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This open non-randomized study had the objective to analyse the course of pregnancy and labor as well as their outcomes in 62 women with hypertensive disease (essential hypertention). The patients were allocated to two groups, one (group 1) comprising 32 the other (group 2, control) 30 women. All patients in group 1 underwent pregravid preparation and remained under observation throughout the pregnancy period in specialized cardiological departments. They were given treatment that included intake of antihypertensive drugs (methyldopa, long-acting nifedipin, metoprolol), desaggregant (dipyridamole, pentoxifllin), and metabolically active agent (vitamin E, folic acid, magnesium orotate, actovegin, cocarboxylase, and inosin). Gestosis developed in 25% of the patients in group 1 within 37 weeks and in 56.7% of the women (p0.05) in group 2 within 23-37 weeks of pregnancy. Circulatory disturbances in the mother-placenta-fetus system were recorded in 25% and 50% of the women in groups 1 and 2 respectively (p0.05), intrauterine fetal hypoxia in 18.8 and 50% (p0.05), chronic fetoplacental insufficiency in and fetal growth retardation syndrome in 12.5 and 40% (p0.05). In group 2, the perinatal mortality rate was 66.7% and perinatal losses amounted to 100.0% compared with their absence in group 1 (p0.05). Premature delivery occurred in 30% of the women in group 2 and was absent in group 1 (p0.05). In group 1, 9.4 of the newborn infants had low birth weight compared with 33.3% of the live full-term infants in group 2 (p0.05). Conjugated jaundice prevailed among the diseases affecting newborns in group 1 whereas intrauterine infections and posthypoxic encephalopathies were most common in group 2 It is concluded than combined therapy of hypertensive disease in women delayed the development of gestosis and made it possible to maintain pregnancy till normal outcome for both the mother and the child.

Having analyzed more than 150 original papers dedicated to the study of cardial pathology risk factors from clinical (specific) and methodological (philosophic) points of view, the authors put forward a hypothesis of the etiology of diseases (by the example of coronary artery disease) as a "critical mass" of these risk factors. Reasoning from it, the authors suggest the ways of using this statement by large quantitative evaluation of clinical data, and application of mathematic modeling to the diagnostics and prognostics of cardial pathology in each particular case.

The subjects of the study were 196 men with verified coronary heart disease (CHD). The subjects were divided into 4 groups: 1) patients without arterial hypertension (AH); 2) patients with mild AH, 3) patients with moderate AH, 4) patients with severe AH (SAH). All the patients were tested by means of veloergometry. The study found that the presence and severity of AH affected functional condition of cardiovascular system and clinical manifestations in patients with CHD. The appearance and aggravation of AH in CHD patients: 1) diminished clinical manifestations (angina), and elevated frequency of ECG signs of myocardial ischemia; there was significant growth of the proportion of patients with painless myocardial ischemia and ventricular arrhythmias associated with physical activity; 2) while causing moderate decrease of physical tolerance, substantially decreased the economy of cardiovascular system functioning, associated mostly with 'pressure overload"; pressor reaction effectiveness lowered; 3) worsened disturbances of recovery period, which manifested in prolongation of the time necessary for systolic pressure to return to initial level. These peculiarities were most prominent in patients with CHD and SAH, which allows considering this combination to be a new condition, requiring new approaches to evaluation of its clinical course and therapy.

Factors of risk of chronic circulatory insufficiency (CCI) were assessed in 263 hypertensive patients with and without ischemic heart diseases. CCI was diagnosed in 218 of these 263 patients. Early stages of CCI may be diagnosed in certain number of these factors. ECG findings in isolated arterial hypertension detected left ventricular dysfunction classified as chronic cardiac failure of functional class I (NYHA criteria).

