[Rare and atypical manifestations of infectious endocarditis]. / Redkie i atipichnye proiavleniia infektsionnogo éndokardita.

Along with typical clinical symptoms in present-day infectious endocarditis atypical picture may arise: impairment of CNS and cardiac muscle with psychosis, arrhythmia, defective cerebral circulation, heart failure. In the absence of typical manifestations diagnosis of infectious endocarditis presents difficulties.

[Role of the neurohormonal regulatory system in the development of impaired electrolyte profiles in chronic circulatory insufficiency]. / Pol' sistem neirogumoral'noi reguliatsii v razvitii narushenii élektrolitnogo profilia pri khronicheskoi nedostatochnosti krovoobrashcheniia.

The parameters of electrolyte profile and some neurohumoral regulatory systems were compared in 257 patients with chronic circulatory insufficiency (CCI) secondary to coronary heart disease in the presence or absence of essential hypertension. The results obtained showed that not only the increased function of the renin-angiotensin-aldosterone system, but the higher activity of the sympathoadrenal system in the presence of weakened adrenocortical glucocorticoid and epiphyseal functions late in CCI played a role in the mechanisms responsible for sodium retention in the patients with the disease.

[Various pathogenetic mechanisms of the progressive course of chronic circulatory insufficiency in patients with ischemic heart disease]. / Nekotorye patogeneticheskie mekhanizmy progressiruiushchego techeniia khronicheskoi nedostatochnosti krovoobrashcheniia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Markedly increased antidiuretic activity, depressed epiphyseal activity and low blood serotonin, and increased sympathoadrenal activity, largely due to mediator effects, were demonstrated in 201 coronary patients with and without essential hypertension in the presence of central hemodynamic disorders. Correlations were established between impaired activities of various regulatory systems as well as between those and some hemodynamic disorders.

[Adaptive and compensatory mechanisms in chronic circulatory insufficiency in ischemic heart disease]. / Nekotorye adaptatsionno-kompensatornye mekhanizmy pri khronicheskoi nedostaochnosti krovoobrashcheniia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Activation of some neuroendocrine systems is one of the compensatory-adaptation mechanisms in circulatory insufficiency in patients with ischemic heart disease. Evidence of this is that patients with stage I--IIA of the disease are marked by an increase in the activity of the sympatheticoadrenal system (increase in the excretion of free catecholamines) and the renin-angiotensin-aldosterone system, in the glucocorticoid function of the adrenal cortex, in the functional condition of the epiphysis cerebri, and in the blood plasma antidiuretic activity. Participation of these systems in the adaptation processes maintains an adequate level of venous blood return to the heart and inotropic myocardial function.

[State of the neurohumoral regulatory system in circulatory insufficiency]. / Sostoianie neiro-gumoral'nykh sistem reguliatsii pri nedostatochnosti krovoobrashcheniia

A moderate elevation of the daily excretion of free noradrenaline and adrenalin is observed in chronic circulatory insufficiency, beginning with Stage IIA. The catecholamines metabolism is elevated, as shown by the daily excretion of normethanpherine and methanpherine and of vanillyl-mandelic acid. The activity of renin and angiotensinases was growing along with the progressing cardiac insufficiency. The blood level of angiotensinogen was decreasing, especially in patients with Stage IIB and III of decompensation. The daily excretion of aldosterone was growing along with the development of cardiac insufficiency. The functional state of the glucocorticoid function of the adrenal cortex was of a phased nature in cases of circulatory insufficiency. The study of the functional state of the epiphysis was conducted by way of determining the blood level of melatonine and of its daily excretion. In Stages I and IIA the level of this hormone was clearly elevated, in Stages IIB and III -- decreased as compared with the initial and normal levels. The plasma level of the antidiuretic hormone was distinctly growing, beginning with Stage IIB, reaching its maximal values in Stage III.

[Antidiuretic hormone content in the blood plasma of patients with chronic circulatory insufficiency]. / O soderzhanii antidiureticheskogo gormona v plazme krovi bol'nykh s khronicheskoi nedostatochnost'iu krovoobrashcheniia

The antidiuretic hormone (ADH) content in the blood plasma in comparison with its osmosis, the mass of circulating blood and the Na/K ratio in the urine was studied in 59 patients with rheumatic heart disease, atherosclerotic cardiosclerosis and chronic nonspecific affections of the lungs with and without circulatory insufficiency. The blood plasma ADH level is shown to increase significantly only with circulatory insufficiency of the IIB-III stage, whereas the plasma osmosis first has a tendency to rise and then gradually declines. This may suggest a deranged regulation of the ADH secretion with a higher osmosis of the plasma. No clear-cut parallelism between changes in the ADH level, the mass of circulating blood and plasma, the Na/K ratio in the urine and diurnal urinary output could be noted.