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Biomedical subjects

A Elenkova

Publications and source records attributed to A Elenkova.

At least 19 recordsLinked to original sources
PubMed2006

Diurnal blood pressure pattern in patients with primary aldosteronism.

BACKGROUND: The aim of the study was to evaluate diurnal blood pressure (BP) profiles in patients with primary aldosteronism and to compare them to those in subjects with essential hypertension. The effects of specific therapy on the circadian BP profiles have been studied. MATERIALS AND METHODS: Sixty-four patients with primary aldosteronism were included in the study. Thirty of them revealed an aldosterone-producing adenoma (APA) and 34 had idiopathic hyperaldosteronism (IHA) due to bilateral adrenal hyperplasia. RESULTS: We did not find any significant differences in ambulatory BP monitoring (ABPM) between patients with APA and IHA. However, the circadian BP variation in the patients with primary hyperaldosteronism due to APA was preserved, while the patients with IHA showed lower nocturnal decline in comparison with patients with essential hypertension. There was a significant decline in office and ambulatory BP levels after treatment in the patients with both APA and IHA. The awake-sleep BP difference in patients with APA remained unchanged after surgical treatment, while in patients with IHA the night-time systolic and diastolic BP decline was significantly higher after spironolactone treatment. CONCLUSIONS: Primary hyperaldosteronism due to APA was associated with normal circadian BP variability and the surgical treatment led to highly significant decline in all BP parameters but had no influence on the extent of nocturnal BP variation. Spironolactone therapy restored normal nocturnal BP decline in patients with IHA. Reduction of night-time BP decline in patients with IHA is more likely to be related to the duration of the disease rather than to the aldosterone levels.

Adenoma↗
PubMed2004

Circadian blood pressure profile in patients with Cushing's syndrome before and after treatment.

The aim of the study was to evaluate the circadian blood pressure (BP) profiles in patients with two forms of Cushing's syndrome, and to compare them to those in patients with essential hypertension. The study included 100 patients with Cushing's syndrome (80 with pituitary adenomas and 20 with adrenal adenomas) and 40 with essential hypertension. Twenty-four-h ambulatory BP monitoring was performed before and after therapy. All 3 groups had similar office-, 24-h-, awake-, and sleep BP mean values. The awake-sleep differences between the patients with two forms of Cushing's syndrome were similar. The night-time BP decline in the patients with Cushing's disease, as well as in those with adrenal adenomas, was significantly lower than that in the patients with essential hypertension. In the patients with both forms of Cushing's syndrome, there was a highly significant decline in the office and ambulatory BP levels after the treatment, and the awake-sleep systolic BP difference became significantly higher. The night-time diastolic BP decline was significantly higher after treatment in patients with adrenal adenomas and not-significantly higher in patients with Cushing's disease. In the patients with Cushing's disease, the duration of hypertension was greater, and lower percentage of normalized BP after treatment was observed in comparison with the patients with adrenal adenomas. The significant negative correlation between duration of the disease and extent of the night-time BP decline suggests that the 'non-dipping' profile is related not only to hypercortisolism itself but also to the severity of hypertension and duration of the disease.

Adenoma↗
PubMed1998

Treatment of moderate or severe arterial hypertension with losartan.

Losartan is the first drug of a new class antihypertensive drags--Angiotensin II receptors antagonists. According to the data in the literature the drug shows a very good efficiency and tolerability. Fifteen patients at the average age of 48.9 are the object of this study. Our study establishes considerable lowering of the systolic BP with 15.9% and of the diastolic BP with 20.3%. No considerable effects on the hematopoiesis, the carbohydrate and the lipid metabolism, and the renal function were observed during treatment with Cozaar.

Adult↗
PubMed1990

[The value of the electrocardiographic indices of left-ventricular hypertrophy for the approximation of the valvular systolic gradient in patients with aortic stenosis].

In 36 patients with mild, moderate and severe aortic stenosis, proved by cardiac catheterization, some electrocardiographic indices for left ventricular hypertrophy were compared with the value of the aortic valve peak systolic gradient. The correlative analysis showed a moderate correlation between the T wave amplitude in leads V5 and V6 of the ECG and the aortic valve gradient--r = 0.46 (p less than 0.005). On the basis of this linear correlation a regression equalization is proposed for the approximate electrocardiographic assessment of the degree of aortic stenosis.

Adult↗
PubMed1986

[Changes in sodium metabolism in essential hypertension patients].

