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1.
Bratisl Lek Listy ; 120(12): 894-898, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31855047

RESUMO

OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which directly influences organs such as brain, heart and kidneys and is related to organ damage. Its value increases with the aortic stiffness. The aim of this study was to analyze the relationships of CSBP to aortic stiffness parameters. METHODS: Central blood pressure (BP) and related parameters were measured by Arteriograph, working based on oscillometric principle, using pulse wave analysis (PWA) approach. We examined 123 patients (69 females, 54 males) with a primary hypertension. RESULTS: Using a linear correlation analysis, we found that CSBP was correlated to aortic pulse wave velocity (PWV), aortic and brachial pulse pressure (PP), aortic augmentation index, return time of reflected pressure wave (RT) and aortic and brachial augmentation indexes. Multivariate analysis defines the aortic pulse pressure (PPao) as the most powerful parameter influencing CSBP. By an individual analysis of BP in each patient separately, we defined two different types of central hemodynamics; those with a higher CSBP than brachial SBP occur in stiffer aorta. CONCLUSION: The CSBP increases with aortic PP, the most powerful stiffness parameter of aorta. Higher CSBP than brachial SBP usually accompanies a stiffer aorta (Tab. 5, Ref. 19).


Assuntos
Pressão Sanguínea/fisiologia , Análise de Onda de Pulso/métodos , Rigidez Vascular , Pressão Arterial , Determinação da Pressão Arterial , Feminino , Humanos , Masculino
2.
Bratisl Lek Listy ; 120(9): 676-679, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475553

RESUMO

OBJECTIVES: Medial arterial calcification (MAC) is a nonobstructive condition leading to reduced arterial compliance. The disease most commonly occurs in diabetes mellitus. Decreased ankle-brachial pressure index (ABI) is a well-known marker of increased cardiovascular mortality. However, also the values of ABI above 1.3, typical in MAC, are associated with increased mortality. METHODS: By means of Holter ECG monitoring, we investigated 41 patients (25 men, 16 women) with mean age of 59±8 years, suffering of type 2 diabetes mellitus and identified as having MAC, and Holter ECG monitoring with an average duration of recording 22.36 hours, was carried out by GE-Marquette MARS ECG Holter system. RESULTS: We found frequent incidence of cardiac arrhythmias and myocardial ischemia in 22 patients (53.7 %). Only 19 patients (46.3 %) had normal Holter ECG recordings. ABI values were significantly higher in patients with abnormal ECG Holter recordings. CONCLUSION: Our results confirm the importance of ABI estimation in clinical practice. As the central goal of therapy for patients with myocardial ischemia and/or complex forms of cardiac arrhythmias is the reduction or elimination of these episodes. Ambulatory Holter ECG monitoring plays an important role in the management of these patients (Tab. 7, Ref. 16).


Assuntos
Arritmias Cardíacas/diagnóstico , Calcinose/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Eletrocardiografia Ambulatorial , Isquemia Miocárdica/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
Vnitr Lek ; 59(6): 444-9, 2013 Jun.
Artigo em Tcheco | MEDLINE | ID: mdl-23808736

RESUMO

Arterial stiffness increases as a result of degenerative processes accelerated by aging and many risk factors, namely arterial hypertension. Basic clinical examination reveals increased pulse pressure as its hemodynamic manifestation. The most serious consequence of increased vascular stiffness, which cannot be revealed by clinical examination, is a change of central hemodynamics leading to increased load of left ventricle, left ventricular hypertrophy, diastolic dysfunction and to overall increase of cardiovascular risk. This review aimed to point at some patophysiological mechanisms taking part in the development of vascular stiffness, vascular remodeling and hemodynamic consequences of these changes. This work also gives an overview of noninvasive examination methods and their characteristics enabling to evaluate the local, regional and systemic arterial stiffness and central pulse wave analysis and their meaning for central hemodynamics and heart workload.


