Background: Cardiovascular diseases (CVDs) is a third leading cause of non-communicable diseases and a leading cause of mortality in Mongolia. Among these, acute myocardial infarction (AMI), a complication of coronary artery disease (CAD), is a leading cause of cardiovascular mortality. In patients with AMI, both epicardial artery blood flow, observed through coronary angiography, and coronary microcirculatory dysfunction (CMD) play critical roles in the disease’s pathophysiology. Recent advancements have introduced artificial intelligence (AI)-based softwares which are capable of analyzing coronary blood flow from coronary angiography images. The AI based softwares can assess not only epicardial blood flow but also CMD in recent studies. In this review, we discussed the role of CMD in pathophysiology of AMI, diagnostic approaches, the application of AI-based technologies, their clinical significance, and future directions. Aim: This review aims to explore the pathophysiological relationship of coronary microcirculatory dysfunction (CMD) in the context of acute myocardial infarction (AMI), diagnostic methodologies, the application of artificial intelligence (AI)-based technologies, and their clinical significance. Hypotheses: 1. AI-based software allows for highly accurate assessment of coronary microcirculation during AMI. 2. CMD during AMI is associated with structural and functional changes in the heart. 3. CMD during AMI is related to disease prognosis and patient outcomes. Methodology:: This narrative review was compiled using a systematic and logical approach, based on publicly available recent clinical and biomedical research literature addressing the above hypotheses. Conclusion In recent years, AI-based image processing software has been developed to analyze angiographic images obtained during percutaneous coronary intervention (PCI) and treatment procedures. These tools show significant promise for early detection and improved diagnosis of CMD during AMI, as well as for better assessment of short- and long-term patient risk.

Background: Type 2 diabetes has increased risk of heart failure 2-4 times more than those in non-diabetic subjects. The early detection of asymptomatic ventricular dysfunction by using NT-pro BNP test in diabetic patients is the best strategy for decreasing morbidity and mortality of heart failure. Aim: The aims of this study were to detect asymptomatic cardiac ventricular dysfunction by using NT-pro BNP test in subjects with type 2 diabetes and to define the factors associated with elevated NT-proBNP. Materials and Methods: This cross-sectional study was included diabetic and non diabetic subjects aged from 35- to 64 years, who had no clinical symptoms of heart failure. Cardiovascular risk factors were detected by clinical examinations. NT-pro BNP determination was performed on an immunoassay analyzer (FIA1100, Getein Bio Medical Inc, China), which uses reagent strip to obtain quantitative NT-pro BNP results in plasma. The cut-off point for NT-pro BNP was 300 pg/ml. Results: A total of 536 subjects without clinical symptoms of heart failure were included in the study of which, 150 were diabetic and 386 were non diabetic. The mean age was 52.8 ± 7.8 years and 281 (52.4%) were females. Cardiac ventricular dysfunction was detected in 7.3% of diabetic and 5.2% of non diabetic subjects. Cardiac ventricular dysfunction in diabetic subjects was increased with age and non-significantly higher in females than in males (8.3% vs 6.4%, p>0.05). In the logistic regression analysis, uncontrolled hypertension (OR 3.80, 95% CI 1.07–13.44), long duration of disease (OR 5.30, 95% CI 1.36-20.66), and ageing (OR 5.40, 95% CI 1.29–22.88) were significantly correlated cardiac ventricular dysfunction in subjects with type 2 diabetes. Conclusion Cardiac ventricular dysfunction in subjects with type 2 diabetes was detected 1.4 times more than those in non diabetic subjects. The likelihood of positive NT-pro BNP test in subjects with type 2 diabetes was independently (p<0.05) associated with advanced age, uncontrolled hypertension and long duration of diabetes.

