[Effects of potassium chloride and triamterene on kaliuresis, natriuresis and diuresis in congestive heart failure]. / Vliianie khloristogo kaliia i triamterena na kaliurez, natriiurez i diurez pri zastoinoi serdechnoi nedostatochnosti.

KCl and triamterene were given to 52 patients (27 males and 25 females with CHF) aged 21-82 years. Large-dose KCl (6 g daily) apparently stimulate kaliuresis, natriuresis and diuresis. As a rule, this is associated with a rise or a fall of plasma potassium concentrations. In the latter case potassium elimination runs more actively and may involve both introduced and body's potassium. As low and moderate doses of KCl (1-4 g daily) showed neither natriuretic nor diuretic effects while enhanced kaliuresis occurred in half of the patients only, did not lower potassium concentrations in plasma they are preferable. Daily treatment with triamterene is characterized by inhibition of its K-retaining action on administration day 2-3. Within first 2 days of triamterene discontinuation all the retained K eliminates from the body. Diuretics-induced metabolic alkalosis decreased intensification of natriuresis and diuresis resultant from large-dose KCl treatment.

[The interrelationship of left ventricular dyskinesia and silent myocardial ischemia in patients with stable stenocardia]. / Vzaimosviaz' diskinezii levogo zheludochka i bezbolevoi ishemii miokarda u bol'nykh so stabil'noi stenokardiei.

A total of 40 patients with Functional Class III-IV stable angina pectoris were examined. Silent myocardial ischemia was detected in 87.5% of patients by using 24-hour Holter monitoring. A statistically significantly greater amplitude and longer duration of pain episodes were observed. The patients underwent exercise echocardiography. Functional exercise was performed by frequent-increasing transesophageal cardiac pacing. The index of local myocardial contractility disturbances was assessed and calculated as the product sum of the number of diseases segments by the rating coefficient: hypokinesia, 1 score, akinesia, 2 scores, and dyskinesia, 3 scores. There was a statistically higher segmental asynchronism in patients having a silent myocardial ischemic episode of more than 15 min. The index of local contractility disturbance in this group of patients was 7.9 +/- 3.2 units. There was a relationship between the duration of silent myocardial ischemia and the presence of heart failure. It was concluded that the duration of silent myocardial ischemia might be used as an additional criteria for assessing the severity, prognosis and adequacy of therapy in patients with stable angina on effort.

[Silent myocardial ischemia in patients with diabetes mellitus without the clinical manifestations of ischemic heart disease]. / Bezbolevaia ishemiia miokarda u bol'nykh sakharnym diabetom bez klinicheskikh proiavlenii ishemicheskoi bolezni serdtsa.

A total of 40 patients with diabetes mellitus without anginal episodes and equivalents were studied. 24-hour monitoring identified 2 groups of patients: (1) 13 patients with recorded silent myocardial ischemic episodes and (2) 23 patients without episodes. Four patients were found to have stress-echocardiographic silent myocardial ischemia. Silent myocardial ischemia was detected in 42.5% of patients with diabetes mellitus. The patients from Group 1 exhibited more frequently Type II diabetes mellitus whose duration was over 9 years and concurrent retino- and polyneuropathies. There was a relationship between silent myocardial ischemia to heart failure and myocardial hypertrophy as evidenced by two-dimensional echocardiography. The patients from Group 1 had a higher pain sensitivity threshold than those from Group 2. Autonomic polyneuropathy was observed in 46% of Group 1 patients and in 21% of Group 2 patients.

[Painless myocardial ischemia in patients with post-infarction cardiosclerosis]. / Bezbolevaia ishemia miokarda u bol'nykh postinfarktnym kardio- sklerozom.

Holter monitoring, echocardiography and 201Tl myocardial scintigraphy were performed in 40 patients with postinfarction cardiosclerosis. The monitoring revealed silent myocardial ischemia (SMI), including 27 having SMI with concurrent anginal episodes, 7 with SMI alone. A direct correlation was found between the duration of SMI and silent myocardial infarction (r = 0.539; p less than 0.05). The patients with left ventricular failure and myocardial hypertrophy exhibited longer SMI, as evidenced by echocardiography. 201Tl myocardial scintigraphy revealed no relationship between the degree of SMI and the dimensions of a postinfarction scar. SMI was detected in 77.5% of the patients with postinfarction cardiosclerosis. The duration of SMI was longer with the presence of angina pectoris, left ventricular failure or myocardial hypertrophy.

[Effect of diltiazem on silent myocardial ischemia]. / Vliianie diltiazema na bezbolevuiu ishemiiu miokarda.

