RESUMEN
Headache as a side effect of corinfar treatment courses for angina of effort was more commonly seen in patients with pretreatment dystonic rheoencephalographic changes. A single corinfar dose produced a drop of venous tone. Corinfar-associated headache was less common in patients after long-term treatment with high-dose nitroglycerin.
Asunto(s)
Angina de Pecho/tratamiento farmacológico , Circulación Cerebrovascular/efectos de los fármacos , Cefalea/inducido químicamente , Hemodinámica/efectos de los fármacos , Nifedipino/uso terapéutico , Adulto , Angina de Pecho/etiología , Angina de Pecho/fisiopatología , Ensayos Clínicos como Asunto , Relación Dosis-Respuesta a Droga , Humanos , Masculino , Persona de Mediana Edad , Nifedipino/administración & dosificación , Nifedipino/toxicidad , Esfuerzo FísicoRESUMEN
In 62 patients with angina pectoris of different functional classes, physical stress tolerance has been compared to changes of apexcardiographic variables in the postural test. It has been demonstrated that anginal patients have abnormal relaxation velocity and left ventricular filling. Passive volume redistribution test allows one to reveal diastolic myocardial dysfunction, severity of which is related to the degree of coronary insufficiency.
Asunto(s)
Enfermedad Coronaria/diagnóstico , Diástole , Contracción Miocárdica , Postura , Angina de Pecho/diagnóstico , Angina de Pecho/fisiopatología , Enfermedad Coronaria/fisiopatología , Pruebas de Función Cardíaca/métodos , Humanos , Cinetocardiografía , Masculino , Persona de Mediana Edad , Resistencia Física , Esfuerzo FísicoRESUMEN
In our previous studies we demonstrated possibility of the use of stress echocardiography with sublingual administration of nitroglycerine for detection of viable myocardium. Basing on data about myocardial and cerebrovascular reserves obtained during nitroglycerine tests we created mathematical model for prediction of hemodynamic effectiveness of coronary bypass surgery. Stress echocardiography, Doppler echography of middle cerebral and internal carotid arteries with nitroglycerine were carried out in 80 patients with coronary artery disease before myocardial revascularization. Quantitative equivalent characterizing degree of myocardial reserve preservation in early postoperative period was used as basis for discrimination of patients into groups with positive and negative result of surgery, and coefficients and constants of discriminant function were calculated for these groups. According to results of clinical testing sensitivity, specificity and diagnostic effectiveness of the model were 76.9, 75 and 76%, respectively.
Asunto(s)
Enfermedad Coronaria/fisiopatología , Ecocardiografía de Estrés/métodos , Hemodinámica/fisiología , Nitroglicerina , Vasodilatadores , Enfermedad Crónica , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/cirugía , Humanos , Masculino , Persona de Mediana Edad , Modelos Cardiovasculares , Valor Predictivo de las PruebasRESUMEN
Dynamics of structural and functional left ventricular parameters was investigated in 51 patients with acute anterior myocardial infarction by means of serial (on days 1, 2, 3, 5, 7, 10 and 21 of infarction) echocardiographical study. Increase of end-diastolic volume index relative to initial values became significant on 5th-7th days and continued to progress until 3rd week of infarction. Left ventricular cavity became dilated and attained more occurred shape predominantly at the account of increased transverse diameters. Abnormalities of left ventricular contractile and pump functions were most pronounced during first 3 days of the disease. Between 5th and 10th days improvement and stabilization of myocardial functional state took place accompanied by progression of left ventricular dilation and increase of its sphericity with lessening of degree of myocardial asynergy.
Asunto(s)
Infarto del Miocardio/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Adulto , Anciano , Protocolos Clínicos , Ecocardiografía/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagen , Remodelación VentricularRESUMEN
In 26 patients with coronary heart disease, transesophageal atrial pacing was used to study cerebral hemodynamics from brain tomoscintigraphic findings as compared to the severity of induced of myocardial ischemia, echocardiographic parameters of left ventricular function and prostacyclin-thromboxane balance. In angina pectoris, the lower rate of cerebral blood flow was found to be correlated with the integral parameter of myocardial ischemia, deteriorated cardiac contractile and pump function, and higher plasma thromboxane A2 levels.
Asunto(s)
Estimulación Cardíaca Artificial , Circulación Cerebrovascular , Isquemia Miocárdica/fisiopatología , Electrocardiografía , Epoprostenol/sangre , Esófago , Atrios Cardíacos/fisiopatología , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Contracción Miocárdica , Isquemia Miocárdica/sangre , Tromboxano A2/sangreRESUMEN
Eighty seven patients with Stages II-III vascular occlusions in the lower extremities were examined. The clinical and biochemical parameters of the course of the disease were found to improve in the patients who received in earlier periods dalargin supplemented to the combined therapy than in those from a matched group. There was a decrease in femoral venous blood lactate concentrations in the diseased extremity, blood cholesterol and parathyroid hormone levels. The mechanisms responsible for effects of dalargin on metabolic parameters and clinical indices of the patients' condition were also discussed. Whether it is possible to use dalargin in the combined therapy for extremity vascular occlusive diseases is considered.
