[Quantitative analysis of the phospholipid composition of the myocardium in experimental diabetes mellitus: effect of total ischemia]. / Kolichestvennyi analiz fosfolipidnogo sostava mikarda pri éksperimental'nom sakharnom diabete: vliianie total'noi ishemii.

Phospholipid composition was studied in the myocardium of rats and rabbits with alloxan diabetes developed after intravenous of intraperitoneal administration of alloxan and complicated by 60-min total ischemia. The diabetes developed within 4 weeks thereafter heart tissue was isolated and used for biochemical analyses. Total cardioplegic ischemia was simulated in the perfused heart after drastic interruption of perfusion. Composition of myocardial phospholipids was altered in alloxan diabetes: content of lysophosphoglycerides, lysophosphatidylcholine, lysophosphatidylethanolamine and of sphingomyelin was increased, while cardiolipin and phosphatidylethanolamine were decreased. In the diabetes-impaired heart tissue, a 2-fold increase was detected in the ratio of cholesterol/phospholipids, which corresponded to the viscosity of plasma membranes. Total ischemia within 60 min caused a further increase in the levels of lysophosphoglycerides in the diabetes-impaired tissue. Considerable differences in the content of phospholipids were maintained in control and diabetes-impaired heart tissues after ischemia and reperfusion; these differences were observed in the preischemic group. Thus, phospholipid composition was altered in the diabetes-impaired myocardia in presence and/or absence of ischemia.

[Changes in central hemodynamics and microcirculation during laser therapy in patients with coronary insufficiency]. / Izmeneniia tsentral'noi gemodinamiki i mikrotsirkuliatsii pod deistviem lazeroterapii u bol'nykh s serdechnoi nedostatochnost'iu.

The study was undertaken to examine 45 patients with Stages IIB-III heart failure (HF) by the classification developed by V. Kh. Vasilenko and N. D. Strazhesko. Thirty patients had laser therapy in addition to the routine treatment, 15 patients served as a control group. The combined drug treatment along with laser therapy in patients substantially improved peripheral circulatory parameters than in the controls. There was a positive dynamics of central hemodynamic parameters as shown by lower left ventricular volumes and higher myocardial contractile and pump functions. Improvement of microcirculatory and central hemodynamic parameters in patients treated with laser occurred in earlier periods of hospital stay than in the controls.

[Energy metabolism and contractile function of the heart in diabetic cardiomyopathy: effect of ischemia and reperfusion]. / Issledovanie énergeticheskogo metabolizma i sokratitle'noi funktsii serdtsa s diabeticheskoi kardiomiopatiei: deistvie ishemii i reperfuzii.

Physiological parameters, rates of mitochondrial respiration, high energy phosphate levels and creatine phosphokinase (CPK) activity were investigated in the hearts from control and alloxan-induced diabetic rabbits before and after 40-min total ischemia and reperfusion. Diabetic hearts demonstrated significant decreases in the rates of contraction (+dP/dt) and relaxation (-dP/dt), heart rates and cardiac work compared to control hearts. Determination of mitochondrial respiration rates in saponin-skinned fibers showed a low mitochondrial respiratory function in diabetic hearts. It was found that the ATP and ADP levels and the total and mitochondrial isoenzyme activities of CPK in diabetic hearts were lowered in comparison with control. A post-ischemic recovery of cardiac performance for diabetic hearts was better than in controls. After reperfusion diabetic hearts had increased ATP levels. The data obtained demonstrate some abnormalities of both cardiac performance and energy metabolism in the hearts of diabetic animals and a decreased sensitivity of the latter to ischemic injury.

[The use of helium-neon laser in drug-resistant cardiac arrhythmias]. / Primenenie gelii-neonovogo lazera pri ustoichivykh k lekarstvennoi terapii aritmiiakh serdtsa.

Out of 85 patients with cardiac arrhythmias in the presence of chronic coronary heart disease, 28 who were resistant to ethacisine and allapinine were included into the study. They had frequent and persistent arrhythmias. The patients were divided into 2 groups: (1) the patients receiving intravenous He-Ne laser therapy in combination with one of the above drugs; (n = 17) and (2) those taking He-Ne laser therapy alone (n = 11). The efficacy of the therapies were controlled by 24-hour monitoring. An antiarrhythmic effect was more frequently observed when He-Ne laser was combined with one of the above drugs than when it was given alone (67.4 and 36.3%, respectively).

[Disorders of cardiac rhythm and the changes in Q-T interval in mitral valve prolapse syndrome]. / Narusheniia serdechnogo ritma i izmeneniia intervala Q-T pri sindrome prolabirovaniia mitral'nogo klapana.

