CLINICAL AND MORPHOFUNCTIONAL DETERMINANT S OF RESTABILIZATION OF THECOURSE OF ACUTE CORONARY HEART-DISEASE FORMS - APPROACHES TO MANAGEMENT TACTICS IN PATIENTS WITH UNSTABLE ANGINA-PECTORIS

There has been no concept of the ways of stabilizing the status in pat ients with unstable angina and preventing further coronary heart disea se progression. The application of stress tests suggests that conseque nt use of transesophageal cardiac pacing and bicycle exercise makes it possible to work out an appropriate regime of graded exercise, to obj ectivize the patients' status to noninvasively evaluate the coronary r eserve, to indirectly define the number of diseased vessels and their topology, and to evaluate the efficiency of therapy. To supplement str ess echocardiography to examination techniques is of interest in study ing left ventricular performance and segmental contractility. Based on their own studies, by using long-term monitoring of the status in ter ms of clinical features, dynamics of coronary reserve and myocardial f unction, changes in the blood lipid spectrum, immune link, the morphof unctional properties of platelets, neurohumoral factors, the authors p ropose a classification of unstable angina. The detected clinical and morphofunctional determinants of restabilization allow one to optimize a long-term management of patients with unstable angina, to identify groups at various risk and to improve the patients lifestyle in adequa te drug correction.