RESUMEN
AIM: to verify the effect of vegetative nervous system on the silent myocardial ischemia. MATERIALS AND METHODS: We included in this study 56 patients with functional class II-III effort angina (22 men and 34 women, age 45-49 years) with silent myocardial ischemia (SMI). Examination included 24hour blood pressure and ECG monitoring. RESULTS: We revealed the interrelation between elevation of parameters of heart rhythm variability reflecting activity of parasympathetic nervous system and ST segment depression depth during episodes of SMI. Also, а significant interrelationship was found between SMI duration and degree of nocturnal diastolic blood pressure decrease which reflected parasympathetic nervous system activity. CONCLUSION: Silent myocardial ischemia more often occurred at the background of elevated activation of the parasympathetic nervous system.
Asunto(s)
Electrocardiografía Ambulatoria , Isquemia Miocárdica , Sistema Nervioso Autónomo , Electrocardiografía , Femenino , Corazón , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The study was carried out to investigate relationship of the level of homocysteine and genetic polymorphisms conditioning disorders of metabolism of folates in healthy population and of various age and gender groups. The study covered 168 donors: 98 males and 70 females. Two gender groups were singled out and in each of them age groups: 18-31, 32-45 and 46-60 years old. The analysis of concentration of homocysteine was implemented using immune chemiluminescence analysis. The polymerase chain reaction was applied for analyzing genetic polymorphisms associated with disorders of folate cycle by genes MTHFR (met hylentetrahydrofolatereductase) (polymorphisms MTHFR: 677 C>T and MTHFR: 1298 A>C), MTR (B12-dependent methionine-synthetase) (polymorphism MTR: 2756 A>G) and MTRR (methionine-synthetase-reductase) (polymorphism MTRR: 66 A>G). The level of homocysteine in blood of donors was reliably higher in male groups of 18-31 and 32-45 years old as against female groups comparable by age. The study established higher rate of occurrence of heterozygous genotypes bringing unfavorable types of polymorphisms of MTHFR and MTRR genes both in male and female groups. The study established higher rate of occurrence of unfavorable genotypes in examined patients in comparison with publications' data. The established statistically significant inverse correlation of concentration of homocysteine and genetic polymorphisms associated with disorders of folate cycle in individuals of young and middle age mainly males, permits to draw a conclusion about absence of their direct relationship. Therefore, implementation of genetic liability to increasing of homocysteine can occur under effect of external unfavorable factors.
Asunto(s)
5-Metiltetrahidrofolato-Homocisteína S-Metiltransferasa/genética , Ferredoxina-NADP Reductasa/genética , Estudios de Asociación Genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Adulto , Alelos , Femenino , Ácido Fólico/genética , Ácido Fólico/metabolismo , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Homocisteína/sangre , Homocisteína/genética , Humanos , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
We have assessed parameters of myocardial electrical instability in patients with postinfarction atherosclerosis before and in one year after coronary bypass surgery. Inclusion criteria were history of myocardial infarction, surgical myocardial revascularization between 1 and 2 years before; stable course of coronary heart disease during previous month; preserved ejection fraction ( more or equal 50%), stable sinus rhythm. Heterogeneity of myocardial electrophysiological properties has diminished after coronary bypass surgery due to improvement of coronary perfusion and restoration of function of ischemic myocardium. This have been associated with positive dynamics of interval QT dispersion, parameters of turbulence and variability of cardiac rhythm, reduction of the rate of registration of ventricular late potentials.
