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Systematization of pleiotropic actions of statins is presented with special stress on effects important for prevention of atherosclerotic diseases, nonatherosclerotic cardiovascular diseases, and diseases of noncardiovascular origin. Dependence of pleiotropic effects of statins on dose and duration of administration is shown. The review contains data on novel studies of pleiotropic effects favorably affecting endothelial function, oxidative stress, arterial pressure, angiogenesis, heart failure, and disturbances of cardiac rhythm.

Photoluminescence, surface photovoltage spectroscopy and high-resolution characterization methods (Atomic Force Microscopy, Scanning Electron Microscopy, X-ray spectroscopy and DC conductivity) are applied to nanostructured Hydroxyapatite (HAp) bioceramics and allowed to study electron (hole) energy states spectra of the HAp and distinguish bulk and surface localized levels. The measured trap spectra show strong sensitivity to preliminary heat treatment of the ceramics. It is assumed that found deep electron (hole) charged states are responsible for high bioactivity of the HAp nanoceramics.

Correlated neuronal activity is instrumental in the formation of networks, but its emergence during maturation is poorly understood. We have used multibeam two-photon calcium microscopy combined with targeted electrophysiological recordings in order to determine the development of population coherence from embryonic to postnatal stages in the hippocampus. At embryonic stages (E16-E19), synchronized activity is absent, and neurons are intrinsically active and generate L-type channel-mediated calcium spikes. At birth, small cell assemblies coupled by gap junctions spontaneously generate synchronous nonsynaptic calcium plateaus associated to recurrent burst discharges. The emergence of coherent calcium plateaus at birth is controlled by oxytocin, a maternal hormone initiating labour, and progressively shut down a few days later by the synapse-driven giant depolarizing potentials (GDPs) that synchronize the entire network. Therefore, in the developing hippocampus, delivery is an important signal that triggers the first coherent activity pattern, which is silenced by the emergence of synaptic transmission.

The article is assigned to general practitioners and devoted to the outpatient combined rehabilitation of coronary heart disease patients, including those after myocardial infarction. In the part concerning the physical rehabilitation there is given the classification of patients by functional classes, the exercise programs of middle intensity for sport and home training. The formula of selection of the walking training temp according to the results of exercise stress test is given. There are presented the psychodiagnostic methods that evaluate the psychological reactions of patients on the disease, and the methods of psychological rehabilitation with use of psychopharmacotherapy. Special part is devoted to the educational program for patients.

Aim: To assess efficacy of early and long-term exercise in patients with ischemic heart disease (IHD) after acute coronary events (acute myocardial infarction--AMI, unstable angina--UA, coronary artery bypass grafting--CABG) in wide outpatient medical practice of Russia., Material and Methods: Three to eight weeks after the acute coronary event (ACE) 373 patients from different clinics of RF regions were randomized into two groups: the study group (n = 188) and a control one (n = 185). Both groups received standard therapy, the study group performed also a special exercise program (moderate exercise for maximum 1 hour 3 times a week for a year). The efficacy of the treatment was assessed by clinical, device and biochemical findings during 6-month follow-up., Results: Physical work capacity, total amount of performed work (PW) in stress test rose in the study group by 26.5% (p < 0.01) and 59.4% (p < 0.01), respectively; HRmax and BPSmax x HRmax increased by 6.4 and 9.8%, respectively, p < 0.01); PW/Hrpeak rose by 48.6% (p < 0.01), PW/DP peak--by 45.9% (p < 0.01). Left ventricular ejection fraction increased by 5.6% (p < 0.05), LV stroke volume--by 3.4% (p < 0.05). In 6 months, controls demonstrated a 4.7% (p < 0.05) rise in HDLP cholesterol, total cholesterol lowered in the study group by 6.4% (p < 0.01), body mass index--by 1.9%, number of anginal attacks--by 0.9%., Conclusion: The proposed exercise program is effective and can be applied in outpatients after acute coronary events. The program can be also used as a method of secondary prophylaxis as it lowers total cholesterol, atherogenic index and body mass index.

Clinical aspects of the use of organic nitrates in the treatment of patients with ischemic heart disease (IHD) are considered. Efficacy of organic nitrates in various forms of IHD as well as in patients with concomitant diseases is discussed. Special stress is made on clinical aspects of application of nitrates in treatment of IHD. Possibilities and safety of contemporary nitrates in patients with various forms of IHD are discussed.

