[An evaluation of the cardioprotective action of the preparation ICRF-187 (Cardioxane) during the treatment of breast cancer with large doses of adriamycin]. / Otsenka kardioprotektivnogo deistviia preparata ICRF-187 (kardioksan) pri lechenii bol'nykh rakom molochnoi zhelezy bol'shimi dozami adriamitsina.

Twenty females with disseminated breast cancer received courses of polychemotherapy with 21-day intervals. The regimen comprised adriamycin (ADM), cyclophosphamide and 5-fluorouracil in the dose 50, 500 mg/m2, respectively. 30 minutes prior to the treatment the patients were given the cardioprotector cardioxan (1000 mg/m2). Cardiological control (ECG, EF according to echo-CG and radionuclide ventriculography, PP/EP M1/M2, T1/T2 according to echo-polycardiography and Doppler cardiography) was performed before the treatment and at ADM total dose 200-300 mg/m2 followed by measurements at each dose increase by 100 mg/m2. The findings showed no evidence of ADM-related cardiac damage up to ADM dose 900-1000 mg/m2 in the case of cardioxan protection, though there was a tendency to M1/M2 increase which needs further studies as it suggests worsening of left ventricular diastolic contractility.

[Comparative evaluation of the cardiotoxic effects of antineoplastic antibiotics adriamycin and pharmorubicin]. / Sravnite'lnaia otsenka kardiotoksicheskogo deistviia protivo- opukholevykh antibiotikov adriamitsina i farmorubitsina.

Thirty patients with Grade III breast cancer, a locally common form, were examined to compare the magnitude of the cardiotoxic effects displayed by the antitumor anthracyclic antibiotics adriamycin (15 patients) and pharmorubicin (15 patients). Clinical symptoms of cardiotoxicity developed in 13.3% of the pharmorubicin-treated and in 40% of the adriamycin-treated patients. Among the noninvasive techniques, electrocardiography turned out to be more informative, which enabled the signs of myocardial dystrophy and cardiac arrhythmias to be identified in 20 and 40% on pharmorubicin and adriamycin, respectively. Poly- and echocardiography proved to be less informative than it was shown by the data available in the literature, which is associated with the use of relatively small total doses of anthracycline in our investigations.

Echocardiographic assessment of the haemodynamic effect of ethmozine and its diethylamine analogue etacizine in patients with heart failure.

The purpose of the study was to compare the haemodynamic effect of new antiarrhythmic preparations - ethmozine and its diethylamine analogue etacizine in 22 patients with heart failure (HF), stage IIa, of different etiology. The patients were given for one week ethmozine and then again for one week etacizine, during which periods they were followed echocardiographically, with pressure measurement in the pulmonary artery (PAP) and in the right atrium (RAP). Ethmozine in a daily dosis of 600-800 mg did not induce changes in left ventricular dimensions, percentual shortening of the anteroposterior left ventricular dimension (% delta S), in PAP, RAP, arterial pressure and heart rate. With application of etacizine in a dose of 150-200 mg/day, a clinically insignificant decrease was observed in % delta S (by 19.7%; p less than 0.05), which was not accompanied by a more marked augmentation of left ventricular dimensions, PAP, RAP or an intensification of clinical signs of heart failure. In spite of this, on administration of etacizine to patients with HF it is necessary to control haemodynamics, the most suitable method for this being echocardiography.

Diagnostic value of pulsed Doppler echocardiography in combined heart defects.

26 patients with combined heart defects were examined by means of ultrasound methods (one-dimensional, two-dimensional and Doppler echocardiography). The results were compared with the results of clinical and roentgenological examinations. Taking into account literary data on high sensitivity and specificity of Doppler echocardiography, its informative value was assessed in cases when affection of two or more valves results in a balancing of haemodynamic changes. It was documented that pulsed Doppler EchoCG makes possible to assess the character and the direction of blood flow in different phases of the cardiac cycle in the heart cavities and the great vessels, and thereby provides additional information on the involvement of the valvular apparatus and on the state of haemodynamics. The sensitivity of this method is particularly high in the detection of regurgitant flow.