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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In patients with unexplained syncope and documented nonsustained VT or complex premature ventricular beats indication for programmed ventricular stimulation (PVS) should be considered. However, the variables derived from noninvasive methods that predict diagnostic yield of PVS are incompletely defined. The purpose of this study was to elucidate the role of noninvasive testing variables in predicting inducible monomorphic sustained ventricular tachycardia (SVT) in 116 patients (pts) presenting with syncope. The study group consisted of 45 pts with remote Q wave myocardial infarction. 5 pts with non-Q wave myocardial infarction, 21 pts with another heart disease and 45 pts without organic heart disease. All pts underwent standard ECG, Holter monitoring, echocardiography, signal-averaged ECG and PVS with 1, 2 and 3 extrastimuli at three basic cycle lengths. Nonsustained VT, low ejection fraction, prolongation of QTc interval, abnormal Q waves in postinfarction pts (Q-MI) and late potentials (LP) indicate a greatly increased probability of inducible SVT. Inducible SVT was present in 15 of 45 (33%) pts with Q-MI. Although in the group of 71 pts without Q-MI, nonsustained VT on Holter monitoring was detected in 20 pts, LP in 16 pts, prolongation of QTc interval in 3 pts and low ejection fraction in 2 pts, the positive yield of PVS was documented in only one case (1%). The combination of Q-MI and LP best predicted inducible SVT showing a sensitivity of 75%, specificity of 93%, overall predictive accuracy of 91%, predictive value of positive response of 63% and negative response of 69% to identify pts who would have inducible SVT. Thus, the combination of Q-MI and LP variables was shown as the best predictor of inducible SVT in pts with unexplained syncope. In pts without Q-MI the noninvasive testing variables have considerably less value in selection of pts to PVS, because inducible SVT is very rare in this population.
Kardiol Pol 1993 Oct
PMID:[Unexplained syncope. Likelihood of inducing sustained ventricular tachycardia with electrophysiologic examination]. 824 55

A quantitative and qualitative analysis of ventricular arrhythmia was performed in 120 patients (64 men and 56 women, mean age 54 +/- 16) who suffered from arterial hypertension or congestive heart failure in the course of organic heart disease or ischaemic heart disease. 60 of them were treated with diuretics and the other 60 were control group. Neither antiarrhythmic drugs nor digitalis were used. There were no signs of left ventricular hypertrophy. Most patients treated with diuretics received potassium supplementation. Besides clinical examination all patients underwent 24 hours monitoring of Holter ECG. 38 patients treated with diuretics were evaluated before and after 6 months of therapy. In the diuretic group significantly higher percentage of patients with greater density of premature ventricular beats (count of premature ventricular beats [PVB]/100,000 heart evolutions) was observed. Number of patients with complex ventricular arrhythmia (Lown IVa and IVb) was also greater in this group. Serum levels of potassium and magnesium fell within the normal range, but the latter was significantly lower (p < 0.05) in those treated with diuretics.
Pol Arch Med Wewn 1993 Sep
PMID:[Ventricular arrhythmia in patients treated with diuretics]. 828 46

Holter monitoring is one of the most commonly done test in the evaluation of patients with syncope. As Holter monitoring may miss an arrhythmia or document an asymptomatic arrhythmia invasive electrophysiologic testing has been applied in patients with syncope. The purpose of this study was to compare Holter monitoring and electrophysiologic tests in patients with syncope of unexplained origin. The group consisted of 100 patients with syncope of unknown origin. Coronary artery disease was present in 43 patients, other heart disease in 19 patients and no structural heart disease was found in 38 patients. Electrophysiological testing consisted of (1) recording of His bundle electrogram, (2) atrial stimulation, (3) ventricular stimulation with 1.2 and 3 extrastimuli at three basic cycle lengths. The results of Holter monitoring were classified by severity of abnormalities into three classes: I--normal study; II--moderate abnormalities; III--severe abnormalities: sinus rhythm with pauses longer than 3 s, Mobitz II or complete atrio-ventricular block, supraventricular arrhythmia faster than 180 bpm, sustained ventricular tachycardia. Abnormalities of electrophysiologic testing were grouped as: I normal study; II--moderate abnormalities; III--severe abnormalities: sinus nodal recovery time more than 3 s, HV interval longer than 100 ms, supraventricular arrhythmia faster than 200 bpm, sustained ventricular tachycardia. Class III abnormalities were documented in 17 patients on Holter monitoring and in 20 patients by electrophysiologic testing. Compatibility between class III abnormalities in Holter monitoring and electrophysiological testing was noted in 4 patients, discordance of class III results in 33 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Kardiol Pol 1993 Jul
PMID:[Paroxysmal loss of consciousness. Comparison of electrophysiologic and holter monitoring results]. 841 41

