Dynamics of structural and functional left ventricular parameters was investigated in 51 patients with acute anterior myocardial infarction by means of serial (on days 1, 2, 3, 5, 7, 10 and 21 of infarction) echocardiographical study. increase of end-diastolic volume index relative to initial values became significant on 5(th)-7(th) days and continued to progress until 3(rd) week of infarction. Left ventricular cavity became dilated and attained more occurred shape predominantly at the account of increased transverse diameters. Abnormalities of left ventricular contractile and pump functions were most pronounced during first 3 days of the disease. Between 5(th) and 10(th) days improvement and stabilization of myocardial functional state took place accompanied by progression of left ventricular dilation and increase of its sphericity with lessening of degree of myocardial asynergy.

Dynamics of structural and functional left ventricular parameters was investigated in 51 patients with acute anterior myocardial infarction by means of serial (on days 1, 2, 3, 5, 7, 10 and 21 of infarction) echocardiographical study. Increase of end-diastolic volume index relative to initial values became significant on 5th-7th days and continued to progress until 3rd week of infarction. Left ventricular cavity became dilated and attained more occurred shape predominantly at the account of increased transverse diameters. Abnormalities of left ventricular contractile and pump functions were most pronounced during first 3 days of the disease. Between 5th and 10th days improvement and stabilization of myocardial functional state took place accompanied by progression of left ventricular dilation and increase of its sphericity with lessening of degree of myocardial asynergy.

Aim. To study possibilities of prediction of postoperative restoration of depressed function of the right ventricle in patients with mitral valve disease. Method. Antiorthostatic test causing an increase in ventricular preload was carried out preoperatively in patients with mitral valve disease and they were followed up for 12 months after surgery. Results. Two groups of patients were distinguished according to results of the test: with (group 1) and without (group 2) augmentation of the right ventricular contractility in response to increased venous return. During follow-up right ventricular pump function improved only in patients of group 1. Conclusion. Results of preoperative antiorthostatic test can be used for prediction of changes of right ventricular function after mitral valve surgery.

Test with graded hypercapnic hypoxia was performed in 35 patients with ischemic heart disease and 15 healthy persons by closed circuit rebreathing method. The state of central and cerebral hemodynamics, parameters of pulmonary ventilation, blood gases and acid-based balance were studied. Both in healthy persons and in patients with ischemic heart disease hypercapnic hypoxia led to increase in cardiac output while volume velocity of cerebral blood flow remained unchanged in patients but rose significantly in healthy persons. At equal contents of oxygen in inhaled air relative lack of development of arterial hypoxemia was noted in patients compared to healthy persons. Course intervention by hypercapnic hypoxia resulted in increased physical working capacity of patients with angina pectoris.

Recent progress in biomedical optics resulted in increased activity in this area at a number of different centers. Reported are the first results of the program directed to incorporate at Tomsk Cardiology Center experience gained in Tomsk optical profile research institutions in areas of light-matter interaction, high resolution spectroscopy, laser physics and relevant software and their usage in cardiac therapy, surgery, and diagnostics. To coordinate research work in this direction the special unit-laboratory of laser medicine is organized at the Center. Laboratory activity goes in the following directions: study of spectral properties of vessel walls in norm and atherosclerosis, comparative study of different wavelength laser radiation action on normal and atherosclerotically damaged tissues, novel approach to intravascular imaging, and usage of high sensitive laser spectroscopy for early diagnosis of cardiac diseases. The spectroscopic study of AP and normal tissue is aimed at understanding of differences in internal energy structures and ways of energy migration which are of critical importance for reaching selective laser action on normal and deceased tissues. To compare thermal, mechanical, and photo-chemical variations of tissues caused by laser radiation the XeCl excimer laser with Raman shifting cell and Nd:YAG laser with second, third, and fourth harmonic converters are employed. Fine influence of pulse duration, intensity, and repetition rates on AP removal is considered in laboratory experiments with vessel samples. Preliminary results on theoretical consideration for determination of spectroscopically detectable markers of some cardiac diseases are reported as well.

In the multicenter trial, the hypolipidemic efficacy and adverse event profile of lovastatin were estimated in 294 patients with primary hypercholesterolemia. The mean baseline (on placebo) lipid and lipoprotein values were: total serum cholesterol (TC) 313 mg/dl, triglycerides (TG) 168 mg/dl, low density lipoprotein cholesterol (LDL-C) 235 mg/dl, high density lipoprotein cholesterol (HDL-C) 44.9 mg/dl. Lovastatin was begun with 20 mg/day, the dose being doubled after 4 and 8 weeks if the target reduction of TC < 200 mg/dl was not reached at those moments. At the end of the treatment the mean TC decreased by 29.5% (p) as compared with the baseline level, TG by 14% (p). The normal target level of TC was reached in 106 patients (36%), the borderline levels (200-240 mg/dl) in 123 (42%), high TC (240 mg/dl) remained in 65 patients (22%). LDL-C decreased by 38% (p), HDL-C increased by 7.8% (p), whereas LDL-C/HDL-C ratio decreased by 40% (p). The treatment was well tolerated by patients: mild clinical side effects were noticed in 2.7% of patients and asymptomatic transient deviations of laboratory tests in 8.2%. The authors conclude about high hypolipidemic efficacy and low adverse event profile of lovastatin in patients with primary hypercholesterolemia.

In 26 patients with coronary heart disease, transesophageal atrial pacing was used to study cerebral hemodynamics from brain tomoscintigraphic findings as compared to the severity of induced of myocardial ischemia, echocardiographic parameters of left ventricular function and prostacyclin-thromboxane balance. In angina pectoris, the lower rate of cerebral blood flow was found to be correlated with the integral parameter of myocardial ischemia, deteriorated cardiac contractile and pump function, and higher plasma thromboxane A2 levels.

The loading tests, instrumental and biochemical methods were employed to study the effect of mildronate, dalargin, rokornal, gevilon, dibunol, emoxipine and plasmapheresis on the coronary, cerebral, peripheral circulation, the level of cholesterol, its fractions and triglycerides in 247 patients suffering from atherosclerosis. Mildronate, dalargin, rokornal, emoxipine and plasmapheresis were shown to exert a beneficial effect on the regional circulation, lipid metabolism and can be used in the treatment of patients with concomitant forms of atherosclerosis.

The organism's oxygen balance was studied in 27 patients with atherosclerosis of the peripheral arteries during the test on a bicycle ergometer. The decrease in the patient's physical capacity was found to be in high correlation with the severity of oxygen disbalance.

Eighty seven patients with Stages II-III vascular occlusions in the lower extremities were examined. The clinical and biochemical parameters of the course of the disease were found to improve in the patients who received in earlier periods dalargin supplemented to the combined therapy than in those from a matched group. There was a decrease in femoral venous blood lactate concentrations in the diseased extremity, blood cholesterol and parathyroid hormone levels. The mechanisms responsible for effects of dalargin on metabolic parameters and clinical indices of the patients' condition were also discussed. Whether it is possible to use dalargin in the combined therapy for extremity vascular occlusive diseases is considered.