[Intravenous obsidan-induced changes of coronary venous blood flow in patients with coronary heart disease in the presence of transient myocardial ischemia]. / Dinamika koronarnogo venoznogo krovotoka u bol'nykh ishemicheskoi bolezn'iu serdtsa v usloviiakh tranzitornoi ishemii miokarda pod vliianiem vnutrivennogo vvedeniia obzidana.

Intravenous obsidan was evaluated for its effects on the blood flow in the coronary sinus and the major cardiac vein in 23 coronary heart disease patients with hyperkinetic central hemodynamics. The use of the drug was found to be effective when the patients had had high baseline coronary venous blood flow. At the peak of cardiac pacing, the patients with low coronary sinus blood flow on obsidan showed decreased blood flow in the ischemic myocardial portions, developed signs of left ventricular failure and diminished anginal threshold. Those with moderate baseline blood flow on obsidan displayed an insignificant increase in anginal threshold, higher blood flow was inadequate to oxygen consumption.

[Treatment of severe ventricular arrhythmia by means of repeated cardiac stimulation]. / Lechenie tiazhelykh zheludochkovykh aritmii pri pomoshchi uchashchaiushchei stimuliatsii serdtsa.

The overdrive pacing method is widely used now in clinical practice for prevention and treatment of severe ventricular disorders of the cardiac rhythm. The mechanisms of arrhythmia suppression by means of this stimulation is analysed. Indications are determined for the choice of the site of stimulation and optimal impulce frequency in ischemic heart disease, and overdosage with digitalis drugs, as well as in myocardiopathy.

[Effect of the intravenous administration of finoptin on coronary venous blood flow in patients with ischemic heart disease]. / Vliianie vnutrivennogo vvedeniia finoptina na sostoianie koronarnogo venoznogo krovotoka u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Intravenous finoptin (verapamil), 10 mg, was tested for effects on the coronary venous blood flow by probing the coronary sinus and great vein of the heart and performing atrial pacing in 24 patients with ischemic heart disease and eukinetic central hemodynamics. In persons who had had initial high blood flow in the coronary sinus, the agent was found to induce resting coronary venous blood flow changes which were inadequate for its demand and during cardiac pacing; whereas in patients with mean initial venous blood flow values, finoptin enabled myocardial oxygen consumption to be provided both in the region of non-infarcted myocardium and in the ischemic area.

[Status of coronary venous blood flow in patients with ischemic heart disease in myocardial ischemia induced by the atrial stimulation test]. / Sostoianie koronarnogo venoznogo krovotoka u bol'nykh ishemi- cheskoi bolezn'iu serdtsa pri ishemii miokarda, indutsirovannoi testom predserdnoi stimuliatsii.

A total of 85 patients (68 with coronary heart disease in the presence of effort angina of various functional classes (a major group) and 17 with neurocirculatory++ dystonia and cardialgic syndrome (a control group)) were examined. Heart failure severity and blood flow distribution in the functioning myocardial areas were evaluated in transient ischemia induced by atrial pacing. Three levels of coronary venous blood flow were defined in patients with coronary heart disease. A relationship between the coronary blood flow, disease history duration, and coronary blood flow changes was examined in cardioselective exercise.

[Prognostic value of the state of the heart atria in determination of the time of sinus rhythm preservation after correction of auricular fibrillation]. / Prognosticheskoe znachenie sostoianiia predserdii v opredelenii srokov sokhraneniia sinusovogo ritma posle ustraneniia mertsatel'noi aritmii.

Data are presented from atrial vectorcardiograms of 130 patients with different forms of auricular fibrillation including an analysis of their parameters and a study of the catamnestic data following the elimination of auricular fibrillation, which permitted to develop prognostic criteria for determining the period of sinus rhythm preservation after this type of arrhythmia had been eliminated.

[Coronary venous blood flow in patients with acute myocardial infarction]. / Sostoianie koronarnogo venoznogo krovotoka u bol'nykh ostrym infarktom miokarda.

In 94 patients with large myocardial infarction, their coronary venous blood flow was studied in the acute period of the disease by continuous coronary sinus thermodilution. No relationship was established between the coronary venous blood flow and the duration of coronary heart disease. The patients with anterior myocardial infarction had a significantly less blood flow in the vena cordis magna than those with posterolateral infarction. No correlation was found between the blood flow and precordial mapping parameters. Thus, continuous coronary sinus thermodilution cannot be used for indirect identification of the site of myocardial infarction and for prediction of its progression severity.

[Effect of myocardial ischemia on prostacyclin and thromboxane levels in arterial and coronary venous blood]. / Vliianie ishemii miokarda na soderzhanie prostatsiklina i tromboksana v arterial'noi i koronarnoi venoznoi krovi.