Thirty-four patients with coronary heart disease who had silent myocardiac ischemic episodes as evidenced by long-term ECG monitoring were examined. Silent ST-segment elevations and depressions were encountered 2.7- and 4.9-fold as compared to manifest ones. The fact that the CHD patients had silent ST-segment depressions and/or prolonged high-amplitude silent ST-segment elevations suggests a grave severity of abnormal myocardial processes. There was a reduction in the number, duration of silent ST-segment elevations and depression episodes and in the amplitude of silent ST-segment depressions. This may indirectly indicate that the agent affects predominantly coronary blood flow and coronary vascular tone.

[Characteristics of the treatment of ischemic heart disease with delayed-action verapamil]. / Osobennosti lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa prolongirovannym verapamilom.

Pre- and posttreatment indices of platelet and plasma hemostasis, parameters of long-term ECG-ST monitoring were measured in 30 coronary patients on long-term verapamil regimens. ++Anti-ischemic effect of the drug was dependent on clinical pattern of the disease and initial function of the platelets. Plasma hemostasis was found unaffected. Long-term verapamil treatment is indicated in stable angina pectoris class II and III provided platelets demonstrate enhanced functional activity.

[Use of food products containing polyunsaturated fatty acids of the omega-3 group in patients with disorders of lipid metabolism]. / Primenenie pishchevykh produktov, soderzhashchikh polinenasyshchen- nye zhirnye kisloty gruppy omega-3 u bol'nykh s narushennym obmenom lipidov.

The clinical efficiency of the ichtyenic oil obtained by processing some commercial fishes was explored. The oil was used as a supplement to foodstuffs: edible inchtyenic oil (EIO) in a daily dose of 30 g (containing 8.0 g omega-3 polyunsaturated fatty acids); dietary protein caviar (DPC) in a daily dose of 45 g (0.6 g omega-3 polyunsaturated fatty acids); an emulsified protein-and-fat product (EPFP) in a daily dose of 30 g (1.2 g fatty acids), EIO was given to 44 patients with dyslipidemia (Group 1), DPC to 12 (Group 2), and EPFP to 8 patients (Group 3). Following a month therapy, there was a decrease in total cholesterol (TC) by 12.2%, triglycerides (TG) by 28%, low density lipoprotein cholesterol (LDLC) by 9.4%, very low density lipoprotein cholesterol (VLDLC) by 20.0%, whereas high density lipoprotein cholesterol (HDLC) rose by 15.3% in Group 1. Group 2 showed 12.4 and 20.8% reductions in TC and TG, respectively. In Group 3, TC and TG fell by 7.1 and 8.7%, respectively. In the two latter groups, lipoprotein cholesterol remained unaltered. Thus, omega-3 polyunsaturated fatty acid-containing foods may be used to correct lipid metabolism disturbances in patients with atherogenic dyslipidemia.

[Early systolic and pansystolic murmurs--the main variants of the papillary muscle dysfunction in patients after myocardial infarction]. / Rannii sistolicheskii i pansistolicheskii shumy--osnovnye varianty shuma disfunktsii sosochkovykh myshts u bol'nykh perenesshikh infarkt miokarda.

Cardiac auscultation, phonocardiography, and two- dimensional echocardiography were performed in 32 patients who had sustained myocardial infarction in the presence of signs of mitral valve malfunction. Incomplete systolic closure of the mitral valve leaflets was detected in all the patients. The pattern of murmur appeared as its pansystolic and early systolic varieties. Apex rhomboid and late systolic murmurs were found in individual patients. The early systolic murmur was less loud and more frequently local than the pansystolic murmur. Twelve of 15 patients with the murmur proved to have an ++un-enlarged left ventricle. It is concluded that the occurrence of systolic murmur in the papillary muscle dysfunction syndrome is attributed to incomplete closure of the mitral++ valve. Left ventricular dilation results in transition of early systolic murmur to its pansystolic variant.

[Characteristics of nicardipine treatment of patients with ischemic heart disease]. / Osobennosti lecheniia nikardipinom bol'nykh ishemicheskoi bolezn'iu serdtsa.

The new calcium antagonist nicardipine (barizine) was tested for effects on platelet function and transient myocardial ischemia in 23 patients with coronary heart disease. Prior to the therapy, lower platelet function was more frequently encountered in patients with more severe angina pectoris and more prolonged myocardial ischemia. The efficacy of nicardipine was demonstrated to be related to the clinical course of coronary heart disease and the baseline platelet function. It is advisable to prescribe the drug to patients with Functional Class II stable angina and higher platelet functional activity.

