Intravascular laser therapy of acute myocardial infarction.

The efficacy of a new method of treatment, endovascular blood irradiation with He-Ne laser, developed by the authors, was studied in 295 patients with primary acute transmural myocardial infarction (MI). Twenty-four-hour Holter monitoring findings before and after laser irradiation suggested the possibility of preventing sudden death in the acute period of MI owing to the high anti-arrhythmic efficacy of the method with respect to high-grade ventricular arrhythmias. Precodial ECG mapping and serial determination of blood enzyme activities (CPK and MB-CPK) showed that irradiation performed within the first hours of MI development contributed to effective limitation of the infarction area and restricted the spread of the area of myocardial ischemic damage.

[Effect of intravascular irradiation of blood by helium-neon laser on the markers of the area of ischemic myocardial damage in patients with acute myocardial infarction]. / Vliianie vnutrisosudistogo oblucheniia krovi gelii-neonovym lazerom na markery zony ishemicheskogo povrezhdeniia serdechnoi myshtsy u bol'nykh ostrym infarktom miokarda.

In 80 patients with acute transmural myocardial infarction (30 patients with anterior infarction and 50 with posterior infarction), endovascular irradiation of blood with helium-neon laser was studied for effects on the time-course of the processes of ischemic lesion and myocardial necrotization from the data on precordial mapping of 35 leads ECG (epsilon ST, nST, nQS) and serum creatinine phosphokinase and its MB fraction (maximal activity peak attainment time, level normalization, summary Q ejection and activity increase rate, delta E/delta t) were measured. The irradiation initiated no later than 4 hours after the development of anginal pains was found to contribute to a more rapid formation of a necrotic zone and to a decrease in extension and relapses of myocardial infarction.

[Effectiveness of blood irradiation using a helium-neon laser in the acute period of myocardial infarction]. / Effektivnost' gemooblucheniia gelii-neonovym lazerom v ostrom periode infarkta miokarda.

The efficacy of endovascular irradiation of the blood with He-Ne laser by the method developed by the authors was examined in 295 patients with primary acute transmural myocardial infarction. Laser therapy was conducive to effective alleviation of the pain syndrome and prevention of anginous status. Twenty-four-hour Holter monitoring, carried out before and after irradiation, has detected high antiarrhythmic activity in respect of complex ventricular arrhythmias and a preventive possibility of fibrillations. Studies of precardial ECG parameters and measurements of the blood enzymic activities (creatine phosphokinase and MB creatine phosphokinase) have shown that irradiation carried out within the first hours of myocardial infarction is conducive to limitation of the infarction area, i.e. that endovascular laser therapy is a highly effective and pathogenetic method for acute myocardial infarction treatment.

[Evaluation of the anti-arrhythmic effect of intracardiac laser therapy by 24-hour electrocardiographic monitoring of patients with acute myocardial infarction]. / Otsenka antiaritmicheskogo éffekta vnutriserdechnoi lazeroterapii metodom kruglosutochnogo monitorirovaniia EKG u bol'nykh ostrym infarktom miokarda.

Ventricular arrhythmias were studied by Holter's 24-hour ECG monitoring in 215 acute myocardial infarction patients within the first day of the disease. Twenty-five minutes sessions of blood irradiation by a 2-4 mW helium-neon laser (HNL) through a light guide, introduced into the right atrium via the subclavian vein, were conducted for 3-5 days in 180 patients. The HNL therapy showed a marked antiarrhythimic effect in acute myocardial infarction, significant for the prevention and treatment of ventricular arrhythmias. High antiarrhythmic activity was noted in patients with frequent ventricular extrasystoles and high-grade arrhythmias. Control patients showed no significant spontaneous reduction of the rate of ventricular arrhythmias over a comparable period of time.

[Intravenous administration of molsidomin in the acute period of myocardial infarct]. / Vnutrivennoe primenenie molsidomina v ostrom periode infarkta miokarda.

A study of central hemodynamic parameters, ECG charting and the activity of serum CPK and its MB fraction in 58 patients with acute myocardial infarction demonstrated that intravenous administration of 20 mg Corvaton, at the rate of 3 micrograms/kg/min, was effective for both controlling an acute left-ventricular failure, and limiting the infarcted area. A three-day treatment normalized systemic and central hemodynamic parameters in cases of medium-size infarction, and considerably reduced manifestations of acute left-ventricular failure in patients with a large area of necrosis.

[Parathormone and calcitonin in men suffering from ischemic heart disease]. / Paratgormon i kal'tsitonin u muzhchin, stradaiushchikh ishemicheskoi bolezn'iu serdtsa.

It has been shown that in men with coronary heart disease (CHD), the basal concentrations of parathyroid hormone (PTH) and calcitonin (CT) in blood serum were increased both during an angina pectoris attack and the interparoxysmal period. During an angina pectoris attack, the highest CT concentration was detected in CHD patients with angina pectoris of effort on the day of the anginal attack. In acute myocardial infarction (AMI), the basal PTH level in the patients' blood serum was increased, particularly during the subacute disease stage. The blood serum CT content during AMI depended on the disease onset: in patients with a sudden disease onset, the parameter under study was increased, whereas in AMI patients with a history of angina pectoris, the CT concentration remained within normal. The authors discuss the pathogenetic role of the shifts in the function of the parathyroid glands and C cells of the thyroid during CHD and the possibility of the use of calcium antagonists and CT in the treatment of myocardial infarction.

[Indications for the use of inosine in myocardial infarct (a clinical and experimental study)]. / O pokazaniiakh k primeneniiu inozina pri infarkte miokarda (kliniko-éksperimental'noe issledovanie).

The effect of the nucleoside Inosie-F (inosin) on the intracardiac hemodynamics and the contraction and relaxation of a diseased myocardium was studied in the clinic and in experiments. An examination was made of 102 patients with macrofocal myocardial infarction (22 received inosin by intravenous drip in a single dose of 200 mg in the acute stage of infarction; 60 patients were given inosin pills in a daily dose of 800 mg in the restoration period for one month, and 20 patients were given placebo). Comparative appraisal of treatment in the period of rehabilitation showed prevailing improvement in the condition of individuals treated with inosin, positive ECG dynamics, increase of cardiac output and decrease of peripheral resistance. In experiments on 28 dogs with a model of acute myocardial ischemia a noticeable improvement in myocardial contraction and relaxation in the absence of negative ECG dynamics was recorded after intravenous infusion of inosin. Inosin achieves maximum effect by 60-90 mins after the beginning of infusion.