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A total of 46 patients who had sustained myocardial infarction, including those with concurrent arterial hypertension were examined at polyclinic rehabilitation. The patients with myocardial infarction and those with myocardial and concurrent arterial hypertension proved to belong to various general populations having specific features of formation of the phenomenon of structural adaptative stabilization (SAS). There were hemodynamic variations to a single procedure of manual therapy in relation to the extent of cardiac lesion. The single procedure of manual therapy was found to affect the patients with myocardial infarction concurrent with arterial hypertension and to transfer the latters to the general myocardial patient population without arterial hypertension. The manual impact on the vertebrogenic links of myocardial infarction pathogenesis favour the formation of the SAS phenomenon.

Clinical examination of 25 males with new-onset and progressive angina pectoris resistant to inpatient combined antianginal treatment versus 15 healthy males established hyperfunction of the platelets in low antithrombogenic activity of the vascular walls in patients with unstable angina pectoris. A 5-day course of fraxiparin resulted in a trend to a decrease in ADP-induced platelet aggregation and in the level of platelet factor IV. The endothelium recovered normal antiaggregation and fibrinolytic properties. This may underlie the drug efficacy against unstable angina pectoris.

The authors have developed and validated algorithms, programs, regimens and techniques of manual and instrumental treatment which produced positive effects in 99% of patients with neurological syndromes of spinal affections. The criteria of the treatment discontinuation were alleviation of painful syndrome by 25-50%. This occurred, as a rule, after 3-4 sessions. The course averaged 10 sessions and more. The treatment was discontinued after stabilization of subjective improvement.

The paper compares the data of selective coronary angiography and 24-hour monitoring in 39 patients with refractory angina pectoris. Transient ST-segment changes were revealed in 79% of the patients, ST-segment depression occurring in 54%, ST-segment elevation in 46%, T-wave inversion in 38%. A combination of ST-T interval changes and occurrence of ventricular premature contraction was found in a third of the examinees. There was no statistically significant correlation between the extent of major coronary lesion and the mean length of ST-segment displacements.

Captopril administration in chronic cor pulmonale (CCP) stage I and II produced positive objective and subjective responses evident from a significant improvement of right heart myocardial contractility, external respiration which lower systolic pressure in the artery. Captopril can be introduced in CCP stage I for preventive and CCP stage II for therapeutic purposes.

The clinical suggestion on the dysfunction of the mitral valve in 20 patients with post-infarction cardiosclerosis was confirmed by ventriculography (8 persons) and in autopsy (12 persons). The paper presents a clinical characteristics of the both groups of patients, the indices of the central hemodynamics, the end diastolic pressure in the left ventricle of the heart, coronaroangiography, as well as morphometric data of the examination of the hearts and of the extent of the scar lesions of the myocardium in patients who died of congestive cardiac insufficiency against the background of postinfarction cardiosclerosis combined with the papillary muscle affection.

The results of bicycle ergometry in 115 patients with various paroxysmal rhythm disorders are reported. A comparative analysis of the rate of provoked arrhythmia paroxysms in patients with supraventricular tachycardia (SVT) and paroxysmal atrial fibrillation (PAF) is presented. The exercise test proved to be of diagnostic value in 18.5% of the SVT patients and in 16.4% of those with PAF.

The clinical effect of the peripheral vasodilator prazosin (Adwersuten, GDR) was studied in 51 patients with second-stage essential hypertension. A single dose of 1 to 2.5 mg produced hypotensive effect in 48 (94.1%) patients, that lasted between 3 and 4 hours, with the lowest ABP drop occurring 1.5-2.5 hours after the administration. When prazosin was given as a course of monotherapy, its daily dose varied between 3 and 20 mg (6.7 +/- 0.6 mg). A marked hypotensive effect was obtained by the end of the first week in 91.4% of patients. A 28.6% decrease in total peripheral resistance was the principal hemodynamic effect of prazosin. No significant changes of heart rate were recorded on the group basis, while side-effects were noted in 7 (13.7%) patients (orthostatic hypotension and allergic response).

Comparative analysis of the causes of fatal outcomes in hypertensive disease is presented on the grounds of postmortem findings in 2,091 patients who had died in hospitals in the period between 1953 and 1975. It was established that the mortality of disorders of cerebral circulation reduced significantly in 1973--75 as compared to that in 1963--05 and 1953--55. One fourth of patients with hypertensive disease died of myocardial infarction. It was noted that death of renal failure among patients with hypertensive disease decreased progressively.

The paper deals with a comparative analysis of the results of using 2 methods of investigation (daily Holter's monitoring of ECG and bicycle ergometry in patients with paroxysmal heart rhythm disturbances (group 1) and in those with extrasystole (group 2). The method of the Holter monitoring proved to be diagnostically significant in 77.2% of the first group and in all the patients of second one. In 40.9% of patients with paroxysmal rhythm disturbances and 64.7% of those with extrasystole, arrhythmias were provoked by trials with a dosed physical exercise. The comparison of both the methods revealed a concurrence of the results in 40% of the cases. A joint application of both the methods was found to enhance their diagnostic value.

Subsequent to an examination of 133 patients, made several years after transmural myocardial infarction sustained by them, features specific for the clinical course of post-infarction cardiac insufficiency are analyzed. The examination included studies of the hemodynamics, veloergometry, measurements of the end diastolic pressure in the left ventricle, ventriculography and selective coronaroangiography. A considerable proportion of patients with extensive infarction in their history were found to suffer from chronic left ventricle incompetence with recurrent attacks of cardiac asthma. In the development of congestive cardiac insufficiency along the larger circulation an important role plays a sharply diminished contractility of the left ventricle due to the presence of extensive areas of akinesia and, in individual cases, also because of mitralism of the heart.

