[Effect of fluvastain and its combination with aspirin and trental on hemostasis and microcirculation in atherosclerosis]. / Vliianie fliuvastatina i ego sochetanii s aspirinom i trentalom na gemostaz i mikrotsirkuliatsiiu pri ateroskleroze.

AIM: To assess effects of fluvastatin monotherapy and combined therapy with aspirin and trental on hemostasis and microcirculation in atherosclerosis. MATERIAL AND METHODS: Hemostasis and microcirculation were studied in 68 patients with coronary atherosclerosis and aortic atherosclerosis on fluvastatin monotherapy and on combined therapy fluvastatin + aspirin + trental. RESULTS: Hypolipidemic treatment with fluvastatin reduced thrombogenic blood potential due to enhancement of plasmic fibrinolytic activity [the time of XII-a dependent fibrinolysis decreased by 33% (p < 0.05)], decreased thrombinemia [blood level of soluble fibrin-monomeric complexes fell by 44% (p < 0.05)] and reduced stimulated platelet aggregation: by 18.2% in response to ADP (p < 0.05) and by 11% in response to adrenalin (p < 0.05). CONCLUSION: Correction of lipid metabolism and blood hypercoagulation improved microrheology. Combination of fluvastatin with aspirin made platelet aggregation reduction in response to both inductors faster and more stable, while combination of fluvastatin with trental contributed to better results in microcirculation improvement.

[Lipid and non-lipid effects of enduracin in patients with arterial hypertension]. / Lipidnye i nelipidnye éffekty primeneniia énduratsina u bol'nykh arterial'noi gipertoniei.

AIM: To analyze lipid and non-lipid effects of 6-month administration of enduracine in patients with marked dislipoproteinemia suffering from arterial hypertension with ischemic heart disease or without it. MATERIALS AND METHODS: 40 hypertensive patients (27 males and 13 females, mean age 52.43 +/- 1.68 years) entered the study of enduracine effects. Most of them received enduracine for 6 months in a dose 1500 mg/day. Lipids levels were measured in all the patients. Blood flow along major brain arteries was determined at transcranial dopplerography in 23 patients. RESULTS: A 6-month course of enduracine in a dose 1500 mg/day promoted normalization of serum lipid spectrum, vascular tonicity and reactivity of cerebral arteries, produced a mild hypotensive effect. CONCLUSION: Endurance (a long-acting form of nicotinic acid) has favourable lipid and non-lipid effects in patients with dislipoproteinemias and arterial hypertension in the presence or absence of ischemic heart disease.

[Features of individual pain sensitivity of patients with ischemic heart disease during different variants of bicycle ergometry test]. / Osobennosti individual'noi bolevoi chuvstvitel'nosti u bol'nykh ishemicheskoi bolezn'iu serdtsa pri razlichnykh variantakh veloérgometricheskoi proby.

AIM: To assess the significance of individual pain sensitivity in the development of painful and painless episodes of acute myocardial ischemia. MATERIALS AND METHODS: Bicycle ergometry test was carried out in 50 patients aged 35-65 years with angina of effort, functional classes II-III. Before bicycle ergometry, tactile and pain sensitivity thresholds and duration of pain tolerance were assessed by SSM-01 sensometer. RESULTS: Twenty-seven patients showed painful reaction to exercise; 40% of them had a low threshold of pain and 81% poorly tolerated pain. In 11 patients who complained of pain before ECG showed myocardial ischemia, these values were 64 and 91%, respectively. All of 9 patients with painless myocardial ischemia had a high threshold of pain, and 44% of them poorly tolerated pain. CONCLUSION: The data indicate significance of individual pain sensitivity in the development of painless episodes of acute myocardial ischemia.

[The use of the delayed-action form of korinfar in arterial hypertension, stenocardia and hypertrophic cardiomyopathy]. / Primenenie retardirovannoi formy korinfara pri arterial'noi gipertonii, stenokardii i gipertroficheskoi kardiomiopatii.

Corinfar-retard (CR) was tried in 146 patients, the acute test was performed in 26 cases. The findings confirm antihypertensive activity of the drug, reduced frequency of sharp changes in blood pressure and of hypertensive crises, side effects, its ability to diminish platelet aggregation. As for coronary heart disease. CR is more beneficial in non-severe angina of effort, spontaneous angina, associated hypertension. In hypertrophic cardiomyopathy prolonged administration of CR resulted in moderate subjective response. A CR two-month course did not induce noticeable changes in serum lipids. Hypertensive subjects on the acute test improved some hemodynamic and diastolic parameters.

