[Experimental and clinical studies of coronary circulation after administration of mildronate]. / Eksperimental'noe i klinicheskoe issledovanie koronarnogo krovoobrashcheniia pri primenenii mildronata.

In experiments on dogs, application of the cross-over circulation method revealed that mildronate increased coronary blood flow due to active coronary dilation. In experiments on cats, a cardioprotective effect of mildronate was found, which prevented the development of acute ischemic heart failure by stabilizing the major hemodynamic parameters. Clinical studies of patients with Functional Classes I-III angina provided evidence for positive effects of mildronate on coronary blood flow.

[Adaptive reserves of the myocardium in patients with ischemic heart disease]. / Adaptatsionnye rezervy miokarda u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Myocardial adaptive reserves and their relation to the function of the adrenocorticohypophyseal system were examined in 69 patients with coronary heart disease. To define the adaptation of the myocardium during exercise, the index of myocardial adaptation was used. The function of the adrenocorticohypophyseal system was judged from blood levels of somatotropic hormone and cortisol before, at the peak, and 2 hours after exercise testing. A substantial decrease in myocardial adaptive capacity was found in CHD patients as compared with healthy subjects. These abnormalities proved to be more marked in patients with clinical signs of severe coronary failure than in those with moderate coronary circulatory failure. It was concluded that the function of the adrenocorticohypophyseal system was one of the factors determining myocardial adaptation during exercise in patients with coronary heart disease.

[Adaptive capacity of the myocardium in middle-aged and elderly persons]. / Adaptatsionnye vozmozhnosti miokarda u lits pozhilogo i starcheskogo vozrasta.

Myocardial activity was evaluated in 165 individuals between 60 and 82 years of age. Only one parameter, myocardial stress adaptation index (MSAI), was shown to differ significantly between individuals. An earlier diagnosis of coronary heart disease was not confirmed in 43 (26.1%) patients. Myocardial adaptability was quite good (MSAI greater than 7.1) in 98 (60%) patients. There was a direct correlation between plasma potassium levels and ST depression in response to stress, which makes the hypoxic origin of ST depression in the absence of other signs of coronary insufficiency in this category of patients rather questionable.

[Indicators of scintigraphy using technetium Tc 99m pyrophosphate in angina pectoris in relation to the activity of the pituitary-adrenal system]. / Pokazateli stsintigrafii s 99mTc-pirofosfatom pri stenokardii v zavisimosti ot aktivnosti sistemy gipofiz-kora nadpochechnikov.

The effect of exercise on the parameters of the scintigraphy of the myocardium with labelled pyrophosphate was studied in 35 patients with coronary heart disease and angina of effort and at rest with regard to the activity of the pituitary-adrenal cortex system. The functional status of this system was evaluated on the basis of data on the blood changes in somatotrophic hormone and cortisol. The use of a scoring system made it possible to identify four types of the pattern of the scintigraphic parameters. Type I and II of the pattern of the scintigraphic parameters indicating the normal ratios between the requirements of the cardiac muscle in oxygen and myocardial perfusion were characteristic of the patients with angina pectoris in the presence of an increased activity of the pituitary-adrenal cortex system. When the coronary heart disease patients with angina had a lower activity of this system, the authors more frequently recorded types III and IV of the pattern of scintigraphy which reflected a decreased perfusion and myocardial damage during exercise.

[Phenomenon of pyrophosphate accumulation in the prognosis of different forms of ischemic heart disease]. / Fenomen nakopleniia pirofosfata v prognoze razlichnykh form ishemicheskoi bolezni serdtsa.

The results of pyrophosphate 99mTc scintigraphy of the myocardium during exercise were compared with the parameters of the tolerance and adaptation to the load and the frequency of manifestations of myocardial ischemia during bicycle ergometry in relation to the prognostic value with regard to coronary heart disease (CHD) development. The studies involved 21 patients with myocardial infarction at the early recovery period and 23 CHD patients without a history of myocardial infarction. Manifestations of myocardial ischemia and the pattern of pyrophosphate build-up in the myocardium during exercise are approximately equally informative with regard to the prognosis of a high risk of complications in CHD patients. As regards the capacity to detect patients with a low risk of CHD complications, the finding of pyrophosphate 99mTc scintigraphy of the myocardium are more reliable than the electrocardiographic manifestations of myocardial ischemia or chest pain during bicycle ergometry. The parameters of the tolerance and adaptation to the load were found to be of little use in predicting CHD complications.

[Means of differential diagnosis between angina pectoris and neurocirculatory dystonia]. / Sposob differentsial'noi diagnostiki stenokardii i neirotsirkuliatornoi distonii.

Plasma somatotropic hormone and cortisol were measured at rest, at the peak of physical stress and 2 hours after the discontinuation of exercise in 15 normal male subjects, 18 male patients with neurocirculatory dystonia and 69 with angina pectoris. The determination of one-dimensional hyperplanes of plasma STH and cortisol during and after exercise allows one to distinguish anginal patients from those with neurocirculatory dystonia and make a diagnosis in patients with nonspecified chest pains.

[Clinical evaluation of 2 new methods of non-invasive diagnosis of coronary insufficiency]. / Klinicheskaia otsenka dvukh novykh sposobov neinvazivnogo vyiavleniia koronarnoi nedostatochnosti.

One-dimensional hyperplane was determined as capable of distinguishing between patients with coronary insufficiency and normal subjects by some parameters of bicycle ergometry. Twenty-four normal subjects and 159 anginal patients (males with normal blood pressure and normal body weight) were tested by bicycle ergometry. Test results were assessed individually with respect to changes in electrocardiographic repolarization complex, changes in R-wave amplitude, Robinson's index and the index of myocardial adaptation to exercise. All examined tests showed similar specificity. The myocardial adaptation index had significantly higher sensitivity as compared to other three indices.

[Pyrophosphate-99mTc scintigraphy in stenocardia patients]. / Stsintigrafiia s pirofosfatom-99mTc u bol'nykh so stenokardiei.

The authors examined 166 patients with ischemic heart disease and attacks of angina pectoris and 21 healthy individuals. Scintigraphy, electrocardiography and tests for the activity of creatine phosphokinase and its MB fraction were carried out at rest, during physical exercise and 1--3 days after it. It was found that pyrophosphate-99mTc may accumulate in the myocardium both during the attack of angina pectoris and after its cessation. Angina pectoris may occur both with diffuse and with focal pyrophosphate-99mTc accumulation in the myocardium. Positive results of scintigraphy were encountered considerably more often in patients examined during physical exercise than in those examined at rest. Scintigraphic signs of angina pectoris which occurs under the effect of physical exertion develop less frequently, but persisted for a longer time than its electrocardiographic signs.

[Toxoplasmosis-induced myocarditis]. / Toksoplazmoznye miokardity.

The clinical picture of myocarditis was studied in 72 patients with toxoplasmic infection and in 44 patients not suffering from this infection. Comparison of the clinical signs of myocarditis in these two groups showed that myocarditis of toxoplasmic etiology has no characteristic features. The only distinction between these two groups was the different frequency of various symptoms. In view of this, methods of laboratory diagnosis of toxoplasmosis acquire much significance.