[The nature of the changes in the repolarization complex of the ECG in patients with arterial hypertension and left ventricular hypertrophy]. / O kharaktere izmenenii repoliarizatsionnogo kompleksa EKG u bol'nykh arterial'noi gipertoniei s gipertrofiei levogo zheludochka.

Altogether 58 patients suffering from arterial hypertension (AH) were examined. The patients with left ventricular hypertrophy (LVH) and changes in the ST-T demonstrated a high correlation between an increase of the end systolic tension (EST) and interval elongation and the minimal size of the left ventricle before mitral valve opening. These data point to the development of "high-stressful LVH" which is accompanied by a non-proportional increase of EST, subendocardial ischemia of the myocardium (changes in the ST-T) and derangement of diastolic heart function.

[State of hemodynamics, function and perfusion of the myocardium in patients with arterial hypertension with different degree of left ventricular hypertrophy]. / Sostoianie gemodinamiki, funktsii i perfuzii miokarda u bol'nykh arterial'noi gipertoniei s razlichnoi stepen'iu gipertrofii levogo zheludochka.

Seventy eight patients with arterial hypertension were examined by echo-, radiocardiography and scintigraphy of the myocardium, using 99mTc pyrophosphate and 201Tl. A relationship was found between the development of hypertrophy of the left ventricle and the impairment of it perfusion and function. At the same time there was a correlation between the decrease in cardiac output and the deterioration of myocardial blood supply. It was demonstrated that 99mTc pyrophosphate or 201Tl myocardial scintigraphy yielded the coincident results when relative heart failure was evaluated in patients with arterial hypertension and left ventricular hypertrophy.

Efficacy of intravenous verapamil in arterial hypertension refractory to three-step antihypertensive therapy.

Intravenous verapamil infusion reduced the arterial pressure (AP) in 13 out of 71 (76.5%) patients with severe arterial hypertension (AH) refractory to a two-week, three-step oral antihypertensive medication. Investigations including echo- and radio-cardiography were performed: in the control period before starting the three-step treatment; after two weeks before intravenous verapamil infusions; 10 days after stopping the verapamil administration, and before leaving the hospital during continued 3-4 weeks three-step therapy. The AP reduction was caused by decreased total peripheral resistance. Verapamil administration improved also intracardiac haemodynamics and left ventricular contraction. The AP was effectively controlled even after stopping the verapamil administration and continuing the three-step oral antihypertensive treatment. No manifest changes in the left ventricular function were registered.

[Status of central hemodynamics in patients with hypertension and secondary arterial hypertension]. / Sostoianie tsentra'lnoi gemodinamiki u bo'lnykh gipertonicheskoi bolez'niu i vtorichnoi arteria'lnoi gipertoniei.

A study was undertaken to examine 285 patients with hypertensive disease and 187 with secondary arterial hypertension. Their hemodynamic parameters were assessed by a radionuclide method. It was found that there were various blood circulatory types at each stage, no matter what the clinical type of the disease. The state of central hemodynamics was demonstrated to be associated with interaction of cardiac and peripheral mechanisms responsible for blood circulatory regulation.

[Cardiac adaptation in hypertension]. / Adaptatsiia serdtsa pri gipertonicheskoi bolezni.

As many as 75 patients with essential hypertension were examined by echocardiography and radiocardiography. The development of hypertrophy was accompanied by the rise of the diastolic dimensions of the left ventricle regardless of the type of the heart overload (by volume or pressure). As left ventricle hypertrophy developed, the myocardial contractility declined and normal hemodynamic function of the heart was maintained due to the Frank-Starling mechanism. The relationship has been established between the intensity of hypertrophy, left ventricle function and the hemodynamic profile of the disease.

[Effect of hypertrophy of the left ventricle on myocardial perfusion in patients with arterial hypertension]. / Vliianie gipertrofii levogo zheludochka na perfuziiu miokarda u bol'nykh arterial'noi gipertoniei.

A study of 32 patients with arterial hypertension using echocardiography, electrocardiography and myocardial 99mTc-pyrophosphate scintigraphy, demonstrated that developing left-ventricular hypertrophy may interfere with myocardial perfusion. Regression of left-ventricular hypertrophy and recovery of myocardial perfusion is shown to be possible under the effect of antihypertensive treatment.

