[Myocardial infarction in colon cancer].

Paraneoplastic syndromes have a variety of clinical manifestations most frequently resembling systemic diseases and phlebothrombosis. Also, hypercoagulative paraneoplasic syndrome may have some clinical features of myocardial infarction which makes difficult nosological diagnostics.

[Optimization of treatment of patients with chronic cardiac insufficiency of the ischemic genesis and hobnail liver].

Clinical efficacy of combined therapy including the use of rifaximin and L-ornithin-l-aspartate, as well as the dynamics of the biochemical indices, the manifestation levels of portal-systemic-encephalopathy and intestinal microbiocynosis were investigated in patients with chronic cardiac insufficiency of ischemic genesis and hobnail liver. The combined therapy resulted in improvement of the patients clinical state, lower levels of the portal-systemic encephalopathy manifectation by decreasing hyperammonium, normalization of the large intestine microflora, and blood serum biochemical parameters.

[Shifts in the heart left ventricle function in patients with pulmonary tuberculosis during adequate chemotherapy].

To investigate the hemodynamics and myocardic contraction of the heart left ventricle, 61 patients with pulmonary tuberculosis (main group) and 26 healthy subjects (control group) were observed. Higher ultimate systolic and diasystolic volumes of the left ventricle and lower levels of the efflux fraction in the patients with active pulmonary tuberculosis were stated. There was shown inverse correlation of the systemic systolic arterial pressure and the left ventricle efflux fraction with ESR, evident of the tuberculosis intoxication. The most pronounced aggravation of the left ventricle function was recorded in the patients with the most severe tuberculosis process. The impairments in the left ventricle in the patients with active pulmonary tuberculosis were of functional nature. Due to intensive therapy of the tuberculosis, the indices of the left ventricle efflux function improved and the systemic arterial pressure came to normal, along with elimination of the tuberculosis intoxication signs.

[Hypertensive disease and metabolic syndrome: application of metoprolol].

The aim of this work was to study effects of metoprolol on structural and functional characteristics of left ventricle (LV), cerebral circulation (CC), microcirculation (MC), lipid spectrum, rheologic and viscous properties of blood in patients with grade II-III hypertensive disease (HD) and metabolic syndrome. 65 patients in this condition (ESH/ESC, 2007) were given metoprolol (100-150 mg/d) and indapamide (1.5 mg/d) for 6 months. Daily AP profile, structural and functional characteristics of left ventricle were evaluated before and after therapy by echocardiography, cerebral dopplerography, conjunctival biomicroscopy, measurement of MC, hemorheologic parameters, blood lipid spectrum and glucose level. The target AP level and normalization of AP daily profile were achieved in 65% of the patients. The treatment improved myocardial contractility and diastolic function, decreased LV mass, corrected autoregulation of cerebral blood flow and MC. Metoprolol was shown to be metabolically inert. The study confirmed benefits of its application to the treatment of HD with metabolic syndrome.

[Correction of antioxidative state during statin therapy of coronary heart disease with dyslipidemia].

Treatment with simvastatin (vasilip) at a daily dose of 20 mg combined with conventional cardiac therapy was given for 3 months to 132 patients with coronary heart disease and postinfarction cardiosclerosis with dyslipidemia. Activity of tissue and plasma antioxidative enzymes increased in 60% of the patients and decreased in 40%. Treatment with antioxidants 2-ethyl-6-methyl-3-oxypiridine succinate (mexidol) and ubichinon (cudesan QIO) improved antioxidative status of the patients and clinical picture of cardiac pathology.

[Hemodynamic features in persons with posttuberculosis pulmonary changes].

The specific intravascular and central hemodynamic features were studied in 42 patients with pronounced posttuberculous changes in the lung in comparison to a group of healthy individuals without a history of tuberculosis. Along with clinical, functional, and electrocardiographic studies, the authors used echocardiography. End ventricular and atrial systolic and diastolic areas, end left ventricular systolic and diastolic volume, ejection fraction, stroke and cardiac indices were determined. Dilation of the right ventricle and right atrium and their increased specific contractility were ascertained in patients with pronounced posttuberculous changes. At the same time hypertrophy of the right ventricular wall was rarely observed. This gives grounds to regard dilatation of the right ventricle as an earlier sign of evolving chronic cor pulmonale that its hypertrophy. There were no changes in the left ventricle, left atrium, ejection fraction, stroke and cardiac indices, which was explained by the absence of intoxication and toxic infective action in the persons clinically recovered from tuberculosis.

[The specific features of coronary heart disease in patients with pulmonary tuberculosis].

The prevalence and some specific features of coronary heart disease (CHD) were studied in patients with pulmonary tuberculosis. Its prevalence was determined in relation to age, gender, and the type of a tuberculous process. ECG changes in ST segment and T wave were found in patients with pulmonary tuberculosis without concomitant CHD under intoxication. The diagnosis of CHD was established in 41 of 491 patients, which was 8.4%. CHD was more common in elderly and senile females. The clinical manifestation of CHD was observed in females of older age than in males; under the age of 60 years, the prevalence of CHD is less among the patients with pulmonary tuberculosis and above the age of 60 years, it does not differ from that in the general population. CHD most commonly manifests clinical signs in patients with residual changes after experienced pulmonary tuberculosis and in cirrhotic tuberculosis, i.e. when the tuberculosis process is less active.

