[The prognostic significance of changes in the level of natural antibodies to thrombin in stenocardia patients]. / Prognosticheskaia znachimost' izmenenii urovnia estestvennykh antitel k trombinu u bol'nykh stenokardiei.

Coagulation in angina pectoris has been analyzed in a normal and elevated level of natural antibodies (nAb) to thrombin. A correlation was found between the level of nAb to thrombin and hemostatic shifts. The correlation of a nAb rise was attempted by means of plasmapheresis (PA) or plasmosorption (PS), altering coagulation potential. PA and PS produced more pronounced anticoagulative effects in patients with a normal baseline level of nAb to thrombin. When the latter levels tended to reduction from initially high, hemostatic processes improved. It is concluded that nAb to thrombin levels have prognostic potential as an indicator of coagulation activity and efficacy of anticoagulant therapy in extracorporeal interventions.

[Effect of blood gravitation surgery on lipid metabolism in patients with ischemic heart disease]. / Vliianie gravitatsionnoi khirurgii krovi na metabolizm lipidov u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Gravitation plasmapheresis (GP) used in coronary heart disease patients with unstable angina pectoris of the III-IV functional class, in the presence of dyslipoproteinemia, leads to a significant decrease of high levels of cholesterol (Ch), triglycerides (TG), cholesterol in low-density lipoproteins (Ch-LDLP) and an increase of cholesterol in high-density lipoproteins (Ch-HDLP) followed by gradual recovery of these parameters up to the initial level in the whole group of patients during 6 months of observation. In patients with dyslipoproteinemia (DLP), types IV and II A, the initial level was recovered earlier (during one month), in those with type II B--after 6 months, although the levels of Ch and TG were high, that does not exclude the presence of progressing coronarosclerosis. The duration of clinical remission comprised on the average 7.4 months, in patients with type II A it was 5 months, with type IV--6.5 months. It has been suggested that pathogenetic features of DLP types formation are responsible for varying effects of GP on different types of DLP.

[Use of plasma sorption in the treatment of hypercholesterolemia in patients with stenocardia]. / Primenenie plazmosorbtsii dlia lecheniia giperkholesterinemii u bol'nykh so stenokardiei.

Plasma sorption was performed in patients with Functional Classes III-IV angina pectoris by using the sorbent FAS. A positive clinical effect was achieved in 81%. There was a significant reduction in the levels of total cholesterol and low density lipoprotein cholesterol. The concentration of high density lipoprotein cholesterol remained unchanged.

[The effect of plasmasorption on the content of natural antibodies to thrombin and alpha 2-macroglobulin in stenocardia patients]. / Vliianie plazmosorbtsii na soderzhanie estestvennykh antitel k trombinu i al'fa 2-makroglobulinu u bol'nykh stenokardiei.

A study was made of changes in the content of natural antibodies (N-AB) to thrombin and alpha 2-macroglobulin in patients with angina pectoris under the influence of plasma perfusion. The content of N-AB being increased, plasma perfusion makes it possible to reduce their content to normal. Provided the content of N-AB is initially normal, plasma perfusion does not produce any changes in their level. In 78% of the patients, a beneficial clinical effect was attained, being more pronounced in initially high content of N-AB.

[State of lipid metabolism, platelet aggregation and microcirculation in patients with angina pectoris during plasmapheresis treatment]. / Sostoianie lipidnogo obmena, agregatsii trombotsitov i mikrotsirkuliatsii u bol'nykh so stenokardiei v protsesse lecheniia plazmaferezom.

The paper presents the changes found in the lipid spectrum in 48, platelet aggregation in 23 and microcirculation in 35 patients with coronary heart disease after plasmapheresis. In patients with Functional Classes III and IV angina, repeated procedures of plasmapheresis were found to result in a clinical improvement of its course in 92% of the patients and in conversion to a lower functional class of angina in 71%. Massive plasmapheresis performed by the developed methods caused a significant improvement in the lipid spectrum, blood rheology, and microcirculation, which persisted for 1 to 6 months after plasmapheresis in relation to the type of hyperlipoproteinemia.

[Contents of natural antibodies to thrombin and alpha-2-macroglobulins in the blood of donors and patients with ischemic heart disease]. / Soderzhanie estestvennykh antitel k trombinu i alfa2-makroglobulinu v plazme donorov i bol'nykh ishemicheskoi bolezn'iu serdtsa.

