[Adaptation of the myocardium to psychoemotional stress in patients with myocardial infarction and painless ischemia]. / Adaptatsiia serdtsa k psikhoémotsional'nomu napriazheniiu u bol'nykh infarktom miokarda s bezbolevoi ishemiei.

To assess features of heart adaptation to psychoemotional stress in patients with myocardial infarction (MI), we studied contractile and pump functions of the left ventricle in conditions of modelled informational stress. A total of 36 MI patients were examined using informational stress, echocardiography, electrocardiography, impedance plethysmography. We established variants of biological rhythms of the heart in MI patients with painless myocardial ischemia of psychogenic origin.

[Radiologic evaluation of effectiveness of physical training in patients with myocardial infarction]. / Rentgenologicheskaia otsenka éffektivnosti fizicheskikh trenirovok u bolnykh infarktom miokarda.

The findings of two-projection large-image fluorography of the thorax of 134 men aged 32 to 60 with a history of myocardial infarction are presented. Physical rehabilitation of these patients was either traditional (controls) or enhanced by physical training (test group). X-Ray characteristics of the pulmonary vascular bed help to detect left ventricular insufficiency even in cases when there are no clinical symptoms of it. Time course of X-ray and cardiometrical data helps not only to assess the efficacy of training, but permits detection of the progress of left ventricular insufficiency as well. Cardiometrical parameters (volume of the heart, left ventricular coefficient, hvs index, right-atrial coefficient) may be used to predict the course of coronary heart disease in the postinfarction period.

[Features of the clinical and functional state of myocardial infarction patients with psychogenic silent ischemia]. / Osobennosti kliniko-funktsional'nogo sostoianiia bol'nykh infarktom miokarda s psikhogennoi bezbolevoi ishemiei.

A total of 111 patients with myocardial infarction were studied in the early, period of the disease. Exercise and information load tests, impedance plethysmography, electrocardiography, and large-framed fluorography were performed. Among the patients with myocardial infarction who responded to information load by exhibiting transient silent ischemia, vasospastic reactions were demonstrated to be diagnosed mainly in those with posterior myocardial infarction. The patients with anterior myocardial infarction responded to psychoemotional stress mainly by showing ischemia formed under the conditions of higher myocardial oxygen uptake due to increased blood minute volume. In most patients, the area of silent psychogenic vasospastic ischemia coincided with that of infarct-related myocardium, whereas ischemic changes were largely located in the anterior left ventricular wall despite the area of myocardial necrosis when psychogenic ischemia developed with increased myocardial oxygen uptake.

[Possibilities for the rehabilitation of patients with myocardial infarction without application of coronary drugs during hospital treatment ]. / Vozmozhnosti vosstanovitelnogo lecheniia bolnykh infarktom miokarda bez primeneniia koronaroaktivnykh preparatov so statsionarnogo etapa reabilitatsii.

When restorative treatment was performed in 51 patients with myocardial infarction, 3 groups were identified, each including 17 persons. The main group comprised those whose rehabilitation had been achieved by early physical trainings with coronary active agents; the first control consisted of those who had gone in for physical exercises and received antianginal drugs, the second control group included those whose rehabilitation had been conducted by the well-known procedures (therapeutical exercises, graded walking, nitrates, beta-blockers, calcium antagonists). The treatment resulted in improvement in the functional status of patients from the main and the first control groups as compared to those from the second control group. It is concluded that in patients with myocardial infarction without pain syndrome in the subacute period of the disease the efficiency of restorative treatment may be enhanced by using early individualized physical trainings without application of coronary active drugs.

[Comparative analysis of pathophysiologic mechanisms of myocardial infarction development under conditions of physical and information load in patients with ischemic heart disease]. / Sravnitel'nyi analiz patofiziologichekikh mekhanizmov razvitiia ishemii miokarda v usloviiakh fizicheskoi i informatsionnoi nagruzok u bol'nykh ishemicheskoi bolezniu serdtsa.

