[The effect of antianginal preparations on the hemodynamics and metabolism of the ischemic myocardium].

The effect of nitroglycerin, beta-blockers, and calcium antagonists on the main parameters of central hemodynamics and myocardial metabolism is described. The original algorithm of the choice of the most effective drug or a combination of drugs depending on the initial state of central hemodynamics and coronary venous blood flow is presented.

[Verapamil binding with the blood erythrocytes and cardiac output in myocardial infarct patients].

In 14 patients with myocardial infarction the degree of verapamil binding with blood erythrocytes after a single oral administration (80 mg/kg) and the dependence pharmacological effect, the minute heart output (+ % MOC), on verapamil content in plasma and erythrocytes were studied. Intraindividual variability of verapamil distribution coefficients between erythrocytes and plasma (RBC/Ptot) is 9.7 +/- 2,3%, and it differs reliably from values of inter-individual variability of this index (33.

[Myocardial function in patients with type I diabetes mellitus].

Myocardial contractility was examined in patients with type I diabetes mellitus without coronary disease by selective tolerance test with transesophageal heart stimulation using doppler cardiography. Nineteen diabetics aged 17 to 36 with the disease duration from 0 to 20 years were examined. Maximal ejection time before and after the test was assessed.

[The effect of transvenous laser therapy on lipid peroxidation function in patients with ischemic heart disease].

The papers deals with changes in the levels of lipid peroxidation products in patients with stable angina of effort, which occurred with intravenous helium-neon blood irradiation. The therapy was highly effective in patients with lower functional classes and persons with normal circulation, resulting in a reduction in lipid peroxidation intensity. Predictors are recommended to determine the efficiency and expediency of laser therapy in patients with coronary heart disease.

[Intravenous obsidan-induced changes of coronary venous blood flow in patients with coronary heart disease in the presence of transient myocardial ischemia].

Intravenous obsidan was evaluated for its effects on the blood flow in the coronary sinus and the major cardiac vein in 23 coronary heart disease patients with hyperkinetic central hemodynamics. The use of the drug was found to be effective when the patients had had high baseline coronary venous blood flow. At the peak of cardiac pacing, the patients with low coronary sinus blood flow on obsidan showed decreased blood flow in the ischemic myocardial portions, developed signs of left ventricular failure and diminished anginal threshold.

[Comparative evaluation of the effectiveness of using peripheral vasodilators in the treatment of patients with acute myocardial infarction complicated by left-ventricular failure].

The effects of intravenous nitroglycerin, isodinit, and monizid were compared in patients with myocardial infarction complicated by left ventricular failure. Central and peripheral hemodynamic parameters, coronary venous blood flow and precardial mapping data were analyzed. The drugs were found to be potent vasodilators in the treatment of these patients; the mechanism of their action was identical.

[Coronary venous blood flow in patients with acute myocardial infarction].

In 94 patients with large myocardial infarction, their coronary venous blood flow was studied in the acute period of the disease by continuous coronary sinus thermodilution. No relationship was established between the coronary venous blood flow and the duration of coronary heart disease. The patients with anterior myocardial infarction had a significantly less blood flow in the vena cordis magna than those with posterolateral infarction.

[Status of coronary venous blood flow in patients with ischemic heart disease in myocardial ischemia induced by the atrial stimulation test].

A total of 85 patients (68 with coronary heart disease in the presence of effort angina of various functional classes (a major group) and 17 with neurocirculatory++ dystonia and cardialgic syndrome (a control group)) were examined. Heart failure severity and blood flow distribution in the functioning myocardial areas were evaluated in transient ischemia induced by atrial pacing. Three levels of coronary venous blood flow were defined in patients with coronary heart disease.

[Diagnostic and prognostic value of quantitative indicators of 12 ECG leads in ischemic heart disease].

The study was undertaken to examine 35 patients with chronic coronary heart disease and 20 patients with neurocirculatory dystonia concurrent with the cardialgic syndrome, the latter were enrolled into a control group. Detection of sigma R in the standard leads of resting ECG and at the peak of atrial pacing made it possible to single out groups of chronic coronary heart disease patients, which differed in clinical manifestations of the disease, myocardial contractility, hemodynamics, and myocardial lactate extraction. In patients with chronic coronary heart disease ti is recommended to use ECG measurements (sigma R and nST) in the standard leads during loading tests to give a comprehensive characterization of the pump function and the severity of myocardial ischemia, the prognosis of the natural history of the disease and risk for myocardial infarction.

[Effect of the intravenous administration of finoptin on coronary venous blood flow in patients with ischemic heart disease].

Intravenous finoptin (verapamil), 10 mg, was tested for effects on the coronary venous blood flow by probing the coronary sinus and great vein of the heart and performing atrial pacing in 24 patients with ischemic heart disease and eukinetic central hemodynamics. In persons who had had initial high blood flow in the coronary sinus, the agent was found to induce resting coronary venous blood flow changes which were inadequate for its demand and during cardiac pacing; whereas in patients with mean initial venous blood flow values, finoptin enabled myocardial oxygen consumption to be provided both in the region of non-infarcted myocardium and in the ischemic area.

[Effect of isoptin on catecholamine levels in arterial and coronary venous blood during an attack of myocardial ischemia].

