Chronic cor pulmonale.

The aim of the study was to evaluate the influence of physical stress in the «free selection mode» on the dynamics of heart rhythm disturbances, its variability and myocardial ischemia parameters in patients with myocardial infarction (MI) on the stage of rehabilitation in special facilities. 75 patients admitted to the facility for rehabilitation treatment on days 19-38 following acute MI have been studied, divided into 2 groups: the basic one, with patients using veloergometry training with the mode of free selection of stress parameters; and the comparison group using no veloergometry training in treatment. All patients underwent physical rehabilitation programme, dose-adjusted walking, climbing stairs, physical training. Upon admission and at the discharge from the facility patients underwent 24-hours Hotter ECG monitoring. The inclusion of veloergometry training with the mode of free selection of stress parameters in the special facilities rehabilitation complex promotes restoration of vegetative balance and increases activity of parasympathetic autonomous nervous system, exerting protective action and increasing myocardial electrical stability, veloergometry training with the mode of free selection of stress parameters have been established to exert antiarrhythmic influence, decrease the prevalence of potentially hazardous high grade ventricular premature beats, decrease myocardial ischemia.

 

The article contains results of studies of clinical features of acute myocardial infarction in patients with Mycoplasma spp. infections; discussions of peculiarities in the development of the disease, as wells as possible mechanisms of atherogenesis induction in Mycoplasma spp. persistence.

A screening of chronic heart failure (CHF) in patients with Coronary Heart Disease (CHD) has been done. An echocardiography study (echo) was used to reveal possible variants of left ventricle myocardium dysfunction. A group of patients with left ventricle diastolic dysfunction (LVDD) was selected. After a meticulous clinical examination including stress tests the diagnosis of CHF has been made in 85.9 % patients. An attempt has been made to determine most diagnostically valuable echo parameters characterizing left ventricle relaxation function in various CHF functional classes in coronary patients. Therefore the presence of normal contractile function of left ventricle myocardium probably does not rule out the presence of CHF in patients with long term CHD. Patient assessments must include evaluation of LV diastolic function with subsequent physical stress tests for final decision on the presence of CHF.

Endothelial dysfunction, redox-potential systems of energy supply and aldosterone synthesis in chronic heart failure with and without atrial fibrillation.

The article contains data on the influence of programmed hemodialysis on the structure and incidence of supraventricular and ventricular arrhythmias in patients with end stage chronic renal failure. 67 patients have been studied with the usage of continuous ECG monitoring, assessment of heart rate temporary and spectral parameters before, during and after hemodialysis (n = 48) and in patients with chronic renal failure one the pre-dialysis stage (n = 19). It have been noted that hemodialysis procedures are accompanied by activation of the whole autonomous nervous system with predominant vagus influence on the heart and decreased sympathetic tone. Following hemodialysis the activity of autonomous nervous system is decreased significantly with predominant sympathetic influence on the heart increasing myocardium electric instability. Relationship between changes in heart rate variability and the development of hazardous arrhythmias, as well as with changes in electrolytes concentration, is covered.

The role and clinical significance of endothelial dysfunction (ED) in the diagnostics and prognosis of non-ST-segment-elevation acute coronary syndrome (ACS) in subjects under 55 years of age with verified CHD (by heart catheterization). The comparison group was made of 32 patients with stable angina (SA) II and III functional classes. Non-Q-wave myocardial infarction was diagnosed in 50 (37 %) troponin-positive patients, unstable angina in 84 (63 %) troponin-positive patients. Endothelial function was evaluated by plasma and red blood cells nitrates and I-arginine levels, the number of desquamated endotheliocytes (DE) in plasma, concealed endothelial dysfunction was revealed. A reliable increase of nitrates and DE has been found, most marked in patients with ACS. ED may be present as concealed (compensated), intermediate (subcompensated) and acute (decompensated) forms.