Asunto(s)
Puente de Arteria Coronaria , Muerte Súbita Cardíaca/prevención & control , Técnicas Electrofisiológicas Cardíacas , Fenómenos Electrofisiológicos , Infarto del Miocardio , Enfermedad de la Arteria Coronaria/etiología , Enfermedad de la Arteria Coronaria/fisiopatología , Muerte Súbita Cardíaca/etiología , Femenino , Frecuencia Cardíaca , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Contracción Miocárdica , Infarto del Miocardio/complicaciones , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/cirugía , Volumen Sistólico , Factores de TiempoRESUMEN
Effect of enalapril and telmisartan on hemodynamic indices, structural-functional parameters of the left ventricle, and vasomotor function of arterial endothelium was studied in 49 patients (mean age 48.3+/-3.2 years) with 1-2 degree arterial hypertension (AH) and abnormal relaxation type of left ventricular diastolic dysfunction. Enalapril was given to 24 and telmisartan to 25 patients. Examination included 24-hour arterial pressure monitoring, echocardiography, duplex scanning of the left brachial artery. At the background of therapy with enalapril target levels of systolic and diastolic arterial pressure (AP) were achieved in 79.2 and 70.85% of patients. This was associated with 54.2% reduction of number of non-dippers and night peakers. Therapy with telmisartan (30 weeks) besides effective AP control provided normalization of 24-hour AP profile in 90% of patients with pathological circadian rhythm. This was accompanied by improvement of vasomotor endothelial function of arteries, positive dynamics of structural-functional parameters of the left heart chambers, improvement of indices of left ventricular diastolic function.
Asunto(s)
Bencimidazoles , Benzoatos , Enalapril , Hipertensión/tratamiento farmacológico , Vasodilatación/efectos de los fármacos , Función Ventricular Izquierda/efectos de los fármacos , Remodelación Ventricular/efectos de los fármacos , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Inhibidores de la Enzima Convertidora de Angiotensina/farmacocinética , Bencimidazoles/administración & dosificación , Bencimidazoles/efectos adversos , Bencimidazoles/farmacocinética , Benzoatos/administración & dosificación , Benzoatos/efectos adversos , Benzoatos/farmacocinética , Presión Sanguínea/efectos de los fármacos , Monitoreo Ambulatorio de la Presión Arterial , Arteria Braquial/diagnóstico por imagen , Ecocardiografía , Enalapril/administración & dosificación , Enalapril/efectos adversos , Enalapril/farmacocinética , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Telmisartán , Resultado del TratamientoRESUMEN
Markers of electric myocardial instability were studied in 82 patients during painless episodes of coronary heart disease (CHD). Clinical examination was supplemented by 12-lead ECG, 24-hour ECG monitoring, functional tests, echocardiography, signal-averaged ECG, recording of LVP, analysis of cardiac rhythm variability, and assessment of ventricular repolarization time. It is concluded that a combination of 24-hr ECG monitoring and functional tests (veloergometer) is indispensable for diagnostics of CHD and the evaluation of the patient"s condition. Daily dynamics of myocardial ischemia and the number of its painless episodes are shown to correlate with the results of signal-averaged ECG, Q-T dispersion and LF/HF ratio. Patients with painless CHD show enhanced frequency of myocardial infarction with the Q-wave, high-grade ventricular extrasystole, and LVP coupled to disordered autonomous vegetative control of the sinus rhythm.
Asunto(s)
Electrocardiografía , Corazón/fisiopatología , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatología , Anciano , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/fisiopatologíaRESUMEN
AIM: To study parameters characterizing electric myocardial unstability in coronary heart disease (CHD) patients with different variants of diastolic dysfunction (DD) of the left ventricle (LV). MATERIAL AND METHODS: The study included 86 outpatients (26 females, 60 males, mean age 57.3 +/- 5.6 years) who had myocardial infarction (MI) more than 1 year before the trial with stable course of CHD during a previous month, LV ejection fraction more than 45% and with a stable sinus rhythm. Group 1 consisted of 36 patients with abnormal LV relaxation, group 2--of 28 patients with pseudo-normal LV DD, group 3--22 patients with a restrictive type of LV DD. The following examinations were made: Holter ECG monitoring, echocardiography, signal-average ECG with isolation of late ventricular potentials (LVP), estimation of heart rate variability, ventricular repolarization (Q-T interval dispersion, corrected interval Q-T). RESULTS: The following variants of LV DD were detected: type 1--42%, type 2--32.5%, type 3--25.5%. LV DD progression was accompanied with enhancing vegetative imbalance and sympathetic activity: in the group with abnormal relaxation--in 52.5% patients, in the group with a restrictive type--in 93.3%. CHD patients with restrictive DD had more frequent LVP (chi-square = 4.1; p < 0.05) and visualization of anomalous contractility zones (60%), ventricular extrasystole (VE) was registered in 100% cases (VE of grade IV-V in 43.3%), QT(c) and QT(d) were higher than threshold--450.2 +/- 5.4 and 71.2 +/- 6.5 ms. CONCLUSION: Because of multifactorial genesis of electric unstability, perfection of diagnosis and prognosis of risk in CHD patients with aggravation of LV DD demands a complex analysis of parameters respecting functional condition of the myocardium, relations between electric and structural-geometric remodeling of the heart.
