Efficiency of refracterin in patients with chronic cardiac insufficiency caused by coronary heart disease.

Composite preparation refracterin administered in a dose of 300 mg/day for 3 days in addition to routine therapy significantly improved the results of treatment of severe cardiac insufficiency of ischemic genesis compared to placebo. Improvement of clinical status of patients is determined by positive dynamics of systolic and diastolic functions of the left ventricle.

[The subcellular pathophysiology of heart failure due to toxic-allergic myocarditis and the action of refracterin on intracardiac hemodynamics and the functional state of the 3 subcellular cardiomyocyte systems responsible for the act of contraction-relaxation]. / Subkletochnaia patofiziologiia nedostatochnosti serdtsa, obuslovennoi toksiko-allergicheskim miokarditom, i deistvie refrakterina na vnutriserdechnuiu gemodinamiku i funktsional'noe sostoianie trekh subkletochnykh sistem kardiomiotsita otvetstvennykh za akt sokrashchenie--rasslablenie.

It is shown that cardiotropic drug refracterin promotes recovery of cardiac contraction and relaxation, their coordination destroyed in cardiac failure (CF) caused by 10-day toxico-allergic myocarditis (TAM). Pumping capacity of the heart returns to normal after normalization of functional activity of three systems of cardiomyocyte responsible for contraction-relaxation: contractile proteins, energy supply and calcium transport. The key process is refracterin-related reestablishment of normal content and proportion of adenyl nucleotides and creatininephosphate and regulation role of phosphorylation and energy of metabolic processes in the cells and their interaction. Thus, refracterin effectiveness lies in its ability to interfere in intracellular metabolic processes in the myocardium, to reestablish normal homeostasis of the systems responsible for contraction-relaxation function and eventually to remove left ventricular cardiac dysfunction.

Oxyfedrine in myocardial stunning.

Effect of oxyfedrine (OXF)(1 mg/kg) administered just before reperfusion (post-treatment) was investigated in a canine model of myocardial stunning. In the saline-treated animals, myocardial stunning was evidenced by fall in MAP, decrease in LV peak (+) dP/dt, rise in LVEDP and incomplete regeneration of myocardial ATP, after reperfusion. OXF was found to be effective in preventing the haemodynamic and metabolic changes associated with myocardial stunning.

[Effects of oxyfedrine on high blood viscosity and myocardial necrosis induced by epinephrine and ice water stress in rats].

Acute high blood viscosity (HBV) and myocardial necrosis was established by epinephrine (Epi) and ice water stress in rats. Effects of iv oxyfedrine (Oxy) on HBV, plasma viscosity (PV), hematocrit, erythrocyte electrophoretic time (EET), and fibrinogenic viscosity (FV) were studied in model. Results showed that Oxy 1 mg.kg-1 iv markedly decreased the arterial and venous blood HBV at shear rates of 700 s-1 and 70 s-1, respectively (P < 0.01). There were significant differences in the alleviation of HBV among 3 groups (Oxy 0.01, 0.1, and 1 mg.kg-1 iv). The above doses markedly decreased the HBV, PV, and FV, and shortened the EET. Effects of iv Oxy on the myocardial necrosis rat model were scrutinized under the light and electron microscopes. Oxy iv 1 mg.kg-1.d-1 x 1, 3, and 5 d prevented or mitigated the occurrence and development of myocardial necrosis. The structure of heart mitochondria and myofibrils were clearly discernible. This action may be related to the alleviation of HBV by Oxy.

Effects of oxyfedrine on regional myocardial blood flow in patients with coronary artery disease.

