[The use of the results of current instrumental methods of cardiological examination in the sociomedical expert assessment of patients with rheumatic heart defects]. / Primenenie rezul'tatov sovremennykh instrumental'nykh metodov kardiologicheskogo obsledovaniia pri mediko-sotsial'noi ékspertize bol'nykh s revmaticheskimi porokami serdtsa.

Altogether 103 patients with rheumatic heart disease were examined within different times after prosthetics of heart valves (mitral or aortal). The purpose was to elaborate the principles of applying the data of instrumental methods of cardiological examination to the improvement of disability criteria. The examination included echocardiography, tetrapolar chest rheography and ECG exercise test. The data allowed one to estimate myocardial reserves and to specify the intensity of functional disorders of the cardiovascular system. The expert medical conclusions on the working ability were revised in 47 patients, bearing in mind the data obtained. Before the examination 70 patients (68%) were considered to completely lose the working ability. However, after the examination their number dropped to 34 (33%), whereas the number of persons able to work rose from 5 to 12%.

[The characteristics of the myocardial morphofunctional status of hypothyroidism patients]. / Osobennosti morfofunktsional'nogo sostoianiia miokarda u bol'nykh gipotireozom.

Electro- and echocardiography were used to examine the morphofunctional state of the heart in 19 patients with hypothyrosis during disease decompensation and after therapy with thyroid hormones. The hormonal blood content was measured by RIA. Nonspecific alterations of the electro- and echocardiographic readings characterizing hypothyroid myocardiodystrophy were discovered. Almost half of the cases manifested hydropericardium. The discovered myocardial alterations were marked by a slow positive dynamics. In patients over 45 years, they appeared irreversible in nature. The pericardial exudate resolved shortly after the euthyroid status was attained.

[Importance of parameters of central hemodynamics in examining working capacity of patients with renovascular hypertension]. / Znachenie pokazatelei tsentral'noi gemodinamiki dlia ékpertizy trudosposobnosti bol'nykh vasorenal'noi gipertenziei.

Cardiovascular system parameters were measured in 80 patients with renovascular hypertension using resting and bicycle exercise readings of tetrapolar chest rheography. The findings were indicative of various defects in central hemodynamics. Signs of subclinical initial stage of cardiac insufficiency were revealed in 57.5% of cases. Cardiovascular reserves were reduced in patients operated on fading with increasing duration of the disease. Labor prognosis appeared more favorable in operated on patients with good hypotensive effect of the surgery.

[Importance of ultrasonic diagnosis to medical expert evaluation of the work capacity of ischemic heart disease patients]. / Znachenie ul'trazvukovoi diagnostiki dlia ékspertizy trudosposobnosti bol'nykh ishemicheskoi bolezn'iu serdtsa.

Using the methods of ultrasonic diagnosis such as M-mode echocardiography and sectoral scanning, the cardiac activity of 92 myocardial infarction survivors was studied. Initially, the patients were examined 3-3.5 months after the infarction, then one year later. The findings of the primary examination suggest that factors aggravating the prognosis of the disease and adversely affecting the work fitness of the patients include the detection of the zones of a- and dyskinesia of the myocardium, an enlargement of the cardiac cavities, a decrease in the rate of the circulatory shortening of myocardial fibers, a reduction in the blood stroke volume and in the ejection of the left ventricle. It is concluded to be advisable to use the ultrasonic data for solving questions of medical evaluation of the work fitness of myocardial infarction survivors.

[Effect of nitrates on cardiodynamics in patients with atrioventricular block treated by electrocardiostimulation]. / Vliianie nitratov na kardiodinamiku u bol'nykh s predserdno-zheludochkovoi blokadoi na fone elektrokardiostimuliatsii.

The clinical and hemodynamic effect of nitrates with both their single administration and a prolonged therapy in patients with atrioventricular block related to elecrocardiostimulation has been studied. Nitroglycerin has been found to exercise its action in two phases: first decreasing and then increasing cardiac output. The character of phase I has been ascertained to correlate with the potential development of various complications during the treatment with nitrates. A conclusion has been drawn as to the efficacy of nitrosorbid employment in the multiple modality treatment of chronic cardiac insufficiency in patients with an implanted cardiostimulator.

[Evaluation of the state of cardiodynamics in patients with artificial pacemaker]. / Otsenka sostoianiia kardiodinamiki u patsientov s iskusstvennym voditelem ritma.

Cardiodynamic parameters were studied in 23 patients with an implanted cardiostimulator both at rest and in conditions of an isometric exercise test. Three types of blood circulation were identified, namely eu-, hypo-, and hyperkinetic. The individual types of circulation were shown to be correlated with the severity of the clinical course of the underlying disease. The isometric exercise test allowed the researchers to differentiate between adequate and inadequate responses of hemodynamics in patients with an artificial pacemaker. It is concluded advisable to investigate the hemodynamic state of patients with an implanted artificial pacemaker so as to decide on any corrective measures that may be needed.

[Importance of a comprehensive instrumental assessment of cardiovascular system function for the expert medical work evaluation of ischemic heart disease patients]. / Znachenie kompleksnoi instrumental'noi otsenki funktsional'nogo sostoianiia serdechno-sosudistoi sistemy dlia vrachebno-trudovoi ékspertizy bol'nykh ishemicheskoi bolezn'iu serdtsa.

A total of 103 patients with ischaemic heart disease (IHD) were investigated 1 1/2 to 10 years after myocardial infarction. The functional state of the cardiovascular system was studied with the aid of electrocardiography, tetrapolar chest rheography and spiroergometry in the bicycle ergometric test. This test revealed ischaemic shifts on the ECG in 63% of patients with IHD. Patients with IHD, as compared to the control group of normal individuals, showed lowered tolerance to exercise and shifts in the indices of the central haemodynamics and gaseous exchange, including less manifest increase of the stroke and minute volume of blood, and oxygen consumption. The results of the study permitted the authors to diagnose the initial state of the cardiac insufficiency and to graduate the functional possibilities of the cardiovascular system in patients with IHD. It is recommended to use such a comprehensive cardiological study of the functional state of the cardiovascular system for medical assessment of the working capacity of IHD patients.

[Early diagnosis of cardiac insufficiency in patients with ischemic heart disease and hypertension in medical jurisprudence]. / Ranniaia diagnostika serdechnoi nedostatochnosti u bol'nykh ishemicheskoi bolezn'iu i gipertonicheskoi bolezn'iu v praktike vrachebno-trudovoi ekspertizy.

Results of a study into the myocardium function in 440 patients with ischemic heart and hypertensive diseases are presented. In the study poly-kineto-apex-cardiography, rheography of the aorta and lungs, ultrasonic cardiography at rest in 123 of 440 patients were used after veloergometric loading. The application of the mentioned methods in conjunction with the veloergometric test helped diagnose a latent cardiac insufficiency that proved most frequent among patients with myocardial infarction in their past history (84.5%) and among those suffering from hypertensive disease with prevalence of the cardiac syndrome. An inference is drawn on the need for a complex investigation of patients at the clinic and especially in the practice of the medical expert testimony on the work capacity.