Publications by authors named "A V Egorova"

221 Publications

Computed Tomography Derived Coronary Triangulated Orifice Area-Deduction of a New Parameter for Follow-up After Surgical Correction of Anomalous Aortic Origin of Coronary Arteries and Call for Validation.

Front Cardiovasc Med 2021 24;8:668503. Epub 2021 Jun 24.

CAHAL, Center for Congenital Heart Disease Amsterdam Leiden, Leiden, Netherlands.

Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare congenital abnormality. Computed tomography angiography (CTA) is primarily used as a diagnostic tool to evaluate the anatomy and identify potentially malignant AAOCA variants. Limited data is available on the role of CTA during postoperative follow-up. We aimed to develop an objective CTA derived parameter for diagnostic evaluation and follow-up after surgical correction of AAOCA and correlate the anatomical features to the postoperative outcome. All consecutive patients who underwent surgical repair of AAOCA from 2001 to 2018 and had pre and postoperative CTA imaging available were included. A retrospective analysis of the pre- and postoperative CTA and the outcomes was performed. The origin and course of the anomalous coronary artery and the ostial dimensions were evaluated and correlated with restenosis of operated coronary artery. To allow an accurate evaluation of the effective orifice area at diagnosis and after surgical repair we deduce and propose a new parameter-the coronary triangulated orifice area (CTOA). Out of the 54 patients who underwent surgical treatment for AAOCA, 11 fulfilled the inclusion criteria. The median follow-up was 19 months [IQR 3;42]. The mean age at surgery was 41 ± 16 years, with six patients (55%) being male. Postoperatively, the angle between the proximal coronary artery and the aortic wall increased from 20 ± 5° to 28 ± 9° ( < 0.01) and ostial diameter in the transversal plane increased from 4.1 ± 2.5 mm to 6.2 ± 2.7 mm ( < 0.01). The median CTOA increased significantly from 1.6 mm [IQR 0.9;4.9] to 5.5 mm [IQR 3;11.8] ( < 0.005). During follow-up, in three patients a restenosis of the operated coronary artery was suspected. In these patients, the CTOA only showed a limited postoperative increase of ≤ 1.4 mm. CTA can play an important role in the evaluation of the pre- and postoperative anatomy in AAOCA patients. CTOA may be of use in conjunction with the acute angle take-off and ostial diameter order to comprehensively evaluate the operated ostium after unroofing or patch angioplasty.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fcvm.2021.668503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263932PMC
June 2021

Effect of Aprotinin and Avifavir Combination Therapy for Moderate COVID-19 Patients.

Viruses 2021 06 27;13(7). Epub 2021 Jun 27.

ChemRar High-Tech Center, 141401 Moscow, Russia.

COVID-19 is a contagious multisystem inflammatory disease caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We studied the efficacy of Aprotinin (nonspecific serine proteases inhibitor) in combination with Avifavir or Hydroxychloroquine (HCQ) drugs, which are recommended by the Russian Ministry of Health for the treatment therapy of moderate COVID-19 patients. This prospective single-center study included participants with moderate COVID-19-related pneumonia, laboratory-confirmed SARS-CoV-2, and admitted to the hospitals. Patients received combinations of intravenous (IV) Aprotinin (1,000,000 KIU daily, 3 days) and HCQ (cohort 1), inhalation (inh) treatment with Aprotinin (625 KIU four times per day, 5 days) and HCQ (cohort 2) or IV Aprotinin (1,000,000 KIU daily for 5 days) and Avifavir (cohort 3). In cohorts 1-3, the combination therapy showed 100% efficacy in preventing the transfer of patients ( = 30) to the intensive care unit (ICU). The effect of the combination therapy in cohort 3 was the most prominent, and the median time to SARS-CoV-2 elimination was 3.5 days (IQR 3.0-4.0), normalization of the CRP concentration was 3.5 days (IQR 3-5), of the D-dimer concentration was 5 days (IQR 4 to 5); body temperature was 1 day (IQR 1-3), improvement in clinical status or discharge from the hospital was 5 days (IQR 5-5), and improvement in lung lesions of patients on 14 day was 100%.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/v13071253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310315PMC
June 2021

[Results of a two-year clinical study of myopia control with bifocal defocus-inducing soft contact lenses].