Background: Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide. CVD risk increases significantly even in the early stages of chronic kidney disease (CKD) and CVD deaths account for more than half of all known causes of death in patients with end stage renal disease. Cardiovascular risk factors such as hypertension, anemia, hyperphosphatemia, volume overload and uremic toxins usually occur when eGFR is below 60 ml/min/1.73m2, while the subclinical atherosclerosis starts to develop in early stages of CKD. Serum N-terminal pro B type netriuretic peptide (NT-proBNP) is important for predicting subclinical heart failure in patients with CKD. Methods: Plasma NT-proBNP concentrations were measured in 37 patients with CKD (mean age = 54 years, female 48.6%). Renal function was assessed by estimated glomerular filtration rate (eGFR; ml/min/1.73m2) and the subjects were classified into five stages of CKD. Pearson correlation analysis was used to analyze he relationship between renal function and serum NT-proBNP levels. Results: The mean serum NT-proBNP level was in CKD stage I ( <50pg/ml, p<0.0001), CKD stage II (64.86±21.79 pg/ml, p<0.0001), CKD stage III(119.56±158.1pg/ml, p<0.0001), CKD stage IV (5801.8±7213.7 pg/ml, p<0.0001), CKDstage V (6993.1±9029.9 pg/ml l, p<0.0001). Serum NT-proBNP level was inversely correlated significantly with eGFR (r = -0.464, р = 0.004). Conclusion Our findings indicate the circulating levels of NT-proBNP increased with deteriorating kidney function and these values were highest in patients with CKD IV and CKD V stages.

BACKGROUND. Hypertension is an increasingly important medical and public-health issue. Recent years complementary and alternative medicine therapies are getting popular and frequently than medical treatment used by patients with hypertension and cardiovascular disease. Aiming to analyze the efficacy of bloodletting to treat impure blood and hypertension and to implement to the clinical practice. METHODS. 14 day before and after loodletting treatment, triglycerides, cholesterol, high- density lipoprotein were analyzed and compared to body type for 30 patients (30- 60 years old ) who have 1st stage arterial hypertension. The LDL was calculated with Fridvalid formula. The participants took traditional prescription ( formula of three seeds) 2gr twice per day for 5 days after bloodletting vena. ( jinshug) RESULTS. The study showed that triglycerides are decreased by 0,4mml/l (P value 0.0047), cholesterol was decreased by 1,54 mml/l (P value 0.00001), LDL was decreased by 1,68 mml/ l (P value 0.00001), and HDL was increased by 0,22 mml/ l (P value 0.0001) after bloodletting treatment. After treatment we observed decreasing hypertension when measured the systolic and diastolic blood pressure for three months. LDL and cholesterol increasing in the blood is risk for cardiovascular disease. But in this study LDL and cholesterol were decreasing after bloodletting treatment which means it is possible to prevent from cardiovascular disease. As well after treatment HDL was increased in the blood that showed prevention from arteriosclerosis. СONCLUSION. Most of patients were shar and badgan type. The badgan type with patients had obesity and high cholesterol compared to other body types. After treatment cholestrol was decreased in all patients, LDL was decreased and HDL was significantly increased in the badgan type patients with hypertension. Systolic and diastolic blood pressure were decreased and stable and kept for long time after bloodletting treatment.

BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.

BACKGROUND. To introduce a new electronic technology which is mobile-based ophthalmoscope to the clinical practice for the patients with diabetes and hypertension. MATERIAL AND METHODS. There are 32 participants who were diagnosed with hypertension (blood pressure measured more than 140/90 mm Hg three times a month or for 2 weeks) participated in our study. We selected the patients with type II diabetes and hypertension who were referred to the RTW diabetes center. RESULTS. In the hypertensive group, based on Keith Wagener Barker (KWB) Grades, there are 1st and 2nd degree retinopathy cases are more common and it increases with the age. In the diabetic group, non-proliferative diabetic retinopathy is diagnosed among the patients aged above 60 years old and it correlates with the duration of disease.

