[Assessment of quality of life of patients with cardiovascular diseases].
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Biomedical subjects
Publications and source records attributed to D M Aronov.
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Effect of an HMG-CoA reductase inhibitor pravastatin on atherogenic changes in the lipid transport system during postprandial hyperlipidemia immediately after ingestion of fatty meal was studied in patients with coronary heart disease and fasting hyperlipidemia. Treatment with pravastatin (20-40 mg/day for 3 months) resulted in normalization of fasting levels of blood lipids and decreased postprandial hyperlipidemia due to of enhanced removal of triglyceride-rich atherogenic lipoproteins from blood and their diminished secretion in response to fat load. Moreover pravastatin increased tolerance of the lipid-transport system to exogenous saturated fats. KEY WORDS. coronary heart disease; postprandial hyperlipidemia; pravastatin; lipoproteins, metabolism.
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Hypertensive patients with hyperlipidemia are at high risk to develop coronary heart disease (CHD). Chemotherapeutic correction of hyperlipidemia seems most reliable modality to prevent CHD. Hypolipidemic effect and tolerance of leskol (fluvastatin) in dietotherapy-resistant hypercholesterolemia were studied in 74 patients with essential hypertension treated with hypotensive drugs. The patients were included in a multicenter trial. A 12-week course reduced total cholesterol level under 6.2 mmol/l in 59% of the patients, under 5.2 mmol/l in 29% of them. LDLP cholesterol lowered to 3.5% in 34% of the patients. Mean apo B diminished by 23%. There was a 27% decrease in the proportion of atherogenic fraction apo B to antiatherogenic fraction of transport proteins apo A-I. Leskol is well tolerated and effective against hypercholesterolemia, it is safe in relation to side effects and blood biochemistry.
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Short-term maximal and long-term submaximal regimens of physical exercise had been assessed for effect on serum lipoproteins in healthy subjects, in preclinical coronary heart disease (CHD) sufferers and in manifest CHD patients having food fat-induced lipemia. Fat loading caused hypertriglyceridemia in all the examinees. In healthy subjects it was associated with a rise in apo AI, while in CHD patients with relevant fall. Maximal exercise in preexisting alimentary hyperlipidemia provoked elevation of total cholesterol, triglycerides, LDL cholesterol, being atherogenic. Apo AI grew with a decrease in apo B/apo AI ratio in healthy subjects, in coronary patients apolipoprotein changes were of atherogenic origin. Prolonged submaximal exercise at the height of food lipemia resulted in lowering of total cholesterol, triglycerides and LDL cholesterol along with elevation of HDL cholesterol and apo AI both in healthy and coronary subjects evidencing anti-atherogenicity. It is noted that the response of lipids and apolipoproteins to fat and physical exercise loads was similar in subclinical and manifest CHD patients.
The hypolipidemic effects of induracin, a new long-acting nicotinic acid dosage form based on the waxy matrix, and its tolerance were studied in 31 patients with Types IIa and IIb hyperlipoproteinemias in a 6-month blind crossover study. There were decreases in the levels of total cholesterol by 9-13% and low density lipoprotein cholesterol by 12-22%, an increase in high density lipoprotein cholesterol by 12-15%, and a good dynamics in the ratio of blood lipid-transport proteins--a 12-16% increase to the levels of apoprotein AI to a 29% decrease in those of apoprotein B. The drug is well tolerated by patients and may be recommended for correction of atherogenic dyslipidemias.
The impact of graded exercises of various intensity and duration on serum lipoprotein values was examined in 20 patients with coronary heart disease (CHD) and 10 healthy individuals after a single dietary fat load (FL). FL resulted in hypertriglyceridemia which was accompanied by elevated apo-AI levels and reduced apo-B/apo-AI ratio in the healthy persons, whereas it was accompanied by lower apo-AI levels and increased apo-B/apo-AI ratio in the patients. The short-term maximum exercise in the presence of FL caused negative shifts in the lipid transport system both in the healthy persons and the patients, by elevating the level of apo-B-containing lipoproteins. Yet, the healthy individuals showed a further increase in apo-AI concentrations. The long-term exercise in the training mode corrected changes in lipid values, which had been induced by FL in the two groups of the examinees. There was a decrease in the levels of triglycerides, low density lipoprotein, cholesterol and an increase in the level of high density lipoprotein cholesterol.
The study was performed of the effect of bicycle exercise and occupational therapy (embroidery, knitting, sewing, drawing, etc.) on physical and psychological status of postmyocardial infarction females at the in-hospital stage of rehabilitation. It was found that occupational therapy improved the psychological status and life quality, whereas low-intensity physical training increased performance status in relevant women.
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A comprehensive study was made of 140 males aged 26-55 years who were divided into 3 groups: (1) 47 healthy individuals; (2) 67 subjects with early signs of coronary heart disease; and (3) 29 patients with coronary heart disease (Functional Class II). The pattern of chest pain was thoroughly analyzed by a specially developed questionnaire. The results were compared with the data obtained from an interview by Rose's questionnaire. The analysis demonstrated that neither Rose's questionnaire nor the detailed one specially developed by the authors identified subjects with preclinical coronary heart disease.
A total of 92 males aged 28 to 55 years were examined. These included 28 apparently healthy individuals, 45 subjects with preclinical coronary heart disease and 19 patients with Functional Class I-II coronary heart disease. A special questionnaire was used to examine the dietary patterns of the subjects with preclinical coronary heart disease, i.e. those having no typical clinical signs of the disease, but showing signs of myocardial infarction during the maximum exercise testing and minimal coronary arterial changes at selective coronary angiography. The subjects, unlike healthy individuals and CHD patients, were found to have 1 or 2 meals a day, frequently late at night, consume large amounts of sugar and other candies, fatty milk products, butter, eggs; small quantities of vegetables, fruits, and fish, often put additional amounts of salt to their diet. The subjects, as patients with severe CHD but unlike healthy individuals, were shown to have hypercholesterolemia and display high low density lipoprotein and apo-lipoprotein B levels; apo B/apo A being more than 1. The above dietary patterns of subjects with preclinical CHD represent one of the causes of abnormal changes in the blood lipid profile, which result in further CHD development.
A total of 158 males with a history of myocardial infarction were examined. The examination involved collection of information on their histories, course of the disease and symptoms in the hospital period and early (mean, on day 13) bicycle ergometric exercise tests. A multifactorial analysis made it possible to derive the decision rule to predict the condition of a patient within the first year following the onset of myocardial infarction, which involved prognostically unfavorable history data, such as disability prior to myocardial infarction, alcohol usage, exertional anginal hospital-stage parameters, such as bradycardia, premature contraction, circulatory failure, nodal rhythm, as well as 1 mm or more of ST-segment elevation during the early bicycle ergometric exercise test. The sensitivity of the predictive rule developed was 88.5%, its specificity was 78.5%. The study shows that it is impossible to successfully solve the problem in attempting to predict the outcome from some parameters, including the bicycle ergometric test findings. It is possible to do so only when the complex of data on a patient is taken into account.