[Disorders of myocardial contractile function and the mechanisms of their compensation in ischemic heart disease in man].

Myocardial contractile function was investigated in 84 patients with coronary diseases CD of I-IV functional classes (according to NYHA) and 17 persons with normal coronary arteries using new noninvasive method of construction LV end-systolic pressure-volume relation (ESPVR). Significant decrease of end-systolic elastance, ejection fraction, circumferential fibers shortening velocity and increase of end-systolic and end-diastolic ventricular volume was increased with patient's class number. These data correlated with the increase of total amount of lesion of coronary vessels and extension of asynergic zones. But this contractile function disturbances were not accompanied by significant changes of cardiac output and arterial pressure. When blocking beta-adrenergic receptors with anaprillin it was established that at early stages of CD the compensation of contractile function disturbances is reached via the increasing of heart adrenergic stimulation, and in the patients of III-IV classes the Frank-Starling's law becomes of great significance homo- and heterometric mechanisms efficiency reduces with CD development. These data show that ESPVR reconstruction before and after the blocking of beta-adrenergic receptors allows systolic LV function and efficiency of its regulation to be estimated.