Asunto(s)
Enfermedad Coronaria/fisiopatología , Diástole/fisiología , Disfunción Ventricular Izquierda/fisiopatología , Función Ventricular Izquierda/fisiología , Remodelación Ventricular/fisiología , Enfermedad Coronaria/complicaciones , Ecocardiografía Doppler en Color , Ecocardiografía Doppler de Pulso , Electrocardiografía Ambulatoria , Fenómenos Electrofisiológicos/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Disfunción Ventricular Izquierda/complicacionesRESUMEN
AIM: To study markers of myocardial electrical instability in patients with coronary heart disease (CHD) during silent myocardial ischemic episodes. SUBJECTS AND METHODS: Eighty-two patients with stable CHD (mean age 62.6 +/- 5.4 years) were examined. In addition to standard physical examination, a complex of their study comprised 12-lead electrocardiography (ECG), Holter ECG monitoring, exercise testing, echocardiography, average signal (AS) ECG recording with identification of late ventricular potentials (LVP), analysis of cardiac rhythm variability (CRV), and estimation of QT interval duration. RESULTS: The study revealed that a combination of Holter ECG monitoring and exercise testing (bicycle ergometry) was required to diagnose silent CHD and to evaluate functional condition severity. Diurnal myocardial ischemia and the number of silent ischemic episodes were found to associate with AS-ECG readings, QT interval dispersion, and LF/HF ratio. In patients with silent CHD, the incidence of Q-wave myocardial infarction and the frequency of high-grade ventricular premature beats were higher, late ventricular potentials were more frequently found, and autonomic vegetative control of sinus rhythm proved to be more significantly impaired. CONCLUSION: No pain signal in patients with CHD leads to underestimation of the seriousness of the situation and, accordingly, to inadequate measures for its elimination therefore early diagnosis and correction of silent myocardial ischemia are prognostically important in preventing life-threatening acute manifestations of CHD and arrhythmic complications.
Asunto(s)
Electrocardiografía , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/fisiopatología , Electrocardiografía Ambulatoria , Fenómenos Electrofisiológicos , Prueba de Esfuerzo , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Contracción Miocárdica/fisiologíaRESUMEN
The study was designed to evaluate effect of enalapril and telmisartan on hemodynamic characteristics and diastolic function (DF) of left ventricle (LV) in patients with type 2 diabetes and arterial hypertension (AH). It included 64 patients aged 54.3 +/- 5.2 years. Those in group 1 (n = 31) were given enalapril (enap), patients of group 2 (n = 33) were treated with telmisartan (micardis). Examination included 24 hour AP monitoring, Holter ECG monitoring, and echocardiography. Compensation of metabolic disorders was evaluated from fasting and postprandial blood glucose and HbAc1 levels. Impaired LV DF was the main feature of affected myocardium in patients with DM2 and elevated AP in the absence of contractility disturbance. Enalapril therapy ensured the desired level of systolic and diastolic AP in 77 and 64.5% of the patients respectively in association with a decreased number of non-dippers and night-peakers in 45.4% of the observations in the absence of changes in HbAc1 level and LV DF. Treatment with telmisartan ensured within 24 weeks efficacious control of systolic AP and normalization of its daily profile in 87.5% patients with pathological circadian rhythm, besides improvement of carbohydrate metabolism and LV DF.
Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Bencimidazoles/uso terapéutico , Benzoatos/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Enalapril/uso terapéutico , Hemodinámica/fisiología , Hipertensión/complicaciones , Bloqueadores del Receptor Tipo 1 de Angiotensina II/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Bencimidazoles/administración & dosificación , Benzoatos/administración & dosificación , Glucemia/metabolismo , Monitoreo Ambulatorio de la Presión Arterial , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Diástole , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Enalapril/administración & dosificación , Femenino , Estudios de Seguimiento , Hemodinámica/efectos de los fármacos , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Contracción Miocárdica/efectos de los fármacos , Contracción Miocárdica/fisiología , Telmisartán , Resultado del Tratamiento , Ultrasonografía , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Izquierda/fisiopatologíaRESUMEN
AIM: To study the effects of enalapril and telmisartan on hemodynamic parameters and diastolic function (DF) of the left ventricle (LV) in patients with type 2 diabetes mellitus (DM) concurrent with arterial hypertension (AH). SUBJECTS AND METHODS: The study included 64 patients (mean age 54.3 +/- 5.2 years) with type 2 DM. For the treatment of AH, Group 1 (n = 31) received enalapril and Group 2 (n = 33) took telmisartan (micardis). Their examination comprised 24-hour blood pressure (BP) monitoring, Holter ECG monitoring, and echocardiography. The fasting and postprandial levels of blood glucose and glycosylated hemoglobin were measured to evaluate the compensation for carbohydrate metabolism. RESULTS: In patients with type 2 DM and elevated BP, LV diastolic dysfunction was detectable in the absence of reduced contractility. LF DF, isovolumetric relaxation time, and the ratio of the peak blood flow velocity during early diastolic filling to that during atrial systole were found to correlate with HbA(1c), diastolic hypertension time index, and the diurnal duration of asymptomatic ST-segment depression. During enalapril therapy, the goal level of BP was achieved in systolic BP (SBP) in 77% of the patients and diastolic BP (DBP) in 64.5%, which was accompanied by reductions in the number of nondippers and night-pickers in 45.4% of cases with no changes in HbA(1c) and LV DF. CONCLUSION: In addition to effective SBP and DBP control with the normalization of their diurnal profiles in 87.5% of the patients with abnormal circadian rhythm, the 24-week course of telmisartan therapy ensures improvements in carbohydrate metabolism and LVDF.
Asunto(s)
Antihipertensivos/uso terapéutico , Bencimidazoles/uso terapéutico , Benzoatos/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Enalapril/uso terapéutico , Hemodinámica/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Antihipertensivos/administración & dosificación , Antihipertensivos/farmacología , Bencimidazoles/administración & dosificación , Bencimidazoles/farmacología , Benzoatos/administración & dosificación , Benzoatos/farmacología , Glucemia/análisis , Presión Sanguínea/efectos de los fármacos , Metabolismo de los Hidratos de Carbono/efectos de los fármacos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Enalapril/administración & dosificación , Enalapril/farmacología , Femenino , Humanos , Hipertensión/sangre , Hipertensión/complicaciones , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Telmisartán , Resultado del Tratamiento , Función Ventricular Izquierda/efectos de los fármacosRESUMEN
The objective of this study was to evaluate the vasculomotor function of endothelium in patients with type 2 diabetes mellitus and assess the role of its functional state in the development of ischemic episodes. A total of 93 patients (52 men and 41 women) of the mean age of 58.3+-4.8 years were involved in the study. Group 1 comprised 47 patients with coronary heart disease (CHD) and type 2 diabetes, group 2 included 46 patients with CHD in the absence of disturbances of carbohydrate metabolism. Patients of the two groups were matched for age, gender, and major risk factors. Their comprehensive examination included 24 hour ECG monitoring, veloergometry, echocardiography, and reactive hyperemia test (ultrasound evaluation of endothelium-dependent dilation of the brachial artery). The patients of group 2 showed longer total duration of episodes of myocardial ischemia, the elevated number of painless (PMI) episodes, and greater maximum depression of ST-segment compared with CHD patients having no disturbances of carbohydrate metabolism. Correlation analysis demonstrated significant negative relationship between endothelial dysfunction, the number and duration of PMI episodes, and delay of pain syndrome with respect to ischemic depression of ST-segment in patients of group 1.
