[Left ventricular systolic function in patients with infectious allergic myocarditis]. / Sostoianie sistologicheskoi funktsii levogo zheludochka serdtsa u bol'nykh s infektsionno-allergicheskim miokarditom.

Examination of 26 patients with infectious-and-allergic myocarditis and of 12 cases with myocarditic cardiosclerosis, performed with the aid of radionuclide ventriculography revealed signs of impairement of left ventricular systolic function, with both end-systolic volume and the mean myocardial fiber circular shortening rate measurements showing a downward tendency. A relationship was established between alterations in systolic function of the heart and clinical pattern of the medical condition.

[Structural and functional disorders of the left ventricle as a predictor of the subsequent course of the disease in patients with unstable angina]. / Narusheniia struktury i funktsii levogo zheludochka kak prediktor dal'neishego techeniia zabolevaniia u bol'nykh s nestabil'noi stenokardiei.

Significance of total ejection fraction was assessed in the long-term follow-up of 270 patients with unstable angina pectoris in the course of bidimensional echocardiography and 99mTc radioisotope ventriculography of the myocardium in order that we might be able to forecast the remote outcomes of this particular disease. Ejection fraction was shown to be an independent predictor of informative value for the end point of the disease.

[Cardiodynamics and left ventricular myocardial contractile reserve in patients with dilated cardiomyopathy]. / Sostoianie kardiodinamiki i sokratitel'nyi rezerv miokarda levogo zheludochka u bol'nykh dilatatsionnoi kardiomiopatiei.

Cardiodynamics and contractile myocardial reserves were measured at radionuclide ventriculography and volume loading of the heart (upward position of the legs at 45 degrees) in 43 patients with dilated cardiomyopathy (DCM). The patients displayed a sharp fall in total and regional ejection fractions (BP), stroke volume (SV), cardiac index, a decrease in Vcf and maximum ejection rate (Vmax) in combination with notable cardiomegaly. There were two types of responses to loading test: positive (increased BP, SV, Vcf, Vmax, reduced end-systolic volume) and negative (decreased EP, SV, Vcf, Vmax, increased end-systolic volume) Inotropic effects evidencing the existence or depletion of myocardial contractile reserve. Loading test in DCM patients allows more objective evaluation of the patient's condition and validated therapeutic measures.

[The ratio of the left ventricular systolic and diastolic functions in patients with hypertrophic cardiomyopathy]. / Sootnoshenie sistolicheskoi i diastolicheskoi funktsii levogo zheludochka serdtsa u bol'nykh gipertroficheskoi kardiomiopatiei.

A total of 60 patients with hypertrophic cardiomyopathy (HCMP) and 26 normal subjects were examined. HCMP patients showed increase in maximum ejection rate (ERmax) and shortening of time to reach it, which fact reflects augmentation of myocardial contractility in these patients. Significant alterations were also detectable in left ventricular diastolic function, manifested by a drop in maximum filling rate (FRmax), prolongation of time to reach it, diminution of filling fraction during phase of rapid filling, tendency toward increase of the filling fraction during diastasis phase and atrial systoles, reduction in indices of left ventricular volume compliance. The above alterations had a clear-cut association with the myocardial mass index. Comparative evaluation of left ventricular systolic and diastolic functions in HCMP patients indicated early and marked alterations in diastolic function of the left ventricle, preceding the development of systolic dysfunction, which fact is to be taken into account in choosing suitable medical treatment for HCMP patients.

[Left ventricular function in patients with dilated cardiomyopathy]. / Funktsional'noe sostoianie levogo zheludochka serdtsa u bol'nykh dilatatsionnoi kardiomiopatiei.

Functional state of left ventricle was studied in 43 patients with dilated cardiomyopathy. All the patients showed pronouncedly reduced total ejection, stroke volume and cardiac index, increased final diastolic and final systolic volumes, decreased ejection rate indices. Analysis of regional contractility of left ventricle allowed to detect significant fall of ejection fraction in 96.3% of segments. Diastolic dysfunction was characterized by disorders of isovolumetric relaxation, changes in hemodynamical structure and contribution of atrial systole to ventricular filling, decrease of volumetric compliance of left ventricle. The data obtained give a reason to consider that appropriate therapy of dilated cardiomyopathy should be carried out with taking into account both systolic and diastolic left ventricle dysfunction.