To study the incidence and nature of cardiac arrhythmias and the changes in the corrected Q-T interval, 60 patients with the prolapsed mitral valve syndrome were examined. All the patients underwent resting ECG and leg isometric exercise. 24-hour ECG monitoring was performed in 48 patients. The latter technique was found to be the most informative tool for detecting cardiac arrhythmias (66.8%). Prolonged corrected Q-T interval (more than 440 msec) was more frequently revealed in leg isometric exercise (41.6%) than in resting ECG (26.6%) and 24-hour monitoring (29.2%). Its degree was directly related to the severity of cardiac arrhythmias in patients with the prolapsed mitral valve syndrome.

[Use of isometric exercise to enhance the diagnostic value of dipyridamole testing in patients with angina pectoris]. / Primenenie izometricheskoi nagruzki dlia povysheniia diagnosticheskoitsennosti dipiridamolovoi proby u bol'nykh so stenokardiei.

A dipyridamole test was performed in 40 patients with coronary heart disease who were divided into 2 groups, each consisting of 20 subjects. The dipyridamole test alone was performed in the patients from Group 1, while the agent was given by using manual dynamometry and increasing venous return in those from Group 2. Positive results were obtained in 55 and 85%, respectively (p less than 0.05). The mean dipyridamole dose was 0.64 mg/kg for Group 1 patients and 0.48 mg/kg for Group 2 patients (p less than 0.05).

[Functional state of the left regions of the heart in healthy persons during isometric exercise]. / Funktsional'noe sostoianie levykh otdelov serdtsa u zdorovykh liudei pri izometricheskoi nagruzke.

Hemodynamic parameters of left and atrial contractile and pump functions were examined in 25 healthy males undergoing leg isometric exercise, by employing echocardiography. Analysis of changes in intracardiac hemodynamics showed that for provision of a marked pressor reaction occurring in healthy persons during isometric exercise, there was enhanced left ventricular myocardial contractility and thereby higher stroke and minute volumes. To maintain the required increase in stroke volume at the maximal exercise level, an accessory mechanism of compensation gears (by the Frank-Starling type), which operates due to myocardial diastolic relaxation, elevated venous blood supply at the expense of sucking cardiac action, and augmented left atrial contractility.

[Evaluation of the effect of intravenous administration of streptodecase on the extent of the damage in myocardial infarction]. / Otsenka vliianiia vnutrivennogo vvedeniia streptodekazy na razmer porazheniia pri infarkte miokarda.

Precordial mapping was employed to examine 29 patients with acute anterior transmural myocardial infarction (MI). Seventeen of them received intravenous streptokinase, eleven underwent symptomatic therapy. The size of the lesion was assessed in the course of the disease. It is shown that streptokinase administration within the initial 6 hours of MI promotes arrest of the ischemic lesion augmentation and eventually diminishes the area of MI.

[Changes in fluid spaces in patients with heart failure under the effects of isolated ultrafiltration]. / Izmeneniia vodnykh prostranstv u bol'nykh s serdechnoi nedostatochnost'iu pod vliianiem izolirovannoi ul'trafil'tratsii.

The study was undertaken to examine 22 patients with chronic heart failure of Stages IIB-III according to the classification developed by V. Kh. Vasilenko and N.D. Strazhesko. In patients with severe heart failure accompanied by the edematous syndrome, sessions of isolated ultrafiltration was found to result in substantially lower volumes of circulating plasma, extracellular and interstitial fluids and in increased total protein and hematocrit. When decreased just after each session of isolated infiltration, the volume of circulating plasma increased later due to fluid transfer from the extracellular space into the vascular bed. On day 20 of treatment the volume of circulating plasma reached the baseline values by altering the qualitative composition of plasma.

[Use of isometric load for evaluation of the anti-arrhythmia effect of drugs]. / Primenenie izometricheskoi nagruzki dlia otsenki anti-aritmicheskogo éffekta lekarstvennykh preparatov.

Possible use of pedal isometric stress for the assessment of antiarrhythmic effect of ethacizine was explored in 34 patients with various heart rhythm disorders. They showed similar results of pedal isometric stress test and 24-hour ECG monitoring. Heart rhythm monitoring in the presence of the acute test and a treatment course demonstrated complete agreement between positive results of the pedal isometric stress test and 24-hour ECG monitoring in 85% of the patients, exhibiting an obvious antiarrhythmic effect. The pedal isometric stress test may be useful for the assessment of antiarrhythmic medication efficacy.

