[Demons-Meigs syndrome or cardiomyopathy: a difficult case of a differential diagnosis].

The article presents an overview of the data related to Demons-Meigs syndrome and the clinical situation associated with a complex differential diagnosis between myocarditis with the formation of secondary cardiomyopathy and Demons-Meigs syndrome. A variety of clinical symptom complexes that are associated with Demons-Meigs syndrome is discussed. The concepts of classical and non-classical, full and incomplete Demons-Meigs syndrome are considered. The current views on the pathogenesis of the syndrome and the mechanism of the formation of ascites and pleural effusion are given.

[Echocardiography with physical exercise in patients with stable angina pectoris concurrent with chronic obstructive pulmonary disease: safety, informative value, and performance conditions].

AIM: To define the safety, informative value, and performance conditions of exercise echocardiography (EchoCG) in patients with stable angina (SA) concurrent with chronic obstructive pulmonary disease (COPD). SUBJECTS AND METHODS: Forty patients aged 45 to 66 years (mean age 54.8 +/- 4.9 years) with Functional Class (FC) II-III SA concurrent with COPD and 40 patients aged 46 to 65 years (mean 56.6 +/- 4.9 years) with FC II-III SA without COPD were examined. All the patients underwent exercise EchoCG during the chosen therapy. RESULTS: Exercise EchoCG is safe in patients with SA with COPD. To enhance the informative value of this test and to achieve the ischemic threshold in patients of this category require the use of adequate bronchodilator therapy. In this case, the informative value of the technique is 75%. CONCLUSION: Exercise EchoCG in patients with SA concurrent with COPD may serve as a reliable tool in determining exercise endurance during antianginal, bronchodilator therapy and in assessing its adequacy.

[Endothelial dysfunction in patients with combined coronary heart disease and chronic obstructive pulmonary disease].

The aim of this work was to evaluate functional incompetence of endothelium in patients with chronic coronary heart disease (CHD, stable angina) combined with chronic obstructive pulmonary disease and to choose the most informative method for the diagnosis of endothelial dysfunction. A total of 103 patients aged 36-66 (mean 57.2 +/- 7.6) years were examined. Group 1 comprised 38 patients with CHD and concomitant chronic obstructive pulmonary disease (COPD). Group 2 included 36 patients with stable angina alone, group 3 consisted of 29 patients with COPD without CHD. Attention is focused on the characteristic of endothelial function by instrumental and laboratory methods. Comparative analysis of the severity of endothelial dysfunction in patients of the three groups revealed different mechanisms of plasma nitrogen oxide dynamics in patients with CHD and/or COPD. CHD and COPD caused mutual aggravation (potentiation) of pathological reactions leading to the development of the disease. Blood levels of nitrogen oxide metabolites in patients with cardiovascular problems or with COPD alone did not reflect the actual amount of "vasodilatory" NO. Reactive hyperemia test is believed to be the most informative method for the assessment of endothelial function in patients with CHD and COPD.

[Effects of beta 1-adrenoblocker bisoprolol on endothelial dysfunction in patients with stable angina pectoris in combination with chronic obstructive pulmonary disease].

AIM: To study effects of a cardioselective beta-adrenoblocker bisoprolol on vascular wall endothelium and external respiration function in stable angina of effort combined with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Endothelial function and external respiration were studied before and after 4-week treatment with bisoprolol in 36 patients with stable angina and COPD using assessment of endothelium-dependent vasodilatation (EDVD) and concentrations of nitric oxide metabolites. RESULTS: Significant improvement of endothelial function was achieved due to bisoprolol 4-week treatment which did not affect external respiration function. CONCLUSION: Bisoprolol is effective and safe drug in the treatment of stable angina combined with COPD. It can noticeably improve endothelial function.