[Preventive strategy for atrial fibrillation in arterial hypertension].

The aim of the study was to evaluate effectiveness and safety of angiotensin II receptor blockers and inhibitors of angiotensin-converting enzyme (ECE) for protective therapy following medicamentous cardioversion with propafen at a loading dose of 600 mg in patients with paroxysmal atrial fibrillation and arterial hypertension. 101 patients were divided in 2 groups. Group 1 included 75 patients who received ACE inhibitor lisinopril (10 mg BID) after recovery of sinus rhythm by propanorm. 26 patients of group 2 were treated with angiotensin II receptor blocker candesartan (8 mg daily). Combined treatment with angiotensin II receptor blocker and propafenone leads to cardioversion faster than therapy with ACR inhibitor. It is concluded that alternative approach to the maintenance of sinus rhythm using angiotensin II receptor blockers has advantages over traditional anti-arrhythmic therapy; it is well tolerated by the patients and produced no serious side effects.

[Spectral analysis of the variability of heart rhythm in the analysis of changes in the autonomic regulation during treatment of hypertension with sodium chloride baths]. / Izmeneniia vegetativnoi reguliatsii pri lechenii gipertonicheskoi bolezni khloridnymi natrievymi vannami po dannym spektral'nogo analiza variabel'nosti ritma serdtsa.

Changes in spectral parameters of heart rate variability were assessed in patients with mild and moderate hypertension (n = 48) and healthy subjects (n = 34) taking sodium chloride bath and in active orthostatic test before and after balneotherapy. Significant changes were not registered. The course of balneotherapy stimulated sympathetic or parasympathetic activity (relative enhancement occurred in 67, absolute in 15% versus 8 and 10% patients, respectively).

[The diameter of the descending thoracic aorta in patients with Fallot's tetralogy (angiographic study)]. / Diametr niskhodiashchei grudnoi aorty u bol'nykh tetradoi Fallo (angiograficheskoe issledovanie).

The diameter of the descending thoracic aorta was measured at the level of the diaphragm on angiograms in 91 patients with Fallot's tetralogy. The existence of an exponential dependence of the diameter on the body surface area of patients as well as of healthy individuals was shown. The course of the regression curve in patients with Fallot's tetralogy repeated exactly the course of that in healthy individuals, but the former ran 0.5 mm higher. Thus, to determine the diameter of the descending thoracic aorta in patients with Fallot's tetralogy one may use the nomogram of the dependence of this diameter on the body surface area of healthy individuals or an equation suggested by the authors. It is practically impossible to locate the descending thoracic aorta by means of echography, whereas the size of its diameter is included in equations for calculating the important hemodynamic parameters. The data obtained by the authors allow wider use of noninvasive methods for the diagnosis (echo-morphometry) and prognostication of the results of radical correction of Fallot's tetralogy in a concrete patient.

[Characteristics of afferent innervation of the ischemic heart and the development of the pain syndrome]. / Osobennosti afferentatsii ishemizirovannogo serdtsa i razvitie bolevogo sindroma.

Pain excitation during myocardial ischemia and its electrostimulation were investigated by recording evoked potential and iris movement in cats. It has been demonstrated that pain perception of the heart declines at an early stage of ischemia, but increases noticeably after prolonged and repeated ischemia.

[Effect of alcohol on conduction of afferent impulsation from the area of the sinus node of the heart to structures of the central nervous system]. / Vliianie alkogolia na provedenie afferentnoi impul'satsii ot zony sinusovogo uzla serdtsa k strukturam tsentral'noi nervnoi sistemy.

Acute experiments in cats, using the induced potentials technique, showed intraperitoneal 30% alcohol administration (1.5-2 ml per 1 kg body weight) as well as direct application of 2 or 3 ml of similarly concentrated alcohol solution to the sinus node area (SNA) to block afferent impulse conduction from the SNA to central nervous structures, such as cerebral cortex, reticular formation of the midbrain, peri-aqueduct gray matter. The fact that the induced potentials generated within the cerebral cortex and subcortical structures in response to SNA stimulation showed a pattern of change that was similar to the one associated with alcohol administered intraperitoneally or applied directly to SNA has suggested that alcohol may block the cardiac afferent flow directly at the level of SNA structures.

[Morphofunctional features of the left ventricle of rabbits with experimental alcoholic cardiomyopathy]. / Morfofunktsional'nye osobennosti levogo zheludochka serdtsa krolikov pri éksperimental'noi alkogol'noi kardiomiopatii.

In chronic alcoholic poisoning the rabbits demonstrate an abrupt decrease in heart left ventricular contractility and a significant noticeable prolongation of the phases of isometric effort and isometric relaxation. The morphologic study of the heart showed marked myocardial hypertrophy and enhanced intramyocardial lypolysis leading to accumulation of acid lipids by the cardiac muscle. It seems likely that these lipids requiring additional oxygen amounts for utilization give rise to relative hypoxia in the myocardium. In conjunction with diastolic inadequacy this can lead to attenuation of the heart contractility and to compensatory development of myocardial hypertrophy.

[Differential diagnosis and treatment of ischemic heart disease and dyshormonal myocardial dystrophy]. / O differentsial'noi diagnostike i lechenii ishemicheskoi bolezni serdtsa i disgormonal'noi miokardiodistrofii.

The informative value of functional tests (with inderal, potassium and bicycle ergometer), the state of central hemodynamics, and the effectiveness of the anabolic hormone retabolil were studied in young females with dyshormonal myocardial dystrophy. The group consisted of 33 females between the ages of 33 and 45 with maintained menstrual cycle. The presence of cardialgia, syndrome of negative T wave, aggravated gynecologic anamnesis and the absence of clinical and laboratory data testifying to coronarogenous, inflammatory or some other lesion of the heart muscle made it possible to make the diagnosis of dyshormonal myocardial dystrophy. Functional tests with inderal and potassium and bicycle ergometry are objective criteria in the differential diagnosis of ischemic heart disease and dyshormonal myocardial dystrophy. Negative drug tests in individuals with persistent signs of dyshormonal dystrophy of the myocardium are evidence in favour of the development of postdystrophic cardiosclerosis. According to the data of hemodynamics, the functional state of the myocardium in patients with diffuse myocardial dystrophy is impaired. The anabolic hormone retabolil is an agent of pathogenetic therapy in the group of patients studied.