[Cardiovascular responses to feeding in patients with ischemic heart disease combined with duodenal ulcer].

Postprandial (after standard breakfast 590.1 kcal) hemodynamic response (PHR), vegetative reaction and cimetidine effect were registered in 120 coronary patients with duodenal ulcer, 126 patients with duodenal ulcer and 30 healthy controls. It was found that PHR is determined primarily by duodenal mucosa condition and is independent of baseline type of circulation and antral mucosa structure. In normal or slightly changed duodenal mucosa test meal induced positive inotropic reaction, a fall in total peripheral vascular resistance, cardiac performance index. In marked duodenitis cardiac output is reduced, total peripheral resistance and cardiac efficacy grows. Coronary patients with duodenal ulcer had duodenitis and more frequent associated severe angina pectoris, circulatory insufficiency and gastric acid hypersecretion. Cimetidine in a dose 400 mg in patients with normal or slightly damaged duodenal mucosa had minimal effect on the PHR, whereas in duodenitis patients it prevented negative inotropic reaction and rise of the total resistance. Minor sympathetic effect on the sinus rhythm entails no increase in double product and cardiac performance efficacy.