Cardiac output, plasma and blood volume were studied in 180 patients with essential hypertension via the method of dye dilution and neuro-hormonal studies were realized. In part of tha patients observed, the plasma renin activity and plasma aldosterone were established by radioimmune methods. The values of sodium in plasma and its excretion with urine were determines. Aldosterone and plasma sodium in the circulating blood volume were determined by methods, introduced by the author. Three subgroups of patients were differentiated on the base of the changes in sodium metabolism: with elevated sodium in plasma, with normal values of plasma sodium and with reduced sodium content in the circulating plasma volume. The changes in plasma sodium of the subgroups of patients with essential hypertension are accompanied by certain deviations in hemodynamics, in plasma aldosterone and in plasma renin activity.

Adult↗
PubMed1986

[Plasma volume changes in essential hypertension patients].

Plasma volume, cardiac output, velocity of blood flow and total peripheral vascular resistance were studied in 180 patients with essential hypertension, stages I, II and III according to WHO classification. Increased plasma volume was established in the majority of the patients with early stage of the disease and in 36 per cent of the patients with advanced essential hypertension. The studies reveal that the changes in plasma volume are of importance for the deviations of the other hemodynamic indices and for the reorganization of the hemodynamics in the patients with essential hypertension.

Adult↗
PubMed1986

[Preoperative clinical and hemodynamic assessment of patients for surgical revascularization of the myocardium].

A group of 35 patients with ischemic heart disease (IHD) and 6 patients with aquired heart defects, with established significant coronary obstruction were studied. The clinical picture of the patients with IHD is dominated by severe, refractory to treatment angina pectoris with extensive and high-degree stenosing coronary angina pectoris in combination with a relatively preserved left ventricular function. The patients with aquired defects have no anginal complaints. The aortic-coronary by-pass is justified in the light of the modern studies in the world. The necessity of rapid advancement of coronary surgery in Bulgaria is underlined.

Angina Pectoris↗
PubMed1982

[Urinary excretion of aldosterone in patients with hypertension].

Plasma value, by dye-dilution method, sodium excretion and potassium quantity in plasma by flame photometry, plasma renin activity by radioimmune method and aldosterone excretion with urine by spectrophotometric method were studied in 34 patients with I, II and III stage of hypertonic disease. Aldosterone excretion was established to be normal in 55.8 of the patients and increased in 44.2 per cent. The excretion of aldosterone showed no discrepancies in the patients with hypertonic disease depending on the size of plasma volume. Aldosterone excretion was increased in hypertonic patients with high plasma renin activity as compared with the subjects with normal and with reduced plasma renin activity. Reverse interrelations were established as regards sodium excretion.

Adult↗
PubMed1982

[Treatment of chronic congestive failure with vasodilators (acute trial with prazosin and erythrityl tetranitrate)].

An acute clinical experiment was carried out with 34 patients with chronic refractory cardiac insufficiency with stasis and idiopathic dilating (stasis) cardiomyopathy so as to follow up the hemodynamic effect of the vasodilators prazosin and erythrityl tetranitrate. The values of the central and peripheral vascular hemodynamics were followed up before and one hour after the peroral intake of 2 mg prazosin and half an hour after the peroral intake of 40 mg erythrityl tetranitrate. The results indicate that a statistically significant decrease of the arterial pressure and the total peripheral vascular resistance developed after prazosin intake. The systolic arterial pressure was decreased from 121,80 +/- 3,52 to 102,40 +/- 3,71 (p less than 0,001) and the diastolic--from 80,20 +/- 2,41 to 68,20 +/- 2,56 (p less than 0,01). The values of the total peripheral vascular resistance were decreased from 2629,65 +/- 174 to 1865,53 +/- 153 (p less than 0,001). The indices of the pump function--Stl and SI were increased (Stl from 22,74 +/- 1,85 to 30,37 +/- 2,14 with p less than 0,025 and Sl--from 1,90 +/- 0,08 to 2,64 +/- 0,19; p less than 0,02). The indices of the pressure in the left ventricular filling had no statistically significant change. After the administration of erythrityl tetranitrate, a statistically significant improvement of the indices of the cardiac output was also observed as well as of the total peripheral vascular resistance. The systolic index grew from 1,74 +/- 0,20 to 2,70 +/- 0,16 (p less than 0,01); stroke index--from 18,35 +/- 2,82 to 32,99 +/- 2,88 (p less than 0,01), and the total peripheral vascular resistance was decreased from 2897,0 +/- 186,0 to 1556,0 +/- 154,0 (p less than 0,001). Prazosin and erythrityl tetranitrate led to a considerable decrease of the counter load of the heart and improvement of the pump function of left ventricle in an acute experiment in case of chronic cardiac insufficiency with stasis.

