[Sudden cardiac death: the possible role of latent myocardial ischemia in the mechanisms of its formation and development]. / Raptova sertseva smert': mozhnaia rol' latentnoï ishemiï miokarda v mekhanizmakh formuvannia i rozytku.

An analysis was performed of comprehensive (non-invasive and invasive) observations of IHD patients presenting with atherosclerotic lesions of coronary arteries of the heart and atypical clinical picture of the condition. A possibility was shown of a significant obstruction of arteries of the heart in atypical localization of pain and in those patients who had not derived much benefit from nitroglycerin during the development of ischemia and measures instituted against it. Inadequate reaction to nitroglycerin may be explained by specificities of changes in the vegetative nervous system, by the hemodynamics reaction, and, in the first place, by a propensity for developing tachycardia under physical loading, emotional stress, and after ingestion of nitroglycerin.

[The hormone level of the blood from the aorta and the coronary sinus in patients with ischemic heart disease under conditions of preoperative stress]. / Soderzhanie nekotorykh gormonov v krovi iz aorty i koronarnogo sinusa u bol'nykh ishemicheskoi bolezn'iu serdtsa v usloviiakh predoperatsionnogo stressa.

A total of 156 patients with ischemic heart disease were examined under conditions of preoperative stress in a multiple-modality study performed with the aid of such techniques as echocardiography involving calculation of the myocardial mass index, coronaroventriculography, measurements of the adrenocorticotrophic hormone, hydrocortisone, somatotrophic hormone, triiodothyronine and thyroxin in the blood from the coronary sinus and aorta. A conclusion has been reached that emotional strain influences myocardial hypertrophy. A possible significance of the studied hormonal indices is shown together with features thereof in IHD patients presenting with different degrees of left ventricular hypertrophy.

[General trends in the pathomorphosis of surgical diseases of the thyroid after the Chernobyl catastrophe]. / Obshchie tendentsii patomorfoza khirurgicheskikh zabolevanii shchitovidnoi zhelezy posle chernobyl'skoi katastrofy.

An analysis is presented of changes in the patterns of surgical pathologies of the thyroid gland that had occurred during the 15-yr follow-up of the Kiev Region representatives operated on in a specialized clinic facility. Increase in the incidence rates of autoimmune Hashimoto's thyroiditis, benign and malignant tumours of the thyroid gland--such were main trends in pathomorphosis of thyroidal pathologies having been noted during the post-ChPP accident years. Increase in the number of cases of carcinoma with concurrent hyperplastic and autoimmune thyroid diseases attests to the need for a comprehensive evaluation of patients presenting with different forms of goiter as well as for their surgical treatment in a timely fashion.

[Myocardial ischemia occurring during coronary ventriculography in patients with ischemic heart disease]. / Ob ishemii miokarda, voznikshei v protsesse koronaroventrikulografii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Analysis of myocardial ischemia that occurred during coronary ventriculography in patients suffering from ischemic heart disease (IHD) depending on the severity of the illness showed that it tended to develop in patients with the most restricted coronary reserve, clinically apparent affection of major arteries of the heart and significant dysfunction of left ventricular myocardium. While preparing patients for the invasive evaluation it is necessary that the clinical course of the disease be taken into consideration. At most risk in this respect are persons whose IHD course is aggravated by myocardial infarction and associated with hypertensive disease.

[Ventricular arrhythmias in patients with ischemic heart disease: a possible role of the autonomous nervous system]. / Zheludochkovye narusheniia ritma u bol'nykh ishemicheskoi bolezn'iu serdtsa: vozmozhnaia rol' avtonomnoi nervnoi sistemy.

