[State of the coronary arteries and function of the left heart ventricle in patients with ischemic heart disease with silent episodes of myocardial ischemia]. / Sostoianie koronarnykh arterii i funktsiia levogo zheludochka u bol'nykh ishemicheskoi bolezn'iu serdtsa s bezbolevymi épizodami ishemii miokarda.

The results of multiviewed coronary angiography with left ventriculography were compared in 36 patients with coronary heart disease concurrent with Functional Classes II-IV stable angina pectoris, who had had frequent episodes of silent myocardial ischemia (SMI), as evidenced by Holter monitoring, and in 23 patients with coronary heart disease in the presence of Functional Classes II-IV stable angina pectoris without SMI episodes. In patients with SMI, the changes in coronary arteries were found to have some features: the extension of an atherosclerotic process (common lesion of all three major arteries), its frequent site in the main trunk of the left coronary artery, high collateralization in the diseased vascular channels, and great extent of stenoses. There were no differences between the groups in the major functional parameters of the left ventricular myocardium.

[Comparison of antianginal effects of diltiazem and metoprolol in patients with ischemic heart disease with different clinical forms of angina pectoris]. / Sravnenie antianginal'nogo deistviia dil'tiazema i metoprolola u bol'nykh ishemicheskoi bolezn'iu serdtsa s razlichnymi klinicheskimi formami stenokardii.

Diltiazem, a new calcium antagonist, and metoprolol, a cardioselective beta-adrenoblocker, were comparatively studied in 53 patients with exertional angina and 11 patients with spontaneous angina. A simple blind random method using placebo, graded physical exercise test employing a bicycle ergometer, and Holter monitoring were applied to evaluate the efficiency of the antianginal treatment. A good antianginal effect was exhibited by the both drugs in exercise-induced angina. Diltiazem was found to be effective in 74% of the patients with exertional angina, whereas metoprolol was beneficial in 62%. Unlike diltiazem (85.7%), metoprolol (50.0%) was less potent in spontaneous angina.

[Value of 24-hour ECG Holter monitoring in the evaluation of painless episodes of ST segment depression in patients with ischemic heart disease]. / Znachenie sutochnogo kholterovskogo monitorovaniia EKG v otsenke bezbolevykh épizodov snizheniia segmenta ST u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The paper presents the results of examination of 149 patients with ischemic heart disease. All the patients underwent 24-hour Holter monitoring; selective coronary angiography according to M. Judkins was performed in 142 patients, 29 patients were subjected to a bicycle ergometric test adopted in the All-Union Cardiology Research Center, USSR Academy of Medical Sciences. In the patients with ischemic heart disease, features and rates for detecting the painless episodes of ST-segment depression from the data of 24-hour Holter monitoring. Painless episodes of ST-segment depression were revealed in 82% patients with sclerosing atherosclerosis of the coronary bed. These were most frequently found in patients with three diseased vessels in the coronary bed or impaired left coronary trunk. Painful episodes of ST-segment depression were more pronounced and prolonged in the majority of patients.

[Circulating immune complexes and apolipoproteins in ischemic heart disease]. / Tsirkuliruiushchie immunnye kompleksy i apolipoproteiny pri ishemicheskoi bolezni serdtsa.

Levels of circulating immune complexes (CIC) and apolipoproteins (apo-A and apo-B) were compared and correlated with the severity of atherosclerotic affection of heart vessels in coronary patients with coronarographically-verified coronary arterial atherosclerosis. An inverse correlation between blood CIC and apo-A levels, and a direct correlation between the CIC level and the apo-B/apo-A index were demonstrated. The variation of CIC levels in patients with atherosclerotic lesions of varying severity corresponded to that of the apo-B/apo-A index. The correlation of these parameters was particularly significant in coronary patients with 2 coronary vessels affected.

[Spontaneous disappearance of myocardial ischemia during continuous physical stress]. / Spontannoe ischeznovenie ishemii miokarda vo vremia nepreryvnogo fizicheskogo napriazheniia.

Five coronary patients showing transitory ST rise during a spontaneous anginal attack were investigated. Myocardial ischemia had an uncommon pattern of response to physical stress in all cases; several episodes of myocardial ischemia developed during one continuous effort, which were not accompanied with pain and disappeared spontaneously as stress continued. The pattern and depth of ECG changes were similar to those of ischemic episodes associated with pain. It is suggested that transitory stress-related functional constriction of coronary arteries may underline this variety of myocardial ischemia.

[Diagnostic importance of the ergometrine test in ischemic heart disease]. / Diagnosticheskoe znachenie proby s érgometrinom u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The ergometrine test was performed in 102 patients with ischemic heart disease (IHD) and cardialgias of various genesis. The diagnosis was verified in all patients by the bicycle exercise test and coronary arteriography. The variant of angina pectoris was diagnosed when there were precordial pains and the ST-segment elevation after intravenous ergometrine injection. The appearance of angina pectoris and ischemic ST-segment depression was observed in patients with angina of effort and at rest. This type of reaction in the ergometrine test indicates obstructive coronary heart disease. The appearance of precordial pain without ECG changes is probably the sign of latent coronary insufficiency. The ergometrine testing is proposed for the differential diagnosis of different forms of angina pectoris.