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Biomedical subjects

D Zdrenghea

Publications and source records attributed to D Zdrenghea.

At least 19 recordsLinked to original sources
PubMed2005

Cardiovascular risk factors and risk behaviors in railway workers. Professional stress and cardiovascular risk.

UNLABELLED: The research considers the hypothesis that stressful professions, such as engine driver, influence the morbidity and mortality through cardiovascular diseases and favour some harmful habits with an impact upon cardiovascular morbidity. METHODS: There were selected for study 496 engine drivers, males, and a control group of 305 males. They were questioned about: name, address, family history, pathological personal history, alcohol intake, smoking, diet habits, physical activity, sleeping hours and stress perception. There were measured: height, weight, blood pressure. There were determined: fasting plasma glucose, cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol. RESULTS: Hypertension was registered in 23.5% of the engine drivers and in only 9.5% the control group (P<0.05). Dyslipidemia was noted in 57.4% of the engine drivers and 52.45% of the control group. Prevalence of smoking and overweight was higher in the control group. Unhealthy dietary patterns and physical inactivity were present in both groups, the circadian rhythms were altered only for engine drivers and questionnaires for stress perception showed higher irritability in the control group. CONCLUSIONS: The prevalence of some risk factors is higher for engine drivers, but for the others it is not. Also it seems that professional stress favours some harmful habits such as tobacco smoking, but the control group smokes more and they are inactive individuals with a great amount of irritability. The results do not totally sustain the idea we started from, that engine driver is a stressful profession; it seems that the effort/reward imbalance is more important than job-demand itself.

Adult↗
PubMed2005

Genetic analysis of angiotensinogen gene polymorphisms (M235T and T174M) in Romanian patients with essential arterial hypertension.

BACKGROUND: Several studies suggested the role of the genes of the rennin-angiotensin system in the pathogenesis of essential arterial hypertension. PATIENTS: We investigated 100 consecutive hypertensive patients (42 males and 58 females; mean +/- SD age, 55.14 +/- 9.49 years) for M235T and T174M polymorphisms. Seventy six normotensive patients (28 males and 48 females; mean +/- SD age, 54.94 +/- 9.56 years) formed the control group. METHODS: M235T and T174M polymorphisms were analyzed using PCR-RFLP methods. RESULTS: The carrier frequency of M235T polymorphism in the AGT gene was 73% in hypertensive patients and 34.21% in normotensive patients (OR 5.2, 95%CI [2.72-9.93], p<0.01, chi2 test). The carrier frequency of T174M polymorphism in the AGT gene was 42% in hypertensive patients and 11.84% in normotensive patients (OR 5.39, 95%CI [2.41-12.01], p<0.01, chi2 test). CONCLUSIONS: Essential arterial hypertension is associated with polymorphisms in the AGT gene, M235T and T174M.

Adult↗
PubMed2004

The effect of simvastatin associated with ranitidine and alcohol upon serum lipids.

Statins are highly effective in lowering TC and LDL-C but the increasing of HDL-C is modest and the cost of long-term treatment is too high. On the other hand it is known that the association of H2 receptor blockers increases the plasmatic level of statins, and moderate alcohol consumption increases HDL-C. The purpose of the study was to compare the effect of statins alone and in association with either H2 receptor blockers or alcohol upon serum lipids in dyslipidemic patients. Three groups of dyslipidemic patients were studied, each of them consisting of 20 patients. The group A was treated with simvastatin 20 mg/day, the group B with simvastatin 20 mg/day + ranitidine 150 mg/day and the group C with simvastatin 20 mg/day + 30 g alcohol/day. Before and after two weeks treatment TC, LDL-C, HDL-C and TG were determined in each patient. For the group A patients the studied lipid fractions were modified into the limits described by the literature; for the group B patients, the decreasing of LDL-C was significantly, higher than for A group; for the group C patients, the incresing of HDL-C was significantly, higher than for A group, after two week alcohol consumption. In conclusions, the association of H2 receptor blockers increases the effect of statins upon dyslipidemia and the association of statins with moderate alcohol consumption increases the effect of statins upon HDL-C but the clinical implication has to be established.

Adult↗
PubMed2004

Results of a long-term training program after acute myocardial infarction.

