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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of angiotensin converting-enzyme inhibitors in the therapy of chronic heart failure are well documented and is mainly explained by a decrease of afterload via reduction of angiotensin II formation in the vascular system and myocardium. The aim of our study was to study the effectiveness of ACCUPRO on structural and hemodynamic indices in patients with heart failure. 37 patients aged 61-84 years with postinfarction cardiosclerosis and mild or moderate hypertension, class I-III heart failure received Accupro (13,7+/-0,97 mg/day) for 3 months in combination with furosemide (40-80 mg 1-3 times a week). The treatment with Accupro and diuretics was associated with corrective effect on left ventricular and diastolic dimension, increases of left ventricular ejection fraction and cardiac index. Left ventricular diastolic function improved in more than two thirds of patients. Positive dynamics of structural-functional state of the heart was accompanied with lowering of total peripheral resistance. Our results indicates that Accupro has positive effects in treatment of chronic heart failure.
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PMID:[Effects of Accupro on structural and hemodynamic changes in patients with chronic heart failure]. 1590 28

The purpose of the study was to investigate the character of clinical and functional manifestations of ischemic cardiac dysfunction in patients with idiopathic coronary microangiopathy, and their correlation with insulin level, as a possible diagnostic criterion of coronary heart disease (CHD). The subjects were 115 men, including 35 individuals (mean age 41.8 +/- 1.2 years) with microvascular form (MVF) of coronary artery lesion, 60 patients with CHD with postinfarction cardiosclerosis (PICS), and 20 healthy individuals. Patients with glucose tolerance disorder, diabetes mellitus, arterial hypertension, and other severe pathology were not included in the study. The diagnostic tests included selective coronaroventriculography with right ventricle endomyocardium biopsy, and myocardial perfusion scintigraphy. Parameters of coronary, intracardial and system hemodynamics were evaluated; insulin and glucose serum levels were measured at rest and during stress-tests with physical exercise. Endocardial biopsy in MVF patients found plastic insufficiency of the endothelium of hemocapillars, prearteriols and cardiomyocytes. Alterations in the parameters of metabolism, intracardial and system hemodynamics, and physical exercise tolerance were found to be comparable in MVF and PICS patients. Insulin level at rest in both groups was equal to that in the control group. At threshold physical load during veloergometry insulin levels in MVF and PICS patients demonstrated comparable elevation (222.8% and 201%, respectively; p < 0.05-0.01). Glucose concentrations in patients with microangiopathy decreased by 28% (p < 0.05), while in patients with CHD it increased significantly by 27.3% (p < 0.05). The study shows that structural and functional lesion of hemocapillar endothelium underlies cardiac syndrome X It results in perfusion ability impairment, chronic hypoxia, impairment of myocardial contractility under the conditions of physical activity. Hyperinsulinemia, manifesting when ischemia is induced, is not caused by insulinresistence. Probably, it presents and adaptive and compensatory reaction to increase of myocardial glucose requirement, and may be one of early CHD markers.
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PMID:[Hyperinsulinemia in patients with microvascular coronary artery lesion as a possible diagnostic criterion of coronary heart disease]. 1607 44

The subjects of the study were 85 patients with arterial hypertension alone or in combination with coronary heart disease with stable stenocardia attacks and postinfarction cardiosclerosis. The purpose of the study was to evaluate the peculiarities of left ventricular (LV) remodeling in such patients. The study demonstrated peculiarities of the structural and geometric indices in men and women, as well as their connection with the process progression within the framework of the cardiovascular continuum. The authors offer an original scheme of the dynamics of cardiovascular system condition in connection with exposure to risk factors and the forming of concentric or eccentric LV hypertrophy. The studies of structural changes included in the scheme may serve as a study model of the most important mechanisms responsible for progression or regression of the pathological changes in the LV at particular stages of the disease.
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PMID:[Left ventricular remodeling in patients with arterial hypertension]. 1682 77

