[Measured physical load test and the atrial stimulation test in the differential diagnosis of ischemic heart disease in patients with unchanged coronary angiograms]. / Proba s dozirovannoi fizicheskoi nagruzkoi i test predeserdnoi stimuliatsii v differentsial'noi diagnostike ishemicheskoi bolezni serdtsa u bol'nykh s neizmenemnymi koronarogrammami.

Assessment of the clinical findings and the results of the bicycle ergometry test conducted in 17 patients and the atrial stimulation test performed in 13 patients allowed the diagnosis of ischemic heart disease to be made in 8 of 20 patients with normal coronary arteriogram. It is noted that the combined performance of the test with dosed physical load on a bicycle ergometer and the atrial stimulation test raises their values in differential diagnosis. The authors content that to improve the differential diagnosis of ischemic heart disease and functional cardiopathy in patients with normal coronary arteriogram it is advisable to study coronary microcirculation and myocardial metabolism during performance of the atrial stimulation test.

[Content of endogenous prostanoids in patients with paroxysmal supraventricular disorders of the heart rhythm]. / Soderzhanie éndogennykh prostanoidov u bol'nykh s paroksizmal'nymi nadzheludochkovymi narusheniiami ritma serdtsa.

Blood endogenous prostaglandins, E, F2 alpha, prostacyclin and thromboxane levels were measured in the ascending aorta and the coronary sinus of 32 patients (29 males and 3 females) with paroxysmal supraventricular arrhythmias (atrial fibrillation and supraventricular tachycardia) during the sinus rhythm and an arrhythmic paroxysm. Group 1 was made up by 22 patients with idiopathic cardiac rhythm disorders, and group 2 comprised 10 coronary patients with arrhythmias. A relationship was demonstrated between cardiac endogenous prostanoids balance and the clinical pattern of cardiac rhythm abnormality (duration and frequency of paroxysms) as well as changes in cardiac prostanoid rations associated with tachyarrhythmic paroxysms.

[Characteristics of lactate metabolism in the myocardium of patients with auricular fibrillation]. / Osobennosti metabolizma laktata v miokarde bol'nykh s mertsatel'noi aritmiei.

Coronary arteriovenous difference in lactate was measured in 20 patients with permanent atrial fibrillation and coronaroangiographic evidence of unchanged coronary arteries before and after the recovery of sinus rhythm by electric-pulse treatment (EPT); and in 15 patients with neurocirculatory dystonia (NCD) and intact cardiac rhythm, subjected to the atrial stimulation test (AST). Before EPT, the majority of atrial fibrillation patients exhibited myocardial lactate production, which was particularly pronounced in patients with prolonged (over 6 months) duration of fibrillation. After the sinus rhythm was recovered, lactate production was replaced by lactate extraction. None of the NCD patients showed lactate production in spite of high AST-induced heart rates. Both the heart rate and the pattern of intracardiac and coronary hemodynamics may be involved in disrupted lactate metabolism in patients with permanent atrial fibrillation and intact coronary arteries.

[Concentration of endogenous prostanoids and cyclic nucleotides in patients with atrial fibrillation]. / Soderzhanie éndogennykh prostanoidov i tsiklicheskikh nukleotidov u bol'nykh s mertsatel'noi aritmiei.

The variations in the content of endogenic prostanoids and cyclic nucleotides in the blood plasma of the coronary sinus and ascending aorta were studied in patients with the idiopathic stable form of atrial fibrillation before and after sinus rhythm recovery effected by electroimpulse therapy. Changes in the levels and ratios of these compounds in the coronary venous and arterial blood were found to be opposite in their trends. A significant elevation in TxB2 levels and the TxB2/6-keto-PGF1 ratio as well as increased cGMP concentrations in the plasma of the coronary venous blood appear to be suggestive of an unfavourable prognosis because patients with such changes developed atrial fibrillation recurrences soon after electroimpulse therapy.

