[Performance of fragmenting operation for restoration of a correct rhythm while treating the isolated failure of a mitral valve].

Possibilities of application of the proposed procedure for intraoperative restoration of the sinus rhythm while the mitral valve prosthesis (MVP) were studied up. In 161 patients, suffering the isolated mitral valve failure stage IV, a surgical treatment was conducted in Department of surgical treatment of acquired heart failures. The left atrium plasty was conducted in 119 (73.9%) of them with the objective to reduce its size and eliminate the re-entry waves passability. Fragmentation in left atrium was conducted in lowradiofrequency regime of diathermy (25-35 W) in accordance to variant (cut and sew) of operations Maze - 3 and Maze - 4. On a hospital stage 3 patients died (hospital lethality 1.9%). MVP in combination with Maze operation in a lowradiofrequency regime have permitted to restore successfully a correct rhythm in 80.2% of patients on a hospital stage and to stabilize it during 1 year postoperatively.

[Functional state of arterioles in patients with essential hypertension and arterial hypertension developed at the background of diabetes mellitus].

With the aim of studying linear velocity characteristics of arteriolar blood flow and reactivity of arterioles we examined 80 patients with essential arterial hypertension (AH), 83 patients with type 2 diabetes mellitus (DM) with concomitant AH, and 63 healthy people. In all patients examination included ultrasound continuous wave dopplerography of microcirculatory vascular bed at rest and after distant warming test. It was found that in patients with essential AH blood flow velocity in arterioles was maximal, increment of arteriolar blood flow in response to warming was lower than in healthy persons. In patients with type 2 DM minimal linear velocity characteristics of arteriolar blood flow and its increment in response to warming test were minimal. Results of the study evidence for principal differences of functioning and reactivity of arterioles in patients with essential AH and AH developed at the background of diabetes mellitus.

[Arteriolar circulation and arterial pressure in patients with essential hypertension].

Arteriolar circulation and its relationship with arterial pressure were studied in 127 patients with essential hypertension and 63 healthy subjects using continuous US dopplerography of the microcirculatory system at rest. Linear arteriolar blood flow rate was measured in healthy subjects and 47 patients before and after primary indapamide therapy. It was found to equal 17.7 (mean 9.1) cm/s in systole and 8.7 cm/s in diastole in the patients versus 12.2 (7.3) and 4.3 respectively in the healthy subjects (p = 0.005) giving indirect evidence of narrowed diameter of arterioles. Arteriolar circulation was shown to depend on the duration of arterial hypertension. Both AP and linear arteriolar blood flow rate decreased under effect of hypotensive therapy but there was no significant correlation between the two parameters.

[State of microcirculation and endothelial dysfunction in patients with type 2 diabetes mellitus and arterial hypertension].

In order to evaluate microcirculation and endothelial dysfunction in type 2 diabetes mellitus accompanied by arterial hypertension, 40 men aged 54.9 +/- 1.49 years suffering from these conditions were examined using ultrasound continuous-wave microcirculation dopplerography (Minimax-Doppler-K) and ischemic test. The controls, 28 practically healthy persons, were sex- and age-comparable. Compared to the controls, the patients with diabetes and concomitant arterial hypertension displayed lower linear blood flow velocity both initially and during the postischemic period, their velocity parameters recovered after ischemic test more slowly, and the parameters of blood flow were rigid within the entire study. This could result from an increased microcirculatory blood vessel (arteriolar) diameter, changes in vessel reactivity, and the presence of endothelial dysfunction in these patients.

[Diagnosis and treatment of biatrial myxomas of the heart]. / Diagnostika i lechenie biatrial'nykh miksom serdtsa.

Of the multiple myxomas of the heart (MH) the bilateral myxomas were revealed in 57.1%. Of 4 patients before the operation the correct diagnosis was established only in one. Meticulous data on clinical signs, diagnosis and surgical treatment peculiarities of patients with bilateral MH were adduced. Morphological peculiarities of the tumor were analyzed. Special attention was paid to the necessity of clinical and surgical guard toward revelation of undiagnosed tumors, the choice of optimal approaches to the heart cavities while performing radical operation. Basing on results of histological studying of operational specimen it was established that MH is originated from transformed vessels of interatrial septum.

[Changes in hypophyseal-thyroid system function and in the level of atrial natriuretic factor and cyclic nucleotides in the blood of patients with ischemic heart disease exposed to ultrasonic irradiation of the precordial area]. / Izmeneniia sostoianiia gipofizarno-tireoidnoi sistemy, urovnia predserdnogo natriiureticheskogo faktora, tsiklicheskikh nukleotidov v krovi bol'nykh ishemicheskoi bolezn'iu serdtsa pod vozdeistviem ul'trazvukovogo oblucheniia prekordial'noi oblasti.

Radiation of the precordial region with ultrasound at 880 kHz, 0.4 W/cm2 for 12 minutes was examined for its impact on blood levels of thyrotropin, tri-iodothyronine, thyroxine, atrial natriuretic factor, cyclic nucleotides (cAMP and cHMP) in 70 patients with Functional Classes II-III exercise-induced angina. The radiation was found to lead to elevated plasma levels of atrial natriuretic factor, cHMP and inhibited plasma cAMP in patients with coronary heart disease as compared to the control group.