Vestn Oftalmol 2021 ;137(3):5-12

National Myopia Institute, Moscow, Russia.

The development of methods for myopia control remains one of the most topical trends in modern ophthalmology. Optical approaches to myopia control employ the induction of peripheral myopic defocus, which can be done with the use of multifocal soft contact lenses (SCLs).

Purpose: To review the results of a two-year multicenter clinical study of myopia control with bifocal defocus-inducing SCLs.

Material And Methods: The two-year study enrolled 100 patients aged 8 to 16 years who had mild or moderate bilateral myopia with spherical equivalent of (-)0.25 to (-)5.75 D. Based on the degree of myopia and the method of its correction, patients were divided into two main and two control groups. Multifocal SCLs with +4.0 D add power and monofocal SCLs were used for myopia correction. The results were evaluated by the clinical data of refraction, axial length and state of accommodation. The observation times were 3, 6, 12, 18 and 24 months.

Results: After 12 months of bifocal SCLs usage, signs of stabilization of myopia progression were identified in 72 and 73.5% of subjects of both main groups, after 24 months - in 54 and 79.5% of subjects, respectively. Statistically significant reduction in axial elongation amounting to 87-88% was also observed in patients using bifocal SCLs. A significant increase in positive relative accommodation (PRA) was observed in all groups.

Conclusion: The study indicates the effectiveness of bifocal soft contact lenses in slowing the progression of mild and moderate myopia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17116/oftalma20211370315DOI Listing
June 2021

Failing systemic right ventricle in a patient with dextrocardia and complex congenitally corrected transposition of the great arteries: a case report of successful transvenous cardiac resynchronization therapy.

Eur Heart J Case Rep 2021 Apr 12;5(4):ytab068. Epub 2021 Apr 12.

Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.

Background : Patients with congenitally corrected transposition of the great arteries (ccTGA) are prone to the development of advanced atrio-ventricular block requiring chronic ventricular pacing. The morphological right ventricle (RV) often develops systolic dysfunction as it is unable to withstand the chronic pressure overload it is exposed to when supporting the systemic circulation.

Case Summary : A 56-year-old woman with dextrocardia and complex ccTGA with a history of dual-chamber implantable cardioverter-defibrillator (DDD-ICD, high degree atrio-ventricular-block and syncopal ventricular tachycardia), presented with progressive heart failure and symptomatic atrial arrhythmias. She underwent a successful ablation and concomitant invasive haemodynamic evaluation of potential alternative/biventricular pacing modalities. During biventricular pacing, the QRS narrowed and the systemic RV intraventricular pressure (Dp/Dt) increased with 30%. She underwent a successful transvenous upgrade to cardiac resynchronization therapy (CRT). The electrocardiogram post-implantation showed biventricular capture and patient showed subjective and objective clinical improvement.

Discussion : Systemic RV dysfunction in ccTGA can be aggravated by chronic pacing-induced dyssynchrony, contributing to progression of heart failure in this patient group. Transvenous CRT is feasible in ccTGA anatomy and may be pursued in order to improve or preserve the functional status of pacing-dependent ccTGA patients. Invasive haemodynamic contractility evaluation can help assess the potential benefit of CRT in patients with complex anatomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjcr/ytab068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188871PMC
April 2021

Reduced purine biosynthesis in humans after their divergence from Neandertals.

Elife 2021 May 4;10. Epub 2021 May 4.

Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.

We analyze the metabolomes of humans, chimpanzees, and macaques in muscle, kidney and three different regions of the brain. Although several compounds in amino acid metabolism occur at either higher or lower concentrations in humans than in the other primates, metabolites downstream of adenylosuccinate lyase, which catalyzes two reactions in purine synthesis, occur at lower concentrations in humans. This enzyme carries an amino acid substitution that is present in all humans today but absent in Neandertals. By introducing the modern human substitution into the genomes of mice, as well as the ancestral, Neandertal-like substitution into the genomes of human cells, we show that this amino acid substitution contributes to much or all of the reduction of de novo synthesis of purines in humans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7554/eLife.58741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133780PMC
May 2021
-->