To reveal possible factors that initiate ventricular arrhythmias (VA) in patients with coronary heart disease (CHD), a total of 44 patients with documented coronary artery stenosis were examined. The patients underwent coronary ventriculography, bicycle ergometry, 24-hour Holter monitoring, and examination of the autonomic nervous system (ANS). In 24 patients (Group 1), myocardial ischemic episodes were accompanied by VA. The latter were absent in myocardial ischemia in 20 patients (Group 2). In the two groups, there were no statistically significant differences in parameters, such as severity of atherosclerotic lesion of coronary arteries, total ejection fraction, existence of regional asynergy, exercise tolerance, number of daily myocardial ischemic episodes, their duration, degree of ST segment displacement. Increased activity of the sympathetic ANS was detected in 20 (83.3%) patients from Group 1 and only in 3 (15%) from Group 2 (p < 0.05). It is suggested that enhanced functional activity of ANS may be a prerequisite for displaying arrhythmogenic mechanisms in myocardial ischemia.

Significance of myocardial ischaemia before cardiac catheterisation in patients with ischemic heart disease.

Eighty one patients with ischemic heart disease divided in four groups (group 1, n = 24, without ischemia; group II, n = 20, myocardial ischemia before invasive procedure; group III, n = 18, myocardial ischemia during invasive procedure, group IV, n = 19, myocardial ischemia before and during the invasive procedure) were studied at rest, by bicycle ergometric exercise test and cardiac catheterisation (including selective coronary angiography) to assess the response of autonomic nervous system as judged by the non-invasive parameters of myocardial oxygen demand. Patients in group II and IV had increased double product before the invasive procedure, diminished coronary reserve and left ventricular ejection performance although the vessel involvement in these groups was similar to that of other two groups. Patients with ischemic heart disease manifest different degree of myocardial ischemia before and during cardiac catheterisation depending upon the activity of autonomic nervous system.

[Causes and significance of myocardial ischemia occurring during coronary-ventriculography in patients with ischemic heart disease]. / Prichiny i znachenie ishemii miokarda, voznikaiushchei pered koronaroventrikulografiei u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A relationship was examined between the development of myocardial ischemia in patients with coronary heart disease before coronary ventriculography and the status of coronary vessels, coronary reserve, myocardial contractility, and the autonomic nervous system. Before coronary ventriculography, myocardial ischemia was found to occur in the patients when there was a marked activation in the sympathetic portion of the autonomic nervous system and a clear-cut decrease in coronary reserve. The occurrence of myocardial ischemia in the patients before coronary ventriculography contributed to decreased left ventricular myocardial contractility and increased the cardiodepressive effects of a contrast agent.

[Complications and side effects in patients with ischemic heart disease before coronary and ventricular radiography]. / Ob oslozhneniiakh i pobochnykh reaktsiiakh u bol'nykh ishemicheskoi bolezn'iu serdtsa do koronaroventrikulografii.

The author analyzes the reaction (myocardial ischemia, disorders of the cardiac rhythm and their associations) in 151 patients with ischemic heart disease immediately before the initiation of narcosis in patients undergoing coronary and ventricular radiography. Several disorders were revealed and measures on the prophylaxis and treatment of these disorders are proposed.

Significance of left ventricular shape, its blood supply and calcium turnover for evolving myocardial hypertrophy.

To explore relationship between hypertrophy of left ventricle and its shape, blood supply and calcium turnover, the study enrolled 105 male patients with ischemic heart disease or those suspected of its presence. All patients underwent contrast coronary ventriculography, M-mode echocardiography and sectorial scanning. Moderately limited myocardial blood supply was found to be a factor, stimulating its local hypertrophy. In the event of severely impaired blood supply, no substantial myocardial hypertrophy is detectable in corresponding regions, while dynamic observation not infrequently reveals thinning of the wall. Patients with intact coronary arteries, and having more elongated shape of left ventricular cavity, demonstrate larger thickness of walls along the long axis, that is probably due to dependence of intramyocardial tension on the radius of the wall curvature. While performing ventriculography in the patients with hypertrophic myocardium, disclosed elevated level of calcium in the blood and enhanced calcium uptake by cardiac muscle versus patients without left ventricular hypertrophy.