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In the examination of 120 patients without valvular heart disease suffering from atrial fibrillation paroxysms mechanical function of the left atrium (LA) was assessed using Doppler echocardiography. The majority of the examinees had dilated LA which is thought to be arrhythmogenic. The recovery of the sinus rhythm is accompanied by electromechanical dissociation the longest duration of which took place in subjects exposed to electrical defibrillation. An inverse relationship was established between the time of the last fibrillation and recovery of LA mechanical function. The duration of the electromechanical dissociation of the atria holds prognostic importance in relation to recurrent fibrillation.

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Echocardiographic tools (M-mode and 2D-scanning) were applied to examine 83 patients with complete bundle-branch block and/or its anteroapical bifurcation block. Six types of abnormal ventricular septal motions associated with the intraventricular asynchronism typical of complete bundle-branch block and with the specific features of electric pulse propagation in the His-Purkinje system were identified. There was a reduction in left ventricular ejection fraction that is peculiar to Types I and VI abnormal ventricular septal motions, whereas in patients with complete bundle-branch block, it is associated with anteroapical bifurcation block. A moderate decrease in ejection fraction is more common for Types III and IV abnormal ventricular septal motions (despite the severity of cardiac disease). Complete bundle-branch block alone and in combination with anteroapical bifurcation block contributes to a decrease in left ventricular function and diminished myocardial contractility. Whether the severity of complete bundle-branch block affects cardiodynamics is discussed in the present paper.

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The paper presents data (from 15 case histories) and the methods for ECG analysis of ventricular parasystole of the modulated type with accelerated or delayed paracenter activity entrainment and annihilation phenomena. A relationship between classical and modulated types of parasystole is discussed.

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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 latter differs from rheumatic aortic stenosis in commissural fusions. 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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In a group of 250 patients suffering from frequent paroxysms of atrial fibrillations (flutters), the application of cordarone for 1 to 5 years prevented the occurrence of arrhythmic paroxysms in 23.6%, contributed to a reduction of their numbers up to 1 a year in 35.6%, up to 2-3 a year in 20.4%. Good and satisfactory results were obtained nearly in 80% of the patients. Cordarone failed to act in 10.4%. In 12.8%, the "escape" phenomenon was observed, i.e. loss of the agents' action following its long-acting effect when the patients were on a maintenance dosage. The results of the preventive usage of cordarone were not clearly related to the degree of atrial dilatation and the pattern of cardiac disease.

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The hypotensive effect and interrelations of some hemodynamic parameters in the course of intravenous administration of sodium nitroprusside (SNP) were examined in an experimental study in cats with induced hypertension. Both in normotensive and hypertensive conditions, the SNP injection produced an almost instantaneous drop in systolic and diastolic ABP, its principal mechanisms being the depression of total peripheral resistance (TPR). The magnitude of decrease in stroke and minute volumes was dependent on the extent of ABP fall that was in turn related to the dose of the drug and the baseline TPR values.

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The clinical and echocardiographic picture of calcinosis of the mitral valve ring is described in 40 patients (mostly females of advanced age). Echocardiographic correlates and auscultatory manifestations of mitral calcinosis are analysed. Differential diagnosis against valvular heart defects is presented. The contribution of mitral calcinosis to the development of degenerative atrioventricular and intraventricular block is discussed.

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The clinical analysis of the rhythmilene efficacy was performed in 247 patients receiving the drug for various arrhythmias. Due to its anticholinergic properties rhythmilene somewhat increased the sinus rhythm and improved atrioventricular conduction. These properties of the drug often caused urination retention, largely in males over 55 years. The drug was highly active in ventricular paroxysmal tachycardia and extrasystole. The scheme of an interrupted administration of rhythmilene and cordaron for preventing attacks of atrial fibrillation and flutter was worked out. The necessity of the systematic control of the duration of the Q-T interval is emphasized.

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Extracellular, intravascular and interstitial fluid volumes were measured in 67 patients with essential hypertension, Stage II, using Na82 Br and I131-albumin dilution techniques. Simultaneously, central hemodynamic parameters were examined, and renin activity and plasma aldosterone were assayed radioimmunologically. Clinical, hemodynamic and biochemical patterns of the hyperhydration-hypervolemic essential hypertension are described. A reverse dependence has been noted between total peripheral resistance and circulating plasma volume in normovolemic and hypovolemic hypertension. The coefficient reflecting the ratio between plasma and interstitial fluid volumes suggests an adaptive redistribution of fluid into interstitial space in some patients.

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The indications for the catheterization of the heart and the recording of cavity electric potentials at the emergency aid centre are being considered. The possibilities have been studied of the electrography of the conductive system of the heart for differentiation of supraventricular paroxysmal tachycardias with blocks of pedicles of the His' bundle and ventricular paroxysmal tachycardias, and of irregular ventricular tachycardia and attacks of auricular fibrillation with pedicle blocks, and for the determination of the level of the atrioventricular blocks.

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It is shown that the main trend of changes in water homeostasis in complicated myocardial infarction consists in the development of intercellular hypohydration. Three variants of cardiogenic shock are distinguished: (a) normovolemic shock with intercellular hypohydration; (b) hypovolemic shock with intercellular hypohydration; (c) hypovolemic shock without intercellular hypohydration. Acute congestive cardiac insufficiency in most patients occurs without an increase in the volume of interstitial fluid. Approximately 12% of these patients have a reduced volume of circulating plasma. A syndrome of intercellular hyperhydration develops in the presence of satisfactory hemodynamics on the 3rd day after electrical defibrilation in individuals restored to life after clinical death. The VCP/VIF coefficient may serve as an index of the transcapillary flow of fluid and may be used in determining the indications for infusion therapy.

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