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A L Syrkin

Publications and source records attributed to A L Syrkin.

At least 19 recordsLinked to original sources
PubMed2006

[HIV-associated cardiomyopathy].

Dilated cardiomyopathy (DCMP) is a non-coronary heart disease, which leads to the severe degenerative changes and destruction of cardiomyocytes, heart chamber dilatation, systolic and diastolic myocardial dysfunction, steady heart failure progression, disability, and high mortality. HIV is considered to be one of the possible causes of DCMP. Heart involvement in AIDS influences prognosis by lowering survival rate. The number of HIV-infected patients grows in our country; thus, the number of patients with various AIDS manifestations is going to grow, too. In this article the authors adduce the observation of DCMP development in a HIV-infected patient.

Adult↗
PubMed2006

[Effectiveness and safety of clopidogrel bisulfate in complex therapy of patients with acute coronary syndrome with ST segment elevation].

UNLABELLED: Efficacy of clopidogrel in acute myocardial infarction (AMI) was studied only in two trials. However efficacy and safety of loading dose of this drug and its long-term effectiveness were not studied in these trials. AIM: To assess effects of clopidogrel loading dose and long term therapy in addition to standard treatment on death, re-infarction, recurrence of angina and bleedings rate in patients with ST segment elevation acute coronary syndrome. METHODS: Patients (n=107) with AMI who met the criteria for thrombolytic therapy (TLT) were assigned randomly into either clopidogrel group A (n=51) or conventional therapy group B (n=56). Group A received loading dose of clopidogrel (300 mg) in addition to conventional therapy (TLT, aspirin, statin, ACE inhibitor and beta-blocker). Group B received only conventional therapy. The follow-up was 6 months after inclusion during which patients in group A continued to receive clopidogrel (75 mg/day after Day 2 of the study). Primary endpoint included death, re-infarction, recurrence of angina and bleedings. In addition, changes of ST segment after TLT and local contractility were assessed. RESULTS: During 30 days of follow-up rates of primary endpoint were 2.0 and 41.1% in groups A and B, respectively (p=0.003). Subgroup analyses showed that this difference depended on the rate of angina recurrence (2.4 and 36.1% in groups A and B, respectively, p=0.002). These differences were maintained during all follow-up period. Odds ratios for clopidogrel were 0.235 for primary endpoint (95% CI 0.104-0.528, p=0.0003), 0.078 for angina recurrence (95% CI 0.022-0.279, p=0,0001). No significant differences were obtained for mortality, re-infarction and bleeding rate. TLT in group A was more effective. ST depression 90 min after TLT was 86.23+/-4.38 and 61.00+/-6.97% (p=0.010), reperfusion arrhythmia rate - 72.6+/-3.27 and 33.9+/-2.78% (p=0.005) in groups A and B, respectively. CONCLUSION: The use of clopidogrel in addition to standard therapy for AMI is safe and effective. Long-term clopidogrel treatment decreases angina recurrence rate.

Acute Disease↗
PubMed2005

[Characteristics of the pathogenesis, manifestations and clinical course of psychogenically induced myocardial infarctions].

With the purpose of investigating peculiarities of psychogenically induced myocardial infarction (PIMI) 82 patients with primary myocardial infarction (MI) were chosen as the subjects of the given controlled study and divided into two groups. The main group consisted of 33 patients, the rest 49 formed the control group. The study showed that coronary atherosclerosis was more pronounced in the patients of the main group, among whom cases of exertional angina in past history were more frequent, and who had more pronounced coronary calcinosis compared to the patients of the control group. At the same time, the clinical course of MI in such patients is relatively benign, but it is more often complicated by early postinfarction angina. All this suggests that the pathogenesis of PIMI differs from that of "classic" MI. In particular, PIMI may be associated with the involvement of more distant parts of coronary vessels. Patients with PIMI seem to need to be regarded as having high risk of repeated coronary disasters.

Adult↗
PubMed2005

[Plasma lipids oxidation in patients with occlusive atherosclerosis of lower extremities and ischemic heart disease].

Dynamics of lipoprotein oxidation in blood plasma was studied by Cu-induced plasma oxidation in 114 patients with atherosclerosis of lower extremities of various severity with and without ischemic heart disease. Preparedness of plasma lipoproteins to oxidation in patients was higher than in healthy subjects. Degree of oxidizeability increased with increase of severity and extent of atherosclerosis and was highest in patients with atherosclerosis of lower extremities and ischemic heart disease. There were no significant differences between groups of patients with various severity and extent of atherosclerosis in levels of total cholesterol and triglycerides as well as in other parameters of lipid spectrum. Correlation analysis revealed no relationship between age of patients and degree of plasma oxidizeability.

