Background: The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services. Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary embolism through the development of standardized questionnaires and their association with various clinical parameters. Aim: To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate the quality of life of affected patients. Materials and Methods: A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer QoL. Data analysis was performed using SPSS version 16. Results: The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000 MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8; max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05). Conclusion The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in post-diagnosis medical care and long-term management strategies to improve patient outcomes.

Background: The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population, with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years, the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters, has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can become impair quality of life. Aim: We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism. Materials and Methods: This retrospective research included total 232 patients meeting inclusion criteria. The information was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables. Results: Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%). According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001). As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more frequent in those aged 65 and older. Conclusion Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing age.

Background: In 1904, Monkeberg was first described about the coronary calcification which is the degenerative change that occurs with aging process, but the last decades many studies have been confirmed that coronary calcification was an active process same as the signaling pathways with bone mineralization. Coronary calcification increases the risk of myocardial infarction during bypass graft surgery and PCI (СМ СN. Shanahan, 1999). Goal: To evaluate Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography. Objectives:
1. To assess Agatston Coronary Artery Calcium score
2. Age and gender relationship of coronary calcification Materials and Methods: We evaluated total 215 patients who were admitted to the Reference center of Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary Professor of the Third State Central Hospital awarded with the Red banner of the Labor diagnosed with the coronary calcification by contrast enhanced 64 slice CT (Philips Ingenuity CT 64) between 2020 to 2022. Patient’s age was considered into 6 groups and coronary calcification was assessed by Agatston’s score. The result of our study determined by common statistical averages and errors and probabilities of the indicators were determined by Student’s criteria. Result: When evaluating Agatston coronary artery calcium scoring by CT-coronary angiography, 11-400 Agatston score was predominantly in our study with p value of (P<0.001). Considering relationship of age and gender, coronary calcification occurs 42.3% of patients aged 50-69, male and female ratio was 1.7:1. Conclusions
1. We established Agatston coronary calcification 11-400 was occurred in 66.96% of the patients.
2. Coronary calcification predominantly occurred in 65% patients aged 50-69 years.

Background: The American Heart Association estimates that more than 1 million people die each year from acute coronary heart disease and half a million from acute coronary syndrome, and that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health Organization, 2013]. Goal: In this study we aimed to using coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease. Material and methods: From 2018 to 2021, we performed a coronary computed tomography angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT) device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital.
Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. Result: In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease that coronary artery diameters more widening to compared healthy artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18 (38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5). Conclusion We detect that computed tomography angiography (CCTA)’s specific signs of unstable plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes and rupture of intima.

Background: Lower extremity arterial diseases are chronic stenosis of the artery and occlusive arterial diseases, which are commonly caused by atherosclerosis. Prevalence of lower extremity arterial diseases has positive proportional relationship with age of the patients. Furthermore, prevalence of lower extremity arterial disease is 16% among the males over the age of 60, whereas prevalence among same aged woman is 13%. Among the age group of 38 to 59 age, 60 to 69 age and 70-82 age group, prevalence of lower extremity arterial disease was 5.6%, 15.9%, and 33.8%, respectively. Goal: Identifying lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions. Obiective:
1. To identify age and sex of the patients with lower extremity arterial occlusive disease and chronic stenosis of arteries.
2. To identify lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions. Material and methods: Study sample consisted of 237 patients, who were diagnosed with lower extremity arterial occlusive disease and chronic stenosis of arteries from 2019 to 2020 at reference centre on Diagnostic Imaging na after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital. Computed angiogram images of lower extremity arteries were examined. Contrast agent “Ultravist” was pumped by automatic syringe. Lower extremity arterial occlusive disease and chronic stenosis of arteries are categorized by CTA-TASC classification of аorta-iliac and femoral popliteal lesions. The youngest participant was 20 years old and the oldest participant was 76 years old. Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. Results: We have found following results: 185(78.1%±3.0) cases out of 237 diagnosed patients with lower extremity arterial occlusive disease and chronic stenosis of arteries are males and 52(21.9%±3.0) cases are female. Distribution of lower extremity arterial occlusive disease and chronic stenosis of arteries by the age group of patients are: up to 20 years of age is 3 (1.3%±0.7), 21 to 40 years of age is 14(5.9%±1.5), 41 to 60 years of age is 86(36.3%±3.1) and over the age of 61 is 134(56.5%±3.2). It is statistically highly significant that experiencing lower extremity arterial occlusive disease and chronic stenosis of arteries among the age group of over 61(P<0.001).
The result of lower extremity arterial occlusive disease and chronic stenosis of arteries by the CTA-TASC classification of aorta-iliac and femoral popliteal lesions are: CTA-TASS аorta-iliac lesions A-16(6.8%±1.8), B-8(3.4%±1.2), C-12(5.1%±1.4), D-41(17.3%±2.5), CTA-TASS femoral popliteal A-41(17.29%±2.5), B-53(22.36%±3.6), C-47(19.83%±2.6), D-96(40.5%±3.2), respectively. Conclusions
1. Lower extremity arterial occlusive disease and chronic stenosis of arteries occurs 46.5% over the age of 60 and 78.1% of the patients are males.
2. Following two categories have identified more than the rest, 17.3% CTA-TASC classification of аorta-iliac lesions, type D and 23.3% CTA-TASC classification of femoral popliteal lesions, type D.

