[Effect of physical training with reference to anaerobic threshold on the indicators of exercise tolerance and restoration of work capacity in patients after myocardial infarction]. / Vliianie fizicheskikh trenirovok s uchetom anaérobnogo poroga na pokazateli tolerantnosti i vosstanovlenie trudosposobnosti u bo'lnykh, perenesshikh infarkt miokarda.

In patients who had sustained myocardial infarction including that of complicated history, the anaerobic threshold was defined to choose the optimum intensity of physical training. The latter were also examined for effects on exercise tolerance. It was ascertained that measuring physical exercise by heart rate at the level of the anaerobic threshold made it possible to choose the optimal conditions for the aerobic supply of metabolic demands during physical training. Applying physical training under aerobic conditions greatly increases exercise tolerance, prevents recurrent myocardial infarctions and plays an important role in the secondary prevention of coronary heart disease.

[Prognostic significance of the area of myocardial lesion and the status of the coronary bed during restoration of work capacity in patients with a complicated course of acute myocardial infarction]. / Prognosticheskoe znachenie ploshchadi porazheniia miokarda i sostoianiia koronarnogo rusla pri vosstanovlenii trudosposobnosti bol'nykh s oslozhnennym techeniem ostrogo perioda infarkta miokarda.

The effect of heart failure and acute left-ventricular aneurysm on the recovery of working capacity was assessed with reference to the size of necrotic focus and the extent of coronary arterial involvement in 117 patients with acute myocardial infarction. The size of necrotic focus and magnitude of coronary arterial affection were shown to be the principal determinants of heart failure in acute myocardial infarction. The presence of heart failure and acute left-ventricular aneurysm in combination with multiple coronary-arterial lesions is an adverse predictive sign in the assessment of the severity of acute myocardial infarction and the recovery of patients' working capacity. On the contrary, the presence of a local aneurysm in combination with an isolated coronary-arterial lesion should not be regarded as an unequivocal indicator of disability.

Left ventricular contractility related to the state of the coronary bed.

The authors studied total and segmental contractility of the left ventricular (LV) myocardium in patients with acute myocardial infarction with single and multiple coronary artery (CA) disease. The group included 75 patients with acute transmural myocardial infarction; coronary arteriography was performed in 56 of them. All patients underwent echocardiography (sector scanning), on the basis of which total (ejection fraction) and segmental parameters (segmental ejection fraction, fraction of segmental wall shortening, velocity of change of segmental area, velocity of change in segmental wall thickness) of LV contractility were calculated. Patients with single CA affection display only a moderate decrease in total ejection fraction, and an insignificant number of complications of myocardial infarction. Segmental contractility data showed severe hyperkinesis of the intact segments of the left ventricle. Multiple CA disease is associated with a marked decrease in both total and segmental contractility of the LV myocardium, and there is no hyperkinesis of the intact segments of the heart.

[Diagnosis of impairment of segmental myocardial contractility during the acute phase of infarction using sector scanning]. / Diagnostika narushenii segmentarnoi sokratimosti miokarda v ostreishei faze infarkta metodom sektoral'nogo skanirovaniia.

The paper is concerned with sector scanning for early diagnosis of acute myocardial infarction. A total of 157 patients were examined within the first 2 to 6 hours after transmural infarction. The segments of the left ventricle which are mostly affected in infarctions of different sites were defined. Application of two-dimensional echocardiography permitted an earlier detecting of the segmental disorders and the extent of the focus of lesion as compared with the ECG. The method appeared particularly informative in the diagnosis of conduction impairment and repeated lesions of the left ventricular myocardium. It has been demonstrated that involvement of over 65% of left ventricular segments is an unfavourable sign from the standpoint of the disease prognosis.

[Assessment of myocardial contractility by the sector scanning of myocardial infarct patients]. / Otsenka sokratimosti miokarda metodom sektoral'nogo skanirovaniia u bol'nykh infarktom miokarda.

A comparative assessment of left-ventricular myocardial contractility in patients with myocardial infarction was made using sector scanning and ventriculographic techniques. Eight patients were investigated within 2-4 hours of the infarction, and twenty patients, on days 20-25 of the disease. Ultimate diastolic, ultimate systolic and stroke volumes were calculated, as was the expulsion fraction, using the mono- and biplane method and modified formula 5/6 AL. Ventriculography was the testing method. Sector scanning is shown to be one of the most informative methods of myocardial contractility assessment in patients with myocardial infarction; the formula 5/6 AL appears to yield the best information when left-ventricular volumes are computed.

[Use of echocardiography in diagnosing heart failure in the acute stage of myocardial infarct]. / Primenenie ékhokardiografii dlia diagnostiki serdechnoi nedostatochnosti v ostrom periode infarkta miokarda.

The authors studied prognostic criteria and early diagnosis of cardiac insufficiency during the acute period of myocardial infarction. 44 patients with macrofocal myocardial infarction were examined during the acute phase. Phase analysis of time intervals of the cardiac cycle and a number of integral indices reflecting the contractile and pumping function of the myocardium came under scrutiny. It is established that the indices can be used for the diagnosis of circulatory insufficiency in the acute period of myocardial infarction and also for prognosis of the severity of the disease.

[2-dimensional echocardiography in the diagnosis of heart aneurysms]. / Dvukhmernaia ékhokardiografiia v diagnostike anevrizm serdtsa.

The authors observed 157 patients with the myocardial infarction, of them 88 were in the acute phase of the disease. They compared different noninvasive methods of diagnosis of aneurysms. They believe that the method of sectoral scanning is the best. The mono-dimensional echocardiography is effective in detecting apical aneurysms. Dynamic echocardiography is essential for early detection of cardiac aneurysms. Taking of the apical section of the heart is to be preferred.