[Effect of propranolol on hemodynamic manifestations of emotional stress of different types in patients with arterial hypertension]. / Vliianie propranolola na gemodinamicheskie proiavlwniia razlichnykh vidov psikhoémotsional'noi nagruzki u bol'nykh s arterial'noi gipertenziei.

Seventy-five male patients with arterial hypertension were exposed to psycho-emotional stress (PES). One group was investigated, using mental arithmetic exercise (MA), and the other, using a clock or compass model (C/C). The measurements were made in the absence of medication and using a 40 mg propranolol dose. The prevalent rise in arterial blood pressure, heart rate, minute volume and total peripheral resistance, associated with the MA model, is suggestive of PES-induced beta-adrenoreceptor activation. Conversely, diastolic hypertension prevailing over a moderate rise in heart rate where the C/C model was used is an evidence that there is no considerable beta-receptor activation by this test. In group 1, propranolol treatment depressed systolic, but not diastolic, arterial blood pressure, and considerably raised total peripheral resistance, whereas in group 2 both systolic and diastolic blood pressure, minute volume and total peripheral resistance declined after treatment. It is suggested that the blockade of beta-receptors has a greater hypotensive effect where those are not activated excessively, as there is no associated compensatory adjustment of the adrenoreceptor apparatus.

[Effect of seduxen on stress-induced hemodynamic reactions in patients with hypertension]. / Vliianie seduksena na gemodinamicheskie reaktsii u bol'nykh gipertonicheskoi bolezn'iu pri emotsional'nom napriazhenii.

Some circulatory parameters were examined, using tetrapolar chest rheography and rheoencephalography, in patients with essential hypertension of stages I-II during emotional stress after oral administration of 5 mg seduxen. Seduxen was not shown to prevent hypertensive response to emotional stress. In the post-stress recovery period, this drug reduces the duration of hypertension. Seduxen is conducive to redirecting the trends of hemodynamic response of hypertensive patients so that it becomes similar to that of normal subjects. In patients with hypokinetic response to emotional stress, seduxen restores the autoregulation capacity of cerebral vessels.

[Hemodynamic mechanisms of the decrease in physical work capacity in hypothyroidism and thyrotoxicosis]. / Gemodinamicheskie mekhanizmy snizheniia fizicheskoi rabotosposobnosti pri gipotireoze i tireotoksikoze.

A study of 21 patients with hypothyroidism, 22 patients with thyrotoxicosis and 18 normal subjects, using echocardiography and bicycle ergometry, demonstrated different mechanisms of reduced working capacity, associated with those conditions. The decrease in chronotropic and inotropic heart reserve, associated with hypothyroidism, is shown to be rooted in slowed-down relaxation of left ventricular posterior wall in the presence of diastolic arterial hypertension, while limited working capacity, associated with thyrotoxicosis, is rooted in resting myocardial hyperfunction due to hyperkinetic circulation.

[Changes in the systemic and intracardiac hemodynamics of healthy persons as affected by emotional tension]. / Izmeneniia sistemnoi i vnutriserdechnoi gemodinamiki u zdorovykh lits pod vliianiem émotsional'nogo napriazheniia.

Twenty-four normal subjects were examined during exposure to emotional stress, simulated by mental arithmetic exercise under time shortage and interfering light and sound stimuli. Hemodynamic parameters were determined on the basis of echocardiographic M-records in resting condition and under mental stress. Irrespective of the baseline hemodynamic type, emotional stress produced a hyperkinetic circulatory response. Increased cardiac index resulted from higher heart rate in the presence of unchanged venous return and stroke index. Myocardial contractility increased to a greater extent in individuals with hypokinetic and eukinetic hemodynamics.

[Detection of risk factors for hemodynamic dysadaptation under physical loading by data of genetic studies (echocardiography data) (Part 2)]. / Vyiavlenie faktorov riska gemodinamicheskoi dezadaptatsii pri fizicheskoi nagruzke po dannym geneticheskikh issledovanii (dannye ékhokardiografii) (soobshchenie 2).

Examination in 28 pairs of twins who were studied by echocardiography just after their performance of exercise (Stage I) and at the peak of effects produced by oral anapriline (Stage II) have shown that at rest such parameters as end-systolic volume, ejection fraction, relative changes in the internal dimension of the left ventricular cavity during a cardiac cycle, show moderate-to-high genetic predisposition. At the same time, a persistent contribution of heredity to myocardial contractility is found only for end-systolic volume when the conditions of the examination were changed. The lesser extent to which contractility parameters had hereditable signs, the more intensively they varied under different conditions. It is assumed that the contraction rate of circulatory myocardial fibers is less resistant to environmental factors. A significant decrease in this parameter during anapriline administration allows one to suppose that cardiac decompensation in patients with coronary heart disease starts with damages to the very myocardial circulatory muscles.

[Tolerance of the cardiovascular system of hypothyroidism patients for physical loading]. / Tolerantnost' serdechno-sosudistoi sistemy bol'nykh gipotireozom k fizicheskoi nagruzke.

