Search PubMed⌕ Search

Biomedical subjects

E Michalak

Publications and source records attributed to E Michalak.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Disturbances of myocardial perfusion by exertion scintigraphy in patients with hypertrophic cardiomyopathy and their relationship with sudden death risk factors].

Heart muscle perfusion was studied by exertion scintigraphy Tal-201 in 24 patients, 16M and 8F, aged 16-45 years, means--28 +/- 7.4 years with hypertrophic cardiomyopathy. The relationship between perfusion disturbances and sudden death risk factors occurring in this group of patients was evaluated. Disturbances of heart muscle perfusion were found in 20 pts (83%); 2 pts had permanent perfusion defects, in 18 pts these defects were completely or partially reversible at rest. Only 4 pts (17%) had normal heart muscle perfusion. In patients with perfusion disturbances there was found a significantly more frequent occurrence of the following sudden death risk factors: 1. syncope (p less than .01) 2. ventricular arrhythmia of IV b class according to Lown (p less than .01) 3. advanced hypertrophy of intraventricular septum (p less than .01) 4. sudden death in patients families (p less than .05) The evaluation of the heart muscle perfusion confirmed the occurrence of myocardial ischemia in most of the examined patients. Normal coronaro-angiography in all the patients over 35 years as well as the young age of the other patients exclude atherosclerosis as the cause of myocardiac ischemia in the group under study. This is a confirmation of nonatherosclerotic etiology of myocardiac ischemia in hypertrophic cardiomyopathy patients. The correlation between perfusion disturbances and sudden death risk factors points to the role of ischemia in the natural course of disease and the value of exertion scintigraphy TI-201 in prognosing patients with hypertrophic cardiomyopathy.

Adolescent↗
PubMed1989

[Sudden death risk factors in patients with hypertrophic cardiomyopathy].

In 79 patients aged 13-65 (mean 36.6) with different types of the hypertrophic cardiomyopathy ECG Holter's monitorings, M-mode and 2-dimensional echocardiographic examinations as well as hemodynamic ones were performed. Ventricular arrhythmias were observed in ECG Holter's recordings in 59.9% of patients. More frequent occurrence of higher grades (3, 4, 5 grades by Lown's classification) of ventricular arrhythmias were stated in patients with significantly thicker intraventricular septum, increase of a left ventricular ejection fraction and a lower left ventricular myocardial mass. There were observed 7 patients without significant forms of ventricular arrhythmias in ECG 24-hours monitoring, but with several, coexisting, well known in literature sudden cardiac death risk factors such as: history of cardiac arrest, sudden cardiac death occurrences in a family before the age of 50, preexcitation syndrome, ecg repolarization disorders, history of fainting, physical activity performance or mental stress. It was stated, that risk of severe ventricular arrhythmias occurrence or a sudden cardiac death in patients with coexisting several, above mentioned, risk factors is higher than in remaining patients with the hypertrophic cardiomyopathy.

Adolescent↗
PubMed1989

[Cardiac rhythm disorders in patients with hypertrophic cardio- myopathy detected by ECG monitoring by the Holter method].

24-hours Holter's ecg monitoring was performed in 79 patients with the hypertrophic cardiomyopathy. Ventricular arrhythmias were recorded in 75.9% of patients, including those revealed in the second recording in 29.5% of patients. Subsequent ecg monitoring was especially useful in detection of complex forms of ventricular arrhythmias (in 27.5%). Average doses of verapamil and Beta-adrenergic blockers were not sufficient in the antiarrhythmic therapy. There was no close correlation between ventricular arrhythmias and a morphologic type of a cardiomyopathy. Patients with episodes of fainting or loss of consciousness require repeated Holter's ecg monitorings.

Adolescent↗
PubMed1989

[Results of long-term verapamil treatment of patients with hypertrophic cardiomyopathy].

In 50 patients with different forms of hypertrophic cardiomyopathy the effect of many months (mean 23.3 +/- 15.7) therapy with verapamil was estimated. Interventricular septum thickness, isovolumetric relaxation period (IRP), "a" wave amplitude were evaluated as well as changes of parameters indirectly testifying to intraventricular obstruction such as: abnormal systolic anterior mitral leaflet motion (SAM) and midsystolic aortic valve closure (AVC). Pre- and post therapy physical efficacy was estimated basing on effort duration. Results were compared with those observed in a group of 20 patients with hypertrophic cardiomyopathy not treated with calcium channel antagonists. Verapamil therapy resulted in inhibition of a disease progression and in diminution of interventricular septum thickness respectively in 74% and 48% of patients. Differences are significant in comparison with a control group. Characteristics of diastole was improved almost in a half of verapamil patients. In the majority of cases, active diastolic period improvement was referred to patients with nonobstructive cardiomyopathy forms and corresponded with their physical fitness improvement. Verapamil resulted in diminution or regression of SAM and AVC in patients with obstructive forms and most likely caused physical efficacy improvement in some of them. The study also confirmed that the group of patients with hypertrophic cardiomyopathy is not homogenous one with regard to morphology of hypertrophy, hemodynamics, disease progression and response to therapy. Observed differences do not always depend on a cardiomyopathy form which suggests that the applied nowadays classification is not sufficient.

Adult↗