[Characteristics of coronary artery lesions in patients with painless myocardial ischemia]. / Osobennosti porazheniia koronarnogo rusla u bol'nykh s bezbolevoi ishemiei miokarda.

AIM: To assess extent and localization of coronary artery lesions in patients with painless myocardial ischemia. MATERIAL AND METHODS: Tredmill stress-echocardiograghy, Holter ECG monitoring and coronary angiography were carried out in 59 male patients (age 30-72, mean 54.5 years) with either angina pectoris or painless ischemia. RESULTS: Among patients with painless ischemia 50% had 2-vessel disease, mostly with right coronary artery involvement (87.5%) and there was no case of left main stenosis. Patients with angina were characterized by significantly higher index of obstruction (p<0.005) and often had multivessel coronary artery disease (48.8%). CONCLUSION: Patients with effort angina compared with those with painless ischemia had more extensive and severe coronary artery involvement while the latter more often had right coronary artery stenoses.

[Relationship between myocardial viability and ventricular late potentials in patients with history of myocardial infarction]. / Vzaimosviaz' mezhdu zhiznesposobnost'iu miokarda i nalichiem pozdnikh potentsialov zheludochkov u patsientov, perenesshikh infarkt miokarda.

AIM: To study relationship between presence and volume of viable myocardium and registration of late ventricular potentials in patients with history of myocardial infarction. MATERIAL AND METHODS: High resolution ECG, dobutamine stress echocardiography and Holter ECG monitoring were carried out 34 patients (mean age 54.1-/+3.1 years) with history of documented myocardial infarction. RESULTS: According to data of dobutamine stress echo patients were divided into 2 groups: with irreversible myocardial dysfunction (n=16, group 1) and with hibernating myocardium (n=18, group 2). Ventricular late potentials were registered in 3 (18.7%) and 11 (61,1%) patients in groups 1 and 2, respectively. Group 2 patients more often had high-grade ventricular arrhythmias. There was no association between presence of ventricular late potentials and Lown grade of ventricular arrhythmias on Holter ECG. Duration of filtered QRS (QRSt) complex correlated directly with index of regional wall motion abnormality, end-diastolic volume, and negatively - with total ejection fraction. CONCLUSION: Among myocardial infarction survivors patients in whom dobutamine stress echo detects viable myocardium significantly more often have ventricular late potentials and high grade ventricular arrhythmias compared with patients with myocardial scars without viable myocardium.