[Effect of diltiazem on silent myocardial ischemia]. / Vliianie diltiazema na bezbolevuiu ishemiiu miokarda.

Thirty-four patients with coronary heart disease who had silent myocardiac ischemic episodes as evidenced by long-term ECG monitoring were examined. Silent ST-segment elevations and depressions were encountered 2.7- and 4.9-fold as compared to manifest ones. The fact that the CHD patients had silent ST-segment depressions and/or prolonged high-amplitude silent ST-segment elevations suggests a grave severity of abnormal myocardial processes. There was a reduction in the number, duration of silent ST-segment elevations and depression episodes and in the amplitude of silent ST-segment depressions. This may indirectly indicate that the agent affects predominantly coronary blood flow and coronary vascular tone.

[Characteristics of the treatment of ischemic heart disease with delayed-action verapamil]. / Osobennosti lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa prolongirovannym verapamilom.

Pre- and posttreatment indices of platelet and plasma hemostasis, parameters of long-term ECG-ST monitoring were measured in 30 coronary patients on long-term verapamil regimens. ++Anti-ischemic effect of the drug was dependent on clinical pattern of the disease and initial function of the platelets. Plasma hemostasis was found unaffected. Long-term verapamil treatment is indicated in stable angina pectoris class II and III provided platelets demonstrate enhanced functional activity.

[Characteristics of nicardipine treatment of patients with ischemic heart disease]. / Osobennosti lecheniia nikardipinom bol'nykh ishemicheskoi bolezn'iu serdtsa.

The new calcium antagonist nicardipine (barizine) was tested for effects on platelet function and transient myocardial ischemia in 23 patients with coronary heart disease. Prior to the therapy, lower platelet function was more frequently encountered in patients with more severe angina pectoris and more prolonged myocardial ischemia. The efficacy of nicardipine was demonstrated to be related to the clinical course of coronary heart disease and the baseline platelet function. It is advisable to prescribe the drug to patients with Functional Class II stable angina and higher platelet functional activity.

[Effects of nicardipine in silent myocardial ischemia]. / Vliianie nikardipina na bezbolevuiu ishemiiu miokarda.

201Tl myocardial scintigraphy was performed in 29 patients with coronary heart diseases and silent myocardial ischemic episodes revealed during a long-term monitoring of ST segment. The painless ST segment depression episodes and long high-amplitude painless ST segment elevations were found to be indicative of a significant severity of pathological processes in the myocardium. A 12-day nicardipine monotherapy produced antianginal and hypotensive effects and contributed to decrease in the frequency, duration, and amplitude of silent ST-segment depressions and in the duration of silent ST-segment elevations.

[Characteristics of dilzem treatment of patients with ischemic heart disease]. / Osobennosti lecheniia dilzemom bol'nykh ishemicheskoi bolezn'iu serdtsa.

In 47 patients with coronary heart disease, the function of platelet was studied and ECG ST-segment was monitored. It was found that lower platelet function was more common in patients with severe coronary heart disease if they had long episodes of transient myocardial ischemia. Following 12 days of dilzem monotherapy, the most marked ++anti-ischemic and antianginal effects were observed in patients who had had higher platelet function.

[Clinical evaluation of transient myocardial ischemia]. / Klinicheskaia otsenka prekhodiashchei ishemii miokarda.

Out of 432 patients with coronary heart disease, 106 (24.5%) were found to have transient myocardial infarction during ECG monitoring of ST segment for 10 hours of daily activity. High-grade ventricular arrhythmias were revealed in 74.6% of mainly male and middle-aged subjects. 63.4% of the patients exhibited congestive heart failure, 48.1% had postinfarct cardiosclerosis, and 25.5% presented with diabetes mellitus. Transient myocardial ischemia was more frequently detected during exercise and more rarely during emotional stress (21.7%), meal (19.8%), and smoking (7.8%). Asymptomatic episodes of ST segment elevation were recorded in 36.8%, while asymptomatic episodes of ST segment depression, in 29.2%. The duration of asymptomatic episodes of ST segment elevation and depression was twice and 1.5 times, respectively, less than that of symptomatic ones. Substantial myocardial perfusion and metabolic impairments were revealed with an asymptomatic ST segment depression frequency of at least one an hour, an amplitude of more than 2 mm, and a duration of no less than 40 min.