The role of hospital therapy chair №1 of the therapy faculty RSMU in development of native science and public health. To 90th of chair.

We have studied the relationship between the onset of an anginal attack and ST depression exceeding 1 mm and the quantity of silent myocardial ischemia episodes on Holter monitoring in 59 patients with stable class II-III angina. No patient with early angina attacks demonstrated silent ischemia predominance. Every third patient with simultaneous pain and ST depression demonstrated silent ischemia over 75%. If an angina attack appeared 60 sec after an ST depression, almost half of such patients had silent ischemia over 75%. The time ratio between angina onset and ST depression is a value revealing patients prone to the silent course of the disease. 

The aim of the study was to evaluate the influence of millimeter-length waves on the functional condition of patients with acute myocardial infarction as established by veloergometry.

We have studied 95 patients with acute myocardial infarction, divided into 3 groups depending on the mode of treatment: 55 with radiation in conjunction with conventional treatment, the control group of 30 with conventional treatment only and the placebo group of 14.

The basic group demonstrated reliably higher tolerance to physical stress as compared to the control and placebo group after 30 and 60 days. 

The comparative analysis of CHD risk factors which are known metabolic syndrome components was conducted in groups of patients with arterial hypertension (AH) combined with abdominal obesity (AO), in hypertensive subjects with normal body mass index, and in those with AH, AO and glucose intolerance. The combination of AH with AO was coupled with higher SBP and DBP, and with more pronounced atherogenic shifts in lipoprotein profile: elevated levels of triglycerides, total cholesterol, apo B and apoB/AI ratio. The magnitude of these parameters was closed to that in group with AH, AO and glucose intolerance; hyperlipidemia in the last group was aggravated by decreased HDL cholesterol level. Patients with AH and AO had significantly higher blood insulin level and lower glucose/insulin ratio than subjects with AH only. These results might indicate the existence of latent insulin resistance in hypertensive patients with abdominal (visceral) obesity. Global CHD risk for these patients appeared to be higher than in subjects with AH only. 

Increased LV myocardial mass (LVM) and alteration of its geometric model further cardiovascular risk and deteriorate prognosis in chronic renal failure (CRF).

The aim of the study was to observe the fine mechanism of early myocardial remodeling on various stages of CRF. The study included 106 patients aged 44,9±13,6 with non-diabetic CRF (74 pre-dialysis and 32 with dialysis-stage CRF) and normal LVM. Concentric myocardial remodeling (C-remodeling) was established with echocardiography with normal LVM and increased relative width of LCV walls. C-remodeling accounted for 36,7% cases in pre-dialysis and 63.3% in dialysisstage CRF. The risk factors for C-remodeling were: age, female sex with no physiological nocturnal fall in blood pressure, anemia, a more severe renal function impairment, a longer history of arterial hypertension, systolic and diastolic arterial hypertension. A greater mass increase between dialysis sessions was observed in patients with dialysis-stage CRF as compared to those with normal LV geometry. 

Systolic blood pressure as one of the factors decreasing aorta tensility in elderly patients with essential hypertension.

Characteristics of blood pressure in digital microvessels depending on the body position in patients with essential hypertension.

A novel approach to estimating hemodynamics in the arterial portion of the vasculature.

A study of social and economical factors in the development of cardiovascular diseases with a screening of 4 towns in the Moscow region.

In main group 104 patients of Q-myocardial infarction were treated during the first 7 days of the moment it entered a hospital by trimetazidine and sulodexide combine with the traditional treatment (nytroconnection, aspirin, beta- adrenoblocators). In control group 130 patients were treated only by traditional treatments. The blood of 62 patients from main group and 65 patients from control group was examined on thrombin’s time, partly activated tromboplastine’s time and thrombocite aggregation in dynamics three times in the first, the third and the 7-th days of observation. There were undergoing daily ECG-monitoring on Cholter. The results of treatments were valued in both groups according the number of patients with Q-myocardial infarction, average daily frequency of attacks angina pectoris, the number and duration of episodes painless myocardial ishemic, changes of parameter of hemostasis. It was exposed, that in main group Q-myocardial infarction was developed only in 2,9% patients and in 14,6% patients in control group. The average daily frequency of attacks of angina pectoris, the number of episodes of painless myocardial ishemic and their duration in main group were nearly 2 times less them in control group. It was accompanied by improvement hemostasis in main group. Thus, trimetazidine and sulodexide promote the prophylaxis Q-myocardial infarction. 

The influence of treatment with Losartan and Enalapril on postinfarctional left ventricle remodeling.

25 patients with heart failure (HF) were investigated (I FC - 8 patients, II FC - 17 patients). All the patients were administered metoprolol in the average dose 37,5+3,2 mg/day. Dopplerechocardiographic investigation of systolic-diasolic function of the left ventricle (LV) was carried out. Investigations were conducted before the treatment, after 2-week treatment course and in 19 patients after 3-month intake of the preparation.

Results of conducted investigation demonstrated, that both short-term (2-weeks) and long-term (during 3 months) intake of metoprolol in the above mentioned dose in patients with HF results in the improvement of systolic and diastolic function of the LV at early and moderate stages of disease. 

Heart protection against ischemic lesions: the role of stress-limiting systems and stabilizing myocardial structure.

We have created a mathematical model of diagnozing Coronary Heart Disease by means of multifactorial discriminate analysis of objectibe biological data (laboratory and non-invasive measurements, anthropometric data) if subjective data (complaints, history, non-formalized medical interpretation), traditionally used in diagnosing the disease, are present. We have proved the model to be highly sensitive and reliable, applying it to a group of patients with CHD morphologically verified by means of angiography.

We have analyzed 56 coronary patients receiving nitroglycerine and 37 on prolonged nitroglycerine (Sustac), aged 39 to 70. Проанализировано 56 больных с ишемической болезнью сердца, получавшими нитроглицерин и 37 больных с ИБС, лечившихся пролонгированным нитроглицерином (сустаком) в возрасте от 39 до 70 лет. Apexcardiography was registered before and after nitroglycerine intake in the first group, before and after the course of treatment in the second group. The first group demonstrated significantly decreased atrial complex in 24 and disappeared in 32 patients. The second group demonstrated significantly decreased amplitude coefficient.

The authors conclude the apexcardiography curve provides control of the hemodynamics changes in coronary patients under the influence of nitroglycerine.

Arterial hypertensison in postmenopausal women: current possibilities of medical therapy in out-patients.

Ischemic syndromes and cytoprotection (trimetazidine).

Propaphenon: clinical pharmacology and efficacy in supraventricular arrhythmias (Part 2).

The usage of low-energy laser in internal medicine.

Aortic dislayering.

Information announcement about the National Symposium «Long QT Syndrome» Moscow, Russia 22-23 March, 2001.

To the jubilee of Vladimir S. Zadionchenko.

To the jubilee of Natalia N. Teplova.

European Heart Journal (2001) 22, 1151-1153.