Twenty-one patients with primary hypothyroidism were subjected to electro- and echocardiography, and 10 patients, to bicycle ergometry, to examine their central and intracardiac hemodynamics at rest and cardiovascular response to exercise. The results were compared with the respective parameters of 18 normal subjects. Hypothyroidism was shown to be associated with increased left-ventricular myocardial weight (echocardiographic evidence in the presence of normal myocardial contractility at rest, lowered stress tolerance due to a smaller chronotropic reserve of the heart, and myocardial metabolic disorders.

[Hemodynamics and its control in patients with thyrotoxicosis and in healthy persons according to the data of anapriline and graded exercise tests]. / Gemodinamika i ee reguliatsiia u bol'nykh tireotoksikozom i zdorovykh lits po dannym prob s anaprilinom i dozirovannoi fizicheskoi nagruzkoi.

The study was undertaken to examine effects of anapriline on bicycle ergometric and echocardiographic parameters and catecholamine excretion in 17 patients with thyrotoxicosis and 21 healthy subjects. A single dose of anapriline contributed to transition of hyperkinetic central hemodynamics to eukinetic one and a more saving regimen of heart performance at rest and submaximal exercise levels in the healthy subjects. In contrast, the patients maintained hyperkinetic hemodynamics and had a high energy demand during exercise and showed a reduction in left ventricular systolic and diastolic function and a significant decrease in catecholamine excretion. Disintegration of regulatory mechanisms in thyrotoxicosis was found to be due to the function interrelationship between thyroid hormones and catecholamines.

[Functional status of the myocardium in thyrotoxicosis]. / Funktsional'noe sostoianie miokarda pri tireotoksikoze.

Twenty-two patients with thyrotoxicosis, showing no clinical signs of heart failure were examined electro- and echocardiographically. Bicycle ergometry was also used in 13 of those. Central and intracardiac hemodynamics were assessed at rest, as was cardiovascular response to exercise. The results were compared to similar parameters in 18 normal subjects. Echocardiography demonstrated hyperkinetic circulation and normal myocardial contractility in the resting patients. Bicycle ergometry showed considerably limited working capacity in those patients. Limited chronotropic and inotropic reserve of the heart in the presence of increased left-ventricular operation at rest may be pathogenetically involved in reduced stress tolerance, seen in patients with thyrotoxicosis.

[The hemodynamic support of physical loading in patients with mitral valve prolapse]. / Gemodinamicheskoe obespechenie fizicheskoi nagruzki u bol'nykh s prolabirovaniem mitral'nogo klapana.

Bicycle ergometry and echocardiographic studies were carried out in 29 patients aged 17-29 years with first revealed mitral valve prolapse (MVP) without any signs of mitral regurgitation. According to bicycle ergometry, the patients manifested changes in hemodynamics pointing to dysfunction of the cardiovascular system. Echocardiography discovered a reduction of the mass and a rise of the rate of contraction of the circular fibers of the left ventricle, evidence of the myocardial genesis of the hemodynamic changes. Comparison of the findings of bicycle ergometry and echocardiography allowed a conclusion about the necessity of the follow-up of patients with MVP in spite of the high level of threshold load and the lack of the clinical signs of heart failure.

[The role of changes in central and intracardiac hemodynamics in lowering the physical work capacity of patients with ischemic heart disease and diabetes mellitus]. / Rol' izmenenii tsentral'noi i vnutriserdechnoi gemodinamiki v snizhenii fizicheskoi rabotosposobnosti u bol'nykh ishemicheskoi bolezn'iu serdtsa i sakharnym diabetom.

The data of bicycle ergometry test and echocardiography were studied and compared in patients with postinfarction cardiosclerosis and type II diabetes mellitus without the clinical signs of heart failure. The patients showed the decreased work fitness and the identity of cardiovascular responses to graded exercise, pointing to the common character of the pathogenesis of these diseases. Both groups of the patients manifested the hyperkinetic type of the central hemodynamics as well as the lowering of the rate of diastolic relaxation and the rise of the end diastolic volume of the left ventricle. The intracardiac hemodynamics of coronary heart disease was characterized, in addition, by the reduction of myocardial contractility of the left ventricle due to focal injuries to the myocardial structures, which are more pronounced than in diabetes mellitus.

[Clinicofunctional features of arterial hypertension in chronic broncho-obstructive syndrome]. / Kliniko-funktsional'nye osobennosti arterial'noi gipertonii pri khronicheskom bronkhoobstruktivnom sindrome.

AIM: To describe clinicofunctional features of essential and pulmogenic hypertension in chronic bronchoobstructive syndrome, 24-h profile of arterial pressure (AP), intracardiac hemodynamics and to propose differential diagnostic criteria for these hypertension forms. MATERIALS AND METHODS: 24-h monitoring of arterial pressure (MAP), cardiohemodynamics, external respiration function (ERF) and blood gases examinations were made in 100 hypertensive subjects with chronic obstructive bronchitis and bronchial asthma. RESULTS: Significant differences were found between the groups of essential and pulmogenic hypertension by major values of MAP, echo-CG and ERF. Early disturbances in diastolic function of both the ventricles in essential and pulmonary hypertension in chronic bronchial obstruction arise long before clinical, x-ray and ECG signs of chronic pulmonary heart. CONCLUSION: The findings enable formulation of criteria of differential diagnosis of essential and pulmogenic hypertension and identify the latter as an independent nosological entity.