Research Strategic Plan 2016

Fundamental research project № 0546-2015-0010

Scientific rationale for effective management methods in healthcare institutions and medical research institutes, ensuring the implementation of measures aimed at the improvement of medical care for population suffering from circulatory system diseases in the current social and economic conditions of the subjects of the Russian Federation.

1. To assess the impact of professional factors on the dynamic changes in the cardiovascular risk profile based on the prospective study; to determine the cause and effect relationships between the prevalence of cardiovascular risk factors, cardiovascular diseases and working environment in the occupational groups in the coal mining and steel industries.

2. To assess the potential role of the factors, related to urbanization levels, in the mechanisms which thought to cause cardiovascular morbidity and mortality in the Kemerovo region; to evaluate the prevalence of cardiovascular risk factors and circulatory system diseases in different social, economic and ethnic communities; to perform an integrated analysis of the population risk for circulatory system diseases in different communities with heterogeneous prevalence of cardiovascular risk factors; to determine the relationships between ambient air pollution and the incidence of coronary artery disease (CAD).

3. To study the potential role of ethnic differences in the development of circulatory system diseases in populations of the South West Siberia; to study genetic determinants of cardiovascular risk in populations of the indigenous minorities of the West Siberia.

4. To assess the differences in health care provision for circulatory system diseases, including a retrospective analysis of healthcare facilities perfromance, the definition of healthcare key performance indicators, the development of a health care transition-planning algorithm for the provision of staged medical care for patients with ACS and other circulatory system diseases, the development of novel management decision models.

5. To study the impact of social and motivational factors of the personnel of medical institutions on job performance in various occupational groups; to obtain evidence-based data on the efficiency of the quality management system in medical research institution according to the international requirements.

6. To develop and obtain evidence-based data on promising organizational and methodological approaches to clinical health examination for circulatory system disease, diagnostic and treatment measures aimed at early diagnosis, prompt surgical treatment and postoperative rehabilitation of patients with congenital heart disease.

Subject number 0546-2015-0011

Pathogenetic rationale for developing implants for cardiovascular surgery on the basis of biocompatible materials, with the implementation of a patient-centered approach, using mathematical modeling, tissue engineering and genomic predictors.

1. To evaluate short and medium-term (five years) outcomes of implantation of epoxy-terated xenopericardial bioprosthesis “UniLine” in the aortic position; to analyze the outcomes of repeat mitral valve replacement and to develop approaches for their optimization; to study the parameters and mechanisms of cardiac adaptive remodeling in biological mitral valve recipients.

2. To modify stent geometry for valve-in-valve replacement, based on the results of hydrodynamic and functional testing; to perform prototyping of balloon catheter for delivery of biorposthesis for valve-in-valve implantation.

3. To assess the impact of recipient-related factors on the dysfunction of epoxy-treated bioprosthetic heart valves.

4. To determine gene polymorphisms of the immune response, contributing to the formation of defects and calcific degeneration of mitral valve bioprosthesis.

5. To assess the efficiency of the integrated approach to improve the effectiveness and safety of anticoagulation therapy in patients with prosthetic heart valves, based on the continuity of inpatient and outpatient management of patients and ensure the organization of the centralized control service for anticoagulation levels.

6. To determine genetic and immunological factors, contributing to the development of congenital heart disease (CHD) in the preconception period; to study the associations between gene polymorphisms of major histocompatibility complex and the formation of CHD during fetal development in the Kemerovo region.

7. To study the properties of scaffolds with incorporated growth factors and extracellular matrix proteins to enhance the adhesion and migration of endothelial cells using human umbilical vein endothelial cells (HUVEC) and cell line Ea.hy 926.

8. To develop the protocols for the incorporation of differentiation factors, namely growth factors and chemoattractants, into tubular scaffold layers.

Fundamental research project № 0546-2015-0012

Multivessel coronary artery disease, polyvascular disease and comorbid conditions. The diagnosis and risk management in a large industrial region of Siberia

1. To determine informative genetic markers of predisposition to renal dysfunction in patients with ST-segment elevation acute coronary syndrome (STE ACS) and multivessel coronary artery disease.

