Some new facts about the influence of different groups of drugs on myocardial perfusion were educed during the research. Educed facts conduce representation extension by matching the optimal therapy of ischemic heart disease. With the help of SPECT-scanning were educed myocardial blood flow, areas of maximal hypoperfusion and its influence on time pattern and redistribution of myocardial blood flow in patients receiving disease-modifying agents and statins. Some regularities of change of myocardial blood flow depending on applied group of drugs and peculiarities of influence of myocardial perfusion in certain time interval were revealed. Criteria with prognostic significance in prospective individual effectiveness of anti-ischemic drugs were pointed out. New approach, based on choice of anti-ischemic therapy depending on extent of influence on myocardial perfusion and also individual clinical and functional traits of patients, was applied.

The ever-growing morbidity, disablement, and mortality from coronary heart disease, chronic cardiac failure dictate the necessity of the search for new methods to verify, and evaluate prognosis of the clinical course of these diseases. Currently, myocardial perfusion scintiography is most widely used for the purpose.

To study the sympathetic myocardial innervation in coronary artery disease patients with chronic atrial fibrillation, 20patients aged 69.2±8.3 years (62 78 years) and 14 healthy subjects aged 45.85±2.67 years were examined.

Статья посвящена способу анализа изменения значений ритмограммы с приведением к постоянной величине – показателю биохронологической упорядоченности сердечного ритма (lim a). Исследования проведены в группе пациентов с мерцательной аритмией до и после фармакологической или электрической кардиоверсии. Было выявлено, что чем больше значение показателя (lim a), тем менее однородна структура сердечного ритма вследствие сохраняющейся активности синусового узла, благодаря которой и удается восстанавливать синусовый ритм. Таким образом, на основании полученных результатов можно предположить, что показатель (lim a) является предиктором успешности восстановления синусового ритма.

Diffuse lesions of the anterior interventricular artery (AIVA) at different levels were diagnosed in 27 out of 417 patients operated for post-infarction aneurysm of the left ventricle (PIALV). During the preoperative period coronography, ventriculography, ultrasonic examination of the heart were made in all the patients, one-photon emission computed tomography with 123I-iodopent was used for radioisotope investigation of perfusion and metabolism of the myocardium. The presence of PIALV, diffuse atherosclerotic lesion of AIVA and viable myocardium in its basin was taken as an indication for autovenous plasty of the artery with the following shunt of the left intrathoracic artery and resection of PIALV.

The diagnostics of occult inflammation foci up to day remains the major and complicated problem in almost each clinical discipline. Whole-body scintigraphy and SPECT studies with 99mTc-autoleucocytes show silent foci of inflammation and infection. 68 patients (24 females and 44 males) aged 14-59 years with non-localized inflammatory diseases were evaluated. Each patient underwent routine clinical and laboratory investigation. But because of the inadequacy of other diagnostic procedures, the Tc-99m-WBC scans may be of great clinical importance. For the determining of the SPECT of thorax were performed using Tc-99m-HMPAO (hexametylpropilenaminoxime) labeled autoleucocytes. In 1, 3 and 24 hours post injection inflammatory foci were seen as the areas of pathogenic activity. In 24 patients the circumscribed activity seen in relation to heart convincingly demonstrated endo- and/or myocarditis. 16 patients showed acute inflammation in postoperative wound, empyema of pleura and mediastinitis as the consequences of cardiosurgery. In 16 patients whole-body scanning and SPECT of the head revealed chronic infection in nasopharynx and accessory nasal sinuses dental infection and the rest 7 patients had abdominal and pelvic inflammatory diseases, such as ulcerative colitis, intraabdominal and retroperitoneal septic foci, tubo-ovarial inflammatory disease. The data demonstrated that Tc-99m-leucocytes imaging is a highly sensitive and specific for the detection of inflammatory diseases of different localization.

The aim of the present study was to compare the results of 2 methods of examination of patients with non-rheumatic myocarditis: scintigraphy with labeled autoleukocytes and immunological investigation. On the basis of the obtained results we assume that there are 2 stages in the disease pathogenesis. During the initial stage the diffuse inflammatory process develops in the myocardium and cardiac antigens enters the blood. During the second stage of pathogenesis specific antibodies and sensibilized to cardiac antigen lymphocytes are accumulated in blood. This stage is characterized by local inflammatory process in the myocardium. The enhanced spontaneous IL-8 production in blood cultures of these patients evidences the important role of this chemokine in the disease pathogenesis. (Med. Immunol. 2001, vol. 3, N 1, pp 99-103)

The radionuclide investigation was performed 1-3 and 24 hours after injection of a radiopharm preparation and included the single photon emission computed tomography of the heart and scintigraphy of the whole body. Inflammation foci were found on the scans as hyperfixation foci of autoleukocytes labeled with 99mTc-HMPAO (hexamethylpropilene aminooxime). Four patients had abscesses with 0.8-1.5 cm diameter in projection of the aortal and mitral valves of the heart, and in 10 patients there were foci of inflammation and suppuration of extracardiac localization (in the area of the operation wound, anterior mediastinum, frontal sinuses, transverse colon, parietal pleura). The data obtained convincingly speak of high sensitivity and specificity of radionuclide diagnostic methods with the help of labeled elements of the whole blood in recognizing latent inflammatory and suppurative processes in cardiosurgical patients at the pre- and postoperative periods.