findings are high insertion of the vertebral artery into the foramen of the transverse process, above the level of the VI cervical vertebra, or hypoplasia of one of the vertebral arteries. We present a rare clinical observation of a 12-year-old boy with right vertebral artery doubling at the site V1, who was examined in the Department of Pediatric Neurology with the diagnosis of the mixed type of vegetovascular dystonia. Detailed information about the variants of vertebral artery anatomy is important for all specialists involved in the diagnosis and treatment of patients with cerebrovascular diseases.

In the modern understanding of the system of vascular trophic support, the haemomicrocirculatory bed is a sequential connection of arterioles, precapillaries, capillaries, postcapillaries and venules, ordered by their location in tissues, as well as the presence of arteriolo-venular anastomoses. Differentiation of various links of the microcirculatory bed is based not only on the size of the vessel lumen, but also on the peculiarities of the structure of their walls and the functions performed. The main metabolic link of the human circulatory system is the capillary bed, in which the presence of three types of capillaries is currently described, the distinction of which is established by the peculiarities of the structure of their walls. At the same time, morphological differences of capillary wall structure determine essential differences in their functions, which causes a number of critical comments on the validity of uniting capillaries into one type of vessels only in the absence of diameter differences. In addition, when forming an objective morphofunctional assessment of the organization of the haemomicrocirculatory bed of an organ and/or tissue, it is necessary to evaluate topographic-anatomical regularities of the architectonics and mutual location of different types of capillaries in the vascular network of organs and tissues, which can be determined using modern methods of morphometry. The results of further research in this direction can become new knowledge about the regularities of blood supply organization, allowing to detail the role of various microvessels in the organization of microhemodynamics and metabolic processes in organs and tissues in norm and pathology, as well as find an important applied use in the development of new methods of selective drug delivery to the focus of pathological process in various human diseases.