Attitude of district internists to the realization of a concept of secondary prevention (SP) of ischemic heart disease was studied in one of large cities in Russia. Among preparations most necessary for SP the following were named: b-blockers (79.5%), angiotensin converting enzyme inhibitors (49.3%), antiaggregants (43.8%), hypolipidemic drugs (13.7%), nitrates (63%), biologically active supplements, phyto-preparations, metabolic drugs, and glycosides (3-5% each). However actually prescribed drugs were b-blockers (100%), nitrates (96%), angiotensin converting enzyme inhibitors (89%), calcium antagonists (87%), antiaggregants (83%), cardiac glycosides (66%), vitamins (39%). Average doses of drugs were low: 21.7, 47.4 and 35.5% of possible maximal doses for statins, angiotensin converting enzyme inhibitors, and beta-blockers, respectively. Nondrug measures were used "rarely" and "often" by 26 and 74% of physicians, respectively. Only 18% of physicians directed their patients to corresponding specialists. Recommendations were mostly formal, without explanation of goals, methods and specific features of recommended measures. Moreover their prescription by physician was determined largely by subjective factors: availability of sufficient time (50%), cultural level of a patient (79%), patient's own initiative (33%), physician's personal attitude to a patient (21%).

Effect of single bout of dynamic physical exercise on parameters of lipid-transport system and carbohydrate metabolism and hormones (insulin, cortisol) in the blood was studied in patients with coronary heart disease with class I-III angina and type 2 diabetes. Intensity of exercise was limited by severity of stable effort angina and was > 95, 80 and 70% of predicted maximum in patients with class I (n=10), II (n=12) and III (n=14) angina, respectively. High intensity exercise provoked development of atherogenic dyslipidemia: elevation of levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, apolipoprotein B and apolipoprotein B/A1 ratio, and lowering of levels of high density lipoprotein cholesterol and apolipoprotein A1. Patients with diabetes responded to high intensity exercise by elevation of blood glucose and insulin levels and lowering of sensitivity of tissues of the periphery to insulin (glucose/insulin ratio). On the contrary exercise of moderate intensity did not affect negatively metabolism of blood lipids and carbohydrates. Six months course of physical training in patients with diabetes (n=10) corrected exogenous atherogenic dyslipidemia and derangements of carbohydrate metabolism, which developed after acute dynamic effort of high intensity.

Aim: To evaluate effects of dynamic exercise (DE) and static leg exercise (SE) varying by intensity on blood serum spectrum of lipoproteins and apolipoproteins in healthy persons and patients with coronary heart disease (CHD)., Material and Methods: Healthy 12 men and 12 CHD patients of functional class I performed bicycle DE of maximal (for age) intensity (100%), submaximal (80, 70 and 60%), SE of maximal and submaximal intensity. Blood samples were taken before the exercise, after it and 3 hours after the exercise., Results: DE of high intensity (80% and higher) and SE of maximal and moderate intensity (100 and 60%, respectively) produced atherogenic changes in the blood of both healthy subjects and CHD patients: a rise in total cholesterol, LDLP cholesterol, triglycerides, apolipoprotein (apo) B and apo B/ apo AI. Moderate (60%) DE gave rise to antiatherogenic changes in the blood: a fall in lipoproteins containing apoB and a rise in concentration of apo AI both in healthy and CHD subjects., Conclusion: To prevent atherosclerosis by correction of atherogenic lipid disorders, CHD patients and healthy persons should do DE of moderate intensity in addition to other prophylactic measures.

Quantifying the dissimilarity (or distance) between two sequences is essential to the study of action potential (spike) trains in neuroscience and genetic sequences in molecular biology. In neuroscience, traditional methods for sequence comparisons rely on techniques appropriate for multivariate data, which typically assume that the space of sequences is intrinsically Euclidean. More recently, metrics that do not make this assumption have been introduced for comparison of neural activity patterns. These metrics have a formal resemblance to those used in the comparison of genetic sequences. Yet the relationship between such metrics and the traditional Euclidean distances has remained unclear. We show, both analytically and computationally, that the geometries associated with metric spaces of event sequences are intrinsically non-Euclidean. Our results demonstrate that metric spaces enrich the study of neural activity patterns, since accounting for perceptual spaces requires a non-Euclidean geometry.

