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In this manual, the authors focused on the principal methods for diagnosis of peripheral artery disease in cardiological patients, from the interview and physical examination to functional tests and vascular visualization. Diagnostic and prognostic value of each method, its potentialities for reducing the risk of cardiovascular events (CVE), including myocardial infarction (MI), ischemic stroke (IS) or extremity amputation in critical ischemia, and overall mortality are discussed. The authors provided current information about a possibility of reducing the risk of CVE by intensifying the antithrombotic therapy according to results of the COMPASS study.

The frequency of recording late potentials and their dynamics were studied in 25 patients with coronary heart disease before, during, and after transluminal angioplasty (TAP). Baseline late potentials were observed in 6 (20.7%) cases. During TAP, late potentials were recorded significantly more frequently (48.3%) than the baseline ones (p < 0.03), in 6 (20.7%) patients, late potentials appeared only in arterial dilatation and disappeared after TAP. There was a profound decrease in root-mean-square amplitude of late 40 msec in the QRS complex and an increase in the duration of low-amplitude (less than 40 microV) signals at the end of the QRS complex as compared to the baseline values. In ST-segment elevation, the parameters of the ECG signal-average become deteriorated to a greater degree than those in ST-segment depression.

The dynamics of signal-averaged ECG and late potentials was studied in 19 patients with coronary heart disease during spontaneous anginal episodes. Baseline late potentials were observed in 9 (45%) patients, they remaining in all during and after anginal episodes. The occurrence of new late potentials was recorded in none of them. There were no significant differences in some parameters of signal-averaged ECG before, during, and after an anginal episode, though the duration of low-amplitude signals tended to increase at the end of the QRS complex and the mean square amplitude of late 40 msec of QRS complex decreased during transient myocardial ischemia. The differences did not achieve their statistical significance. It was concluded that transient myocardial ischemia during spontaneous anginal episodes failed to lead to the appearance of a substrate for the occurrence of late potentials.