Asunto(s)
Arteriosclerosis Obliterante/tratamiento farmacológico , Colesterol/sangre , Leucina Encefalina-2-Alanina/análogos & derivados , Lactatos/sangre , Pierna/irrigación sanguínea , Hormona Paratiroidea/sangre , Adulto , Anticolesterolemiantes , Arteriosclerosis Obliterante/sangre , Leucina Encefalina-2-Alanina/uso terapéutico , Humanos , Lactatos/antagonistas & inhibidores , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/antagonistas & inhibidoresRESUMEN
In the multicenter trial, the hypolipidemic efficacy and adverse event profile of lovastatin were estimated in 294 patients with primary hypercholesterolemia. The mean baseline (on placebo) lipid and lipoprotein values were: total serum cholesterol (TC) 313 mg/dl, triglycerides (TG) 168 mg/dl, low density lipoprotein cholesterol (LDL-C) 235 mg/dl, high density lipoprotein cholesterol (HDL-C) 44.9 mg/dl. Lovastatin was begun with 20 mg/day, the dose being doubled after 4 and 8 weeks if the target reduction of TC < 200 mg/dl was not reached at those moments. At the end of the treatment the mean TC decreased by 29.5% (p) as compared with the baseline level, TG by 14% (p). The normal target level of TC was reached in 106 patients (36%), the borderline levels (200-240 mg/dl) in 123 (42%), high TC (240 mg/dl) remained in 65 patients (22%). LDL-C decreased by 38% (p), HDL-C increased by 7.8% (p), whereas LDL-C/HDL-C ratio decreased by 40% (p). The treatment was well tolerated by patients: mild clinical side effects were noticed in 2.7% of patients and asymptomatic transient deviations of laboratory tests in 8.2%. The authors conclude about high hypolipidemic efficacy and low adverse event profile of lovastatin in patients with primary hypercholesterolemia.
Asunto(s)
Hipercolesterolemia/tratamiento farmacológico , Lovastatina/uso terapéutico , Adulto , Anciano , Tolerancia a Medicamentos , Femenino , Humanos , Hipercolesterolemia/sangre , Lípidos/sangre , Lipoproteínas/sangre , Lovastatina/administración & dosificación , Lovastatina/efectos adversos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/sangre , Isquemia Miocárdica/tratamiento farmacológico , Factores de Tiempo , U.R.S.S.RESUMEN
Hemodynamics was studied during transesophageal pacing test in 49 coronary patients and 22 patients with alcoholic cardiomyopathy by means of impedance plethysmography. Sinus node dysfunction, impaired ventricular contractility and decreased cardiac output were detected in the coronary patients.
Asunto(s)
Estimulación Cardíaca Artificial , Cardiomiopatía Alcohólica/diagnóstico , Enfermedad Coronaria/diagnóstico , Adulto , Cardiomiopatía Alcohólica/fisiopatología , Enfermedad Coronaria/fisiopatología , Diagnóstico Diferencial , Electrocardiografía , Esófago , Prueba de Esfuerzo , Femenino , Atrios Cardíacos/fisiopatología , Hemodinámica , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: To assess detectability of carotid atherosclerosis in patients with coronary heart disease (CHD) and arterial hypertension (AH) by the data of ultrasonic screening, to study location and detectability of atherosclerotic lesion of common carotid arteries, internal carotid arteries, external carotid arteries in correlation with basic disease. MATERIAL AND METHODS: Ultrasonic screening of brachyocephalic arteries was made in 469 patients: with CHD (n = 239), AH (n = 230) including patients with concomitant postinfarction cardiosclerosis (PICS) and moderate chronic cerebrovascular failure (CCVF). RESULTS: Ultrasonic angiography detected atherosclerotic carotid artery lesion in patients with CHD and PICS (81.6%) or CCVF (76.9%) or angina pectoris (64.2%). In hypertension subjects carotid artery atherosclerosis was encountered in 28.1%. CONCLUSION: It is justified to make ultrasonography of carotid arteries in all patients with CHD and AH irrespective of age, gender, underlying clinical diagnosis.