How can neural activity propagate through cortical networks built with weak, stochastic synapses? We find precise repetitions of spontaneous patterns of synaptic inputs in neocortical neurons in vivo and in vitro. These patterns repeat after minutes, maintaining millisecond accuracy. Calcium imaging of slices reveals reactivation of sequences of cells during the occurrence of repeated intracellular synaptic patterns. The spontaneous activity drifts with time, engaging different cells. Sequences of active neurons have distinct spatial structures and are repeated in the same order over tens of seconds, revealing modular temporal dynamics. Higher order sequences are replayed with compressed timing.

Aim: To study effects of 6-month physical training on some parameters of hemostasis in patients with coronary heart disease and non-insulin dependent diabetes (NIDDM)., Results: Long-term physical training resulted in lowering of fibrinogen level and increase of fibrinolytic activity assessed as euglobulin fraction clot lysis time, while factor VII activity remained unchanged. These changes were accompanied with elevation of total and high density lipoprotein cholesterol levels without any shifts in low density lipoprotein cholesterol and triglycerides. Most pronounced positive effect physical training exerted on results of a test with standard single fat load, which was used as a model of postprandial lipemia. Serum cortisol level significantly decreased after 6-month training, especially after fat load and subsequent physical exertion., Conclusion: In patients with combination of coronary heart disease and NIDDM long-term physical training was associated with decreased thrombogenicity of blood.

Aim: To examine relationships between lipemia, atherogenicity of blood lipoproteins spectrum after fat loading (FL) and severity of angiographic manifestations of coronary atherosclerosis., Material and Methods: The study enrolled 72 males free of ischemic heart disease (IHD)--group 1; 60 IHD patients with moderate affection of the coronary arteries (CA), i.e. maximal narrowing of one CA 50%--group 2; 107 IHD patients with severe CA affection, i.e. CA narrowing > 50%--group 3. FL was given by J. R. Patsch technique, blood sampling was made before meal, 3 and 6 hours after FL., Results: It was shown that intake of food fats in IHD and IHD-free patients stimulated development of postprandial lipemia of different severity and duration. It appeared due to increased fraction of lipoproteins rich in triglycerides. In group 2 and 3 there was a definite and up to 6 hours in duration postprandial hypertriglyceridemia associated with proatherogenic deviations in lipid and protein components (LDL and HDL) by FL hour 6: growing of LDL cholesterol, apoB, apoB/apoAI and lowering of HDL cholesterol and apoAI. Patients with severe CA atherosclerosis (> 50% narrowing of three CA) had the most severe atherogenic affections in the postprandial lipoprotein spectrum., Conclusion: Postprandial lipemia/hypertriglyceridemia and atherogenic changes in the spectrum of lipoproteins after FL correlate directly with angiographic manifestations of coronary atherosclerosis.

Concept of sequence and time of appearance of various effects of statins is presented. Apart from hypolipidemic action due to inhibition of HMG CoA reductase activity statins exert multiple pleiotropic effects. Combination of these effects makes statins a unique instrument for solution of global tasks of prevention and treatment of atherosclerosis and its consequences (ischemic heart disease etc.). Manifestations of various pleiotropic effects of statins appear after different time intervals and in most cases are not related to suppression of cholesterol synthesis in the body. First 3-4 months (first level of the statin cascade) are characterized mainly by activity of pleiotropic properties aimed at restoration of endothelial function. These properties are responsible for enhanced eNOS expression, antiischemic, antithrombotic and antiatherogenic effects. During same period of time stabilization of unstable atheromas takes place. Manifestations of second level of the cascade of statin action appear after 2 years of treatment. They are represented by retardation of progression and even partial regression of atheromatosis of coronary and peripheral arteries. Third level is signified by achievement of strategic aims of therapy with statins (in 4-5 years) -- lowering of total and cardiac mortality, reduction of number of cardiac complications. Forth level of the cascade is represented by beneficial influences on nonatherogenic cardiological phenomena and comprise hypotensive, antiarrhythmic and cardiotonic effects. And finally some other important properties of statins constitute the fifth level of the therapeutic cascade. These properties are responsible for effects directed at noncardiac pathology (prevention of diabetes, dementia, including dementia associated with Alzheimer's disease, fractures). Immunodepression, ability to reduce saturation of bile with cholesterol belong to this group of effects.

