[Determination of the concentration of cytochrome c and its antibodies in the blood serum for the diagnosis and prognosis of complications in myocardial infarct patients]. / Opredelenie kontsentratsii tsitokhroma c i antitel k nemu v syvorotke krovi dlia diagnostiki i prognozirovaniia oslozhnenii u bol'nykh infarktom miokarda.

EIA was used to demonstrate that the development of acute ischemia of the heart muscle progressing to necrosis is accompanied by an increase of the concentration of cytochrome c and antibodies against cytochrome c in the blood serum. As regards its specificity and sensitivity, the alteration in the antibody concentration is comparable with that in the myoglobin concentration but it is marked 1 to 3 hours earlier. The high level of antibodies against cytochrome c remaining unchanged for 2 to 3 days in myocardial infarction patients attests to the possibility of a complicated, often relapsing course of the disease. The test for determining antibodies against cytochrome c may be recommended for the control over the patient's status and forecasting the course of myocardial infarction.

[Combined use of nitrates and beta-adrenergic blockaders in patients with acute myocardial infarct]. / Kombinirovannoe primenenie nitratov i beta-adrenergicheskikh blokatorov u bol'nykh ostrym infarktom miokarda.

A combination of isosorbide dinitrate (40-120 mg daily) and propranolol (80-160 mg) was administered to 146 patients during the early hours of myocardial infarction. The therapeutic effect was assessed for 10 days and compared to the effect observed in a control group of 70 patients selected at random. The combination used was shown to relieve the pain syndrome and extrasystolic arrhythmia during the early days of the disease. The occurrence of signs of heart failure was twice as low during the observation period, as compared to the control group. The treatment evoked typical hemodynamic changes: rhythm deceleration (by an average 7%), a fall in systemic arterial blood pressure (by 19%) and in "double product" (by 25%), a moderate reduction of cardiac output (by 15%) coupled with a marked drop in left-ventricular filling pressure (by 25%). The spread of infarcted area in the first days after the attack, as evidenced by serial electrocardiotopograms and the activity of serum CPK and its MB fraction, was recorded in 13.9% of the treated patients and in 44% of the controls (p less than 0.001).

[Effect of the combined use of nitrates and beta-adrenergic blockaders on hemodynamics in patients with acute myocardial infarction]. / Vliianie kombinirovannogo primeneniia nitratov i beta-adrenergicheskikh blokatorov na gemodinamiku bol'nykh ostrym infarktom miokarda.

The effect of combined treatment with nitrosorbide and obsidan on major hemodynamic parameters was studied in 47 myocardial infarction patients within the first 24 hours of the disease. Intravenous drip injection of 0.15 mg/kg obsidan simultaneously with the administration of 20 mg nitrosorbide reduced heart rate by 12.7%, systemic blood pressure by 23.5%, and diastolic pulmonary arterial pressure by 38.4%. The cardiac index decreased by 22.8%, mainly due to reduced heart rate. The treatment improved myocardial function as evidenced by and increased number of positive post-treatment "functional curves". This method is safe and efficient, provided it is applied under careful hemodynamic control.