[Use of preductal in therapy of hemodynamic complications in patients with tuberculosis].

To treat hemodynamic disorders, preductal was used in combination with antibacterial therapy in 30 patients with disseminated destructive pulmonary tuberculosis for a month. A control group comprising 31 patients was in parallel observed. Clinical, electrocardiographic, and echocardiographic studies were performed to evaluate the efficacy of preductal. The drug was found to promote improvements in left ventricular function and central hemodynamics as a decrease in end-systolic volume and increases in ejection fraction and stroke and minute volumes. Preductal exerted no significant effect on right ventricular dysfunction associated with chronic cor pulmonale.

[Use of alpha-tocopherol acetate in the treatment of hemodynamic disorders in patients with pulmonary tuberculosis].

Examination of 101 patients with pulmonary tuberculosis established the impact of specific intoxication on central hemodynamics in 51 patients. Specific treatment was found to have a certain positive effect on impaired hemodynamics. However, there were no significant changes in patients with severe tuberculosis. Hemodynamics substantially improved when alpha-tocopherol acetate was supplemented to antibacterial therapy.

[Effect of eprosartan on microcirculation and blood rheology in patients with hypertensive disease]. / Vliianie éprosartana na mikrotsirkuliatsiiu i reologiiu krovi u bol'nykh gipertonicheskoi bolezn'iu.

The use of eprosartan (600-1200 mg/day for 4 weeks) in 28 patients with stage II hypertensive disease was associated with improvement of parameters of microcirculation and blood rheology.

[Nebivolol in the treatment of ischemic heart disease patients with chronic heart failure]. / Nebivolol v lechenii bol'nykh ishemicheskoi bolezn'iu serdtsa s khronicheskoi serdechnoi nedostatochnost'iu.

AIM: To assess effectiveness of inclusion of nebivolol in complex therapy of patients with chronic heart failure (CHF) due to ischemic heart disease (IHD). MATERIAL: Patients (n=62, age 47-73 years) with NYHA class II-III CHF and left ventricular (LV) ejection fraction (EF) less than 45% receiving standard therapy +/- nebivolol (5 mg/day). The patients were followed up for 4 months. RESULTS: After 4 months improvement of clinical state, exercise tolerance, parameters of central hemodynamics and LV remodeling, lipid spectrum, rheological properties of blood and platelets haemostasis was more pronounced in a group of nebivolol treated patients. CONCLUSION: Inclusion of nebivolol in complex therapy increases efficacy of treatment of patients with CHF due to IHD.

[Lisinopril effects on cerebral blood flow and blood rheology in hypertensive patients]. / Vliianie lizinoprila na mozgovoi krovotok i reologicheskie svoistva krovi u bol'nykh arterial'noi gipertoniei.

AIM: To access the effect of lisinopril (diroton) on cerebral circulation and blood rheology in patients with arterial hypertension stage II. MATERIAL AND METHODS: The trial included 37 patients (16 males, 21 females) with a mean arterial hypertension (AH) history 15.9 +/- 5.6 years. Diroton was given in a dose 10-40 mg/day for 6 months. Cerebral circulation (total cerebral circulation and venous outflow--TCC and VOF) was accessed by means of doppler ultrasonography. Blood and plasm rheology was determined using a rotational viscozymeter ACP-2. Instrumental tests were performed at baseline and at the end of the study. RESULTS: Rheology tests showed that diroton-treated patients achieved a significant decrease in blood viscosity in high, moderate and low shear stress and plasma viscosity, a decrease in platelet aggregation index and an increase in the index of erythrocytic deformability. All these changes were accompanied with a significant fall in fibrinogen and hematocrit. Doppler ultrasound revealed an insignificant increase in TCC and VOF. CONCLUSION: Diroton significantly improved impaired blood rheology and viscosity in AH patients as well as cerebral hemodynamics in patients with subnormal cerebral circulation and venous outflow at baseline.

[The state of hemodynamics and microcirculation in patients with hypertensive disease during long term controlled therapy with lisinopril]. / Sostoianie gemodinamiki i mikrotsirkuliatsii u bol'nykh gipertonicheskoi bolezn'iu pri dlitel'nom kontroliruemom lechenii lizinoprilom.

Lisinopril (Diroton, 10-40 mg/day) was given for 6 months to 30 patients (mean age 57.2+/-0.64 years) with stage II hypertension (WHO, 1999). Left ventricular diastolic function and microcirculation were assessed by echocardiography and biomicroscopy, respectively. Treatment with lisinopril was associated with improvements of impaired left ventricular diastolic function, structural and functional state of the heart. Parameters of microcirculatory vascular bed also improved.

[Effect of eprosartan on left ventricular diastolic function and cerebral hemodynamics in patients with hypertension]. / Vliianie éprosartana na diastolicheskuiu funktsiiu i tserebral'nuiu gemodinamiku u bol'nykh gipertonicheskoi bolezn'iu.

