Association of platelet function in hypertensive patients with left ventricular hypertrophy, transient myocardial ischemia, and coronary artery disease.

The aim of the study was to evaluate how platelet aggregation relates to left ventricular hypertrophy, presence of transient myocardial ischemia and coronary atherosclerosis in essential hypertensive patients. For that purpose platelet aggregation, symptom-limited treadmill-test, echocardiography and coronary angiography were performed in 65 male patients with uncomplicated essential hypertension. Aggregation was monitored both by a turbidometric method and by a method based on real-time estimation of mean aggregate size.

[Comparative analysis of the parameters of left ventricular systolic and diastolic functions in patients with hypertension and patients with hypertrophic cardiomyopathy].

17 patients with essential hypertension and asymmetric, 12 ones with concentric left ventricular (LV) hypertrophy and 13 patients with asymmetric hypertrophic cardiomyopathy (HCM) were examined by M-mode and Doppler echocardiography. There were significant changes of LV diastolic volumes, mitral flow velocities and phase duration in all groups of patients compared to healthy subjects. Nevertheless, the hypertensive groups had noninvolved LV systolic function.

[Anomalous chordae tendineae].

ECG of 322 patients with various cardiovascular diseases allowed the conclusion on the occurrence of anomalous chordae of the heart in 21.7% of cases. The chordae had no effect on the disease diagnosis, running, hemodynamics, left ventricular myocardial mass.

[The prognosis of the disease course in patients with hypertension and coronary failure].

The analysis of 3-year follow-up and treatment of 33 and 113 hypertensive subjects without and with coronary insufficiency, respectively, suggested the conclusion on an independent role of left ventricular hypertrophy as a risk factor of cardiac complications in hypertensive patients either with or without coronary insufficiency. A high risk of cardial complications can be expected in hypertensive patients without coronary insufficiency, but with systolic pressure above 200 mm Hg, thickness of the left ventricular posterior wall more than 1.3 cm, % delta S under 40.

Silent myocardial ischemia in patients with essential hypertension.

The aim of this study was to determine the significance of the "coronary factor" in patients with essential hypertension (EH). Electrocardiogram Holter monitoring was performed in 61 patients with EH stage II (according to the World Health Organization criteria). Silent, ie, painless ST-segment depression, was found in 34 patients on whom echocardiography, a treadmill test, and transesophageal pacing were performed.

Altered sympathetic tone in hypertensives with angina and lowered threshold for pacing ischemia.

To determine the role of the sympathetic nervous system in myocardial ischemia with essential hypertension, plasma norepinephrine, heart rate (HR), blood pressure (BP), and the HR.BP double product at the time of silent ischemia during pacing and exercise treadmill test (ETT) were compared with basal values in 20 patients with sustained essential hypertension and stable angina, 3 to 60 days (12.6 +/- 11.

[Silent myocardial ischemia in patients with essential hypertension].

Holter monitoring was performed in 61 patients with essential hypertension. Painless, silent ST segment depression was found in 34 patients. Exercise myocardial scintigraphy indicated the occurrence of transient perfusion defects without abnormal clearance (Group 1) and those with abnormal clearance (Group 2).

[Hypertension and "silent" myocardial ischemia. I. The results of stress scintigraphy of the myocardium in patients].

As many as 24 patients suffering from essential hypertension (EH) were examined. The patients were subjected to Holter ECG monitoring, echocardiography, coronary angiography, exercise scintigraphy of the myocardium with transesophageal pacing of the atria and the dipyridamole test. The patients manifested defects of thallium accumulation during exercise scintigraphy of the myocardium.

[The ST-segment-dependent indices of patients with left ventricular hypertrophy and coronary failure].

As many as 40 men suffering from essential hypertension (EH) and left ventricular hypertrophy (LVH) or hypertrophic cardiomyopathy (HCMP) were examined. All the patients exercised on a treadmill according to the Cornell protocol taking into consideration the ST/HR slope and the ST/HR index, underwent echocardiography with measurements of the left ventricular mass (LVM), and coronary ventriculography. Coronary insufficiency was revealed in all the patients.

[A painless decrease in the ST segment during the 24-hour ECG monitoring of hypertensive patients].

The daily Holter ECG monitoring and echocardiography were conducted in 61 men aged on the average 50.5..

[HLA-associated susceptibility to ischemic heart disease].

Tissue typing was used to study characteristic features of class I and II HLA-antigens distribution in two populations of young IHD patients: Russians (n-32) and Georgians (n-72). Healthy donors (267 Russians and 579 Georgians) served as controls. Genetic markers of IHD predisposition are revealed: for Russians relative risk for B12, DR1 equaled 2.

[HLA-associated predisposition to dilated cardiomyopathy].

