Predictive and preventive strategies to advance the treatments of cardiovascular and cerebrovascular diseases: the Ukrainian context

Abstract

Despite great efforts in treatments of cardiovascular diseases, the field requires innovative strategies because of high rates of morbidity, mortality and disability, indicating evident deficits in predictive vascular diagnosis and individualized treatment approaches. Talking about the vascular system, currently, physicians are not provided with integrated medical approaches to diagnose and treat vascular diseases. Only an individual global approach to the analysis of all segments in the vascular system of a patient allows finding the optimal way for vascular disease treatment. As for the existing methodology, there is a dominance of static methods such as X-ray contrast angiography and magnetic resonance imaging in angiomode. Taking into account the world experience, this article deals with innovative strategies, aiming at predictive diagnosis in vascular system, personalization of the biomedical treatment approaches, and targeted prevention of individual patient cohorts. Clinical examples illustrate the advances in corresponding healthcare sectors. Recommendations are provided to promote the field.

Figure 1

High trust and understanding of the heart portrait in dynamics by a patient. The methods of highly sensitive ECG allows the diagnosis and monitoring of early ischemic changes in the myocardium with the correction of vascular blood flow.

Figure 2

Clinical interpretation of the functional state of brain arteries and veins through ultrasound dopplerography. Only methods of clinical interpretation of the functional state of arteries and veins in the brain with the help of ultrasound dopplerography can localize signs of the arteriovenous shunting and define its size and risk of development of deficit in regional blood supply [25-27,30].

Figure 3

An example of an examination of the arteriovenous cerebral balance with ultrasound dopplerography[30]. If we do not take into account the degree of violation of this balance, treatment of any vascular pathology in the regional reservoir may be not effective.

Figure 4

Equipment in obtaining images. Due to the obtained images, we can estimate large amount of microcirculatory parameters that enable to estimate the influence of rehabilitation on all stages.

Figure 5

Interchanging of various neurorehabilitation exercises. This takes into account a level of blood filling and the brain readiness to loads. Born in 1989. Diagnosis: apallic syndrome, the stage of ‘high’ full consciousness, first degree of disability.

Figure 6

Microcirculatory image.

Figure 7

The six-year rehabilitation program is successfully completed. Born in 1983. Diagnosis: multiple sclerosis, 1st degree of disability, tied down to the bed.

Figure 8

The microcirculatory picture testifies about the necessity of continuation of regular exercises.

Figure 9

A stage of preparation to some group activity in a preschool establishment. This became possible due to the circulation improvement and strengthening of cognitive functions. Born in 2001. Diagnosis: autism, arrest of psycho-motor development.

Figure 10

Microcirculatory image.

Figure 11

Psychokinetic therapy. This helps to restore sanogenic reactions of the vascular system to psychological and physical loadings, and to prepare the vascular system to the body verticalization of the patient after long staying in bed. Born in 1977. Diagnosis: apallic syndrome, stage of ‘large’ (full) consciousness, first degree of disability.

Figure 12

Microcirculatory image.

Figure 13

The capillaroscopy complex. For visualization, archiving, mathematical processing, and clinical interpretation of etiopathogenesis of microcirculatory disorders [28,30].