Doppler M-mode echocardiography was made in 156 males with ischemic heart disease (IHD) verified coronarographically. The patients were normotensive or had mild, moderate and severe arterial hypertension (AH) (groups 1, 2, 3 and 4, respectively). The groups were similar by functional anginal class. Echocardiographic findings were in many cases similar. This supports the hypothesis that IHD and AH are closely related. However, the addition of AH to atherosclerotic affection of the coronary artery or atherosclerosis rise in the presence of AH is associated with development of myocardial hypertrophy which is registered at echocardiography and correlates in severity with severity of AH. Myocardial hypertrophy is, on the one side, compensatory as it prevents dilation of the left ventricle and impairment of its contractility rising at later stage of the disease with depletion of the myocardial and coronary reserves, but, on the other side, it promotes diastolic dysfunction of the left ventricle, lowers its performance. The above phenomena are most pronounced in combination of IHD with severe AH. This combination presents a new qualitative state and, therefore, needs new approaches to its correction.

Lipid peroxidation, cell stability, lipid spectrum, conjunctival microcirculation, levels of ceruloplasmin and myoglobin were studied in 107 males with ischemic heart disease before and after coronaroangiography by M. Judkins (CAG). It was found that CAG provokes oxidative stress, promotes membranodestructive processes, dyslipidemia and circulation disorders in the bulbar conjunctive. Preventive (3 days before CAG) administration of alpha-tocopherol or emoxipin proved cardioprotective. The highest cytoprotective effect was produced by trimetasidine given 10 days before the procedure.

The authors review their studies conducted for many years on cardiological prognostication in the context of the republican program "Cardiology" performed in the Udmurt Republic. The lines of the research and results obtained are described.

The impact of clinical and instrumental findings on prognosis was evaluated in patients with myocardial infarction and a mathematical model was proposed to predict their recovered working ability. The developed predictive index for prediction of recovered working ability is of high informative value and accuracy. It may be practically used by a cardiologist to choose a protocol of medical and rehabilitative measures in myocardial infarction.

The paper shows how to improve the quality of diagnosing coronary heart disease (CHD). It proposes a mathematical model of coronary circulatory disorders, which is based on the definition of CHD as a cardiac abnormality caused by the imbalance of coronary blood flow and myocardial oxygen consumption, outlines an algorithm for construction of this model. With this model, a computer system has been designed for examining a patients with CHD, which permits the construction of a virtual model of coronary circulatory disorders.

Admission and discharge values of rosette formation, adhesive and phagocytic ability of neutrophils, exercise tests with calculation of the tension index (TI), serum concentrations of IgG, IgA and IgM, circulating immune complexes (CIC) and cardiolipin antibodies (CAB) were studied in 48 males with unstable angina pectoris and acute myocardial infarction. Acute coronary syndrome is shown to be associated with marked immune alterations, primarily, with elevated levels of CIC and CAB, reduced TI. These alterations persisted for 3-5 weeks of the hospital stay and provoked the risk of repeated infarctions and thrombotic complications after relief of clinical symptoms of acute coronary failure.

46 patients with coronary heart disease with hypercholesterolemia were exposed to therapeutic plasmapheresis (TP) in combination with alpha-tocopherol treatment (AT). The results of 3-month follow-up with assessment of the clinical status, lipid spectrum, lipid peroxidation, concentration of ceruloplasmin indicated high hypolipidemic effectiveness of TP 2-3 weeks after the treatment as shown by inhibition of lipid peroxidation and antioxidant system. The addition of AT prolonged the hypolipidemic effect of TP, promoted optimization of plasma antioxidant potential (a rise in HDL, stabilization of ceruloplasmin levels).

A new gradual exercise test (gravimetric test (GT)) has been proposed to use in early myocardial infarction (MI). GT is more physiologically and safe than a bicycle ergometry test, its sensitivity being 54.9%. The use of GT allows one to detect a group of patients with subsequent slower readaptation to exercises on post-MI days 7-10 and to make appropriate correction of treatment.

The paper describes the use of the expert's error technique to provide evidence and pool medical specifications for an electron amplifying stethophonoendoscope, a medical diagnostic device. It illustrates the impact of variations in amplitude-frequency responses (AFR) on the auscultation properties of the devise. An AFR variation of only 10-12 dB can distort sound perception at auscultation. The results of development of the electron stethophonoendoscope indicate that the correct choice of criteria for expert's estimates allows the device's specifications to be worked out with simultaneous simplification of testing procedures.