Free oxygen radicals are highly active oxygen compounds contributing to several pathological states. A possible source of free oxygen radicals during reversible ischemic heart disease and mechanisms of their toxicity to the myocardium are discussed. Despite controversial results of clinical trials with the use of antioxidants in reducing an area of necrosis in the experimental myocardial infarction, it seems that free oxygen radicals play an important role in ischemic-reperfusion heart disease. Some promising results with the use of antioxidants (significant decrease in dyskinesis of ischemic left ventricular muscle and reduction of cardiac arrhythmias incidence) may be of clinical importance.
Pol Tyg Lek
PMID:[Role of oxygen free radicals in ischemic reperfusion lesions to the myocardium]. 841 39

The aim of study was to assess the value of signal averaged ecg for detection of patients (pts) at risk for paroxysmal atrial fibrillation (paf). We examined three groups of pts: group I-41 pts with nonvalvular paf, group II-20 pts with hypertension and/or ischemic heart disease without paf and group 3-26 health persons, without organic heart disease. In all pts the signal-averaged electrocardiogram triggered by P waves was recorded. Seven parameters of the spatial magnitude of filtered P wave were measured. Significant difference between group I and group II or III was found in most parameters. Using the method of multidimensional variance analysis we constructed "the diagnostic vector" in multidimensional parameters space, which was used to determine patients belonging to group. Total percent of right decision was 85%. These findings suggest that pts at risk for paf could be detected while in sinus rhythm by using the P wave-triggered signal-averaged ecg.
Pol Tyg Lek 1995 Oct
PMID:[P-wave ekg averaging technique--a new method of selecting patients with paroxysmal atrial fibrillation]. 865 57

Of the total 25381 delivered in our Department, in the time from January 1987 to December 1993, 175 (0,69%) were from pregnancies with complicated by diabetes mellitus. 171 of that number ended with healthy babies (172), which is a relatively satisfactory outcome. Only 4 patients lost their babies. They were 3 patients admitted to our programme late in their pregnancy period. Already during their first medical examination the diagnosis was a) nonviable pregnancy in 1 case and b) multiple, congenital defects in the remaining 2 cases. 1 baby was died three days after delivery (congenital heart disease). All patients attended classes of special diabetes mellitus education in the Pathology Ward. Each patient underwent programmed control visits by obstetrician and diabetologist; metabolic therapy reached the level of near normoglycemia. In each case the time of delivery was selected individually. As result of such approach majority of patients gave natural birth. Only in 29 cases (16,6%) caesarean operation was performed. The reason for caesarean operation in 12 of the 29 cases was a previous operation of this kind. In the other 5 cases natural birth was impossible, because of the big foetus. Observation of the newborn babies during their first days of life showed that most of them suffered from the following complications: hypoglycaemia (39,8%), hyperbilirubinemia (25,1%), anaemia (12,9%) and hypocalcaemia (7%). All the babies being in generally good condition were discharged from the hospital on the 5th-10th day together with their mothers. It seems that such good results could obtained owing to special programme, which could by applied also in Regional Gynecological-Obstetrical Ward with help of a local diabetologist.
Pol Tyg Lek 1996 Jan
PMID:[Diabetes mellitus complicating pregnancy]. 875 96

The aim of this study was to assess if amiodarone hydrochloride administered intravenously influenced signal-averaged electrocardiogram and if this effect can be used in diagnosing patients prone to sustained ventricular tachycardia (sVT). Two hundred thirty seven patients were divided into 3 groups: group K--58 patients with no apparent heart disease, group W--121 patients with remote myocardial infarction and group C-58 patients with remote myocardial infarction and at least one episode of sVT. Signal-averaged electrocardiograms (SAECG) were assessed in time domain (QRS, LPD, RMS40) and frequency domain analysis logarhythmically (40 D, 60 A) and linearly [formula: see text] for windows lasting 120 and 140 ms, and starting 20, 40, 80 ms before the end and 60 ms after the beginning of QRS complex. Amiodarone hydrochloride increased frequency of late potentials (LP) in all groups especially in group C (K 5.2%-9.1%, W 33.9%-41.4%, C 75.9% -90.9%. Amiodarone hydrochloride prolonged total activation time--QRS (K -4.27 ms, W -6.06 ms, C -5.82 ms), time of low amplitude signals LPD (K -2.64 ms, W -2.87 ms, C -5.39 ms) and decreased the amplitude of RMS40 (K -2.12 mV, W -4.67 mV, C -5.0 mV). In group C the influence of amiodarone hydrochloride was found the strongest in the terminal part of the QRS complex whereas its influence on total activation time of QRS complex was weaker. We concluded that in patients prone to sVT amiodarone hydrochloride most strongly influenced the terminal part of QRS complex which suggested predominant influence on the zone of delayed conduction and amiodarone hydrochloride non significantly influenced on the results of frequency domain analysis.
Pol Arch Med Wewn 1996 Apr
PMID:[The influence of amiodarone on results of the signal-averaged electrocardiogram]. 875 35