Introduction: Studies demonstrated that the apolipoprotein B/apolipoprotein A-I (Apo B/apo A-I) ratio predicts cardiovascular risk better than any of the cholesterol indexes. Apo B and Apo A-1 are assumed to be superiormarkers for lipoprotein abnormalities [1,2]. The concentrations of Apo B and Apo A-1 are associated with cardiovascular disease more strongly than the corresponding lipoprotein cholesterol fractions, the discriminant value of these apoproteins in absolute terms appears to be less important than of their ratio (the Apo B/Apo A-1 ratio) [3, 5-7]. The Apo B/Apo A-1 ratio reflects the balance of atherogenic and antiatherogenic lipoproteins in plasma [4]. Multiple clinical and epidemiological studies have confirmed that the Apo B/Apo A-1 ratio is a superior marker for cardiovascular disease compared with lipids and lipoproteins or their ratios [8, 9]. Goal: We determined the variation limits of the Apo B/Apo A-1 ratio in healthy participants with normolipidemia and the relationship of this ratio with other lipid parameters. Material and Methods: A total of 146 normolipidemic healthy participants aged 25–60 years were included in the study. Anthropometric measurements (height and weight) and other personal information were obtained during the clinical examination and the interview. Participants were included in the study using the following criteria:
1. body mass index < 30 kg/m2;

2. TC < 5.2mmol/L;
3. triglycerides (TG) ≤1.7 mmol/L;
4. HDL-C ≥1.03 mmol/L ( woman), ≥ 1.29 mmol/L (male) .
The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apo A-I, Apo B and Apo B/Apo A-1 were determined after a 12 h fasting period. The non-HDL-C was calculated as the difference between the TC and HDL-C. Most research data emphasized that the values for the Apo B/Apo A-1 ratio that define a high cardiovascular risk were proposed to be 0.9 for men and 0.8 for women. Statistical Analysis. The statistical analysis was performed using SPSS 21.0 (USA). Differences between the groups were analyzed using the Mann-Whitney test and the chi-squared test. Correlations between the indices were assessed using the Spearman’s rank correlation. A value of < 0.05 was accepted as statistically significant. Results: The relationship of ratio of apolipoprotein (Apo) B/Apo A-1 with other indicators of lipid metabolism in healthy people with normal lipidemia was analyzed. The Apo B/Apo A-1 ratio in the studied normolipidemic subjects was 0.69 ± 0.17. The percentage of subjects with the Apo B/Apo A-1 ratio exceeding 0.9 (the accepted risk value of cardiovascular disease) was 36.3 %.The subjects with Apo B/Apo A-1>0.9 were characterized by higher HDL-C levels and atherogenic Aпo B, Apo B/Apo A-1 but lower values Apo A-1. Conclusion The subjects with normolipidemia the unfavorable Apo B/Apo A-I ratio> 0.9 had more atherogenic lipid profile.

Introduction: Cardiovascular Disease (CVD) is a major cause of morbidity and a leading contributor to mortality in both developed and developing countries. With rapid socioeconomic development, CVD has reached epidemic proportions in developing countries in recent decades. Dyslipidemia, elevated level of plasma cholesterol, together with arterial hipertension, is the main modifiable risk factor atherosclerosis and cardiovascular diseases (CVD) development. Surveys to monitor and measure dyslipidemia burden in a Mongolian population has not been conducted in recent years and the available data on the prevalence, types, and associated factors of dyslipidemia in the general population is relatively insufficient and outdated. Monitoring of lipid profile at populational level is an important instrument of prevention medicine, applied for CVD populational risk assessment. Goal: Evaluate comparisons of adult blood lipid levels in age, gender and location. Material and Methods: In this study, 500 people aged 25-65 were classified into age groups (47.1% for males and 52.9% for females). Blood plasma in total cholesterol (TC), triglyceride (TG), high density (HDL-C) and low density (LDL-C) lipoprotein-cholesterol, apolipoprotein - ApoA1, Apo B and ratio of ApoB / ApoA1 were estimated. Statistical analysis was performed using SPSS 22.0 Results: Mean age of the participants was 48.8±14.2 years old. Mean values for male TC-4.85±0.92 mmol/l, TG-1.58±1.19 mmol/l, LDL-C-3.24±0.98 mmol/l, HLD-C-1.62±0.21, for women- 4.47±0.96 mmol/l, 1.22±0.47 mmol/l, 2.95±1.01 mmol/l, 1.77±0.23 mmol/l respectively. The mean blood TC,TG levels tended to increase with age group in male compared to women. The prevalence of an increased blood LDL-C levels or risks for an increased blood LDL-C was statistically significantly high in male. Conclusion The prevalence of lipid was shown as high, that demands respective prevention and management.