Variations in arterial and venous blood prostacyclin and thromboxane were examined in 32 patients with coronary heart disease, neurocirculatory dystonia and the cardialgic syndrome, exposed to cardioselective stress as a result of the atrial stimulation test. Prostacyclin and thromboxane measurement in blood specimens obtained from the left ventricle and the coronary venous network may provide additional markers of myocardial ischemia in cases where diagnosis is otherwise difficult to make.

[Effect of obzidan on coronary blood flow in patients with the hyperkinetic type of hemodynamics in the acute period of myocardial infarct]. / Vliianie obzidana na sostoianie koronarnogo krovotoka u bol'nykh s giperkineticheskim tipom gemodinamiki v ostrom periode infarkta miokarda.

Changes in the rate of coronary venous flow through the affected area under the effect of intravenous jet injections of propranolol, 0.1 mg per 1 kg body weight, were assessed in 18 patients of the hyperkinetic central hemodynamic type during acute myocardial infarction. In the first group of patients, whose mean flow rate through the affected wall was 106.2 +/- 5.7 ml/min, the latter parameter decreased in proportion to the drop in double product. In the second group of patients, whose coronary venous flow rate was reduced (51.4 +/- 6.9 ml/min), propranolol-induced drop in the flow rate was less marked, as compared to the drop in double product. It was correlated with dramatically depressed pumping function of the heart.

[Clinical and hemodynamic effects of captopril in patients with chronic circulatory failure]. / Klinicheskie i gemodinamicheskie éffekty kaptoprila u bol'nykh s khronicheskoi nedostatochnost'iu krovoobrashcheniia.

The effect of a new drug, captopril, an inhibitor of the enzyme responsible for the conversion of angiotensin I to angiotensin II, were examined in 15 patients with chronic circulatory insufficiency in the presence of coronary heart disease. The efficiency of single doses and four-week courses of the drug was assessed. Captopril was shown to reduce significantly pulmonary arterial occlusion pressure and total peripheral resistance and increase the minute volume, thus improving left-ventricular function. Considering good tolerance of the drug, it can be recommended for the treatment of chronic circulatory insufficiency.

[Relation between indices of ECG cartography, central hemodynamics and myocardial energy metabolism in acute infarct]. / Vzaimosviaz' mezhdu pokazateliami kartografirovaniia EKG, tsentral'noi gemodinamiki i énergeticheskogo metabolizma miokarda pri ostrom infarkte.

A study of 30 patients with acute myocardial infarction, including the assessment of central hemodynamic parameters, ECG records from 35 leads and the investigation of myocardial energy metabolism by means of lactate, nonesterified fatty acids and glucose measurement in coronary venous blood, demonstrated that hyperkinetic hemodynamics was associated with a great spread of the necrotic and ischemic zone and predominant myocardial extraction of nonesterified fatty acids in uncomplicated acute myocardial infarction. It is suggested that propranolol should be used in those cases where hyperkinetic hemodynamics complicate the course of acute myocardial infarction.

[Central hemodynamic function of neurocirculatory dystonia patients at rest and during the performance of load tests]. / Sostoianie tsentral'noi gemodinamiki u bol'nykh neirotsirkuliatornoi distoniei v pokoe i pri provedenii testov s nagruzkoi.

Central hemodynamic (CH) parameters were examined in 288 patients with neurocirculatory dystonia (NCD) and 50 normal subjects, using radiocardiography (RCG), echocardiography (EchoCG) and heart catheterization thermodilution (TD). All the tests were carried out at rest and during bicycle ergometry (BEM), the atrial stimulation test (AST) and the intravenous isadrin test (IT). Patients with severe NCD and basically hyperkinetic hemodynamic type responded to stress with an inadequate rise in the minute volume (MV) and a decline of the stroke index (SI). Thermodilution during the AST demonstrated increased MV, lowered end diastolic left-ventricular pressure and insignificantly reduced SI. TD and EchoCG during stress exposure produced similar results.

[Prostaglandins A1, E1 and F2 alpha concentrations in the arterial and coronary venous blood of patients with ischemic heart disease during induced myocardial ischemia]. / Soderzhanie prostaglandinov A1, E1, F2 alpha v arterial'noi i koronarnoi venoznoi krovi u bol'nykh ishemicheskoi bolezn'iu serdtsa pri indutsirovannoi ishemii miokarda.

Prostaglandins (PGA1, PGE1 and PGF2 alpha) were assayed in 15 patients with chronic coronary disease during an anginal attack induced through frequent atrial stimulation. Measurements from eleven patients with intact coronary arteries served as control. Lactate extraction coefficient was used as a biochemical indicator of myocardial ischemia; the latter was associated with increased production of coronary sinus PGF2 alpha and arterial PGA1. No correlation could be established between PG levels in the studied series, the extent of ST depression on electrocardiograms, lactate extraction level and hemodynamic manifestations.