Assuntos
Doenças da Aorta/complicações , Doenças Cardiovasculares/etiologia , Sistema Cardiovascular/fisiopatologia , Hemodinâmica/fisiologia , Rigidez Vascular/fisiologia , Doenças da Aorta/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , Humanos , Fatores de Risco
4.
Bratisl Lek Listy ; 114(5): 279-82, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23611051

RESUMO

BACKGROUND: Metabolic syndrome (MS) is a cluster of proatherogenic risk factors (RF) (abdominal obesity, atherogenic dyslipidemia, impaired fasting glucose or type 2 diabetes mellitus, higher blood pressure or antihypertensive therapy) that move patients into a higher risk for development of cardiovascular disease (CVD) and type 2 diabetes. The preclinical (subclinical) target organ diseases (SOD) are early signs of atherosclerosis. An increased aortic stiffness characterised by an increased pulse wave velocity in aorta (PWV Ao) is one of SOD.The aim of the present study was to assess the impact of metabolic syndrome (MS) on aortic wall stiffness and the risk profile in premenopausal women. METHODS: The aortic stiffness was measured using Arteriograph-Tensiomed, based on oscillometric measurement and analysis of the shape of brachial pulse wave, giving the PWV Ao. The results of measurements characterise a global aortic stiffness. RESULTS: We examined 81 premenopausal women (without history of CVD). The MS (according to the 2009 "harmonizing" definition) was present in 31 women (mean age 41.5 y), in the control group, there were 50 women (39 y). The most frequent components of MS were abdominal obesity (93 % vs 42%), arterial hypertension (68 % vs 10 %) and dyslipidemia (29 % vs 8 %). The PWV Ao was significantly higher in women with MS (9.26 m/s) compared to the control group (7.44 m/s). CONCLUSION: The aortic stiffness in women with MS compared to controls was significantly higher despite a presumed general protective hormonal effect on cardiovascular system in women with child-bearing potential (Tab. 4, Ref. 25).


Assuntos
Síndrome Metabólica/complicações , Pré-Menopausa/metabolismo , Rigidez Vascular , Adulto , Feminino , Humanos
5.
Physiol Res ; 61(1): 35-42, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22188110

RESUMO

In this retrospective study we analysed changes of the ST segment in patients with arterial hypertension using multi-lead body surface mapping of the electric heart field as the ST segment often shows non-specific changes and is influenced by many different conditions. We constructed isointegral maps (IIM) of chosen intervals (the first 35 ms, the first 80 ms, and the whole ST segment) in 42 patients with arterial hypertension (with and without left ventricular hypertrophy) and in the control group involving 23 healthy persons. We analysed the position and values of map extrema. Spatial distribution of voltage integrals was similar in the control group and in the "pure" hypertensives. Patients with the left ventricular hypertrophy exhibited shifts of the integral minima. Despite our expectations, the highest extrema values were found in the control group and not in the left ventricular hypertrophy group. The extrema values were similar in all hypertensives, with or without left ventricular hypertrophy. Differences could be explained neither by the influence of the age, nor by the body habitus.


Assuntos
Mapeamento Potencial de Superfície Corporal/métodos , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/complicações , Masculino , Pessoa de Meia-Idade , Modelos Cardiovasculares , Estudos Retrospectivos
6.
Physiol Res ; 60(5): 777-84, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21812513

RESUMO

The aim of our work was to study the opposite polarity of the PQ segment to the P wave body surface potential maps in different groups of patients. We constructed isointegral maps (IIM) in 26 healthy controls (C), 16 hypertensives (HT), 26 patients with arterial hypertension and left ventricular hypertrophy (LVH) and 15 patients with myocardial infarction (MI). We analyzed values and positions of map extrema and compared the polarity of maps using the correlation coefficient. The IIM P maxima appeared mainly over the precordium, the minima mainly in the right subclavicular area. The highest maxima were in the MI group, being significantly higher than in the HT and LVH groups. No differences concerning any values of other extrema were significant. The IIM PQ maxima were distributed over the upper half of the chest; the minima mainly over the middle sternum. A statistically significant opposite polarity between the IIM P and IIM PQ was found in 80 % of cases. The opposite polarity of the P wave and the PQ segment was proved in isointegral body surface maps. The extrema occurred in areas not examined by the standard chest leads. This has to be considered for diagnostic purposes.