Introduction: Coronary atherosclerosis is the leading cause of morbidity and mortality in the world. Hypogonadism is not considered a traditional risk factor for coronary artery disease (CAD). Higher CVD mortality may be partially attributed to behavioral and physical characteristics of males, including increased smoking, drinking, endocrine and metabolic factor like fat distribution, and low male engagement in preventive care. In the last decades, many studies have suggested that low testosterone levels are associated with increased prevalence of risk factors for CVD, including dyslipidemia and diabetes. For the reason, this research focused on identifying any association between testosterone deficiency and risk factors of coronary heart disease. Goal: This study aimed to identify any association between testosterone deficiency and risk factors of coronary heart disease in Mongolian men. Material and methods: In this case control study, we determined plasma total testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol, apolipoprotein – ApoA1, Apo B and glucose in 287 subjects, among them 125 patients with ACS and 162 healthy subjects. Statistical analysis was performed using SPSS 22.0 of IBM. Results: Mean age of the participants was 55.19±6.99 years old. It was found that, mean plasma TT levels in patients with ACS (4.17 ng/ml) was significantly lower than in the healthy subjects (4.70 ng/ml). There was a negative association between plasma TT level and glucose level (r=-0.185; p=0.002) and ApoB/ApoA1 (r=-0.132, p=0.026). Conclusion The results in the present study suggest that low plasma TT level may be a risk factor for CHD in men, which may relate to the influence of plasma lipoprotein and glucose metabolism by endogenous testosterone.

The anatomy and diseases of the coronary artery, and number or death toll in relation to the coronary artery disease in Mongolia, CT and HRCT the pathologic physiology and risk factors of atherosclerotic calcifications of the coronary artery, the comparison between CT, HRCT and Coronary angiography of coronary arteries of the heart, the selection of a patiant, the preparation of a patient, and the steps of examination that how the patient going through ,the advantages and the disadvantages of CT coronary angiography, the limitation of use of HRCT, the indications and the contraindications to HRCT, the method and devices to reveal a calcification of the coronary artery, the AGATSTON score of calcification and its radiologic imaging, the index of calcification of the coronary artery, a guideline devoted to the patients who have coronary artery calcifications, an amount of 50 references in relation to unstable atherosclerotic plaques radiologic signs on the HRCT were used .

Background : The frequency of tetralogy of Fallot among newborns and infants is 5.6-14.0% of all congenital heart defects [5, 14, 17] The most frequent complication of the early postoperative period is right ventricular failure, which is formed when the anatomy of the right ventricle and the progressive pulmonary regurgitation are disturbed [1, 3, 12]. With the development of new minimally invasive methods of examination and their introduction into clinical practice, the understanding of hemodynamic parameters after surgical correction, pathophysiological mechanisms of development of right ventricular dysfunction has improved.
One of these methods is transpulmonary thermodilution and pulse waveform analysis, which allows in the early hours after operation to determine preload, heart function and postload parameters [9, 20].
In the long-term period, many patients after radical correction have right ventricular dysfunction due to many years of massive pulmonary regurgitation. With the introduction of MRI improved understanding of the pathophysiological mechanisms of development of right ventricular dysfunction.. Recent reports indicate that the global functional assessment of the right ventricle after surgical correction does not reflect its present function [7, 10]. Aim: The aim of the study was to estimate the early postoperative indices of hemodynamics in different types of the right ventricular output plastics after radical correction of Fallot’s tetralogy and to access the functional state of the right ventricle in the long- term postoperative period. Materials and Methods: On the basis of cardiovascular surgery department of the Shastin P.N. hospital, a prospective cohort study of 52 patients (28 boys, 24 girls), underwent radical correction of Fallot’s tetralogy, was conducted.
Patients were divided into 2 groups by the type of reconstruction of the right ventricular outlow tructs: group I included patients with transannular plasty of the output part (group I, 26 patients), group II-patients with preserved fibrous ring of the pulmonary artery (group II, 26 patients). The postoperative hemodynamic status was assessed with transpulmonary thermodilution. The right ventricular function in the long-term period was estimated by means of US and MRI. Results: During the first postoperative hours, hemodynamic indices according transpulmonary thermodilution technique were significantly lower in group I and reliable differed from group II. However, later (12.24,48 hour after), restoration of hemodynamic indices in group I, which did not significantly differ from group II, was observed. In the long-term period, ejection of the right ventricle was reliable higher in group II, while terminal diastolic volume of the right ventricle was significantly higher in group I. Pulmonary regurgitation was also significantly higher in group I-36.7 (32,44) versus 13,2 (3;14) (p<0,01). Conclusions Preservation of pulmonary artery fibrous ring provides better parameters of hemodynamics in the early postoperative period including systolic and diastolic functions. In the long-term period, this group of patients is less subjected to the right ventricular function.