[Coronary venous blood flow in patients with acute myocardial infarction]. / Sostoianie koronarnogo venoznogo krovotoka u bol'nykh ostrym infarktom miokarda.

In 94 patients with large myocardial infarction, their coronary venous blood flow was studied in the acute period of the disease by continuous coronary sinus thermodilution. No relationship was established between the coronary venous blood flow and the duration of coronary heart disease. The patients with anterior myocardial infarction had a significantly less blood flow in the vena cordis magna than those with posterolateral infarction. No correlation was found between the blood flow and precordial mapping parameters. Thus, continuous coronary sinus thermodilution cannot be used for indirect identification of the site of myocardial infarction and for prediction of its progression severity.

[Status of coronary venous blood flow in patients with ischemic heart disease in myocardial ischemia induced by the atrial stimulation test]. / Sostoianie koronarnogo venoznogo krovotoka u bol'nykh ishemi- cheskoi bolezn'iu serdtsa pri ishemii miokarda, indutsirovannoi testom predserdnoi stimuliatsii.

A total of 85 patients (68 with coronary heart disease in the presence of effort angina of various functional classes (a major group) and 17 with neurocirculatory++ dystonia and cardialgic syndrome (a control group)) were examined. Heart failure severity and blood flow distribution in the functioning myocardial areas were evaluated in transient ischemia induced by atrial pacing. Three levels of coronary venous blood flow were defined in patients with coronary heart disease. A relationship between the coronary blood flow, disease history duration, and coronary blood flow changes was examined in cardioselective exercise.

[Effect of isoptin on catecholamine levels in arterial and coronary venous blood during an attack of myocardial ischemia]. / Vliianie izoptina na soderzhanie katekholaminov v arteria'lnoi i koronarnoi venoznoi krovi vo vremia pristupa ishemii miokarda.

Blood catecholamines (dopamine, adrenaline and noradrenaline) were measured in the coronary sinus and artery of 35 patients divided into 2 groups: coronary patients with stable angina of effort, functional class II-III (group 1) and patients with NCD (group 2), before and during a cardioselective load test (atrial stimulation). Developing myocardial ischemia was associated with a significant rise of noradrenaline in arterial and coronary venous blood. The use of isoptin changed noradrenaline balance, resulting in increased noradrenaline level in the coronary sinus, while coronary flow increased, as did the anginal threshold. Noradrenaline rise may well be an additional antianginal factor mediating the action of isoptin.

[Effects of isoptin and obsidan on the coronary blood flow and tactics in anti-angina therapy of patients with ischemic heart disease]. / Vliianie izoptina i obzidana na koronarnyi krovotok i taktika antianginal'noi terapii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Single intravenous doses of isoptin (10 mg) and obsidan (5 mg) were tested for their effects on hemodynamic and coronary blood flow parameters in 35 patients with coronary heart disease and functional classes II-III angina pectoris of effort. In most cases, hemodynamic and coronary blood flow responses to the drug administered were found to be identical. It was concluded that isoptin was effective as an antianginal agent in eukinetic hemodynamics, obsidan, in hyperkinetic one.

[Effect of obzidan on coronary blood flow in patients with the hyperkinetic type of hemodynamics in the acute period of myocardial infarct]. / Vliianie obzidana na sostoianie koronarnogo krovotoka u bol'nykh s giperkineticheskim tipom gemodinamiki v ostrom periode infarkta miokarda.

Changes in the rate of coronary venous flow through the affected area under the effect of intravenous jet injections of propranolol, 0.1 mg per 1 kg body weight, were assessed in 18 patients of the hyperkinetic central hemodynamic type during acute myocardial infarction. In the first group of patients, whose mean flow rate through the affected wall was 106.2 +/- 5.7 ml/min, the latter parameter decreased in proportion to the drop in double product. In the second group of patients, whose coronary venous flow rate was reduced (51.4 +/- 6.9 ml/min), propranolol-induced drop in the flow rate was less marked, as compared to the drop in double product. It was correlated with dramatically depressed pumping function of the heart.

[Effect of renokinase on the space velocity of coronary vein flow during systemic administration to patients with acute myocardial infarct]. / Vliianie renokinazy na ob"emnuiu skorost' koronarnogo venoznogo krovotoka pri sistemnom vvedenii bol'nym ostrym infarktom miokarda.