Effect of physical training, therapy with extended-release nicotinic acid (enduracin) or their combination on clinical course of the disease, physical working capacity, hemodynamics and blood lipids was studied in 136 patients. Patients were recruited 8-12 weeks after onset of acute coronary incident in several hospitals of Moscow region and followed up for 1 year. Type of intervention implemented in a given hospital was determined by randomization of the hospitals. Combined use of training and nicotinic acid resulted in increased physical working capacity, improved hemodynamics both at rest and during exercise, improved systolodiastolic left ventricular function and lipid profile. Combined use of interventions produced better effect than each one alone. However positive significant effect of enduracin on physical working capacity, blood pressure and frequency of angina was also demonstrated. The data obtained were used for creation of recommendations on out of hospital physical rehabilitation of this group of patients.

Aim: To evaluate efficacy of combined use of moderate exercise and nicotinic acid drug enduracin in patients with coronary heart disease (CHD) with moderate dyslipidemia (DE)., Material and Methods: The effects of exercise therapy alone, enduracin alone and their combination on physical performance (PP), hemodynamics, blood lipid spectrum and clinical course of CHD were studied in 93 CHD patients with moderate DE. The results were evaluated clinically after 1-year treatment., Results: Combined used of exercise and enduracin in CHD patients showed its efficacy manifesting in improvement of PP, hemodynamics at rest and exercise test, left ventricular systolic function, clinical course, reduction of DE. Enduracin + exercise appeared more efficient than their use in monotherapy. Enduracin monotherapy had a positive action on PP, arterial pressure and anginal attacks frequency., Conclusion: Enduracin is recommended as monotherapy and in combination with moderate exercise in outpatient rehabilitation and secondary prophylaxis of CHD patients with moderate dyslipidemia and angina pectoris to relieve myocardial ischemia under exercise, to raise PP, improve lipid composition of blood and prevent maladaptive left ventricular remodeling.

Dendritic spines receive excitatory synapses and serve as calcium compartments, which appear to be necessary for input-specific synaptic plasticity. Dendrites of GABAergic interneurons have few or no spines and thus do not possess a clear morphological basis for synapse-specific compartmentalization. We demonstrate using two-photon calcium imaging that activation of single synapses on aspiny dendrites of neocortical fast spiking (FS) interneurons creates highly localized calcium microdomains, often restricted to less than 1 microm of dendritic space. We confirm using ultrastructural reconstruction of imaged dendrites the absence of any morphological basis for this compartmentalization and show that it is dependent on the fast kinetics of calcium-permeable (CP) AMPA receptors and fast local extrusion via the Na+/Ca2+ exchanger. Because aspiny dendrites throughout the CNS express CP-AMPA receptors, we propose that CP-AMPA receptors mediate a spine-free mechanism of input-specific calcium compartmentalization.

We examine the responses of single neurons and pairs of neurons, simultaneously recorded with a single tetrode in the primary visual cortex of the anesthetized macaque monkey, to transient presentations of stationary gratings of varying spatial phase. Such simultaneously recorded neurons tended to have similar tuning to the phase of the grating. To determine the response features that reliably discriminate these stimuli, we use the metric-space approach extended to pairs of neurons. We find that paying attention to the times of individual spikes, at a resolution of approximately 30 ms, and keeping track of which neuron fires which spike rather than just the summed local activity contribute substantially to phase coding. The contribution is both quantitative (increasing the fidelity of phase coding) and qualitative (enabling a 2-dimensional "response space" that corresponds to the spatial phase cycle). We use a novel approach, the extraction of "temporal profiles" from the metric space analysis, to interpret and compare temporal coding across neurons. Temporal profiles were remarkably consistent across a large subset of neurons. This consistency indicates that simple mechanisms (e.g., comparing the size of the transient and sustained components of the response) allow the temporal contribution to phase coding to be decoded.

The cerebral cortex receives input from lower brain regions, and its function is traditionally considered to be processing that input through successive stages to reach an appropriate output. However, the cortical circuit contains many interconnections, including those feeding back from higher centres, and is continuously active even in the absence of sensory inputs. Such spontaneous firing has a structure that reflects the coordinated activity of specific groups of neurons. Moreover, the membrane potential of cortical neurons fluctuates spontaneously between a resting (DOWN) and a depolarized (UP) state, which may also be coordinated. The elevated firing rate in the UP state follows sensory stimulation and provides a substrate for persistent activity, a network state that might mediate working memory. Using two-photon calcium imaging, we reconstructed the dynamics of spontaneous activity of up to 1,400 neurons in slices of mouse visual cortex. Here we report the occurrence of synchronized UP state transitions ('cortical flashes') that occur in spatially organized ensembles involving small numbers of neurons. Because of their stereotyped spatiotemporal dynamics, we conclude that network UP states are circuit attractors--emergent features of feedback neural networks that could implement memory states or solutions to computational problems.

