[Basic and metabolic therapy of hypertensive disease in pregnant women].

This open non-randomized study had the objective to analyse the course of pregnancy and labor as well as their outcomes in 62 women with hypertensive disease (essential hypertention). The patients were allocated to two groups, one (group 1) comprising 32 the other (group 2, control) 30 women. All patients in group 1 underwent pregravid preparation and remained under observation throughout the pregnancy period in specialized cardiological departments. They were given treatment that included intake of antihypertensive drugs (methyldopa, long-acting nifedipin, metoprolol), desaggregant (dipyridamole, pentoxifllin), and metabolically active agent (vitamin E, folic acid, magnesium orotate, actovegin, cocarboxylase, and inosin). Gestosis developed in 25% of the patients in group 1 within 37 weeks and in 56.7% of the women (p < 0.05) in group 2 within 23-37 weeks of pregnancy. Circulatory disturbances in the mother-placenta-fetus system were recorded in 25% and 50% of the women in groups 1 and 2 respectively (p < 0.05), intrauterine fetal hypoxia in 18.8 and 50% (p < 0.05), chronic fetoplacental insufficiency in and fetal growth retardation syndrome in 12.5 and 40% (p < 0.05). In group 2, the perinatal mortality rate was 66.7% and perinatal losses amounted to 100.0% compared with their absence in group 1 (p < 0.05). Premature delivery occurred in 30% of the women in group 2 and was absent in group 1 (p < 0.05). In group 1, 9.4 of the newborn infants had low birth weight compared with 33.3% of the live full-term infants in group 2 (p < 0.05). Conjugated jaundice prevailed among the diseases affecting newborns in group 1 whereas intrauterine infections and posthypoxic encephalopathies were most common in group 2 It is concluded than combined therapy of hypertensive disease in women delayed the development of gestosis and made it possible to maintain pregnancy till normal outcome for both the mother and the child.

[The clinicomethodological aspects of the etiology of coronary artery disease].

Having analyzed more than 150 original papers dedicated to the study of cardial pathology risk factors from clinical (specific) and methodological (philosophic) points of view, the authors put forward a hypothesis of the etiology of diseases (by the example of coronary artery disease) as a "critical mass" of these risk factors. Reasoning from it, the authors suggest the ways of using this statement by large quantitative evaluation of clinical data, and application of mathematic modeling to the diagnostics and prognostics of cardial pathology in each particular case.

[Arterial hypertension and coronary heart disease: clinical and functional aspects].

The subjects of the study were 196 men with verified coronary heart disease (CHD). The subjects were divided into 4 groups: 1) patients without arterial hypertension (AH); 2) patients with mild AH, 3) patients with moderate AH, 4) patients with severe AH (SAH). All the patients were tested by means of veloergometry. The study found that the presence and severity of AH affected functional condition of cardiovascular system and clinical manifestations in patients with CHD. The appearance and aggravation of AH in CHD patients: 1) diminished clinical manifestations (angina), and elevated frequency of ECG signs of myocardial ischemia; there was significant growth of the proportion of patients with painless myocardial ischemia and ventricular arrhythmias associated with physical activity; 2) while causing moderate decrease of physical tolerance, substantially decreased the economy of cardiovascular system functioning, associated mostly with 'pressure overload"; pressor reaction effectiveness lowered; 3) worsened disturbances of recovery period, which manifested in prolongation of the time necessary for systolic pressure to return to initial level. These peculiarities were most prominent in patients with CHD and SAH, which allows considering this combination to be a new condition, requiring new approaches to evaluation of its clinical course and therapy.

[Quantitative assessment of some risk factors of chronic cardiac failure and non-invasive diagnosis of its early (preclinical) stages]. / Kolichestvennaia otsenka znacheniia nekotorykh faktorov riska khronicheskoi serdechnoi nedostatochnosti i shchadiashchaia diagnostika ee rannikh (doklinicheskikh) stadii.

Factors of risk of chronic circulatory insufficiency (CCI) were assessed in 263 hypertensive patients with and without ischemic heart diseases. CCI was diagnosed in 218 of these 263 patients. Early stages of CCI may be diagnosed in certain number of these factors. ECG findings in isolated arterial hypertension detected left ventricular dysfunction classified as chronic cardiac failure of functional class I (NYHA criteria).