A new thrombolytic drug, renokinase, was administered intravenously to 30 patients with macrofocal myocardial infarction (MI), admitted to hospital within early hours of its onset. Changes in the venous network of the heart were assessed, using continuous thermodilution, in the presence of thrombolytic treatment. Coronary venous flow was shown to increase by 20% and more in 17 patients, more than 30% in 15 patients, and more than 40% in 10. Low MI was associated with a significant increase of blood flow rate in the coronary sinus as well as other cardiac veins, while anterior MI was associated with flow rate increase in the coronary sinus only. A 20-30% increase in any of the coronary flow parameters limited the necrosis focus, as evidenced by precordial mapping from 35 ECG leads. Renokinase (60,000 units) was well tolerated by the patients.

[Effect of myocardial ischemia on prostacyclin and thromboxane levels in arterial and coronary venous blood]. / Vliianie ishemii miokarda na soderzhanie prostatsiklina i tromboksana v arterial'noi i koronarnoi venoznoi krovi.

Variations in arterial and venous blood prostacyclin and thromboxane were examined in 32 patients with coronary heart disease, neurocirculatory dystonia and the cardialgic syndrome, exposed to cardioselective stress as a result of the atrial stimulation test. Prostacyclin and thromboxane measurement in blood specimens obtained from the left ventricle and the coronary venous network may provide additional markers of myocardial ischemia in cases where diagnosis is otherwise difficult to make.

[Concept of the polyfascicular structure of the atrioventricular junction in patients with reciprocal paroxysmal nodal tachycardias]. / Kontseptsiia polifastsikuliarnogo stroeniia atrioventrikulianogo soedineniia u bol'nykh s retsproknymi paroksizmal'nymi uzlovymi takhikardiiami.

Intracardiac electrophysiologic studies were carried out in 41 patients with paroxysmal supraventricular tachycardias. Reciprocal atrioventricular tachycardia due to dissociated conduction through the atrioventricular junction was diagnosed in 29 patients. Electrophysiologic data suggested trifascicular atrioventricular conduction in 4 patients, and quadrifascicular conduction in 2. A concept of polyfascicular impulse conduction through the atrioventricular junction in some cases of reciprocal nodal tachycardia is proposed. It is demonstrated that combinations of congenital cardiac conduction abnormalities may be possible in the same individual.

[Latent Wolff-Parkinson-White syndrome as the electrophysiological and morphological basis of supraventricular tachycardia]. / Skrytyi sindrom Vol'fa-Parkinsona-Uaita kak elektrofiziologicheskaia i morfologicheskaia osnova nadzheludochkovykh takhikardii.

The concealed Wolff-Parkinson-White (WPW) syndrome, the electrophysiologic and morphologic basis of cardiac arrhythmias, was shown to be a cause of the attacks of supraventricular tachycardia. The latter is rooted in the concealed WPW syndrome in about 30% of patients showing no electrocardiographic signs of pre-excitation. Electrophysiologic criteria of the diagnosis of supraventricular tachycardias due to the concealed WPW syndrome are listed. Concealed Kent's bundle was most commonly found on the left side. As regards antiarrhythmic therapy, disopyramide is one of the most effective drugs for patients with supraventricular tachycardias due to the concealed WPW syndrome.

[Use of isoptin in the acute period of myocardial infarction (its effect on hemodynamics and myocardial metabolism)]. / Primenenie izoptina v ostrom periode infarkta miokarda (vliianie na gemodinamiku i metabolizm miokarda).

To study the hemodynamic and metabolic effects of isoptin, the drug was infused intravenously to 15 patients with acute transmural myocardial infarction at a dosage of 0.13-0.17 mg per kg bw. Along with the parameters of the central hemodynamics and the myocardial contractility of the left ventricle, using extraction coefficients the authors determined some parameters of myocardial metabolism. The drug was well tolerated by the patients, virtually did not affect the parameters of myocardial contractility, decreased the work of the heart at the expense of a significant reduction of the after-load and lowered manifestations of the ischemia of the intact myocardium (the coefficient of lactate extraction by the myocardium was found to elevate).