Natural IgG and IgM antibodies to thrombin and alpha 2-macroglobulin were measured in donor and coronary patients' plasma by enzyme immunoassay. The patients were divided into 3 groups with various types of changes in antibody levels. Increased level of antithrombin antibodies appears to be related to additional production of antibodies in response to elevation of thrombin concentration in the blood stream or to shift of the synchronous process between free antibodies and thrombin, bound in immune complexes. Further studies will clarify the mechanism of these processes.

[Correction of hypercholesterolemia and dyslipoproteinemia by plasmapheresis in patients with stenocardia resistant to drug therapy]. / Korrektsiia giperkholesterinemii i dislipoproteidemii metodom plazmafereza u bol'nykn so stenokardiei, rezistentnoi k medikamentoznoi terapii.

Plasmapheresis was used to correct blood lipid composition in patients with angina at rest and angina of effort (functional classes 3-4). In addition to a drop in total cholesterol and triglycerides, cholesterol in low and very-low-density lipoproteins fell abruptly, while high-density-lipoprotein cholesterol, on the contrary, increased considerably. Clinical improvement of the patients was also recorded.

[Changes in the indices of central hemodynamics and myocardial metabolism as affected by plasmapheresis in patients with myocardial infarct]. / Izmeneniia pokazatelei tsentral'noi gemodinamiki i metabolizma miokarda pod vozdeistviem plazmafereza u bol'nykh infarktom miokarda.

Gravitation plasmapheresis (PP) on PF-0.5 fractionator was used in 32 patients with acute myocardial infarction to control blood rheologic disorders. Central hemodynamics and myocardial metabolism were monitored by means of right heart probing and echocardiography. A control group of 7 patients were subjected to "mock PP" with a rheopolyglucin infusion. PP limited manifestations of heart failure, normalized the levels of compounds with high molecular weights which conditioned plasma viscosity, reduced significantly total peripheral and total pulmonary resistance, increased the cardiac index, stroke volume and ejection fraction, and improved regional left-ventricular contractility. Myocardial metabolic studies demonstrated a decline in left-ventricular myocardial ischemia, as evidenced by the arteriovenous difference in lactate levels. It is therefore suggested that PP can be effectively used as part of combined treatment for complicated acute myocardial infarction.

[Evaluation of the antithrombotic effect of plasma and thrombocyte apheresis in the complex therapy of patients with unstable stenocardia]. / Otsenka protivotromboticheskogo éffekta afereza plazmy i trombitsitov v kompleksnoi terapii bol'nykh s nestabil'noi stenokardiei.

Antithrombotic effect of plasmapheresis and thrombocytapheresis, used as part of combined treatment in 12 patients with unstable medication-resistant angina pectoris of functional class 4, was assessed by means of coagulation tests and resonance thrombography. The incorporation of three sessions of apheresis, removing 90% of plasma and 30% of platelet population, into the conventional treatment schedule is shown to have an anticoagulant, thrombolytic and platelet hypersensitivity-controlling effect. It is directly related to the volume of removed plasma and platelets, allows control of prethrombotic conditions and paves the way for an adequate response to subsequent medication.

[Effect of gravitation plasmapheresis on central hemodynamics and indices of myocardial metabolism in patients with acute complicated myocardial infarct]. / Vliianie gravitatsionnogo plazmafereza na tsentral'nuiu gemodinamiku i nekotorye pokazateli metabolizma miokarda u bol'nykh ostrym oslozhnennym infarktom miokarda.

A study of 32 patients with complicated acute myocardial infarction, treated with gravitation plasmapheresis during the acute phase of the disease, demonstrated a significant drop in blood concentrations of compounds with high molecular weights (fibrinogen, cholesterol, triglycerides, total protein) as well as a significant activation of the heart's pumping function, while total peripheral resistance declined, as did the degree of myocardial ischemia. This is interpreted as an evidence of positive effect of plasmapheresis on central hemodynamics, myocardial metabolism and clinical course of myocardial infarction in such patients.

[Use of plasma- and thrombocytapheresis in patients with stenocardia]. / Primenenie plazma-i trombotsitafereza u bol'nykh so stenokardiei.

Marked microcirculatory changes, hemorheologic and immunologic disorders were found in anginal patients. Plasmapheresis with repeated thrombocytopheresis sessions as part of combined treatment improves these parameters, the improvement correlating with a stable clinical remission.