[Changes in left ventricular diastolic function and in tolerance to physical loading under the influence of finoptin in stenocardia patients]. / Izmenenie diastolicheskoi funktsii levogo zheludochka i tolerantnosti k fizicheskoi nagruzke pod vliianiem finoptina u bol'nykh stenokardiei.

A total of 45 patients aged 53.6 +/- 6.1 years who had Functional Class II-IV angina pectoris were examined. In patients with stable angina and normal left ventricular diastolic pressure, a moderate antianginal effect of finoptin was shown to be associated with decreased myocardial afterload. The normalizing effects of finoptin on baseline left ventricular diastolic dysfunction along with lower myocardial afterload resulted in an increase in coronary reserve and a more pronounced antianginal effect.

[Combined use of cold (chloroethyl) and ergometry tests in the diagnosis of vasospastic angina]. / Kombinirovannoe primenenie kholodovoi (khlorétilovoi) i érgometrinovoi prob v diagnostike vazospasticheskoi stenokardii.

The study was undertaken to examine the informative value of cold (chloroethyl) and ergometrine tests in the diagnosis of vasospastic angina. A total of 36 patients with clinical and electrocardiographic signs of vasospastic angina were studied. They underwent coronary ventriculography, Holter monitoring, bicycle ergometry with continuously increasing or single submaximum exercise, pulmonary hyperventilation, cold, ergometrine, and chloroethyl tests. The examinations have shown that cold and ergometrine tests are of informative value in the diagnosis of vasospastic angina.

[Clinical course of the disease, myocardial functional status and rheological properties of blood in patients with post-infarction cardiosclerosis and angiographically documented unchanged coronary arteries]. / Klinicheskoe techenie zabolevaniia, funktsional'noe sostoianie miokarda i reologicheskie svoistva krovi u bol'nykh s postinfarktnym kardiosklerozom i neizmenennymi po dannym koronaroangiografii koronarnymi arteriiami.

The clinical course of the disease, myocardial functional status and blood rheological properties were examined in coronary heart disease patients with postinfarction and angiographically evidenced intact coronary arteries. This group of patients was shown to be characterized by young age, acute onset of the disease and rather favourable prognosis. The abnormalities were caused by extended postinfarction asynergies, yet there was no significant progression of circulatory insufficiency even in patients with left ventricular aneurysm during a long-term follow-up (5.2 +/- 0.2 years). A correlation was found between the level of myocardial blood flow and the degree of disturbed blood rheological properties. It is suggested that impaired blood rheology along with altered coronary tone should determine the functional component of coronary resistance and represent a main mechanism of coronary insufficiency in patients with coronary heart disease and unchanged coronary arteries, as evidenced by angiography.

[Correlation of antianginal effect of corinfar and diastolic function in patients with ischemic heart disease]. / Zavisimost antianginalnogo effecta corinfara ot sostoianiia diastolicheskoi funktsii serdtsa u bolnykh ishemicheskoi bolezníu serdtsa.

The study was undertaken to examine 45 patients with coronary heart disease and 14 healthy subjects by using radionuclide ventriculography, apex- and echocardiographies, bicycle ergometry, transesophageal electrocardiostimulation before therapy and at the action peak of corinfar in a dose of 30 mg. It was shown that corinfar failed to affect the unaltered diastolic function of the left ventricle. The normalizing effect of corinfar on left ventricular stiffness was found to result in higher coronary reserve, significantly enhanced exercise tolerance and to be an important mechanism of antianginal effect of the drug. Impaired left ventricular stiffness may be an additional criterion for using corinfar in patients with coronary heart disease.

[Adaptation of myocardial function to conditions of myocardial insufficiency in patients with marked coronary arteriosclerosis]. / Adaptatsiia funktsii miokarda k usloviiam koronarnoi nedostatochnosti u bol'nykh vyrazhennym aterosklerozom koronarykh arterii.

