[Pharmacological protection of the myocardium with reamberin in coronary artery bypass grafting in patients with postinfarction angina].

AIM: To assess efficacy of reamberin in preoperative preparation and after coronary bypass (CB) in patients with macrofocal myocardial infarction (MI) complicated with postinfarction angina. MATERIAL AND METHODS: A total of 45 patients with Q-positive MI complicated with postinfarction angina pectoris entered the trial. The study group consisted of 20 (44.4%) patients given 200-400 ml injections of 1.5% reamberin solution for 3 days before coronary artery bypass grafting (CABG) and 3-5 days after it. The control group consisted of 25 (55.6%) patients given basic therapy without cardioprotection. ECTG-60, echocardiography, CM-ECG, laboratory tests were made before CABG. CABG was made in conditions of artificial blood circulation in all the patients. RESULTS: Clinical stabilization was observed after direct myocardial revascularization in hospitalized 25 (100%) patients of the study group and 22 (88%) patients of the control group. Early postoperative acute cardiac failure (ACF) developed in 3 (12%) patients from the study group and 9 (36%) from the control group (p = 0.04), arrhythmia occurred in 2(8%) and 8(32%) patients, respectively (p = 0.03). Two (8%) control patients died in early postoperative period from acute cardiac failure. Perioperative MI occurred in 2(8%) control patients. After 12 months of the follow-up, patients of the study group had no recurrent angina pectoris, while among the controls 4(16%) patients had recurrent angina of FC III. After surgical intervention at discharge and 12 months after treatment patients of both groups improved systolic and diastolic functions of the left ventricle. Normalization of the diastolic function was registered in 80% patients of the study group (p < 0.001) and in 44% from the control group (p < 0.001) after 1 year follow-up. CONCLUSION: Reamberin reduces the number of postoperative complications, ischemic damage to the myocardium, significantly improves systolic and diastolic functions of the left ventricle.

[Modern aspects of war against smoking: are there any opportunities left?].

The war against smoking requires taking immediate measures because of the growing spread and severe consequences. All minuses and pluses of the Mass Media are underlined in this article. Anti-smoking technical means should to meet the following requirements: (1) each inhalation of cigarette smoke should be carried to the level of conscience; (2) each smoking act should be accompanied by unpleasant perceptions; (3) A conscientious registration number of cigarettes smoked is necessary. These problems have been solved by now. artery stiffness, defined by pulse wave propagation velocity increases after the act of smoking thus imitating aging. The smoker should be aware of this fact.

[Modification of clinical classification of heart failure with quantitative evaluation of functional state]. / Modifikatsiia klinicheskoi klassifikatsii serdechnoi nedostatochnosti s kolichestvennoi otsenkoi funktsional'nykh narushenii.

Definite dissociation exists between severity of clinical symptoms of heart failure and degree of cardiac dysfunction. Comparative analysis of existing heart failure classifications reveals low degree of congruence in evaluation of patient's state by different experts. This disagreement is mainly caused by limited number of gradations in NYHA classification and descriptive character of information. That is why supplementation of current classification with quantitative assessment of functional state by means of introduction of precise and easily obtainable statements is required. A modification of 6 min walk test is suggested for this purpose. The paper contains methodology of the test and calculations necessary for assessment of working capacity (in joules) and intensity of work (in watts). Possibility of evaluation of results of cardiovascular surgery is especially stressed.

[The no-reflow phenomenon and its clinical significance]. / Fenomen 'nevozobnovleniia krovotoka' (no-reflow) i ego klinicheskoe znachenie.

The no-reflow phenomenon is characterized by inadequate myocardial perfusion without angiographic manifestations of mechanical vascular occlusion. The phenomenon occurs after coronary vascular interventions (coronary angiography, percutaneous coronary angioplasty, stenting, coronary artery bypass surgery). The development of the no-reflow phenomenon significantly worsens clinical evolution of disease increasing the number of cases of congestive heart failure and hospital mortality. Changes of endothelial function and morphology, changes of blood rheology and microvascular autoregulation are important for pathogenesis of the phenomenon. The treatment include intracoronary introduction of verapamil, adenosine, intravenous introduction of activators of KATP channels (nicorandil), inhibitors of glycoprotein IIb/IIIa receptors. The reasons for early preventive use of intracoronary introduction of verapamil and other drugs in the presence of risk of development of no-reflow phenomenon are presented. The interrelationship between no-reflow phenomenon and syndrome X is also stressed.

[Use of the mother-fetus-newborn infant system for the study of combined effects of pesticides and other chemicals]. / Ispol'zovanie sistemy mat'-plod-novorozhdenny'i dlia izucheniia kombinirovannogo deistviia pestitsidov i drugikh khimicheskikh veshchestv.

It is possible to state on the basis of the studies carried out that the system mother-fetus-new-born may be used as the most sensitive biological model to study separate, complex and combined exposure of mammals to chemicals. It was found out that the above mentioned system is highly sensitive and makes it possible to detect a damaging effect to chemicals even on the level of standardized values, while such doses do not produce any negative influence on the adult organism. The proposed system makes it possible to assess material and functional cumulation of chemical substances in the organism of mammals.