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Biomedical subjects

B Bacior

Publications and source records attributed to B Bacior.

At least 19 recordsLinked to original sources
PubMed1997

Effect of exercise rehabilitation on heart rate variability in hypertensives after myocardial infarction.

OBJECTIVE: The aim of the study was to find out whether the presence of hypertension affects heart rate variability in patients rehabilitated after myocardial infarction. DESIGN: Echocardiography, exercise testing and 24 h Holter monitoring were performed before and after 27 days of early postdischarge cardiac rehabilitation. PATIENTS: The study population consisted of 64 patients aged 34-65 years (mean+/-SD 51.6+/-6.6) discharged from hospital after a first myocardial infarction who were subdivided into two groups, group A comprising 34 patients with arterial hypertension which had lasted 4.8+/-2.1 years and group B comprising 30 normotensives. MAIN OUTCOME: We expected exercise rehabilitation to affect heart rate variability, exercise tolerance and myocardial ischemia in patients after myocardial infarction with and without arterial hypertension. RESULTS: At baseline no intergroup differences were seen in the duration of exercise, workload and heart rate variability parameters. All parameters increased significantly after cardiac rehabilitation (P < 0.01): SD of all normal RR intervals 123.4+/-30.0 versus 123.8+/-30.0 ms; SD of the averages of normal RR intervals in all 5-min segments of the entire recording 115.1+/-30.5 versus 116.3+/-28.3 ms; mean of the SD of all normal RR intervals for all 5-min segments of the entire recording 49.0+/-12.5 versus 48.3+/-11.8 ms; square root of the mean of the sum of the squares of differences between adjacent RR intervals 29.7+/-9.1 versus 28.0+/-8.5 ms; percentage of differences between adjacent RR intervals > 50 ms 7.9+/-6.0 versus 7.1+/-6.1% (group A versus group B, respectively, NS). The duration of exercise and the workload were significantly increased (the rise was higher in normotensives). No differences were seen in the frequency and severity of silent myocardial ischemia. CONCLUSIONS: Early stationary exercise rehabilitation after myocardial infarction improves heart rate variability parameters and exercise tolerance both in hypertensives and in normotensives.

Adult↗
PubMed1996

[Syncope as a cardiologic problem].

Syncope is a frequent clinical event. It is mainly caused by a suddenly reduced cerebral blood flow. There are two reasons for sudden cerebral underperfusion: cardiogenic - associated with cardiac disorders and neurocardiogenic - resulting from a sudden fall of arterial blood pressure due to impaired autoregulation of the circulation. Cardiogenic syncopes prevail in cardiac diseases associated with impaired blood flow and cardiac arrhythmias. They develop in aortic stenosis, hypertrophic cardiomyopathy, atrial myxoma, myocardial infarction, pulmonary embolism, cardiac tamponade. Cardiac arrhythmias associated with syncope include ventricular tachycardia, supraventricular tachycardia in the preexcitation syndrome, sinus bradycardia, II degrees and III degrees atrioventricular block, atrial fibrillation with rapid ventricular response. The prognostic value and pathomechanisms loss of consciousness in these disease states have been discussed. Neurocardiogenic syncopes include vasovagal syncope, carotid sinus syndrome, orthostatic hypotension, event-induced syncope. It is frequently difficult to establish the reason for syncope. Physical examination and a history should be taken first followed by noninvasive studies such as standard ECG, exercise testing, carotid sinus compression, Holter monitoring, tilt testing, signal-averaged ECG. Noninvasive diagnosis helps establish the cause of syncope in 53-62% of cases and is indispensable before proceeding to electrophysiological testing. Such testing should be limited to patients with organic heart disease, in whom previous examinations did not reveal the etiology of loss of consciousness.

Blood Circulation↗
PubMed1994

[Late prognosis of patients after myocardial infarction complicated by atrioventricular conduction disorders].

The purpose of the study was to follow-up postmyocardial infarction patients with atrioventricular conduction disorders complicating the acute phase of the disease. The study population consisted of 42 patients, 30 men and 12 women, aged 42 = 91 years (x = 65.2 +/- 12.6). Inferior and anterior myocardial infarction developed in 28 and 16 patients, respectively. The follow-up ranged from 1 to 5 years (x = 3.6). Within the first year there were 14 deaths, and 28 patients had control check-up. All the patients were submitted for physical examination, routine electrocardiography, 24-hr continuous ECG recording. At 1 year none of the patients developed new conduction disorders, whereas 71.4% of the patients revealed arrhythmias in ECG recording. Within 5 years there were 20 deaths (47.66%). A group of those who died, when compared with survivors was characterized by higher mean age, significantly more frequent presence of arterial hypertension and prior myocardial infarction.