Assuntos
Mapeamento Potencial de Superfície Corporal/métodos , Sistema de Condução Cardíaco/fisiopatologia , Cardiopatias/fisiopatologia , Modelos Cardiovasculares , Adulto , Idoso , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos
7.
Vnitr Lek ; 57(3): 243-7, 2011 Mar.
Artigo em Eslovaco | MEDLINE | ID: mdl-21495404

RESUMO

INTRODUCTION: The mechanical load of left the ventricular wall by blood pressure generated during systole causes a strain associated with the impedance to ventricular emptying. Among several indices, the circumferential systolic wall stress is used to describe this load. The calculated stress depends on systolic blood pressure, wall thickness and ventricular cavity dimension. Methods enabling noninvasive quantification of those indices are based on echocardiographic examinations and blood pressure measurements. Left ventricular hypertrophy in hypertension is considered as a compensatory mechanism allowing the heart to withstand the hemodynamic strain associated with increased arterial pressure. SUBJECTS AND METHODS: In the group of 25 female patients with treated arterial hypertension with suboptimal blood pressure levels in the initial evaluation, we realized echocardiographic examination and calculated left ventricular mean circumferential systolic wall stress. The re-evaluation was done after achieving the target blood pressure levels (below 140/90 mm Hg) in the time interval of 6 month to 2 years. RESULTS: The statistically significant decrease of systolic wall stress was mainly due to lowering of blood pressure. The next favourable factor was diminishing of the left ventricular end-diastolic diameter, though the difference was not statically significant. By the multiple regression analysis we found that the final significant lowering of systolic wall stress was influenced also by favourable geometrical remodelling of the left ventricle by the tendency of diminishing of left ventricular diastolic diameter and the increase of relative wall thickness. CONCLUSION: We considered repeated echocardiographic examination and the systolic wall stress calculation (which integrates the ventricular geometry with the blood pressure values achieved) as an appropriate parameter for evaluation of the effect of antihypertensive therapy in the long-term management of hypertensive patients.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Função Ventricular Esquerda , Idoso , Ecocardiografia , Feminino , Humanos , Hipertensão/fisiopatologia , Pessoa de Meia-Idade , Sístole , Função Ventricular Esquerda/efeitos dos fármacos
8.
Vnitr Lek ; 56(9 Suppl): 1000-4, 2010 Sep.
Artigo em Eslovaco | MEDLINE | ID: mdl-21137174

RESUMO

INTRODUCTION: The metabolic syndrome (MS) is a cluster of risk factors that move the patient into higher level of risk category of cardiovascular disease and the probability of type 2 diabetes mellitus manifestation. Definition of MS is s based on the presence of selected risk factors as: abdominal obesity (lager waist circumpherence), atherogenic dyslipidemia (low value of HDL-cholesterol and increased level of triglycerides), increased fasting blood glucose (or type 2 DM diagnosis), higher blood pressure or antihypertensive therapy. In 2009 there were created harmonizing criteria for MS definition; the condition for assignment of MS is the presence of any 3 criteria of 5 mentioned above. The underlying disorder of MS is an insulin resistance or prediabetes. The patients with MS more frequently have subclinical (preclinical) target organ disease (TOD) which is the early sings of atherosclerosis. Increased aortic stiffness is one of the preclinical diseases and is defined by pathologically increased carotidofemoral pulse wave velocity in aorta (PWV Ao). With the aim to assess the influence of MS on aortic stiffness we examined the group of women with arterial hypertension and MS and compare them with the group of women without MS. PATIENT AND METHODS: The aortic stiffness was examined by Arteriograph--Tensiomed, the equipment working on the oscillometric principle in detection of pulsations of brachial artery. This method determines the global aortic stiffness based on the analysis of the shape of pulse curve of brachial artery. RESULTS: From the cohort of 49 pts 31 had MS, the subgroups did not differ in age or blood pressure level. The mean number of risk factors per person in MS was 3.7 comparing with 1.7 in those without MS. In the MS group there was more frequently abdominal obesity present (87% vs 44%), increased fasting blood glucose (81% vs 22%) and low HDL-cholesterol level. The pulse wave velocity in aorta, PWV Ao, was significantly higher in patients with MS (mean value 10,19 m/s vs 8,96 m/s without MS). CONCLUSION: The higher PWV Ao indicates a higher aortic stiffness in patients with MS and more severe subclinical target organ damage of cardiovascular system.