The classification approach gives rise to the necessity of designing new devices for cardiological care, which are predetermined where to be used. The criterion used for making up a prognostic index is original. The devices have been to be promising in clinical practice.

The paper discusses problems in the development and organization of production of inexpensive diagnostic devices designed for use at primary health care services. It also provides a programme for developing a family of diagnostic medical devices: electron two- and multi-channel medical phonoendoscopes, attachments to a portable phonocardiogram-recording electrocardiograph, a portable diagnostic apparatus for comprehensive examinations.

176 patients with myocardial infarction were subjected to a sequence of tests: an original gravimetric test on the disease day 7-10, bicycle ergometry on day 12-20, repeated bicycle ergometry on days 30-35 and 100-120. The results of the investigations performed in different times were interrelated. This helped to make accurate prognosis of recovering ability in 85% of patients. This system of dynamic control demonstrated that the greatest positive effects on exercise tolerance are reached in combined use of intravenous blood radiation with He-Ne laser and combined chemotherapy. Nitroglycerin+heparin combination is the least effective. Nitroglycerin+heparin in combination with metabolism correctors is of moderate efficacy.

The paper presents the results of unstable angina pectoris treatment in 121 patients who received or did not receive (65 and 56 patients, respectively) contrykal in a dose of 20,000 units as an adjuvant to standard treatment (analgetics, tranquilizers, vasodilators). All the patients were admitted to cardiological departments. The comparative assessment of the data favours contrykal infusions in emergency prehospital care of developing unstable angina pectoris. The drug produces a cardioprotective effect reducing the risk of macrofocal myocardial infarction.

The effect of contrykal was evaluated in 146 male patients with first myocardial infarction and 116 control patients in the prehospital period. Intravenous contrykal was given in a single dose of 20,000 IU within 30 to 360 minutes of onset of myocardial infarction, followed by intravenous administration of heparin, 10,000-15,000 U. The control patients received conventional therapy. Earlier application of contrykal contributed to attenuation of clinical manifestations of myocardial infarction. The drug was found to produce a clear-cut antianginal effect. It also exerted a positive action on the abdominal syndrome. There was a rapid inverse dynamics in ECG changes, fermentaemia (aspartate aminotransferase and alanine aminotransferase), decreased myocardial necrotic mass.

Clinical efficacy of solcoseryl was studied in 58 patients with acute myocardial infarction. Forty patients receiving no solcoseryl were included into a control group. The agent contributed to a reduction in the frequency of anginal episodes, a more rapid improvement of circulatory failure signs, and an increase in exercise tolerance.

The authors have analysed 527 case histories of patients with acute myocardial infarction, examined clinico-roentgenologically in intensive care wards in order to detect early venous congestions and oedema in the lungs. X-ray symptoms of these states are given as obtained from the patient in horizontal position. Either degree of the left ventricular insufficiency with venous congestion of the lungs were detected in 71% of cases, including 32% of interstitial or alveolar pulmonary oedema. Diagnostic information value of a number of clinical symptoms for early detection of lung oedema according to X-ray verification is discussed. Mortality of patients with acute myocardial infarction is in direct, clear-cut correlation with the degree of venous congestion in the lungs and lung oedema. Out of 306 patients with acute myocardial infarction without lung oedema at the moment of hospitalization, getting on admission small doses of strophantin (0.25 mg circadian) and diuretics lung oedema developed only in 11 (3.6%) as a result of relapse or early mobilization.

The effect of a series of drugs (retabolil, strophanthin, retabolil with strophanthin, retabolil with panangin , methyluracil with panangin ) on protein metabolism was investigated in 246 patients with acute myocardial infarction. Retabolil both alone and combined with panangin , and a methyluracil-- panangin combination were found to have anticatabolic and protein synthesizing effects. Strophanthin, when used in the acute period of myocardial infarction, contributes to an increase in the protein decay rate and a decrease in protein synthesis. When it is employed in combination with metabolism corrective agents (retabolil), the adverse effects of strophanthin mentioned above are eliminated.