Asunto(s)
Estenosis de la Válvula Aórtica , Enfermedades Óseas Metabólicas , Calcinosis , Cardiomiopatías , Animales , Estenosis de la Válvula Aórtica/epidemiología , Estenosis de la Válvula Aórtica/etiología , Estenosis de la Válvula Aórtica/terapia , Enfermedades Óseas Metabólicas/complicaciones , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/terapia , Calcinosis/complicaciones , Calcinosis/epidemiología , Calcinosis/terapia , Cardiomiopatías/complicaciones , Cardiomiopatías/epidemiología , Cardiomiopatías/terapia , Humanos , Incidencia , Prevalencia , Federación de Rusia/epidemiologíaAsunto(s)
Antagonistas Adrenérgicos beta/uso terapéutico , Angina de Pecho/tratamiento farmacológico , Atenolol/uso terapéutico , Benzazepinas/uso terapéutico , Electrocardiografía/efectos de los fármacos , Anciano , Angina de Pecho/fisiopatología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Ivabradina , Masculino , Estereoisomerismo , Resultado del TratamientoRESUMEN
The aim of the study was to estimate clinical and functional indices under stable course of coronary heart disease (CHD) against the background of therapy with coraxan and atenolol. 95 patients (70 males and 29 females, average age 52.3 +/- 4.5 years) were observed. Addition of coraxan and atenolol to the standard therapy in patients with CHD made possible to improve patients" quality of life; tolerance to physical exercises was increased, and myocardial ischemia daily duration (MIDD) and number of ischemia episodes were decreased. Under the course coraxan therapy it was detected growth of ejection fraction and improvement of heart diastolic function. MIDD decrease accompanied improvement of indices, characterizing heart electrical instability.
Asunto(s)
Antagonistas Adrenérgicos beta/uso terapéutico , Atenolol/uso terapéutico , Enfermedad Coronaria/tratamiento farmacológico , Enfermedad Coronaria/fisiopatología , Angina de Pecho/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: To assess ivabradin and nebivolol efficacy in combined treatment of ischemic heart disease patients with chronic heart failure (CHF) of functional class (FC) II-III by NYHA, impact of these drugs on quality of life, circadian indices of myocardial ischemia (CMI), left ventricular (LV) contractility. MATERIAL AND METHODS: A total of 92 patients with CHF of FC II-III (mean age 57.3 +/- 4.5 years) were randomized into 3 groups. Patients of group 1 (n = 30) received combined basic therapy: inhibitors of ACE, diuretics, aspirin, statins, on demand nitrates. Patients of group 2 (n = 33) received basic combined treatment plus nebivolol (nebilet, Berlin-Chemie/Menarini) in a dose 5.0 mg/day. Group 3 (n = 29) was given basic therapy plus ivabradin (coraxan) in a mean dose 7.5 mg. RESULTS: The addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction brought about control over heart rate (HR), improved quality of life, reduced severity of CHF, CMI, number of episodes of painful and painless ischemia. In reduced by nebivolol HR addition of ibavradin improved systolic and diastolic LV function. The analysis of HR variability in ivabradin administration showed enhancement of parasympathic activity in the vegetative balance. Administration of nebivolol produced modulated attenuation of sympathic activity. CONCLUSION: Addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction raises efficacy of treatment.
