[Dietary effect of omega-3 polyunsaturated fatty acid supplementation on blood fatty acids, lipid and lipoproteins in patients with ischemic heart disease]. / Vliianie diety, obogashchennoi omega-3 polinenasyshchennymi zhirnymi kislotami, na zhirnokislotnyi sostav, lipidy i lipoproteidy krovi u bolnykh ishemicheskoi bolezníu serdtsa.

Seventeen patients with a more than 5-month-history of angina pectoris were allocated a diet for 4 weeks. The diet was supplemented with 6.15 g of omega 3-polyunsaturated fatty acids (PUFA) in 125 g canned Far-Eastern sardine. This increased the proportion of eicosapentaenic (EPA) and docosahexaenic acids from 1.28 +/- 0.72 to 9.02 +/- 2.83% and from 2.48 +/- 0.91 to 6.54 +/- 2.01%, respectively; p = 0.0003) in the total serum lipid fraction. The levels of omega 6-PUFA decreased due to linoleic acid (from 24.9 +/- 3.9 to 19.7 +/- 5.2%, p = 0.0014). The EPA/arachidonic acid ratio rose from 0.23 +/- 0.11 to 1.76 +/- 0.58 (p < 0.001). The levels of triglycerides decreased by 36.4% (from 162.3 +/- 55.2 to 103.9 +/- 42.4 mg/dl; p < 0.0005); those of very low density lipoproteins and total cholesterol by 36 and 6.8%, respectively (from 32.5 +/- 11.0 to 20.8 +/- 8.5 mg/dl; p < 0.0005 and from 234.8 +/- 43.2 to 218.4 +/- 39.7 mg/dl; p < 0.05, respectively). The concentrations of high density lipoproteins remained unchanged. Thus, a short-term supplementation of canned Far-Eastern sardine to the diet of patients with CHD caused a substantial changes in blood fatty acid composition and favourable shifts in the levels of lipids and lipoproteins. This allows the Far-Eastern sardine to be regarded as a valuable source of omega 3-PUFA which can be used in the secondary prevention of coronary heart disease.

[New-onset stenocardia: the detection of clinical variants of ventricular arrhythmia]. / Vpervye voznikshaia stenokardiia: vyiavlenie zheludochkovykh aritmii pri razlichnykh klinicheskikh variantakh.

A total of 130 patients with angina of new onset (ANO), i.e. first three months after the onset of anginal attacks, were investigated by means of 24- and 48-hour Holter's electrocardiographic monitoring. All the patients underwent selective coronarography. Ventricular arrhythmias (isolated and paired extrasystoles, ventricular tachycardias) and their correlation to acute myocardial ischemia were analysed. Ventricular tachycardia was more common in unstable ANO, as compared to stable angina, and in patients with signs of coronary spasm, as compared to anginal patients showing no such signs. The combination of unstable angina with signs of coronary spasm is the least favorable ANO variant in terms of the risk of grave ventricular arrhythmias.

[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.

[Newly developed stenocardia: various clinical characteristics of its stable and unstable course]. / Vpervye voznikshaia stenokardiia: nekotorye klinicheskie osobennosti stabil'nogo i nestabil'nogo techeniia.

A total of 130 anginal patients were examined within 3 months after the onset of anginal attacks. Angina was stable (SA) in 100 patients and unstable (UA) in 30. There were no differences between SA and UA patients in terms of the degree and spread of coronary arterial stenoses. Signs of coronary arterial spasm were detected in 27 (20.8%) of 130 patients, being more frequent in UA (53%), as compared to SA (11%; p less than 0.001). Acute myocardial ischemia produced groups of ventricular extrasystoles more frequently than it did isolated extrasystoles in patients with recent angina (78.6% vs. 16.7%; p less than 0.001). Groups of ventricular extrasystoles were recorded more frequently in UA patients, as compared to SA ones (23.3% vs. 7%; p less than 0.05).

[Recent angina pectoris: the first experience using programmed stimulation of the heart for the detection of the electrical instability of the heart ventricles]. / Vpervye voznikshaia stenokardiia: pervyi opyt primeneniia programmiruemoi stimuliatsii serdtsa s tsel'iu vyiavleniia élektricheskoi nestabil'nosti zheludochkov.

Programmed ventricular stimulation was performed in 41 patients with recent angina pectoris (RAP, defined as less than 3 months old), 14 patients after large focal myocardial infarction (MI) and 9 patients without organic heart disease (WHD). The prevalence and number of repetitive ventricular responses (RVR) after programmed stimulation with one to three extra stimuli (2 ms, 2 MDS) from 2 right-ventricular sites at sinus rhythm and three basic pacing cycle lengths (600, 500 and 400 ms) were compared in RAP, MI and WHD patients. In 56% of WHD patients, 32% of RAP patients, and 22% of MI patients, RVRs were absent. Five or more RVR were provoked in MI patients only (43%). The incidence of ventricular fibrillation during programmed stimulation was 2.5% in RAP patients and 22% in MI patients. Differences in incidence are not significant, but show the influence of the severity or organic coronary arterial and left-ventricular damage on the prevalence of RVRs. Programmed stimulation seems to have no diagnostic value for the detection of electrical instability in RAP patients without a history of MI.

[Programmed transesophageal electrostimulation of the left atrium]. / Programmirovannaia chrespishchevodnaia élektrostimuliatsiia levogo predserdiia.

In 34 patients with complex arrhythmias and conduction disturbances, programmed transesophageal electric stimulation of the left atrium was performed to determine the sinoatrial conduction time, relative refractory period of the atrioventricular conducting system, effective refractory period of the atrioventricular conducting system, that of the atria, that of an accessory tract in the Wolff-Parkinson--White syndrome, and stimulation parameters to trigger and reverse supraventricular tachicardia in order to define its mechanism. Potentials of a new noninvasive method of study are discussed.