[Automatic regulation and central hemodynamics in patients with postinfarct cardiosclerosis and heart failure]. / Vegetativnaia reguliatsiia i tsentral'naia gemodinamika pri ortoprobe u bol'nykh s postinfarktnym kardiosklerozom i serdechnoi nedostatochnost'iu.

The study was undertaken to examine the specific features of autonomic regulation and the parameters of central hemodynamics in patients with postinfarct cardiosclerosis (PICS) and circulatory insufficiency who had different types of left ventricular remodelling (LVR). Thirty-two patients with PICS and heart failure (HF) were examined. The autonomic status was studied, by analyzing cardiac rhythm variability (CRV) from 5-min resting cardiointervalograms and by the cardiovascular tests described by D. Y. Ewing; integral rheography was also performed. The patients were divided into 2 groups according to the type of LVR. Patients with PICS + HF and concentric LVR were found to have a more balanced autonomic circulatory regulation and a hemodynamic type that was more energetically efficient for the myocardium. Those with PICS + HF and eccentric LVR had a hemodynamic type that was less efficient for the myocardium, which was accompanied by the enhanced activity of the sympathetic nervous system (SNS) even at resting. Patients with PICS + HF, particularly in the presence of the latter's higher functional class and eccentric LVR, seemed to have desensitized adrenoceptors and impaired baroreflex activity, as appeared as no rise in peripheral vascular resistance with the enhanced sympathetic activity. The findings support the expediency of using beta-adrenoblockers in HF in patients with PICS, particularly with eccentric LVR. Analysis of cardiac rhythm variability is sufficiently informative in evaluating autonomic regulation and autonomic balance, SNS tone in particular, in patients with HF.

[Autonomic regulation and emotional status in patients with ischemic heart disease having pain syndrome of various severity]. / Osobennosti vegetativnoi reguliatsii émotsional'nogo statusa u bol'nykh ishemicheskoi bolezniiu serdtsa s razlichnoi vyrazsennost'iu bolevogo sindroma.

To study vegetative regulation and emotional status of ischemic heart disease (IHD) patients with various pain severity, 81 patients with IHD were examined. Personality characteristics were studied by the data of MMPI questionnaire, reactive and personal anxiety--of Spilberger questionnaire, depressive changes--of Beck's questionnaire, vegetative status--by vegetative discharge, Seattle angina questionnaire of life quality, heart rhythm variability and cardiovascular tests. All the patients have undergone clinical examination, exercise stress tests, echocardiography. Selective coronary angiography was made in some examinees. The patients were divided into two groups by anginal pain severity. The patients with more severe anginal pain had higher reactive and personal anxiety, neurotization. This was not associated with changes in the vegetative status and hemodynamics at rest. The detected emotional disorders in IHD patients may cause higher sensitivity of these patients to pain, on the one side, and changes in vegetative regulation of cardiovascular system and hemodynamics, on the other.