Data on clinical efficiency of concentrated insulin-glucose-heparin mixture in 52 patients with acute myocardial infarction are presented. In the control group (19 patients) routine treatment was supplemented by heparin administration. The efficiency of the insulin-glucose-heparin mixture was assessed on the basis of general clinical data as well as radioimmuno-assays of plasma myoglobin patterns. The treated patients demonstrated a more favourable course of infarction, and manifest positive changes in their ECG parameters and blood transaminase activity. Myoglobinemia augmentation was inhibited within the first hours of myocardial infarction. It is suggested that the therapeutic mixture examined is conducive to limiting the area of myocardial lesion.

The purpose of the study was a comprehensive analysis of the level of calcitonin and parathormone in patients with acute myocardial infarction (MI) and postinfarction cardiosclerosis as compared to similar data on healthy persons and coronary patients without a previous history of myocardial infarction. A total of 122 persons were examined using a radioimmunoassay and biochemical methods. The data obtained demonstrated an increase in the level of circulating calcitonin in patients with chronic CHD including postinfarction cardiosclerosis. The phasing of changes was revealed in the patients with acute MI: hypercalcitoninemia and hyperparathyrinemia on the 1st and 27-th-30th day of disease. Hypocalcemia was noted on the 14th-16th day of disease in the presence of normalization of the level of both hormones.

The serum myoblobin concentration was studied by radioimmunoassay in healthy individuals and in patients with transmural, macrofocal (non-penetrating) and diffuse subendocardial myocardial infarction and chronic ischemic heart disease. The data obtained evidence that marked increase in the blood myoglobin concentration occurs on the first day of the disease in patients with myocardial infarction. Similarly directed shifts in patients with exacerbation of chronic ischemic heart disease are moderate and do no occur in all cases.

One hundred and forty-nine of 199 patients with myocardial infarction (MI) were treated with varying doses of kallikrein-protease inhibitors (KPI), contrical or gordox, for 4 to 5 days as part of combined treatment. KPI added to combined treatment at early dates of MI contributed significantly to the elimination or abatement of some syndromes and complications (pain syndrome, acute circulatory insufficiency, abdominal syndromes, resorption-necrotic syndrome, etc.), improvement of the re-adaptation potential, and early recovery of myocardial metabolism, as evidenced by serial measurements of enzymemia and myoglobinemia, ECG monitoring from 12 leads, and cardiotopography from 35 leads, limiting the necrosis area and the ultimate size of myocardial damage. KPI treatment in the given doses produced no side effects.

The paper reports on the efficacy of the protease inhibitors Contrycal and Hordox in acute myocardial infarction. The authors observed 154 patients, of whom 50 constituted the control group. They used to watch the process in the myocardium with biochemical, radioimmune and electrocardiographic methods. It was established that Contrycal (Hordox) used in the combined therapy of acute myocardial infarction during the first hours of the disease is effective.

The authors report on the experience with amino acid drugs ( alvesin -new, aminon ) used in combination with anabolic steroids (retabolil) in patients with acute myocardial infarctions. Specific protein reparative therapy was associated with a favourable course of the disease, earlier (as against the control group) normalization of the electrotopocartographic (precordial mapping) and enzymic (CPK, LDH and LDH1) parameters. The patients' faster readaptation toward exercise and a significant elevation in the hemodynamic parameters justify the advisability of including protein reparative agents into the multiple modality treatment of myocardial infarction.

Fifty-four patients with acute myocardial infarction were evaluated repeatedly, with 28 of those treated with piracetam, and 26 used as controls. Piracetam produced a considerable favorable effect on the clinical course of myocardial infarction, as reflected in a more rapid clinical improvement of acute circulatory insufficiency and an analgetic effect. The drug reduced heart rate and moderately elevated systolic arterial blood pressure. Positive changes in total CPK, LDH, AST and ALT activities, and in ECG from 12 and 35 leads were quicker to come.