Changes of the echocardiographic parameters in chronic heart failure patients with Ile337val, Glu23lys, and Ser1369ala polymorphisms of genes encoding the ATP-sensitive potassium channels subunits in the Ukrainian population.

Different allelic variants of genes that encode ATP-sensitive potassium (KATP ) channels' subunits may contribute to the development of heart failure. The purpose of the work to investigate SNPs in genes that encode KATP channels in relation to echocardiographic parameters in chronic heart failure (CHF) patients. Ninety-nine people with CHF of ischemic origin with left ventricular systolic dysfunction were examined. The control group is represented by 108 clinically healthy subjects. KCNJ11 polymorphisms Ile337Val and Glu23Lys, and ABCC8 polymorphism Ser1369Ala were genotyped using polymerase chain reaction. In CHF patients, the frequency of the Ile337Val genotype was: Ile/Ile, 40.4%; Ile/Val, 45.5%; and Val/Val, 14.1%. The patients with the Val/Val genotype had left ventricular (LV) mass that was 334.15 g, which was 27.3% (P < 0.05) lower versus Ile/Val patients (425.48 g). The index of this parameter was also significantly lower (28.4%, P < 0.05). In CHF patients, the frequency of Glu23Lys and Ser1369Ala was: Glu/Glu and Ser/Ser, 43.4%; heterozygote, 44.4%; Lys/Lys and Ala/Ala, 12.2%. The patients with the Lys/Lys and Ala/Ala genotypes had a significantly lower LV mass index and LV end-diastolic volume (22.9% and 26.8%, P < 0.05) versus heterozygotes. Thus, the greatest LV mass and LV end-diastolic volume values are associated with heterozygotes, while the smallest are associated with minor homozygotes.

[Clinical and instrumental predictors of survival in patients with chronic heart failure and intact systolic left ventricle function]. / Kliniko-instrumental'nye prediktory vyzhivaemosti bol'nykh s khronicheskoi serdechnoi nedostatochnost'iu i sokhranennoi sistolicheskoi funktsiei levogo zheludochka.

165 patients with clinically-manifested chronic heart failure (CHF) and preserved (ejection fraction--EF > 40%) left ventricular (LV) systolic function have been investigated. 135 of them have ischaemic heart disease (IHD) and high blood pressure, 8 patients are without IHD and 22 patients with normal blood pressure. 62 patients have chronic atrial fibrillation. Survival value in patients with CHF and preserved LV systolic function was compared to survival value of those with CHF and impaired ejection fraction (EF < 40%). Patients with preserved LV systolic function have been found to be with better survival value than those with impaired ejection fraction (68 and 33% accordingly).

[Use of inhibitors of the angiotensin-converting enzyme and the beta-adrenoblocker metoprolol combined in treatment of chronic cardiac insufficiency]. / Lechenie khronicheskoi serdechnoi nedostatochnosti ingibitorom angiotenzinprevrashchaiushchego fermenta v sochetanii s beta-blokatorom metoprololom.

Clinical-and-hemodynamic effects were studied of a supplementary use of a selective beta-adrenoblocker metoprolol in an ongoing therapy of chronic cardiac insufficiency (CCI) with inhibitors of the angiotensin-converting enzyme (ACEI) and diuretics. It has been found out that long (over 8 weeks) course of therapy supplemented with metoprolol results in improvement of the left ventricular systolic function and lowering of the functional class. Long-term administration of metoprolol enhances tolerance to a graded physical exercise in CCI patients, which observation is accompanied by a more economic character of its performance. The findings secured validate the expediency of a supplementary use of the beta-adrenoblocker metoprolol in the routine regimen of the supporting treatment of CCI patients involving the use of ACEI plus a diuretic.

[The clinico-hemodynamic effects of losartan in treating patients with chronic heart failure]. / Kliniko-gemodinamicheskie éffekty lozartana pri lechenii bol'nykh s khronicheskoi serdechnoi nedostatochnost'iu.

Clinical and hemodynamic effects were studied of the blockader of AII receptors lozartan in patients with chronic cardiac insufficiency (ChCI). Inclusion of losartan into the conventional therapy of ChCI is accompanied by a lowering of the functional class in patients and improvement of haemodynamic maintenance of the physical exercise performance as evidenced by veloergometry. An 8-week's course of lozartan therapy leads also to a decrease in the anterior-posterior dimensions of the left auricle and an increase in the left ventricular ejection fraction in ChCI patients.

[The use of angiotensin-converting enzyme inhibitors in left ventricular dysfunction (the generalization of the experience of multicenter studies)]. / Primenenie ingibitorov angiotenzinprevrashchaiushchego fermenta pri disfunktsii levogo zheludochka (obobshchenie opyta mnogotsentrovykh issledovanii).