Assuntos
Aorta/fisiopatologia , Hipertensão/fisiopatologia , Síndrome Metabólica/fisiopatologia , Idoso , Feminino , Humanos , Hipertensão/complicações , Síndrome Metabólica/complicações , Fluxo Pulsátil
9.
Vnitr Lek ; 56(8): 832-7, 2010 Aug.
Artigo em Eslovaco | MEDLINE | ID: mdl-20845615

RESUMO

INTRODUCTION: Arterial hypertension is an important component of global cardiovascular risk profile of an individual patient. Estimation of global cardiovascular risk besides the blood pressure level incorporates all risk factors (RF), preclinical cardiovascular diseases (hypertension--induced target organ disease--TOD) and associated clinical conditions, and it should influence the therapy and long-term patient management. A group of metabolic risk factors comprizes several modifyable risk factors, detection of which influences the antihypertensive drug selection. The main goal of antihypertensive therapy is to achieve maximum reduction in the long-term total risk of cardiovascular disease, treating all modifyable risk factors in hypertensive patients. PATIENTS AND METHODS: In this work we present the results of group of 60 hypertensive patients examined for different risk factors detection and subsequent total cardiovascular risk estimation. RESULTS: The mean number of risk factors per patient was 4,1 (3% of patients had two RF, 22% of patients had three RF, 37% patients had four factors and 38% patients had five RF present). The ischaemic heart disease was found more frequently among hypertensives with higher number of RF. Metabolic syndrom (MS) was present in 53% of patients. Hypertensives with MS have higher rate of RF (4.9 per person) comparing to thouse without MS (3.6 RF per person). CONCLUSION: We found a quite high number of RF per individual hypertensive patient; the serious unfavourable consequence of this finding was the increased rate of coronary heart disease with the increasing number of risk factors found.


Assuntos
Doenças Cardiovasculares/etiologia , Hipertensão/complicações , Idoso , Feminino , Humanos , Masculino , Fatores de Risco
10.
Vnitr Lek ; 50(2): 126-33, 2004 Feb.
Artigo em Eslovaco | MEDLINE | ID: mdl-15077587

RESUMO

BACKGROUND: Carcinoid syndrome occurs in about 10% of patients with carcinoid tumors. OBJECTIVES: The main objective of the present study was to determine the presence of the carcinoid syndrome in the group of patients with the carcinoid tumor. SUBJECTS AND METHODS: 43 pts. (22 w/21 m) with carcinoid tumors (M group--26 pts. with metastatic disease, B group--17 pts. after resection of the primary tumor without known metastases at the time of the investigation) were included in the study. We estimated the presence of the carcinoid syndrome in all patients. The urinary excretion of 5-HIAA was performed and echocardiography were done. RESULTS: The amount of the 5-hydroxyindolacetate acid in urine in pts. with metastatic carcinoid was statistically significant higher than in the pts. without metastases (p < 0.001). The carcinoid syndrome in metastatic group we found in 10 patients. Flush had 9, diarhoe 7 pts., and cardiac involvement with endocardial fibrosis had 3 pts. During the treatment with lanreotide the amount of 5-HIAA in urine decreased from 1155 (207.6-1406) to 471 (96.6-1000) mumol/24 h (p < 0.05). During the follow up period 3 patients with carcinoid syndrome died.


