[Angiotensin converting enzyme inhibitor enalapril in the treatment of endomyocardial fibrosis in patients with lymphogranulomatosis subjected to radio- and chemotherapy]. / Ingibitor angiotenzinprevrashchaiushchego fermenta énalapril v lechenii postluchevogo i lekarstvenno-indutsirovannogo éndomiokardial'nogo fibroza pri limfogranulematoze.

Echocardiography was used in the study of 40 patients with stage IIA-IVB lymphogranulomatosis. In 2-6 years before the study all patients had been treated with combination radio- (36-44 Gy) and chemotherapy. Echocardiography revealed endomyocardial fibrosis and signs of cardiac remodeling (reduced left ventricular dimensions and volumes, decreased myocardial mass and impaired diastolic function). The patients were divided into 2 groups. Patients of group 1 were given enalapril (5-10 mg/day), of group 2 - potassium and magnesium aspartate and inosine. In 2 months 68% of patients in group 1 demonstrated improvement of structural and functional state of the heart, no such changes occurred in group 2.

[Morpho-functional condition of heart in patients with lymphogranulomatosis late after chemoradiotherapy]. / Morfofunktsional'noe sostoianie serdtsa pri limfogranulematoze v otdalennye sroki posle khimioluchevoi terapii.

AIM: The study of clinical and echocardiographic status of the heart in patients with lymphogranulomatosis (LGM) late after chemoradiotherapy. MATERIAL AND METHODS: 44 patients with IIA-IV stage of LGM exposed to irradiation of lymph nodes and polychemotherapy according to the schemes ACOP, ABVD, COPP, CHOP, CVPP were examined. Echocardiography was carried out on the unit Sigma-44 and Toshiba. RESULTS: Some changes in the heart by type of myocardiodystrophy or endomyocardial fibrosis were found. The latter are characterized by diminution of the left and (or) right ventricles due to apex obliteration, hardening and thickening of the endocardium and subvalvular structures, diastolic dysfunction and pulmonary hypertension. The main and additional signs are distinguished. The reasons of endomyocardial fibrosis are discussed: severity of the disease, frequent exacerbations and, consequently, higher doses of specific chemoradiotherapy. CONCLUSION: It is necessary to employ sparing policy in planning radiotherapy after high loading antracycline antibiotics.

[Multiple organ failure in patients with hemoblastosis during long-term follow-up of treatment]. / Poliorgannaia patologiia u bol'nykh gemoblastozami v otdalennom periode lecheniia.

AIM: Investigation of the condition of the liver, gastrointestinal tract, heart in patients at the stage of clinicohematological remission after treatment for hemoblastosis (acute leukemia, Hodgkin's disease, non-Hodgkin's lymphoma). RESULTS: Marked functional-morphological changes were found: endomyocardial fibrosis, cardiopathy, pulmonary hypertension, chronic atrophic gastritis, colon lesions, dysbacteriosis, viral or drug-induced hepatitis. CONCLUSION: The above affections have developed because of the treatment: chemotherapy, radiotherapy, hemotransfusions, antibacterial drugs. They deteriorate life quality and require a special system of rehabilitation measures.

[Prognostic significance of bicycle ergometry test in patients with myocarditis]. / Prognosticheskoe znachenie rezul'tatov veloérgometricheskoi proby u bol'nykh miokarditami.

A total of 42 patients with rheumatic carditis were examined in the acute-subacute period and following 3-5 years. Seventeen patients were diagnosed as having primary rheumatic carditis, 9 presented with tonsillogenic rheumatic carditis, and 16 had viral rheumatic carditis. The diagnosis of myocarditis was established on the basis of clinical, immunological, and virological findings. The study involved ECG, PhCG, PCG, and bicycle ergometer testing recordings. Groups of patients with good and poor prognosis were identified. Low threshold exercise, exercise-inadequate tachycardia, complex cardiac arrhythmias, phasic myocardial hypodynamic syndrome and volume exercise syndrome that are formed during performance are prognostically poor indicators. More profound electric and mechanic dysfunctions were observed in patients with tonsillogenic or viral myocarditis.

[Information value of right precordial ECG leads in the diagnosis of right ventricular myocardial infarct]. / Informativnost' pravykh prekardial'nykh otvedenii EKG v diagnostike infarkta miokarda pravogo zheludochka.

An analysis of the right ECG precordial leads in 61 patients with left ventricular posteroinferior myocardial infarction and in 55 patients with combined affection of the right and left ventricular posteroinferior walls revealed a high informative value of ST segment elevation for recognition of right ventricular myocardial infarction on the 1st day. Further on the formation of the QS complex in V3R-5R leads was of certain value. Combined assessment of ST segment elevation and the QS formation in the right precordial leads significantly increased diagnostic potentialities in the detection of right ventricular myocardial infarction.

[Efficacy of physical training and types of hemodynamics of essential hypertension patients and healthy subjects]. / Effektivnost' fizicheskikh trenirovok i tipy gemodinamiki u bol'nykh gipertonicheskoi bolezn'iu i zdorovykh lits.

Physical stress tolerance and the effect of swimming-pool exercise were examined in patients with essential hypertension (EH) and normal untrained subjects with respect to their hemodynamic types. Threshold load capacity at bicycle ergometry and the amount of swimming-pool exercise were lower in EH patients and normal individuals with hypokinetic circulation, as compared to other hemodynamic types. Insufficient dilatation of the precapillary channel during exercise may be implicated here. In patients with stable EH and hypokinetic hemodynamics, exercise should be less intensive.