[Results of monotherapy with retard formulation of indapamide of elderly patients with isolated systolic hypertension and left ventricular hypertrophy].
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Biomedical subjects
Publications and source records attributed to O A Kisliak.
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A contribution of specific features of myocardial hypertrophy and hypercontractility left ventricular diastolic dysfunction to decreased exercise tolerance and developed coronary failure is discussed on the basis of results obtained from a bicycle ergometric test performed in 40 patients with hypertrophic cardiomyopathy. Thallium-201 myocardial scintigraphy conducted at the maximum exercise in 17 patients revealed a reduction in coronary reserve with increased myocardial mass index that was higher than the critical value. An implication of severe myocardial hypertrophy in the presence with coexisting left ventricular posterior wall hypertrophy and impaired perfusion/mass ratios is considered as a risk factor for death of patients with hypertrophic cardiomyopathy.
Superficial cardiac ECG mapping was performed to examine 16 patients with acute myocardial infarction and 13 with hypertrophic cardiomyopathy who had electrocardiographic signs of focal myocardial changes (QS complex and/or abnormal Q wave). Deviation of instantaneous ventricular depolarization vectors in the direction opposite the malfunctioning myocardial portion that had partially or completely lost its electric activity was found to underlie the formation of QS complex in patients with acute myocardial infarction. In some patients with hypertrophic cardiomyopathy, an abnormal QS complex is attributed to sharp changes in central and end instantaneous depolarization vector orientation in the direction of the most hypertrophic septal portions, the location of a QS areas corresponding to variants of asymmetric septal hypertrophy.
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Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.
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To study the state of the contractile function of the myocardium and the function of the left ventricle with hypertrophic cardiomyopathy 27 patients were examined. The main method of examination was mono- and bi-dimensional echocardiography. As a result of this examination it became possible to determine the output fraction, the rate of circulatory contraction of the myocardial fibres, the degree of shortening of the antero-posterior dimension of the left ventricle and a number of other indices of the contractile properties of the interventricular septum and the posterior wall of the left ventricle which enables one to use different medicinal agents in such patients under the ECG control.
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