Medical treatment of angina pectoris is largely based on the use of beta-blocking agents, calcium antagonists, and nitrates. Oxyfedrine, an amino ketone derivative and partial agonist at beta receptors, has been shown to have potent antianginal properties and to increase coronary blood flow in normal and ischemic myocardial regions in experimental studies. We assessed the effects of intravenous oxyfedrine on regional myocardial blood flow, using positron emission tomography (15-oxygen water), in six patients with chronic stable angina, positive exercise tests, and documented coronary artery disease. Myocardial blood flow was measured in all patients before (baseline) and 10 minutes after the intravenous administration of a single bolus (0.11-0.13 mg/kg) of oxyfedrine. Compared to baseline, heart rate and systolic blood pressure remained almost unchanged after the administration of oxyfedrine. Mean baseline myocardial blood flow was 0.90 +/- 0.15 ml/g/min in areas supplied by arteries with significant coronary stenosis and 1.08 +/- 0.19 ml/g/min in areas supplied by nonstenotic coronary vessels (p less than 0.05). After the administration of oxyfedrine, myocardial blood flow increased significantly in both the regions supplied by stenotic vessels (by 25%; from 0.90 +/- 0.15 to 1.20 +/- 0.31 ml/g/min; p = 0.002) and in areas supplied by angiographically normal coronary vessels (by 22%; from 1.08 +/- 0.19 to 1.38 +/- 0.49 ml/g/min; p less than 0.05). The results of this study indicate that in patients with coronary artery disease, intravenous oxyfedrine significantly increases regional myocardial blood flow, both in areas supplied by critically obstructed vessels and in areas supplied by normal or less severely narrowed coronary arteries.

[Ageusia as the aftereffect of oxyfedrine use]. / Ageusia jako nastepstwo ubocznego dzialania oksyfedryny.

Out of oxyfedrine++ side effects known up to the present (mild agitation, stupor, heat sensation, pains in the epigastrium++, skin allergy) 24 cases of ageusia appearing usually after 4 weeks of treatment with oxyfedrine++ were presented. Disturbances of taste are found to be unpleasant for patients, and result in remarkable exacerbation of their general feeling. The complaints subside completely after finishing treatment, and the time of taste disorder withdrawal is prolonged according to the time of oxyfedrine++ treatment.

Effect of intravenous oxyfedrine on exercise in patients with ischaemic heart disease.

In a double blind crossover trial, acute effects of 8 mg intravenous oxyfedrine were compared with those of placebo in 18 patients with stable effort angina assessed by treadmill exercise testing. In the resting state, oxyfedrine caused an increase in heart rate (84 +/- 23 to 103 +/- 19 bpm, p less than 0.01), systolic blood pressure (123 +/- 16 to 133 +/- 20 mmHg, p less than 0.01) and double product (11 x 10(3) +/- 2 x 10(3) to 13.7 x 10(3) +/- 3.1 x 10(3), p less than 0.01) as compared to placebo. However, these parameters were not significantly different at the end of first or second stage of the treadmill test (p = NS). Time to one mm ST segment depression was increased with oxyfedrine as compared to placebo (1.5 +/- 1.5 to 1.9 +/- 1.5 minutes, p less than 0.05). Oxyfedrine did not increase the total duration of exercise (4.1 +/- 1.0 to 4.7 +/- 2.2 minutes, p = NS) or time to ischaemic symptoms (2.7 +/- 1.3 to 2.9 +/- 1.9 minutes, p = NS). The total work done was significantly more on oxyfedrine 312 +/- 189 joules/kg to 370 +/- 209 joules/kg, p less than 0.01) as also the double product achieved (20.6 x 10(3) +/- 6.1 x 10(3) to 22.5 x 10(3) +/- 6.4 x 10(3), p less than 0.01). It is concluded that intravenous oxyfedrine improves exercise capacity in patients with stable effort angina presumably by reducing myocardial ischaemia.

[Use of beta 1-adrenostimulants in circulatory failure in patients with chronic inflammatory lung diseases]. / Primenenie beta 1-adrenostimuliatorov pri nedostatochnosti krovoobrashcheniia u bol'nykh s khronicheskimi vospalitel'nymi zabolevaniiami legkikh.

