[An improved classification of chronic heart failure]. / Usovershenstvovannaia klassifikatsiia khronicheskoi serdechnoi nedostatochnosti.

A clinicofunctional classification is proposed of chronic cardiac insufficiency (ChCI), based on the modified classification by Strazhesko-Vasilenko on the syndrome type and New York Association of Cardiologists. Each of the clinically important functional classes is subdivided into subclasses. Clinically manifest ChCI is subdivided into reversible, partly reversible and irreversible subclasses.

[The clinical classification of ischemic heart disease]. / O klinicheskoi klassifikatsii ishemicheskoi bolezni serdtsa.

The IHD classification needs to be brought up-to-date, for the existing IHD classifications according to WHO and All-Union Research Centre for Cardiology of the Academy of Medical Sciences of the USSR have already become outdated and require additions to be made. In view of the above-stated, the contributors to this article propose an updated IHD classification, having supplemented it with new forms of the disease. This will help physicians in studying pathogenesis, clinical course of the disease, as well as in developing specific therapies and preventive measures to be instituted in this particular disease.

[The dynamic echocardiographic indices after restoration of the sinus rhythm in patients with the compensated type of atrial fibrillation]. / Dinamika ékhokardiograficheskikh pokazatelei posle vosstanovleniia sinusovogo ritma u bol'nykh s kompensatornym tipom mertsaniia predserdii.

The authors observed 19 patients with paroxysmal atrial fibrillation (AF) and compensatory intracardiac hemodynamics accounting for 10% of all their examinees with AF. Following the retaining of sinus rhythm with the help of lanicor, nitrosorbide and lasix patients of group 1 exhibited increased Vs, Vd, Vcf, EF against decreased left atrial size and left atrial index. Patients of groups 2 and 3 in whom the conversion of sinus rhythm occurred due to guanidine or electric impulses, respectively, the above indices changed insignificantly. These patients had depression of left ventricular contractility, increased end-systolic volume, slowing of Vs, Vcf against slight enhancement of left ventricular pump capacity.

[Short-term pharmacological block of the atrioventricular node in the diagnosis of cardiac arrhythmias]. / Kratkovremennaia farmakologicheskaia blokada predserdno-zheludochkovogo uzla v diagnostike aritmii serdtsa.

73 patients were examined with the aim of establishing the clinical importance of the method of short-term pharmacologic blockage (SPB) of atrioventricular node (AVN) in the diagnosis of paroxysmal tachycardias, latent forms of ventricular pre-excitation and attached forms of parasystole. SPB AVN was performed as an intravenous bolus of adenosinetriphosphate (ATP) in graded doses (10-30 mg) with simultaneous ECG recording. If adverse effects of ATP occurred its reinfusions were tapered to a dose of 5-10-15 mg in the presence of preliminary intravenously administered verapamil (5 mg). Objective nature of the diagnostic information obtained by using SPB AVN in the above outlined cardiac arrhythmias is analysed.

[Clinical effectiveness, adverse effects and complications of intravenous administration of ATP in paroxysmal tachycardia]. / Klinicheskaia éffektivnost', pobochnye deistviia i oslozhneniia vnutrivennogo vvedeniia ATF pri paroksizmal'nykh takhikardiiakh.

Forty patients with paroxysmal tachycardias were studied. After intravenous bolus administration of ATP, 10-20 mg sinus rhythm restored in 24 patients with nodal reciprocal tachycardia or Wolff-Parkinson-White syndrome. In patients with ventricular tachycardia, antidromal paroxysmal tachycardia in the presence of the Wolff-Parkinson-White syndrome and atrial flutter, bolus administration of ATP made the diagnosis more precise. Adverse reactions were seen in 75% of patients. There was a case of cardiac asystole, 50 sec long, with symptoms of clinical death. The sick sinus syndrome and atrioventricular block are regarded as a contraindication for bolus administration of ATP due to binodal dysfunction induced by the agent.

[The clinico-electrocardiographic prodromes of fatal cardiac arrhythmias in patients with an acute myocardial infarct]. / Kliniko-élektrokardiograficheskie predvestniki fatal'nykh aritmii serdtsa u bol'nykh ostrym infarktom miokarda.

The authors made a retrospective analysis of case histories of 201 patients who had died of fatal cardiac arrhythmias. The predictors of their death were ventricular fibrillation in 133 (66.2%) patients, asystole in 68 (32.8%), electromechanical dissociation in 2 (1%). Terminal sinus tachycardia, atrial fibrillation and flutter, the second-third degree atrioventricular block, the third-fifth grade ventricular extrasystole were the most common clinical and electrocardiographic prodromes of ventricular fibrillation. In the development of the latter, various mixed disturbances of cardiac rhythm and conduction in combination with prolonged Q-T interval were of more unfavorable value. Asystole was more frequently preceded by the second-third degree atrioventricular block, complete bundle branch block, third-fifth grade ventricular extrasystole, atrial fibrillation and flutter, and various mixed disturbances of cardiac rhythm and conduction. Cardiac arrhythmias and conduction disturbance with prolonged Q-T interval were found to be precursors of asystole in 84.8%.