[Use of a static exercise test for evaluating anti-angina effects of drugs in patients with ischemic heart disease at a polyclinic]. / Primenenie proby so staticheskoi nagruzkoi dlia otsenki antianginal'nogo effekta lekarstvennykh preparatov u bol'nykh ishemicheskoi bolezn'iu serdtsa v usloviiakh polikliniki.

Only in 115 of 320 patients who had attended the polyclinic for cardialgias, static exercise and bicycle ergometer tests could be performed because of medical contraindications and the patients' refusal to participate in the investigation. Positive results were found in 15 patients who had undergone bicycle ergometer tests and in 12 patients who did static exercise. It has been shown that static exercise tests may be useful for selecting antianginal drugs (glyceryl trinitrate, anapriline, corinfar) for outpatients with coronary heart disease on an individual basis.

[Functional status of the left side of the heart in patients with ischemic heart disease during isometric exercise]. / Funktsional'noe sostoianie levykh otdelov serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa pri izometricheskoi nagruzke.

Hemodynamic parameters of left-ventricular and left-atrial contractility and pumping function were examined in 47 males with postinfarction cardiosclerosis and no clinical signs of circulatory insufficiency and in 30 normal male subjects, exposed to isometric leg exercise with the highest possible compression force. At the height of exercise, normal subjects showed increased left-ventricular myocardial contractility along with the initiation of the Frank-Starling mechanism, spreading to the left atrium as well, while coronary patients responded to increased stress by growing left-atrial reservoir function during the first minutes of exercise, and activated left-atrial transport and pumping functions afterwards. Isometric leg exercise is capable of detecting left-atrial and left-ventricular pumping and contractility disorders in coronary patients.

[Comparative evaluation of the results of the bicycle ergometry test in patients with stress stenocardia after treatment with propranolol and nifedipine]. / Sravnitel'naia otsenka rezul'tatov veloérgometricheskoi proby u bol'nykh so stenokardiei napriazheniia posle priema propranolola i nifedipina.

The results of bicycle ergometry (BE) following administration of placebo, 80 mg propranolol (anaprilin), 30 mg nifedipine (corinfar) and a combination of 60 mg propranolol and 20 mg nifedipine were reviewed in coronary patients with angina pectoris of functional classes (FC) II-IV. Patients with FC-II angina showed the greatest increment in stress tolerance after nifedipine administration, and patients with FC-IV angina, after propranolol, apparently due to a predominance of the functional (coronaro-spastic) pathogenetic factor in the FC-II angina, and the organic factor, in angina of more severe functional classes. In patients belonging to FC-III, the two drugs had similar antianginal efficiency. Stress tolerance increased considerably after simultaneous administration of both drugs in all patients with angina of effort, irrespective of functional class.

[Method of diagnosing ischemic heart disease by using isometric loading]. / Sposob diagnostiki ishemicheskoi bolezni serdtsa s ispol'zovaniem izometricheskoi nagruzki.

Twenty-five male patients, aged 41 to 57, with typical clinical signs of angina of effort and positive bicycle ergometric tests, were investigated to compare diagnostic possibilities of bicycle ergometry, manual dynamometry and the combination of the latter with increased venous return achieved by means of changed position of the body in coronary patients. The analysis of ECG changes showed ST displacement by more than 1 mm in 100% of cases with bicycle ergometry (in keeping with the criteria of patient selection), in 24% with manual dynamometry, and in 76% with increased venous return as part of the combination. Considering disorders of cardiac rhythm as a sign of coronary disease, static load tests were positive in 32% of cases, and the same tests combined with increased venous return gave positive results in 88%. The simplicity of the test makes it acceptable for out-patient use.

[Changes in arterial pressure, heart contraction rate and ECG indices in ischemic heart disease patients undergoing static-dynamic loading]. / Izmeneniia arterial'nogo davleniia, chastoty serdechnykh sokrashchenii i nekotorykh pokazatelei EKG u bol'nykh ishemicheskoi bolezn'iu serdtsa pri statiko-dinamicheskoi nagruzke.

Thirty males with coronary heart disease were examined using bicycle ergometry and a combined statico-dynamic test. It was established that the latter was accompanied by a more rapid (as compared with bicycle ergometry) increase of the heart rate, the systolic arterial pressure, the value of "double multiplication" and, in contrast to dynamic exercise, by an elevation of the diastolic arterial pressure. During a combined test an anginal attack and displacement of the ST segment occurred earlier as against bicycle ergometry. The above characteristics of the hemodynamics during the statico-dynamic exercise justify the use of this test for studying the relationship of the coronary blood flow and myocardial contraction.