The study of predictors of the development of arrhythmia in elderly age people with IHD is an important task requiring the thorough investigation. The presence of late potentials of ventricles (LPV) is considered presently as one of the most highly informative parameters indicating an electrical inhomogeneity of myocardium, which would result in cardiac rhythm disturbance. The presence of early, late ventricle potentials as well as a dispersion of QT, QRS and T intervals are believed to be the predictors of arrhythmia along with other indices. The study focused on determining a frequency of such predictors among patients of 60-74 y.o. with various clinical picture of IHD. 300 patients were observed: 120 of them with IHD, 100--additionally having essential hypertension, 60--PICS (postinfarction cardiosclerosis), 20--HF. 20 people aged 60-89 formed the control group. The registration of LPV, EPV as well as QT, QRS and T dispersion was carried out by means of Megacart electrocardiograph (produced by "Siemens" company, Germany). The findings are the following: 48 % of the patients with IHD were found with LPV, 33%--with EPV (early potentials of ventricles). LPV is also more frequently met in the patients with IHD complicated with heart failure (HF) and hypertension; dispersion of QRS and T is for sure higher in patients with IHD and HF.
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PMID:[High resolution electrocardiogram in the diagnosis of risk of the cardiac rhythm disorder development in elderly patients with ischemic heart disease]. 1705 4

We carried out a multicenter controlled study of case histories of patients with schizophrenia and acute myocardial infarction (AMI) or postinfarction cardiosclerosis (PIC) from cardiological (n=44), psychosomatic (n=19) and psychiatric (n=23) hospitals was. In hospital mortality, ischemic heart disease (IHD) risk factors, peculiarities of IHD course, antipsychotic therapy were analyzed. Elevation of in hospital mortality related to PIC and its complications was revealed in somatopsychiatric (21% vs 1.26%; p<0.05) and psychiatric (29% vs 1.26%; p<0.05) hospitals. Hypercholesterolemia, excess weight in patients with schizophrenia were met more rarely (36, 32, 9, 21%, 16, 0% vs 61, 45%, respectively; p<0.05) while diabetes mellitus (5, 5, 9% vs 15%, respectively; p>0.05), arterial hypertension (89, 84, 45% vs 77%, respectively; p>0.05) - with same frequency as in comparison group. Patients with schizophrenia do not differ from persons not suffering from this psychiatric disease by proportion of patients with AMI (39, 47, 49% vs 43%; p>0.05) and PIC (73, 74, 61% vs 73%; p>0.05). Probability of effect of inadequate body weight and psychotherapy with phenothiazine derivatives and antiparkinsonian cholinolytic medications on elevation of mortality of patients with IHD and schizophrenia is discussed.
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PMID:[Ischemic heart disease in patients with schizophrenia (clinico-epidemiological study)]. 1749 45

Coronary artery bypass grafting (CABG) has been widely used for the treatment of patients with coronary artery disease. Patients with low ejection fraction (EF) are at a higher risk for postoperative complications and mortality. Our objective was to assess the effect of low EF on clinical outcomes of CABG. We analyzed 1156 patients, who have undergone CABG in our department between 2002 - 2009 years. Patients were stratified into I of II EF groups: I Group - EF< or = 35% (100 patients) and II Group - EF > 35 % (1056 patients). EF was estimated by left ventriculography preoperatively and by echocardiography postoperatively. Surgical treatment was carried out only in cases, where the target coronary arteries were of relatively good diameter, to achieve complete revascularization. Group I experienced a higher incidence of postoperative respiratory failure. intraoperative mortality - 0, postoperative mortality- 4 (4%), reoperation - 0. Postoperative survival data were available for 73 patients. These data were obtained from our own medical records. This follow up manifested, that long term survival was 95, 8%. EF significant improvement (EF >40%) was in 82% and EF unimportant improvement only in 13% of cases. Multivariate analysis showed previous myocardial infarction, congestive heart failure, age, diabetes mellitus and arterial hypertension as independent significant predictors of in-hospital complications. Patients with low EF have higher incidence of postoperative complications, as well as preoperative sickness and risk factors, than patients with normal EF. Therefore CABG remains a viable option in selected patients with low EF. In patients with compromised left ventricular function and low EF, caused by atherosclerotic cardiosclerosis, lyal factors of CABG are angina and qualitative coronary arteries.
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PMID:Coronary artery bypass grafting in patients with low ejection fraction. 1999 96