The lecture highlights the results of a 10-yr experience gained with the clinical trial of the angiotensin-converting enzyme inhibitors (ACEI) in patients presenting with left ventricular dysfunction (LVD) on an international multicentre basis. The results obtained and conclusions drawn from the above megatrial were employed in giving guidelines on ACEI use in a clinical setting in different categories of LVD patients.

[An evaluation of the role of paired loading tests in selecting the long-term drug therapy for patients with stable angina]. / Otsenka roli parnykh nagruzochnykh testov v podbore dlitel'noi medikamentoznoi terapii bol'nym so stabil'noi stenokardiei.

The examination of 208 patients with stable exercise-induced angina has demonstrated that the long-term (12 weeks and 12 months) antianginal effect can be predicted with a high accuracy from the results of acute pair exercise test using the drugs. The negative result of the test with verapamil is not informative due to the accumulation of its antianginal effect when the agent is used long. The long-term antianginal effect of nitrosorbide is determined not only by positive pair exercise test, but mainly by its dosage regimen during a day. The fact that half the patients who took labetalol for a long time developed tolerance to its anginal effect casts some suspicion on the advisability of its administration in stable angina. Lipid peroxidation as a mechanism of platelet aggregability regulation.

[Effect of various antianginal agents on the frequency and duration of myocardial ischemic episodes in patients with stable angina pectoris]. / Vliianie razlichnykh antianginalnykh sredstv na chastotu i prodolzhitelnost epizodov ishemii miokarda u bolnykh so stabilnoi stenokardiei.

The effects of verapamil, nifedipine, propranolol, and combinations of nifedipine+propranolol and nifedipine+verapamil were studied in 60 patients with stable angina pectoris. Verapamil was found to have a pronounced antianginal activity against all types of myocardial ischemia, whereas nifedipine relieved mainly painful ischemic episodes. By the end of 12-week therapy with propranolol, the agent lost its antiischemic effect in a third of patients, which was accompanied by an increase in the number and severity of silent ischemic episodes.

[The significance of the ergometrine test for the diagnosis of ischemic heart disease and the choice of antianginal treatment]. / Znachenie érgometrinovoi proby dlia diagnostiki ishemicheskoi bolezni serdtsa i vybora antianginal'nogo lecheniia.

A study of 68 patients showed that the ergometrine test is a rather informative method of the diagnosis of ischemic heart disease that supplements essentially the results of loading tests. The authors demonstrate the possibility of using the ergometrine test with the purpose of evaluating the effect of antianginal therapy.

[Anti-anginal effect of long-term use of obsidan, corinfar and finoptin in patients with stable exercise-induced stenocardia]. / Antianginal'nyi éffekt dlitel'nogo primeneniia obzidana, korinfara i finoptina u bol'nykh so stabil'noi stenokardiei napriazheniia.

Time course changes in antianginal effect were evaluated for obsidan, corinfar and finoptin under 12-week administration in 104 patients with stable angina pectoris. The response to finoptin appeared to rise while for obsidan and corinfar it was stable. Some patients with stable angina developed clinical tolerance to corinfar.

[The efficacy of the long-term therapy of patients with stable stenocardia using korinfar and finoptin]. / Effektivnost' dlitel'noi terapii bol'nykh stabil'noi stenokardiei korinfarom i finoptinom.

The authors evaluated the antianginal and hemodynamic effect of the combination of finoptin (80 mg) and corinfar (20 mg) in 52 patients with stable stenocardia. By the end of a three-month course of treatment the antianginal effect was marked in 49% of patients and this was related to reduced requirements of the myocardium in oxygen due to the peripheral hemodynamic effect of the agents and realization of the true coronary reserve under conditions of physical loading.

[Mechanisms of the anti-anginal effect of korinfar]. / K voprosu o mekhanizmakh antianginal'nogo éffekta korinfara.

Some clinical, hemodynamic and biochemical parameters were studied in 25 patients with ischemic heart disease of II-III functional classes depending on the presence of the antianginal effect during paired loading pharmacodynamic tests with corinfar. The antianginal effect of corinfar was found to be associated with a marked growth of "double product" and the presence of a clinical symptom of adaptation. In patients with the lack of corinfar antianginal effect there were noted the adaptation symptom absence and a higher blood catecholamine level. A decrease of the postloading did not correlate with the drug antianginal effect. The data could indicate that in the mechanism of corinfar antianginal effect the determining factor is its direct influence on the coronary circulation.

[Comparative analysis of the information value of electrocardiographic loading tests in relation to the characteristics of atherosclerotic lesions of the coronary arteries]. / Sravnitel'nyi analiz informativnosti élektrokardiograficheskikh prob s nagruzkoi v zavisimosti ot osobennostei ateroskleroticheskogo porazheniia koronarnykh arterii.

Diagnostic possibilities of various exercise tests (bicycle ergometry, the dipyridamole test, atrial electrostimulation) were demonstrated, as was a relationship between their sensitivity and the number of stenosed coronary arteries, the extent and level of obstruction, collateral circulation specificity and myocardial function.