Dipyridamole (curantil) treatment of anginal patients: results of treatment for many years]

AIM: To assess effect of curantil optimal doses on clinical condition, coronary reserves, systemic microcirculation and peripheral hemodynamics in patients with stable angina pectoris (AP) given a course or continuous treatment. MATERIALS AND METHODS: A 2-month treatment with curantil with a gradual increase of the daily dose to 0.45 g was given to 261 patients with AP. After that the treatment was continued to 3 years in 38 patients. The coronary reserves were examined with bicycle exercise tests, peripheral hemodynamics and microcirculation were investigated with tachooscillography and conjunctival biomicroscopy. RESULTS: The 2-month curantil treatment was effective in 81% of the patients with AP functional class II-III and 60% of those with AP class 4. Exercise tolerance increased in AP of functional class II-III and IV by 50 and 24%, respectively. Ischemic depression of ECG ST segment induced by the exercise shortened. Prolongation of the treatment to 1 year resulted in further regression of AP and provided a 57% increase in muscular performance. The 3-year treatment maintained the 1-year effectiveness which was associated with lowering of postload and improvement of microcirculation, in particular, a 2-fold decrease in manifestations of sludge. CONCLUSION: The antianginal effect of optimal daily doses of curantil is more potent in angina of effort, grows step-by-step and reaches maximum if continued for a year. A hemodynamic effect of curantil manifests with lowering of postload and improvement of microcirculation. This allows to recommend curantil in combined treatment of chronic coronary heart disease.     

Barofunction of auditory tube in patients with central perforation of tympanic membrane]

Patients with otitis media chronica with central tympanic perforation underwent glue myringoplasty or radical operation. In 52.2 and 33.3% of them an original technique developed by the authors, has discovered defect of barofunction of the auditory tube named inflation effect of the auditory tube. High intratympanic pressure observed in this effect should be taken into consideration in tympanoplasty as it underlies rupture or dislocation of the transplant in myringoplasty or dislocation of the neotympanic membrane in reconstructive surgery on the middle ear.     

Characteristics of the dynamics of rapid changes in blood phosphoinositides in patients with alcoholic heart diseases]

A total of 42 patients who had been abusing alcoholic beverages during different periods and 12 healthy individuals were examined. Their intracardiac hemodynamic parameters were evaluated by echocardiography and rapid changes in inositol-containing blood lipids were determined by thin-layer flow chromatography. The patients showed significantly reduced contractility of the left ventricle, its wall hypertrophy and greater cavity dimensions. These abnormalities were more pronounced in patients with an over 10-year history. Biochemical studies revealed a time course of rapid changes in inositol-containing lipids in patients, which showed more fluctuations in the content of phosphoinositides and their lower baseline and final levels and differed from that in healthy persons. It was stressed that the changes in inositol-containing lipids were also related to the duration of alcohol abuse and they reflected the mechanisms of the toxic action of ethanol on the myocardium, which might be useful in the assessment of the severity of cardiovascular events in alcoholism.     

Gated MR imaging of left atrial myxomas

Two cases of left atrial myxoma were evaluated with magnetic resonance (MR) imaging. In both cases, the myxoma was clearly defined as to its location, origin, and size. In one case, the myxoma prolapsed through the mitral valve. Our study indicates that MR imaging is valuable in the diagnosis of myxomas.