Cardiology City, U.S.S.R.

By Anastasia Toufexis

Investing in research to combat an epidemic

It sprawls across a vast expanse on the northwestern outskirts of Moscow, a semicircular complex of 23 interconnected buildings whose cream-colored fac,ades shine brightly in the late-fall sunshine. The sparkle is only fitting, because this is the crown jewel of Soviet academic medicine: the new headquarters of the eight-year-old U.S.S.R. Cardiology Research Center. American specialists got their first view of the buildings' endless white corridors and advanced diagnostic equipment last year, shortly after the new medical complex opened, when the Soviet Union played host to more than 5,000 physicians from around the globe, who were attending the Ninth World Congress of Cardiology. Says one impressed visitor, Harvard Heart Specialist Bernard Lown: "It is a cardiology city." With pardonable pride, the center's director, Yevgeni Chazov, declares, "I don't think there's another institute in the world that has as many functions."

Why would the Soviet Union want to spend 78 million rubles (about $117 million) on a single cardiology complex? Answer: a Soviet epidemic of heart disease. As in the U.S., cardiovascular diseases are the U.S.S.R.'s No. 1 killer. In America over the past decade the death rate from stroke has fallen 37% and from heart attacks it has dropped by 25%, largely owing, many cardiologists believe, to an aggressive program for the treatment of hypertension. By contrast, the Soviet death rate from heart-related diseases more than doubled between 1960 and 1980. Among the causes, according to U.S. researchers: rampant alcoholism, smoking, and the stress resulting from crowded urban living conditions.

The focus of the center's research is understanding the development of arteriosclerosis (hardening of the arteries), a condition that can lead to strokes and heart attacks. Director Chazov and his team of scientists have developed several compounds to dissolve potentially fatal blood clots. One such compound is a more effective version of streptokinase, a drug increasingly used in the West to dissolve blood clots.

Using computer linkups with more than 1,000 statisticians in 20 cities, the center also is exploring possible risk factors in arteriosclerosis among Soviet citizens. Chazov's prediction about the outcome of the work by Soviet scientists and researchers worldwide: "We will solve the problem of arteriosclerosis in the next ten years. Once that is done, we will be able to prevent heart attacks and strokes almost entirely and raise the life span of human beings to 80 to 85 years."

American researchers who have been involved in a Soviet-U.S. medical exchange program that has been going on since 1972 generally give the Moscow institute and its researchers high marks. Others have some reservations. George Washington University Internist William Knaus, author of Inside Russian Medicine, says of the center, "Individual projects might be comparable, but overall it would not compare with Stanford, the University of Texas, Harvard or the Mayo Clinic."

Even so, the huge Soviet center is impressive. It runs a busy outpatient service for citizens with heart-related ailments, trains doctors and scientists, and coordinates the cardiological research and treatment efforts of hundreds of regional institutes and hospitals. Its recommendations for programs to prevent heart disease are passed on to the Ministry of Health, which channels them to factories and schools. The center's own research projects are conducted at its three Moscow-based institutes of clinical, experimental and preventive cardiology and at a branch in the Siberian city of Tomsk. Many of the center's 2,500 staff members are not medical doctors but chemists, biochemists and physicists.

The center is pursuing two other important projects. It tests such remedies as diet and exercise in the control of hypertension. "The U.S.S.R. has been at the forefront of biofeedback and behavioral intervention since Pavlov," comments Claude Lenfant, director of the U.S.'s National Heart, Lung and Blood Institute. The center is also preparing a nationwide program for 1984 to give an electrocardiogram to every Soviet citizen. The aim: to shed light on sudden heart stoppage.

The center's primary asset may be Director Chazov, 54, a chunky, red-haired dynamo with a taste for American catsup and hunting wild boars and goats. He has impeccable Communist Party credentials: member of the ruling Central Committee, Hero of Socialist Labor and 1982 recipient of the Lenin Prize. He is also a Deputy Minister of Health and head of the elite medical unit that treated the late Leonid Brezhnev and, presumably, is ministering to ailing Party Chief Yuri Andropov.

Chazov also works for survival in another sense. Along with Harvard's Lown, he is a founder of the 35,000-member International Physicians for the Prevention of Nuclear War. Says Lown: "Chazov tells me that when all is said and done, it is not what he has contributed to cardiology that really matters."

--By Anastasia Toufexis.

Reported by Erik Amfitheatrof/Moscow and Anne Constable/Washington

With reporting by Erik Amfitheatrof/Moscow, Anne Constable/Washington This file is automatically generated by a robot program, so viewer discretion is required.