Magnetic resonance imaging is the next in a succession of noninvasive methods for evaluation of the heart and great vessels after total correction in congenital heart disease and percutaneous interventional cardiology procedures. Between October 1994 to March 1995 we performed 28 magnetic resonance investigations in children after surgical treatment of coarctation of the aorta and after Senning, Rastelli and Fontan procedures. Five children after correction of coarctation of the aorta were qualified for balloon angioplasty. After hemodynamic evaluation and aortography, balloon angioplasty was done in 3 children. In children after Senning, Rastelli and Fontan procedures no postoperative abnormalities were detected. Magnetic resonance imaging is a usefull, noninvasive method in long-term follow-up of patients after total correction in congenial heart disease.
Pediatr Pol 1996 Mar
PMID:[Evaluation of the usefulness of magnetic resonance imaging after correction of congenital heart disease in children--pilot experiment]. 896 92

Abnormalities in left ventricular (LV) diastolic function may be the earliest indications of hypertensive heart disease. Because the two ventricles influence each other's performance this study was designed to investigate the impact of chronic LV pressure overload in essential hypertension (HT) on diastolic function of right ventricle (RV). RV and LV diastolic function was evaluated in 74 patients with mild-to-moderate essential HT using pulsed wave Doppler echocardiography. Fifty-five normotensive patients without heart disease acted as control subjects. In studied group, 17 patients (23%) had normal mitral (MV) and tricuspid (TV) flow parameters, 28 (38%) had impaired LV filling parameters [MV early (E) to late (A) peak flow velocity ratio (MV E/A) 0.81 +/- 0.12 vs control 1.19 +/- 0.18, p < 0.001] while 29 patients (39%) had abnormal both mitral [MV E/A) 0.72 +/- 0.15 vs control 1.19 +/- 0.18, p < 0.001] and tricuspid flow parameters (TV E/A) 0.8 +/- 0.19 vs control 1.23 +/- 0.1, p < 0.001). In group with impaired diastolic filling of both ventricles indices of mitral flow were significantly more abnormal compared to group with normal TV flow parameters (MV E/A 0.72 +/- 0.15 vs control 0.81 +/- 0.12, p < 0.05). RV filling parameters correlated with filling parameters. There was good correlation between TV A and MV E (r = -0.56, p < 0.01), the time velocity integral of early mitral inflow (MV E-VTI) (r = -0.64, p < 0.001) and positive correlation with MV A (r = 0.78, p < 0.0001). Also there was good correlation between LV mass and TV E (r = -0.56, p < 0.01) and the time velocity integral of early tricuspid inflow (r = -0.72, p < 0.001). Data indicate that RV diastolic function is abnormal in essential hypertension and these abnormalities are closely related to those of LV diastolic function and LV mass.
Pol Arch Med Wewn 1997 Apr
PMID:[Right ventricular diastolic disfunction and its relation to left ventricular performance in patients with hypertension]. 941 9

Pharmacologic management of patients with ventricular arrhythmias remains in a state of considerable flux. New findings from controlled clinical trials, suggest that use of the principles of risk stratification permits identification of patients at very high risk for developing sustained ventricular tachyarrhythmias or ventricular fibrillation. Available data suggest that patients with sustained ventricular tachyarrhythmias require treatment. Patients with frequent ventricular ectopy or nonsustained ventricular tachycardia in the absence structural heart disease do not require treatment except when relief of symptoms is warranted. The indication for treatment of patients with underlying structural heart disease, particularly coronary artery disease and a previous myocardial infarction, who manifest frequent ventricular ectopy or more particular nonsustained ventricular tachycardia remain uncertain. From meta-analytic studies, it has become clear that beta-blockers reduce sudden death and total cardiac mortality. Data also suggest that amiodarone appears to be the safest antiarrhythmic drug for treatment sustained and nonsustained arrhythmias, and improved survival in patients with advanced heart failure.
Pol Merkur Lekarski 1997 Aug
PMID:[Pharmacologic treatment for ventricular arrhythmias]. 948 Jan 72


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