УДК 616.33/.34-02:616.988:578.834]-053.2

Пандемія коронавірусної інфекції 2019–2021 рр. об’єднала людство в пошуку ефективних методів діагностики, лікування та профілактики цієї інфекції. За даними Всесвітньої організації охорони здоров’я, в Європі станом на 19.07.2021 р. зафіксовано 58 558 098 випадків інфекції, спричиненої коронавірусом SARS-Cov-2 (SARS-Cov-2) [1], а згідно з повідомленнями ЮНІСЕФ, понад 8700 дітей і підлітків померли від COVID-19, що становить 0,3 % від 2,7 мільйона смертей від COVID-19 у 78 країнах [2]. У квітні 2020 р. з’явилися повідомлення про асоційований із SARS-Cov-2 мультисистемний запальний синдром у дітей (MIS-C), який характеризується гарячкою та поліорганним ураженням, часто з порушенням гемодинаміки [3]. За клінічними проявами MIS-C подібний до хвороби Кавасакі, однак встановлено, що це окрема нозологічна одиниця. З-поміж найбільш характерних клінічних проявів цього синдрому відзначимо ураження легень, міокарда, шлунково-кишкового тракту (ШКТ), шкірні та неврологічні симптоми. За даними деяких авторів, найпоширенішими при MIS-C є гастроінтестинальні прояви, їх виявляють у 50–87 % дітей [4,5]. Абдомінальний синдром часто імітує гострий живіт, становлячи серйозну діагностичну проблему для педіатрів і дитячих хірургів, коли пацієнт не має катаральних симптомів.

UDC 611.132.2:616.12-005.4]-055.2-073.756.4

Angiographic examination of the coronary arteries – coronary angiography allows for intravital evaluation of the coronary arteries. Structural lesions of the coronary arteries are a prerequisite for developing coronary heart disease, the most common form of cardiovascular disease among women. The work aimed to carry out a morphometric analysis of coronary artery valves in women in normal conditions and under coronary artery damage, with an assessment of the relationship between age and anthropometric indicators. Angiographic images of the coronary arteries of 56 normal women and those with structural lesions of the coronary arteries served as materials and methods. Used methods: coronary angiography, mathematical and statistical calculations. In women with lesions of the coronary arteries, the height of the left coronary artery ostia (4.78±1.16 mm) exceeded the height of the right coronary artery ostia (3.94±0.98 mm) (p=0.003). Similar differences were found in women without lesions of the coronary arteries, in particular, the height of the left coronary artery ostia was 5.96±0.91 mm, the height of the right coronary artery ostia was 4.58±1.10 mm (p<0.0001). The height of the ostia of the left (p=0.0001) and right (p=0.027) coronary arteries prevailed in healthy patients, compared to the group with coronary artery lesions. According to the analysis of the combined effect of several factors on the height of the coronary artery valves, it was established that with increasing age, height (r=-0.35, р=0.047) and body surface area (r=-0.37, р=0.035) decreased. Height was directly correlated with body weight (r=+0.36, p=0.043). According to the results of the paired correlation, a direct correlation of average strength between height and body weight (r=+0.49, p=0.014) and body surface area (r=+0.63, p=0.001) was proved. Thus, with the help of the angiographic method of research, various relationships between the height of the coronary artery ostia and the age-anthropometric parameters in women with coronary artery lesions and under normal conditions were established.

