[The effect of the morphofunctional state of the thrombocytes on the activation of destabilization processes in patients with acute forms of ischemic heart disease]. / Vliianie morfofunktsional'nogo sostoianiia trombotsitov na aktivatsiiu protsessov destabilizatsii u bol'nykh s ostrymi formami ishemicheskoi bolezni serdtsa.

With the purpose of assessing the influence that platelet morphofunctional state may have on the degree of destabilization in patients with different forms of unstable angina we examined 198 patients using stress tests, Holter ECG monitoring, studying activation of thrombocytes with the aid of a luminescent-microscopy technique, and performing an analysis of aggregation. Important differences have been revealed in the studied parameters in those patients presenting with freshly detected and progressive stenocardia and with a developing, despite of the treatments administered, myocardial infarction, that might be caused by abnormal shifts in the thrombocyte intact/activated forms ratio.

[Ventricular fibrillation in myocardial infarct patients: the factors determining the prognosis]. / Fibrilliatsiia zheludochka u bol'nykh infarktom miokarda: faktory, opredeliaiushchee prognoz.

Improvement of methods for diagnosis and treatment of myocardial infarction and its complications permitted the mortality and disability resulting from this condition to be considerably reduced. The aim of the study was to analyse in retrospect clinical and functional disorders in subjects with a history of ventricular fibrillation in the acute phase. Over 3 years, 1096 patients with acute myocardial infarction had been admitted to the Department of Cardioresuscitation. Ventricular Fibrillation was cause of death in 2.1% of cases. Over this time period, resuscitation was a success in 2.9%. The following item was found out to be a factor of unfavourable prognosis during the first two years after development of acute myocardial infarction: it was postinfarction dilatation of the left ventricle having a part in the evolution of cardiac insufficiency and contributing to formation of arrhythmogenic substrate and, to a lesser degree, to ventricular fibrillation in the acute phase.

[Structural and functional disorders of the left ventricle as a predictor of the subsequent course of the disease in patients with unstable angina]. / Narusheniia struktury i funktsii levogo zheludochka kak prediktor dal'neishego techeniia zabolevaniia u bol'nykh s nestabil'noi stenokardiei.

Significance of total ejection fraction was assessed in the long-term follow-up of 270 patients with unstable angina pectoris in the course of bidimensional echocardiography and 99mTc radioisotope ventriculography of the myocardium in order that we might be able to forecast the remote outcomes of this particular disease. Ejection fraction was shown to be an independent predictor of informative value for the end point of the disease.

[The structure of the ventricular arrhythmias in patients in the first 24 hours of a myocardial infarct]. / Struktura zheludochkovykh aritmii u bol'nykh v pervye sutki infakta miokarda.

Therapeutic interventions policy and efficiency rely on whether one succeeds in identifying accurately and in timely fashion the nature of ventricular arrhythmia which is frequently a primary manifestation of acute coronary disaster. With the view to studying cardiac arrhythmias in 85 patients with acute large size myocardial infarction admitted within 12 hours of the condition development. 24 h Holter monitoring was instituted. The results obtained showed only 27% of patients at relatively low risk development of life-threatening arrhythmias. In all the others, high grades ventricular extrasystoles are recorded, including episodes of ventricular tachycardia in 50% of the patients. High incidence rate of the complex rhythm disturbances development during first 12 hours of monitoring suggest a need for an adequate supplementary antiarrhythmic treatment to be administered within this time period, subsequent to which anti-ischemic therapy is thought to be capable of exerting sufficient antiarrhythmic effect.

[The prediction of the probability of the development of a myocardial infarct in patients with unstable angina]. / Prognozirovanie veroiatnosti razvitiia infarkta miokarda u bol'nykh s nestabil'noi stenokardiei.

Coronary reserve and functional state of myocardium were studied in 27 patients with unstable angina and myocardial infarction which had developed in spite of the treatment. Non-invasive study included stress-tests (transesophageal electrocardiostimulation, bicycle ergometry [correction of veloergometry)], echocardiography and Holter's monitoring. Possibility of early forming of risk group with consequent optimization of the treatment was shown.

