[The significance of exacerbations of lung diseases in the development of chronic cor pulmonale and their treatment]. / Znachenie obostrenii legochnykh zabolevanii v razvitii khronicheskogo legochnogo serdtsa i ikh lechenie.

In 61 patients, pulmonary tuberculosis was complicated by thrombosis of the pulmonary artery or its embolism and by bronchial asthma. In various lung diseases, there was a combination of some factors predisposing to chronic cor pulmonale. These included specific infection, sympathoadrenal activation, reduced capillaries, and hypoxia in pulmonary tuberculosis, alveolar hypoventilation with arteriolar spasms, and elevated intrathoracic pressure in bronchial asthma; higher pulmonary arterial systolic pressure due to spasms of the pulmonary branches and drastically reduced arterial bed in pulmonary thromboembolism.

[Significance of cyclic nucleotides in pathogenesis of cor pulmonale in tuberculosis of respiratory organs and the use of beta adrenoblockers]. / Znachenie tsiklicheskikh nukleotidov v patogeneze legochnogo serdtsa pri tuberkuleze organov dykhaniia i primenenii beta-adrenoblokatorov.

Blood levels of cyclic nucleotides and their actions on central hemodynamics were studied in 129 patients with pulmonary tuberculosis. A direct correlation was established between heart rate, pulmonary artery systolic pressure and concentrations of cyclic adenosine monophosphate. Basing on this finding, the authors propose introduction of beta-adrenoblockers in hyperkinetic circulation tuberculous patients to prevent cor pulmonale. Administration of anapriline in tuberculous patients with compensated cor pulmonale and symptoms of sympathoadrenal hyperfunction improves the patients' condition, promotes a decrease in cardiac output, cardiac index, systolic pressure in the pulmonary artery. No side effects of the drug were reported.

[Ventricular ejection fraction in oxygen therapy of patients with pulmonary tuberculosis]. / Fraktsiia vybrosa pravogo zheludochka serdtsa pri kislorodoterapii bol'nykh tuberkulezom legkikh.

Radionuclide study of ejection fraction of the right heart ventricle was carried out in lung tuberculosis patients with respiratory insufficiency and cor pulmonale. Oxygen therapy was found to promote reduction of right ventricle heart failure in effective treatment of lung tuberculosis. The greatest reduction of heart failure was recorded in cases where oxygen therapy was combined with cardiac glycosides. As the tuberculosis process progresses, oxygen therapy does not decrease right ventricle heart failure. The treatment by antibacterial agents alone without using oxygen does not lead to the rise of ejection fraction of the right ventricle of the heart.

[Classification of respiratory insufficiency in pulmonary tuberculosis]. / Klassifikatsiia dykhatel'noi nedostatochnosti pri tuberkuleze legkikh.

605 patients with different forms of pulmonary tuberculosis were examined. Blood gases and acid-base condition (ABC) were studied. In 22.2 per cent of the patients, hypoxemia was lacking with normal ABC and no respiratory failure (RF); in 36.6 per cent, hypoxemia was not accompanied by ABC changes and hence was caused by circulatory disturbances; in 15.6 per cent, it was combined with respiratory alcoholism; and in 6.8 per cent, with respiratory acidosis. The rest of the cases found to have metabolic disturbances of the ABC. Thus, hypoxemia is observed both with chronic forms of tuberculosis and with infiltrative/focal one, i.e. it follows a subacute course. In case of pulmonary tuberculosis, it is recommended to isolate subacute RF with PaO2 of 68.3 +/- 0.56 mm Hg, chronic RF of the 1-st phase with PaO2 of 71.8 +/- 0.7 mm Hg and chronic RF of the 2-nd phase with PaO2 of 64.2 +/- 0.88 mm Hg and accompanied by chronic cor pulmonale. In this case it seems necessary to find the basic mechanism of RF which is important for the treatment purposes.

[The effect of nitroglycerin on the external respiration function and central hemodynamics in patients with tuberculosis of the lungs]. / Vliianie nitroglitserina na funktsiiu vneshnego dykhaniia i tsentral'nuiu gemodinamiku bol'nykh tuberkulezom legkikh.

To estimate the effect of nitroglycerin (NTG) on the external respiration function and central hemodynamics, 124 patients with various forms of pulmonary tuberculosis and chronic nonspecific diseases of the lungs were examined. The indices of the external respiration function, central hemodynamics, pulmonary artery systolic pressure (PASP), general pulmonary resistance (GPR) and blood gaseous composition were determined before and after NTG sublingual use in a dose of 1 mg. It was noted that improvement of bronchial patency after the use of NTG was not significant and subsequently its indication as an agent arresting bronchospasm is not expedient. A statistically significant decrease in PASP and the indices of central hemodynamics, as well as a decrease in GPR might be considered as a basis for the use of nitrates in prophylaxis and treatment of chronic pulmonary heart in patients with pulmonary tuberculosis.