[The clinical pharmacology of antianginal agents].

This paper provides the basic advances made in studying the clinical pharmacology of antianginal agents (AAs), demonstrates the contribution of current tools for evaluating their antianginal effects, namely pharmacodynamic studies using pair bicycle ergometry and repeated treadmill exercises, 24-hour ECG monitoring, pharmacokinetic studies. It shows that AAs can be chosen on an individual basis. The authors present pharmacodynamic characteristics of a number of new AAs from nitrates (trinitrolong, dinitrosorbilong, etc.

[An assessment of the efficacy of a course of using different forms of prolonged-action nitrates in patients with stable stenocardia with the help of repeated daily ECG monitoring].

A study was made of the antianginal and anti-ischemic effects of sustac (ST) and trinitrolong (TNL) during their cross continuous use in patients with stable angina pectoris, functional class II-III (according to the classification of the Canadian Association of Cardiologists). In accordance with the daily ECG monitoring data, the three-month treatment with the effective doses of ST and TNL produced a significant lowering of the frequency and the total intensity of the episodes of ST segment depressions of the ischemic type as compared to the continuous administration of placebo. The use of criteria for evaluating the efficacy of the antianginal drugs (the decrease of the total number of ST segment depression episodes during one day by 3 and over and/or reduction of the total intensity of ST segment depression by 50% and over) made it possible to reveal varying effects of the nitrates on painful episodes (PE) and painless episodes of ST segment depression.

[Evaluation of the efficacy of a course of verapamil and nifedipine in patients with stable stenocardia by daily monitoring of the electrocardiogram].

The daily ECG monitoring was used in 20 patients with stable functional class II-III angina pectoris to study the antianginal and anti-ischemic effects of verapamil and nifedipine during the cross use of the drugs. Verapamil and nifedipine applied in the effective doses provoked a significant decrease of the number and total depth of painful depressions of the ST segment. The effect of verapamil on painful episodes of ST segment depressions was significantly more pronounced than that of nifedipine.

[Methodological approaches to the evaluation of the effectiveness of anti-anginal preparations in patients with stenocardia by 24-hour ECG monitoring].

Scientific rationale are given for methodological approaches promoting improved reproducibility of 24-hour ECG monitoring data, for the method to be used repeatedly in assessing patient's condition. Repeated 24-hour-ECG monitoring in identical motor conditions (a standard mobility regimen) has been shown to improve considerably the reproducibility of its results. Criteria for the efficiency of antianginal therapy in patients with angina of the 2nd and 3d functional classes, as evidenced by 24-hour ECG monitoring, have been developed and substantiated.

[Diagnostic value of changes in Q wave amplitude in left thoracic leads during physical loading].

The informative value of stress-induced changes in Q wave amplitude and ST segment for the diagnosis of coronary heart disease was compared in records from left chest leads. Bicycle ergometry was conducted in 74 patients with coronary angiographically documented stenosis (more than 70% of the lumen) of one or more coronary arteries, and 28 subjects showing no apparent coronary arterial changes. The lack of increment in Q wave amplitude was shown to be a fairly sensitive sign of myocardial ischemia.