Aged↗
PubMed2005

[Influence of therapy with atenolol on lethality of patients with chronic heart failure].

The paper demonstrates that the hydrophilic beta-adrenoblocker (BAB) atenolol is effective in patients with III-IV functional class chronic heart failure (CHF), associated with postinfarction cardiosclerosis (PIC) and dilatational cardiomyopathy (DC). In reduction of general and cardiovascular mortality in the given category of patients atenolol was not less effective than the lipophilic BAB bisoprolol (in comparison with the results of the CIBIS II study). Sudden death was typical of the patients with DC, whereas most of PC patients died of repeated myocardial infarctions and progressive CHF. There was no significant difference between lethality in DC and PIC groups (p > 0.05). The results of the study suggest that hydrophilic BABs are not less effective in improving the prognosis than lipophilic BABs. Further research into this problem is appropriate.

Adrenergic beta-Antagonists↗
PubMed2005

[Muscular mechanisms of lowering of physical working capacity in chronic heart failure and action of beta-adrenoblockers].

Parameters of physical working capacity (symptom limited treadmill test with gas analysis, 6 min walk test and usual everyday activity), activity of muscular metaboreflex, efficacy of pulmonary ventilation, and heart rate variability were studied in 50 patients with postinfarction cardiosclerosis with chronic class I-III heart failure and 30 patients without heart failure. Patients with heart failure of all functional classes had lowered parameters of working capacity while metaboloreflex hyperactivation and diminished effectiveness of ventilation were found only in patients with clinical signs of chronic heart failure but not in those with symptomless left ventricular dysfunction. Therapy with metoprolol was associated with lowering of activity of metaboloreflex, augmented effectiveness of ventilation and heart rate variability, improvement of results of 6 min test and everyday activity without considerable changes of peak oxygen consumption.

Adrenergic beta-Antagonists↗
PubMed2005

[Remote catamnesis of paroxysmal supraventricular arrhythmias which debuted in childhood].

This article deals with the 23-years assessment of natural history of 57 patients with paroxysmal supraventricular tachycardia debuted in childhood. Variants of clinical course of disease are described: cardiac, syncopal, abdominal, asymptomatic. In absence of treatment majority of paroxysmal tachycardias were characterized by wavy change of their clinical manifestations with periods of pronouncedly increased and decreased activity lasting from 3 to 5 years. Time interval between attacks was important for prognosis. Severity of disease was determined by relationship of three factors: frequency, duration of attacks and ability of a tachycardia to cause disturbances of central hemodynamics. Tachycardia with asynchronous AB conduction and heart rate above 250/min in one year old and above 220/min in older children was associated with increased risk of development of acute heart failure during an attack. Risk of heart failure was not related directly to frequency of attacks but arose when duration of tachycardia with critical heart rate exceeded 8 hours.

Adolescent↗
PubMed2004

[Psychosomatic reactions comorbid with ischemic heart disease: psychogenically provoked infarctions and myocardial ischemia].

Ischemic heart disease (IHD) with psychogenic provoked myocardial infarctions (MI) and myocardial ischemic disease (MID) is considered as a psychosomatic disorder. Seventy patients, 17 female and 53 male, aged between 39-77 years, mean age 61.2 +/- 9.9 years, were observed. The presence of both somatic (prolonged atherosclerotic lesion of coronary arteries) and mental (personality disorders with symptoms of reactive lability under psychic trauma influence) predisposition is obligate for manifestation or exacerbation of this IHD type. It is suggested that atherosclerotic coronary vessels affection of heterogeneity may exist. Two types of vulnerability are described. In type 1 cardiovascular system exhibits selective sensitivity to the influence of obligate and of great personality significance cathatymic affect. A strict condition of its realization is amplification of negative emotions up to a level of pathological affective outbursts in the spectrum of paranoiac or explosive reactions. In these cases, IHD is characterized by a stable course (angina of high tensions, without instable anginal episodes etc). In type 2 cardiovascular system reveals vulnerability to negative emotions, the continuum of which is ended by polar pathological affects-cathatymic and anxiety. In contrast to cathatymic affect, a common feature of anxiety affect is a fast, like short-term emotional outburst, manifestation of instable, labile, dramatic external appearances (with tears, converse disorders etc). IHD symptom complex is distinguished by pronounced clinical manifestations (stenocardia of tension with progressive impairment of tolerability to loadings).

