[Effect of perindopril on indices of cardiac function and quality of life in patients with arterial hypertension in regard to age].

At present in the treatment of arterial hypertension the role of angiotensine converting enzyme inhibitors is significant. From this group the most special attention was attracted to peridopril-esbumin. High efficiency of this preparation has been corroborated by numerous controlled, multicentral investigations. Study of the effect of dosage and peculiarities of peridopril appears to be the most important taking into account age factor that has been insufficiently studied. The goal of our investigation was to study effect of 4 mg and 8 mg of peridopril on functional indices of the heart of patients with hypertonic disease and their psychoemotional sphere in the aspect of age. Total of 78 patients with hypertension and without clinical manifestations of cardiac insufficiency, diabetes mellitus and having had myocardial infarction were examined. According to the age patients were divided into two groups: <65 and >65. The investigations lasted for 12 months. Besides ECG investigations, patients were subjected to echoscopic and doplerographic investigations. For the estimation of life quality a questionnaire of evaluation of general health state (SF-36 Health Status Surveu) containing 11 questions was used. It was shown that peridopril has the different action among patients of different age groups. In older patients (>65 years) it increases indices of physical activity, while in younger patients it has a beneficial effect on the emotional parameters.

[Predictor of early thrombolysis in acute coronary syndrome by estimation of the QT interval variability on 12 lead standard electrocardiogram].

It has been stated that decreased dispersion of QT interval (QTd) on 12 lead ECG is associated with successful thrombolysis (TH) in acute myocardial infarction but it is not clear whether QTd can predict early successful TH. The goal of the investigation was to evaluate significance of QTd and QT interval variability between adjacent precordial leads (QTdl) for prediction of successful early TH in acute coronary syndrome (ACS). Two groups of patients after 6 hours from the beginning of acute coronary attack with elevation of ST segment on ECG were under investigation: I group -- 26 patients with resolution of ST> or =70% after 60-90 min from the starting of TH and II group -- 21 patients with no resolution of ST. QTd was defined as the difference between maximal and minimal QT interval and QTd as the difference between adjacent precordial ECG leads. QTd is a marker of successful TH but does not predict its efficiency, QTde<50 predicted TH with 80% sensitivity, 85% specificity and 87% positive predictive value.

[QT interval variability in adjacent areas on standard ecg during ectopic activity in patients with acute coronary syndrome].

Clinical and experimental evidence closely link malignant ventricular arrhythmia with increased dispersion of refractoriness and thus electrical heterogeneity in different kinds of heart diseases. Most increased dispersion of refractoriness is due to inhomogenous action potential duration in adjacent areas, decreased local conduction velocity or both. The article focuses on ectopic ventricular activity and on QT interval variability in adjacent segments on standard ECG in patients with acute coronary syndrome. The adjacent QT dispersion was defined as a difference between two adjacent leads. Seventy nine patients aged 54+/-6,5 in 6 hour interval after the attack with elevation of ST segments on ECG were studied. Fifteen patients aged 48+/-7 without elevation of ST segment on ECG served as control subjects. Patients were allocated to two groups: one included patients with 1-2 ectopic degree; group two included patients with 3-5 ectopic degree. In patients with acute coronary syndrome QT max and QTd was significantly higher than in control subjects (p<0,05). The increase of ventricular ectopic degree is linked with the increased adjacent QT dispersion.

[Detection of latent disorders of coronary circulation and heart rhythm in ischemic heart disease patients by using psychoemotional loading]. / Vyiavlenie skrytykh narushenii koronarnogo krovoobrashcheniia i ritma serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa s primeneniem psikhoémotsional'noi nagruzki.

A relationship between the emergence of ventricular arrhythmias and other signs of myocardial ischemia was assessed in 96 coronary patients on the basis of comparative results of the physical and psychoemotional stressful tests, and the nitroglycerin and aspirin tests. Ventricular rhythm disorders may develop in the course of mental exercise in some coronary patients with low hemodynamic values as the only manifestation of myocardial ischemia. Large-scale use of the mental stressful test is advocated for cardiologic medical institutions.

[Effect of tobanum on various functions of the heart in patients with ischemic heart disease and prospects for its clinical application]. / Vliianie tobanuma na nekotorye funktsii serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa i perspektivy ego klinicheskogo primeneniia.

In coronary patients with relatively intact myocardial function, tobanum increases physical stress tolerance and produces positive central hemodynamic shifts, while myocardial contractility is depressed insignificantly. In patients with low myocardial functional reserve, these parameters, on the contrary, deteriorate, particularly during exercise. Combined use of tobanum and corinfar in patients with impaired myocardial contractility controls cardio- and hemodynamic shifts and increases physical stress tolerance.

[Haptoglobin phenotype distribution in patients at high risk of developing myocardial infarct]. / Raspredelenie fenotipov gaptoglobina u bol'nykh s vysokim riskom razvitiia infarkta miokarda.

Haptoglobin (Hp) phenotyping was carried out in patients at risk for myocardial infarction. A highly significant increase in the incidence of the phenotype Hp 2-2 was demonstrated in the high-risk group, as compared to a group of normal subjects.

[Combined use of psychological and physical loading tests in the diagnosis of ischemic heart disease]. / Kompleksnoe primenenie psikhologicheskogo i fizicheskogo nagruzochnykh testov v diagnostike ishemicheskoi bolezni serdtsa.

Reactions of heart ectopic activity in psychological exercise were similar to those in bicycle ergometry, but the values of pulse and arterial pressure increase were lower. The advantages of the psychological exercise test in detecting disorders of cardiac rhythm in patients, particularly in those hypersensitive to psychogenic effects, is noted. The importance of using psychological exercises in patients with high tolerance to physical exercises, by means of which latent forms of arrhythmias cannot always be detected, is pointed out.

[Study of ectopic cardiac activity under the effect of psychological stress]. / Izuchenie éktopicheskoi aktivnosti serdtsa pod vliianiem psikhologicheskoi nagruzki.

Mental and emotional load consisting of several psychological tests was used in 35 patients with ischemic heart disease to disclose hazardous and latent forms of disorders of cardiac rhythm as possible forewarning of sudden death and to study the role of the psychological factor and stress situation in their origin. The reaction of extopic myocardial activity to the load proved different. In distinction to patients with functional cardiovascular disorders, patients with organic affections of the myocardium responded to the load by the appearance of extrasystoles during the load or by their greated frequency. In patients with functional cardiovascular disorders there was mostly a decrease in the number of initial extrasystoles and in some cases their total disappearance.