Relationships between myocardial blood flow, myocardial contractility, anaerobic metabolic products, and myocardial oxygen requirement and uptake were investigated in 52 coronary atherosclerotic patients. Myocardial functioning under the conditions of inadequate myocardial perfusion, where blood supply requirement, determined by myocardial activity, exceeds actual magnitude of coronary blood flow, is shown to be basically possible in patients with marked atherosclerosis of coronary arteries. Specific features of myocardial performance under the circumstances are its partially reduced effectiveness and activated anaerobic carbohydrate oxidation pathway, as evidenced by a negative arteriovenous difference between lactic and pyruvic acid levels in blood from the aorta and the coronary sinus.

[Effectiveness of nitrosorbide, corinfar and obsidan in preventing ischemia caused by the dipyridamole test]. / Effektivnost' nitrosorbida, korinfara i obzidana v preduprezhdenii ishemii, vyzvannoi dipiridamolovoi proboi.

The efficacy of nitrosorbide, corinfar and obsidan in preventing myocardial ischemia, induced by exercise or intravenous dipyridamole, was evaluated in 20 coronary patients. Nitrosorbide was found to be the most effective, and obsidan, the least effective, drug in preventing the steal syndrome. It is suggested that the efficiency of anti-anginal drugs is based on their effect on coronary flow control as well as hemodynamic determinants of myocardial oxygen requirements. The dipyridamole test can be used for the assessment of the effects of antianginal agents.

[Comparative analysis of the information value of electrocardiographic loading tests in relation to the characteristics of atherosclerotic lesions of the coronary arteries]. / Sravnitel'nyi analiz informativnosti élektrokardiograficheskikh prob s nagruzkoi v zavisimosti ot osobennostei ateroskleroticheskogo porazheniia koronarnykh arterii.

Diagnostic possibilities of various exercise tests (bicycle ergometry, the dipyridamole test, atrial electrostimulation) were demonstrated, as was a relationship between their sensitivity and the number of stenosed coronary arteries, the extent and level of obstruction, collateral circulation specificity and myocardial function.

[ECG changes during the performance of a loading test in coronary atherosclerosis patients with asynergies]. / Izmeneniia EKG pri provedenii proby s nagruzkoi u bol'nykh koronarnym aterosklerozom s nalichiem asinergii.

The findings of coronary angiography, ventriculography and bicycle ergometry were compared in 64 patients with coronary heart disease and asynergic zones in the left ventricle. An increase in the sum of the amplitudes of R waves of the ECG during the exercise test generally combined with a displacement of the ST segment was predominantly observed in patients with asynergies of ischemic genesis. By contrast, in patients with asynergies secondary to post-infarction cardiosclerosis, an elevation of R waves during bicycle ergometry cannot be a reliable sign of coronary failure, yet it permits the identification of individuals with marked disorders of the contractile function of the left ventricle.

[Morphofunctional changes in the myocardium in patients with coronary insufficiency and disorders of the contractile function of the heart]. / Morfofunktsional'nye izmeneniia miokarda u bol'nykh koronarnoi nedostatochnost'iu s narusheniem sokratitel'noi funktsii serdtsa.

Altogether 64 patients with coronary heart disease (CHD) were examined using coronaroventriculography, bicycle ergometry with echocardiogram recorded at rest and in threshold exercise. During aortocoronary bypass surgery myocardial biopsies were taken from 20 patients. A correlation analysis of the morphofunctional state of the microcirculatory bed and changes in myocardial contractility showed that a decrease in myocardial contractility occurred in parallel with structural shifts.

[Myocardial blood flow and its relation to myocardial function in ischemic heart disease patients with various manifestations of coronary arteriosclerosis]. / Miokardial'nyi krovotok i ego sviaz' s funktsional'nym sostoianiem miokarda u bol'nykh ishemicheskoi bolezn'iu serdtsa s razlichnoi vyrazhennost'iu ateroskleroza koronarnykh arterii.

An analysis of variance applied to myocardial flow (MF) data obtained using 133Xe clearance technique, coronaro- and ventriculography in 53 coronary patients and 22 patients with intact coronary arteries, demonstrated a relationship between the MF level, myocardial contractility, oxygen requirement of the heart muscle and left-ventricular isovolumic relaxation time. The rate of myocardial fibres circular shortening and the ejection fraction were found to be the most sensitive indicators of myocardial contractility, responding to MF reduction. The latter was noted in coronary patients with ischemic and postinfarction asynergies. In cases of a normokinetic left ventricle, MF did not differ significantly from that of the controls, irrespective of the extent of lesion.

