[Diastolic filling of the right ventricle in patients with arterial hypertension and ischemic heart disease]. / Diastolichne napovnennia pravoho shlunochka u khvorykh z arterial'noiu hiperetenziieiu ta na ishemichnu khvorobu sertsia.

Our objective in this study was to compare particular features of pathogenesis of diastolic dysfunction of the right ventricle (RV) in patients with arterial hypertension (AH), stable exertional angina, and myocardial infarction of the left ventricle (LV) and to establish diagnostic significance thereof. As many as 429 AH patients presenting with different clinical forms of ischemic heart disease (IHD) were examined. Of these, 209 patients presented with stage I to III AH, 105 had functional class (FC) I-III stable exercise-induced angina, 115 patients had acute LF myocardial infarction (MI) verified by clinical findings, changes in ECG, and time-course of activity of myocardial enzymes. The control group was 30 essentially healthy subjects with no signs of cardiovascular and respiratory affections. All examinees underwent Doppler echocardiography as recommended by the American Society of Echocardiography. Measured in the above series were LV wall relative thickness, LV ejection fraction (EF) as recommended by L. Teichholz et al., LV isovolumetric relaxation time (IVRT), peak velocities of early (E) and atrial (A) filling of the heart's ventricles, E/A ratio, early diastolic filling deceleration time (DT) for both transmitral and transtricuspid flows, acceleration time of systolic flow in the pulmonary trunc as an indirect indicator of pressure in it. In AH patients, there was a close direct correlation between indices for filling of both ventricles (E/A ratio, E-wave DT and IVRT) but no significant correlation between indices for RV diastolic function and dimensions of left chambers or LV EF. In AH patients, disturbances in the diastolic function of the heart were at their greatest in eccentric hypertrophy of the myocardium when in the presence of pseudonomal and restrictive indices for LV filling "pseudonormalization" of the transtricuspid flow was being formed. In stable angina and MI, it was LV systolic dysfunction and pulmonary diastolic dysfunction that proved to play a major part in the development of RV diastolic dysfunction, its indices correlating significantly with heart failure and stable angina functional classes.

[Diastolic dysfunction of the myocardium: the mechanisms of its development, its diagnosis and treatment characteristics]. / Diastolichna dysfunktsiia miokarda: mekhanizmy rozvytku, diahnostyka, osoblyvosti likuvannia.

Diastolic dysfunction of the myocardium (DDM) is a very common abnormality having an important part in the origination of cardiac insufficiency. The main factors of DDM pathogenesis include greater rigidity of the myocardium, its hypertrophy and failure to relax normally. Findings from echocardiography and invasive techniques allow the DDM diagnosis to be made and hemodynamic patterns to be ascertained. Treatment options are to be chosen with regard to the underlying condition, with the beta-blockers and calcium antagonists being given the preference over other medicinal substances.

[The mechanisms of diastolic dysfunction and their assessment by a Doppler method]. / Mekhanizmy diastolichnoï dysfunktsiï ta ïkh otsinka doplerivskym metodom.

The Doppler method makes possible to reveal the relaxation disturbances and the increased left ventricular (LV) stiffness-pathophysiologic mechanisms of diastolic myocardial dysfunction (DMD), exerting opposite influence on the correlation of transmitral flow peaks. The decrease of the "diastolic reserve" in the patients with lung congestion is useful to diagnose DMD. But the type of LV filling, when the relative role of early diastole is decreased and of the late diastole-increased, cannot itself be recognized as pathologic. From the other side, the normal transmitral flow graphics doesn't allow to exclude DMD completely. The interpretation of Doppler parameters must take into consideration other factors influencing the LV diastolic filling: preload, systolic dysfunction and mitral regurgitation.

[Cardiac involvement in Reiter's disease]. / Urazhennia sertsia pry khvorobi Reitera.

The present article discusses modern concepts on possible instances of cardiovascular involvement in Reiter's disease during the early and late stages of this medical condition. A case is reported in a clinical setting of left ventricular dilatation development and complicated life-threatening arrhythmia in a patient presenting with Reiter's disease.