Blood catecholamines (dopamine, adrenaline and noradrenaline) were measured in the coronary sinus and artery of 35 patients divided into 2 groups: coronary patients with stable angina of effort, functional class II-III (group 1) and patients with NCD (group 2), before and during a cardioselective load test (atrial stimulation). Developing myocardial ischemia was associated with a significant rise of noradrenaline in arterial and coronary venous blood. The use of isoptin changed noradrenaline balance, resulting in increased noradrenaline level in the coronary sinus, while coronary flow increased, as did the anginal threshold.

[Effect of myocardial ischemia on the metabolism of nonesterified fatty acids].

The pattern of nonesterified fatty acid consumption was assessed on the basis of the arteriovenous difference during the atrial stimulation test in patients with neurocirculatory dystonia and coronary heart disease. NEFA extraction coefficients were shown to be basically different in these two groups of patients, possible evidence of disturbed lipid metabolism in coronary disease.

[Effect of obzidan on coronary blood flow in patients with the hyperkinetic type of hemodynamics in the acute period of myocardial infarct].

Changes in the rate of coronary venous flow through the affected area under the effect of intravenous jet injections of propranolol, 0.1 mg per 1 kg body weight, were assessed in 18 patients of the hyperkinetic central hemodynamic type during acute myocardial infarction. In the first group of patients, whose mean flow rate through the affected wall was 106.

[Effect of myocardial ischemia on prostacyclin and thromboxane levels in arterial and coronary venous blood].

Variations in arterial and venous blood prostacyclin and thromboxane were examined in 32 patients with coronary heart disease, neurocirculatory dystonia and the cardialgic syndrome, exposed to cardioselective stress as a result of the atrial stimulation test. Prostacyclin and thromboxane measurement in blood specimens obtained from the left ventricle and the coronary venous network may provide additional markers of myocardial ischemia in cases where diagnosis is otherwise difficult to make.

[Central hemodynamic function of neurocirculatory dystonia patients at rest and during the performance of load tests].

Central hemodynamic (CH) parameters were examined in 288 patients with neurocirculatory dystonia (NCD) and 50 normal subjects, using radiocardiography (RCG), echocardiography (EchoCG) and heart catheterization thermodilution (TD). All the tests were carried out at rest and during bicycle ergometry (BEM), the atrial stimulation test (AST) and the intravenous isadrin test (IT). Patients with severe NCD and basically hyperkinetic hemodynamic type responded to stress with an inadequate rise in the minute volume (MV) and a decline of the stroke index (SI).

[Effect of ischemic state on myocardial utilization of nonesterified fatty acids].

In patients with ischemic heart disease (IHD), neurocirculatory dystonia (NCD) and acute myocardial infarction (AMI), we observed significant, positive, linear correlations between total concentration of non-etherified fatty acids (NEFA) as well as between the percentage of individual fatty acids in arterial and coronary sinus blood. Correlation analysis of the results demonstrated that in patients with IHD and NCD there is significant myocardial NEFA extraction which is highly reduced by electrically induced myocardial ischemia in patients with IHD and by increased myocardial load in patients with NCD. These changes are more evident in patients with IHD.

[Relation between indices of ECG cartography, central hemodynamics and myocardial energy metabolism in acute infarct].

A study of 30 patients with acute myocardial infarction, including the assessment of central hemodynamic parameters, ECG records from 35 leads and the investigation of myocardial energy metabolism by means of lactate, nonesterified fatty acids and glucose measurement in coronary venous blood, demonstrated that hyperkinetic hemodynamics was associated with a great spread of the necrotic and ischemic zone and predominant myocardial extraction of nonesterified fatty acids in uncomplicated acute myocardial infarction. It is suggested that propranolol should be used in those cases where hyperkinetic hemodynamics complicate the course of acute myocardial infarction.

[Clinical and hemodynamic effects of captopril in patients with chronic circulatory failure].

The effect of a new drug, captopril, an inhibitor of the enzyme responsible for the conversion of angiotensin I to angiotensin II, were examined in 15 patients with chronic circulatory insufficiency in the presence of coronary heart disease. The efficiency of single doses and four-week courses of the drug was assessed. Captopril was shown to reduce significantly pulmonary arterial occlusion pressure and total peripheral resistance and increase the minute volume, thus improving left-ventricular function.

[Effect of isoptin on myocardial hemodynamics and contractility during an anginal attack induced by the atrial stimulation test].

The effect of 10 mg intravenous isoptin on myocardial hemodynamics, contractility and metabolism during an anginal attack provoked by the atrial stimulation test was examined in 15 coronary patients with angina of effort. Isoptin administration increased anginal threshold, reduced the values indicative of cardiac activity and myocardial oxygen requirement and had no basic effect on coronary flow, while metabolic manifestations of ischemia were neutralized. Isoptin is recommended as an effective means of treatment for angina of effort in patients with atherosclerotic lesions of coronary arteries.

[Comparison of the indices of left ventricular pumping function, contractility, myocardial metabolism and the magnitude of the R wave on the ECG of ischemic heart disease patients].

Central hemodynamics, myocardial contractility and consumption of major energy substrates (lactate, glucose, non-esterified fatty acids, NEFA), as well as the total R wave amplitude from 12 standard leads were assessed in 20 patients with neurocirculatory dystonia (the control group) and 36 patients with chronic coronary disease. The changes in central hemodynamics and contractility were particularly marked in 12 of the more severe coronary cases with a raised total R wave amplitude. Myocardial energy supply in such patients is provided at the expense of NEFA.