Adult↗
PubMed1994

[Selected aspects of diagnosis and treatment of cardiac arrhythmias. Invasive and noninvasive methods in diagnosis of cardiac arrhythmias].

The paper summarizes the use of current technique in the diagnosis of cardiac arrhythmias. The value of non-invasive 24-hr continuous ECG monitoring and signal-averaged electrocardiography has been discussed. The predictive value of circadian changes in RR intervals (HRV) in 24-hr ECG recording was emphasized in patients after myocardial infarction. HRV below 50 ms leads to a 5-fold increase in the risk of death within 3 months after myocardial infarction. The value of signal-averaged ECG in predicting sudden death ion patients after myocardial infarction is also independent of other techniques. Abnormal signal-averaged ECG was found to be a sensitive indicator of susceptibility to sustained ventricular tachycardia. Electrophysiology testing as one of invasive technique, was discussed with respect to its indications and usefulness in selecting non-pharmacological treatment of cardiac arrhythmias (implantation of antiarrhythmic devices, radiofrequency ablation).

Arrhythmias, Cardiac↗
PubMed1992

[Aneurysms in acute myocardial infarction (multicenter studies)].

The authors present outcomes concerning frequency of appearance and clinical course of aneurysms after acute myocardial infarction. The study population consisted of 730 patients (mean age 54 +/- 9 years) with acute myocardial infarction, including 579 men and 151 women. The diagnosis was based on the following criteria: 1) coronary artery disease history, 2) physical examination, 3) ECG, 4) 2-dimensional echocardiography, 5) biochemical data. Post-infarction aneurysm was revealed in 42 patients (5.8%, 33 men and 9 women); antero-lateral aneurysm--in 36 patients (85.7%), and inferior-posterior aneurysm--in 6 patients (14.3%). Ventricular arrhythmias in the first day of infarction had a high frequency in both groups; with aneurysm--92.9%, without aneurysm--82.2%. The frequency of arrhythmia in 21-st day of infarction decreased similarly in both groups with aneurysm--40.5%, without aneurysm--38.9%. There was no statistically significant difference among both groups. There was no correlation between localisation of aneurysms and degree of contractility disturbances of the heart muscle (dyskinesis, akinesis). Heart failure--class III and IVK (Killip-Kimball classification) occurred in 19.0% of patients with aneurysm and in 10.4% of patients without aneurysm. That was no essential correlation between localisation of aneurysms and advancement of the heart failure.

Adult↗
PubMed1992

[Assessment of clinical course of myocardial infarction complicated by atrioventricular conduction disorders].

The aim of the study was to assess the clinical course of myocardial infarction complicated by atrioventricular conduction disorders. The patient group consisted of 155 subjects, 117 men and 38 women, aged 31-91 (mean = 61 years). Analysis included the type and frequency of AV conduction disorders with respect to the infarct site and size, the presence of complications, therapy used with particular consideration of temporary electrical stimulation. AV conduction disorders were found in 15.8% of patients with myocardial infarction. They were found significantly more frequently in those with the inferior myocardial infarction. The patients with the infarction complicated by AV conduction disorders showed more extensive myocardial necrosis, with the degree of the block correlating with the infarct size, more frequent occurrence of such complications as cardiogenic shock, pulmonary edema. Despite the use of electrical stimulation the mortality rate in the myocardial infarction complicated by complete AV block was high, reaching 50.7%.

Adult↗
PubMed1990

[Effects of isosorbide dinitrate on left and right ventricular systolic time intervals in patients after myocardial infarction].

The purpose of the study was to assess effects various doses of isosorbide dinitrate (ISDN) on left and right ventricular systolic time intervals in patients after myocardial infarction. The study population consisted of 25 patients who were eight weeks after their first transmural myocardial infarction. Twelve patients were given 5 mg of ISDN by an intravenous infusion for 60 min, and remaining 13 patients were given 10 mg of ISDN in a similar manner. Subgroups did not differ with respect to their initial arterial blood pressure (mean = 133.3) 82.9 vs 134.3 (87.1 mm Hg) and systolic pulmonary arterial pressure (mean = 27.2 vs 28.8 mm Hg). The infarct localization was also similar. Left ventricular systolic time intervals were calculated noninvasively, whereas right ventricular systolic time intervals were measured from simultaneous electrocardiographic, phonocardiographic and pulmonary arterial pressure tracings. Both left and right ventricular systolic time intervals were determined before and at 15 and 60 min after the drug administration. Student's t-test for unpaired and paired variables was used to test for statistical significance. Changes in the parameters studied at 60 min of the ISDN infusion were greater than at 15 min, and therefore only they are taken into account in the presentation of the results. During a 5 mg infusion of ISDN arterial blood pressure showed a tendency to decrease. Left ventricular ejection time shortened (-3.9%) and the pre-ejection period lengthened (+ 21.9%). The pulmonary artery pressure showed minimal tendency to decrease. The right ventricular systolic time intervals showed a similar tendency but the changes were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Ventricular arrhythmias and QT/QS2 index in patients with ischemic heart disease].

