[Comparative capabilities of the speckle-tracking echocardiography technologiesin two-dimensional and three-dimensional modes in the detection of subclinical cardiotoxicity in patients with breast cancer]

Approaches to early diagnosis and prevention of cardiovascular toxicity induced by targeted drugs and immune checkpoint inhibitors in oncohematology: a literature review

The development of targeted drugs and immune checkpoint inhibitors (ICIs), as well as their implementation into clinical practice has allowed increasing the overall and event-free survival of oncohematological patients. Currently, assessment of the efficacy of a therapeutic strategy in each specific case includes the evaluation of an acceptable tolerability profile. The subject of discussion includes cardiovascular complications induced by target drugs and ICIs. The review mainly presents the issues of cardiovascular toxicity (CVT) in certain groups of oncohematological patients (with chronic lymphocytic leukemia, chronic myeloid leukemia, multiple myeloma). The spectrum of cardiovascular adverse effects associated with targeted and ICI therapy in oncohematological practice is quite wide — coronary artery disease, peripheral arterial disease, myocarditis, heart failure, arrhythmias, hypertension. The high importance of the problem of using targeted and immunosuppressive therapy dictates the need to predict adverse effects. The diagnosis of heart failure (one of CVT manifestations) is based on determining the decreased left ventricular ejection fraction during echocardiography, less often — during cardiac magnetic resonance imaging; global longitudinal myocardial strain is a significant parameter of preclinical heart failure, which is determined using the speckle tracking technique. To determine vascular toxicity, a special attention is paid to the vascular wall structure and microcirculation parameters — capillary density at rest, percentage of capillary recovery and perfused capillaries, stiffness index for large blood vessels, reflection index for small arteries, laboratory markers of inflammation and endothelial dysfunction (C-reactive protein, fibrinogen, homocysteine, endothelin 1, vascular endothelial growth factor). CVT prevention presumes the determination of the risk group, correction of risk factors, and administration of protective therapy to very high and high-risk patients. One of the promising directions for preventing vascular toxicity is the use of sodium-glucose linked transporter-2 inhibitors.

The system of personal early non-invasive diagnosis of cardiac conditions as an element of the cyber physical system

In the 21st century, the most common cause of death in the developed countries is cardio. The Covid’19 pandemic only confirms this claim that the circulatory system and the heart are possible. That is why, even during a pandemic, the quality of cardio remains paramount. The significant cost of solving each element of these problems is the main driver of the idea of developing the ideology of preliminary diagnostics, as it allows you to more quickly (and therefore more effectively) respond to problems. In addition, today in Ukraine (and in the world as well) the cost of medical care is growing rapidly and not every society can afford to pay for medical services according to the usual rules of 20th century. One of the solutions that Ukraine is familiar with is that the pressure measurement is now done independently, and not an ambulance is called (doctor, nurse / brother, driver). The authors set themselves the task of exploring the following possibility in the problem of preliminary diagnostics to reduce the burden on the medical system. The aim of the work is to test the hypothesis of the possibility of early detection of cardio abnormalities by developing / creating an individual mobile device for preliminary diagnosis of the condition. In particular, on the example of monitoring the most common problem, rapid early diagnosis based on cardio signals. The main advantage of using the studied approach is the possibility of early diagnosis (rapid response) to complications, which is read by the sensor and analyzed by the analytical system (monitoring system). A basic study and experimentally tested the basic hypotheses are presented in the paper. The level and number of basic tasks that need to be solved to achieve the ultimate goal are checked. The basic concept of a personal intellectual advisor is tested. The results obtained during the experiments are visualized.