[The possibility for the presumed detection of the obstructive lesion of the coronary arteries in stenocardia patients by the data from circadian ECG monitoring and stress tests]. / Vozmozhnost' predpolozhitel'nogo vyiavleniia obstruktivnogo porazheniia koronarnykh arterii u bol'nykh stenokardiei po dannym sutochnogo monitorirovaniia EKG i nagruzochnykh prob.

Whether 24-h ECG monitoring (ECGM) may be used in detection of multiple arterial obstructions in anginal patients and to compare diagnostic efficacy of ECGM and bicycle exercise (BE) in prediction of 2 or 3 lesions was investigated in 137 patients subjected to ECGM and selective coronarography. 117 of them did bicycle exercise. The number of episodes of painful and painless myocardial ischemia in ECGM was related with the extension and depth of the coronary flow obstruction. The overall index of myocardial ischemia has been estimated warranting higher probability of detection of subjects with obstruction in 1 or more coronary arteries. Sensitivity and prediction value of ECGM was similar to those of BE, but the latter was more specific.

[Effectiveness of drug therapy alone or its combination with plasmapheresis in patients with severe angina pectoris]. / Effektivnost' medikamentoznoí terapii i ee kombinatsii s kursom lechebnogo plazmafereza u bol'nykh stenokardieí tiazhelogo techeniia.

92 patients with ischemic heart disease and severe angina pectoris received either nitro drugs and calcium antagonists (n = 24) or their combination with plasmapheresis (n = 68). The efficacy of the treatment was assessed by the number of anginal episodes, doses of nitro drugs, pre- and posttreatment dynamic ECG readings. It is shown that 75% of the patients benefited from the addition of plasmapheresis to the treatment scheme. According to dynamic ECG, positive effect of plasmapheresis occurred also in painless ischemia.

[Fluctuations in the stenocardia threshold of patients with ischemic heart disease]. / Kolebaniia poroga stenokardii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

In twenty-eight men (the mean age 49.3 +/- 3.2 years) with different clinical varieties of angina pectoris, analysis was made of the heart rate and the grade of ischemic depression of the ST segment, associated with anginous attacks seen during bicycle ergometry and other physical exercises in the course of daily cardiomonitoring. The data obtained indicate that in the same patient, the same grade of ischemic depression of ST was recorded despite varying heart rate. On the contrary, in spite of the same heart rate the grade of ischemic depression of the segment could vary. Dynamic coronary obstruction determined by the mechanisms of adrenergic vasoconstriction is the most probable cause of changeability of the threshold of angina pectoris in patients belonging to functional classes III-IV. The probability of fluctuations in the threshold of angina pectoris should be taken into consideration in deciding expert problems and in the assessment of the efficacy of antianginal therapy.

[Comparison of exercise test and ECG monitoring results in women with ischemic heart disease]. / Sopostavlenie rezul'tatov proby s fizicheskoi nagruzkoi i monitorivovaniia EKG u zhenshchin, stradaiushchikh ishemicheskoi bolezn'iu serdtsa.

To diagnose myocardial ischemia and differentiate the chest pain syndrome in 20 females with coronary heart disease and effort angina pectoris, exercise test and ECG monitoring were performed. Their results were then compared. The informative value of 24-hour ECG monitoring was higher than that of bicycle ergometry in detecting the objective signs of ischemia in patients with effort angina. The indisputable advantage of long-term ECG recording is that one can identify silent ischemia in females with routine physical activity in the outpatient settings. The method of 24-hour ECG monitoring cannot be considered to be sufficiently effective in the differential diagnosis of the atypical chest pain syndrome.