Asunto(s)
Benzazepinas/uso terapéutico , Benzopiranos/uso terapéutico , Etanolaminas/uso terapéutico , Isquemia Miocárdica/tratamiento farmacológico , Vasodilatadores/uso terapéutico , Disfunción Ventricular Izquierda/tratamiento farmacológico , Benzazepinas/administración & dosificación , Benzopiranos/administración & dosificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Ecocardiografía Doppler en Color , Electrocardiografía , Etanolaminas/administración & dosificación , Estudios de Seguimiento , Humanos , Ivabradina , Persona de Mediana Edad , Contracción Miocárdica/fisiología , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/fisiopatología , Nebivolol , Inhibidores de Agregación Plaquetaria , Estereoisomerismo , Resultado del Tratamiento , Vasodilatadores/administración & dosificación , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/fisiopatologíaRESUMEN
Value of functional state of endothelium in assessment of episodes of ischemia was studied in 93 patients (52 men and 41 women, mean age 58.3 +/- 4.8 years) divided into 2 groups. Group 1 comprised 47 patients with ischemic heart disease (IHD) and type II diabetes, group 2 comprised 46 patients with IHD without disturbances of carbohydrate metabolism. Patients of these groups had similar sex, age, and main risk factors. Examination included Holter ECG monitoring, stress test, echocardiography, test with reactive hyperemia (ultrasound measurement of endothelium dependent vasodilation of brachial artery). Number of painless ischemic episodes (PIE), total duration of episodes of ischemia, maximal depth of ST-segment lowering were greater in patients of group I compared with group 2. Correlation analysis revealed significant negative relationship between endothelial dysfunction and number and duration of episodes of ischemia, time interval between appearances of pain and ischemic ST depression.
Asunto(s)
Vasos Coronarios/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/fisiopatología , Endotelio Vascular/fisiopatología , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/fisiopatología , Ecocardiografía , Electrocardiografía Ambulatoria , Prueba de Esfuerzo , Femenino , Humanos , Hiperemia/fisiopatología , Masculino , Persona de Mediana Edad , VasodilataciónRESUMEN
The aim of the investigation was to study the significance of the functional condition of endothelium for the evaluation of ischemic episodes in patients with type 2 diabetes mellitus (DM2). Ninety-three patients (52 men; 41 women; mean age 58.3+/-4.8 years) were examined. Group 1 consisted of 47 patients with coronary heart disease (CHD) and CD2; group 2 consisted of 46 CAD patients without carbohydrate exchange disorder. Both groups were comparable by gender, age, and the main risk factors. The patients were examined using Holter monitoring, physical load test, EchoCG, reactive hyperemia test (ultrasound evaluation of the endothelium-dependent brachial artery dilation). The number of painless ischemic episodes (PIE), the total duration of ischemia, the maximum degree of ST depression prevailed in group 1 patients. Correlation analysis demonstrated a significant negative correlation between endothelial dysfunction, one the one part, and the number and duration of PIE and the time between the ischemic ST depression and pain syndrome, on the other, in group 1 patients.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Endotelio Vascular/fisiopatología , Isquemia Miocárdica/fisiopatología , Vasodilatación/fisiología , Anciano , Arteria Braquial/diagnóstico por imagen , Arteria Braquial/fisiopatología , Ecocardiografía , Electrocardiografía Ambulatoria , Endotelio Vascular/efectos de los fármacos , Prueba de Esfuerzo , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Contracción Miocárdica/fisiología , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/diagnóstico por imagen , Pronóstico , Índice de Severidad de la EnfermedadRESUMEN
The prognostic value of ventricular late potentials (VLP) and the character of rhythm disturbance were studied in 64 patients with acute coronary syndrome. 8 hours after system thrombolysis procedure VLP rate increased from 68.6% up to 85.7%. In all cases of reperfusion arrhythmia deterioration of signal-averaged ECG (SAECG) parameters and VLP were observed. Within the hospital treatment period VLP rate in the 1st group (patients receiving thrombolytic therapy) was lower than in the 2nd (no thrombolytic therapy). In the 1st group VLP was observed in 31.4% of the patients on the 10th day and in 11.4% by the end of hospital treatment; in the 2nd group--in 48.3% and 41.4% of the patients, respectively (p < 0.05). Administration of beta-adrenoblockers in both groups allowed improvement of SAECG parameters and cardiac rhythm variability.