[Use of peripheral vasodilators and beta-adrenergic blockaders in the acute period of myocardial infarction (hemodynamic and metabolic aspects)]. / Primenenie perifericheskikh vazodilatatorov i beta-adrenergicheskikh blokatorov v ostrom periode infarkta miokarda (gemodinamicheskie i metabolicheskie aspekty).

The paper reports hemodynamic and biochemical findings in 76 patients with acute myocardial infarction on the basis of which the patients were treated with either peripheral vasodilators (sodium nitroprusside) or beta-blockers (obsidan). Changes in hemodynamic patterns and myocardial metabolism in response to treatment are described. It is concluded that careful hemodynamic and metabolic monitoring is essential in the management of acute myocardial infarction, particularly, where agents affecting the spread of necrotic areas are administered.

[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.

[Insulin and glucagon content of coronary sinus and left ventricle blood in myocardial ischemia]. / Soderzhanie insulina i gliukagona v plazme krovi koronarnogo sinusa i levogo zheludochka serdtsa pri ishemii miokarda.

The levels of insulin, glucagon, lactate, glucose and nonesterified fatty acids were studied in the plasma of arterial blood and coronary sinus during diagnostic catheterization of the heart and the precardiac stimulation test in patients with coronary heart disease (CHD) and in those with neuro-circulatory dystonia attended by cardialgia. Manifest lactate production by the myocardium was recorded in CHD patients, during the development of anginal attacks, in the precardiac stimulation test. The character of changes in the insulin, glucagon, glucose and nonesterified fatty acids levels was similar in both the groups of patients, thus reflecting the body response to the stress, while the stress adaptation was more complete in the patients with no coronary disease.

[State of the heart conduction system in the sick sinus syndrome (according to the recording of the bundle of His potentials and the atrial stimulation test)]. / Sostoianie provodiashchei sistemy serdtsa pri sindrome slabosti sinusovogo uzla (po dannym registratsii potentsialov puchka Gisa i testa predserdnoi stimuliatsii).

It was established that the presence of Samoilov-Wenckebach's periods and prolongation of the H--V interval at low frequency of the imposed rhythm as well as periods of asystolia of more than 1,200 msec are most typical for these patients. An attempt was made to determine the type of cardiac stimulation indicated for such patients from the character of the disorders of rhythm observed in them and the initial frequency of their own cardiac contractions.

[Clinical, hemodynamic and metabolic changes in neurocirculatory dystonia with the cardialgic syndrome]. / Klinicheskie, gemodinamicheskie i metabolicheskie izmeneniia u bolnykh neirotsirkuliatornoi distoniei s kardialgicheskim sindromom.

Study of the arteriovenous difference in lactate and nonorganic phosphorous during coronary sinus catheterization under conditions of the atrial pacing test in a group of 15 patients with neurocirculatory dystonia and chest pain showed the consumption of lactate by the myocardium to be increased in 4, decreased in 2, and unchangen in 9 patients. Test for the main central hemodynamic parameters showed a significant reduction of the end-diastolic pressure in a maximum rate.

[Method of cardiac stimulation in sick sinus syndrome]. / Taktika kardiostimuliatsii pri sindrome slabosti sinusovogo uzla.

The condition of the conducting system of the heart and the sinus node recovery time were studied in 27 patients with the cardiac rhythm pathology under consideration. On the grounds of the resultant data the question concerning the implantation of this or that type of pacemaker (operating in a fixed regimen or "on demand") and-the positioning of the fixing electrode in the atria or ventricle was resolved. The advantages and shortcomings of each of the suggested methods for surgical treatment of sick sinus node are discussed.

[Metabolic manifestations of myocardial ischemia in the cardialgia syndrome of varying origin (study data on lactate from the coronary sinus, the precardiac stimulation test and coronary angiography)]. / Metabolicheskie proiavleniia ishemii miokarda u bol'nykh s kardialgicheskim sindromom razlichnogo geneza (dannye issledovaniia laktata iz koronarnogo sinusa, testa predeserdnoi stimuliatsii i koronarografii).

Twenty-one patients with various myocardial lesions (myocardial infarction, ischemic heart disease, noncoronarogenous cardialgias) were examined. The atrial stimulation test with collection of blood specimen from the coronary sinus and determination of arteriovenous difference by lactate was conducted. It was established that the beginning of lactate production is the most early and significant sign of myocardial ischemia and is of considerable differential-diagnostic and prognostic value.

[Frequent atrial stimulation in supraventricular tachycardia]. / Chastaia stimuliatsiia predserdii pri supraventrikuliarnykh takhikardiiakh.

Twelve patients with paroxysms of supraventricular tachycardia (8) and atrial flutter (4), in whom the method of frequent atrial stimulation was applied to restore the sinus rhythm, were observed. Three cases with the use of this type of cardiac stimulation are described. It is shown that the method is effective, relatively safe and has some advantages over electrical atrial defibrillation. The mechanisms of sinus rhythm restoration under the effect of frequent atrial stimulation are discussed.