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Biomedical subjects

A A Smirnov

Publications and source records attributed to A A Smirnov.

At least 19 recordsLinked to original sources
PubMed1995

[Predictors of coronary artery restenosis in IHD patients after transluminal balloon coronary angioplasty].

To determine clinical and angiographic predictors of restenosis after successful PTCA, we analysed the data on 63 patients (68 stenoses) who had undergone repeat coronary angiography during the first eight months after successful PTCA. The overall restenosis rate was 42.6%. Four clinical and angiographic factors were associated with high risk of restenosis. Residual stenosis > or = 25% was the strongest predictor of restenosis (p = 0.002). Among other factors presence of unstable angina, complicated lesion morphology and absence of intimal dissection had equal value of significance (p = 0.02 in all the cases).

Angioplasty, Balloon, Coronary↗
PubMed1993

[Left ventricular function in patients with ischemic heart disease at the moment of acute myocardial ischemia induced by transesophageal cardiac electrostimulation].

Repeat transvenous multiphase left ventriculography was performed in 14 patients with coronary stenosis diagnosed by clinical and angiographic findings. The procedure was conducted before and in the course of transesophageal pacing. The latter provoked acute myocardial ischemia responsible for a wide range of left ventricular dysfunctions which are analyzed in the paper in terms of cardiomanometry parameters, cardiocycle energetic balance, diastolic function and local motions of the camera walls.

Acute Disease↗
PubMed1993

[Left ventricular function in patients with arterial hypertension during the performance of acute drug tests with captopril and nifedipine].

An examination was made of 22 hypertensive patients with clinical and echoCG symptoms of left ventricular hypertrophy. All the patients underwent coronary angiography, transvenous multiphase left ventriculography and acute captopril (11 patients), nifedipine (11 patients) tests. A single oral 25 mg dose of captopril increased energetic efficacy of cardiocycle, restored diastolic function of the left ventricle, aroused myocardial contractility.

Adult↗
PubMed1993

[Left ventricular function in patients with arterial hypertension and myocardial hypertrophy based on the data of multiphasic ventriculography].

The study included 39 hypertensive subjects with clinical echocardiographic evidence of left ventricular hypertrophy. All the patients were subjected to coronary angiography and transvenous multiple-phase left ventriculography. Early subclinical signs of left ventricular dysfunction in hypertensive patients have been defined. They concern energetic efficacy of the cardiac cycle, left ventricular diastolic function, myocardial asynchronism. It is noted that the above dysfunction was recorded in cases where standard two-image analysis provides normal values.

Adult↗
PubMed1992

[The function of the collateral bed in patients with ischemic heart disease and isolated occlusion of the anterior descending branch of the left coronary artery].

To study the collateral bed, 39 coronary heart disease patients with isolated occlusion of the anterior descending artery without a history of large-focal myocardial infarction were examined. All the patients were subjected to coronary angiography and left ventriculography. Based on an analysis of left ventricular myocardial contractility, the patients were distributed into 2 groups. The first group included 16 patients without disorders of local contractility of the left ventricular myocardium, the second one 23 patients with derangement of local contractility of the left ventricular myocardium. The conclusion is made that in patients suffering from stable angina pectoris with isolated occlusion of the anterior descending artery without a history of large-focal myocardial infarction, exclusively intersystemic collateralization of the vessel via the conal artery (or the conal branch of the right coronary artery) is most favourable from the standpoint of the maintenance of myocardial contractility.

Collateral Circulation↗
PubMed1992

[Left ventricular function in patients with ischemic heart disease and "critical" stenosis of one coronary artery. The data from multiphasic ventriculography].

As many as 38 patients with the clinical and angiographic signs of "critical" stenosing of one coronary artery were examined. All the patients underwent coronary angiography and transvenous multiphase left ventriculography. The authors defined a complex of fairly early, "preclinical" signs of myocardial ischemia, pertaining to the energetic effectiveness of the cardiocycle, diastolic function of the left ventricle and indices of the local movement of chamber walls. It is important that these signs are recordable in minimal, clinically undetectable myocardial ischemia characterized by the lack of anginous pain, no changes in the ECG, and when the two-picture analysis, commonly used in clinical practice, provides normal results.

Adult↗
PubMed1992

[Prognostic significance of various qualitative and quantitative indicators of coronary angiography in patients with unstable stenocardia].

The coronary bed was qualitatively and quantitatively examined in 41 patients with unstable angina pectoris. The patients were divided into two groups: (1) those with uncomplicated angina and (2) those with complicated angina in relation of follow-up (mean 3.1 +/- 0.8 years) findings. In patients with a poor coronary heart disease outcome a symptom-related lesion was more frequently located mainly in the left coronary trunk during clinical manifestations of unstable angina pectoris, along with more severe overall lesion in the coronary bed. They had also higher incidence rates of complicated lesions and higher values of three quantitative parameters (stenosis extent, the mean and proper diameters of a stenotic segment in the symptom-related vessel) determined by semiautomatic stenosis configuration analysis.

Adult↗
PubMed1991

[State of the coronary arteries and function of the left heart ventricle in patients with ischemic heart disease with silent episodes of myocardial ischemia].