Spike train metrics quantify the notion of dissimilarity, or distance, between spike trains and between multineuronal responses (J. Neurophysiol. 76 (1996) 1310, Network 8 (1997) 127). We present a new algorithm for the implementation of a metric based on the timing of individual spikes and on their neurons of origin. This algorithm surpasses the earlier approach in speed by a factor that grows exponentially with the number of neurons, substantially extending the applicability of metric space methods to the study of coding in larger neuronal populations.

Aim: To study effects of the drug pumpan on exercise tolerance and myocardial ischemia induced by exercise in patients with ischemic heart disease of functional class II-III., Material and Methods: The study included 30 patients with various forms of ischemic heart disease (myocardial infarction, coronary artery bypass grafting) having stable effort angina of functional class II-III., Results: The addition of a compound drug pumpan to a standard antianginal therapy reduced the number of anginal attacks and ST depression at bicycle exercise test., Conclusion: Pumpan is an adjuvant medication in conduction of antianginal therapy in ischemic heart disease patients with stable angina of effort of functional class II-III.

Effect of dynamic exercise of various intensity (maximal 100% and submaximal -- 80, 70 and 60% of individual maximally tolerated work load) on blood lipids, lipo- and apolipoproteins (apo) was studied in healthy subjects and patients with coronary heart disease. Both in healthy persons and patients high intensity (100 and 80%) exercise was associated with atherogenic changes of lipid transport system: increases of levels of total and low density lipoprotein cholesterol, triglycerides, apolipoprotein B and apo B/apo-A1 ratio. On the contrary, changes after exercise of moderate (60%) intensity (lowering of apo-B containing lipoproteins in healthy subjects and patients and elevation of apo-A1 concentration in healthy subjects) were antiatherogenic.

Changes of main lipid and apolipoprotein parameters of lipid transport system during postprandial hyperlipidemia were studied in subjects without (n=72) and with (n=167) overt coronary heart disease (CHD) including patients with noninsulin dependent diabetes (n=48). Tolerance to dietary fat was evaluated by oral fat load test (consumption of 639+/-7 ml of 20% cream after fast). In subjects without CHD reaction of lipid transport system to fat load was characterized by lowered total, low density lipoprotein cholesterol, apolipoprotein apo B and apo B/apo A-1 ratio, lowered or unchanged triglycerides, stable high density lipoprotein cholesterol level at the background of apo A-1 elevation by 6-th hour after load. Patients with CHD exhibited signs of impaired tolerance to dietary fat: elevation of triglycerides, apo B and apo B/apo A-1 ratio, lowering of high density lipoprotein cholesterol, increase of percentage of subfractions of small high density lipoproteins particles, increase of triglyceride content in low and high density lipoprotein fraction during 6 hours after fat load.

Effects of high (100 and 80 kg) and moderate (60 kg) intensity static leg exercise on blood serum lipoproteins and apolipoproteins (apo) A1 and B were studied in healthy subjects (n=11) and patients with coronary heart disease and class I angina (n=11). Static leg exercise with loads exceeding 60 kg were associated with atherogenic changes of blood lipid transport system: elevation of levels of triglycerides, apoprotein B and apo B/A ratio both in healthy subjects and patients, and of total and low density lipoprotein cholesterol in patients. These post exercise changes were more pronounced in the presence of fasting hyperlipidemia and their severity increased with increase in duration of exercise. Static leg exercise did not increase concentration of high density lipoprotein cholesterol. For prevention of post exercise atherogenic dyslipidemia it is expedient to supplement strength training programs with dynamic exercise of moderate intensity.

Myocardial infarction survivors took general carbon dioxide baths and/or did therapeutic exercises. Compared to controls, all these patients experienced a significantly less number and duration of episodes of ST-segment ischemic depressions detected at 24-h ECG monitoring while significant differences by cardiac rhythm variability before and after the treatment were not registered though the test group showed the trend to normalization of the heart rhythm.

