The article presents concise guidelines for quality control and protocol development for spirometry, a routine test of lung function. Based on Russian methodological recommendations for spirometry, standards of the American Thoracic Society, and the European Respiratory Society, these guidelines cover all stages of spirometry, from patient preparation to result interpretation, aiming to ensure high quality and reliability of the tests performed. The importance of adhering to standards and quality control is emphasized to guarantee the accuracy and reliability of spirometry results. The guidelines provide criteria for the quality of individual attempts and the entire test, criteria for selecting the best attempt, and recommendations for assessing the severity of abnormalities. Examples of formulating spirometry protocols are also given. These recommendations are intended for physicians in functional diagnostics, pulmonologists, therapists, anesthesiologists, medical staff, and aim to standardize the formation of spirometry protocols.

The goal the work was to study the possibility of using elastography on an open heart to determine the stiffness of the left ventricular myocardium. Material and methods. Intraoperative elastography was performed in 6 patients with isolated aortic stenosis and dissecting aneurysm of the ascending aorta with aortic insufficiency. Three patients underwent surgery to replace the aortic valve with mechanical prostheses (SIM-19) and three were operated to replace the ascending aorta with an artificial prosthesis with aortic valve replacement (David’s operation). The average age of the patients was 42±9 years (42–53) years. All patients underwent surgery under conditions of artificial blood circulation. Initially, elastography was evaluated on a working heart, and then on full artificial circulation. The study was performed on a VK 5000 ultrasound device with an intraoperative «stick» type sensor at a frequency of 7.5–15 Mhz, gain of 1.6 Db, resolution of 127 hz. The deformation coefficient was evaluated. The imaging program was exposed as for neurosurgery with a frequency of 15 Mhz. Visualization was performed in B-mode, followed by obtaining shear wave elastography with calculation of the deformation coefficient. Results. Wave elastography was evaluated for various heart pathologies with different myocardial thickness. It was found that the stiffness in the studied areas of the myocardium is different. Thus, in patients with atherosclerotic aortic stenosis and a pressure gradient of more than 100 mmHg, the deformation coefficient was increased, in accordance with the thickness of the myocardium and amounted to 3.81–4.06, and in patients with aortic root dilation and aortic insufficiency, the deformation coefficient was 1.64–2.9. Conclusion. Intraoperative assessment of the left ventricular myocardial deformation coefficient is possible only on a stopped heart and gives an idea of the state of the heart muscle with the possibility of soft and hard areas. Shear wave elastography provides information about the elasticity and hardness of the tissue, which indirectly reflects the viscosity of the myocardium. This study was aimed at verifying the methodology for assessing the characteristics of the elasticity of the left ventricular myocardium for myocardial overload by pressure (aortic stenosis) and volume in case of a dissecting aortic aneurysm with aortic insufficiency.

Relevance of the problem. Arrhythmogenic right ventricular dysplasia (ARVD) is one of the significant causes of sudden cardiac death (SCD) among young people. ARVD is characterized by premature ventricular ectopic contractions (PVCs) from the right ventricular outflow tract (RVOT), which may occur before morphological changes appear and, in these cases, it is necessary to assess the risk of developing SCD based on an analysis of the electrophysiological mechanism of the development of PVCs. Purpose of the study. To evaluate the electrophysiological mechanisms of PVCs in patients with ARVD according to stress tests. Material and methods. We examined 13 patients with confirmed ARVD on MRI, including 9 men and 4 women, aged from 26 to 63 years (42.9±11.0). All patients underwent the following studies: standard electrocardiography (ECG), 24-hour ECG monitoring, echocardiography, cardiac MRI, treadmill stress test. During the stress test, at each load level, ventricular ectopy was analyzed (morphology, number of ventricular ectopic complexes), and the dependence of corrected QTc on heart rate was assessed. Results. According to the data obtained, the patients were divided into two groups depending on the response of PVCs to physical activity. The first group – patients in whom the number of PVCs increased during physical activity – stress-induced ventricular ectopy – 10 people (77%). The second group – patients in whom the number of PVCs decreased, or they disappeared at the peak of the load – stress-inhibited ventricular ectopy – 3 people (23%). All patients had a normal reaction of the QT interval to physical activity – its shortening in response to an increase in heart rate. Conclusions. ARVD is characterized by ventricular ectopia from the right ventricle outflow tract or bifocal ectopia from the right ventricle outflow tract and the right ventricle apex. The electrophysiological mechanisms of ventricular ectopia in ARVD are different: the mechanism of trigger activity and increased automaticity.