The results of multiviewed coronary angiography with left ventriculography were compared in 36 patients with coronary heart disease concurrent with Functional Classes II-IV stable angina pectoris, who had had frequent episodes of silent myocardial ischemia (SMI), as evidenced by Holter monitoring, and in 23 patients with coronary heart disease in the presence of Functional Classes II-IV stable angina pectoris without SMI episodes. In patients with SMI, the changes in coronary arteries were found to have some features: the extension of an atherosclerotic process (common lesion of all three major arteries), its frequent site in the main trunk of the left coronary artery, high collateralization in the diseased vascular channels, and great extent of stenoses. There were no differences between the groups in the major functional parameters of the left ventricular myocardium.

Adult↗
PubMed1991

[The effects of delayed transluminal balloon coronary angioplasty in myocardial infarct patients with early thrombolytic recanalization of the coronary artery: the results of dynamic quantitative angiography].

As many as 71 patients with the developing large-focal myocardial infarction (MI) were entered into the study. The purpose was to examine the dynamics of the status of the coronary arteries and left ventricular function in MI patients with early recanalization of the infarct-related artery (IRA) as a result of thrombolytic therapy (TLT) and delayed transluminal coronary angioplasty (TCA). Coronary arteriography and left ventriculography were provided 3 times to all the patients: within the first 4 hours of the disease (in combination with TLT), on days 4-6 of the disease (in combination with TCA of the IRA), and after 6 months of observation. It is concluded that the combined use in MI patients of coronary thrombolysis within the first 4 hours of the disease and delayed TCA (on days 4-6 of the disease) ensure steady recovery of IRA patency, with an insignificant residual stenosis of the artery. At the same time the patients demonstrated improvement of local contractility of the deranged compartment of the left ventricle by the 6th month of observation. Restenosis of the recanalized IRA that occurs during 6 months of observation after the interventions performed does not affect the recovery of left ventricular function.

Angioplasty, Balloon, Coronary↗
PubMed1991

[The ST-segment-dependent indices of patients with left ventricular hypertrophy and coronary failure].

As many as 40 men suffering from essential hypertension (EH) and left ventricular hypertrophy (LVH) or hypertrophic cardiomyopathy (HCMP) were examined. All the patients exercised on a treadmill according to the Cornell protocol taking into consideration the ST/HR slope and the ST/HR index, underwent echocardiography with measurements of the left ventricular mass (LVM), and coronary ventriculography. Coronary insufficiency was revealed in all the patients. Of these, 11 patients suffered from it due to associated EH and coronary heart disease (CHD), 31 had relative coronary insufficiency in the presence of associated EH and LVH phenomena with no stenosis of coronary vessels, and 7 patients showed up relative coronary insufficiency in the presence of HCMP. The ST/HR slope and the ST/HR index correlated well with the LVM and the asymmetry index of the left ventricle but in patients with associated relative coronary insufficiency and EH. In patients with associated EH and CHD, the ST-dependent parameters correlated well neither with the degree of atherosclerosis spreading nor with the LVM. This may indicate that both factors influence the gravity of coronary insufficiency at a time. In case a patient suffering from associated EH and coronary insufficiency phenomena has the ST/HR slope greater than or equal to greater than or equal to 4.5 microV/stroke/min and/or the ST/HR index greater than or equal to greater than or equal to 2.5 microV/stroke/min, it is more likely that myocardial ischemia is provoked by concomitant atherosclerosis of coronary arteries (sensitivity 28%, specificity 71%).

Adult↗
PubMed1991

[An analysis of the myocardial contractile function of the left ventricle in patients with ischemic heart disease and isolated involvement of the anterior descending artery based on data from x-ray contrast ventriculography].

Coronaroventriculography was performed in 36 patients with an isolated injury to the anterior, descending artery (ADA) and in 32 patients with concomitant injury to the ADA and the right coronary artery (RCA) or to the circumflex artery. Associated injury to the ADA and RCA resulted in greater disorders of left ventricular function than an isolated injury to the ADA. Dysfunction of the left ventricle was less pronounced in patients with an isolated injury to the ADA in the presence of postinfarction angina pectoris whereas in ADA occlusion, in proper collateral filling of the vessel.

Angiography, Digital Subtraction↗
PubMed1990

[Effects of restoration of coronary circulation on the function of the left ventricle in patients with acute myocardial infarction (a follow-up after 1 year)].

Values of overall and local left ventricular function were studied in 89 patients in the acute period and 1 year following myocardial infarction. Three patient groups were identified: (1) 26 patients with coronary artery patency recorded by the first coronary angiography; (2) 20 with coronary blood flow recovery made by thrombolytic therapy; and (3) 40 with coronary occlusion. There was a significant improvement of left ventricular function in the patients from Group 1 during their hospital treatment and 1 year after.

Adult↗
PubMed1990

[Results of repeated coronary angiography in patients with unstable angina pectoris in a long-term follow-up].

A total of 27 patients with unstable angina pectoris were examined in the acute period of the disease and 3.4 years later (from 30 to 51 months). A group of patients with a favorable outcome of unstable angina comprised 13 patients who had displayed no recurrences of disease exacerbation, but that of patients with an unfavorable outcome of unstable angina consisted of 14 patients who had had recurrences of symptoms of progressive angina until myocardial infarction (in 6 patients). Coronary angiography made during the first hospitalization showed that 40% of the patients exhibited a "complicated lesion" of the symptom-related artery, which further transformed to an uncomplicated one (Type I stenosis according to the classification by J. Ambrose et al.), the remaining developed coronary occlusion. Comparison of the specific features of a course of the disease and coronary angiographic findings revealed no relationship between the degree of symptom-related artery stenosis and the long-term outcome of unstable angina.

Adult↗