Assuntos
Tumor Carcinoide/complicações , Síndrome do Carcinoide Maligno/complicações , Adulto , Tumor Carcinoide/secundário , Feminino , Humanos , Masculino , Síndrome do Carcinoide Maligno/diagnóstico , Pessoa de Meia-Idade
11.
Vnitr Lek ; 49(10): 802-7, 2003 Oct.
Artigo em Tcheco | MEDLINE | ID: mdl-14682153

RESUMO

AIM: Our aim was to: 1. compare QT dispersion from routine ECG in diabetic and no-diabetic patients with congestive heart failure, 2. describe associations between QT dispersion and circadian blood (BP) pressure variation in type 2 diabetic patients with congestive heart failure (CHF). PATIENTS AND METHODS: 122 patients admitted to hospital due to CHF in the period between years 2000-2001 have been divided into 2 groups: group 1:70 patients (m: 40, f: 30, mean age 64.7 +/- 9 years) with type II diabetes mellitus (DM), group 2:52 patients (m: 28, f:24, mean age 62.5 +/- 10.9 years) without DM. Diagnosis of CHF was made clinically and proved by ECG and ECHO (EF < 40%), DM was defined clinically or by using oral glucose tolerance test (75 g glucose, 2 h blood glucose > 11.1 mmol/l). The QT interval was measured from the beginning of the QRS complex to the end of the T wave from routine 12-lead ECG. QT intervals were corrected for heart rate using Bazett's formula. QT dispersion (QTd) and rate corrected QT dispersion (QTc) were defined as the difference between the maximum and minimum QT and QTc intervals, respectively. Ambulatory blood pressure (AMBP) was measured by an oscillometic technique. Diabetic patients with CHF were divided both according to below and above the median QTc dispersion (65 ms). STATISTICAL ANALYSIS: Chi-square and Student's t-test. Significant differences were assumed of p < 0.05. RESULTS: Both groups were matched by gender, age, duration and intensity of hypertension, the presence and intensity of obesity, hyperlipidemia (TC, TG, LDL-C, HDL-C) and smoking habits. Diabetic patients with CHF had significantly longer QTc interval (maximum and minimum), QT dispersion and QTc dispersion compared with non-diabetic patients with CHF. Diabetic patients with CHF with QTc dispersion > 65 ms had significantly higher night systolic (133 +/- 14 vs. 112 +/- 14) and diastolic (80 +/- 11 vs. 65 +/- 6) BP and significantly higher night/day ratio for both systolic (0.94 +/- 0.05 vs. 0.86 +/- 0.06) and diastolic (0.89 +/- 0.07 vs. 0.80 +/- 0.05) compared with diabetic patients with CHF with QTc dispersion < 65 ms. CONCLUSION: Diabetic patients with CHF are higher risk than non-diabetic. Our data describe both factors related to cardiovascular risk in diabetic patients with CHF-prolongation of the QT and QTc dispersion and reduced nocturnal blood pressure.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Eletrocardiografia , Insuficiência Cardíaca/fisiopatologia , Hipertensão/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Insuficiência Cardíaca/complicações , Frequência Cardíaca , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade
12.
Bratisl Lek Listy ; 103(6): 215-22, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12448569