BACKGROUND. Heart failure is the leading cause of the death among non-communicable diseases. Heart failure is a fatal disease that once its clinical symptoms appeared, five years of survival rate is 50-75%. Chronic heart failures are the main risk factors arterial hypertension, diabetes, obesity and dyslipidemia Thus, early diagnosis before its symptoms are presented and treatment with close monitoring is the most rational and effective approach for decreasing heart failure diseases and deaths caused by it. OBJECTIVE. To determine the level of NT-pro BNP in people with high risk of chronic heart failure and assess its results. METHODS. We conducted hospital-based descriptive study at State Second Central Hospital and Bayanzurkh District Medical Center. Total of 100 participants aged from 35 to 64 who had no symptom of chronic heart failure however with high risk were recruited in this study. Based on the document entitled “Heart failure prevention 2008” of the American Heart Association, old age, arterial hypertension, diabetes mellitus, heart attack and obesity were considered as higher risks of heart failure. Risk factors of heart failure were estimated by questionnaire and physical examination. The level of NT-pro BNP in plasma was determined using FIA8000 analyzer. According to the guideline produced by the European Society of Cardiology in 2016, result of the testing is considered “positive” when NT-pro BNP is higher than 125 pg/ml. Risk factors of chronic heart failure were studied in comparison with two groups which were NT-pro BNP positive and negative results and their statistically significant difference were determined. RESULTS. Of 87 participants, 51 (51%) were female and 49(49%) were male. Half of the participants (51%) were aged between 55-64. Arterial hypertension was determined in 88% of the participant, 38% were overdose drink of alcohol, therefore 55% were 1,2,3 levels obesity and 36% were diabetic. When determining the NT-pro BNP level, in 34 cases (34%) were positive. Hence, 31% of the people with arterial hypertension, 9% of the people overdose drink with alcohol, 20% of the people with obesity, 12% of the people with diabetes showed positive results of NT-pro BNP. When studying the risk factors of chronic heart failure of the compared two groups of NT-pro BNP positive and negative results, statistically significant difference (p<0.05) was increased of the with arterial hypertension and obesity. CONCLUSION. NT-pro BNP is the arterial hypertension and obesity which is increasing for people compared to the other risking factors

BACKGROUND: Cardiovascular diseases (CVDs) account for >17 million deaths globally each year and this figure is expected to grow to 23.6 million by 2030. According to the WHO report, one-third of ischemic heart disease is attributable to high cholesterol. There have been some claims that the atherogenic index of plasma (AIP), which is the logarithmic transformation of the just-mentioned ratio (TG/HDL-C), could be used as a significant predictor of atherosclerosis, and CVD as well. Thus, we aimed to study the relationship between AIP and cardiovascular risk factors. METHODS: The cross-sectional hospital based study was conducted including 117 participants aged between 40-72 years old without cardiovascular symptoms were recruited from Second General Hospital. After filled consent form, participants’ habits of smoking, alcohol usage, obesity, arterial hypertension and sedentary lifestyle were assessed through a structured questionnaire and physical examination. By using fully automated open-system analyzer, determinations of total cholesterol, triglycerides, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) three times and glucose twice were performed simultaneously and then their averages were calculated. At least one abnormal lipid level was considered as “dyslipidemia”. The atherogenic index of plasma (AIP) was calculated as the logarithmically transformed ratio of molar concentrations of TG to HDL-C. Statistical analysis was performed using SPSS 22. RESULTS: Of total 117 participants ranging 40-72 years old, 45.3% were male and 54.7% were female with mean age 53.6±0.79. Regarding cardiovascular risk factors, 63.8% were physically inactive, 32.48% were smokers, 47% were alcohol user, 48% were hypertensive, and 18.26% were diabetic. The mean values plus standard error of lipid components were 195.5±6.09 mg/dL in cholesterol, 181.25±27.36 mg/dL in triglycerides, 60.6±1.39 mg/dL in HDL-C, 138.5±3.74 mg/dL in LDL-C, 6.27±0.26 mmol/L in fasting glucose. The dyslipidemia was detected in 54.7% of total participants and mean level of AIP was 0.33±0.03 (min=-0.52; max=1.51). The mean levels of 10 year and lifetime risk were 6.25±0.63% (min=0.2; max=33.5) and 43±1.53% (min=7.5; max=69), respectively. AIP had weak correlations with gender, smoking, anti-hypertensive drug usage, aspirin usage, 10 year and lifetime risks of CVD, hypertension, fasting glucose, body mass index, and dyslipidemia (0.2

Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare. The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.

Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare.The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.