[Arterial hypertension and ischemic heart disease: clinico-echocardiographic aspects]. / Arterial'naia gipertoniia i ishemicheskaia bolezn' serdtsa: kliniko-ékhokardiograficheskie aspekty.

Doppler M-mode echocardiography was made in 156 males with ischemic heart disease (IHD) verified coronarographically. The patients were normotensive or had mild, moderate and severe arterial hypertension (AH) (groups 1, 2, 3 and 4, respectively). The groups were similar by functional anginal class. Echocardiographic findings were in many cases similar. This supports the hypothesis that IHD and AH are closely related. However, the addition of AH to atherosclerotic affection of the coronary artery or atherosclerosis rise in the presence of AH is associated with development of myocardial hypertrophy which is registered at echocardiography and correlates in severity with severity of AH. Myocardial hypertrophy is, on the one side, compensatory as it prevents dilation of the left ventricle and impairment of its contractility rising at later stage of the disease with depletion of the myocardial and coronary reserves, but, on the other side, it promotes diastolic dysfunction of the left ventricle, lowers its performance. The above phenomena are most pronounced in combination of IHD with severe AH. This combination presents a new qualitative state and, therefore, needs new approaches to its correction.

[Use of antioxidants and trimetazidine in preparation of patients with ischemic heart disease for coronary angiography]. / Ispol'zovanie antioksidantov i trimetazidina pri podgotovke bol'nykh ishemicheskoi bolezn'iu serdtsa k koronaroangiografii.

Lipid peroxidation, cell stability, lipid spectrum, conjunctival microcirculation, levels of ceruloplasmin and myoglobin were studied in 107 males with ischemic heart disease before and after coronaroangiography by M. Judkins (CAG). It was found that CAG provokes oxidative stress, promotes membranodestructive processes, dyslipidemia and circulation disorders in the bulbar conjunctive. Preventive (3 days before CAG) administration of alpha-tocopherol or emoxipin proved cardioprotective. The highest cytoprotective effect was produced by trimetasidine given 10 days before the procedure.

[Application of high information technologies in predicting outcomes of cardiovascular diseases]. / K voprosu ispol'zovaniia vysokikh inforamtsionnykh tekhnologii v prognozirovanii serdechno-sosudistykh zabolevanii.

The authors review their studies conducted for many years on cardiological prognostication in the context of the republican program "Cardiology" performed in the Udmurt Republic. The lines of the research and results obtained are described.

[An algorithm for construction of a mathematical model of coronary circulation disorders]. / Algoritm postroeniia matematicheskoi modeli narushenii koronarnogo krovoobrashcheniia.

The paper shows how to improve the quality of diagnosing coronary heart disease (CHD). It proposes a mathematical model of coronary circulatory disorders, which is based on the definition of CHD as a cardiac abnormality caused by the imbalance of coronary blood flow and myocardial oxygen consumption, outlines an algorithm for construction of this model. With this model, a computer system has been designed for examining a patients with CHD, which permits the construction of a virtual model of coronary circulatory disorders.

[Mathematical model for prognostication of work capacity recovery in patients with myocardial infarct]. / Matematicheskaia model' prognozirovaniia vosstanovleniia trudosposobnosti u bol'nykh infarktom miokarda.

The impact of clinical and instrumental findings on prognosis was evaluated in patients with myocardial infarction and a mathematical model was proposed to predict their recovered working ability. The developed predictive index for prediction of recovered working ability is of high informative value and accuracy. It may be practically used by a cardiologist to choose a protocol of medical and rehabilitative measures in myocardial infarction.

[Immunological characteristics of patients with acute coronary syndrome (unstable angina and myocardial infarction)]. / Immunologicheskie osobennosti bol'nykh s ostrym koronarnym sindromom (nestabil'naia stenokardiia i infarkt miokarda).