In 34 patients with chronic cor pulmonale, the drugs from a group of beta-adrenostimulants, nonachlazinum and oxyphedrinum, were tested for effects on their hemodynamics, pulmonary ventilation function, blood gas composition and acid-base balance. In patients with circulatory failure due to lung diseases, nonachlazinum and oxyphedrinum were found to exert a pronounced positive intropic action, to contribute to an increase in cardiac output. The agents may be included into the multimodality therapy of patients with decompensated chronic cor pulmonale.

[The pathogenesis of psoriasis]. / K voprosu o patogeneze psoriaza.

Ildamen has a positive effect on the course of psoriasis in patients with cardiovascular diseases. Its effect in psoriasis appears to be explained by its stimulating action on skin beta-adrenoreceptors. The study carried out by the authors confirms the contribution of beta-adrenoreceptors to the pathogenesis of psoriasis.

Acute haemodynamic effects of different doses of alifedrine in congestive heart failure.

The haemodynamic effects of single oral doses of alifedrine 40 mg, 50 mg, 60 mg and placebo were compared in 30 patients with mild to moderate heart failure. Individual patients received either alifedrine 60 mg and placebo (15 patients) or alifedrine 40 mg and 50 mg (15 patients). All doses of alifedrine produced qualitatively similar haemodynamic responses, with maximum changes between 90 and 180 min after drug administration. The cardiac index was increased by +39%, +57%, and +50% by 40 mg, 50 mg and 60 mg, respectively. The increases were due to rises in stroke volume index (SVI) and in heart rate of +15%, +20% and +23%. Mean arterial blood pressure fell in a dose-related fashion, with a maximum fall of 11% by 120 min after 60 mg. The systemic vascular resistance index (SVRI) fell by 28%, 39% and 41%, and pulmonary vascular resistance index (PVRI) by 32%, 44% and 32% after 40 mg, 50 mg and 60 mg, respectively. The optimum dose appears to be 40 mg, which caused very little fall in blood pressure or increase in heart rate, yet significantly improved cardiac output. Alifedrine may have a place in the treatment of heart failure as an oral by active, positive inotropic agent.

[Effect of ildamen on the heart conduction system in ischemic heart disease patients]. / Vliianie il'damena na provodiashchuiu sistemu serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Thirty-four patients with ischemic heart disease (IHD) were studied: 18 IHD patients with latent forms of disturbances of conductivity in the atrioventricular junction and sinus node sickness syndrome revealed at frequency stimulation of the heart; 16 patients with acute myocardial infarction complicated with the atrioventricular junction blockade of II and III degrees. Ildamen solution (4 mg) was slowly intravenously infused to all patients under study. Exerting the beta-stimulating effect, ildamen positively influences restoration of the disordered function of the pacemaker and conduction system of the heart: through immediate action on these systems and an increase of the coronary blood flow contributing to improvement of nutrition of the condition system of the heart.

[Bronchial obturation by broncholiths as a cause of recurrent bronchopulmonary inflammatory processes and late recognition of the basic disease]. / Obturatsiia bronkhov bronkholitami kak prichina retsidiviruiushchikh bronkholegochnykh vospalitel'nykh protsessov i pozdnego raspoznavaniia osnovnogo zabolevaniia.

The authors have analyzed their experience in the diagnosis and treatment of 32 patients with broncholiths-induced obturation of the segmentary and lobar bronchi with subsequent prolonged recurring inflammatory, cirrhotic or suppurative bronchopulmonary processes farther to a site of bronchial obstruction. 37% of the patients only knew of primary tuberculosis. Chest pains were noted in 50%, hemoptysis in 40%. The rest of the symptoms were not characteristic. Therefore true diagnosis was established, as a rule, in a late period. Patients with broncholiths were treated for many years with the diagnosis of recurring pneumonia, cirrhotic or suppurative processes. Bronchoscopy is a method of choice because broncholiths can be found in a visible zone of the bronchial tree. The earlier bronchoscopy is performed, the easier and better can be the patients' cure.

