Kardiologiya
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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. ⋯ 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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Calcified aortic valves were detected in 109 patients studied in hospital by an echocardiographic method (2D- and M-scanning). It was found that, unlike rheumatism, calcification starting in the aortic annulus and semilunar bases might result in formation of degenerative (non-inflammatory) calcific aortic stenosis. ⋯ The authors defined clinical and echocardiographic differentially diagnostic criteria for degenerative (non-inflammatory) and rheumatic (inflammatory) calcific aortic stenosis. They also discussed pathogenetic aspects of aortic valve calcification and problems of terminology.
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Right ventricular arrhythmogenic dysplasia (RVAD) is a typical asymptomatic arrhythmogenic cardiopathy in athletes, which is occasionally concurrent with normal ventricular function and life-threatening arrhythmias. A total of 32 athletes (28 males and 4 females, mean age, 23 years, mean follow-up, 6.7 years) were examined for severe cardiac arrhythmias with left bundle branch block. The conclusive diagnosis of RVAD was established from clinical, echocardio-, and angiographic evidence. ⋯ The most severe arrhythmias were observed in athletes whose mean age was 23.4 years, 20 patients had sustained ventricular tachycardia (it occurred only in 19 who were indulging in sports), 6 presented with transient ventricular tachycardia, and 1 had ventricular fibrillation. They all had been considered fit for sports. The disease proceeded severely in 16 of 32 athletes (in 13 of 16 while indulging in sports), the conditions close to syncope were seen in 9 patients (8 had sustained ventricular tachycardias and 1 had transient ventricular tachycardias), syncopes were observed in 5 patients (sustained ventricular tachycardias).
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Comparative Study
[Comparative evaluation of various methods of continuous electric stimulation of the heart in bradycardia].
An analysis was made of the results from clinical application of various implanted systems of cardiac pacing, such as VVI for isolated ventricular pacing, AAI for atrial pacing, VDD, DVI, and DDD for dual chamber pacing, and "Activitrax" for rate responsive pacing. Indications and contraindications for the use of each cardiac pacing mode and possible complications were also considered.