Adult↗
PubMed2004

[Factors influencing policy of examination of patients with stable angina pectoris].

The study was made to evaluate the rate of application of different diagnostic methods in patients with stable effort angina (SEA) treated in the cardiological department; influence of various factors (social, demographic, risk factors, clinical course of ischemic heart disease, associated diseases, internal picture of the disease) on choice by the attending physician of the diagnostic policy. The trial included 49 patients (44 male and 5 female aged 42-73 years, median 63 years) without contraindications to stress tests and without mental diseases. Choice of diagnostic tests (bicycle exercise only, Holter ECG monitoring only, bicycle exercise + ECG monitoring, none of the two) was made by attending physicians. Information on social, demographic, risk factors, clinical features of IHD and associated diseases was obtained in the course of semistructured interview 2-5 days before the discharge from the hospital. The internal picture of the disease was studied by psychometric testing using "Reaction to the Disease Questionnaire". The results were the following: only bicycle exercise, only Holter ECG monitoring were performed in 15 (30.6%) and 19 (38.8%) patients, respectively (95% confidence interval was 17.2-44.0% and 24.6-52.9%, respectively). None of the tests was made in 15 (30.6%) patients (95% confidence interval was 17.2-44.0%). The choice of the physician was significantly influenced by two factors: obesity and internal picture of the disease. The physicians preferred to avoid bicycle exercise conduction in obese patients and patients with hypernosognosia who consider ischemic heart disease a catastrophe and suffer of vital fear and helplessness.

Adult↗
PubMed2004

[Hyperventilation syndrome in bronchial asthma, essential hypertension and organic neurosis. Clinical picture and external respiration function].

The external respiration function was studied in 100 patients with hyperventilation syndrome (HVS) divided into 3 groups: 40 patients with HVS and bronchial asthma (group 1) consisting of 15 males and 25 females (age median--45 years, 25 percentile--37 years, 75 percentile--53 years); 39 patients with HVS and essential hypertension (group 2) consisting of 8 males and 31 females (age median 49, 25 percentile--40 years, 75 percentile--57 years); 21 patients with HVS without concurrent somatic diseases of group 3 (7 males, 14 females, age median 45 years, 25 percentile--28 years, 75 percentile--45 years). It is shown that different disorders of pulmonary ventilation correspond to different clinical manifestations of HVS. Thus, in bronchial obstruction (group 1) HVS manifests with "weak respiration", in restrictive pulmonary disorders (group 2) HVS manifests as "heavy respiration", in high parameters of bronchial permeability (group 3)--"shallow respiration".

Asthma↗
PubMed2004

[Anginal States provoked by psychogenic stimuli. To the problem of psychosomatic reactions in patients with ischemic heart disease].

Two types of vulnerability of coronary vessels damaged by atherosclerosis were proposed basing on results of a study of 94 patients with psychosomatic reactions accompanied with ischemia or myocardial infarction. First variant (35 patients) was characterized by stable course of the disease (high effort angina without coronary catastrophes, episodes of unstable angina, etc.) and selective sensitivity to definite key affect of high personal value. Second variant (49 patients) was distinguished by pronounced clinical manifestations (effort angina with progressive lowering of exercise tolerance). Cardiovascular system displays universal susceptibility to negative emotions of various intensity.

Angina Pectoris↗
PubMed2004

[Automatic regulation and central hemodynamics in patients with postinfarct cardiosclerosis and heart failure].

The study was undertaken to examine the specific features of autonomic regulation and the parameters of central hemodynamics in patients with postinfarct cardiosclerosis (PICS) and circulatory insufficiency who had different types of left ventricular remodelling (LVR). Thirty-two patients with PICS and heart failure (HF) were examined. The autonomic status was studied, by analyzing cardiac rhythm variability (CRV) from 5-min resting cardiointervalograms and by the cardiovascular tests described by D. Y. Ewing; integral rheography was also performed. The patients were divided into 2 groups according to the type of LVR. Patients with PICS + HF and concentric LVR were found to have a more balanced autonomic circulatory regulation and a hemodynamic type that was more energetically efficient for the myocardium. Those with PICS + HF and eccentric LVR had a hemodynamic type that was less efficient for the myocardium, which was accompanied by the enhanced activity of the sympathetic nervous system (SNS) even at resting. Patients with PICS + HF, particularly in the presence of the latter's higher functional class and eccentric LVR, seemed to have desensitized adrenoceptors and impaired baroreflex activity, as appeared as no rise in peripheral vascular resistance with the enhanced sympathetic activity. The findings support the expediency of using beta-adrenoblockers in HF in patients with PICS, particularly with eccentric LVR. Analysis of cardiac rhythm variability is sufficiently informative in evaluating autonomic regulation and autonomic balance, SNS tone in particular, in patients with HF.