[Cardiodynamics and myocardial contractile reserve in patients with hypertrophic cardiomyopathy]. / Sostoianie kardiodinamiki i sokratitel'nyi rezerv miokarda u bol'nykh s gipertroficheskoi kardiomiopatiei.

Cardiodynamics and myocardial contractile reserve were studied in 60 patients with hypertrophic cardiomyopathy by using radionuclide ventriculography at rest and during graded exercise test. All findings that characterize cardiodynamics (normal or higher overall ejection fraction and stroke volume or lower end-systolic volume, higher maximum ejection rate) show the contractility of the left ventricle in patients with hypertrophic cardiomyopathy which can be regarded to be more severe. During graded exercise test, in patients with hypertrophic cardiomyopathy three types of reactions were identified: (1) positive inotropic effect; (2) negative inotropic effect; (3) intermediate (deviation of major cardiodynamic parameters was no more than 20-25% of the baseline levels). Identification of the above types allows one to assess the presence and conditions of myocardial contractile reserve implementation in these patients and to objectivize the choice of corrective drugs.

[The effect of the long-term treatment with calcium antagonists on myocardial function in patients with hypertension]. / Vliianie dlitel'nogo lecheniia antagonistami kal'tsiia na funktsional'noe sostoianie miokarda u bol'nykh gipertonicheskoi bolezn'iu.

Prolonged effect (6-12 months) of verapamil and nifedipine on the systolic and diastolic function of the myocardium was studied in 48 patients with hypertensive disease (stage II). It was established that in patients with a high ejection fraction (55% and more) the two drugs produce a distinct reduction of the pumping heart function. The two drugs increase the rate of early diastolic filling. They also may reduce the arterial pressure via different hemodynamic mechanisms: vasodilatation or via reduction of cardiac output.

[Correlation of antianginal effect of corinfar and diastolic function in patients with ischemic heart disease]. / Zavisimost antianginalnogo effecta corinfara ot sostoianiia diastolicheskoi funktsii serdtsa u bolnykh ishemicheskoi bolezníu serdtsa.

The study was undertaken to examine 45 patients with coronary heart disease and 14 healthy subjects by using radionuclide ventriculography, apex- and echocardiographies, bicycle ergometry, transesophageal electrocardiostimulation before therapy and at the action peak of corinfar in a dose of 30 mg. It was shown that corinfar failed to affect the unaltered diastolic function of the left ventricle. The normalizing effect of corinfar on left ventricular stiffness was found to result in higher coronary reserve, significantly enhanced exercise tolerance and to be an important mechanism of antianginal effect of the drug. Impaired left ventricular stiffness may be an additional criterion for using corinfar in patients with coronary heart disease.

[Arterial hypertension as a prognostic factor in the course of ischemic heart disease]. / Arterial'naia gipertoniia kak prognosticheskii faktor techeniia ishemicheskoi bolezni serdtsa.

Overall 235 patients with a history of uncomplicated myocardial infarction were examined. Of these, in 79 patients (33%), myocardial infarction developed in the presence of arterial hypertension. To predict the efficacy of rehabilitation treatment, postinfarction angina pectoris, arterial hypertension, the size and localization of the injury, the status of the coronary and myocardial reserves were taken into consideration. The data obtained confirmed the prognostic significance of arterial hypertension in the estimation of the efficacy of rehabilitation therapy. Arterial hypertension contributes to an unfavourable course of CHD and to a decrease of the work fitness of the patients who suffered myocardial infarction. Estimating the long-term efficacy of rehabilitation treatment, it is necessary to bear in mind not only the coronary reserves, but also the myocardial reserves, its integral index--the total ejection fraction and regional myocardial contractility.

[The age-related characteristics of the cardiodynamics of patients who have had a myocardial infarct]. / Vozrastnye osobennosti kardiodinamiki u bol'nykh, perenesshikh infarkt miokarda.

Age-related effects on the function of restoration in 254 patients with a history of myocardial infarction were investigated. It was found that the age effect influenced tolerance to physical load, the values of which are not always related to the character of the sustained infarction of the myocardium.

