[Morphological changes in blood plasma of patients with infectious endocarditis].

The aim of the study was to examine the morphological picture of sera obtained from 34 patients with infectious endocarditis (IE) pre-, intra- and postoperatively after their cuneiform dehydration. The method allowed integral homeostasis to be assessed including detection of markers of various pathological processes (onset of generalization of Candida infection and development of polyorgan dysfunction). Results of surgical treatment of IE for the period of 2002-2007 are presented.

[Peculiarities of distribution of catecholamines in the myocardium of patients with congenital heart defects.].

Catecholamines and intracardiac hemodynamics were studied in 37 patients with congenital heart defects. Clinical investigation confirmed importance of assessment of functional state of myocardium based on information, obtained by measurement of catecholamines in the heart. Concentration of catecholamines among various nosological was affected by perfusion and hypoxia of myocardium as well as forms of hyperfunction of cardiac muscle.

[Functional condition of the myocardium after reparative heart surgeries].

The authors of the article analyze the dynamics of the myocardial pumping ability after surgical repair of congenital and acquired heart valvular diseases. Measurement of the intracardial and central hemodynamics allowed the authors to demonstrate the significance of the diastolic component of heart functioning and the subendocardial circulation condition in the development of preclinical heart failure. The study shows a clear interrelation between myocardial functional load and increase of catecholamine concentration in it. An abrupt fall of norepinephrine concentration in the myocardium suggests an extreme overload of the sympathico-adrenal system and its exhaustion, caused by extremal functioning conditions.

[Dynamics of parameters of diastole and subendocardial right ventricular blood flow in adult patients after correction of atrial septal defect]. / Dinamika pokazatelei diastoly i subéndokardial'nogo krovotoka pravogo zheludochka u vzroslykh bol'nykh posle korrektsii defekta mezhpredserdnoi peregorodki.

The study of intracardiac hemodynamics and subendocardial blood flow in 55 adults with atrial septal defect confirmed practical value of assessment of myocardial contractility by long term catheterization of right cardiac chambers, construction of right ventricular function curves and "pressure-volume" diagrams. Simultaneous graphical registration with the help of computer diagnostic system represented character and direction of changes of controlled parameters during the period of observation as well as peculiarities of interventricular interaction after removal of isotonic right ventricular overload. Compared with traditional hemodynamic monitoring this approach to analysis of intracardiac hemodynamics provided real time assessment of cardiac function, facilitated elucidation of causes of cardiac output lowering and optimization of myocardial contractility regulation.

[Assessment of right ventricular function in patients with congenital heart defects with pulmonary hypertension. The role of some parameters of hemodynamics]. / Otsenka funktsii pravogo zheludochka u bol'nykh vrozhdennymi porokami serdtsa s legochnoi gipertenziei.

Intracardiac hemodynamics was studied in 46 patients with intraventricular septal defect and 32 patients with incomplete atrioventricular canal. The study confirmed practical value of assessment of contractility of right ventricular myocardium basing on information obtained during prolonged catheterization of the right cardiac chambers, construction of right ventricular function curves and analysis of pressure-volume loops. Compared with conventional hemodynamic monitoring this approach to analysis of intracardiac hemodynamics provided real time assessment of cardiac function, facilitated elucidation of causes of lowering of cardiac output and elaboration of optimal pathways of regulation of the myocardial contractile state.

[Surgical treatment of subvalvular aortic stenosis]. / Khirurgicheskoe lechenie podklapannogo stenoza aorty.

Among 104 patients with aortic stenosis 15 had subvalvular stenosis. In 4 cases the subvalvular stenosis was caused by fibromuscular constriction of the left-ventricular outlet, in the other cases it was formed by a connective-tissue membrane. A rather frequent combination of the subaortic stenosis with other heart anomalies is pointed out. Two patients died after the operation from progressive cardiac failure.

[Surgical treatment of left-atrial myxoma]. / Khirurgicheskoe lechenie miksom levogo predserdiia.

The authors had 29 patients with myxomas of the left atrium under observation and treated them by operation. Three patients died after the operation. Examination of 22 patients in postoperative periods of 8 months to 15 years did not reveal recurrent tumors of the heart. The extremely rare development of tumors of the heart and the absence of specific clinical manifestations make it difficult to establish the diagnosis in time. The relatively high postoperative mortality (12%) is due, first of all, to establishment of the diagnosis during the operation as a consequence of which an emergency operation on an open heart cannot be conducted. Operative treatment is indicated for all patients with a recognized tumor of the heart.

[Myocardial catecholamine levels in patients with congenital and acquired heart defects]. / Soderzhanie katekholaminov v miokarde bol'nykh vrozhdennymi i priobretennymi porokami serdtsa.

Catecholamine levels were determined in the myocardial slices from 66 patients with congenital and acquired heart diseases by the trihydroxyindole++ method on a Lumilan fluorescence spectrophotometer. The patients were found to have greatly varying epinephrine and norepinephrine levels. The accumulation of catecholamine reflected, to a certain extent, the occurrence of disorders in relation to the functional load, hyperfunctions of the myocardium. Blood hypoxemia and myocardial hypoxia affected the status of the patients.

[Diastolic changes in isolated stenosis of the pulmonary artery after correction of valvular defect]. / Izmeneniia diastoly pri izolirovannom stenoze legochnoi arterii posle korrektsii poroka.

Intracardiac hemodynamics and myocardial function were studied in 20 patients surgically treated for a valve defect. All the patients developed isolated stenosis of the pulmonary artery. It is emphasized that an early postoperative period in relevant correction proceeds with diastolic impairments. Some factors affecting the degree of the diastolic filling of the right ventricle upon the defect correction are determined. Adequate therapy of the disorders in proposed.

[Endomyocardial biopsy in complicated congenital heart defects]. / Endomiokardial'naia biopsiia pri oslozhnennykh vrozhdennykh porokakh serdtsa.

Endomyocardial biopsy followed by myocardium examination helps detect the changes characteristic of bacterial endocarditis at different stages. This allows rational treatment conducive to a favorable course of the postoperative period.

[Changes in the contractility of the myocardium in its various conditions in patients with congenital heart defects after surgery]. / Izmeneniia sokratite'lnoi sposobnosti miokarda pri razlichnykh ego sostoianiiakh u bo'lnykh vrozhdennymi porokami serdtsa posle operatsii.

Intracardiac central hemodynamic parameters were studied and myocardial functional states were assessed in 46 patients with congenital heart disease, 20 of them had stenosed pulmonary artery; 26, presented with secondary atrial septal defect complicated with bacterial endocarditis. The mechanisms responsible for myocardial adaptation after defect correction are discussed. Attention is given to inadequacy of the performance of the heterometric mechanism of regulation due to altered elasticoviscous properties of the cardiac muscle. Plotting the functional curves enables one to gain an insight into the functional states of the myocardium.