BACKGROUND: It is not well known what should be the benefits of a prolonged physical rehabilitation program after an acute myocardial infarction. METHODS: Our study is an open, randomized comparison of a long-term versus a standard rehabilitation program. Sixty-seven patients with acute myocardial infarction were included in an outpatient physical rehabilitation program of 6-8 weeks. Of these, 22 randomly selected patients continued the program until the 36th month (Group A). Twenty-five of the others were rechecked after 36 months, and represented the controls (Group B). For both groups, at the end of this period, a cycloergometer exercise test evaluated the exercise capacity of subjects and an echocardiogram was performed to determine left ventricular systolic and diastolic function. RESULTS: The maximal exercise capacity increased from 147 +/- 13.8 W to 178 +/- 16.4 W in Group A (p < 0.01), but it decreased from 144 +/- 13.2 to 132 +/- 12.8 W in group B. Functional aerobic impairment decreased from 29 +/- 2.7% to 22 +/- 2.1% in Group A, but it increased from 26 +/- 2.5% to 37 +/- 3.8% in Group B. The ejection fraction and diastolic function parameters were not significantly modified during the 36 months, for both groups. CONCLUSION: Long-term physical rehabilitation is useful in patients after an acute myocardial infarction to increase effort capacity, but left ventricular performance is not significantly changed.

Adult↗
PubMed2003

Ischemic preconditioning by repeated exercise tests involves nitric oxide up-regulation.

BACKGROUND: Animal studies show that nitric oxide is involved in delayed ischaemic preconditioning. OBJECTIVES: To determine whether plasma nitrates/nitrites (NOx-, as measure of nitric oxide) are modified by two consecutive effort tests and whether these changes translate into clinical improvement. METHODS: There were studied 22 patients with ischemic heart disease, who performed two effort tests at 24-hour interval. Plasma NOx- level was determined and compared before and after both stress tests. Peak effort, double product at peak effort and maximal ST segment depression were considered clinical end-points and were compared between the two tests. RESULTS: Plasma NOx- increased slightly after the first exercise test compared to pre-test value (17.05 +/- 1.6 vs. 15.38 +/- 1.4 micromol/ml). In turn, after the second test a significant rise of NOx- level (23.65 +/- 2.2 vs. 15.10 +/- 1.3 micromol/ml, p < 0.03) was noticed. The pre-test value was practically identical between the two tests. Peak effort and double product at peak effort remained unchanged between the two tests. Although the ischaemic stress was the same, ST depression was significantly lower (p < 0.01) at the second test (0.85 +/- 0.06 vs. 1.73 +/- 0.16 mm). CONCLUSION: Our study shows an increase of plasma NOx- level after the second of two consecutive exercise stress tests at 24 hour interval, along with a decrease of electrocardiographic consequences of approximately the same ischemic stress. These findings are consistent with experimental data in animals, which point to nitric oxide as both trigger and effector of ischaemic preconditioning.

Adult↗
PubMed2003

The acute effect of ACEI and ARB's upon endothelin in heart failure patients.

PURPOSE OF THE STUDY: to compare the acute effect of ACEI and ARB's upon the plasmatic endothelin level in heart failure patients. METHODS: There were studied 30 patients with congestive heart failure, III-IV functional NYHA class, that were not under ACEI or ARB's treatment. In all the patients the endothelinl-21 plasmatic level was determined. After this, 20 patients, representing group I, received a single dose of 1 mg trandolapril, and 10 patients, representing group II, received a single dose of 40 mg telmisartan. After 24 hours, the plasmatic endothelin 1-21 level was determined again. RESULTS: The mean endothelial plasmatic level was similar in both groups (group I: 0.358+/-0.04 fmol/ml; group II: 0.345+/-0.038). After 24 hours, the endothelin level decreased to 0.295+/-0.03 fmol/ml for group I (p<0.05) and to 0.287+/-0.029 fmol/ml for group II (p<0.05), suggesting that both ACEI and ARB's are equally efficient in decreasing endothelin. The initial endothelinl-21 level was inversely correlated with LVEF (r = -0.989), and the degree of the decrease of endothelinl-21 after both ACEI and ARB's is directly correlated with the initial endothelinl-21 level (r =0.64). CONCLUSION: The acute administration of ACEI and ARB's in heart failure patients decreases the endothelin level, both categories of drugs having the same effects.

Adult↗
PubMed2002

The effect of Simvastatin upon serum pseudocholinesterase and plasmatic factor VII.

UNLABELLED: The statins have a moderate lowering effect upon triglycerides, one hypothesis suggesting an inhibitory effect upon liver VLDL synthesis. Because VLDL synthesis is related to other hepatic protein synthesis we studied the effect of Simvastatin upon serum cholinesterase activity and factor VII activity, which are also synthetized at hepatic level. METHODS: 39 patients with ischaemic heart disease, proved by coronarography and moderate hypercholesterolaemia received for two months 20 mg Simvastatin (Zocor). The value of total Co, LDLCo, HDLCo, triglycerides, serum cholinesterase activity and factor VII activity were determined before and after treatment, by standard methods. RESULTS: Triglycerides were, together with total Co, significantly lowered during the two months treatment with Simvastatin, but the values of serum cholinesterase and factor VII activity were not significantly modified. This suggests that moderate doses of Simvastatin do not depress liver protein synthesis. CONCLUSION: Simvastatin does not lower the triglycerides level through depression of liver protein syntesis, other mechanisms being probably involved.