[Effects of calcium antagonists on the pattern of intracardiac hemodynamics and functional state of the myocardium in patients with angina pectoris relapsing after aortocoronary bypass operation]. / Vliianie antagonistov kal'tsiia na strukturu vnutriserdechnoi gemodinamiki i funktsional'noe sostoianie miokarda u bol'nykh so stenokardiei, vozobnovivsheisia posle operatsii aortokoronarnogo shuntirovaniia.

The hemodynamic pattern of the antianginal effects of calcium antagonists was examined in 111 patients with Functional Classes II-IV angina pectoris relapsing on an average of 36.7 +/- 1.1 months following aortocoronary bypass surgery, as evidenced by radionuclide ventriculography performed in the acute drug test with finoptin and corinfar. The clinical and functional status improved in 49 patients on finoptin and in 62 on corinfar. In three fourths, the efficacy of finoptin was achieved by decreased myocardial diastolic stiffness and only in a fourth, it was due to lower afterload. In three fourths, the efficacy of corinfar was attained by the action of the vascular component and only in a fourth, it was attributable to its effects on diastolic relaxation--to its direct action on the myocardium.

[Diastolic function of the left heart ventricle in patients after myocardial infarct]. / Diastolicheskaia funktsiia levogo zheludochka serdtsa u bol'nykh, perenesshikh infarkt miokarda.

Altogether 129 patients were investigated 3 months after the onset of myocardial infarction (MI). Left ventricular diastolic function was assessed using a set of parameters of radionuclide ventriculography, including fractions of filling of the first and second thirds of the diastole, increments of volumes in the phases of fast and slow filling, a maximum rate of filling and the time of achieving it. Marked disorders of isovolumetric relaxation (indices of filling of the first third of the diastole) as well as changes of volumetric compliance (a ratio of increments of volumes of filling of the first and second thirds of the diastole) were revealed in the patients. A degree of disorder of left ventricular diastolic function and MI localization showed no correlation, however more noticeable changes were observed in the group of patients with the anterio-apical localization of myocardial lesion as compared to patients with lesions of posterior-lateral localization.

[Radionuclide ventriculography in the evaluation of the diastolic function of the left heart ventricle]. / Radionuklidnaia ventrikulografiia v otsenke diastolicheskoi funktsii levogo zheludochka serdtsa.

A maximum filling rate (FRmax), the time of reaching it (T-FRmax), the fraction of filling of the first and second diastolic thirds (FF1/3 and FF2/3), an increment of the volume in the first and second diastolic thirds (delta V1 and delta V2) were investigated on the basis of radionuclide ventriculography findings, 99mTc being used. CHD patients (n = 133) were characterized by a decrease in FF1/3, FRmax, an increase in T-FRmax changes in the ratio of delta V1 and delta V. A normal filling process was characterized by predominance of filling in the first diastolic third (the fast filling phase - delta V1 greater than greater than delta V2). Left ventricular diastolic dysfunction was characterized either by a homogeneous distribution of filling in the phase of fast or slow filling with practically equal increasing of volumes in the first and second diastolic thirds (delta V1 = delta V2) or by shifted filling during diastasis (delta V1 less than delta V2).

[Radionuclide ventriculography in the diagnosis of hypertrophic cardiomyopathy]. / Radionuklidnaia ventrikulografiia v diagnostike gipertroficheskoi kardiomiopatii.

Total and regional (by 7 zones) contractility of left ventricular functions in 25 patients with hypertrophic cardiomyopathy (HCMP) were characterized by a different combination of normal and elevated values of total and regional ejection fractions, rate indices of systolic expulsion. Normal or slightly changed values of the end-diastolic volume were combined with normal or elevated values of the stroke volume. Comparative analysis of the values characterizing cardiodynamics, led to working out criteria of differential diagnosis in HCMP patients with heart pain and in CHD patients with myocardial hypertrophy (predominance of the signs of left ventricular hyperfunction in the former and contractility hypofunction and asynergy in the latter). Changes in the diastolic filling of the left ventricle indicated its disturbed diastolic function in both groups of patients.