RESUMO

BACKGROUND: Left ventricular hypertrophy (LVH) is supposed to be a risk factor of cardiovascular (CV) complications in hypertensive patients. AIM: To compare clinical events in hypertensives with and without LVH. PATIENTS AND METHODS: 319 hypertensives with LVH (mean age 64.1+/-10.6 ys) and 177 hypertensives without LVH (mean age 62.5+/-11.3 ys). LVH defined by echo Penn convention as left ventricular mass index >134 g/m2 in men and >110 g/m2 in women. Clinical events--heart failure (EF<40 %), left ventricular diastolic dysfunction (echo-doppler: transmitral-flow where peak A>peak E), myocardial infarction (history, ECG, cardiac enzymes), chronic atrial fibrillation (more than 2 weeks duration), mitral regurgitation (echo) and renal involvement (creatininemia>120 micromol/l). The two groups of hypertensives were matched by demographic criteria, duration and intensity of hypertension, obesity, diabetes mellitus, lipid serum levels and smoking habits. RESULTS: There were statistically significant at least p<0.05 more CV events (heart failure, left ventricular diastolic dysfunction, myocardial infarction, chronic atrial fibrillation, and mitral regurgitation cases) and renal involvement in LVH-positive patients than in LVH-negative patients. CONCLUSION: LVH is a strong risk factor for clinical events in hypertensives, which necessitates their more intensive treatment, mainly with drugs producing also LVH regression. (Tab. 5, Ref. 48.)


Assuntos
Hipertensão/complicações , Hipertrofia Ventricular Esquerda/etiologia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertrofia Ventricular Esquerda/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
13.
Bratisl Lek Listy ; 103(2): 45-9, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12061020

RESUMO

BACKGROUND: The carcinoid syndrome occurs in about 10% of patients with carcinoid tumors. OBJECTIVES: The main objective of the present study was to determine the presence of the carcinoid syndrome in a group of patients with carcinoid tumor. SUBJECTS AND METHODS: 35 pts with carcinoid tumors (group A--24 pts with metastatic disease, group B--11 pts after resection of the primary tumor with no metastases detected at the time of the investigation) were included into the study. The localisation and the diameter of the primary tumor were ascertained. Somatostatin receptor scintigraphy--Octreoscan and echocardiography were done. The urinary excretion of 5-HIAA was performed. We estimated the presence of the carcinoid syndrome in all patients. RESULTS: We confirmed the difference in the diameter of the primary carcinoid tumor in patients with metastases--group A 3.0 (2.5-4.2) cm by comparison with group B 0.7 (0.6-0.8) cm, (p < 0.001). Patients in the metastatic group are older 64 year (42-70) than pts without metastases--33 y (20-54) (p < 0.01). The amount of the 5-hydroxyindolacetate acid in urine in pts with metastatic carcinoid was statistically significantly higher than in the pts without metastases (p < 0.001). The carcinoid syndrome in the metastatic group was found in 6 patients (25%), with maximum (12.5%) localised in midgut. Out of the whole sample it counts up to 15.1%. During the follow up period, 8 patients from group A died. CONCLUSION: The large diameter of the primary carcinoid tumor and the higher age are the bad prognostic factors in patients with carcinoid tumors. (Tab. 4, Ref. 27.)


Assuntos
Síndrome do Carcinoide Maligno/diagnóstico , Adulto , Idoso , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/secundário , Feminino , Humanos , Ácido Hidroxi-Indolacético/urina , Neoplasias Intestinais/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Pancreáticas/patologia
14.
Vnitr Lek ; 48 Suppl 1: 196-200, 2002 Dec.
Artigo em Eslovaco | MEDLINE | ID: mdl-12744046

RESUMO

Primary pulmonary hypertension is a rare disease characterized by a rise of arterial pressure in the pulmonary artery without a known cause. The authors define, based on a case-history, the etiopathogenesis of the disease, its diagnosis and approach to treatment. They analyze the contribution of ECG examination for detection of right ventricular hypertrophy and for monitoring the therapeutic success with the finding above all of repolarization changes in the right precordium. The patient had a transplantation of the lungs.