The results of examination on a bicycle ergometer and the information test with continuous electrocardiographic and hemodynamic control by means of impedance plethysmography showed that the cardiovascular system of patients with ischemic heart disease is desadapted to physical and informative load, which was manifested by ischemia of the myocardium and disorders of its contractility in both types of loading. The pathogenetic mechanisms of the development of myocardial ischemia in most patients with ischemic heart disease under conditions of physical and information loads differ. In information load, ischemia of the myocardium is a consequence of coronary vasospasm in 72.7% of patients and only in 27.3% of cases it is caused by deficient perfusion of the myocardium with blood in stenosed coronary arteries and increased myocardial requirements for oxygen. Inverse tendencies are encountered in physical load.

[Effects of physical training on tolerance of psychoemotional stress in patients with myocardial infarct]. / Vliianie fizicheskikh trenirovok na tolerantnost' k psikhoémotsional'nym nagruzkam u bol'nykh infarktom miokarda.

Intensive physical training were examined for their impact on tolerance for information loading at various stages of restorative therapy in 62 males of productive age who had extensive myocardial infarction. It was established that the physical training performed at the hospital stage reduced the incidence of ischemic responses to information loading at all stages of restorative therapy. At the same time the physical training in patients with myocardial infarction promote higher frequency of ischemic angiospastic responses during the information test. With this, it is expedient to combine physical training with the drugs that prevent angiospasms.

[Diagnosis of critical stenosis of the coronary arteries in patients with ischemic heart disease]. / Diagnostika kriticheskogo stenoza koronarnykh arterii u bo'lnykh ishemicheskoi bolez'niu serdtsa.

Possible diagnosis of critical coronary stenosis using a bicycle ergometry along with coronary angiography was studied in 193 patients. Informative hemodynamic criteria were proposed for noninvasive diagnosis of anatomic critical coronary stenosis during exercise. Application of coronary angiography combined with a bicycle ergometric testing enabled the true critical coronary stenosis to be diagnosed.

[Pathogenesis of myocardial ischemia in information stress in patients with ischemic heart disease]. / O patogeneze ishemii miokarda pri informatsionnoi nagruzke u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A study of 48 coronary patients demonstrated that coronary as well as systemic vasospasm resulting in a drop of propulsive left-ventricular capacity are the principal pathogenic factors leading to myocardial ischemia under emotional stress. In patients with coronary arterial stenosis, increased myocardial oxygen want due to increased stroke and minute volumes contributes significantly to ischemic response to stress. The use of corinfar is advisable to prevent the development of emotion-induced vasospasm. The use of information stress with ECG and central hemodynamic monitoring permits noninvasive diagnosis of coronary spasm.

[Comparison of the efficacy of different programs of physical rehabilitation for myocardial infarct patients and possibilities of increasing it by incorporating physical training at the hospital stage of rehabilitation therapy]. / Sopostavlenie éffektivnosti razlichnykh programm fizicheskoi reabilitatsii bol'nykh infarktom miokarda i vozmozhnosti ee povysheniia putem vkliucheniia fizicheskikh trenirovok na statsionarnom étape vosstanovitel'nogo lecheniia.

The efficiency of rehabilitation can be improved through early activation of the patients and the beginning of exercise as early as the hospital stage of rehabilitation. The intensity of exercise should be rationed on a strictly individual basis, with regard to the patient's functional status. Hospital exercise in combination with purposeful psychotherapy are major prerequisites for the recovery of working capacity.

[Hemodynamic support of the psychoemotional reaction of ischemic heart disease patients]. / Gemodinamicheskoe obespechenie psikhoémotsional'noi reaktsii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A study of 44 coronary patients and 11 normal subjects (all of them males) demonstrated different patterns of circulatory response to psychoemotional stress in coronary patients, as compared to normal subjects. Hypokinetic circulatory response to psychoemotional stress is indicative of reduced myocardial contractility due to myocardial ischemia induced by a psychogenic stimulus, while hyperkinetic circulatory transformation in response to stress is a more adequate hemodynamic reaction in coronary patients.

[The "information test" in the diagnosis of ischemic heart disease]. / Test "informatsionnaia proba" v diagnostike ishemicheskoi bolezni serdtsa.

The effect of psychophysiologic testing (the information test) on coronary flow was examined in 113 patients with coronary heart disease, 48 patients with neurocirculatory dystonia, 10 patients with essential hypertension and 15 normal subjects. Electrocardiographic evidence of coronary insufficiency was identified that can be found in 75.2% of coronary patients.