UDC: 616.132.11:616.12-005.4]-055.1-073.756.8

Aortic root requires preliminary preoperative analysis for coronary artery bypass graft (CABG) in coronary heart disease (CHD). The dimensions of the aorta correlate with anthropometric indicators. The purpose of the study: to establish the relationship between sinuses of Valsalva height, coronary artery ostia height and biometric parameters (age, height, weight, body surface area and body mass index) in men with CHD using computed tomography. Research materials and methods include contrast-enhanced computed tomography images of the aorta of men with verified CHD. According to growth parameters, division into 2 groups was made. The sinuses of Valsalva height and right and left coronary artery ostia height were measured. Clinical data were analyzed: age, height, body weight, body surface area (BSA) and body mass index (BMI). Statistical analysis: Student's t-test, Kendall's rank correlation method, Pearson's linear correlation, Fisher's multifactorial regression analysis. Analysis of the results of computed tomography of 30 men with CHD (average age 60.80±10.63 years) showed that the average values of the three sinuses of Valsalva height were approximately at the same level. The results of the Pearson linear correlation evaluation showed the absence of a proven relationship between biometric indicators and morphometric data according to CT in men with CHD (p>0.05). Multifactor regression analysis proved the inverse significant influence of weight and the direct significant influence of BMI and BSA on the dependence of left coronary artery ostia height. The multiple correlation coefficient was R=+0.55, with p=0.023, SEE=2.74. Prediction
of the level of left coronary artery ostia height in men with CHD was carried out with confirmation of the constructed model. In the first group of short men (n=11) with CHD (average age 60.11±12.63 years, height 1.677±0.023 m), an inverse correlation between height and left coronary artery ostia height (tb=-0.56, p=0.034). Reliable direct relationships between the left coronary artery ostia height parameter and several anthropometric indicators were established: with weight - a direct strong relationship (tb=+0.72, p=0.007), with BMI - a direct relationship of medium strength (tb=+ 0.67, p=0.008), with BSA - average strength direct connection (tb=+0.58, p=0.023). The relationship between the value of the right coronary artery ostia height and the BSA indicator - the inverse of the average strength correlation (tb=-0.51, p=0.046) was proved. Relationships between morphometric parameters and age were not proven. Thus, in men with CHD, left coronary artery ostia height correlates with weight, BMI, and BSA. In short men with CHD, there is
an inverse relationship between left coronary artery height and height; direct relationships with weight, BMI and BSA.

UDC 611.132:616.132-007.271-055.2]-07

The aortic root is the area subject to interventions in the correction of congenital or acquired heart defects. Aortic stenosis is characterized by a decrease
in the aortic valve area, which impedes blood flow from the left ventricle to the aorta. In aortic stenosis, the processes of degeneration and calcification of
the aortic valve change the geometry of the aortic root. Modern endovascular methods of correcting severe aortic stenosis (for example, transcatheter aortic valve implantation, TAVI) involve detailed morphometric analysis of the aortic root and adjacent structures [1, 2]. Data on the correlation between anthropometric data and mathematical measurements of the aorta at different intervals differ among the authors [3-5]. Obviously, the variability of growth, body weight and body mass index calculated according to them, body surface area differ in different gender and ethnic groups [3, 6, 7]. Data on the morphometry of the height of the aortic sinuses, the branching of the coronary arteries ostia using computed tomography in females with severe aortic
stenosis in Ukraine could not be found in the medical literature.

Severe aortic stenosis still remains a widespread form of valvular heart disease1. Innovative cardiac techniques, such as transcatheter aortic valve replacement (TAVI), require morphometric analysis of the aortic root2,3 annulus, sinus of Valsalva, and ascending aorta.\n\nResults\nThe study population
comprised 80 men and 97 women (age: 82 ± 6 years. Aortic root is a complex and interconnected structure. Some components of the aortic root are posterior (noncoronary) sinuses, as well as the right and left coronary sinuses of Valsalva. Within the norm, the right coronary artery and the left coronary artery arise from the coronary sinuses4. Precise evaluation of the height of the Valsalva sinuses and the coronary ostia is necessary when planning endovascular interventions, predicting and preventing complications5,6. Morphometric analysis of the aortic root allows to estimate the height of the aortic sinuses and the height of the coronary ostia using specific measurements. Computed Tomography (CT) is a gold standard for assessing aortic root7 and conducting appropriate assessments.
The aim of the study is to conduct a morphometric analysis of the height of the Valsalva sinuses in men with severe aortic stenosis and to test predictive
modeling of the height of the Valsalva sinuses based on anthropometric and age differences.