[Disorders of myocardial contractile function and the mechanisms of their compensation in ischemic heart disease in man]. / Doslidzhennia porushen' skorochuval'noï funktsiï miokarda ta mekhanizmiv ïkh kompensatsiï pry ishemichnii khvorobi sertsia u liudyny.

Myocardial contractile function was investigated in 84 patients with coronary diseases CD of I-IV functional classes (according to NYHA) and 17 persons with normal coronary arteries using new noninvasive method of construction LV end-systolic pressure-volume relation (ESPVR). Significant decrease of end-systolic elastance, ejection fraction, circumferential fibers shortening velocity and increase of end-systolic and end-diastolic ventricular volume was increased with patient's class number. These data correlated with the increase of total amount of lesion of coronary vessels and extension of asynergic zones. But this contractile function disturbances were not accompanied by significant changes of cardiac output and arterial pressure. When blocking beta-adrenergic receptors with anaprillin it was established that at early stages of CD the compensation of contractile function disturbances is reached via the increasing of heart adrenergic stimulation, and in the patients of III-IV classes the Frank-Starling's law becomes of great significance homo- and heterometric mechanisms efficiency reduces with CD development. These data show that ESPVR reconstruction before and after the blocking of beta-adrenergic receptors allows systolic LV function and efficiency of its regulation to be estimated.

[The role of collateral cerebral blood flow in the course of atherosclerotic circulatory encephalopathy]. / Rol' kolateral'noho krovotoku holovnoho mozku v perebihu aterosklerotychnoï dystsyrkuliatornoï entsefalopatiï.

The paper is concerned with a study into compensatory capabilities of cerebral hemodynamics in patients with atherosclerotic dyscirculatory encephalopathy in constricting lesions of major arteries of the head. A detailed analysis is provided of hemodynamic mechanisms of the natural collateral's work, viz., via anterior communicating artery and conditions for creation of suprablock anastomosis with the internal carotid artery being occluded. The paper also addresses the advantages and disadvantages of compensatory collaterals in the course of the medical condition in question.

[Brain function in patients with atherosclerotic circulatory encephalopathy]. / Funktsional'nyi stan holovnoho mozku u khvorykh na aterosklerotychnu dystsyrkuliatornu entsefalopatiiu.

Based on the analysis of findings from clinical and paraclinical investigations (ultrasonic vascular diagnosis, electroencephalography, computerized tomography, angiography) in 244 patients with atherosclerotic dyscirculatory encephalopathy, functional status was studied as were structural alterations in the brain tissue in stenosing lesions of precerebral arteries. The first clinical manifestations of atherosclerotic dyscirculatory encephalopathy in the presence of damage to the vestibular-basilar system were found to be dysfunction of column structures of vestibular apparatus, reticular formation and posterior longitudinal fascicle, and, in the presence of damage to the carotid area, -- dysfunction of cortex of frontal, parietal and temporal lobes of the brain.

[The information value of the left ventricular end-systolic volume-pressure ratio for the noninvasive assessment of human cardiac contractile function]. / Doslidzhennia informatyvnosti kintsevosystolichnoï zalezhnosti ob'iem--tysk livoho shlunochka dlia neinvazyvnoï otsinky skorochuval'noï funktsiï sertsia u liudyny.

To create a noninvasive method of myocardial contractility assessment and to evaluate its diagnostical significance, 84 patients with ischemic cardiac disease and 17 healthy persons were clinically investigated including real-time ultrasound sectoral scanning, bicycle ergometry, selective coronaroarteriography and blood pressure measurement. Using noninvasive approximations of end-systolic and maximal isovolumic pressures and left ventricular volume values at the end of systole and diastole, we constructed end-systolic pressure-volume relations (ESPVR) which were compared with relations obtained by traditional methods. Results of this work show that a slope of ESPVR obtained from the study of data of one cardiac cycle is a reliable contractility index more sensitive to small alterations in the contractile state of the heart than traditionally used ejection fraction and circumferential fiber shortening velocity. We suggest that the ESPVR obtained in such a manner has some advantages because it takes into account influences of the afterload changes reflex consequences. The results also support application of this method to early diagnosis of ischemic cardiac disease.

[The clinico-instrumental characteristics of the lesions of the precerebral arteries in patients with atherosclerotic circulatory encephalopathy]. / Kliniko-instrumental'na kharakterystyka urazhennia pretserebral'nykh arterii u khvorykh na aterosklerotychnu dystsyrkuliatornu entsefalopatiu.

Results have been analysed of comprehensive evaluation of 175 patients with discirculatory encephalopathy of atherosclerotic genesis, consisting of inspection of the neck vessels projection, study of neurological status, ultrasonic investigation of the major brain arteries structure and hemodynamics, their angiographic features. At stage I discirculatory encephalopathy subjective complaints predominated, being caused by syndrome of thoracic outlet, steal syndrome, stenosing lesions of brachiocephalic arteries. Encountered more frequently in the middle-aged and elderly patients were affections of several major brain arteries. Specific weight of correlation between ultrasonic investigation and angiography in stenosing lesions of brachiocephalic arteries in patients with discirculatory encephalopathy constituted 84-100%. Therefore patients with discirculatory encephalopathy of atherosclerotic genesis require ultrasonic investigation of brachiocephalic arteries with the purpose of finding out exactly the pathological process and choosing the tactics of treatment.

[The correlation of the clinical and the computed tomographic changes in patients with atherosclerotic circulatory encephalopathy]. / Koreliatsiia klinichnykh ta komp'iuterno-tomohrafichnykh zmin u khvorykh na ateroslerotychnu dystsyrkuliatornu entsefalopatiiu.

Correlation has been carried out between hemodynamic, structural and clinical changes in stenotic lesions of major brain arteries in 175 patients with atherosclerotic dyscirculatory encephalopathy. The paper analyses the results of ultrasonic and radioopaque diagnosis of vascular lesions of the head and neck, those of clinical, neurological observations and data from computerized tomography scans of the brain. Topographic connections have been established between hemodynamic, structural and neurological manifestations of the disease. It was not infrequently that moderately severe hydrocephaly as one of the manifestations of atrophy of the brain in these patients outstripped brain infarction. Vascular aspect is considered of paresthesias in the extremities by monotype in lesions of major arteries of one of the extremities.