This literature review presents data on pharmacological action of pravastatin, its lipid lowering activity, and influence on main mechanisms of atherogenesis. Beneficial pleiotropic (nonlipid) effects of pravastatin: normalization of endothelial function, antiinflammatory action, antiischemic- and antithrombotic effects are also described. These effects represent possible mechanisms of participation of pravastatin in stabilization of prone to rupture atheromatous plaques. Early and pronounced clinical efficacy of pravastatin demonstrated in trials with clinical endpoints is discussed and value of the drug for primary and secondary prevention of atherosclerosis stressed.

Effect of an HMG-CoA reductase inhibitor pravastatin on atherogenic changes in the lipid transport system during postprandial hyperlipidemia immediately after ingestion of fatty meal was studied in patients with coronary heart disease and fasting hyperlipidemia. Treatment with pravastatin (20-40 mg/day for 3 months) resulted in normalization of fasting levels of blood lipids and decreased postprandial hyperlipidemia due to of enhanced removal of triglyceride-rich atherogenic lipoproteins from blood and their diminished secretion in response to fat load. Moreover pravastatin increased tolerance of the lipid-transport system to exogenous saturated fats. KEY WORDS. coronary heart disease; postprandial hyperlipidemia; pravastatin; lipoproteins, metabolism.

The flow of activity in the cortical microcircuitry is poorly understood. We use calcium imaging to reconstruct, with millisecond and single-cell resolution, the spontaneous activity of populations of neurons in unstimulated slices from mouse visual cortex. We find spontaneous activity correlated among networks of layer 5 pyramidal cells. Synchronous ensembles occupy overlapping territories, often share neurons, and are repeatedly activated. Sets of neurons are also sequentially activated numerous times. Network synchronization and sequential correlations are blocked by glutamatergic antagonists, even though spontaneous firing persists in many "autonomously active" neurons. This autonomous activity is periodic and depends on hyperpolarization-activated cationic (H) and persistent sodium (Na(p)) currents. We conclude that the isolated neocortical microcircuit generates spontaneous activity, mediated by a combination of intrinsic and circuit mechanisms, and that this activity can be temporally precise.

Hypertensive patients with hyperlipidemia are at high risk to develop coronary heart disease (CHD). Chemotherapeutic correction of hyperlipidemia seems most reliable modality to prevent CHD. Hypolipidemic effect and tolerance of leskol (fluvastatin) in dietotherapy-resistant hypercholesterolemia were studied in 74 patients with essential hypertension treated with hypotensive drugs. The patients were included in a multicenter trial. A 12-week course reduced total cholesterol level under 6.2 mmol/l in 59% of the patients, under 5.2 mmol/l in 29% of them. LDLP cholesterol lowered to 3.5% in 34% of the patients. Mean apo B diminished by 23%. There was a 27% decrease in the proportion of atherogenic fraction apo B to antiatherogenic fraction of transport proteins apo A-I. Leskol is well tolerated and effective against hypercholesterolemia, it is safe in relation to side effects and blood biochemistry.

The hypolipidemic effects of induracin, a new long-acting nicotinic acid dosage form based on the waxy matrix, and its tolerance were studied in 31 patients with Types IIa and IIb hyperlipoproteinemias in a 6-month blind crossover study. There were decreases in the levels of total cholesterol by 9-13% and low density lipoprotein cholesterol by 12-22%, an increase in high density lipoprotein cholesterol by 12-15%, and a good dynamics in the ratio of blood lipid-transport proteins--a 12-16% increase to the levels of apoprotein AI to a 29% decrease in those of apoprotein B. The drug is well tolerated by patients and may be recommended for correction of atherogenic dyslipidemias.

Short-term maximal and long-term submaximal regimens of physical exercise had been assessed for effect on serum lipoproteins in healthy subjects, in preclinical coronary heart disease (CHD) sufferers and in manifest CHD patients having food fat-induced lipemia. Fat loading caused hypertriglyceridemia in all the examinees. In healthy subjects it was associated with a rise in apo AI, while in CHD patients with relevant fall. Maximal exercise in preexisting alimentary hyperlipidemia provoked elevation of total cholesterol, triglycerides, LDL cholesterol, being atherogenic. Apo AI grew with a decrease in apo B/apo AI ratio in healthy subjects, in coronary patients apolipoprotein changes were of atherogenic origin. Prolonged submaximal exercise at the height of food lipemia resulted in lowering of total cholesterol, triglycerides and LDL cholesterol along with elevation of HDL cholesterol and apo AI both in healthy and coronary subjects evidencing anti-atherogenicity. It is noted that the response of lipids and apolipoproteins to fat and physical exercise loads was similar in subclinical and manifest CHD patients.