HLA-antigens grade I and II were studied by tissue typing in 60 Russians and 40 Georgians suffering from dilated cardiomyopathy (DCMP), and 40 Georgians with virus myocarditis. 267 test-donors Russians and 579 Georgians served as control. Markers of DCMP predisposition were found different for Russians and Georgians: DR4 (relative risk 2.

[A comparative evaluation of loading tests for the diagnosis of ischemic heart disease at the prehospital stage].

Bicycle ergometry, the treadmill test, transesophageal pacing of the left atrium and 24-h monitoring of the ECG were performed on an outpatient basis in 82 persons (all men) with angina pectoris of effort and stenosing atherosclerosis of the coronary arteries verified with the aid of selective coronarography and in 17 men with intact coronary arteries. Transesophageal pacing and the treadmill test exhibited the highest sensitivity (94 and 89%, respectively) in the diagnosis of the latent forms of coronary failure. The sensitivity of bicycle ergometry (77%) was significantly lower which was caused by a considerable number (21%) of tests completed before the appearance of diagnostic criteria.

"Silent" myocardial ischaemia in essential hypertension.

During 16-h electrocardiographic monitoring of 29 patients with stage II (WHO) essential hypertension and left ventricular hypertrophy, the episodes of painless "silent" myocardial ischaemia were registered in 12. In these patients a bicycle ergometry test, transoesophageal atrial pacing, isotope ventriculography at rest and during isometric exercise, and coronary angiography in 3 cases, were performed. A comprehensive evaluation of findings revealed the presence of coronary insufficiency not accompanied by pain syndrome.

[HLA antigens in hypertension patients with myocardial hypertrophy of the left ventricle].

As many as 34 patients with essential hypertension (EH) and 66 with hypertrophic cardiomyopathy (HCMP) were examined. Concentric hypertrophy of the myocardium was identified in 14 patients with EH and 35 patients with HCMP. Asymmetric hypertrophy of the myocardium was diagnosed in 20 EH patients and 31 HCMP patients.

[Functional status of the hypertrophic left-ventricular myocardium in patients with hypertension].

27 patients with IIB stage of essential hypertension (EH) and left ventricular hyperthropy (LVH), 14 of them with IHD, were studied. In all of them coronaro- and ventriculography was performed. In 14 cases atherosclerotic alterations of coronary arteries were present.

The hypertensive heart: pathogenesis, variants, and prognostic value.

We examine the heart's involvement in arterial hypertension, reporting on several studies of hypertensive patients showing that left ventricular myocardial mass is a significant prognostic indicator of essential hypertension and that left ventricular hypertrophy (LVH) correlates with an induced increase in Ca2+ concentration in platelets. We also consider the LVH variant of asymmetric hypertrophy and the role of the hypertensive heart in coronary insufficiency, and we speculate on the significance of the degree of LVH and asymmetric hypertrophy as risk factors for predicting cardiac complications of essential hypertension.

[Comparative aspects of the structural and functional status of the myocardium in left-ventricular asymmetrical myocardial hypertrophy in patients with hypertension and cardiomyopathy].

23 patients with hypertrophic cardiomyopathy (HCMP) and 19 patients with stage II of essential hypertension (EH) with left ventricular asymmetric hypertrophy (ASH) were examined. Echocardiography demonstrated significantly more manifest hypertrophy of interventricular septum and higher coefficient of asymmetry in patients with HCMP compared to those with EH while left ventricular myocardium mass was equal in both groups. Phase-volumetric analysis exhibited in all the patients deterioration of myocardial relaxation processes.

[Origin of the pain syndrome in asymmetric myocardial hypertrophy in patients with stable hypertension].

A study of 20 patients with essential hypertension, stage IIB, asymmetrical myocardial hypertrophy and chest pains has suggested that the pain syndrome, presenting as "possible angina", positive functional tests and reduced label accumulation around the ventricular septum may be indicative of coronary insufficiency.

[Functional state of the heart in patients with hypertension and varying degrees of atherosclerosis of the coronary vessels].

Twenty-five patients with stable arterial hypertension associated with the painful syndrome in the heart region were examined. In addition to the general clinical examination, all the patients were subjected to echocardiography, bicycle ergometry, and coronaroangiography. According to the character of alterations in the coronary arteries the patients were distributed into 3 groups.

[Changes in heart function during the use of the peripheral vasodilator diazoxide on arterial hypertension patients].

An acute depression of arterial blood pressure (ABP) was achieved using intravenous injections of 300 mg diasoxide in 29 patients with persistent arterial hypertension. Peripheral vascular resistance dropped significantly, and the minute volume slightly increased at the point of the deepest ABP fall. Intracardiac hemodynamics showed no significant changes.