Eprosartan (600-1200 mg/day) was given for 4 weeks to 28 patients aged 32-62 years with stage II-III hypertension (WHO, 1999). Left ventricular diastolic function and cerebral blood flow were assessed by echocardiography and ultrasound dopplerography. Treatment with eprosartan was associated with improvements of impaired left ventricular diastolic function, structural and functional state of the heart, venous outflow from cerebral vessels, and restoration of unpaired autoregulation of cerebral blood flow. All these phenomena could potentially lead to normalization of cerebral tissue perfusion and stabilization of cerebral blood flow.

[Respiratory and renal functions and blood electrolytic composition in patients with pulmonary tuberculosis in the treatment of heart failure]. / Sostoianie funktsii dykhaniia, pochek i élektrolitnogo sostava krovi u bol'nykh tuberkulezom legkikh pri lechenii serdechnoi nedostatochnosti.

The authors studied respiratory and renal functions and blood electrolytic composition in 94 patients with pulmonary tuberculosis in the treatment of heart failure with angiotensin-converting enzyme inhibitors (ACEI) and an angiotensin II blocker (AIIB). At the same time they examined a control group of 24 patients untreated with ACEI and AIIB. All the patients received combined antituberculous therapy. Cardiac glycosides and diuctics were given in some cases. During 1-2 months, the patients from the experimental group additionally took captopril, 12.5-25.0 mg, twice a day or prestarium, 2.0-4.0 mg, once a day, or cossar, 50 mg, once a day. After the treatment, ACEI and AIIB were found to have no effect on blood gas and electrolyte composition, and respiratory and renal functions. With captopril and ramipril there was a higher patency of minor bronchi in the experimental groups than in the controls.

[Activity of the renin-angiotensin-aldosterone system and its impact on the effectiveness of treatment of chronic heart failure in patients with pulmonary tuberculosis]. / Aktivnost' renin-angiotenzin-al'dosteronovoi sistemy i ee vliianie ma éffektivnost' lecheniia khronicheskoi serdechnoi nedostatochnosti u bol'nykh tuberkulezom legkikh.

The renin-angiotension-aldosterone system (RAAS) was studied in 93 patients with pulmonary tuberculosis complicated by chronic heart failure (CHF). Radioimmunoassay was used to determine plasma renin activity (PRA) and serum angiotensin I and aldesterone levels. There was higher RAAS activity, as shown by elevated PRA. RAAS activity decreased during CHF treatment with angiotension-converting enzyme inhibitors (captopril, ramipril, prestarium) and an angiotensin II-receptor blocker (cosaar), which is indicative of the efficiency of CHF treatment.

[Effects of angiotensin-converting enzyme inhibitors and cosaar on quality of life of patients with pulmonary tuberculosis and chronic heart failure]. / Vliianie ingibitorov angiotenzinprevrashchaiushchego fermenta i kozaara na kachestvo zhizni bol'nykh tuberkulezom legkikh s khronicheskoi serdechnoi nedostatochnost'iu.

Two and thirty four patients with pulmonary tuberculosis complicated with chronic heart failure (CHF) were examined to study life quality (LQ) and its changes due to hemodynamic correction. LQ was assessed by the Minnesota Life Heart Failure Quality questionnaire filled in by patients before and after treatment of CHF with angiotensin-converting enzyme inhibitors (captopril, ramipril, prestarium) and an angiotensin II-receptor blocker (cosaar) given for 1.5-2 months during chemotherapy for tuberculosis. In patients with pulmonary tuberculosis complicated by CHF, LQ was found to be related to the degree of hemodynamic disorders and to significantly improves with complex treatment of a tuberculous process and with correction of hemodynamic disorders.

[Ramipril treatment of heart failure in disseminated forms of pulmonary tuberculosis]. / Lechenie serdechnoi nedostatochnosti pri rasprostranennykh formakh tuberkuleza legkikh s ispol'zovaniem ramiprila.

A total of 108 patients with heart failure-complicated disseminated pulmonary tuberculosis were followed up. Fifty eight patients received combined therapy including the angiotensin-converting enzyme inhibitor ramipril in a daily dose of 0.25-0.50 mg for 1.5-2 months. Fifty ramipril-untreated patients comprised a control group. Examinations revealed the benefits of the agent in decompensatory chronic cor pulmonale as improved right ventricular systolic and diastolic functions and health in the patients.

[A quantitative assessment of the blood supply to the head by indirect rheography]. / Kolichestvennaia otsenka krovosnabzheniia golovy metodom oposredovannoi reografii.

Clinical-experimental basis of the possibility of application of the method of indirect rheography of head (IRH) in wide clinical practice was presented. Estimation of the results reproduction and accuracy of the method was performed too. 40 healthy individuals of both sexes at the age of 18-50 and 102 patients with spinal osteochondrosis, arterial hypertension and neurocirculatory dystonia were examined. It was determined that IRH provided 93% of results reproduction and its precision was 90% and higher in comparison with ultrasound method. It was established that head circulation was 750-1200 ml/min or 12-24% of cardiac output in healthy individuals. The results of the study of head blood circulation in some groups of patients were also discussed.