[Predicting the efficacy of antianginal therapy].
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Biomedical subjects
Publications and source records attributed to E P Dechko.
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In examination of 62 healthy males and 62 patients with hypertensive disease from 40 to 60 years of age, three types of arterial pressure reaction to standard bicycle ergometry exercise were distinguished on the basis of the relationship between the pressure-pulse index and the time of pressure normalization. This method is suggested for objective appraisal of the efficacy of hypotensive therapy and for distinguishing the group of patients with the risk of hypertensive disease development.
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The functional condition of the left ventricle was studied in 96 patients with I--II stage hypertensive disease by means of echocardiography according to the value of the ejection fraction, tension of the left-ventricular wall and mean rate of circular shortening of the myocardial fibers. It was found that in hypertensive disease tension of the left-ventricular wall increased to a lesser degree than the indices of external work, which was considered to be a manifestation of preserved contractile reserve of the heart muscle. The ejection fraction and the rate of myocardial fiber shortening did not depend on the stage of the disease, did not change under the effect of treatment and were within normal limits. It is concluded that the functional condition of the left-ventricular myocardium does not change in I--II stage of hypertensive disease.
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Central hemodynamics was studied by means of echocardiography in 7 patients suffering from neurocirculatory dystonia with a high cardiac index but normal arterial pressure, and in 41 patients with essential hypertension prior to, and after treatment. Two groups of patients suffering from essential hypertension were distinguished: with a hyperkinetic type of circulation and with a normal cardiac index. In the first group there was a statistically significant increase in the stroke index and the index of diastolic left ventricular diameter with a normal ejection fraction. The increase in the cardiac index in the hyperkinetic type of essential hypertension is caused by an increase in the stroke output according to the Frank--Starling law. The authors believe that the increase in peripheral resistance is the principal pathogenetic mechanism of hypertension with any level of the minute volume.
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