[Use of dietary fish oil--an alternative to drug therapy of dyslipidemia]. / Primenenie masla ikhtienovogo pishchevogo--al'ternativa lekarstvennogo lecheniia dislipidemii.

The clinical efficacy of "Food ichthyenic oil", a new foodstuff, was studied in 129 patients with atherogenic dyslipidemia. The oil was given in a daily dose of 30 ml which contained 8 g polyunsaturated fatty acids of the omega-3 class. All the patients were divided into 3 groups: (1) 44 patients with 5.2-6.5 mmol/l cholesterol; (2) 37 with over 6.5 mmol/l, and (3) 48 with hypercholesterolemia (cholesterol over 5.2 mmol/l and hypertriglyceridemia (triglycerides over 2.3 mmol/l). Following 1-month therapy, all the groups displayed lower low density lipoprotein cholesterol levels and significantly higher high density lipoprotein cholesterol concentrations. After 4-month intake of ichthyenic oil, the levels of total and LDL cholesterol returned to the baseline values, whereas the concentration of HDL cholesterol was significantly higher than the baseline one. Following 12-month therapy, there were 15 and 14% decreases in total and LDL cholesterol, respectively, a 16% increase in HDL cholesterol. The patients from Group 3 exhibited low VLDL cholesterol and triglyceride levels.

[Effects of nicardipine in silent myocardial ischemia]. / Vliianie nikardipina na bezbolevuiu ishemiiu miokarda.

201Tl myocardial scintigraphy was performed in 29 patients with coronary heart diseases and silent myocardial ischemic episodes revealed during a long-term monitoring of ST segment. The painless ST segment depression episodes and long high-amplitude painless ST segment elevations were found to be indicative of a significant severity of pathological processes in the myocardium. A 12-day nicardipine monotherapy produced antianginal and hypotensive effects and contributed to decrease in the frequency, duration, and amplitude of silent ST-segment depressions and in the duration of silent ST-segment elevations.

Comparative evaluation of intravenous isosorbide dinitrate and nitroglycerin in patients with acute myocardial infarction.

The efficacy of isosorbide dinitrate (ISDN) and nitroglycerin was studied in 115 patients with acute transmural myocardial infarction admitted to the Coronary Care Unit not later than 12 h after the onset of chest pain: 58 patients not later than 2 h after the onset of chest pain, 49 after 3-6 h and 8 patients in the period of 6-9 h. There were 69 men and 45 women, mean age 62.4 +/- 0.9 years. The duration of the preceding clinically evident coronary artery disease was in 12 patients 1 year, in 29 2-3, in 22 4-5 and in 16 patients 6 years or more. In 36 cases the chest pain of acute infarction was the first presentation of coronary artery disease. Thirty-seven patients had a previous myocardial infarction. Fifty patients had concomitant systemic hypertension. The patients were divided into 3 groups depending on the type of therapy received: group I, receiving anticoagulants only, served as control; patients of groups II and III received, in addition to the anticoagulants, intravenous ISDN or nitroglycerin, respectively. The patients were monitored for recurrent chest pain, electrocardiographic changes, clinical parameters and cardiac enzyme changes. ISDN, at a dose of 10 mg/h over the first 3 days of infarction, had marked antianginal effect, limited the dimensions of the necrotic area, reduced the number of ischemic relapses and the development of heart failure. Compared to nitroglycerin, ISDN exerted a more prolonged action (up to 12 h), did not affect heart rate and blood pressure, and had a marked antiarrhythmic effect.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of verapamil on the functional state of the liver in ischemic heart disease]. / Vliianie verapamila na funktsional'noe sostoianie pecheni pri IBS.

When treated by verapamil, coronary patients responded differently. Hepatic effects can be either protective or toxic depending on the drug dosage and course duration. Verapamil hepatic protection manifests in day dosage 360 mg and the course duration 3 weeks. 600 mg verapamil is toxic irrespective of the course duration.

[Characteristics of dilzem treatment of patients with ischemic heart disease]. / Osobennosti lecheniia dilzemom bol'nykh ishemicheskoi bolezn'iu serdtsa.

In 47 patients with coronary heart disease, the function of platelet was studied and ECG ST-segment was monitored. It was found that lower platelet function was more common in patients with severe coronary heart disease if they had long episodes of transient myocardial ischemia. Following 12 days of dilzem monotherapy, the most marked ++anti-ischemic and antianginal effects were observed in patients who had had higher platelet function.