Assuntos
Eletrocardiografia , Hipertensão Pulmonar/fisiopatologia , Hipertrofia Ventricular Direita/diagnóstico , Adulto , Humanos , Hipertensão Pulmonar/complicações , Hipertrofia Ventricular Direita/etiologia , Masculino , Doença Cardiopulmonar/diagnóstico , Doença Cardiopulmonar/etiologia
15.
Vnitr Lek ; 47(6): 348-53, 2001 Jun.
Artigo em Eslovaco | MEDLINE | ID: mdl-11494879

RESUMO

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Authors compared the presence of heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 192 hypertensives treated in our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 128 patients (mean age 65.9 years), absence of LVH in 64 patients (mean age 64.8 years). Both groups of hypertensives were matched by demographic parameters, by the presence of hyperlipidemia, by smoking habits. Hypertensive patients with left ventricular hypertrophy were more often treated by ACE inhibitors. There were statistically significant more patients with heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in LVH-positive patients than in LVH-negative once. There was also statistically significant lower ejection fraction (50.3 +/- 11.4% vs 56.5 +/- 7.4%) in LVH-positive patients than in LVH-negative once. Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease with a high contribution to the development of chronic heart failure.


Assuntos
Baixo Débito Cardíaco/etiologia , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/complicações , Ecocardiografia , Feminino , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Disfunção Ventricular Esquerda/etiologia
16.
Bratisl Lek Listy ; 102(12): 564-9, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11889969

RESUMO

The presence of diabetes mellitus and other risk factors of atherosclerosis, such as obesity, smoking and hyperlipidemia, in hypertensive patients makes the prognosis worse. Authors compared the clinical findings in diabetic hypertensive patients with and without left ventricular hypertrophy, the presence of which was diagnosed and defined by echocardiography. The study is based on the analysis of hospital records of 115 hypertensive patients treated at our department during the period 1998-1999. Left ventricular hypertrophy (LVH) was defined by echocardiography as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Left ventricular hypertrophy was found in 79 patients (mean age 64.6 ys) but not in 36 patients (mean age 63.3 ys). Both groups were matched as to age and sex, intensity and duration of hypertension and diabetes, obesity, smoking and hyperlipidemia. In LVH-positive patients, there was a statistically significant incidence of heart failure, mitral regurgitation and renal involvement and a more non-significant incidence of left ventricular diastolic dysfunction, myocardial infarction, chronic atrial fibrillation and stroke than in LVH-negative ones. Left ventricular hypertrophy usually complicates the course of hypertension. Authors recommend to investigate the presence of left ventricular hypertrophy in hypertensives as it carries a much more complicated course of the disease. (Tab. 5, Ref. 28.)


Assuntos
Complicações do Diabetes , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/complicações , Arteriosclerose/etiologia , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
17.
Vnitr Lek ; 47(1): 20-4, 2001 Jan.
Artigo em Eslovaco | MEDLINE | ID: mdl-15635864

RESUMO

Left ventricular hypertrophy is an important risk factor of cardiovascular complications during the course of hypertension. Increased QT dispersion is associated with sudden cardiac death in congestive heart failure and in other cardiovascular diseases. Our aim was to compare QT dispersion from routine ECG in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Authors examined 71 hypertensives treated in our medical department. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. QT dispersion was defined from routine ECG (QTmax - QTmin). Presence of LVH was found in 26 patients (mean age 59.3 years), absence of LVH in 45 patients (mean age 57.8 years). Hypertensives with secondary hypertension, hypertrophic cardiomyopathy, sings of ischemia in ECG, arrhythmias, myocardial infarction, heart failure, diabetes mellitus and patients treated by antiarrhythmic drugs of the Ic and III groups were excluded. Both groups of hypertensives were matched by demographic parameters, and by the presence of hypertension, obesity, hyperlipidemia and smoking habites. There were statistically significant longer QT dispersion and QTc dispersion (59.0 +/- 20.1 ms, 64.0 +/- 23.7 ms) in LVH-positive patients than in LVH-negative once (43.2 +/- 9.5 ms, 48.4 +/- 11.1 ms). Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease. Authors recommend to look after left ventricular hypertrophy presence in hypertensives as it carries much more complicated course of the disease. Measurment of QT dispersion adds farther stratificational information to these patients.