[Effectiveness of long-term treatment of patients with hypertension]. / Effektivnost' dlitel'nogo lecheniia bol'nykh gipertonicheskoi bolezn'iu.

Dispensary care was provided to 122 patients with essential hypertension. During a 3-year follow-up period BP decrease in regularly treated patients (44) was accompanied by the restoration of hemodynamic cardiac function and regression of myocardial hypertrophy and ischemia. BP stabilization, transformation of the blood circulation of hemodynamic type, an increased degree of myocardial hypertrophy and ischemia were noted in irregularly treated patients.

[Diastolic relaxation and left ventricular blood filling in patients with hypertension]. / Diastolicheskoe rasslablenie i krovenapolnenie levogo zheludochka u bol'nykh gipertonicheskoi bolezn'iu.

Disorders of left-ventricular diastolic relaxation and blood filling in patients with first- and second-stage essential hypertension are shown, by means of echo-, radio- and apexcardiography, to be due to the effects of arterial blood pressure, hemodynamic changes, heart rate and the magnitude of left-ventricular hypertrophy. Antihypertensive treatment, affecting major parameters of disease, brings about the recovery of the heart's diastolic function.

[Possible reverse development of myocardial hypertrophy and ischemia in patients with hypertension after short-term antihypertensive therapy]. / Vozmozhnosti obratnogo razvitiia gipertrofii i ishemii miokarda u bol'nykh gipertonicheskoi bolezn'iu pod vliianiem kratkovremennoi antigipertenzivnoi terapii.

The effects of short-term antihypertensive therapy were assessed using echo- and electrocardiography, in patients with first- or second-stage essential hypertension, with respect to possible reverse development of left-ventricular hypertrophy and myocardial ischemia. A reduction of left-ventricular hypertrophy was found to be possible, with regard to the hemodynamic type, in patients with mild or moderate essential hypertension provided their blood pressure was controlled effectively. Reverse development of electrocardiographic signs of myocardial ischemia (ST segment and T wave reaching their normal values) is possible through a decrease of arterial BP and a reduction of adrenergic effects on the heart.

[Treatment of arterial hypertension with calcium antagonists]. / Lechenie bol'nykh s arterial'noi gipertenziei antagonistami kal'tsiia.

The antihypertensive effect of finoptin (verapamil) and corinfar (nifedipin) and their impact on the hemodynamics and the repolarization complex of the ECG were studied in 52 patients with essential hypertension and 48 patients with secondary arterial hypertension. The calcium antagonists were found to effectively decrease the blood pressure by reducing the peripheral resistance. Verapamil may be recommended for the monotherapy of mild and moderate forms of arterial hypertension, whereas corinfar should be used in cases of marked hypertension and at the third stage of therapy. Patients with electrocardiographic signs of myocardial ischemia show the normalization of the ST segment and a decreased depression of T wave under the impact of corinfar.

[Development of heart hypertrophy in hypertension]. / Razvitie gipertrofii serdtsa pri gipertonicheskoi bolezni.

A total of 120 patients with essential hypertension, stage I and II, were examined, using radio- and electrocardiography, before and after a hypotensive treatment. Two mechanisms: excessive volume (in patients with hyperkinetic circulation) and excessive pressure (in those with normo- and hypokinetic circulation) were found to form the basis of the formation of left-ventricular muscular hypertrophy. Antihypertensive effect of treatment reducing electrocardiographic signs of left-ventricular muscular hypertrophy was shown to be related to improved arterial pressure control and lesser adrenergic influence on the heart.

Estimation of size of infarcted focus by spatial quantitative vectorcardiography in patients with acute anterior myocardial infarction.

The study included 113 patients with acute myocardial infarction of the left ventricular anterior wall. The patients were repeatedly followed up from the first hours of the affection onward in the course of the individual stages of treatment (stage of intensive monitoring and therapy; intermediate stage; initial rehabilitation with application of active therapy; early mobilization, activation and rehabilitation). A new approach to the estimation of the size of the infarcted focus is described, namely, the method using spatial quantitative vectorcardiography. It was found that the spatial localization of the 40-ms vector, especially its azimuth, is a specific indicator, with the aid of which the localization, extent and depth of the lesion in the left ventricular anterior wall can be assessed with a high probability in most instances. The compensatory adaptive and reparative capacity of the affected myocardium, estimated on the basis of spatial quantitative VCG, is closely correlated with the size of the infarcted focus.