[Detection of angina pectoris in a 5-year follow-up of patients with initially diagnosed cardialgia]. / O raspoznavanii stenokardii v protsese 5-letnego nabliudeniia bol'nykh s pervonachal'no diagnostirovannoi kardialgiei.

During a 5-year follow-up of 150 patients with initially diagnosed cardialgia, the diagnosis of angina pectoris was revised more frequently in those followed up by therapeutists (46%), significantly more infrequently in those seen by outpatient cardiologists (18%) and much more infrequently in those examined by hospital cardiologists (6%). Risk factors for coronary heart disease were detected 2-4 times more frequently in patients with angina pectoris than in those with preserved cardialgia.

[Crystallogenic properties of serum lipid fraction in healthy persons and in patients with ischemic heart disease]. / Kristallogennye svoistva lipidnoi fraktsii syvorotki krovi zdorovykh i bol'nykh ishemicheskoi bolezn'iu serdtsa.

A crystallization method was proposed to assess disturbances in the lipid system; it was based on the interaction of a serum lipid fraction with a lecithin matrix. A total of 255 invidividuals were examined. A model experiment was performed by using chemically pure cholesterol (96 samples) and 10 different cholesterol esters (240 samples). There were a great differences in the frequency of various pattern structural types (homogeneous texture, fan crystals) in the healthy persons and patients. The test results were found to be related to the ratio of esterified to non-esterified cholesterol in the serum lipid fraction. The application of rheopolyglucin, , hemosorption, quantum hemotherapy in the patients contributed to normalization of crystallization test indices.

[Lipid peroxidation and hyperuricemia in patients with ischemic heart disease]. / Perekisnoe okislenie lipidov i giperurikemiia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Lipid peroxidation, activity of the enzymatic link of the antioxidative system, and parameters of the lipid system were studied in 62 patients with coronary heart disease (27 patients with hyperuricemia and 35 subjects with normal uric acid levels) in relation to blood uric acid concentrations. The levels of uric acid, malonic dialdehyde, total lipids, total cholesterol, beta-lipoprotein cholesterol, triglycerides were measured and the activities of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase were evaluated. In the patients there was an increase in lipid peroxidation and lipid composition changes which were more drastically marked in hyperuricemia.

[Hormone and lipid interrelations in young women with normal and disturbed balance of sex steroids]. / Gormonal'no-lipidnye vzaimootnosheniia u molodnykh zhenshchin s normal'nym i narushennym balansom polovykh steroidov.

Altogether 121 patients with sclerocystic ovaries and 40 normal women aged 16 to 35 years were examined for excretion of estrogens, androgens and pregnandiol with urine and for the blood content of total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) followed by hyperlipoproteinemia (HLP) phenotyping. In the group of normal women, low production of estrogens and pregnandiol was coupled with a reduction in the content of HDLC and an increase in that of TG. In the patients, no relationship was established between the changes in the concentration of estrogens and pregnandiol and the lipid content. Meanwhile the androgen content, which was higher as compared with that in the normal women, correlated with the rise of the TG and TC level, accompanied by a noticeable subsidence of the HDLC level. As compared with the normal persons, the atherogenic types of HLP in the patients occurred 2.2 times as frequently. The data obtained indicate an important role of the primary imbalance of sex steroids in the development of dyslipoproteinemia in young women.

[Effectiveness of the physical training of post-myocardial infarction patients with differing exertion tolerances]. / Ob effektivnosti fizicheskikh trenirovok perenesshikh infarkt miokarda bol'nykh s razlichnoi tolerantnost'iu k nagruzke.

A total of 159 men after myocardial infarction were examined. Of them 73 were engaged in physical training for 11 mos. Its efficacy was analysed after the results of bicycle ergometry taking account of initial exercise tolerance. A positive effect of physical training was noted both in the patients with high and low exercise tolerance. Raised physical working capacity was observed in parallel with the improved indices of the left ventricular contractility in accordance with the results of two-dimensional echocardiography. The authors also observed a favorable effect of physical training on lipoprotein metabolism, in particular a decrease in the value of the apo B/apo AI ratio was noted that might suggest a decrease in the inflow of cholesterol to the vascular wall and an enhanced outflow from it.

