[Correction of episodes of transitory myocardial ischemia with trimetazidine in patients with ischemic heart disease combined with type 2 diabetes mellitus].

Data of treatment of 45 patients with stable angina combined with type 2 diabetes mellitus are presented. Supplementation of standard anti-ischemic therapy with cytoprotective preparation trimetazidine MB (Preductal MB) revealed greater efficacy of treatment manifesting not only by decrease of functional class in observed patients but also by increase of volume of performed physical load, decrease of episodes of ischemia during 24 hours (according to Holter monitoring data), as well as decrease of mean duration of ischemia (painful and painless). A conclusion is made about feasibility of prescribing cytoprotective preparation trimetazidine MB while providing complex therapy to patients with stable form of ischemic heart disease.

Preoperative modeling of an optimal left ventricle volume for surgical treatment of ventricular aneurysms.

OBJECTIVE: We evaluated the results of surgical treatment postinfarction ventricular aneurysms, with preoperative modeling of an optimal left ventricle volume. METHODS: From January 1998 to December 2000, 41 patients underwent left ventricular (LV) aneurysm repair. There were 39 men and two women, with a mean age 45.6+/-6.2 years. With echocardiography study, an optimal end-diastolic volume of LV was modeled on the basis of the proper stroke index and the contractile ejection fraction (EF). A permissible area of aneurysm resection was calculated by using a difference between the initial and the projected surface area of LV. The patch position and sizes were measured preoperatively. Ventricular reconstruction was performed by using linear plasty in eight patients, septal plasty of the Stoney et al. technique in 14 patients, and endoventriculoplasty of the Dor et al. technique in 19 patients. RESULTS: The mean NYHA functional class decreased from 2.9+/-0.6 to 1.6+/-0.7 postoperatively. The improvement of LV contracting function made itself evident in a decreased end-diastolic volume from 216+/-98 to 158+/-35 ml, and end-systolic volume from 133+/-85 to 80+/-34 ml postoperatively. The mean EF increased from 38+/-11 to 49+/-9% after operation. We noted that preoperative contractile EF corresponded with postoperative EF (49.8+/-11% and 49.3+/-9%, respectively). The projected optimal end-diastolic volume of LV estimated before operation agreed with postoperative data (152+/-33 ml and 158+/-35 ml, respectively). The hospital mortality rate was 7.3%. CONCLUSIONS: Preoperative modeling of an optimal LV volume allows for the estimation of a permissible area of aneurysm resection, the position and sizes of the patch, as well as for the prevention of an excessive reduction of the LV cavity after aneurysm repair.