The radioisotope method with Rb86 was used for determining in vitro the serum concentration of Digoxin. The study was conducted in 57 patients with cardiac insufficiency in the acute period of myocardial infarction and with post infarction cardiosclerosis. The mean values of Digoxin concentration depending on the daily maintenance dose were obtained. The direct correlation between the amount of the drug taken and the content of the drug in the blood serum was proved. Digoxin intoxication was found to develop in cases of its content exceeding the mean level for the given dosage (4 patients), however, in 2 patients signs of intoxication developed with a low concentration of Digoxin. The causes favouring the development of intoxication are discussed.

The results of repeated 24-hour ECG monitoring in 81 patients with documented transmural and macrofocal myocardial infarction are reported. The occurrence and pattern of heart rhythm disorders, including high-grade ventricular extrasystoles within the first day of the attack, were determined, as was the correlation between the infarction site and the occurrence of arrhythmia. The frequency and number of extrasystoles were the highest in recurrent myocardial infarction with developing left-ventricular insufficiency. High diagnostic value of 24-hour ECG monitoring, as compared to routine recordings, is demonstrated. The monitoring showed a significant drop in the frequency and number of extrasystoles by the end of the acute phase, including cases where no antiarrhythmic drugs were administered, and a significant rise in those in the subacute phase of myocardial infarction. It is suggested that the latter fact may be due to increased patient's physical activity in the course of convalescence, and myocardial autoimmune processes developing in the subacute phase.

An assessment of antiarrhythmic efficiency of obsidan by means of repeated 24-hour ECG monitoring with tape recording was made in 42 patients with a documented anterior transmural and macrofocal myocardial infarction. A marked and significant antiarrhythmic effect of obsidan was demonstrated with respect to most arrhythmias, particularly high-grade ventricular extrasystoles. The drug is shown to have a favorable effect on the size of the peri-infarction++ area. A moderate negative inotropic effect of obsidan did not provoke clinical signs of heart failure. In the absence of contraindications, obsidan is recommended for use since the very first days of myocardial infarction.

Digoxin concentrations were studied in the blood serum of 128 patients with cardiac insufficiency of different etiology (acute myocardial infarction, postinfarction cardiosclerosis, mitral valve disease). Radioimmunoassay with standard kits was employed, the kits containing 125 I-labelled Digoxin. Mean concentrations of Digoxin were determined in the blood serum corresponding to different maintenance doses of the drug. It was found that signs of overdosage usually appear with concentrations exceeding 2.5 ng/ml. Disorders in the renal excretory function in patients with severe edematous syndrome help a prompt cumulation of Digoxin and the development of glucoside intoxication. Some patients demonstrated a reduced Digoxin tolerance in the acute period of their myocardial infarction. The advantages of the radioimmunoassay, especially in severely ill patients with cardiac pathology are emphasized.

The paper is concerned with an analysis of the results of ECG daily monitoring in 60 CHD patients: 32 of them had a progressive form of unstable angina pectoris (the 1st group), and 28--stable angina pectoris (the 2nd group). Significant differences were revealed in the study groups with regard to the frequency of detection of disturbed rhythm, the total number of extrasystoles during a day, and a degree of their gradation.

The presented analysis deals with the physiopathological mechanisms of the debelopment of postinfarction cardiac insufficiency and the clinical peculiarities of its manifestations. It is emphasized that the leading cause of cardiac insufficiency consists in a reduction of the contractile function of the left ventricular myocardium due to the development of asynergy in the cicatrical zone. The addition of several accompanying factors, such as heart mitralization, tachysystolic form of ventricular fibrillation, repeated infarction with a growing asynergic zone, aggravate the course of cardiac insufficiency providing for the development of hypertension in the general circulation system.

Comparison of data obtained in recording corrected orthogonal leads of the Frank system and 12 classical ECG leads in 118 patients with ischemic heart disease, among whom there were 76 patients with an old myocardial infarction, showed that corrected orthogonal leads may be used in mass population survey with the use of automatic diagnostic machines. It was established that the following ECG indices may be used in recording Frank's corrected orthogonal leads in the diagnosis of cicatricial myocardial changes: amplitude and duration of Q wave, the Q/R and R/S coefficients, the appearance of wave S in lead "Z". In an old myocardial infarction of posterior localization changes are recorded in lead "Y", in infarction of antero-septal localization changes are recorded in lead "Z" and to a lesser degree in lead "X"; in infarction of antero-lateral localization changes are recorded in lead "X" and to a lesser degree in lead "Z".

Antiarrhythmic effect of cordaron in patients with unstable stenocardia (34) and transmural myocardial infarction (39) has been studied in various dose regimens. A dose of 400-600 mg/day was significantly effective in unstable angina pectoris, while in myocardial infarction a 600 mg/day dose failed to attenuate arrhythmia, i.e. the number and frequency of extra-systoles reduced insignificantly. In subacute disease a 200 mg/day cordaron could not prevent an increment of arrhythmia showing inadequacy of a standard scheme of the drug administration.

Left ventricular myocardial hypertrophy was found in patients with repeated myocardial infarctions, the greatest weight of the left ventricle being noted in those with congestive heart failure. A high correlation (r = 0.78) was established between the mass of the left ventricular myocardium calculated with the aid of echocardiography and the actual weight of the left ventricle. The important compensatory role of the ventricular septum is emphasized for the cases of myocardial infarction occurring in the free wall of the left ventricle. Left ventricular hypertrophy was detected by ECG in only 25% of those ischaemic heart disease cases in whom signs of myocardial hypertrophy were revealed by echocardiography.