Autonomic Nervous System Diseases↗
PubMed2004

[A course of coronary heart disease and quality of life in patients with varying depressive states].

AIM: To study a course of coronary heart disease (CHD) in patients with depressive disorders. MATERIAL AND METHODS: The trial included 77 CHD patients aged 39 to 68 years (mean age 54.9 +/- 0.9 years), 40 (51.9%) of them had myocardial infarction. All the examinees had effort angina of functional class II-IV by criteria of the Canadian Cardiology Association. All the patients have undergone standard clinical examination, stress tests, coronaroangiography (n = 30), assessment of the degree of vegetative dystonia and quality of life. The patients were divided into two groups depending on the depression degree. RESULTS: CHD patients with manifest depression vs those with subclinical depression had a higher level of personality and reactive anxiety. They had neurotic and psychopathological personality alterations associated with more pronounced vegetative disorders. These patients suffered from more severe coronary atherosclerosis, more hospitalizations for the previous year, more myocardial infarctions, lower physical activity and quality of life. CONCLUSION: CHD patients with manifest depression have lower physical performance and quality of life though this is not confirmed at exercise tests.

Adult↗
PubMed2004

[The role of stress-echocardiography in diagnostics of hemodynamically significant coronary artery stenosis and determination of indications for myocardial revascularisation.].

In 118 patients dobutamine (n=108) or exercise (n=10) stress-echocardiography and coronary angiography were carried out within time interval of 4 weeks. Retrospective analysis of data obtained showed that sensitivity and specificity of stress echocardiography for detection of more than 70% coronary artery stenosis was 75 and 71%, respectively. No significant reduction of sensitivity or specificity was found in any clinical group. Negative result of stress echo in most of the cases evidenced for continuation of conservative therapy while positive result in 66% of cases attested necessity of myocardial revascularization. Detection of stress induced disturbances of local myocardial contractility could be used as a proof of hemodynamic significance of 50-70% coronary artery stenosis.

Coronary Angiography↗
PubMed2004

[The place of multispiral computed tomography in diagnostics of ischemic heart disease.].

Multispiral computed tomography (CT) of the heart with detection of coronary artery calcification as well as clinical examination, stress tests, single photon emission computer tomography at rest and during stress, and/or stress echocardiography were used in the study of 56 patients with and 26 without ischemic heart disease (mean age 58+/-1 and 55+/-1.5 years, respectively). In 44 patients multispiral CT was performed with intravenous contrast injection and 27 patients were subjected to coronary angiography. Specificity, sensitivity of multispiral CT for detection of hemodynamically significant (>50%) stenoses compared with angiography and for diagnosis of structural changes of the myocardium were 92, 90%, and 89, 91%, respectively. Calcium index was significantly higher in patients with than without ischemic heart disease (253+/-28 and 3+/-1.5 U, respectively) and could be a significant diagnostic criterion of ischemic heart disease.

Coronary Angiography↗
PubMed2004

[Personality disorders in postoperative period of coronary artery bypass graft surgery].

Personality disorders (PD) are recognized among key maladaptive factors in postoperative period of coronary artery bypass surgery (CABS). However studies on PD among CABS patients are predominantly under psychological approach and information on clinical features is very limited. A present investigation aimed at assessing clinical features and prognostic value of PD in late post operative period of CABS (from 1 to 3 years). Using psychiatric, cardiological and psychological methods, 48 patients (42 male, mean age 61.3 +/- 8.2 years) with diagnosis of PD and favorable cardiological status after CABS have been assessed. PD in post operative period is an important predictor of unfavorable social and occupational outcome of CABS. Three types of clinical course of PD were singled out: 1) hypohondric personality development; 2) "second life" personality development; 3) "denial of illness" reactions. Pronounced maladaptation was observed in type 1, most severe one--in type 2 and minimal maladaptation or its absence--in type 3. These types were differentiated by different repertoires of psychological defense mechanisms (PMD): type 1 was characterized by a limited number of them with a drift to mature mechanisms; PD of type 2 are featured by a narrow and rigid repertoire of defenses with predomination of immature mechanisms and in type 3 a maximum number of PMD with balanced involvement of mature and immature mechanisms was observed.

Adaptation, Psychological↗