[Echocardiographic evaluation of left ventricular function in patients after myocardial infarction treated with enalapril]. / Echokardiograficzna ocena czynnosci lewej komory u chorych po zawale serca leczonych enalaprylem.

The studies were carried out in 30 patients (24 men and six women) aged 40-56 years, mean age 51 years after myocardial infarction in whom enalapril in doses 5-10 mg daily, mean dose 8,5 mg daily was added to drugs used as yet. This drug was administered for six weeks. The patients had myocardial infarction 6-18 months before their inclusion to the studies. In all patients two-dimensional echocardiographic and Doppler examinations were performed twice: before and after the treatment with enalapril. Left ventricular contractility disturbances and the following parameters were analysed: maximal early diastolic filling rate (EDF), maximal late diastolic filling rate (LDF), EDF/LDF ratio and early diastolic deceleration time (dec. EDF) and early diastolic slope (EF sl.). Enalapril administered in patients after myocardial infarction caused an increase of ejection fraction and increase of the contractility of left ventricular muscle segments not involved by necrosis. It exerted, however, no effect on the changes of contractility index. After the treatment with enalapril the maximal late diastolic filling rate (LDF) was significantly decreased while early diastolic deceleration slope (EF sl.) was significantly increased. The observed influence of enalapril on the left ventricular filling profile may suggest an improvement of left ventricular diastolic function.

[Effect of physical exercise on aortic blood flow in patients with primary arterial hypertension]. / Wplyw wysilku fizycznego na przeplyw krwi przez aorte u chorych z pierwotnym nadcisnieniem tetniczym.

In 40 patients (30 men and 10 women) aged to 21 to 48 years (mean 42 years) with essential hypertension stage II, according to WHO classification, blood flow was recorder in the ascending aorta by Doppler echocardiography. The investigation was done in erect position, at rest, and during 30 seconds of each phase of exercise on moving track. The control group comprised 20 healthy males aged 23-45 years (mean 38 years). In essential hypertension the values of the heart rate (T), maximal (MAX-V) and mean (ME-V) flow velocity, and systolic volume index (SVI) were significantly higher at rest than in controls. In the 3rd minute of exercise the values of heart rate (T), mean flow acceleration (ACC) and minute volume index (COI) were significantly higher in the patients than in controls. At the peak exercise MAX-V, ME-V and COI were significantly lower than in controls. On the other hand, in the 5th minute after the exercise the values of all the analysed blood flow parametres in the aorta were significantly higher in the patients. After the exercise the fall of the integral flow (INTG) and SVI greater in controls than in patients, while the rise of the mean flow acceleration (ACC) was higher in hypertension than in health.

[Effects of verapamil and propranolol on the left-ventricular diastolic function in patients with primary arterial hypertension]. / Werapamil i propanolol a czynnosc rozkurczowa lewej komory w pierwotnym nadcisnieniu tetniczym.

Mitral flow was assessed by Doppler echocardiography in patients with systemic hypertension. The study was carried out on 40 patients (27 men and 13 women) aged 24-50 years, mean 43 years with essential hypertension stage II according to WHO classification. No patient had other heart disease or diabetes. All patients were randomly assigned to verapamil (20 patients) or propranolol (20 patients). The daily dose of verapamil was 60-120 mg, mean 80 mg and propranolol 120-180 mg, mean 140 mg. Pulsed Doppler studies in all patients were performed before the treatment and after 4-6 weeks of the treatment. Echocardiographic examination was performed with Hewlett-Packard 707020 A ultrasound system using 2.5 MHz transducer. Two dimensionally guided pulsed Doppler echocardiograms were recorded with sample volume positioned in the inflow area below the mitral annulus. The following Doppler parameters were measured: early diastolic flow velocity (EDF), late diastolic flow velocity (LDF) and their ratio (EDF/LDF) which represents the ratio of early and late diastolic flow velocity of left ventricular filling. The study has showed that before treatment the value of EDF, LDF and EDF/LDF ratio in both groups did not significantly differ. Heart rate and arterial pressure in patients with systemic hypertension after treatment with verapamil or propranolol were significant lower than before treatment. Treatment with verapamil caused significant increase of EDF from 61.2 to 78.2 cm/sek and increase EDF/LDF ratio from 1.02 to 1.30. While LDF values were not changed. In the group of patients treated with propranolol the values of EDF, LDF and ratio EDF/LDF were similar to those before treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Curves of aortic and mitral flow recorded by Doppler echocardiography in patients with primary hypertension]. / Krzywe przeplywu aortalnego i mitralnego rejestrowane badaniem echokardiograficznym metoda Dopplera u chorych z pierwotnym nadcisnieniem tetniczym.

The systolic and diastolic left-ventricular myocardium function was assessed by Doppler echocardiography in patients with hypertension. The study was carried out on 40 patients (26 men and 14 women) aged 21-50 years (mean 45 years) with essential hypertension, stage II according to WHO classification. The control group comprised 20 healthy subjects aged 19-48 years (mean 43 years). In patients with hypertension, as compared to controls, the Doppler curve of aortic flow showed an increased maximal and mean velocity of flow, the ejection time was shortened, and the ejection time to acceleration time index was decreased. The Doppler curve of the mitral flow in the patients showed reduced maximal velocity of early diastolic flow, increased velocity of maximal end-diastolic flow, decreased fraction of rapid left-ventricular filling, and lower ration of maximal early diastolic to end-diastolic flow. Doppler echocardiography is a useful method for assessment of left-ventricular myocardium functions in hypertension.

