[Clinical and instrumental predictors of survival in patients with chronic heart failure and intact systolic left ventricle function]. / Kliniko-instrumental'nye prediktory vyzhivaemosti bol'nykh s khronicheskoi serdechnoi nedostatochnost'iu i sokhranennoi sistolicheskoi funktsiei levogo zheludochka.

165 patients with clinically-manifested chronic heart failure (CHF) and preserved (ejection fraction--EF > 40%) left ventricular (LV) systolic function have been investigated. 135 of them have ischaemic heart disease (IHD) and high blood pressure, 8 patients are without IHD and 22 patients with normal blood pressure. 62 patients have chronic atrial fibrillation. Survival value in patients with CHF and preserved LV systolic function was compared to survival value of those with CHF and impaired ejection fraction (EF < 40%). Patients with preserved LV systolic function have been found to be with better survival value than those with impaired ejection fraction (68 and 33% accordingly).

[The hormone level of the blood from the aorta and the coronary sinus in patients with ischemic heart disease under conditions of preoperative stress]. / Soderzhanie nekotorykh gormonov v krovi iz aorty i koronarnogo sinusa u bol'nykh ishemicheskoi bolezn'iu serdtsa v usloviiakh predoperatsionnogo stressa.

A total of 156 patients with ischemic heart disease were examined under conditions of preoperative stress in a multiple-modality study performed with the aid of such techniques as echocardiography involving calculation of the myocardial mass index, coronaroventriculography, measurements of the adrenocorticotrophic hormone, hydrocortisone, somatotrophic hormone, triiodothyronine and thyroxin in the blood from the coronary sinus and aorta. A conclusion has been reached that emotional strain influences myocardial hypertrophy. A possible significance of the studied hormonal indices is shown together with features thereof in IHD patients presenting with different degrees of left ventricular hypertrophy.

[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.

[Myocardial ischemia occurring during coronary ventriculography in patients with ischemic heart disease]. / Ob ishemii miokarda, voznikshei v protsesse koronaroventrikulografii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Analysis of myocardial ischemia that occurred during coronary ventriculography in patients suffering from ischemic heart disease (IHD) depending on the severity of the illness showed that it tended to develop in patients with the most restricted coronary reserve, clinically apparent affection of major arteries of the heart and significant dysfunction of left ventricular myocardium. While preparing patients for the invasive evaluation it is necessary that the clinical course of the disease be taken into consideration. At most risk in this respect are persons whose IHD course is aggravated by myocardial infarction and associated with hypertensive disease.

[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 interrelation of the secretory activity of the myocardium with its hypertrophic characteristics in patients with ischemic heart disease]. / Vzaimosviaz' sekretornoi aktivnosti miokarda s osobennostiami ego gipertrofii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Evaluation of the concentration of atrial natriuretic peptide, angiotensin P, renin activity in the blood of the coronary sinus and aorta in 18 patients with IHD and hypertrophy of the left ventricle during development of induced ischemia revealed that in left ventricular hypertrophy secretion of atrial natriuretic peptide by the myocardium is reduced. The level of this reduction depends on the kind of hypertrophy. Dilatation of the left ventricle cavity furthers exhaustion of the secretory function of the ischemic myocardium.

[Late ventricular potentials and left ventricular performance in patients with hypertrophic cardiomyopathy]. / Pozdnie zheludochkovie potentsialy i funktsional'nye sostoianie levogo zheludochka u bol'nykh s gipertroficheskoi kardiomiopatiei.

Twenty patients with hypertrophic cardiomyopathy were examined. They were found to have late ventricular potentials in the disease, which were characterized by an increase in average QRS complex duration, a decrease in voltage, and a rise in the duration of last 40 msec of the QRS complex filtered. Such patients generally exhibited lower exercise tolerance in severe asymmetric left ventricular hypertrophy, which caused a significant deterioration of cardiac pump function.

[Left ventricular hypertrophy as an indication for the prescribing of calcium antagonists in patients with ischemic heart disease]. / Gipertrofiia levogo zheludochka kak pokazanie k naznacheniiu antagonistov kal'tsiia bol'nym ishemicheskoi bolezn'iu serdtsa.

An analysis of the dynamics of diastolic rigidity, contractile function of the left ventricle and physical load tolerance under the effect of single intakes of phynoptin and corinfar and their course use in patients with IHD showed that they were more effective in case of increased mass of the myocardium. This indicates that increased mass of the myocardium is an additional indication to calcium antagonists in these patients.

[Comparative evaluation of oxygen supply during exercise in healthy persons in relation to smoking]. / Sravnitel'naia otsenka kislorodnogo obespecheniia fizicheskoi nagruzki u zdorovykh lits v zavisimosti ot kureniia.

Seventy males aged 30-59 years who had no signs of coronary heart disease, as evidenced by the epidemiological criteria, and other risk factors were examined. The oxygen supply during exercise was comparatively assessed in relation to smoking. It was found that there were no significant differences in physical fitness parameters in terms of the volume of performed work, in the power of threshold exercise, and respective heart rate in smokers and non-smokers. However, the smokers displayed a double increase in oxygen debt, a substantial elevation of oxygen consumption per unit work at maximum exercise levels, prolongation of its recovery, a decrease in metabolic units, and a more substantial elevation of systolic and diastolic blood pressures. The oxygen and differential pulses were found to be significantly lower in smokers than in non-smokers.

[The functional assessment of left ventricular hypertrophy in patients with ischemic heart disease]. / Funktsional'naia otsenka gipertrofii levogo zheludochka u bol'nykh ishemicheskoi bolezn'iu serdtsa.

It was established that left ventricular hypertrophy in patients with ischemic heart disease associated with hypertensive disease reflects a functionally more intact myocardium than similar hypertrophy in analogous patients without hypertensive disease. Hypertrophy of the left ventricle in patients with ischemic heart of different severity may be considered an index of myocardial lesion and this should be considered in the treatment tactics.

[Causes and significance of myocardial ischemia occurring during coronary-ventriculography in patients with ischemic heart disease]. / Prichiny i znachenie ishemii miokarda, voznikaiushchei pered koronaroventrikulografiei u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A relationship was examined between the development of myocardial ischemia in patients with coronary heart disease before coronary ventriculography and the status of coronary vessels, coronary reserve, myocardial contractility, and the autonomic nervous system. Before coronary ventriculography, myocardial ischemia was found to occur in the patients when there was a marked activation in the sympathetic portion of the autonomic nervous system and a clear-cut decrease in coronary reserve. The occurrence of myocardial ischemia in the patients before coronary ventriculography contributed to decreased left ventricular myocardial contractility and increased the cardiodepressive effects of a contrast agent.

[Electrocardiographic indices in the assessment of left ventricular hypertrophy]. / Elektrokardiograficheskie pokazateli v otsenke gipertrofii levogo zheludochka.

The authors compared the electrical activity of the heart with results of echocardiography during rest and during bicycle ergometry [correction of veloergometry] in 240 patients with ischemic heart disease, 60 patients with hypertensive disease and in 16 healthy persons. In some of the patients coronarography was carried out. It was established that the informative value of electrocardiography in assessment of the anatomo-functional state of the left ventricle depended on the contingent of the examined patients and reduces as disorders of the functional state of the myocardium tended to advance. The specificity and sensitivity of the electrocardiographic signs of left ventricular hypertrophy reduced in disturbances of ventricular conduction, presence of myocardial infarction in the anamnesis, increase of involvement of the cardiac arteries.