[Effects of long-term therapy with losartan on baroreflex regulation of cardiovascular system]. / Vliianie dlitel'noi terapii lozartanom na sostoianie baroreflektornoi reguliatsii serdechno-sosudistoi sistemy.

To assess dynamics of structural-functional parameters of the circulatory system including the state of the cardiopulmonary baroreflex (CPBR) in patients with ischemic heart disease (IHD) and cardiac failure (CF) on losartan treatment, we studied 14 IHD men with CF (NYHA functional class II-III), mean age 54.6 +/- 7.1 years. Before and after losartan treatment the patients were examined using echocardiography, radiocardiography with 131-I albumin, occlusion plethysmography, 131-I hippuran clearance. CPBP was estimated by the change in circulation flow rate in the forearm in low body rarefaction by means of low pressure camera. Losartan was given in maximal tolerance dose (25-100 mg/day). Examination in the end of the treatment demonstrated diminished venous tone, increased blood flow in the forearm, reduced volume of circulating plasm, elevated hematocrit, higher ratio of early to late filling peaks of the left ventricle, progression of baroreflex dysfunction. Thus, long-term losartan treatment promoted improvement in peripheral vascular tonicity, diastolic function of left-ventricular myocardium, reduction in circulating plasm volume, progression of baroreflex dysfunction.

[Clinical efficacy of carvedilol in patients with severe cardiac insufficiency]. / Klinicheskaia éffektivnost' karvedilola u bol'nykh s tiazheloi serdecnoi nedostatochnost'iu.

AIM: To assess clinical response to carvedilol in long-term treatment of cardiac failure (CF). MATERIAL AND METHODS: 34 patients with CF (NYHA functional class III-IV) were observed for 6 months. 25 of them received standard therapy combined with carvedilol, 9 patients received only standard therapy. RESULTS: Carvedilol produced positive changes in the disease functional class, left ventricular ejection fraction, stabilisation of echo-CG parameters and cardiothoracic index, resulted in prolongation of 6-min walk distance. Discontinuation of carvedilol therapy enhances CF symptoms. CONCLUSION: Long-term therapy with carvedilol inhibits CF progression.

[Cardiomyoplasty--a surgical method of treatment in heart failure]. / Kardiomioplastika--khirurgicheskii sposob lecheniia serdechnoi nedostatochnosti.

Until recently heart transplantation has been the only method of surgical treatment of severe myocardial heart failure. In the recent years operations of cardiomyoplasty have been performed more and more often for treatment of patients with this disease. The article presents the literature and personal data on the operation technique, indications and contraindications for it. First clinical results of the operative interventions fulfilled since 1994 are discussed.