The work has studied the therapeutic action of ozone-oxygenated crystalloids as a factor of compensation of hemoreology disorders in coronary patients. 109 coronary patients with II-III unctional class angina at effort, aged 40 to 79, have been followed up. All patients received traditional anti-anginal treatment. Patients in principal groups received ozone therapy in conjunction with traditional treatment. Apparent blood viscosity, fluidity threshold and shift tension were measured before and after the treatment. Study parameters have been found to decrease in all studied groups; with no dynamics inpatients receiving traditional therapy. A conclusion has been made that parenteral introduction of ozone-oxygenated crystalloids in therapeutic dosage promotes improvement of blood reology properties.

The aim of our study was to determine seroepidemiological links of Сhlamydia pneumoniae (CP), by IgA and IgG antibodies titers, with Coronary Heart Disease (CHD) in Makhachkala. A total of 122 coronary patients (average age of 54,6 ± 0,72 years) has been assessed (mean age of 54, 60, 72 years). The control group was made of 40 subjects (mean age 43,8 ± 1,28 years). Antibodies detection was made by means of solid phase immune enzyme assay. CP prevalence value in coronary patients has been found to have almost no difference from the one detected in the control group (p > 0,05). At the same time the difference in anti=CP=IgA in patients and healthy subjects was almost fourfold: 74,5% and 20,0 %, respectively (р < 0,001). A reliable difference in CP prevalence between groups of patients with stable and unstable angina was observed in IgA (p < 0,02) and in IgG (p < 0,05) as well. The data show previous CP infection and bacteria hosting not to be connected to CHD prevalence values. Only acute CP infection was associated with clinically manifest CHD.

The aim of this study was to evaluate LV diastolic reserve (DR) and possibilities of long>term prevention of congestive heart failure with long>term administration of Captopril and Carvedilol in patients with anterior wall MI and silent LV diastolic dysfunction. DR was measured in patients with MI by means of volume stress, and accordingly the patients were divided into 2 groups: 1st (n=20) with preserved LV DR treated by Streptokinase, aspirin, heparin, captopril and atenolol, 2nd (n=43) with decreased LV DR. Patients with decreased LV DR were divided into groups: A – treatment identical to the 1st group, B – atenolol substituted for carvediolol. The results of the study have shown that severe types of LV DD – congestive HF – developed only in patients with decreased LV DR, whereas long>term (6 months) combined administration of Captopril and Carvedilol reliably decreases the incidence of congestive HF in patients with MI.

An experience of evaluation of the following drugs is provided: nifedipine (Corinfar), Nifecard XL and Cordaflex-retard in treatment of patients with mild to moderate arterial hypertension. The aim of the study was to compare hemodynamics values of the drugs with the results of their pharmacokinetic studies in single and course intake. An open label randomized method of drug administration was used. At the same time a comparative evaluation of adverse effects of studied drugs was made.

In the group of patients receiving Nifecard XL in single intake, a moderate increase of antihypertensive effect was observed for 1, 5-2 hours, lasting for 6-8 hours, corresponding to gradually increasing and, respectively, maintained in the stable way drug concentration in blood plasma; no sudden decrease of blood pressure and increase of heart rate was observed. Tolerability of Nifecard XL was assessed as good.

With single intake the group of patients taking Cordaflex-retard demonstrated a rapid increase of antihypertensive effect (for 1-1, 5 hours), but a more short-term maintenance explained by less absorption rate and a more rapid excretion as compared to Nifecard XL. With a course intake, following a dose correction, a sustained maintenance of normal BP values if a twice daily regimen is adhered to.

The study was made to evaluate clinical efficacy, safety and electrophysiological effects of Propaphenon in seizing paroxysms of atrial fibrillation (AF)

45 patients have been evaluated, with AF paroxysms lasting up to 48 hours. To restore sinus rhythm (SR) single oral intake of 600 mg Propaphenon (PRO. MED. CS Praha a.s. ) was used. AF paroxysms were seized under the control of ECG Hotter and BP monitoring.

Antiarrhythmic effect was evaluated based on the results of dynamics of electrophysiological parameters determined by means of transesophageal heart electrophysiology studies (ТЕ EPS) in 12 patients.

