[The hormone level of the blood from the aorta and the coronary sinus in patients with ischemic heart disease under conditions of preoperative stress]. / Soderzhanie nekotorykh gormonov v krovi iz aorty i koronarnogo sinusa u bol'nykh ishemicheskoi bolezn'iu serdtsa v usloviiakh predoperatsionnogo stressa.

A total of 156 patients with ischemic heart disease were examined under conditions of preoperative stress in a multiple-modality study performed with the aid of such techniques as echocardiography involving calculation of the myocardial mass index, coronaroventriculography, measurements of the adrenocorticotrophic hormone, hydrocortisone, somatotrophic hormone, triiodothyronine and thyroxin in the blood from the coronary sinus and aorta. A conclusion has been reached that emotional strain influences myocardial hypertrophy. A possible significance of the studied hormonal indices is shown together with features thereof in IHD patients presenting with different degrees of left ventricular hypertrophy.

[Ventricular arrhythmias in patients with ischemic heart disease: a possible role of the autonomous nervous system]. / Zheludochkovye narusheniia ritma u bol'nykh ishemicheskoi bolezn'iu serdtsa: vozmozhnaia rol' avtonomnoi nervnoi sistemy.

To reveal possible factors that initiate ventricular arrhythmias (VA) in patients with coronary heart disease (CHD), a total of 44 patients with documented coronary artery stenosis were examined. The patients underwent coronary ventriculography, bicycle ergometry, 24-hour Holter monitoring, and examination of the autonomic nervous system (ANS). In 24 patients (Group 1), myocardial ischemic episodes were accompanied by VA. The latter were absent in myocardial ischemia in 20 patients (Group 2). In the two groups, there were no statistically significant differences in parameters, such as severity of atherosclerotic lesion of coronary arteries, total ejection fraction, existence of regional asynergy, exercise tolerance, number of daily myocardial ischemic episodes, their duration, degree of ST segment displacement. Increased activity of the sympathetic ANS was detected in 20 (83.3%) patients from Group 1 and only in 3 (15%) from Group 2 (p < 0.05). It is suggested that enhanced functional activity of ANS may be a prerequisite for displaying arrhythmogenic mechanisms in myocardial ischemia.

[The interrelation of the secretory activity of the myocardium with its hypertrophic characteristics in patients with ischemic heart disease]. / Vzaimosviaz' sekretornoi aktivnosti miokarda s osobennostiami ego gipertrofii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Evaluation of the concentration of atrial natriuretic peptide, angiotensin P, renin activity in the blood of the coronary sinus and aorta in 18 patients with IHD and hypertrophy of the left ventricle during development of induced ischemia revealed that in left ventricular hypertrophy secretion of atrial natriuretic peptide by the myocardium is reduced. The level of this reduction depends on the kind of hypertrophy. Dilatation of the left ventricle cavity furthers exhaustion of the secretory function of the ischemic myocardium.

[Diastolic filling of the left ventricle in relation to the degree of its hypertrophy in patients with ischemic heart disease]. / Diastolicheskoe napolnenie levogo zheludochka v zavisimosti ot ego gipertrofii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The features of diastolic filling of the left ventricle (LV) were examined in relation to the nature of its hypertrophy in patients with coronary heart disease (CHD). A total of 110 male patients with CHD concurrent with essential hypertension or without it who underwent contrast ventriculography in order to determine LV diastolic stiffness. Radionuclide ventriculography was performed in 49 patients at rest and during exercise. The CHD patients with moderate LV concentric hypertrophy had more adequate LV diastolic filling in the presence of concurrent essential hypertension. Abnormal diastolic filling was more pronounced in CHD patients without hypertrophy or its eccentric development than in those without essential hypertension.