The article presents a clinical observation that revealed a decrease in segmental deformation of the left ventricular myocardium in a 15-year-old teenager at the early stage of asymmetric non-obstructive hypertrophic cardiomyopathy (HCM). To assess myocardial systolic function, the following were used: ejection fraction and shortening of the left ventricle, as well as indicators of global and segmental myocardial deformation, determined by echocardiographic study using the 2D speckle-tracking method. There was no change in ejection fractions and shortening of the left ventricle, global longitudinal deformation of the myocardium, but there was a decrease in longitudinal and circular deformation in individual segments of the left ventricle, which, in general, was the basis for prescribing cardioprotective therapy.

Background. The generally algorithm for the initial physical examination of patients with STEMI, including medical history and ECG, is inadequate. Short focal ultrasound protocols can improve the diagnostic accuracy of the initial physical examination, but when they are needed, there are currently no clear and understandable algorithms. Objective. Evaluate the impact of routine focal ultrasound on the initial physical examination of STEMI patients. Material and methods. A total of 228 patients with STEMI were included in a single-center prospective cohort study. The patients will be enrolled at the I.V. Davydovsky Moscow City Clinical Hospital from 2019 to 2023. Results. The main group consisted of 126 patients undergoing routine focal ultrasound, the control group 102 patients with standard physical examination algorithm. The primary endpoint including door-to-instrument time was better in the study group compared to the control group (Me [Q1–Q3], 30 [27–37] vs. 37 [31.5–45] minutes, p < 0.001). The advantage was achieved by a shorter Cath lab-to-instrument time in the study group (Me [Q1-Q3], 10 [10–15] vs. 15 [15–25] minutes, p < 0.001). The secondary endpoint was the probability of a change in diagnosis, which did not differ between groups at the initial examination (abs (%), 24 (19%) vs. 25 (24.5%), p = 0.318), but occurred more frequently after invasive angiography in the control group (abs (%), 15 (11.9%) vs. 24 (23.5), p = 0.036). The detection of significant cardiac pathology during initial physical examination was higher in the main group (abs (%), 87 (69.0%) versus 24 (23.5), p< 0.001). Conclusion. The routine use of focal ultrasound in patients with STEMI does not increase the time to revascularization and has a high degree of diagnostic accuracy.

The narrative review is dedicated to justifying the feasibility of using infrared thermal imaging in children’s sports. It examines the possibilities of thermal imaging in sports physiology and medicine, the concept of a ‘Athlete’s Thermal Passport,’ and various applications of the method during training and competitive periods, as well as its effectiveness in preventing sports injuries. The practical value of thermal imaging is demonstrated within a comprehensive approach for monitoring health, assessing performance, and identifying potential issues throughout a child’s sporting career.

The German psychiatrist and psychophysiologist, Hans Berger (1873–1941), rightfully holds the title of «father of electroencephalography.» He was the first to record an electroencephalogram in July 1924. From 1929 to 1940, Berger published the results of his long-term research on the recording of the overall bioelectric activity of the human brain from the scalp surface. He proposed the term «electroencephalography» and the abbreviation «EEG», characterized the major types of activity, described the phenomena of synchronization and desynchronization. In his research, Berger focused on the EEG’s dynamics during changes in brain functional activity, trying to find electrophysiological correlates of mental functions and states.