A comparative analysis of results obtained has shown that Propanorm is an effective antiarrhythmic drug to treat AF paroxysms. Heart sinus rhythm (SR) restoration takes place in 88. 9 % cases whereas electrophysiological criteria for antiarrhythmic response include: increased value of rate threshold of induction (RTI) by 140 impulses per minute, disappearance of atrial vulnerability zone and prolonged AV node effective refractory period by 50 ms.

Changes in plasma STH in long-term (12 months) drug treatment of essential hypertension (EH) with Nadolol, Propranolol, Prazosine, Hydrochlorothiazide have been studied in 104 men with EH II degree according to the WHO classification. Treatment with Propranolol and Nadolol led to increased plasma STH in the first 2 months of treatment, particularly in subjects with baseline increase and long-term history of EH. Mean plasma STH levels decrease to a greater extent with increasing duration of drug intake. Treatment with hydrochlorothiazide is generally accompanied by no relaible shift in plasma STHlevel, but may lead to increased plasma STH level in young subjects (below 50years of age).

There is a great number of coronary patients to whom traditional methods of myocardium revascularization are not indicated. Addition of dipyridamol to traditional antianginal treatment promotes improvement of clinical features of the disease and decreased functional class of angina in coronary patients. The usage of dipyridamol for 3 months was accompanied by increased physical stress tolerance threshold, increased time of physical stress, decreased asynergy areas on echo ate peak stress, suggesting possible angiogenesis in myocardium hypoperfusion areas in the region of stenotic coronary artery.

The aim of the study was to evaluate the efficacy and safety (influence on carbohydrate, lipid and mineral metabolism, as well as nitrogen-excreting function of kidneys) of monotherapy with rilmenidine in patients with mild to moderate AH, as well as treatment of patients with severe AH as multiple combined treatment. 43 patients with essential AH I-HI degree, aged 22 to 79, were enrolled in this open label study after signing an informed consent form. Enrolled patients were divided into 2 groups. Group 1 included 20 outpatients. They received monotherapy with rilmenidine 1 mg daily. Duration of treatment was 12 weeks. Group 2 was comprised of 23 subjects admitted to an in-patient clinic. Those subjects received Albarel 1 mg or 2 mg daily as a component of multiple antihypertensive therapy. Albarel was administered 7-10 days following the admission to clinic as a second to fifth hypotensive drug. Albarel's combinations with diuretics, ACE inhibitors, calcium antagonists, beta-blockers. The result is - monotherapy with Albarel 1-2 mg daily allows to achieve target BP in 77, 8 % patients with mild to moderate AH. With Albarel as a component of multiple therapy target BP is achieved in 65, 2 % patients with severe AH. Effectively decreasing BP Albarel does not change its daily profile. It has no influence on renal function, carbohydrate metabolism, and electrolyte content of blood. Albarel is well tolerated. Adverse effects included mouth dryness and drowsiness, was noted in 2, 33 % cases and did not require drug withdrawal.

Efficacy of a non-lipophilic angiotensin converting enzyme inhibitor and its possible advantages.

An analysis of relationship and its reliability level between central hemodynamics parameters has been done in 415 patients with arterial hypertension. Correlation coefficient between circulation index and cardiac output was ft 8985 with p < 0. 001, between peripheral resistance index and total peripheral resistance was 0. 9283 with p < 0. 001. Correlation coefficient between circulation index and peripheral resistance index was -0, 6266 with p < 0,001, between cardiac output and total peripheral resistance -ft 7275 with p < 0,001. High degree association and its reliability justify a transition approach from cardiac output and total peripheral resistance to respective indices for cardiovascular evaluation.

Epidemiological aspects of idiopathic dilated cardiomyopathy.

Preventive antiarrhythmic properties of lidocaine and six new combinations of amino acids with microelements. In models of reperfusion arrhythmias in cats all study drugs more or less prevented post-reperfusion arrhythmias including fatal ventricular fibrillation. Therefore the search for new antiarrhythmic medications in the field of amino acids combination with microelements is a perspective area of arrhythmology.

Arterial hypertension and cervical spine osteoarthrosis: problems and solutions.

Myoicardial infarction, inflammation and prognosis.

Psychosocial factors determining prognosis in patients with acute myocardial infarction.

To the jubilee of Lubov Grigoryevna Fomina.