[studies in the early diagnosis of Value of noninvasive diabetic angiopathies].

Eighty-six patients of both sexes (46 males and 40 females) who had type 1 diabetes mellitus (DM1) in the decompensated state were examined. Moderate and severe DM1 were detected in 66 and 20 patients, respectively. The patients' age ranged from 16 to 46 years. The purpose of the study was to improve early diagnosis and to make a differential diagnosis of diabetic and macroangiopathies of the coronary vessels of the heart and the pulmonary arterial system, by using noninvasive (clinical, instrumental examinations, such as echocardiography, phlebography, apex and right ventricular cardiographies, jugular phlebography, oscillography) and immuno-logical studies. The studies yielded definite calculation criteria (the myocardial viability index (MVI) that characterizes subendocardial blood flow and pulmonary pressure). Diabetic coronary microangiopathies may be stated if MVI is more than 1.3 conventional units. The MVI of less than 1.3 conventional units is indicative of diabetic macroangiopathies (coronary heart disease). The calculation values of pulmonary pressure in patients aged above 40 years who had DM1 in the decompensated state were statistically more sig-nificant than those in these patients in the compensated state, which suggested the presence of diabetic macroangiopathies of the pulmonary arterial system. In diabetic patients aged less than 40 years, the difference in these values was insignificant, which may point to the presence of diabetic microangiopathies. This opens up a way to the early treatment of diabetic microangiopathies and to the prevention of diabetic macroangiopathies.

[Clinico-instrumental and pathologicoanatomic comparisons in diabetic cardiopathy and ischemic heart disease in diabetics]. / Kliniko-instrumental'nye i patologoanatomicheskie sopostavleniia pri diabeticheskoi kardiopatii i ishemicheskoi bolezni serdtsa u bol'nykh sakharnym diabetom.

46 patients with diabetes mellitus (DM) of both sexes under 40 years of age in the state of compensation were found to have significantly greater figures (1, 3) for the parameter characterizing the subendocardial bloodflow, obtained by calculating technique, versus 33 DM patients beyond 40 in the state of compensation, which fact suggests the presence of diabetes macroangiopathies (IAD) in the latter. In 6 patients the diagnosis of IHD has been verified postmortem.

[The relationship of vascular changes and immune status disorders in patients with diabetes mellitus type 1]. / Sviaz' vaskuliarnykh izmenenii i narushenii immunnogo statusa u bol'nykh sakharnym diabetom I tipa.

Immunologic status was studied in 86 patients with type-I diabetes mellitus before and after treatment with decarise, thymaline and T-activin. With the aid of ECG, phonocardiogramme, apex cardiogramme, oscillogramme, there has been calculated index of vitality of the myocardium reflecting the subendocardial bloodflow. The principal parameters characterising bodily immune status (absolute number of T- and B-lymphocytes), T-suppressors counts as well as those of circulating immune complexes (CIC) were compared to the values for subendocardial bloodflow (end-diastolic pressure, index of vitality of the myocardium). There has been established strong inverse relation between the absolute numbers of T-, B-lymphocytes, and CIC, end-diastolic pressure and index of vitality of the myocardium, this being regarded as evidence in confirmation of the guarding role of the former and damaging one of the latter (CIC) under vascular pathology in diabetes mellitus.

[The diagnosis of micro- and macroangiopathies of the lesser circulation in diabetic patients]. / Diagnostika mikro- i makroangiopatii malogo kruga krovoobrashcheniia u bol'nykh sakharnym diabetom.

Patients with diabetes mellitus aged under 40 in the state of compensation demonstrate significant drop of pressure in the pulmonary artery system as compared to the corresponding parameter in those patients with diabetes mellitus beyond 40, which fact suggests presence of microangiopathies in the system of the pulmonary artery in the absence of concurrent pulmonary diseases and with similar duration of the illness.

[Gouty heart defects]. / Podagricheskie poroki serdtsa.

The authors revealed heart failure in 7 of 216 patients with gout. Two of them showed isolated mitral valve insufficiency and two patients aortal insufficiency while combined aortal disease, combination of mitral and aortal insufficiency and combined mitral valve disease with aortal insufficiency occurred each in 1 patient. One could not find distinct dependence between the clinical variant of the course of gout and development of a definite heart failure. Clinical and electrocardiographic signs of the revealed kinds of cardiac abnormalities are described. The morphological changes of the valves are described on the basis of 2 autopsy cases. The possible mechanism of development of podagric heart failures is discussed.

[The differential diagnosis of diabetic cardiopathy and ischemic heart disease in diabetics]. / Differentsial'naia diagnostika diabeticheskoi kardiopatii i ishemicheskoi bolezni serdtsa u bol'nykh sakharnom diabetom.

The author examined the subendocardial blood flow in 79 patients with diabetes mellitus (II, II-III degree of decompensation) before and after traditional treatment. The diastolic, terminal-diastolic and average-diastolic pressures were reduced, the diastole ejection period of the left ventricle and vitality index of the myocardium were increased and were more pronounced in patients under 40 years of age after treatment indicating absence of IHD and marked atherosclerosis of the coronary arteries.

[Central hemodynamics, effectiveness of endocardial blood flow and general physical work capacity in impaired glucose tolerance and diabetes mellitus]. / Tsentral'naia gemodinamika, effektivnost' endokardial'nogo krovotoka i obshchaia fizicheskaia rabotosposobnost' pri pri narushennoi tolerantnosti k gliukoze i sakharnom diabete.

The end diastolic pressure, myocardial viability index and other parameters of myocardial contractility, as well as central hemodynamics and general physical working capacity were studied in 120 subjects, including 20 subjects with impaired glucose tolerance, 80 patients with diabetes mellitus, and a control group of 20 healthy subjects. In impaired glucose tolerance, a tendency to reduced endocardial blood flow and myocardial contractility as well as elevated end diastolic pressure were observed. The physical working capacity remained within normal. In decompensated diabetes mellitus, the efficacy of endocardial blood flow considerably reduced, the end diastolic pressure rose more than twofold, myocardial contractility deteriorated, the stroke volume decreased, the general physical working capacity sharply fell. In compensated diabetes mellitus, versus decompensated one, subendocardial perfusion and myocardial contractility improved, stroke volume increased; the exercise tolerance threshold rose but did not reach normal.