[Pharmacological protection of the myocardium with reamberin in coronary artery bypass grafting in patients with postinfarction angina].

AIM: To assess efficacy of reamberin in preoperative preparation and after coronary bypass (CB) in patients with macrofocal myocardial infarction (MI) complicated with postinfarction angina. MATERIAL AND METHODS: A total of 45 patients with Q-positive MI complicated with postinfarction angina pectoris entered the trial. The study group consisted of 20 (44.4%) patients given 200-400 ml injections of 1.5% reamberin solution for 3 days before coronary artery bypass grafting (CABG) and 3-5 days after it. The control group consisted of 25 (55.6%) patients given basic therapy without cardioprotection. ECTG-60, echocardiography, CM-ECG, laboratory tests were made before CABG. CABG was made in conditions of artificial blood circulation in all the patients. RESULTS: Clinical stabilization was observed after direct myocardial revascularization in hospitalized 25 (100%) patients of the study group and 22 (88%) patients of the control group. Early postoperative acute cardiac failure (ACF) developed in 3 (12%) patients from the study group and 9 (36%) from the control group (p = 0.04), arrhythmia occurred in 2(8%) and 8(32%) patients, respectively (p = 0.03). Two (8%) control patients died in early postoperative period from acute cardiac failure. Perioperative MI occurred in 2(8%) control patients. After 12 months of the follow-up, patients of the study group had no recurrent angina pectoris, while among the controls 4(16%) patients had recurrent angina of FC III. After surgical intervention at discharge and 12 months after treatment patients of both groups improved systolic and diastolic functions of the left ventricle. Normalization of the diastolic function was registered in 80% patients of the study group (p < 0.001) and in 44% from the control group (p < 0.001) after 1 year follow-up. CONCLUSION: Reamberin reduces the number of postoperative complications, ischemic damage to the myocardium, significantly improves systolic and diastolic functions of the left ventricle.

[Diagnostic possibilities of hand isometric exercise in the assessment of coronary and contractile reserve of the heart in patients with unstable angina pectoris]. / Diagnosticheskie vozmozhnosti kistevoi izometricheskoi nagruzki v otsenke koronarnogo i sokratitel'nogo rezerva serdtsa u bol'nykh s nestabil'noi stenokardiei.

The potentialities of hand isometric exercise (HIE) were studied in 84 patients with unstable angina pectoris and 25 with stable angina. With HIE, the coronary and contractile reserve was measured in the patients with angina. Lower exercise tolerance was revealed in the patients with unstable angina than in those with stable one. Among the patients with unstable angina, those at risk for myocardial infarction were predominant. Lower exercise tolerance appeared as decreased "threshold" double product values and diminished myocardial contractile reserve (higher left ventricular filling pressure). HIE applied in the study evaluates the efficacy of treatment and the prediction of the disease course more accurately.

[Psychophysiological aspect of the therapeutic use of pyridinolcarbamate]. / Psikhofiziologicheskii aspekt lechebnogo deistviia piridinokarbamata.

The effect of prodectin was examined in 79 patients with coronary disease after a course of treatment, and in 16 normal subjects. A series of electrocardiographic and hemodynamic parameters were investigated at rest and during bicycle ergometric exercise. Resultant psycho-physiologic shifts were reviewed with the aid of the information test recording the time of response, errors and vegetative changes in response to colour and mathematical stimuli. Pyridinol carbamate was found to produce a psychostimulating effect, with information processing and vegetative control improved significantly. Therefore the drug appears to be advisable for patients with coronary disease exposed to increased information inflow which requires greater concentration of their attention in short time.

[Clinical use of arfonad and hygronium aerosols in emergency hypotensive therapy]. / Klinicheskoe primenenie aérozolei arfonada i gigroniia pri neotlozhnoi gipotenzivnoi terapii.

During clinical testing of the administration of ganglion-blocking agents by inhalation (175 persons) it was established that drug aerosols of arfonad and hygronium possess high effectiveness, act rapidly, and are relatively safe. The inhalation method of the management of hypertensive crises may find wide use in out-patient practice, under conditions of the admission room, cardiological and resuscitation departments, as well as in obstetrics when controlled hypotension is necessary.