One hundred patients (36 males, 64 fem ales, the average age 44.6 ± 1.2 yrs) were divided into 3 groups depending on their co-existing somatic or psychical pathology. The 1-st group consisted of 40 patients with hyperventilation syndrome (HVS) and bronchial asthma (15 males, 25 fem ales, the average age 44.3 ± 1.2 yrs). The 2-nd group included 39 patients with HVS and arterial hypertension (8 males, 31 fem ales, the average age 49.4 ± 2.1 yrs). The 3-rd group included 21 patients (7 males, 14 fem ales, the average age 36.6 ± 2.3 yrs) with HVS and panic disorders. Differences were found between the groups regarding clinical manifestations of HVS due to different lung functional status. HVS was characterized as brittle breath in the '1 -s t group patients with bronchial obstruction, as heavy breath in the 2-nd group patients with restrictive disorders, and as empty breath in the 3-rd group patients with high airflow values. We discuss a role of mesenchym al dysplasia in the occurrence of such breathing patterns.

The authors analyzed the medical records of 1414 patients aged 60 +/- 14 years, who were examined in a specialized cardiological clinic within a one-year period. Among the patients, 41.2% complained of dyspnea; the number of women with dyspnea prevailed over the number of men. Dyspnea was caused by chronic heart failure in 42.2% of patients, by transient myocardial ischemia in 12.3% of patients, and by paroxysmal tachyarrhythmia in 6.3% of patients. In 45.6% of the patients, mostly in women, significant non-cardial factors were revealed: obstructive or restrictive respiratory failure (20.6%), obesity (14.7%), thyroid gland dysfunction (3.9%), pulmonary arterial thromboembolism, anemia etc. A combination of two or more etiological factors took place in 22.6% of cases. The reason for respiratory discomfort remained unclear in 21.3% of the patients, mostly women. Symptom-limited load test with gas analysis (ergospirometry) was performed in 70 patients with dyspnea of unclear origin. According to its results, in 75% of elderly patients with essential hypertension and postinfarction cardiosclerosis, who did not have significant systolic dysfunction, restrictive diastolic dysfunction, valvular disorder, or atrial fibrillation, dyspnea was caused by hyperventilation, obesity, and respiratory pathology.

The aim of the study was to determine effective diagnostic methods for use in patients with different probabilities of coronary artery disease (CAD). The 102 subjects were distributed into 3 groups according to CAD risk: low risk (n = 13), moderate risk (n = 29), and high risk (n = 60). The following examinations were performed: Holter ECG monitoring (88 patients), treadmill test (67 patients), stress-echoCG with dobutamine (31 patients), single phase emission computed tomography (SFECT) (30 patients), and multispiral computed tomography (MSCT) with coronary arterial contrasting (14 patients). After non-invasive tests, all patients underwent coronaroangiography. According to the study, MSCT and SPECT were the most effective techniques for CAD diagnostics. The application of all these tests is justified most in cases of moderate risk of stenosing coronary arterial lesion.

The purpose of the study was to evaluate the influence of metoprolol succinate and carvedilol on the physical ability (FA) of patients with chronic heart failure (CHF) of different etiologies. The subjects of the study were 108 patients with postinfarction cardiosclerosis and 39 patients with dilated cardiomyopathy with I to V functional class (FC) CHF and left ventricular ejection fraction of less than 45%. The dynamics of functional parameters were assessed after 6 to 12 months of carvedilol therapy (57 patients) or metoprolol (81 patients) therapy. Therapy with beta-adrenoblockers resulted in a significant decrease in CHF FC (by 0.80 +/- 0.57; p < 0.05), an increase in the distance of six-minute walking test (by 110.7 +/- 86.5 m; p < 0.001) and everyday activity according to DASI questionnaire. The improvement was more substantial in patients with non-ischemic CHF. Peak oxygen consumption during treadmill test did not change, but CO2 ventilatory equivalent increased. The results demonstrate that carvedilol and metoprolol improve subjective and submaximum parameters of the functional status of patients with CHF without changing maximal FA.

The clinical economical analysis was applied to assess the application of different techniques of ischemic heart disease diagnostics - the electro-cardiographic monitoring, the treadmill-testing, the stress-echo cardiographic with dobutamine, the single-photon computerized axial tomography with load, the multi-spiral computerized axial tomography with coronary arteries staining in patients with different initial probability of disease occurrence. In all groups, the best value of "cost-effectiveness" had the treadmill-test. The patients with low risk needed 17.4 rubles to precise the probability of ischemic heart disease occurrence at 1%. In the group with medium and high risk this indicator was 9.4 and 24.7 rubles correspondingly. It is concluded that to precise the probability of ischemic heart disease occurrence after tredmil-test in the patients with high probability it is appropriate to use the single-photon computerized axial tomography with load and in the case of patients with low probability the multi-spiral computerized axial tomography with coronary arteries staining.

The external respiration function was studied in 100 patients with hyperventilation syndrome (HVS) divided into 3 groups: 40 patients with HVS and bronchial asthma (group 1) consisting of 15 males and 25 females (age median--45 years, 25 percentile--37 years, 75 percentile--53 years); 39 patients with HVS and essential hypertension (group 2) consisting of 8 males and 31 females (age median 49, 25 percentile--40 years, 75 percentile--57 years); 21 patients with HVS without concurrent somatic diseases of group 3 (7 males, 14 females, age median 45 years, 25 percentile--28 years, 75 percentile--45 years). It is shown that different disorders of pulmonary ventilation correspond to different clinical manifestations of HVS. Thus, in bronchial obstruction (group 1) HVS manifests with "weak respiration", in restrictive pulmonary disorders (group 2) HVS manifests as "heavy respiration", in high parameters of bronchial permeability (group 3)--"shallow respiration".