The treatment of acute myocardial infarct with perlinganit

As many as 43 patients with myocardial infarction were under observation. There were 30 men and 13 women aged 36 to 82 years. Of these, 26 patients had large-focal and 17 transmural myocardial infarction. Perlinganit was injected in the form of 0.1% solution by means of a drug-dosing apparatus (DDA-1). The drug infusion lasted 51.1 +/- 4.8 h on the average, the mean infusion rate was 74.5 +/- 3.4 micrograms/min. After 24 hours it was required that in 32 patients the mean infusion rate be increased 1.5-fold. The hemodynamics was assessed with the aid of tetrapolar chest rheography. Well-defined clinical and hemodynamic effects were revealed. In some patients, the clinical signs of left ventricular insufficiency could be eliminated. Contractile function of the left ventricle returns to normal within the first hours of disease. During perlinganit treatment, the antianginal and antiarrhythmic effects were recorded. The data obtained point to the fact that the use of perlinganit for the treatment of acute myocardial infarction is advisable.     

Monitoring and treatment of severe bronchial ashma in adults: results of national multicenter trial NABAT

AIM: To study quality of monitoring, features of a course and therapy of severe bronchial asthma (BA) in Russia. MATERIALS AND METHODS: The trial recruited 378 patients with severe bronchial asthma (SBA) in 7 cities of Russia. Each center participating in the study filled in individual case sheets recording demographic, clinical, monitoring, pharmacotherapeutic data. A special focus was on factors influencing the disease course. The chi-square and Mann-Witney criteria were used. RESULTS: It was found that current recommendations of BA patients' management are not used in full. Most of the patients do not receive adequate therapy. Phenotypes of uncontrolled course of severe BA are prevalent. The key role of adequate management of severe BA patients in control of the disease is shown. CONCLUSION: Wider use of updated recommendations on therapy and monitoring of BA with special focus on patients with uncontrolled course of the disease is urgent. Fulfilment of all the components of management of a patient with bronchial asthma recommended by GINA including the patient education and control over the disease triggers contribute much to effective treatment and control over BA.     

Polymorphism of vascular angiotensin II receptor gene and cardiovascular disorders

AIM: To study polymorphism of the gene of vascular angiotensin II receptor. MATERIALS AND METHODS: Polymorphism that consists in variability of adenine (A) and cytosine (C) residues at position 1166 of the gene for vascular angiotensin II receptor (AT1R) was analyzed in a Moscow population (n = 98) and three groups of affected patients with myocardial infarction (n = 32, MI), left ventricular hypertrophy (LVH, n = 38) and essential hypertension (EH, n = 178). Polymorphic region of the AT1R gene was amplified using the polymerase chain reaction (PCR) and genomic DNAs from human whole blood as template. PCR products were electrophoresied in a gel after digestion with BstDEI restriction nuclease. Significance of differences in distribution of both allele and genotype frequencies at the population sample and in affected patients were estimated via exact Fisher's test. RESULTS: A significant decrease in the frequency of the A genotype was detected in all the three affected groups compared to healthy controls. Besides, the frequency of the A allele was significantly decreased in EH group with a corresponding increase in the frequency of both the AC genotype and the C allele. CONCLUSION: The A1166C polymorphism of the AT1R gene is associated with EH, MI and LVH in a Moscow population. The association is stronger with EH. The A allele and the AA genotype protect against development of disorders at early onset while the other genotypes and the C-allele are risk factors. A protective role of the AA genotype is more significant than predisposition action of the CC homozygote.     

Ventricular arrhythmia is predicted by sum absolute QRST integralbut not by QRS width

Background

There is a controversy regarding the association between QRS width and ventricular arrhythmias (VAs). We hypothesized that predictive value of the QRS width could be improved if QRS width were considered in the context of the sum magnitude of the absolute QRST integral in 3 orthogonal leads sum absolute QRST integral (SAI QRST). We explored correlations between QRS width, SAI QRST, and VA in primary prevention implantable cardioverter-defibrillator (ICD) patients with structural heart disease.

Methods

Baseline orthogonal electrocardiograms were recorded at rest in 355 patients with implanted primary prevention ICDs (mean age, 59.5 ± 12.4 years; 279 male [79%]). Patients were observed prospectively at least 6 months; appropriate ICD therapies because of sustained VA served as end points. The sum magnitude of the absolute QRST integral in 3 orthogonal leads (SAI QRST) was calculated.

Results

During a mean follow-up of 18 months, 48 patients had sustained VA and received appropriate ICD therapies. There was no difference in baseline QRS width between patients with and those without arrhythmia (114.9 ± 32.8 vs 108.9 ± 24.7 milliseconds; P = .230). SAI QRST was significantly lower in patients with VA at follow-up than in patients without VA (102.6 ± 27.6 vs 112.0 ± 31.9 mV·ms; P = 0.034). Patients with SAI QRST (≤145 mV·ms) had a 3-fold higher risk of ventricular tachycardia (VT)/ventricular fibrillation (VF) (hazard ratio [HR], 3.25; 95% confidence interval [CI], 1.59-6.75; P = .001). In the univariate analysis, QRS width did not predict VT/VF. In the bivariate Cox regression model, every 1 millisecond of incremental QRS widening with a simultaneous 1 mV·ms SAI QRST decrease raised the risk of VT/VF by 2% (HR, 1.02; 95% CI, 1.01-1.03; P = .005).

Conclusion

QRS widening is associated with ventricular tachyarrhythmia only if accompanied by low SAI QRST.     

Novelty-induced behavioral traits correlate with numbers of brainstem noradrenergic neurons and septal cholinergic neurons in C57BL/6J mice

It is generally accepted that different brain regions regulate specific behavioral responses and that structural alterations in these regions may affect behavior. We investigated whether inter-individual variability in novelty-induced behaviors in C57BL/6J mice correlates with numbers of noradrenergic neurons in the locus coeruleus and cholinergic neurons in the septum. We found that exploration of new stimuli correlated negatively with numbers of noradrenergic neurons, whereas anxiety correlated positively with numbers of cholinergic neurons. The observed correlations suggest physiologically plausible links between structure and function and indicate that precise morphological estimates can be predictive for behavioral responses.     

Relationship between the detection of circulating antibodies to antigen with a molecular weight of 67 kD and the severity of clinical manifestations of infectious-allergic myocarditis]

Infectious allergic myocarditis (IAM) is frequently complicated by signs of congestive heart failure (CHF). IAM patients generally suffer from rhythm and conduction disturbances which can be the leading symptom of the disease in some patients. Slowly progressive immune inflammation in the myocardium makes the differential diagnosis difficult in IAM and dilated cardiomyopathy in which endomyocardial biopsy and cardiospecific immunological examinations of the patient are of great significance. Identification of the autoimmune process in the myocardium and early immunodepressive therapy may arrest the progression of myocardial damage. The purpose of the present study was to examine the relationship between antigen antibodies and clinical manifestations of myocardial damage in IAM.