[Disorders of the heart rhythm].
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Biomedical subjects
Publications and source records attributed to N R Paleev.
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The analysis of endomyocardial biopsies (10 specimens) and clinical observations suggests the conclusion: myocardial lesions in OPD patients with pulmonary hypertension are due to metabolic and hemodynamic disturbances. In addition to myocardial hypertrophy, myocardial dystrophy contributes to development of cor pulmonale.
The authors describe a technique of extracorporeal UV radiation of blood (EUVRB) in flow closed circulation. Its efficacy was assessed in combined treatment of pyo-inflammatory complications of terminal renal failure. Therapeutic effects of EUVRB are due to reduced endogenic intoxication, correction of leukopoiesis and stimulation of immunity. The changes in laboratory findings correlated with clinical pattern of the inflammation. EUVRB produced a favourable response and improved therapeutic results of pyo-inflammation treatment in patients with terminal renal failure.
The present communication is based on an examination of 33 cases with dilated cardiomyopathy and 48 with severe myocarditis. Nine patients with dilated cardiomyopathy were diagnosed as having developed cardiogenic shock. Clinical examination, echocardiography, right heart and pulmonary artery probing were performed. Cardiogenic shock in dilated cardiomyopathy was demonstrated to be characterized by a progressive decrease in cardiac contractility, no increase in peripheral vascular resistance, and high pulmonary hypertension. Profound cardiomyocyte alterations followed by increased fibrosis of intermuscular and perivascular spaces contribute to the development of cardiogenic shock in dilated cardiomyopathy.
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Clinical and morphologic analysis of 63 biopsy specimens and of 23 autopsy specimens has shown the leading role of immune inflammation with the development of delayed and immediate type hypersensitivity in injury to myocardial contractility. It is the immune inflammation that is responsible for disorders in electrolyte metabolism, microcirculation, sympathetic nervous system reactivity.
Radiocardiography and rheography of the pulmonary artery were used to examine impairments in hemodynamics and contractile function of the right ventricle in 40 patients with chronic obstructive bronchitis complicated with persistent hypertension. Right ventricular hemodynamic and contractile impairments were shown to be not equivalent with similar clinical and functional signs of pulmonary hypertension. This fact indicates that the use of special techniques is of practical value in the determination of right ventricular hemodynamics and myocardial contractility in patients with chronic obstructive bronchitis. Radiocardiography and rheography of the pulmonary artery are sufficiently reliable noninvasive techniques for examining the hemodynamics and contractile function of the right ventricular myocardium.
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The ultrastructure of erythrocytes of donor blood and blood of patients suffering from kidney insufficiency was studied with the help of scanning and transmission electron microscopes before and after it was treated with ultraviolet light. It was concluded that after being treated with ultraviolet light, the ultrastructure of donor blood erythrocytes undergoes significant positive changes which are being characterized by normalization of the form of cells, decrease of associative ties between them, the cytoplasm content becomes more homogenous. There was a noticeable increase of a number of discocytes and a decreased number of associative ties between the cells after the patients' own blood was treated with ultraviolet light. The violation of the wholesomeness of erythrocytes membrane was not discovered. The indications are that the observed therapeutical effect after treating blood with ultraviolet light, is explained, to a certain extent, by the ultrastructural modification of erythrocytes membrane.
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Central and intrapulmonary hemodynamic parameters were examined in 40 patients with myocarditis. Morphological evidence for endomyocardial biopsy specimens and morphometric findings were also analyzed. Deterioration of myocardial diastolic relaxation was found to closely correlate with the magnitude of cardiosclerotic changes and cardiomyocytic myolysis. A correlation was also established between the morphometric characteristics of the microcirculatory bed and the parameters of myocardial contractility. Functionally deficiently cardiomyocytic hypertrophy was more profound in severe heart failure.