Remissäo de bloqueio de ramo esquerdo com oxifedrina: relato de cinco casos / Remission of left bundle-blanch block with oxyfedrine: report of 5 cases

Säo relatados 5 casos de remissäo completa de bloqueio de ramo esquerdo (BRE) em pacientes tratados com oxifedrina. Nestes pacientes (4 do sexo feminino e 1 do sexo masculino com idades variando de 55 a 81 anos), a principal condiçäo clínica associada foi a hipertensäo arterial (observada em 4 dos 5 pacientes). As doses de oxifedrina variaram de 24 a 48 mg administradas em 3 tomadas diárias, durante períodos de 9 a 15 meses. O tempo de acompanhamento variou de 38 a 109 meses. Todas as remissöes persistiam por períodos de 9 a 84 meses após a suspensäo da droga. Em todos os eletrocardiogramas obtidos antes, durante e após o tratamento com oxifedrina, foram encontrados ritmo sinusal e intervalos PR normais. Um paciente teve remissäo de sintomas de insuficiência ventricular esquerda. Um paciente, que apresentou estado sincopal antes do tratamento, permanencia assintomático. Em 4 pacientes, nos quais as direçöes dos segmentos ST e ondas T eram opostas às dos complexos QRS, observou-se um retorno progressivo no sentido da normalidade. Em 2 pacientes, foi documentado o BRE intermitente durante o tratamento, como uma transiçäo entre o estágio de BRE estabelecido antes do tratamento e o de completa remissäo após o tratamento. Nestes casos, a completa remissäo ocorreu após um incremento de dose da droga. Durante o tratamento com oxifedrina, a freqüência cardíaca permanece inalterada em quatro pacientes e reduziu-se de 98 para 84 bpm em um

Comparison of oxyfedrine and atenolol in angina pectoris--a double-blind study.

We have compared oxyfedrine 24 mg four times daily with atenolol 100 mg once daily in the relief of angina pectoris in a double-blind cross-over study; assessments were by diary cards and treadmill testing. Both oxyfedrine and atenolol reduced the frequency of angina by similar amounts and both produced similar improvements in treadmill performance. Side effects were infrequent and minor with both drugs. The model of action of oxyfedrine appears to be different from atenolol. Oxyfedrine allows the double product of systolic blood pressure X heart rate at peak exercise to be maintained at levels similar to those with placebo; the double product at peak exercise is significantly less with atenolol.

[Various aspects of drug therapy of chronic forms of ischemic heart disease]. / Nekotorye aspekty medikamentoznogo lecheniia khronicheskikh form ischemicheskoi bolezni serdtsa.

Experience in the treatment of over 500 chronic coronary patients with various anti-anginal drugs or their combinations is summarized. Controlled (double blind) and open studies and acute pharmacologic tests demonstrated comparative efficacy of depot-nitrates, beta-blockers, oxyfedrine, cordaron, lidoflazinum, molsidamine (corvaton). The effects on exercise tolerance (bicycle ergometry) with isolated and combined use of the drugs are described. Indications for surgery are discussed.

[Reperfusion damages to the heart in acute transitory coronary failure and their prevention with myophedrin]. / Reperfuzionnye povrezhdeniia serdtsa pri ostroi tranzitornoi koronarnoi nedostatochnosti i ikh preduprezhdenie miofedrinom.

Experiments were made on 56 white noninbred male rats with transitory coronary insufficiency (duration of myocardial ischemia 10, 40 and 120 min, the length of subsequent reperfusion 10 and 40 min). It was discovered that there were changes in the ultrastructure of cardiocytes and vessels of the microcirculatory bed both in the area of ischemia and reperfusion and in the distant heart regions, an increase in myocardial cell and microvessel lesions during postischemic reperfusion not only in the area of ischemia but also in distant zones. In addition, a reduction was noted in the degree of ischemic and reperfusion myocardial injury during the prophylactic use of myophedrine. The mechanisms of the protective action of myophedrine in acute transitory coronary insufficiency are discussed.