Cardiac rehabilitation in Russia – odds and perspectives.

We have studied the special features of rehabilitation and long-term (1 year) prognosis in 92 patients with myocardial infarction complicated by disturbances of heart rhythm and conduction within the first 48 hours.

Veloergometric test, Holter monitoring and echo were preformed in 2 weeks and 12 months after the onset of the MI, in order to determine the status of the coronary flow, coronary reserve and LV contractile reserve.

We have shown that transient disturbances of heart rhythm and conduction have no significant impact at the clinical course, and the duration of hospital-stage rehabilitation of 14-18 days may suffice in this category. 

Estimating atrium condition by means of high resolution ECG and echocardiography in patients with paroxysmal atrial flutter.

Vascular resistance in essential hypertension: relationship between overall peripheral and regional vascular resistance.

An investigation was made into the clinical features of cardiac-vascular system of 200 patients with antiphospholipid syndrome (APS): 61 patients had PAPS (primary APS), 139 patients had SAPS (secondary APS), associated with systemic lupus erythematosus (SLE) (115 cases) or Sharp syndrome (24 cases). The data obtained indicate certain differences between PAPS and SAPS. Cardiac valve alteration, mainly of mitral valve, with either or insufficiency, stenosis, fibrosis, calcinosis and vegetations were suggestive of PAPS. SAPS was featured by more rare cardiac valve alterations (concerning mainly mitral valve); and arterial hypertension (50 per cent cases) of, probably, renal origin, which caused cardiomyopathy. These results may regard as differential-diagnostic criteria in clinical practice. 

A comparative analysis of how various classes of antihypertensives influence the regression of left ventricle hypertrophy in the elderly.

We have estimated the 10-year absolute (AR) and relative (RR) cardiovascular risk in 30 patients (12 men and 18 women, mean age 55,5±7,2 years with essential hypertension, mild to severe (WHO/ISH, 1999) with the usage of a computer program dealing with the contribution of various risk factors in the Framingham study. The AR calculated from SBP/DBP, equaled 15.4/17.8%, decreasing to 9.8/10.9% after 6 months of Nebivolol treatment (p<0,001), whereas the standard AR for the same age and sex made 5.4/6.7%. The RR, calculated from SBP/DBP ОР, equaled 249/208%, decreasing to 98/65% after 6 months of treatment (p<0,001) with the target level recommended for hypertensive patients (<20%) achieved in 23,3/53,3%. Decreases in AR and RR was not just due to a BP decrease but also the influence of treatment on LVH, absent dynamics of blood lipid and carbohydrate levels, and in smokers – the effect of quitting.

The usage of physiotense in elderly patients with essential hypertension.

Clinical efficacy and safety of and A-2 antagonist eprosartan in patients with mild and moderate hypertension. Results of a multicenter trial.

We studied the effectiveness and safety of administration of the extended-release calcium antagonist Nifedipin-Retard (Cordaflex-Retard, EGIS) in 30 patients with arterial hypertension of the 1st and 2nd degree. The study included general clinical examination, 24-hour ambulatory blood pressure monitoring, assessment of the effect on the lipid and carbohydrate metabolism, and of the glycosylated hemoglobin. Cordaflex-Retard was administered depending on the initial BP, in the daily dose of 20 to 40 mg during 24 weeks. We found not only hypotensive action with the BP level stabilization, but also reduction of the magnitude and the rate of the SBP morning rise, as well as a greater degree of the night dipping of the SBP and DBP against the background of a favorable effect on the indices of the lipid and carbohydrate metabolism. 

We have used stereo- and morphometric studies to examine the influence of the three ways of preliminary adaptation on the size of ischemia and infarction foci, as well as the condition of right atrium and non-ischemic areas, in experimental coronary occlusion. We have found that despite a lack of anti-ischemic effect, preliminary adaptation to a short-lasting stress exhibits a marked beneficial impact at the nectrotic and non-ischemic areas. In animals adapted to physical stress, a moderate anti-ischemic effect with a potent antinecrotic and an even more observed influence on the non-ischemic areas of the myocardium. Adaptation to mild hypoxia possesses a moderate anti-ischemic influence combined with a liewise moderate effect on the necrotic and non-ischemic areas. All kinds of adaptation exert a beneficial effect on mortality rates in animals with coronary occlusion. 

A study of life quality in patients with chronic heart failure: the contemporary status.

Rehabilitation after a surgical correction of congenital heart disease.

Is conservative treatment of hypertrophic cardiomyopathy an alternative to surgical treatment?

The newsletter on the Russian Congress of Cardiology “Efficacy and safety of diagnostics and treatment”.

Information for the practical doctor.