Adult↗
PubMed1996

[Left diastolic ventricular function, systolic blood pressure and erythrocyte magnesium in young type I diabetics].

Early cardiac involvement has been reported in type I diabetes mellitus. This study was undertaken to evaluate the relationship of systolic blood pressure (SBP), erythrocyte magnesium (MgE) and left ventricular diastolic function (LVDF). Forty-four patients with insulin-dependand diabetes (IDD) aged 26 to 31 years, without apparent cardiac complications 8.5 +/- 6 years after the onset of disease were studied. They were compared with 20 healthy subjects of the same age who comprised the control group. Left ventricular diastolic function was evaluated by isotopic technetium 9m ventriculography with a Gamma-Picker scintilation chamber, by determining maximum left ventricular filling velocities (I, VFmax). The MgF was measured by EDTA titrimetry. Patients were divided into two subgroups depending on the SBP: Group A (20 patients) with a mean SBP of 136 +/- 4.2 mmHf and Group B (24 patients) with a mean SBP of 118 +/- 4.4 mmHg; the control group had a mean SBP of 110 +/- 4.4 mmHg. The following results were obtained. [table: see text] The authors conclude that even small increases of SBP may, with a decrease in Mg, be a risk factor for early cardiac complications in IDD in young adults.

Adult↗
PubMed1976

Increased serum gamma-glutamyltransferase in hypertriglyceridemia: comparison with serum pseudocholinesterase.

Both gamma-glutamyltransferase (gammaGT) and pseudocholinesterase (PCE) were found to be increased in hypertriglyceridemic subjects. High values of gammaGT were noted in alcoholic subjects and especially in those with either increased serum triglyceride or alanine aminotransferase higher than 16 mU/ml, while PCE was not significantly changed in alcoholic subjects. Although both enzymes were strongly correlated with the logarithm of serum triglyceride and the prebeta electrophoretic fraction, there were striking differences concerning their behavior in various hypertriglyceridemic subjects. PCE activity was high even in moderate hypertriglyceridemias but its correlation with serum triglyceride had a tendency to flatten with increasing concentration of triglyceride. However, increase of gammaGT was rather characteristic for gross hypetriglyceridemia. Short-term, triglyceride-lowering therapy was accompanied by a tendency to normalization of gammaGT, while PCE values were not influenced. An attempt was made to interpret these changes of serum-enzyme activity in hypertriglyceridemia in connection with mechanisms of lipoprotein synthesis and with the pathogeny of hyperlipemic conditions.

Adult↗
PubMedDate not supplied

Essential arterial hypertension and polymorphism of angiotensinogen M235T gene.

Several candidate genes, chosen from the renin- angiotensin system, were examined for their association with essential hypertension. The genes of the renin- angiotensin system (RAS) are good candidates for such an approach because this system is well known to be involved in the control of blood pressure. One of these candidate genes is the gene encoding for angiotensinogen (the most important gene of the RAS associated with essential hypertension in the most population, is the gene for angiotensin-converting enzyme- ACE). One DNA polymorphism within exon 2- with threonine instead of methionine at position 235 (M235T) was found to be significantly associated with hypertension. The objective of this study is the analysis of M235T polymorphism in angiotensinogen gene in Romanian patients with essential hypertension as well as controls. We examined 38 patients with essential hypertension and 21 normotensive patients. In order to identify the M235T angioteninogen variant, we used the following methods: DNA extraction, PCR amplification and enzymatic digestion of the PCR product using Tth 111I restriction endonuclease enzyme. In the study groups, the M235T variant (Met?Thr in aminoacid position 235) was found more frequently in hypertensive patients (81,57%), than in control subjects (66,66%). We identified 52,63% M235T heterozygotes in the hypertensive group compared with 47,61% in the control group, and 28,94% T235T homozygotes in the hypertensive group compared with 19,04% in the control group. The results of our study suggest an association of the M235T polymorphism in the gene encoding angiotensinogen with essential hypertension.

Adult↗
PubMedDate not supplied

Correlation between left ventricular diastolic function and exercise testing in patients with old myocardial infarction.

There is no correlation between left ventricular (LV) systolic function and effort capacity of the patients with acute or old myocardial infarction (MI). On the other hand, some recent studies suggest such a relationship for LV diastolic function. Twenty-five patients with old MI were submitted to a maximal symptoms limited exercise testing (ET) and to an echo Doppler examination; functional aerobic impairment (FAI), myocardial aerobic impairment (MAI), maximal exercise capacity (METs NYHA class), isovolumic relaxation time (IVRT), E and A wave velocity, E/A rate being calculated. There is a negative significant correlation between MAI and E velocity (r = -0.68), but not between MAI and A velocity or IVRT. The data sustained the correlation between LV diastolic dysfunction and myocardial ischemia, but not with effort capacity of the patients, the last one being determined mainly by other factors. The LV diastolic function indices were modified in anterior but not in inferior MI, in relation with the amount of myocardial necrosis. It is concluded that, like LV systolic function, LV diastolic function does not correlate with the effort capacity of the patients with MI, but it represents a good predictor of the severity of myocardial ischemia mainly in anterior MI.

