[Intravenous digital subtraction ventriculography: technical and methodologic aspects, a comparison with cineventriculography]. / Vnutrivennaia tsifrovaia subtraktsionnaia ventrikulografiia: tekhniko-metodicheskie aspekty, sravnenie s kinoventriculografiei.

Intravenous digital subtraction ventriculography (IDSV) was performed in 294 patients with various pathology. The IDSV method and conditions for obtaining informative ventriculograms were described. Hemodynamic indices and LV segmental contractility were assessed. IDSV and CVG data were compared in 52 cases. The results of both methods showed high correlation, IDSV having advantages over CVG (the absence of a cardiosuppressive effect resulting from direct administration of a contrast medium into the LV chamber and excluding LV quantitative overload). IDSV as a semiinvasive and easy-to-perform method has no contraindications.

[Comparative effectiveness of intracoronary and systemic thrombolytic therapy of acute myocardial infarction]. / Sravnite'lnaia otsenka éffektivnosti intrakoronarnoi i sistemnoi tromboliticheskoi terapii ostrogo infarkta miokarda.

Systemic thrombolytic therapy with streptodekase was shown to produce the same effects as intracoronary thrombolytic therapy with avelysine. The blood flow in the coronary vessels could be restored in 72.7% with intracoronary therapy and in 66.7% with systemic thrombolytic therapy. Death rates were 9.1 and 8.9%, respectively, and in 3.1 and 3.3% with reperfusion. A difference was found in the frequency of myocardial infarction-associated complications, depending on the modality of thrombolytic therapy. In the authors' opinion, in clinical institutions where operations on coronary vessels are not supposed to be made after thrombolytic therapy, the systemic thrombolytic therapy with streptodekase should be preferred as it is simplier, safer and easier to apply.

[Factors contributing to the success of intracoronary thrombolytic therapy]. / Faktory, vliiaiushchie na uspekh intrakoronarnoi tromboliticheskoi terapii.

Intracoronary thrombolytic therapy (ICT) was used in 36 patients with acute transmural myocardial infarction. Recanalization of an infarction-dependent artery was achieved in 26 (72.2%) patients. Factors affecting the success of ICT were analysed, using Bayes' theorem. The ejection fraction (EF) is shown to have the highest predictive value as an indicator of left-ventricular pump function. The anticipated probability of ICT success is 84.9% in patients with acute myocardial infarction and a 35% EF baseline, and 25.7% in those with a 35% EF. In the absence of severe left-ventricular pumping and contractility disorders, the success of ICT is affected by patient's age, history of myocardial infarction and the site of thrombotic occlusion.

[Isolated coronary stenosis: clinical picture, contractile function of the left ventricle and central hemodynamics]. / Izolirovannyi koronarnyi stenoz: klinika, sokratitel'naia funktsiia levogo zheludochka, tsentral'naia gemodinamika.

Clinical manifestations of coronary disease, medical history, left-ventricular segmental contractility and central hemodynamics were examined in 54 patients, aged 32 to 45, with an isolated 75-99% stenosis of a major coronary artery. The most common isolated stenosis in the anterior interventricular branch (AIVB) of the left coronary artery is associated with more severe clinical coronary symptoms. Total damage to the coronary channel is twice as great where AIVB is affected as it is with lesions of the right (RCA) or the circumflex (CA) coronary artery. AIVB stenosis results in more serious disorders of left-ventricular segmental contractility and central hemodynamics, with the end diastolic index showing the most dramatic rise. Isolated AIVB stenosis is associated with a higher risk of myocardial infarction, as compared to the RCA or CA stenosis.

[Coronary circulation and left ventricular function in patients with transmural myocardial infarct]. / Sostoianie koronarnogo krovotoka i funktsii levogo zheludochka u bol'nykh, pereneshikh transmural'nyi infarkt miokarda.

Hemodynamics and left-ventricular segmental contractility were examined in 72 patients, subjected to selective coronarography and ventriculography. Forty-six patients had a history of anterior, and 26, posterior, transmural myocardial infarction (MI). Atherosclerotic stenosis of coronary arteries (more than 75% of vascular diameter) was revealed in 67 of 72 patients. Residual occlusion was shown to occur more commonly in the right coronary artery. Collateral flow was more commonly associated with a history of myocardial infarction affecting the posterior wall of the left ventricle, while segmental contractility disorders, even aneurysms, and generalized disturbance of left-ventricular contractility, as manifested in reduced mean rate of myocardial circular fibre shortening, were more typical for the affection of the anterior wall of the left ventricle.

[Intracoronary thrombolytic therapy of myocardial infarction]. / Intrakoronarnaia tromboliticheskaia terapiia infarkta miokarda.

The results of intracoronary thrombolytic therapy with avelysine given to 21 patients with acute myocardial infarction are described. Intracoronary thrombolysis was performed on the average 5 h and 30 min after myocardial infarction onset. Recanalization of the coronary artery was attained in 16 patients, with no lethal outcomes. One patient died out of the 5, in whom attempts to recanalize the artery ended in failure. Recanalization of the coronary arteries led to improvement of left ventricle function and appreciably accelerated the time-course of the enzymatic shifts (KPK and LDH) in blood of myocardial infarction patients. After successful recanalization of the coronary artery the disease in myocardial infarction patients took a far milder course as compared to those who did receive intracoronary thrombolytic therapy.

[Relationship between myocardial contractility and collateral circulation in patients with ischemic heart disease]. / O zavisimosti sokratimosti miokarda ot kollateral'nogo krovoobrashcheniia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

By analyzing coronary angiograms and ventriculograms of 61 patients with the narrowed lumen of one or several coronary vessels by 90-100%, the dependence of the contractile function of the myocardium on the development of the collateral circulation in the cardiac muscle was studied. The assessment of the segmentary contractility of the left ventricle served as a criterion of the efficiency of the collateral circulation. The segmentary contractility was shown to be dependent on the presence or absence of the collateral circulation and also on the number of damaged vessels. The collateral circulation was also demonstrated to contribute to the maintenance of the contractile function of the myocardium.