2. To provide rationale for a novel approach aimed at the prognosis of developing early postoperative cognitive dysfunction in patients undergoing on-pump coronary artery bypass grafting (CABG); to determine polymorphisms of candidate genes conferring susceptibility to neurocognitive decline, associated with atherosclerosis.

3. To assess the prevalence of genetic polymorphisms associated with the progression of fibrosis in patients with myocardial infarction (MI); to determine associations between genetic markers of myocardial fibrosis and clinical and demographic data and immunochemical parameters in MI patients; to identify informative genetic markers of myocardial fibrosis to assess a 1-year prognosis in patients after myocardial infarction.

4. To determine the role of genetic, immunochemical factors of lipoprotein metabolism in patients with non-ST-segment elevation ACS (NSTE ACS).

5. To evaluate the prevalence of respiratory disease in patients with coronary artery disease (CAD) in a large industrial city of Kuzbass; to determine relationships between respiratory disorders and cardiovascular risk factors.

6. To assess the incidence and prevalence of osteopenia syndrome and hypogonadism in male patients with coronary artery disease; to determine relationships between common clinical and laboratory parameters of cardiovascular risk and manifestations of coronary calcification; to define informative markers of bone metabolism and systemic inflammation relevant to the severity of osteopenia syndrome, hypogonadism, multivessel coronary artery disease and coronary calcification in male patients with stable coronary artery disease.

7. To assess neurophysiological status in patients with concomitant coronary artery lesions and hemodynamically significant stenoses of the brachiocephalic arteries and to justify the need of a novel assessment approach.

8. To obtain new evidence-based data on the outcomes of myocardial revascularization strategies in patients with STE ACS and multivessel coronary artery disease.

9. To assess the impact of residual severity of coronary atherosclerosis on the short and long-term prognosis in patients with STE ACS after percutaneous coronary intervention (PCI).

10. To analyze the outcomes of the treatment strategy with primary PCI in the Kemerovo region before and after the implementation of the Stent for Life Inititative and to assess its economic efficiency.

11. To provide rationale for a novel differentiated approach for selecting extracorporeal blood purification methods in critically ill cardiac patients and to assess its efficiency.

12. To provide rationale for additional organ protection in high risk patients undergoing on-pump surgical procedures; to provide rationale for a goal-oriented therapy for hemostatic disorders and introduce it into the clinical practice from the perspective of evidence-based data and advanced research methods and the potential use of factor therapy for preventive organ protection.

13. To determine psychosocial factors, affecting the course of coronary artery disease, including age and gender differences, and the presence of multivessel coronary artery disease and polyvascular disease. To develop rehabilitation program, aimed at the treatment of psychological and physiological disorders, social adaptation and increase adherence to treatment among patients undergoing CABG.

Fundamental research project № 0546-2015-0013

Scientific rationale for developing and introduction of advanced methods of diagnosis and interventional treatment of complex arrhythmias and conduction disturbances to improve the quality of life and prognosis of patients with cardiovascular diseases

1. To perform comparative analysis of the efficacy and safety of primary catheter procedures for pulmonary vein antrum isolation, extended pulmonary vein antrum isolation, and left atrial autonomic ganglionated plexi ablation in the short and long-term period.

2. To assess the effectiveness of the high-amplitude pace mapping of parahisian ectopic foci; to study the effectiveness of electroanatomical mapping of coronary arteries compared to coronary angiography during radiofrequency ablation of ectopic foci at the coronary aortic sinus.

3. To assess the effectiveness of rapid electroanatomical mapping of ectopic foci in the right ventricular outflow tract and the impact of using multielectrode ablation system consisting of Lasso catheter and navigation system on its duration.

4. To define the optimal value of atrial surface area requiring radiofrequency applications for recovery and long-term maintenance of sinus rhythm.

5. To assess the impact of the surface area of myocardial injury on the left atrial mechanical function and provide scientific rationale for its optimum size.