[Serum apolipoproteins A-1 and B in young males with a history of myocardial infarction]. / Apoproteiny A1 i B plazmy krovi u molodykh muzhchin, perenesshikh infarkt miokarda.

The content of the protein-lipid components of lipoproteins of individual classes was studied in 87 coronary heart disease patients surviving myocardial infarction under 40 years of age. All the patients lived in Sverdlovsk. The control group was made up of 49 age-matched males without any symptoms of CHD. CHD patients aged 30-39 years showed a number of differences as compared to healthy men; these included elevated plasma levels of cholesterol, triglycerides and low-density lipoprotein cholesterol as well as an increase in the apoprotein B levels and the apo-B/apo-A1 ratio. In a group of CHD patients aged 20-29 years enhanced plasma concentrations of apo-B and an increase in the apo-B/apo-A1 ratio, the latter approaching 1 were the only change in the lipoprotein system as against control.

[Cardiovascular disorders, autonomic disorders and atherogenic dyslipoproteinemias in young women with the sclerotic ovary syndrome]. / Serdechno-sosudistye rasstroistva, vegetativnye narusheniia i aterogennye dislipoproteidemii u molodykh zhenshchin s sindromom sklerokistoznykh iaichnikov.

The authors studied 158 young women with the syndrome of sclerocystic ovaries (SCO) and 40 healthy subjects. The patients showed a high rate of vegetovascular dystonia, predominantly according to the hyperparasympathicotonic type, cardialgia and dyspnea. In 54.5% of the patients lipid metabolism disturbances of the atherogenic nature were elicited, being most pronounced in the hypothalamic-pituitary form of the disease. It is postulated that in cases of the SCO syndrome, the deficit of estrogens and pregnanediol decreases "immunity" of females to the development of atherogenic dyslipoproteinemias while a relative or absolute hyperandrogenia accounts for the transformation of the "female" type of the lipid spectrum into the "male" type with lower levels of cholesterol of high density lipoproteins (LP) and higher levels of TG, and cholesterol of very low density LP and of low density LP. It is recommended that the SCO syndrome should be included into the risk factors for atherosclerosis and coronary heart disease.

[Clinical and instrumental characteristics of idiopathic hypertrophic cardiomyopathy and dynamics of echocardiographic indices as affected by beta-adrenergic blockaders]. / Kliniko-instrumental'naia kharakteristika idiopaticheskikh gipertroficheskikh kardiomiopatii i dinamika ékhokardiograficheskikh pokazatelei pod vliianiem beta-adrenergicheskikh blokatorov.

Clinical investigation of 31 patients with idiopathic hypertrophic subaortal stenosis (IHSS) and idiopathic hypertrophic nonobstructive cardiomyopathy (IHNCMP) comprised electro- and phonocardiography, roentgenologic examination and echocardiography. The disease was latent in 3 patients, and ischemic heart disease or rheumatic heart lesion had been diagnosed prior to echocardiography in 26. Asymmetrical hypertrophy and hypokinesia of the upper third of the ventricular septum, narrowed left-ventricular cavity and septum-wise systolic movement of the anterior mitral cusp were findings common to all IHSS patients. The ventricular septum/left-ventricular posterior wall thickness ratio was elevated (1.42 +/- 0.06). In IHNCMP patients, this ratio was within normal range. The results of an acute pharmacologic test with 10 mg intravenous obsidan given to 10 IHSS patients suggested that the obstruction of left-ventricular outflow pathway was somewhat reduced. Prolonged (2 months to 3 years) obsidan treatment was given to 25 patients and was associated with positive effect in terms of improved subjective manifestations of the disease. However, echocardiographic patterns only showed moderate improvement in 9 of the 13 patients who had completed 1-3 years' treatment course.

[Immunological reactions to lipoproteins and heparin in young men with a hereditary tendency to arteriosclerosis]. / Immunologicheskie reaktsii k lipoproteidam i geparinu u molodykh muzhchin s otiagoshchennoi po aterosklerozu nasledstvennost'iu.

Among young men with hereditary tendency to atherosclerosis one frequently finds immunological reactions to serum lipoproteins of very low density, somewhat less frequent reactions to heparin are encountered. Possible mechanisms of actions of antibodies to lipoproteins and heparin are discussed.