[Cardiohemodynamic indices during the physical loading of patients with stenocardia of varying duration]

A total of 232 CHD patients and 93 healthy persons were examined to reveal a possible role of the vasospastic and cardiohemodynamic factor in the pathogenesis of angina pectoris of various duration. Cardiohemodynamics, ECG, PCG and tetrapolar chest rheography were studied during a bicycle ergometry test. Two types of cardiohemodynamic reactions in anginal pain were defined: adequate--with low indices characterizing demand of the myocardium for oxygen and sufficient diastole (demand--supply) and inadequate--with an unusually high (1.5-3-fold above the normal) intensity of demand and supply (IDS). The adequate type prevailed in the patients with early angina pectoris and inadequate in the patients with long existing stable angina pectoris. Spontaneous improvement and improvement after administration of antianginal therapy or nitroglycerin in the patients with the adequate type resulted in pain at a higher IDS level. In the inadequate type the level of the demand and supply index did not change either in deterioration or improvement. Deterioration in such patients meant the appearance of inadequacy of demand and supply in lowered physical exercise and improvement in increased physical exercise. It has been assumed that investigation of cardiohemodynamics makes it possible to specify whether the vasospastic or cardiohemodynamic factor of inadequacy plays a leading role in the pathogenesis of coronary insufficiency in CHD patients.