[Myocardial blood flow in patients with different forms of supraventricular arrhythmia]. / Sostoianie miokardial'nogo krovotoka u bol'nykh s razlichnymi formami nadzheludochkovykh narushenii ritma serdtsa.

The authors studied the status and changes in the myocardial blood flow volume in 25 patients with supraventricular cardiac arrhythmias in the presence of coronary heart disease and without organic abnormalities on the part of the cardiovascular system. As regards the status of the sinus rhythm, the total myocardial blood flow in patients with idiopathic rhythm disturbances versus coronary heart disease showed no significant differences. In conditions of electrostimulation-induced tachyarrhythmia, patients with idiopathic arrhythmias exhibited a linear increase in the blood flow in the basin of both coronary arteries while in the coronary heart disease patients there were heterogeneous alterations of the myocardial blood flow with a general downward trend. In patients with the idiopathic form of continuous fibrillations with the comparable heart rate the values of the myocardial blood flow are significantly lower than in patients with idiopathic paroxysmal tachyarrhythmia. The decrease of the coronary blood flow observed in tachycardia is believed to result from an increased coronary vascular resistance which points to a reduction of the reserve capabilities of the coronary bed in relation to its dilatation.

[Significance of the atrial stimulation test in the diagnosis of ischemic heart disease. A comparison with measured physical loading on the bicycle ergometer and with coronary angiographic data]. / Znachenie testa predsernoi stimuliatsii v diagnostike ishemicheskoi bolezni serdtsa. Sravnenie s dozirovannoi fizicheskoi nagruzkoi na veloérgometre i dannymi koronarografii.

The results of the atrial stimulation test were compared with the data of the test on a bicycle ergometer and coronary arteriography. The atrial stimulation test made it possible to diagnose coronary insufficiency in 91.6% of patients with ischemic heart disease. It was established that atrial stimulation helps in determining exactly the causes of a vague cardialgic syndrome in some cases in which the test on a bicycle ergometer cannot be carried out or when it is difficult to appraise its results. As compared to the test with dosed physical load on a bicycle ergometer, the atrial stimulation test proved more sensitive and less specific.

[Effect of Ritmilen and allapinin on central hemodynamics and myocardial contractility of patients with heart rhythm disorders]. / Vliianie ritmilena i allapinina na tsentral'nuiu gemodinamiku i sokratimost' miokarda u bol'nykh s narusheniiami ritma serdtsa.

The effect of Ritmilen and allapinin, a new Soviet antiarrhythmic drug, on hemodynamics and myocardial contractility were evaluated in 36 patients with various heart rhythm disorders during diagnostic coronary angiography. Ritmilen has been shown to have an essential cardiodepressive effect. An intravenous 150 mg dose of Ritmilen results in a depression of dp/dtmax, Veragut's index, ejection fraction, mean standard circular fibre shortening rate, and increase in left ventricular systolic and end diastolic pressure, total peripheral resistance and mean arterial blood pressure. Allapinin (30 mg) has no marked cardiodepressive effect, as compared to Ritmilen.

[Effect of ritmilen and allapinin on prostanoid and cyclic nucleotide levels in patients with cardiac rhythm disorders]. / Vliianie ritmilena i allapinina na soderzhanie prostanoidov i tsiklicheskikh nukleotidov u bol'nykh s narusheniiami ritma serdtsa.

The effect of antiarrhythmic drugs, ritmilen and allapinin, on endogenic prostanoid and cyclic nucleotide levels was examined in patients with heart rhythm disorders. Intravenous administration of antiarrhythmic agents is shown to be accompanied with increased release of prostacyclin that has antiarrhythmic properties into myocardial outflow. Both ritmilen and allapinin promoted the predominance of prostacyclin over thromboxane, with its intrinsic arrhythmogenic properties. Ritmilen- or allapinin-induced changes in prostaglandins E and F2 alpha consisted in that PGE prevailed, as compared to PGF2 alpha. There were no significant changes in cyclic nucleotide ratios (cAMP/cGMP) in response to treatment.