Asunto(s)
Angina de Pecho , Enfermedades de las Arterias Carótidas/diagnóstico , Hipertensión , Adulto , Anciano , Angina de Pecho/complicaciones , Angina de Pecho/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/etiología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico por imagen , Masculino , Tamizaje Masivo , Persona de Mediana Edad , UltrasonografíaRESUMEN
AIM: To compare echomorphostructure of atherosclerotic plaques and vascular stenosis degree with structural changes of the brain according to MR image in patients with combined atherosclerotic affection of coronary and carotid arteries in an asymptomatic course of carotid atherosclerosis. MATERIAL AND METHODS: MR imaging was made in 53 men aged 44 to 78 years with stenosing atherosclerotic affection of the internal carotid arteries. Vascular obstruction reached 30-80%. Neurological examination detected no signs of focal brain lesions. Hypertension, myocardial infarction, permanent atrial fibrillation were diagnosed in 19 (36%), 20 (38%) and 12 (23%) patients, respectively. RESULTS: Ultrasound investigation has established that carotid arteries contain more frequently spongy and heterogenic plaques than dense and calcinated. MRI registered structural alterations of cerebral tissue of various degree in 96% cases. CONCLUSION: Significant correlations were established between ischemic affection of the brain with myocardial infarction, arterial hypertension, cardiac fibrillation, type of atherosclerotic plaque.
Asunto(s)
Arteriosclerosis/patología , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Arterias Carótidas/patología , Estenosis Carotídea/patología , Adulto , Anciano , Imagen Eco-Planar , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
The loading tests, instrumental and biochemical methods were employed to study the effect of mildronate, dalargin, rokornal, gevilon, dibunol, emoxipine and plasmapheresis on the coronary, cerebral, peripheral circulation, the level of cholesterol, its fractions and triglycerides in 247 patients suffering from atherosclerosis. Mildronate, dalargin, rokornal, emoxipine and plasmapheresis were shown to exert a beneficial effect on the regional circulation, lipid metabolism and can be used in the treatment of patients with concomitant forms of atherosclerosis.
Asunto(s)
Arteriosclerosis/tratamiento farmacológico , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Arteriosclerosis Intracraneal/tratamiento farmacológico , Adulto , Arteriosclerosis/sangre , Arteriosclerosis/fisiopatología , Enfermedad Crónica , Terapia Combinada , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/fisiopatología , Evaluación de Medicamentos , Prueba de Esfuerzo , Hemodinámica/efectos de los fármacos , Humanos , Arteriosclerosis Intracraneal/sangre , Arteriosclerosis Intracraneal/fisiopatología , Lípidos/sangre , Lipoproteínas/sangre , Masculino , Persona de Mediana Edad , PlasmaféresisRESUMEN
The study included 53 patients (males at the age of 44-78 years) with ischemic heart disease and arterial hypertension with asymptomatic unilateral atherosclerotic affection of carotid arteries (CA). Ultrasonic investigation registered 30-80% stenosis of carotid arteries in the absence of neurological deficit. Cerebrovascular reactivity was assessed by means of the hypercapnic hypoxic test (HHT) including breathing via additional "dead space" for 3 min. Initial and peak linear velocity of the blood flow in the middle cerebral artery was measured with ultrasonic transcranial dopplerography. By HHT results, three types of cerebral vascular reactions in patients with combined atherosclerosis of coronary and carotid arteries were identified: subnormal dilatation on the side of stenosed internal carotid artery, increased dilatation and paradoxical vasoconstriction on the affected side. Cerebrovascular reactivity and the type of atherosclerotic plaques did not collerate.
Asunto(s)
Enfermedades de las Arterias Carótidas/fisiopatología , Enfermedad de la Arteria Coronaria/fisiopatología , Hipertensión/fisiopatología , Adulto , Anciano , Enfermedades de las Arterias Carótidas/etiología , Circulación Cerebrovascular/fisiología , Enfermedad de la Arteria Coronaria/complicaciones , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
The results of treatment of 161 patients with atherosclerotic small degree stenoses of carotid arteries (up to 50% of diameter) were analyzed. From them 67 patients underwent operations for chronic cerebro-vascular failure and 11 patients--for acute cerebro-vascular failure. 31 patients, who had contraindications for surgery or refused it, plasmapheresis procedures were carried on, 52 patients with asymptomatic carotid arteries' disease underwent conservative treatment. On the base of the results of examination and late results of treatment it is shown valid to recommend carotid endarterectomy as a prophylactic measure in acute cerebrovascular failure in asymptomatic patients who have morphologically unstable plaques of carotid arteries. If there are general contraindications for carotid endarterectomy, with the aim of prophylaxis of cerebrovascular failure the procedures of plasmapheresis for alteration of morphologic structure of plaques are advisable.
Asunto(s)
Estenosis Carotídea/diagnóstico , Estenosis Carotídea/cirugía , Endarterectomía Carotidea , Adulto , Anciano , Arteriosclerosis/complicaciones , Arteriosclerosis/diagnóstico , Arteriosclerosis/cirugía , Estenosis Carotídea/etiología , Toma de Decisiones , Endarterectomía Carotidea/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The organism's oxygen balance was studied in 27 patients with atherosclerosis of the peripheral arteries during the test on a bicycle ergometer. The decrease in the patient's physical capacity was found to be in high correlation with the severity of oxygen disbalance.