[Spiroergometry in assessing the late results of the aortocoronary shunting operation]. / Spiroérgometriia v otsenke otdalennykh rezul'tatov operatsii aortokoronarnogo shuntirovaniia.

The remote results of aorticocoronary shunting were studied in 105 patients (follow-up periods of 1 to 5 years and more). The values of bicycle ergometry and spiroergometry (rehabilitation coefficient, oxygen expenditure per 1 kgm of work, maximum oxygen consumption per 1 kg body mass during muscular exertion, effectiveness of work) were studied before and after operation. The data obtained were compared with the results of spiroergometry in 175 patients with various lesions of the coronary arteries identified by coronarography and in 50 healthy individuals. Spiroergometry is an effective method for diagnosing coronary atherosclerosis before performing coronarography. Patients with good postoperative results showed values which were close to normal; in poor results of surgery and in thrombosis of the coronary shunts initial values characteristic of atherosclertoic involvement of the coronary arteries are encountered. Increase of the effectiveness of work to normal, decrease in oxygen expediture per 1 kgm of work, diminution of maximum oxygen consumption per 1 kg body mass during muscular exertion in the remote postoperative period make it possible to presume, before performing coronarography, that the shunts are functioning. The study conducted allow bicycle ergometry and spiroergometry to be considered demonstrative functional methods for appraising the remote results of operation.

[Bicycle spiroergometric studies in the diagnosis of ischemic heart disease]. / Spiroveloérgometricheskie issledovaniia v diagnostike ishemicheskoi bolezni serdtsa.

The indices of pulmonary ventilation and gas exchange, oxygen consumption per 1 kgm of work, the restoration coefficient, the effectiveness of work, etc. were studied at rest, during dosaged physical exertion on a bicycle ergoraph, and in the restoration period in 50 healthy individuals and in 175 patients with ischemic heart disease. Selective coronary angiography was conducted in all of the patients. Spiro-bicycle-ergometry is an informative method in the diagnosis of ischemic heart disease, enabling the physician to presume the presence of coronary sclerosis and judge the degree and extent of involvement of the coronary arteries before performing coronarography. With the gradual increase in the number of involved arteries, there were noted a gradual decrease of the restoration coefficient, diminution of the effectiveness of work, and an increase in oxygen consumption per 1 kgm of load. Changes in spiro-bicycle-ergometric indices in patients with ischemic heart disease and normal coronary arteries had the same trend as those in patients with coronary atherosclerosis.

[Ergospirometry study of the functional state of the cardiovascular system in chronic ischemic heart disease]. / Izsledvane na funktsionalnoto sustoianie na surdechno-sudovata sistema s pomoshtta na ergospirometriia u bolni s khronichna iskhemichna bolest na surtseto.

Sixty three patients were examined. The diagnosis of all was made on the base of clinical picture, electrocardiographic examinations and the results from the selective coronarography. The following indices of the oxygen consumption and gas metabolism were analysed in the paper: oxygen consumption per kilogram body weight, oxygen consumption per kilogramometer work performed, labour effectivity and restoration coefficient. The results obtained reveal that the adaptation ability of the respiratory and cardiovascular system in conditions of physical loading was disturbed in patients with chronic ischemic heart disease. At the same time, the physical capacity for work and the restoration coefficient were also disturbed. The decrease of oxygen consumption per kilogram body weight, deteriorated labour effectivity, restoration coefficient and the increased oxygen consumption per kilogramometer work performed occur in parallel with the extension of the lesions of the coronary arteries and the diminution of coronary reserve. The results from those examinations, together with the results from a series of non-invasive methods for the examination of cardio-vascular system could aid the thorough diagnostic-prognostic character of ischemic heart disease and give a tentative idea for the stage of the coronary arteries lesions prior to coronarography.

[Remote results of the aorto-coronary shunting in chronic forms of ischemic heart disease]. / Otdalennye rezul'taty operatsii aorto-koronarnogo shuntirovaniia u bol'nykh s khronicheskimi formami ishemicheskoi bolezni serdtsa.

Remote results of the aorto-coronary shunting operation performed in 102 patients with ischemic heart disease are reported. Of this number 75 suffered from severe angina pectoris at rest, while the others had angina pectoris on effort of some or other degree of intensity. An excellent late result was achieved (over periods from 6 months to 5 years) in 33.3, good--in 49.5, satisfactory--in 10.1% of the cases, with the surgery being of no avail in 5.1 and aggravating the patients' condition in 2.0% of the instances. Excellent and good results were obtained in 83% of the cases, viz. disappearance of angina pectoris, improved ECG at rest and on effort. The excellent and good results did not depend on the initial coronary reserve, the degree of the coronaries lesion and on the adequacy of the operation, whereas all the other results (satisfactory, ineffective, deterioration) were seen, as a rule, with an inadequate aorto-coronary shunting in patients with extensive cicatricial changes of the myocardium. A direct relationship between remote results and the extent of the myocardial lesion was established.

[Use of coronaroactive agents with beta-stimulating effect in ischemic heart disease]. / O primenenii koronaroaktivnykh sredstv s beta-stimuliruiushchim effektom u bol'nykh ishemicheskoi bolezn'iu serdtsa

In feline experiments and 65 clinical cases of ischaemic heart disease the efficacy of a new beta-stimulating agetn -- Ildamen -- was studied, the obtained effect was compared to that of Euphillin. Ildamen was found to be highly effective in patients with a moderately decreased coronary reserve and without atherosclerotic lesions in the coronary vessels.

[Intraoperative hemodynamics in patients with pre-infarct stenocardia and acute myocardial infarct]. / Intraoperatsionnaia gemodinemika u bol'nykh s pred'infarktnoi stenokardiei i ostrym infarktom miokarda

Intraoperative haemodynamics was studied in 31 patients with pre-infarction angina pectoris and in 3 patients with acute myocardial infarction. Twelve of them (3 with myocardial infarction) were subjected to a graphic examination of 12 haemodynamic parameters. Aorto-coronary bypass procedures using autovenous grafts were demonstrated to improve the contractile function of the left-ventricular myocardium in this group of patients, as manifested in a decrease of the binite diastolic pressure, increase of the cardiac index and stroke volume in the aorta. Tracing the intraoperative haemodynamics helps in determining the immediate postoperative prognosis and in choosing the optimum regimens of drug therapy. The determination of the volume blood flow in the bypass with the help of a flowmeter is a compulsory procedure, since it permits an objective assessment of the adequacy of the conducted revascularization of the myocardium.

[Experience with the use of izoptina]. / Opyt primeneniia izoptina

The effect of isoptin was studied in 271 patients with ischemic heart disease and various disturbances of the cardiac rhythm. Clinical, functional indices and coronarographic findings proved the drug to be highly effective. The mechanism of its action is discussed.