[Possibility of coronary angiography without hospitalization].

Coronary angiography is the necessary investigation in the diagnostic complex of patients with ischemic heart disease (IHD). The use of trans-radial access makes it possible to do the angiography without hospitalization. The algorithm of coronary angiography in day-time clinic was proposed. Non-hospital angiography in 15 patients was successful. It is the first time this method has been used in this country.

[Long-term assessment of clinical parameters in patients with coronary heart disease after balloon angioplasty and stenting balloon angioplasty]. / Otsenka klinicheskikh pokazatelei bol'nykh IBS v otdalennom periode posle ballonnoi angioplastiki i ballonnoi angioplastiki so stentirovaniem.

The aim of this study was to assess clinical parameters in patients with coronary heart disease (CHD) in the late period after balloon coronary angioplasty (BCA) and intracoronary stenting (ICS). The study included 104 patients who underwent repeated coronary angiography (CA) 2-10 months after successful coronary angioplasty. Clinical parameters were analyzed in 2 groups comparable at the moment of its performance in terms of major clinical characteristics. Group 1 comprised 51 patients following BCA and group 2 included 53 patients after ICS. Six months after the first procedure, repeated coronary angioplasty was performed in 19 (37.2%) and 6 (9.4%) patients after BCA and ICS, respectively (p < 0.05). Recurrent angina pectoris was observed in 42 patients from group 1 and in 25 ones from group 2, which was 82.3 and 47.2%, respectively (p < 0.05). Control CA revealed restenosis of the dilated artery in 22 (43.1%) of the 51 patients of group 1 and in 12 (22.6%) of the 53 patients of group 2. There were no differences between the groups in late postoperative bicycle ergometric and 24-hour ECG monitoring findings. The findings have led to the conclusion that implantation of a stent into the coronary artery greatly prolongs the antiischemic effect of coronary angioplasty and reduces a need for repeated endovascular intervention, which appears as lower incidence rates of restenosis and recurrent angina as compared to routine balloon angioplasty.

[Quantitative and qualitative assessment of X-ray morphology of coronary restenosis after balloon angioplasty and stenting]. / Kolichestvennaia i kachestvennaia otsenka rentgenomorfologii restenoza koronarnoi arterii posle ballonnoi angioplastiki i stentirovaniia.

The study was undertaken to compare the data of quantitative angiographic analysis of early and late outcomes of intracoronary stenting (ICS) and balloon coronary angioplasty (BCA) with the X-Ray morphology of restenosis. The prospective study enrolled 67 patients undergone repeated coronary angiography 2-10 months after successful BCA. Group I included 34 patients with coronary restenosis. Group II comprised 33 patients without restenosis signs. Each group was divided into 2 subgroups: A--patients undergone BCA; B--patients undergone ICS. Subgroups IA and IB included 22 and 12 patients, respectively, and subgroups IIA and IIB consisted of 24 and 19. The X-ray morphology of the underlying versus restenosis lesions in the subgroups was quantitatively and qualitatively assessed. The findings have led to the following conclusions that ICS yields more optimal early and late angiographic results than does BCA; according to the site of restenosis against the underlying lesion, the following types of restenosis following BCA and ICS are identified: diffuse, localized, marginal, and mixed; restenosis after ICS is characterized by for concentric morphology while that following BCA preserves the morphology of a primary lesion.

[The results of catheterization and the x-ray angiographic assessment of cardiac contractility and volume in primary pulmonary hypertension]. / Rezul'taty kateterizatsii i rentgenoangiograficheskaia otsenka sokratimosti i ob''emov serdtsa pri pervichnoi legochnoi gipertonii.

To ascertain the role of invasive investigations in the diagnosis of primary pulmonary hypertension (PPH), 12 PPH patients underwent catheterization of the left and right heart compartments, contrast right and left ventriculography and oximetry. Compared to control values, the patients had high pressure in the pulmonary artery and right ventricle. Some of them exhibited elevated pressure in the right atrium. Pulmonary artery wedge pressure, left ventricular end-diastolic and systolic, diastolic pressure in the aorta did not differ significantly from those in the controls. Right and left ventriculography revealed an increase in the end-systolic and end-diastolic volumes of the right ventricle which diminished its stroke index and ejection fraction. The latter two were reduced in the left ventricle also. Because the procedure was well tolerated by the patients, it is recommended for PPH diagnosis and follow-up.

[A comparative assessment of the effect of Omnipaque and Verografin on ECG indices and myocardial contractility in patients with unstable angina during coronary ventriculography]. / Sravnitel'naia otsenka vliianiia omnipaka i verografina na pokazateli EKG i sokratimosti miokarda u bol'nykh nestabil'noi stenokardiei pri koronaroventrikulografii.

Altogether 30 patients with unstable angina (UA) were examined. In 15 patients omnipaque was used during coronography and ventriculography (VG), in the rest of 15 patients--verografin at common dosages. A study was made of the changes in the indices of central hemodynamics and myocardial contractility resulting from the action of these radiopaque media during VG, and of ECG changes during coronography. VG with verografin was accompanied by more noticeable disorders of left ventricular contractility, an increase in myocardial oxygen consumption; coronography with omnipaque was characterized by later ECG changes, less noticeable disorders of intraventricular conductivity. It is advisable that coronaroventriculography in patients with UA should be performed using a new group of radiopaque media, in particular omnipaque.

[Comparison of methods for computer and visual assessment of stenosing lesions of the coronary arteries. 1]. / Sravnenie metodov komp'iuternoi i vizual'noi otsenki stenoziruiushchikh porazhenii koronarnykh arterii. Chast' 1.

A system of computer analysis of coronary arteries stenotic lesions developed in the USSR Cardiology Research Centre, Academy of Medical Sciences of the USSR, is described. Reliability of the computer analysis data was assessed, and computer and visual methods were compared on the basis of phantom study. The study was performed in 5 models of stenotic coronary arteries, the main parameters of which were measured mechanically as well as by computer and visual analysis of their images. Both methods proved to give highly reproducible intraobserver and interobserver results. Comparison to mechanically obtained data showed that the results of computer analysis are highly significant while visual evaluation allows no accurate evaluation of the stenosis degree (it is overestimated).

[Clinical assessment of indices of total involvement of the coronary vessels]. / Klinicheskaia otsenka indeksov summarnogo porazheniia koronarnykh arterii.

Selective coronary radiography was performed in 100 patients with chronic CHD. Three indices of total affection of the coronary arteries including that modified by the authors, were analyzed with regard to assessment of relationships between the main clinical characteristics and indicators of left ventricular functions. A higher sensitivity of Califf's index modified by the authors was noted.