This multicenter study comprised a group of 900 patients (207 females and 693 males, aged 23-68 years, mean 53) with ischaemic heart disease. Go medications other than nitrates, nifedipine and diuretics were administered at the time of study. In all patients a simultaneous standard 12-lead ecg and a phonocardiogram was registered. QT and QS2 intervals were then measured, and the QT/QS2 index calculated. QT/QS2 ratio 1.0 was considered as a normal one. A 24-h Holter ecg monitoring was performed in each patients, and ectopic ventricular activity was graded according to the Lown's classification. For patients with each class of arrhythmia the mean value of QT/QS2 was calculated. All means were similar, with values 1.0. Proportion of patients with abnormal values of QT/QS2 index was similar in patients showing different Lown classes of arrhythmia. Since a 24-hour monitoring does not give a full information about the arrhythmic events, patients with the history of VT/VF were analyzed separately. In this group an increase of QT/QS2 index was observed significantly more frequently than in other patients (37% vs 19%, p = 0.016). It is concluded that no close relationship exists between QT/QS2 index and the type of ventricular arrhythmia found on the Holter monitoring. However, pathologic QT/QS2 values seem to characterize the patients with increase risk of VT/VF.

Adult↗
PubMed1990

[Effect of amiodarone and disopyramide on the results of electrocardiographic exercise stress testing in patients with coronary disease].

The study was designed to assess the influences of antiarrhythmic therapy on exercise tolerance in patients with coronary artery disease and ventricular arrhythmias. Subjects for this study were subdivided into 3 groups: group I - 46 patients treated with amiodarone 1,200 mg daily during 10 days and 200-600 mg daily within next days, group II - 79 patients receiving disopyramide 300-600 mg daily, group III - 129 patients with combined administration of disopyramide 300-600 mg daily and propranolol 30-240 mg daily. propranolol 30-240 mg daily. Submaximal exercise stress testing was performed in each patient before treatment and after the medication for 4 weeks (group I) and for 2 weeks (groups II, III). The following parameters have been evaluated: maximal archived workload, maximal heart rate blood pressure response, double product (maximal heart rate x maximal systolic blood pressure), reasons for ending the test (target heart rate, typical angina, exhaustion, ST-segment depression greater than or equal to 2 mm, occurrence of ventricular arrhythmia, blood pressure greater than 250/120 mm Hg, significant drop in systolic pressure). Positive result of exercise ECG was defined: horizontal or down-sloping ST-segment depression greater than or equal to 1 mm and/or typical chest pain. The data from the first and second tests were estimated for significance of differences between the mean values with following results: 1) maximal achieved workload, 86 +/- 46 and 103 +/- 49 W (p less than 0.02) in group I; 101 +/- 64 and 106 +/- 50 W (NS) in group II; 107 +/- 55 and 119 +/- 54 W, W (p less than 0.01) in group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Amiodarone↗
PubMed1988

Diagnostic value pharmacological autonomic blockade in patients with suspected sick sinus syndrome.

The study comprised 67 subjects, mean age 43.7 years, with suspected sick sinus syndrome, in whom rapid atrial pacing before and after combined atropine and propranolol was performed by Narula's method. Three groups were formed: group I--with normal sinus node recovery time (SNRT) and corrected sinus node recovery time (CNRT) before and after the autonomic blockade; group II--with functional disorders of the sinus node and group III--with intrinsic sinus node dysfunction. After autonomic blockade in groups I and II mean SNRT, CNRT, post-stimulation cycle lengths (except No. 2 and Nos. 5, 6, 10, respectively) shortened, whereas HR rose. In contrast, in group III mean SNRT, CNRT, post-stimulation cycle lengths (Nos. 1, 2, 6, 10) and HR increased. Significant differences in post-stimulation cycle lengths were observed between groups I and III as well as groups II and III. In conclusion, rapid atrial pacing after combined atropine and propranolol helps us to diagnose latent sick sinus syndrome and extrinsic sinus node dysfunction more precisely, and significant differences in post-stimulation cycle lengths between the groups confirm diagnostic value.

Adolescent↗