Adult↗
PubMed1982

[Clinical and hemodynamic effect of molsidomine in patients with unstable angina pectoris].

In 30 patients with a grave form of ischemic heart disease--unstable angina pectoris, peroral treatment with molsidomin (Corvaton) was carried out in a dose I table of 20 mg, three times daily, in the course of 33 days at an average. The incidence, intensity and duration of stenocardiac paroxysms were followed up as well as the nitroglycerine need- and electrocardiographic changes. The main hemodynamic indices, prior to and post treatment, were also determined. The stenocardiac paroxysms were established to disappear after molsidomin treatment in 30 per cent of the cases as well as reduction of anginose symptomatics in more than 50 per cent in 50 per cent of the patients, reduction of stenocardiac symptomatics to 50 per cent in 3.3 per cent of the cases and no effect in 16.7 per cent of the patients. The hemodynamic molsidomin effect was conditioned by the increase of the volume of the venous vascular system, due to which the venous flow to the heart was diminished--a reduction of the overloaded myocardium and its oxygen needs occurred.

Angina Pectoris↗
PubMed1982

[Clinical and hemodynamic characteristics of the decompensation syndrome in patients with congestive cardiomyopathy].

Thirty seven patients were clinically and hemodynamically studied under hospital conditions. The stage of cardiomegaly, the stasis in the pulmonary and systemic circulations were followed up as well as the presence of manifestations of pulse deficit, incidence of gallop rhythm manifestation. It was established that in the patients with II-A stage of decompensation of circulation, a decreased cardiac output was found, enhanced peripheral resistance and normovolemia. In the patients with II-B stage of circulation decompensation, further decrease of stroke and minute volume was found as well as moderately slowed down blood flow in the pulmonary and systemic circulation and normal peripheral vascular resistance. Conclusions were drawn, on the base of the data obtained, about the optimal treatment depending on the circulation decompensation stage.

Arrhythmias, Cardiac↗
PubMed1982

[Urinary catecholamine excretion and cardiac output in hypertensive patients].

Cardiac output was determined to 70 patients with hypertonic disease I, II and III stage by dye-dilution method and urine excretion of adrenaline and noradrenaline was determined by fluorescence method. The extent of stroke and minute volume was determined depending on the stage of the disease, degree of arterial hypertension and patients' age. Noradrenaline excretion was normal in 75.8 per cent from the whole group of the patients examined and decreased in 24.2 per cent. Adrenaline excretion was increased in 7.1 per cent and with normal values--in 92.9 per cent of the patients. No discrepancies in adrenaline and noradrenaline excretion were found in the patients with hypertonic disease, depending both on the degree of arterial hypertension and patients' age. A moderate positive correlation was found between noradrenaline excretion and cardiac index and stroke index.

Adult↗
PubMed1981

[Vasodilator treatment of chronic heart failure: a chronic double-blind trial with prazosin and erythrityl tetranitrate].

A chronic double-blind experiment was carried out with 32 patients with severe chronic stasis cardiac insufficiency, with concomitant idiopathic congestive cardiomyopathy and ischemic heart disease, in assessing the effect of vasodilators prazosin or erythrityl tetranitrate upon the decompensation symptomatics and hemodynamic indices. The clinical indices of cardiac insufficiency with hemodynamic signs of pre-loading, myocardial contractility and postloading of left ventricle were followed up. Besides vasodilators the patients were administered the ordinary maintenance therapy with digoxin and diuretics. The experiment was a double blind one, controlled by placebo-periods and covered a 6 months follow-up period. The combined venous-arteriolar vasodilator prazosin was reduced pre and post-loading, it increased the cardiac output, without essential changes in functional capacity of the patients with chronic cardiac insufficiency. Erythrityl tetranitrate, however, has no substantial effect on the clinical and hemodynamic indices of statis cardiac insufficiency even in higher doses. That suggests the necessity of the chronic cardiac insufficiency treatment to be carried out with vasodilators with venous and arteriolar effect.

Chronic Disease↗
PubMed1981

[Hemodynamic changes in ischemic heart disease with disordered intraventricular conduction].

Cardiac output, blood volume and velocity of blood flow were studied in 30 patients with ischemic heart disease with intraventricular conductivity. Thirty patients with ischemic heart disease without disturbances of conductivity and 30 healthy subjects were used as a control group. Decreased heart stroke volume and blood flow velocity in pulmonary circulation were found in the patients with left bundle block. In the patients with right bundle block--changes in blood volume, heart rate and velocity of blood flow in systemic circulation were established. The type of conductivity disturbances in patients with ischemic heart disease was concluded to be dependent on stage and type of hemodynamic disturbances.

Aged↗