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The effectiveness of treatment of coronary insufficiency according to the variables of the central hemodynamics of the heart in experiments and the clinic Cardiac and coronary insufficiency



The effectiveness of treatment of coronary insufficiency according to the variables of the central hemodynamics of the heart in experiments and the clinic Cardiac and coronary insufficiency



Meditsina Moscow : 211-217



Determinations were made in anesthetized cats of the effect of persantin (I), korontin (II), isoptin (III), papaverine (IV), 2-phenyl-l,4-naphthoquinone, and vitamin B15 (VI) on the rate of flow of the coronary circulation (RFCC), as measured by the method of N. V. Kaverina, the consumption of O2 by the myocardium (COM) by the method of I. E. Kisina, and the systemic blood pressure and the heart rate. All the drugs were given intravenously. The best effect was caused by I at 5 mg/kg, which increased the RFCC by 100-110% with a 40% increase in the COM, and a 20-25 mm Hg fall in the blood pressure without a change in the heart rate, II, III, IV, and V were less effective, and VI at 0.5 mg/kg had the weakest effect: it increased the RFCC by only 10-12% while increasing the COM 27.5%. When there was an acute disturbance of the coronary circulation (pituitrin spasm or ligation of the descending branch of the left coronary artery), I was also the most effective, increasing the RFCC, preventing arrhythmia, and reducing spasm. The other preparations proved to be less active (II, IV, and V) or had no effect (II and VI). In the clinic, 60 patients with atherosclerotic angina pectoris were treated with I at 150 mg/day, later 100 mg/day for a month, II at 75-60 mg/day for 15 days, and HI at 10 mg/day intravenously for 15 days. Taken into consideration were the subjective and objective variables (ecg, blood pressure, heart rate and data from radiocardiography with Kr85). Of the 20 patients on each drug, good results were observed in 18 with I, 13 with n, and 15 with HI. I did not cause undersirable effects. II caused deterioration in 3 patients. When III was given intravenously it caused brief extrasystoles in 6 patients. Thus, favorable effects on the hemodynamics in patients with coronary insufficiency were exerted by I and HI, and, to a smaller extent and less consistently, by III.

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