The aim of the study was to estimate efficiency and safety of treatment by non-direct anticoagulant--warfarex in the patients with persistent and paroxysmal forms of AF for the prevention of thromboembolic complications. 55 patients between 37 and 75 years old with atrial fibrillation (AF) were investigated. Follow-up was 2 years. Primary diseases were post myocardic cardiosclerosis, cardiomyopathy, IHD, arterial hypertension. The patients with persistent form of AF underwent treatment by warfarex. In the case of paroxysmal form of AF patients were prescribed warfarex during the first 48 hours from the beginning of paroxysm and for 3-4 weeks after cardioversion. The dose of warfarex was chosen according International Normalized Ratio (2.0-3.0). The results of the study show, that warfarex is effective and safe for the prevention of thromboembolic complications in the case of persistent and paroxysmal forms of AF.
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PMID:[Prevention of insult with nondirective anticoagulant therapy by warfarin (warfarex) in patients with atrial fibrillation]. 2143 76

Analysis of experimental data indicates that aging, metabolic syndrome may be serious obstacle against realization of cardioprotective effect of postconditioning. The moderate hypercholesterolemia, postinfarction cardiosclerosis and cardiac hypertrophy do not abolish protective effect of postconditioning in experimental animals. The issue whether diabetes mellitus and arterial hypertension affect an efficacy of postconditioning is a subject of discussion. Clinical investigations testify on cardioprotective impact of postconditioning in patients with acute myocardial infarction and cardiosurgery patients. At the same time, it is remained unclear when after coronary artery occlusion postconditioning exhibits cardioprotective effect. It is remained unknown how do affect aging, diabetes mellitus, metabolic syndrome, arterial hypertension, myocardial hypertrophy, cardiac postinfarction remodeling and efficacy postconditioning in clinical praxis. It is required a further clinical investigations turning the development pharmacological approaches to prophylaxis of reperfusion injury of the heart.
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PMID:[Adaptive phenomenon of ischemic postconditioning of the heart. Perspectives of clinical use]. 2380 34

This study focuses on the most topical issue: non-cardiac surgery safety in elderly patients. According to different authors data, the mortality rate due to cardiovascular pathology %, and postoperative cardiac events incidence -from 2 to 4.4 %. For this reason we decided to conduct prospective risk assessment in the most dificult elderly patients group. Within the framework of this study we performed cardiorespiratory exercise testing (KAREN-test) in 17 elderly patients with various located colon cancer Concomitant diseases were: ischemic heart disease (12 patients), postinfarction cardiosclerosis (4 patients), arterial hypertension (12 patients), rhythm disturbances of varying degrees (11 patients), CHF (2 patients), and others. Patients were aged from 58 to 94 years. Subsequently, 14 of 17 patients were operated on, 11 of them underwent radical intervention. Cardiorespiratory exercise tolerance test was carried out according to moderate treadmill-test protocol for elderly patients developed in our clinic. Test duration was more than 4 minutes in all patients. During exercise stress peak, submaximal heart rate was observed in all patients, the peak oxygen consumption to a maximum current oxygen consumption ratio amounted to 94% on the average in a group, the oxygen consumption at the aerobic threshold level exceeded 11 mI/min/kg in all patients. There was no acute myocardial infarction and cerebrovascular events during perioperative period; the hospital mortality rate was 0%. Actual age by itself is not a contraindication for surgery. KAREN tests should become one of the key components for the assessment and treatment tactics choice.
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PMID:[Cardiorespiratory exercise tolerance tests: a preoperative surgical risks assessment in elderly patients]. 2400 Jun 47

We performed 89 transesophageal electric cardiac stimulation procedures (TEECS) in order to restore sinus rhythm in 75 (84.3%) men and 14 (15.7%) women with type I atrial flutter (AF) due to coronary heart disease (n=59, 66.3%) and cardiosclerosis after myocarditis (n=30, 33.7%). Before cardioversion all patients underwent transthoracic and transesophageal echocardiography. All patients were divided into two groups: in group I (n=39) mean left atrium appendage ejection velocity was less or equal 40 cm/s, in group 2 (n=50) - > 40 cm/s. Patients of group I had significantly longer duration of AF episode, more often had concomitant hypertension and atrial fibrillation. Cardioversion in group I was less effective with frequent relapses and transformation into constant form. Patients of group 2 had no spontaneous contrast phenomenon grade II-IV and intra-atrial hemodynamics of type II-III, while at TEECS cardioversion straight into sinus rhythm without episode of transient fibrillation was observed significantly more frequently, suggesting possibility of shortening of anticoagulant preparation period before the procedure.
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PMID:[Assessment of results of transesophageal echocardiography in patients with atrial flutter]. 2408 61


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