[The clinical efficacy of verapamil in ventricular extrasystolic arrhythmia and parasystole]. / Klinicheskaia éffektivnost' verapamila pri zheludochkovoi ékstrasistolicheskoi aritmii i parasistolii.

An arrhythmogenic mechanism has been investigated pharmacologically by acute drug tests (ADT) and alternate block of slow calcium channels and fast sodium channels of the cellular membranes. ADT with verapamil reduced extrasystoles by 60% in 44% of patients demonstrating the predominance of calcium-dependent arrhythmogenesis. An antiarrhythmic efficacy of fast sodium channels blockers was ascertained in 33% of the patients. ADT with rhythmilen and verapamil produced a satisfactory antiarrhythmic effect in 18% of the examinees. These patients seem to have parallel activation of both fast sodium and slow calcium channels. They received courses of both drugs. It is stated that a pharmacological analysis of extrasystolic arrhythmia allows inference on pathogenesis of myocytic electrolyte disturbances which serves the basis for adequate corrective therapy.

[The differential diagnosis of the main forms of paroxysmal tachycardias and tachyarrhythmias]. / Differentsial'naia diagnostika osnovnykh form paroksizmal'nykh takhikardii i takhiaritmii.

A study is presented of 150 in-patients with paroxysmal tachycardias and tachyarrhythmias. Urgent management was carried out using a diagnostic algorithm designed by the authors that helped to establish early diagnosis using clinical adequate rational methods. Identification of clinico-pathogenetic form was realized in 95% of patients. Invasive examination was carried out in dubious cases. Transesophageal examination of the heart is of high value in emergency cardiology.

[Clinical effectiveness of cordarone in combination with other anti-arrhythmia agents in refractory atrial fibrillation and adverse effects of the drugs]. / Klinicheskaia éffektivnost' kordarona v sochetanii s drugimi antiaritmicheskimi preparatami pri refrakternoi k terapii forme mertsaniia predserdii i pobochnye deistviia primeniaemykh lekarstv.

The study was undertaken to examine 105 patients with various circulatory diseases complicated by atrial fibrillation. Patients with refractory atrial fibrillation who had taken combined antiarrhythmic therapy were found to be more responsive to the combinations of cordarone + kinilentin (quinidine disulphate) and cordarone + ethacizin. The combinations of cordarone+digoxin and cordarone + finoptin were demonstrated to be less beneficial.

[A method for the individual choice of anti-arrhythmia preparations in extrasystole]. / O metodike individual'nogo podbora antiaritmicheskikh preparatov pri ékstrasistole.

Pharmacological analysis of arrhythmogenesis was approved in 60 patients with ventricular extrasystolic arrhythmia (EA). Individual choice of anti-arrhythmia agents (AAA) was realized by successive drug-induced block of slow calcium cancels by isoptin and rapid sodium channel by class I AAA. Changes of arrhythmogenesis were registered electrocardiographically. Acute tests with isoptin revealed a good antiarrhythmic effect in 46.67%, with AAA--in 30%. It is concluded that methods of pharmacological analysis of arrhythmogenesis widely used in experimental cardiology may be used in the clinic for individual choice of AAA.

[Clinical efficacy of combined therapy with verapamil and fast sodium channel blockers for refractory atrial fibrillation]. / Klinicheskaia éffektivnost' kombinirovannoi terapii refrakternoi k lecheniiu formy mertsaniia predserdii verapamilom i blokatorami bystrykh natrievykh kanalov.

A total of 70 patients aged 38-73 years who suffered from various circulatory disorders and refractory atrial fibrillation were examined. The majority of patients with refractory atrial fibrillation displayed normalized cardiac rhythm after the combined therapy with verapamil plus one of the fast sodium channel blockers (novocainamide, ethmozine, ethacizine, kinilentin). If the therapy failed, electric cardioversion was applied.

[Effect of the optimal dose of finoptin on various components of the circulatory system in heart failure in patients with ischemic heart disease]. / Vliianie finoptina v optimal'no podobrannykh dozakh na razlichnye zven'ia sistemy krovoobrashcheniia pri serdechnoi nedostatochnosti u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Following sublingual finoptin and following its course therapy, 27 patients with coronary heart disease in the presence of Stages I-IIA circulatory failure displayed positive central hemodynamic changes, myocardial contractile function improvement, afterload decrease, and a tendency to normalization of vascular and intravascular alterations.

[The effect of molsidomine on the conjunctival microcirculation in patients with ischemic heart disease]. / Vliianie molsidomina na kon''iunktival'nuiu mikrotsirkuliatsiiu u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Sublingual administration of molsidomin in average dose of 3 mg with an interval of 15 and 60 minutes was used in the treatment of 24 patients with ischemic heart disease with stable exertion stenocardia of the II-III functional classes. Course treatment in optimal chosen doses resulted in an improvement of the indices of conjunctival microcirculation and rheological properties of erythrocytes.