[Diagnostic and treatment characteristics of ischemic heart disease patients with asynergies]. / Nekotorye osobennosti diagnostiki i lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa s asinergiiami.

A total of 64 patients with coronary heart disease were examined using contrast coronaro-ventriculography, veloergometry and estimation of the lactic acid level in the coronary sinus blood. Fifty-seven patients were referred to obsidan therapy by the "blind" method. Two groups of patients with asynergies of ischemic and cicatricial genesis were singled out. The sensitivity of the ST segment depression and sigma R increment as objective signs of ischemia significantly reduced in the presence of postinfarction cardiosclerosis. Obsidan monotherapy caused a rise of load power and volume of work performed in the patients with asynergies of ischemic origin: an antianginal effect of the drug in such cases was comparable to that in the patients without disturbed myocardial regional cantractility.

[Physical exertion tolerance in patients with coronary insufficiency in relation to the presence of asynergic areas]. / Tolerantnost' k fizicheskoi nagruzke u bol'nykh s koronarnoi nedostatochnost'iu v zavisimosti ot nalichiia zon asinergii.

A comparative study of coronarographic, ventriculographic and bicycle ergometry results in 81 coronary patients demonstrated that myocardial contractility disorders (extensive asynergic areas, elevated ultimate diastolic pressure) combined with considerable coronary arterial lesion could result in reduced physical stress tolerance. In cases where one coronary artery is affected, asynergic areas may produce no basic influence on exercise tolerance. The predictive value of summary R amplitude increment at bicycle ergometry was estimated at 70.5% for the diagnosis of asynergia so that it can be used as a sign of possible left-ventricular dysfunction.

[R wave amplitude and left ventricular contractile function in ischemic heart disease]. / Amplituda zubtsa R i sokratitel'naia funktsiia levogo zheludochka u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Coronarography and bicycle ergometry data in 70 patients with ischaemic heart disease and in 35 patients with the intact cardiac arteries have been compared. In 42 patients with ischaemic heart disease and in 28 healthy individuals the state of intracardiac haemodynamics after exercise have been studied with echocardiography. It was shown that the changes in the total of R (sigma R) waves in multiple leads serve as a sensitive (70%) and specific (88.6%) criterion to detect lesions of the coronary arteries. The increase of sigma R after exercise is, as a rule, combined with marked atherosclerosis, upset contractile function of the myocardium and decreased tolerance to exercise. Uniform decrease of sigma R in multiple leads points to normal or insignificant changes in the function of the left ventricle and is seen in patients with lesion of one vessel or with intact coronaries.

[Intracardiac hemodynamics and myocardial contractile function indices in chronic ischemic heart disease]. / Nekotorye pokazateli vnutriserdechnoi gemodinamiki i sokratitel'noi funktsii miokarda u bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa.

Echocardiography was used in the examination of 51 patients with chronic ischemic heart disease (IHD) without accompanying hypertension and congestive circulatory insufficiency. With gradual advancement of the disease, a significant increase in left-ventricular volumes during the systole and diastole was recorded as well as a decrease in the ejection fraction (IF) and velocity of circulatory shortening of the myocardial fibres (Vch) in slight variations of the stroke volume. The IF and Vch were the most characteristic indices for appraising the early manifestations of myocardial contractility disorders. The index of left-ventricular structure functioning intensity (SFI) was used to characterize the functional state of the heart muscle. In patients with a severe course of the disease, SFI was found to be reduced because of an increase in the myocardial mass. The developing damage hypertrophy, however, did not provide for full compensation of left-ventricular function and was attended by a reduction of the indices of contractility and pump function of the heart. This provides the grounds for the assumption that the reduction of SFI in patients with severe IHD is associated with exclusion of part of the myocardium involved in the pathological process from effective functioning.