[Segmental dysfunction of the left ventricle in the assessment of the myocardial component in selecting patients with ischemic heart disease for an operation on the coronary arteries].

Eighty-eight coronary patients were examined, 75.8% of them were exposed to multiple aortocoronary bypass surgery. Impaired left-ventricular myocardial contractile function was found in 91.

[Functional state of the myocardium during transesophageal cardiac pacing in patients with ischemic heart disease selected for surgical treatment based on nuclear stethoscope findings].

A nuclear stethoscope was used to examine central hemodynamic parameters and myocardial contractility in 70 patients with coronary heart disease (CHD). The findings were analyzed according to the degree of cicatricial changes in the myocardium and coronary atherosclerotic lesion. The patients, unlike apparently healthy individuals, were found to show an increase in systolic cardiac output and a decrease in left ventricular ejection fraction in response to transesophageal cardiac pacing.

[Detection of cardiac insufficiency by computer-assisted monitoring of the response of intra-cardiac hemodynamics to exercise test in patients with ischemic heart disease with similar lesions of the coronary arteries (patient selection for the aortocoronary bypass)].

Preoperative identification of cardiac insufficiency in patients with ischemic heart disease (IHD) has proved essential for the success of surgery on the coronary arteries. To provide for an objective assessment of the contractile function of the myocardium in selecting candidates for surgery among IHD patients with over 70-percent narrowing of one, two, and three coronary arteries, use was made of the central hemodynamics indices in response to the loading test during right heart catheterization with computer-assisted monitoring and mathematical analysis. Two patient groups were distinguished during the hemodynamic loading test: group I showing a high and effective chronotropic reserve (+X) and group II presenting a negative chronotropic reserve (-X).

[Indications for aortocoronary shunting in relation to ejection fraction and segmental activity of the left ventricle (data of the coronarography, ventriculography and intra-cardiac hemodynamics)].

The left-ventricular ejection fraction, reflecting the contractile capacity of the myocardium according to the clinical data, is the most objective criterion in indication for the operation for aortocoronary shunting. The indices of central hemodynamics appearing in response to the exercise test during intracardiac catheterization of the right heart and monitor-computer control with mathematical analysis were used in objective appraisal of the left-ventricular ejection fraction in selecting for surgical treatment patients suffering from ischemic heart disease with normal and reduced ejection fraction of the left ventricle. Two gradations of patients with ischemic heart disease were set apart during the hemodynamic exercise test: the first--patients with a high and effective chronotropic reserve--subgroup I("+X") and the second--patients with a poor and ineffective chronotropic reserve--subgroup II("--X").