[Causes and significance of myocardial ischemia occurring during coronary-ventriculography in patients with ischemic heart disease]. / Prichiny i znachenie ishemii miokarda, voznikaiushchei pered koronaroventrikulografiei u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A relationship was examined between the development of myocardial ischemia in patients with coronary heart disease before coronary ventriculography and the status of coronary vessels, coronary reserve, myocardial contractility, and the autonomic nervous system. Before coronary ventriculography, myocardial ischemia was found to occur in the patients when there was a marked activation in the sympathetic portion of the autonomic nervous system and a clear-cut decrease in coronary reserve. The occurrence of myocardial ischemia in the patients before coronary ventriculography contributed to decreased left ventricular myocardial contractility and increased the cardiodepressive effects of a contrast agent.

Significance of left ventricular shape, its blood supply and calcium turnover for evolving myocardial hypertrophy.

To explore relationship between hypertrophy of left ventricle and its shape, blood supply and calcium turnover, the study enrolled 105 male patients with ischemic heart disease or those suspected of its presence. All patients underwent contrast coronary ventriculography, M-mode echocardiography and sectorial scanning. Moderately limited myocardial blood supply was found to be a factor, stimulating its local hypertrophy. In the event of severely impaired blood supply, no substantial myocardial hypertrophy is detectable in corresponding regions, while dynamic observation not infrequently reveals thinning of the wall. Patients with intact coronary arteries, and having more elongated shape of left ventricular cavity, demonstrate larger thickness of walls along the long axis, that is probably due to dependence of intramyocardial tension on the radius of the wall curvature. While performing ventriculography in the patients with hypertrophic myocardium, disclosed elevated level of calcium in the blood and enhanced calcium uptake by cardiac muscle versus patients without left ventricular hypertrophy.

[Myocardial blood flow and changes in the electrocardiogram during veloergometry in patients with ischemic heart disease]. / Miokardial'nyi krovotok i izmeneniia élektrokardiogrammy vo vremia veloérgometrii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The authors studied in 64 patients with ischemic heart disease and 14 control persons the myocardial blood flow and its relationship with depolarization and repolarization indices and depression of the ST segment at threshold loads. The myocardial blood flow in IHD patients with stenosing atherosclerosis of two and three coronary arteries was reduced by 50% and the tolerance to physical load was low.

[ECG changes during the exercise test and perfusion pressure in the basin of the left coronary artery]. / Izmeneniia EKG vo vremia veloérgometrii i perfuzionnoe davlenie v basseine levoi koronarnoi arterii.

Variation in cumulative electrocardiographic depolarization (delta epsilon QRS) and repolarization (delta epsilon T and ST depression below 1 mm and more) parameters at threshold stress, achieved by stepwise augmentation, was compared with perfusion pressure in the left coronary arterial network, measured at coronaro-angiography, in 103 coronary patients. It is concluded that changes in cumulative ECG parameters at threshold stress can only be suggestive of a possible drop in perfusion pressure in the left coronary arterial network.

[Comparative analysis of the information value of electrocardiographic loading tests in relation to the characteristics of atherosclerotic lesions of the coronary arteries]. / Sravnitel'nyi analiz informativnosti élektrokardiograficheskikh prob s nagruzkoi v zavisimosti ot osobennostei ateroskleroticheskogo porazheniia koronarnykh arterii.

Diagnostic possibilities of various exercise tests (bicycle ergometry, the dipyridamole test, atrial electrostimulation) were demonstrated, as was a relationship between their sensitivity and the number of stenosed coronary arteries, the extent and level of obstruction, collateral circulation specificity and myocardial function.

[Importance of collateral circulation for compensating for myocardial ischemia during physical loading in ischemic heart disease patients]. / Znachenie kollateral'nogo krovotoka dlia kompensatsii ishemii miokarda pri fizicheskoi nagruzke u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Exercise-induced electrocardiotopographic ST depression was analysed with reference to the presence of a collateral blood flow, angiographic assessment of the coronary bed and a history of myocardial infarction in 94 coronary patients. The presence of a collateral blood flow is shown to contribute to a more rapid elimination of post-exercise myocardial ischemia, irrespective of the number of affected coronary arteries and the history of myocardial infarction. Myocardial ischemia developing in response to exercise is particularly extensive in case of multiple coronary arterial lesions and the presence of a collateral blood flow.