[The complex assessment of myocardial electrical instability in exacerbated ischemic heart disease]. / Kompleksnaia otsenka élektricheskoi nestabil'nosti miokarda pri obostrenii ishemicheskoi bolezni serdtsa.

Risk of sudden coronary death in patients with unstable stenocardia is studied insufficiently. 39 patients with unstable stenocardia underwent Holter's monitoring, loading tests and invasive programmed ventricular stimulation coming lately into increasingly wide use for assessment of myocardial electric stability. Programmed stimulation allowed to single out two groups of patients: with ventricular tachycardia (56.4%) and without it (43.6%). Results obtained by aforementioned methods showed no correlation which is explained by the authors as being due to different pathogenetical mechanisms initiating ventricular arrhythmias. Thus, for example, rhythm disorders emerged not infrequently in the periods of ischemia during Holter's monitoring while myocardial ischemia was not observed in all cases of programmed ventricular stimulation. That is why complex approach needs to be pursued for assessment of electric stability of myocardium in patients with advancing stenocardia.

[The effect of ultraviolet-irradiated blood on the factors determining an unfavorable prognosis in patients with progressive stenocardia]. / Vliianie obluchennoi ul'trafioletovymi luchami krovi na faktory, opredeliaiushchie neblagopriiatnyi prognoz u bol'nykh s progressiruiushchei stenokardiei.

Effect of autohemotransfusions of ultraviolet-irradiated blood (UVIB) on ventricular arrhythmias and electric stability of myocardium were studied in 85 patients with advancing stenocardia. Bicycle ergometry [correction of Veloergometry], Holter's monitoring and invasive programmed cardiostimulation were used. Results of examination carried out before and after the treatment suggest anti-ischemic effect of PVIB and beneficial influence electrophysiological properties of myocardium which manifested in reduced periods of ventricular tachycardia and onsets of twin extrasystoles.

[Unstable angina: long-term dynamic observation based on the data from Holter ECG monitoring]. / Nestabil'naia stenokardiia: dlitel'noe dinamicheskoe nabliudenie po dannym kholterovskogo monitorirovaniia EKG.

The choice of treatment of patients with unstable angina is one of the most important problems in cardiology. Establishment of its tactics is necessary both in hospital and in posthospital periods. 24-hour Holter monitoring is a safe and informative method which makes it possible to objectivize the state in such category of patients. In order to study the structure of ischemia and arrhythmias this approach was used in 50 patients with unstable angina at the first admission twice and also twice within the first year of follow-up. It was shown that stabilization which was achieved during the first hospitalization was retained in 58.2% during 1 year. In other cases increases of frequency, duration and significance of ischemia were observed. In the global structure of myocardial ischemia, silent ischemia composed 56-65%.

[The vasospastic component in the pathogenesis of unstable angina]. / Vklad vazospasticheskogo komponenta v patogenez nestabil'noi stenokardii.

A comprehensive dynamic investigation revealed a group which included 31 (9.8%) patients with a response to the introduction of a probe-electrode during transesophageal pacing. It was characterized by ST-segment elevation and development of an anginal attack. The hemostatic parameters examined suggest that there is a special group among patients who have unstable angina with increasing vasospastic activity. The introduction of a probe-electrode may be considered to be a provocative test.

[The quantum hemotherapy of myocardial infarct patients]. / Kvantovaia gemoterapiia bol'nykh infarktom miokarda.

Results are reported of an examination of 81 patients with acute macrofocal myocardial infarction. Routine methods of treatment were supplemented by laser and ultraviolet radiation of the blood. This treatment was highly effective in rapid control of stenocardia pain, early stabilization of the ST segment. The proposed treatment is recommended in patients with acute myocardial infarction.

[Effects of laser irradiation of blood on electrical ventricular instability in patients with progressive angina pectoris]. / Vlianie lazernogo oblucheniia krovi na élektricheskuiu nestabil'nost' zheludochkov serdtsa u bol'nykh s progressiruiushchei stenokardiei.

