New-onset angina pectoris: initial characteristics and results of a 6 to 12-month follow-up.

173 patients, aged 46.8 years on the average, were examined in the first 3 months after onset of angina pectoris. 97% of them presented at least one of risk factors (smoking, arterial hypertension, overweight, dyslipoproteinaemia), in 79% two or more risk factors were present simultaneously. A greater than 70% stenosis of one coronary artery was present in 51%, in 10% the stenosis was smaller than 70%, in 4% the coronary arteries were intact. In 131 patients without a history of myocardial infarction, vasospastic angina, overweight, and simultaneous presence of 3 or 4 risk factors occurred more frequently than in 42 patients with a history of myocardial infarction. In the first month, complications were registered only in patients with unstable angina pectoris (5 out of 41, i.e., 12%). During the later period of follow-up in 102 patients, complications occurred in 5% and complete clinical remission was registered in 35%. In patients with remission, positive exercise tests and haemodynamically significant stenoses of 2 or 3 coronary arteries were less frequently found on initial examination than in patients with sustained angina pectoris.

[Primary vasospastic angina pectoris: relations between manifestations of ischemia and presence of ventricular arrhythmia]. / Vpervye voznikshaia vazospasticheskaia stenokardiia: sviaz' mezhdu vyrazhennost'iu ishemii i nalichiem zheludochkovykh aritmii.

24-hour ECG monitoring was performed in 12 patients with primary vasospastic angina (PVA). Angiography revealed a predominant lesion to a single coronary vessel (83%). There were 64 episodes of ST-segment changes (46 elevations and 18 depressions) during the monitoring that lasted 388 hours and 54 minutes. Ventricular arrhythmias were concomitant in 34% of the episodes. Ventricular arrhythmia significantly more frequently occurred when an ischemic episode lasted more than 5 minutes. No significant relation was established between the presence of ventricular arrhythmia and other indicators of ischemic manifestation.

[Newly developed stenocardia: lack of ventricular electrical instability in the absence of acute myocardial ischemia]. / Vpervye voznikshaia stenokardiia: otsutstvie élektricheskoi nestabil'nosti zheludochkov vne ostroi ishemii miokarda.

A total of 130 patients with angina of new onset were examined within first 3 months of the disease. Macrofocal myocardial infarction survivors were not admitted to the study. The investigation included selective coronaro-angiography and ventriculography, Holter's ECG monitoring over 24 to 48 hours and bicycle ergometry. Programmed right-ventricular electric stimulation was conducted in 41 patients. Only one major coronary artery was affected in 78% of patients. Left-ventricular ejection fraction nearly always exceeded 50%. Groups of ventricular extrasystoles were detected by ECG monitoring in 10.8% and by bicycle ergometry in 2.5%. No signs of electrical instability were ever detected at programmed stimulation, done in the absence of anginal attacks. Groups of ventricular extrasystoles were more common, as compared to single extrasystoles (p less than 0.001), in acute myocardial ischemia, being more frequently associated with unstable rather than stable angina of new onset (p less than 0.05). In early coronary heart disease, signs of electric ventricular instability are not detectable in the absence of myocardial ischemia.

[Initial occurrence of angina: diagnostic value of bicycle ergometry and Holter ECG monitoring]. / Vpervye voznikshaia stenokardiia: diagnosticheskoe znachenie veloérgometrii i kholterovskogo monitorirovaniia EKG.

The diagnostic value of exercise tests and Holter's ECG monitoring was assessed in 111 patients within the first 3 months since the onset of anginal attacks; 22 of those had a history of large-focal myocardial infarction. Coronaro-angiography was performed in all cases, and its results were compared with those of exercise tests in 107 patients, and of Holter's ECG monitoring, in 104. Bicycle ergometry was positive in 48% of patients. In Holter's ECG monitoring, ST changes were found in 53% of patients. Combined use of bicycle ergometry and Holter's monitoring allowed detecting ST displacement in 60%. Ischemic ST depression during bicycle ergometry in postinfarction patients is an evidence of polyvascular coronary arterial involvement.

[Experience with intraluminal balloon dilatation of constricted coronary arteries in ischemic heart disease]. / Opyt primeneniia vnutriprosvetnoi ballonnoi dilatatsii stenozirovannykh koronarnykh arterii pri ishemicheskoi bolezni serdtsa.

Twenty-seven attempts at coronary arterial intraluminal balloon dilatation (CAIBD) were made in 24 patients; 16 of those were successful. The procedure could only be accomplished in patients with affected anterior interventricular branch. Thrombotic occlusion of the dilated segment was recorded in 3 patients, and 2 of those developed intramural myocardial infarction. While the procedure is not yet fully set up, it is indicated to patients with an isolated lesion of the anterior interventricular artery that does not exceed 90%, no apparent signs of coronary spasm and no effect of conventional antianginal therapy.

[Newly developed stenocardia: electrocardiographic and angiographic comparisons and the possibility of conducting intraluminal dilatation of coronary arteries]. / Vpervye voznikshaia stenokardiia: elektrokardiograficheskie i angiograficheskie sopostavleniia, vozmozhnost' vypolneniia vnutriprosvetnoi dilatatsii koronarnykh arterii.

Fifty coronary patients were examined within the first 3 months after the onset of anginal attacks. All patients were subjected to coronaroangiographic investigation, bicycle ergometry, and 45 patients, to ECG-monitoring. Resting ECG patterns were assessed. One coronary vessel, the anterior interventricular branch of the left coronary artery in most (73%) cases, was affected in 66% of the patients. The stenoses suitable for intraluminal balloon dilatation were found in 58% of the patients with one vessel affected. In a considerable proportion (24%) of the patients, 2 or 3 arteries were affected. Combined electrocardiographic investigation demonstrated lesions of the anterior interventricular branch of the left coronary artery. The early results obtained with the intraluminal balloon dilatation of coronary arteries (16 attempts in 13 patients) showed good clinical effect to accompany anatomically-successful procedures (8 patients).