Asunto(s)
Potenciales de Acción/fisiología , Angina de Pecho/complicaciones , Arritmias Cardíacas/fisiopatología , Fibrinolíticos/uso terapéutico , Frecuencia Cardíaca/fisiología , Terapia Trombolítica/efectos adversos , Potenciales de Acción/efectos de los fármacos , Angina de Pecho/tratamiento farmacológico , Arritmias Cardíacas/inducido químicamente , Quimioterapia Combinada , Electrocardiografía Ambulatoria/efectos de los fármacos , Femenino , Fibrinolíticos/efectos adversos , Estudios de Seguimiento , Frecuencia Cardíaca/efectos de los fármacos , Ventrículos Cardíacos/fisiopatología , Heparina/efectos adversos , Heparina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Estreptoquinasa/efectos adversos , Estreptoquinasa/uso terapéuticoAsunto(s)
Electrocardiografía/efectos de los fármacos , Fibrinolíticos/uso terapéutico , Isquemia Miocárdica/tratamiento farmacológico , Estreptoquinasa/uso terapéutico , Terapia Trombolítica/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/fisiopatología , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Effects of monotherapy with class IC, II and III antiarrhythmic drugs on parameters of signal averaged (SA) ECG and heart rate variability were studied in 88 patients (mean age 45.6+/-7.8 years). Class IC drugs (ethacizine, disopyramide) caused worsening of qualitative parameters of SA ECG and appearance of ventricular late potentials. Therapy with beta-adrenoblockers, amiodarone and sotalol in patients with ventricular arrhythmias was associated with improvement of parameters of SA ECG, lowering of sympathetic and augmentation of parasympathetic activity without sings of arrhrythmogenic and negative inotropic effects. Combination of noninvasive diagnostic methods including SA ECG, temporal and spectral analysis of heart rate variability, Holter ECG monitoring can facilitate selection of appropriate antiarrhythmic therapy and control of its efficacy.
Asunto(s)
Antiarrítmicos/farmacología , Antiarrítmicos/uso terapéutico , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/tratamiento farmacológico , Electrocardiografía/métodos , Frecuencia Cardíaca/efectos de los fármacos , Corazón/efectos de los fármacos , Antagonistas Adrenérgicos beta/farmacología , Antagonistas Adrenérgicos beta/uso terapéutico , Adulto , Amiodarona/farmacología , Amiodarona/uso terapéutico , Arritmias Cardíacas/fisiopatología , Interpretación Estadística de Datos , Disopiramida/farmacología , Disopiramida/uso terapéutico , Electrocardiografía Ambulatoria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fenotiazinas/farmacología , Fenotiazinas/uso terapéutico , Sotalol/farmacología , Sotalol/uso terapéuticoRESUMEN
Thirty patients with subclinical thyrotoxicosis and 32 with subclinical hypothyroidism with attacks of atrial fibrillation were investigated. At levels of thyroid-stimulating hormone below 0.1 or above 10.0 mIU/l average triiodothyronine and thyroxine levels in patients with subclinical thyrotoxicosis were 89.6 and 73.2%, respectively, higher than in patients with subclinical hypothyroidism. Some relationships were found between levels of thyroid hormones and hemodynamic and electrophysiological parameters of the heart. Differential therapy of attacks of atrial fibrillation was effective in 80 and 62.5% of patients with subclinical thyrotoxicosis or hypothyroidism, respectively.