HighlightsThe review presents an analysis of the current literature on studies of variant pulmonary vein anatomy as a factor that predicts predisposition to atrial fibrillation, as well as the outcome of interventional treatment. AbstractThis review examines the role of variant pulmonary vein anatomy in predisposition to the development of atrial fibrillation. The use of individual pulmonary vein anatomy in assessing the outcome of interventional treatment is discussed.

Роль гребенчатых мышц сердца в морфофункциональной регуляции сократительной деятельности миокарда: обзор литературы

Cardioembolic stroke, like other types of acute cerebrovascular disorders, is a global priority medical and social problem. This review analyzes the role of anatomical factors, which, along with other factors of thrombus formation in the heart chambers, may represent an important and yet insufficiently studied link in the pathogenesis of this disease.

Diseases of the sinoatrial node (SАN) are characterized by its inability to perform the function of the dominant pacemaker. This review presents data from recent studies of the anatomy and physiology of the SАN, which demonstrate the presence of structural and functional heterogeneity of the SAN and its components, describes the structure and function of the conducting intra-nodal pathways, the “novel paranodal area”, and also discusses the phenomenon of a shift in the site of excitation generation and the presence of a “non-firing mode” of cardiomyocytes. The authors critically discussed the genetic mechanisms of the development of sick sinus node syndrome (SSS), justified a multidisciplinary approach and further anatomical, morphological and physiological studies that play a fundamental role in the development of therapy and diagnosis of related diseases.

The state of the heart after a coronavirus disease 2019 (COVID-19, coronavirus disease 2019) is very diverse and in some cases requires a complex differential diagnosis. We described a 35-year-old smoking male patient who, by the end of the first month after COVID-19, developed left ventricular dysfunction with decrease in ejection fraction to 25-30% and persistent left bundle branch block (LBBB). Echocardiography also detected local contractility disorders. A significant increase in blood anticardiac antibody titers was noted. Myocardial biopsy revealed active lymphocytic myocarditis, coronavirus ribonucleic acid, while coronary angiography revealed extensive stenosis of the anterior interventricular artery. On the first day after balloon angioplasty and stenting, the disappearance of LBBB block was noted with the appearance of deep negative T waves in the precordial leads, which did not allow ruling out a previous myocardial infarction. As a result of treatment of heart failure and steroid therapy, the structural and functional cardiac parameters and the electrocardiography were completely normalized by the end of the second year of treatment. Only a transient LBBB remained at high loads. Cardiac computed tomography after 2 years showed no delayed contrast agent accumulation in the myocardium, and coronary stenosis up to 30%.The mechanisms of complex myocardial and coronary damage (including the role of coronaritis in the atherosclerosis progression) after COVID-19 are discussed.

Studying the regularities of organization of hemodynamic conditions in the heart cavities is a complex issue, since this organ has a complex geometric configuration and applying classical theories of hydrodynamics leads to significant contradictions, which are the object of discussion. Currently, researchers tend to vortex (tornado-like) organization of blood flow movement in the heart. A vortex organization is understood as a flow structure with circular or swirling movement of blood around a virtual central axis, which provides it with the ability to accumulate kinetic energy (KE) during swirling. At the same time, the swirling movement of blood should be distinguished from the turbulent one, which is characterized by the chaotic movement of vortices of different magnitudes and the dissipation of KE. The purpose of this review is to summarize the results and conclusions of studies on the anatomical mechanism of forming the conditions for the organization of swirling blood flow in the left ventricle (LV), as well as clinical evaluation and methods of studying swirling flows in patients.