Chronic heart failure laboratory

CHRONIC HEART FAILURE LABORATORY

The Laboratory of Chronic Heart Failure (CHF) was established in 1994 on the basis of Scientific and Consultative Laboratory (Head — Evgeniy Atroshchenko).  Since 2011 the laboratory is headed by Elena Kurlyanskaya.

MAIN DIRECTIONS OF WORK OF CHRONIC HEART FAILURE LABORATORY

1. Development of treatment methods of patients with cardiac insufficiency, prevention of disease progression and development of adverse clinical outcomes;
2. Monitoring the disease course in patients with CHF refractory to medication therapy;
3. Development and implementation of measures for primary and secondary prevention of CHF;
4. Development of approaches to cardiomyopathy treatment taking into account etiological certainty and prognostic risk;
5. Development of methods increasing the effectiveness of surgical treatment of heart failure;
6. Study of clinical outcomes and survival rates of patients with cardiomyopathy after endovascular correction of secondary mitral insufficiency;
7. Study of pre- and post-transplant survival factors in orthotopic heart transplantation;
8. Study of phenotypic manifestations of genotype in Belarusian patients with noncompact myocardium syndrome to develop a method of clinical and genetic diagnosis. To study the contribution of genetic factors to clinical manifestations of various forms of arrhythmogenic right ventricular cardiomyopathy;
9. Conducting work on the implementation in practical health care of the results of scientific research, modern approaches to the diagnosis and treatment of patients with CHF;
10. Organization of regional centers and schools of patients with CHF on the basis of public health institutions of the Republic of Belarus;
11. Conducting the annual Republican CHF Awareness Day;
12. Participation in the international pilot multicenter double-blind randomized prospective clinical trial Accucinch.

LABORATORY ACHIEVEMENTS

The results of chronic heart failure laboratory activities have allowed to develop a scientifically grounded strategy of CHF patient management, based on the use of high-tech methods of prevention, diagnosis and treatment taking into account risk stratification of cardiac failure progression and development of adverse cardiac events and outcomes.

The laboratory was the first in the Republic of Belarus to study the prevalence and incidence of chronic heart failure among the adult unorganized population of Minsk. The non-pharmacological program of the secondary prevention of CHF has been developed which allows to decrease the rate of CHF progression beginning from the out-patient-polyclinic stage of medical aid.

Employees of the laboratory implemented self-monitoring tools for patients with CHF: "Diary of a patient with heart failure" as an interactive mobile application on the Android platform and in hard copy.

The laboratory developed indications for intramyocardial injections of mesenchymal stem cells in patients with cardiomyopathy of non-ischemic genesis. The technology of renal artery denervation in patients with CHF who are ineligible or resistant to resynchronization therapy was introduced. Preoperative prognostic criteria of clinical outcomes after secondary mitral insufficiency correction in patients with cardiomyopathy with severe left ventricular insufficiency were determined. The algorithm for treatment selection of patients with cardiomyopathy with left ventricular ejection fraction less than 30% and severe mitral insufficiency has been introduced. The method of coronary artery disease prognosis in different periods after heart transplantation was developed.

The laboratory implemented in practical health care 18 instructions for use approved by the Ministry of Health of the Republic of Belarus.

In 2019 the laboratory staff prepared and published national "Recommendations on diagnosis and treatment of chronic heart failure". Six patents of the Republic of Belarus for invention were received. During the existence of the laboratory, its staff has published more than 150 scientific printed papers.

Using multifactorial prognostic models developed by the laboratory we created "Prognostic calculator of CHF progression " and "Survival calculator after mitral valvuloplasty in patients with cardiomyopathy".

Using our own scientific data obtained as a result of scientific activities of the laboratory, as well as taking into account national and European recommendations for the diagnosis and treatment of CHF, protocols for managing patients with heart failure, instructions for the use of diagnostic methods and treatment, the algorithm of medical care for patients with CHF ("Roadmap") was developed. "Roadmap" is based on risk-stratification of patients taking into account the severity of CHF at different stages of medical care and differentiated use of high-tech methods of diagnosis and treatment.

Employees of the laboratory of chronic heart failure participated in the creation of international registers of patients: with heart failure "EURObservational", peripartum cardiomyopathy, hypertrophic cardiomyopathy. The scientific associates actively participate in international clinical investigations, in organization and realization of scientific and practical conferences, consultations and councils, hold meetings of Belarusian Heart Failure Association, constantly raise their professional level.

Chronic Heart Failure Laboratory conducts active education and motivational work with patients and their relatives in order to form commitment to healthy lifestyle and disease treatment. Laboratory staff take part in "Chronic Heart Failure Awareness Day": the event is held annually in European countries to raise awareness of the disease symptoms, the importance of early and accurate diagnosis. This is a pan-European initiative, developed jointly by national heart failure societies across Europe in the framework of the activities of the European Society of Cardiology and the Heart Failure Association. In 2016, 2017 the Republic of Belarus was awarded the title of the winner.

On the basis of the laboratory 4 dissertations for the degree of Candidate of Sciences and 2 dissertations for the degree of Doctor of Medicine in the specialty 14.01.05–cardiology were defended.

LABORATORY STAFF

Elena Kurlyanskaya, leading researcher, MD, Associate Professor, doctor of the highest qualification category. The Head of the Laboratory, Deputy Director for Internal Medicine. She is an author of 2 monographs, 202 scientific publications, 4 patents of the Republic of Belarus for invention and 12 instructions for use approved by the Ministry of Health of the Republic of Belarus.

Svetlana Komisarova, leading researcher, MD, Associate Professor, doctor of the highest qualification category. Since 1992 up to now she has been working in RSPC "Cardiology" in the position of leading research worker. She is the author of more than 350 scientific publications in Belarusian and foreign editions, including 11 guidelines for diagnosis and treatment, and the author of 9 patients for inventions, including Russian Federation patents.

Olesya Shatova, senior researcher, PhD. She has been working at the RSPC "Cardiology" since 2007, since 2015 — in the laboratory of chronic heart failure. She is the author of 2 scientific articles, co-author of 13 scientific publications and 5 method instructions.

Tatiana Denisevich, researcher. She has been working at the RSPC "Cardiology" since 1996, since 2016 — in the laboratory of chronic heart failure. She is co-author of 246 scientific publications, 7 patents of the Republic of Belarus for invention and 12 instructions for method.

Elena Kozyreva, junior researcher. She has been working in the laboratory of chronic heart failure since 2018. She is the co-author of 5 scientific publications and 2 method instructions.

Maria Zarozhnaya, laboratory assistant. She has been working in RSPC "Cardiology" since 2005, since 2011 — in the laboratory of chronic heart failure.

Inga Yurkevich, laboratory assistant. Works in RSPC "Cardiology" since 1996, since 2011 — in the laboratory of chronic heart failure.

Elena Grebenshchikova, laboratory assistant. Works in the RSPC "Cardiology" since 2008, since 2011 — in the laboratory of chronic cardiac insufficiency.