The impact of graded exercises of various intensity and duration on serum lipoprotein values was examined in 20 patients with coronary heart disease (CHD) and 10 healthy individuals after a single dietary fat load (FL). FL resulted in hypertriglyceridemia which was accompanied by elevated apo-AI levels and reduced apo-B/apo-AI ratio in the healthy persons, whereas it was accompanied by lower apo-AI levels and increased apo-B/apo-AI ratio in the patients. The short-term maximum exercise in the presence of FL caused negative shifts in the lipid transport system both in the healthy persons and the patients, by elevating the level of apo-B-containing lipoproteins. Yet, the healthy individuals showed a further increase in apo-AI concentrations. The long-term exercise in the training mode corrected changes in lipid values, which had been induced by FL in the two groups of the examinees. There was a decrease in the levels of triglycerides, low density lipoprotein, cholesterol and an increase in the level of high density lipoprotein cholesterol.

The study was performed of the effect of bicycle exercise and occupational therapy (embroidery, knitting, sewing, drawing, etc.) on physical and psychological status of postmyocardial infarction females at the in-hospital stage of rehabilitation. It was found that occupational therapy improved the psychological status and life quality, whereas low-intensity physical training increased performance status in relevant women.

A total of 92 males aged 28 to 55 years were examined. These included 28 apparently healthy individuals, 45 subjects with preclinical coronary heart disease and 19 patients with Functional Class I-II coronary heart disease. A special questionnaire was used to examine the dietary patterns of the subjects with preclinical coronary heart disease, i.e. those having no typical clinical signs of the disease, but showing signs of myocardial infarction during the maximum exercise testing and minimal coronary arterial changes at selective coronary angiography. The subjects, unlike healthy individuals and CHD patients, were found to have 1 or 2 meals a day, frequently late at night, consume large amounts of sugar and other candies, fatty milk products, butter, eggs; small quantities of vegetables, fruits, and fish, often put additional amounts of salt to their diet. The subjects, as patients with severe CHD but unlike healthy individuals, were shown to have hypercholesterolemia and display high low density lipoprotein and apo-lipoprotein B levels; apo B/apo A being more than 1. The above dietary patterns of subjects with preclinical CHD represent one of the causes of abnormal changes in the blood lipid profile, which result in further CHD development.

A comprehensive study was made of 140 males aged 26-55 years who were divided into 3 groups: (1) 47 healthy individuals; (2) 67 subjects with early signs of coronary heart disease; and (3) 29 patients with coronary heart disease (Functional Class II). The pattern of chest pain was thoroughly analyzed by a specially developed questionnaire. The results were compared with the data obtained from an interview by Rose's questionnaire. The analysis demonstrated that neither Rose's questionnaire nor the detailed one specially developed by the authors identified subjects with preclinical coronary heart disease.

A total of 158 males with a history of myocardial infarction were examined. The examination involved collection of information on their histories, course of the disease and symptoms in the hospital period and early (mean, on day 13) bicycle ergometric exercise tests. A multifactorial analysis made it possible to derive the decision rule to predict the condition of a patient within the first year following the onset of myocardial infarction, which involved prognostically unfavorable history data, such as disability prior to myocardial infarction, alcohol usage, exertional anginal hospital-stage parameters, such as bradycardia, premature contraction, circulatory failure, nodal rhythm, as well as 1 mm or more of ST-segment elevation during the early bicycle ergometric exercise test. The sensitivity of the predictive rule developed was 88.5%, its specificity was 78.5%. The study shows that it is impossible to successfully solve the problem in attempting to predict the outcome from some parameters, including the bicycle ergometric test findings. It is possible to do so only when the complex of data on a patient is taken into account.

One hundred and forty five patients were subjected to graded psychoemotional stress, their oxygen demand being simultaneously analysed. Ischemia was found to develop the more frequently, the more severe functional class a patient has with a negative stress, the patients had higher oxygen consumption, larger cardiac output, lower total peripheral resistance. Myocardial ischemia occurred with inadequately increased oxygen consumption during the test, diminished stroke volume and enhanced total peripheral resistance.