[Characteristics of disorders of thrombocytic hemostasis in patients with recurrent myocardial infarction]. / Osobennosti narusheniia trombotsitarnogo gemostaza u bol'nykh povtornymi infarktami miokarda.

The levels of thromboxane B2, prostaglandin 6-keto F1 alpha (PG F1 alpha), thrombocytic factor IV (TF IV), and beta-thromboglobulin (beta-TG) were measured in 66 patients with postinfarction cardiosclerosis concurrent with acute recurrent myocardial infarction or unstable angina pectoris. There was a substantial increase in thromboxane B2 activity and a less significant elevation of PG F1 alpha, as well as a rise of TF IV and beta-TG. Circulatory insufficiency, cardiac aneurysm, intracardiac thrombi were accompanied by much more severe abnormalities in the above-mentioned parameters.

[Sensitivity of creatine phosphokinase in early diagnosis of myocardial infarction and improvement of the test's specificity by determination of the rate of increase of enzyme activity]. / Chuvstvitel'nost' kreatinfosfokinazy v rannei diagnostike infarkta miokarda i povyshenie spetsifichnosti testa putem opredeleniia skorosti prirosta aktivnosti fermenta.

The activity of serum enzymes: creatine phosphokinase (CPK), CPK isoenzyme MB and asparagine aminotransferase--was examined every 1-3 hours after the onset of a painful attack in 68 patients with "determined" (according to the 1979 WHO classification) myocardial infarction (DMI) and 32 patients with unstable angina pectoris. The activity of all three enzymes was increased in 100% of DMI cases. The rate of enzyme activity increment (delta E/delta T) calculated for the first 3-12 hours of the disease demonstrated that absolute delta E/delta T values for CPK were significantly higher than those for other enzymes. The CPK delta E/delta T was several times as high in DMI patients as it was in patients with unstable angina. Measurement of the rate of CPK activity increment over any 6-hour interval within the first day after the painful attack is suggested as a way of further improvement of the test specificity.

[Detection of arrhythmias in patients with ischemic heart disease using different methods of prolonged ECG recording on a magnetic tape]. / Raspoznavanie aritmii u bol'nykh ishemicheskoi bolezn'iu serdtsa s pomoshch'iu razlichnykh metodov dlitel'noi registratsii EKG na magnitnuiu lentu.

Prolonged ECG recording on magnetic tape was performed in 327 coronary patients. In 187 out of them, continuous 24-hour ECG recording (Holter's monitoring) was performed and in 178 subjects, intermittent recording (for 14 s every 15 min) was conducted over 24 hours. In 38 patients, both methods were used. Various heart rhythm irregularities were determined by these methods in 92.1 and 86.8% of the patients, respectively, with the nature and frequency of arrhythmias in both groups displaying basically the similar pattern. The employment of both methods made it possible to detect in a considerable proportion of patients cardiac rhythm disturbances which had not been elucidated in the previous clinical and ECG examinations. The method of Holter's monitoring proved to be more informative in comparison with intermittent ECG recording, i.e. it was effective in determining the precise number and duration of arrhythmia episodes occurring over the period of 24 hours.

[Late arrhythmias in myocardial infarct]. / Pozdnie aritmii pri infarkte miokarda.

The authors had 75 patients with myocardial infarction under observation. After the 15th day of the disease various disorders of cardiac rhythm and conductivity were revealed in 85% of patients during cardiomonitor surveillance. The most frequent occurrences were ventricular extrasystole (72.5%), sinus bradycardia (40%) and atrial extrasystole (37.5%). Primary ventricular fibrillation was noted in 4 (5.3%) patients two of whom were resuscitated. In 50 patients with myocardial infarction of more than one month duration disorders of cardiac rhythm during physical load were studied (dosed walking under telectrocardiographic control and/or on a treadmill). During dosed waling 28% of patients developed arrhythmia or it was intensified (sinus tachycardia was not taken into account). During a load on a treadmill such changes were encountered in 30% of patients. A favourable effect of treatment with cordarone was produced in most patients with ventricular extrasystole some of whom were resistant to lidocain treatment. A good effect was produced in some patients by means of the pulsnorma or rythmodan. Beta-adrenergic blocking agents as well as cordaron and isoptin were effective in atrial extrasystole and sinus tachycardia. Hyperbaric oxygenation was used in 14 patients with disorders of rhythm. Disappearance of arrhythmia or considerable improvement was registered in 11 patients after treatment consisting of 10-12 procedures.

[Catecholamines and 17-hydroxycorticosteroids in the blood of patients with myocardial infarct in the surgical and internal disease clinics]. / Katekholaminy i 17-OKS krovi u bol'nykh infarktom miokarda v khirurgicheskoi i terapevticheskikh klinikakh.

The blood of 131 patients with myocardial infarction and of 131 patients who underwent operation and had no necrosis of the cardiac muscle was tested for the content of adrenaline, noradrenaline, and 17-oxycorticosteroids (17-OCS). In 20 patients with postoperative myocardial infarction the level of adrenaline, noradrenaline, and 17-OCS rose during the operation and before and after the development of the disease. In patients with myocardial infarction the level of catecholamines was found to be increased in the first 10 days and the level of 17-OCS only in the first 3 days of the disease. In patients who underwent operation but had no myocardial infarction, the content of adrenaline, noradrenaline, and 17-OCS increased before and during the operation and on the 1st postoperative day. The authors believe that the increase in the level of catecholamines and 17-OCS may be one of the mechanisms of the development of postoperative myocardial infarction.

[Anti-arrhythmic effectiveness of ethmozine, cordaron and rhythmodan in treating ischemic heart disease]. / Antiaritmicheskaia éffektivnost' étmozina, kordakona i ritmodana pri lechenii bol'nykh ishemicheskoi bolezn'iu serdtsa.

The authors observed 127 patients with different disorders of the cardiac rhythm treated with ethmozine, cordarone and rhythmodan. To assess the efficacy of the therapy circadian ECG was recorded on a magnetic tape with a portable cardiomonitor, exercise tests (bicycle ergometry, treadmill and walking under ECG control) were conducted. Good effect was seen after a course of treatment in patients with ventricular and atrial extrasystolae, paroxysms of supraventricular, ventricular tachycardia and auricular fibrillation. Cordarone was found effective in the Wolff-Parkinson - White syndrome and paroxysms of supraventricular tachycardia.

[Thromboxane, prostacyclin and platelet factor 4 in patients with atrial fibrillation]. / Tromboksan, prostatsiklin i 4-i faktor trombotsitov u bol'nykh mertsatel'noi aritmiei.

Thromboxane++ (TX), prostacyclin (PC) and platelet factor IV (PF) were assayed using radioimmune kits in 46 patients with cardiac fibrillation secondary to coronary heart disease and rheumatic fever. The study established elevated TX beta 2 levels, low concentrations of 6-ketoPGF1 alpha, enhanced activity of PF. Restoration of the sinus rhythm by electroimpulse treatment (EIT) brought about augmentation of the Tx-Pc-PF unbalance on day 2-3. This may give rise to "normalization" thromboembolism. On days 5-7 after EIT the intensity of platelet aggregation and PF secretion diminish. It is concluded that patients with sudden cardiac fibrillation in need of sinus rhythm correction will benefit from disaggregation and anti-coagulant therapy.