Assuntos
Eletrocardiografia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/etiologia , Masculino , Pessoa de Meia-Idade
18.
Bratisl Lek Listy ; 101(8): 455-9, 2000.
Artigo em Eslovaco | MEDLINE | ID: mdl-11153171

RESUMO

Left ventricular hypertrophy LVH is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Occurrence of other risk factors of atherosclerosis in these hypertensive patients such as hyperlipidemia and smoking deteriorate the prognosis too. The authors compared clinical findings in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 185 hypertensive patients treated at our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 109 patients (mean age 66.7 years), absence of LVH in 76 patients (mean age 64.7 years). Both groups of hypertensive patients were matched by demographic parameters by the presence of hyperlipidemia and by smoking habits. Hypertensive patients with diabetes mellitus and obesity were excluded. They were statistically significant in the incidence of heart failure, myocardial infarction, renal failure and mitral regurgitation, and non-significant in the incidence of left ventricular diastolic dysfunction. There were more cardiovascular complications in LVH-positive patients than in those with LVH-negative findings. The incidence of stroke was slightly higher in LVH-negative patients. Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease. The authors recommend to examine the patients with arterial hypertension for the presence of left ventricular hypertrophy as it complicates the course of the disease significantly. (Tab. 3, Fig. 2, Ref. 26.)


Assuntos
Hipertensão/complicações , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/etiologia , Ecocardiografia , Feminino , Humanos , Hipertrofia Ventricular Esquerda/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
19.
Vnitr Lek ; 45(7): 421-8, 1999 Jul.
Artigo em Eslovaco | MEDLINE | ID: mdl-11045162

RESUMO

The left ventricular hypertrophy is a risk marker of the cardiovascular morbidity and mortality in hypertensive patients--it contributes to sudden death, myocardial infarction, myocardial ischemia, heart failure, arrhythmias, left ventricular diastolic dysfunction, stroke and renal failure. The mechanisms by which the heart hypertrophy increases the risk of cardiovascular morbidity and mortality, however, is not completely clear yet. Pressure overload (resulting in the concentric hypertrophy) and volume overload (resulting in the eccentric hypertrophy) of the left ventricle play a significant role in the development of the hypertrophy of the left ventricle. Other risk factors, stimulating left ventricular hypertrophy, include growth factors, genetic predisposition, age, obesity, hyperinsulinemia and anemia. The hypertrophy of left ventricle most often occurs with hypertension, cardiomyopathy and aortic stenosis. Several clinical studies evaluated functional consequences of the reduction of the ventricular hypertrophy and found out that the function of the left ventricle to be improved in hypertensive patients who had undergone an effective and long-term antihypertensive treatment. However, these studies did not differentiate whether for the improvement in the function of left ventricle was the matter of the reduction of the left ventricular mass or whether it was because of the decrease of the arterial pressure during the period of anti-hypertensive treatment. On the basis of the literature studied we can emphasize that the reduction of myocardial hypertrophy resulting from a specific antihypertensive treatment appears to be more favourable than harmful for the heart's pump performance.


Assuntos
Hipertrofia Ventricular Esquerda , Humanos , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/complicações , Hipertrofia Ventricular Esquerda/diagnóstico , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Prognóstico
20.
Bratisl Lek Listy ; 99(3-4): 146-8, 1998 Mar.
Artigo em Tcheco | MEDLINE | ID: mdl-9664735

RESUMO

The therapy of AMI is aimed at the prevention of death, minimalization of discomfort caused by the disease and the reduction of the infarction focus (as soon and as markedly as possible) since the success of this step links with the later short-term as well as the long-term prognoses of the patient. (Tab. 2, Ref. 15.)

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