[Preventive cardiology: educational problems].
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Biomedical subjects
Publications and source records attributed to G I Bragina.
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Sixty-nine coronary heart disease patients with stable angina of effort of Classes II-IV of functional activity were studied for the effect of three nonselective beta-adrenergic blockers on the incidence and intensity of angina attacks, on the tolerance to exercise on the bicycle ergometer, as well as on the heart rate, arterial pressure, cardiac volumes and intracardiac hemodynamics using a complex of clinical and instrumental methods. It was proved that nadolol, pindolol and propranolol hydrochloride possessed similar anti-anginal effects but nadolol exerted the greatest negative chronotropic action while propranolol hydrochloride exerted a negative inotropic action. As regards the degree of the effect on cardiac volumes, corgard (nadolol) occupied an intermediate position between anaprilin (propranolol hydrochloride) and visken (pindolol).
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On the basis of clinical examination and the results of bicycle ergometry and echocardiography in 58 patients with chronic ischemic heart disease the authors determined the contingent of patients in whom long-acting nitrates were most effective. The high clinical effectiveness of the agents in patients with symptoms of the initial stage of cardiac insufficiency is proved and the absence of any essential differences between long-acting nitrates in the character of their effect on hemodynamics is shown. It is established that nitroglycerin and long-acting nitrates cause a qualitatively similar effect on myocardial contractile function and intracardiac hemodynamics in patients with ischemic heart disease.
The article discusses the results of dynamic echocardiographic examination of 46 patients with chronic ischemic heart disease before and after 15-day treatment with agents capable of blocking beta-receptors: propranolol (anaprilin), pindolol (visken), talinolol (cordan) which were prescribed in mean therapeutical doses. It is shown that agents blocking beta-adrenergic receptors lead to regular decrease in the indices of myocardial contractility. The character of changes in the volumetric characteristics of the left ventricle depends on the initial levels of arterial pressure and the degree of its dynamics during treatment with beta-adrenergic blocking agents. In patients with chronic ischemic heart disease developing against the background of hypertensive disease the dynamics of changes in the volumetric indices depends on the degree of arterial pressure reduction.
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