[Significance of total and regional myocardial contractility in determining the indications for aortocoronary shunting]. / Znachenie obshchei i regionarnoi sokratimosti miokarda v opredelenii pokazanii k aortokoronarnomu shuntirovaniiu.

As shown dy static radionuclide ventriculography and nitroglycerin test used to study 72 coronary patients aged 38-65, myocardial function is the essential factor for deciding on aortocoronary shunting. Focal destruction ot the myocardium responsible for a sharp attenuation of myocardial contractility may be indicative of poor prognosis and high risk of aortocoronary shunting.

[Characteristics of glucose and lactate oxidation in the myocardium at different stages of mitral stenosis]. / Osobennosti okisleniia gliukozy i laktata v miokarde pri raznykh stadiiakh mitral'nogo stenoza.

Content of glucose, lactate, pyruvate and cAMP was estimated in biopsy from left atrium of 120 patients with the III and IV degree of mitral valve stenosis. Content of 14CO2, developed after incubation of myocardium homogenates with labelled substrates--glucose, glucose-I-phosphate, glucose-6-phosphate, succinate, lactate, was also measured. In patients with the IV degree of mitral valve stenosis concentration of carbohydrates and cAMP was decreased in myocardium as compared with those of patients with the III degree of the disease, whereas consumption of labelled glucose, lactate and succinate was increased. Estimation of the oxidation rate of glucose phosphorylated derivatives enabled to suggest that main part of glucose carbon was involved in reactions of the Krebs cycle. At the same time, a decrease in the content of carbohydrate substrates in myocardium of patients with the IV degree of the stenosis occurred due to elevated rate of these substrates oxidation. The data obtained suggest that adaptation reactions to hemodynamic impairments were responsible for dissimilar character of glucose and lactate metabolism in myocardium of patients with various degree of mitral valve stenosis.

[Spiroergometric assessment of the reserves of the heart pumping function at different times following closed mitral commissurotomy]. / Spiroérgometricheskaia otsenka rezervov nasosnoi funktsii serdtsa v razlichnye sroki posle zakrytoi mitral'noi komissurotomii.

The paper is concerned with the results of a spiroergometric study of cardiac pumping function reserves (an ability of the heart to increase its output in response to physical load of maximum intensity) and physical working capacity in 35 patients after closed mitral commissurotomy during a dynamic follow-up in the first year after operation. Altogether 30 healthy subjects were entered into a control group. The data obtained made it possible to reveal residual hemodynamic disorders retained for the entire follow-up period and noted with physical load (a decrease in cardiac pumping function reserves) among the examined patients. The disorders determined lowered physical working capacity. The time course of cardiac pumping function reserves and physical working capacity was studied during the first half year after operation. There was no significant change of the studied values in the second half year.

[Role of hemodynamic factors and heart volume in the prognosis of acute cardiac insufficiency during the early postoperative period in patients with mitral valve stenosis]. / Znachenie gemodinamicheskikh faktorov i velichiny ob''ema serdtsa v prognozirovanii ostroi serdechnoi nedostatochnosti v rannem posleoperatsionnom periode u bol'nykh mitral'nym stenozom.

Investigations performed in 172 patients have shown that the state of the myocardium (such parameters as the heart volume, degree of lung hypertension, end-diastolic pressure in the right and left ventricles) is of great importance in pathogenesis of the development of acute heart failure in the early postoperative period in patients with mitral stenosis of the IIIrd and IVth stage of the blood circulation insufficiency.

[Myocardial substrate support before and after mitral commissurotomy]. / Substratnoe obespechenie miokarda do i posle mitral'noi komissurotomii.

The utilization by the myocardium of 8 substrates of the carboxydrate-lipid metabolism was assessed in 44 patients with the 3d and 4th stages of mitral stenosis before and after mitral commissurotomy by the method of the arterio-venous difference. The character of the myocardium supply with substrates with different energetic value was established to depend and to be a sufficiently objective criterium of prognosis of cardiac insufficiency in the early postoperative period.