The impact of laser blood irradiation (LBI) on electrical instability has been studied in 71 patients with progressive angina pectoris. The amount of couplets of ventricular premature beats after LBI was decreased, as evidenced by 24-hour monitoring. Invasive programmed ventricular stimulation provided better electrophysiological properties of the myocardium after LBI: primary examination showed that electrical ventricular instability was detected in 40%, but after the therapy it was only in 20% patients. Thus, LBI is an effective tool to decrease electrical ventricular instability, a major risk factor for sudden coronary death in patients with progressive angina pectoris.

[The characteristics of the Holter monitoring data on patients with a vasospastic reaction during the performance of transesophageal electrocardiostimulation]. / Osobennosti dannykh kholterovskogo monitorirovaniia u bol'nykh s vazospasticheskoi reaktsiei pri provedenii chrespishchevodnoi élektrokardiostimuliatsii.

Along with organic involvement of the coronary arteries their spasm is one of the mechanisms of development of acute myocardial ischemia. Transesophageal electrocardiostimulation in 314 patients with non-stable stenocardia revealed in 32 (10.2%) increased vasospastic activity. Holter monitoring allowed to find essential differences in patients with vasospasm manifested in a significant increase of the frequency and duration of nonpainful myocardial ischemia in the absence of distinct changes in painful ischemia. Two-week treatment with calcium antagonists allowed to reduce the ischemia level in the group of patients with vasospasm tendencies.

[The circadian rhythm dynamics of myocardial ischemia in patients with unstable stenocardia during one year of observation]. / Dinamika tsirkadnykh ritmov ishemii miokarda u bol'nykh s nestabil'noi stenokardiei v techenie odnogo goda nabliudeniia.

Dynamics of circadian rhythms of myocardial ischemia in patients with nonstable stenocardia within one year of observation was studied in 50 patients by means of Holter monitoring. By the second admission depending on the clinical course of the disease 4 groups of patients were singled out and their painful and nonpainful heart ischemia was assessed with 6-hour intervals. Comparison of results of painful arrhythmia during the first and repeat admission indicated that the diurnal dynamic and peaks of myocardial ischemia duration coincide as to time and direction. Nonpainful ischemia appears mainly during the night hours.

[The data from clinical, instrumental and laboratory studies as markers in the prognosis of the restabilization process in patients with a history of unstable stenocardia]. / Dannye klinicheskikh, instrumental'nykh i laboratornykh issledovanii kak markery prognoza restabilizatsii protsessa u bol'nykh, perenesshikh nestabil'nuiu stenokardiiu.

With the purpose of preventing the development of acute clinical ischemic lesions of the myocardium, and their further progression, regression of coronary atherosclerosis the authors followed up for more than one year 250 patients with unstable stenocardia and singled out two groups of these patients, each group having important differences as to coronary reserve, functional state of the myocardium, lipid spectrum, dynamics of vasoactive substances, immunological reactivity, thrombocytic activity. Early detection of groups with an unfavourable course of IHD in patients with unstable stenocardia will allow to optimize treatment and avoid development of acute coronary catastrophies.

[The circadian rhythms of myocardial ischemia and ectopic activity in patients with unstable stenocardia]. / Tsirkadnye ritmy ishemii miokarda i éktopicheskoi aktivnosti u bol'nykh nestabil'noi stenokardiei.

Holter monitoring was used in 81 patients with non-stable stenocardia with the purpose of establishing the relationship between the development of myocardial ischemia and cardiac rhythm disorders in the course of 24 hours. It was found that cardiac arrhythmia and painless ischemia develops mainly from 0 to 6 hours. Anti-ischemic therapy proved rather effective in relation to to controlling ventricular extrasystole. The dependence of ventricular extrasystole on myocardial ischemia requires further investigation.

[Stress tests in the assessment of the status of patients with unstable stenocardia]. / Stress-testy v otsenke sostoianiia bol'nykh nestabil'noi stenokardiei.

The authors studied in 60 patients with non-stable stenocardia clinico-functional determinants using stress-tests during exacerbation and during stabilization of the patients' states and analyzed the value of different stress-tests in detection of the coronary blood blow. Results revealed that in course of observation different clinico-functional groups could be distinguished requiring individualized treatment.