[Dynamics of left ventricular contraction in patients with myocardial infarction after hospital rehabilitation, assessed by Doppler echocardiography]. / Dynamika skurczu lewej komory u chorych z zawalem serca po rehabilitacji szpitalnej oceniana za pomoca echokardiografii dopplerowskiej.

The reported study was carried out in 30 men with myocardial infarction. In all cases after completion of rehabilitation treatment in hospital the exercise test was done on cycle ergometer and echocardiographic examination was performed (TM, 2D and Doppler). The patients were divided into two groups depending on the size of the necrotic zone (limited or extensive infarction in ECG) and physical fitness (low and high) determined by means of the PCW-170 test. In such formed groups certain left-ventricular contraction parameters (PEP, PEPI, LVET, LVETI, PEP/LVET, CO) were calculated by means of Doppler echocardiography. It was found that after hospital rehabilitation the patients with extensive myocardial infarction had significantly lower values of LVETI, SV, CO and higher PEP/LVET value in relation to patients with limited infraction zone, which suggested worse left-ventricular contraction. Moreover, patients with lower physical fitness had worse left ventricular contraction activity (significantly lower values of LVET, LVETI, SV, CO, and higher value of PEP/LVET) than patients with better fitness. Thus the indices describing the left-ventricular contraction activity calculated by means of Doppler echocardiography correlated well with fitness and infraction zone size. The method of Doppler echocardiography is useful for determination of left-ventricular contraction activity after myocardial infraction and for programming of exercises during rehabilitation treatment in hospital.

[Effect of the treatment with propranolol and pindolol on selected hemodynamic parameters in patients with primary arterial hypertension]. / Wplyw leczenia propranololem oraz pindololem na zachowanie sie wybranych parametrów hemodynamicznych u chorych z pierwotnym nadcisnieniem tetniczym.

On the basis of echocardiographic investigations changes were analysed of certain haemodynamic parameters in 40 patients aged 21-50 years, mean 44 years, with primary arterial hypertension in stage II according to WHO classification. All patients were randomly chosen to receive for 6-9 weeks propranolol 120-480 mg daily, mean dose 280 mg, or pindolol 10-35 mg daily, mean dose 22 mg daily. The changes developing during the treatment with both drugs in relation to the initial values included the mean arterial blood pressure, the heart rate, the index of cardiac output and the systolic left-ventricular tension. In the studied patients treated with propranolol the heart rate and the ejection volume were decreased more than during pindolol treatment. Propranolol increased evidently the total peripheral vascular resistance and decreased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol decreased slightly the peripheral vascular resistance and increased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol, in relation to propranolol, had a more favourable effect on haemodynamics in patients with primary hypertension.

[Value of Doppler echocardiography in evaluating pulmonary arterial pressure in patients with mitral valve defect]. / Wartosc badania echokardiograficznego metoda Dopplera w ocenie cisnienia w tetnicy plucnej u chorych z wada mitralna.

In 40 patients aged 25-52 years (mean 36 years) with mitral valve disease but without overt circulatory failure haemodynamic studies and echocardiographic examinations were carried out recording the blood flow in the pulmonary artery and the blood flow through the tricuspid valve by pulsating and continuous-wave methods. From the obtained curves the time was calculated from the beginning of the flow to its maximum (TPV), the pre-ejection time (RPEP) and the right-ventricular ejection time (RVET), and the indices TPV/RVET and RPEP/RVET. Moreover, in 14 patients with coexistent insufficiency of the tricuspid valve the systolic pressure in the pulmonary artery was calculated by determining the systolic gradient across the tricuspid valve. On the basis of the results of haemodynamic examination the patients were divided into two groups: with normal (24 patients) and with raised (16 patients) pressure in the pulmonary artery. In the group of mitral valve disease and pulmonary hypertension a significantly shorter TPV, lower values of the TPV/RVET index and greater values of the RPEP/RVET index were found as compared with the patients with mitral disease and normal value of the systolic arterial pressure in the pulmonary artery. The systolic arterial pressure in the pulmonary artery determined on the basis of Doppler echocardiography with measurement of the regurgitation wave in tricuspid valve insufficiency showed a high agreement (r = 0.94) with the pressure recorded during cardiac catheterization.

[Value of sustonit in the treatment of patients with stable angina pectoris]. / Wartosci preparatu sustonit w leczeniu chorych z dusznica bolesna stabilna.

The clinical trial was carried out in 40 men with stable angina receiving for three weeks Sustonit mite or forte. Before and after three weeks of the treatment the exercise test was done on cycle ergometer, followed by echocardiography (for evaluation of left ventricular function) noting also the number of anginal pains and the number of nitroglycerin tablets taken as emergency treatment. In the light of the obtained results it was estimated that Sustonit reduced anginal pains in 82.5% of the patients with stable angina, and exerted a beneficial effect on the left ventricular function as evidenced by increased mean velocity of shortening of the circumferential fibres and reduced number of echocardiograms with segmental contractility disturbances in the ventricular septum and posterior wall of the left ventricle after 3 weeks of treatment. Moreover, Sustoinit treatment increased significantly the amount of work done until reaching of submaximal heart rate and working time during submaximal exercise, as well as the greatest workload necessary for reaching of submaximal heart rate. The drug had no significant effect on the heart and arterial blood pressure. Sustonit mite and forte is regarded as highly valuable and effective drug in the treatment of patients with stable angina.