Diastole↗
PubMedDate not supplied

Effect of exercise training upon left ventricular systolic performance and effort capacity in patients with old myocardial infarction.

Recent studies suggested an improving of left ventricular (LV) systolic function during exercise training in patients with old myocardial infarction. Twenty patients with old myocardial infarction (3-6 weeks) were included in an exercise training programme (mainly cycloergometer) for 2 to 8 weeks. Before and after the exercise training programme, the effort capacity and LV systolic function were determined through exercise testing on cycloergometer and echocardiography. The peak effort raised from 4.39 to 5.27 METs (p < 0.05) and the difference DAF-DAM was reduced from 25% to 12% (p < 0.05). The double product (DP) at peak effort raised nonsignificantly (4.91%, p > > 0.05), but at submaximal effort levels DP decreased significantly on each effort step (12.16%, p < < 0.05). In turn, LV systolic function calculated parameters were practically the same before and after the exercise training programme. (EDD 54.3 vs 5.3 mm, ESD 39.3 vs 38 mm, EDV 160 vs 169 ml, ESV 60.6 vs 54.8 ml, EF 54.1% vs 57.8%, SF 27.6% vs 31.2%). It is concluded that exercise training raised the effort capacity in patients with old myocardial infarction, mainly through peripheral mechanisms, LV systolic function being unchanged. It is also important that exercise training have not any detrimental effect upon LV systolic function and consequently exercise training programmes can be applied and can be useful also in patients with old myocardial infarction and impaired LV systolic function.

Adult↗
PubMedDate not supplied

Ischemic preconditioning during successive exercise testing.

It was suggested recently that ischemic preconditioning can occur in clinical practice. We investigated this hypothesis in 26 patients with old myocardial infarction (MI) or stable angina pectoris, subjected to two successive exercise testings at 1 hour interval. The ST depression was significantly lesser during the second exercise testing (1.83 +/- 0.12 mm, vs 1.02 +/- 0.14 mm p < 0.01) at the same double product (DP) (24.877 +/- 1206 vs 24.711 +/- 1152 p > 0.05) and peak effort (76.92 +/- 6.63 w vs 75.96 +/- 6.27 w p > 0.05). The improvement was attributed to ischemic preconditioning.

Adult↗
PubMedDate not supplied

Transesophageal determination of SNRT and SACT in paroxysmal supraventricular tachyarrhythmias.

The paper tested the hypothesis that supraventricular tachyarrhythmias (SVT) could represent the first clinical manifestation of the sick sinus syndrome (SSS). Absolute sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) were determined through transesophageal approach in 16 patients with paroxysmal SVT, but without bradycardic episodes between crises. The values considered normal were: SNRTa less than or equal to less than or equal to 1500 ms; SNRTc less than or equal to 525 ms; SACT less than or equal to 150 ms. SNRTa, SNRTc and SACT were normal in all subjects (SNRTa: 1077 ms; SNRTc: 400 ms; SACT: 111 ms) and suggest the absence of a notable sinusal disfunction in these patients. We concluded that SVT unassociated with bradycardia do not usually represent a manifestation of SSS. Consequently the administration of sinusal depressant drugs in such patients could be permitted without restrictions.

Cardiac Pacing, Artificial↗
PubMedDate not supplied

Comparative value of arm and leg exercise testing.

Arm exercise test (AET) is described as an alternative to the classical leg exercise test (LET). The value of these two types of exercise was studied in a group of 32 patients aged 34 to 65 years. The patients performed LET for several reasons and, after 24 hrs, AET under the same conditions. The effort level reached under LET was always greater than that achieved under AET and the calculated functional aerobic impairment (FAI) was 50% greater during AET thus supporting the idea that AET cannot be used instead of LET in determining the functional capacity (NYHA) of cardiac patients. However, AET remains useful for the determination of the occupational working capacity in certain occupational categories. The double product (DP) (or index tension time (ITT) calculated after AET represented 85% of the calculated value after LET. The results proved that MVO2 is similar for both LET and AET, but in the latter at lower levels of exercise (VO2). The LET-DP was greater than the AET-DP in 66.5% of our cases, thus suggesting that AET should be reserved for situations in which LET cannot be performed. This is also supported by the presence of ST depression during AET in only 66% of the 18 subjects with ST depression during LET and in five of the six patients without ST depression, DP-AET was lower than DP-LET.

Adult↗