[Radionuclide ventriculography in the diagnosis of dilated cardiomyopathy]. / Radionuklidnaia ventrikulografiia v diagnostike dilatatsionnoi kardiomiopatii.

Assessment of myocardial contractility function and its diastolic features (according to the results of radionuclide ventriculography with 99mTc-pertechnetate) in patients with dilatory cardiomyopathy (DCMP) revealed a significant decrease in the total ejection fraction, regional ejection fractions, cardiomegaly (an increase in the end-diastolic volume combined with an increase in end-systolic volume and a decrease in the stroke volume) and a decrease in ejection rate indices. Differential criteria for the diagnosis of DCMP and CHD were a greater degree of cardiodynamic indices and a diffuse decrease in myocardial regional contractility function in the former and heterogeneity of changes in regional contractility in the latter pathology. The process of diastolic filling in DCMP patients was characterized by a marked decrease in a filling rate at reduced time of its achievement, and in CHD patients by a decrease in a maximum filling rate in combination with increased time of its achievement.

[Regional and general contractile function of the myocardium following myocardial infarct]. / Regionarnaia i obshchaia sokratitel'naia funktsii miokarda posle infarkta miokarda.

A total of 93 patients with myocardial infarction were investigated 3-4 mos. after the beginning of disease by the method of radionuclide ventriculography. Total and regional ejection fractions (for 7 zones), left ventricular functional volumes (end-systolic, end-diastolic and stroke volumes), rates of contraction and expulsion were determined. A certain level of left ventricular pump function in patients after myocardial infarction was determined by the ratio of the number of hypokinetic segments and the expression of a decrease in their contractility and normo- and hyperkinetic segments which are the main compensatory factor. Variations in the structure of formation of the total ejection fraction with relation to a site of myocardial infarction were revealed. Compensatory significance of hyperkinetic zones is decreased with a growing degree of expression of contraction asynergia.

[The regional contractility of the left ventricle in patients with ischemic heart disease and concomitant hypertension]. / Regionarnaia sokratimost' levogo zheludochka u bol'nykh ishemicheskoi bolezn'iu serdtsa s soputstvuiushchei gipertonicheskoi bolezn'iu.

Differential evaluation was carried out of hypertrophy as a factor possibly of compensatory or that of furthering disturbances of the coronary circulation and contractile function of the myocardium. Echocardiography, radionuclide ventriculography tests with physical loads revealed that only moderate hypertrophy of the left ventricle in IHD patients with hypertensive disease (grade II) may be considered as one of the compensatory factors maintaining the functional state of the left ventricle myocardium.

[Radionuclide ventriculography in the evaluation of the functional state of the left heart ventricle in patients following myocardial infarct]. / Radionuklidnaia ventrikulografiia v otsenke funktsional'nogo sostoianiia levogo zheludochka serdtsa y bol'nykh, perenesshikh infarkt miokarda.

The use of an expanded set of parameters of radionuclide ventriculography with 99mTc-pertechnetate, characterizing myocardial function, made it possible to specify radionuclide semiotics of myocardial infarction, to identify 4 cardiodynamic types, and to establish correlation between a degree of cardiodynamic changes and a site of lesion, and the relationship with exercise tolerance.

[Radionuclide ventriculography in the evaluation of the diastolic function of the left heart ventricle]. / Radionuklidnaia ventrikulografiia v otsenke diastolicheskoi funktsii levogo zheludochka serdtsa.

Early changes of left ventricular diastolic function were revealed in patients with various types of coronary heart disease (CHD) on determination of a maximum filling rate (FRmax) and the time of maximum filling rate (T-FRmax) on the basis of radionuclide ventriculography data. A decrease in FRmax and a tendency to an increase in T-FRmax were noted in the group of patients with chronic CHD with normal ejection fraction at rest as well as in the groups of patients with chronic CHD and lowered total ejection fraction at rest and with acute myocardial infarction. Correlation of changes in left ventricular diastolic and systolic functions (the ratio of FRmax/stroke volume) with predominant change of the former was revealed in all the examinees. A high sensitivity of FRmax and T-FRmax in the detection of change of diastolic function in CHD patients was shown.