Admission and discharge values of rosette formation, adhesive and phagocytic ability of neutrophils, exercise tests with calculation of the tension index (TI), serum concentrations of IgG, IgA and IgM, circulating immune complexes (CIC) and cardiolipin antibodies (CAB) were studied in 48 males with unstable angina pectoris and acute myocardial infarction. Acute coronary syndrome is shown to be associated with marked immune alterations, primarily, with elevated levels of CIC and CAB, reduced TI. These alterations persisted for 3-5 weeks of the hospital stay and provoked the risk of repeated infarctions and thrombotic complications after relief of clinical symptoms of acute coronary failure.

[Therapeutic plasmapheresis and alpha-tocopherol in patients with coronary heart disease]. / Lechebnoe primenenie plazmafereza i alpha-tokoferola u bol'nykh ishemicheskoi bolezn'iu serdtsa.

46 patients with coronary heart disease with hypercholesterolemia were exposed to therapeutic plasmapheresis (TP) in combination with alpha-tocopherol treatment (AT). The results of 3-month follow-up with assessment of the clinical status, lipid spectrum, lipid peroxidation, concentration of ceruloplasmin indicated high hypolipidemic effectiveness of TP 2-3 weeks after the treatment as shown by inhibition of lipid peroxidation and antioxidant system. The addition of AT prolonged the hypolipidemic effect of TP, promoted optimization of plasma antioxidant potential (a rise in HDL, stabilization of ceruloplasmin levels).

[Use of a new exercise test in the early period of myocardial infarction: rationale and experience]. / Obosnovanie i opyt primeneniia novoi nagruzochnoi proby v rannie sroki infarkta miokarda.

A new gradual exercise test (gravimetric test (GT)) has been proposed to use in early myocardial infarction (MI). GT is more physiologically and safe than a bicycle ergometry test, its sensitivity being 54.9%. The use of GT allows one to detect a group of patients with subsequent slower readaptation to exercises on post-MI days 7-10 and to make appropriate correction of treatment.

[Experience in developing devices for medical use exemplified by the electronic stethophonoendoscope]. / Opyt razrabotki priborov meditsinskogo naznacheniia na primere élektronnogo stetofonendoskopa.

The paper describes the use of the expert's error technique to provide evidence and pool medical specifications for an electron amplifying stethophonoendoscope, a medical diagnostic device. It illustrates the impact of variations in amplitude-frequency responses (AFR) on the auscultation properties of the devise. An AFR variation of only 10-12 dB can distort sound perception at auscultation. The results of development of the electron stethophonoendoscope indicate that the correct choice of criteria for expert's estimates allows the device's specifications to be worked out with simultaneous simplification of testing procedures.

[Problems in the planning of medical technology for a cardiological clinic]. / O nekotorykh voprosakh planirovaniia vypuska meditsinskoi tekhniki dlia kardiologicheskoi kliniki.

The classification approach gives rise to the necessity of designing new devices for cardiological care, which are predetermined where to be used. The criterion used for making up a prognostic index is original. The devices have been to be promising in clinical practice.

[Perspectives of development and production of portable diagnostic devices for therapeutic and cardiological care]. / Perspektivy razrabotki i proizvodstva portativnykh diagnosticheskikh priborov terapevticheskoi i kardiologicheskoi napravlennosti.

The paper discusses problems in the development and organization of production of inexpensive diagnostic devices designed for use at primary health care services. It also provides a programme for developing a family of diagnostic medical devices: electron two- and multi-channel medical phonoendoscopes, attachments to a portable phonocardiogram-recording electrocardiograph, a portable diagnostic apparatus for comprehensive examinations.

[Dynamic exercise tests in the assessment of rehabilitation in patients with myocardial infarction]. / Dinamicheskie nagruzochnye proby v otsenke reabilitatsii bol'nykh infarktom miokarda.

176 patients with myocardial infarction were subjected to a sequence of tests: an original gravimetric test on the disease day 7-10, bicycle ergometry on day 12-20, repeated bicycle ergometry on days 30-35 and 100-120. The results of the investigations performed in different times were interrelated. This helped to make accurate prognosis of recovering ability in 85% of patients. This system of dynamic control demonstrated that the greatest positive effects on exercise tolerance are reached in combined use of intravenous blood radiation with He-Ne laser and combined chemotherapy. Nitroglycerin+heparin combination is the least effective. Nitroglycerin+heparin in combination with metabolism correctors is of moderate efficacy.