Biomedical subjects
F F Kostiuk
Publications and source records attributed to F F Kostiuk.
[Comparative analysis of the significance of transesophageal stimulation of the left atrium and bicycle ergometry in the detection of residual myocardial ischemia during the early period of myocardial infarct].
The study was undertaken to compare transesophageal left atrial pacing (TLAP) and bicycle ergometry (BE) in the detection of residual myocardial ischemia (RMI) in 187 patients with myocardial infarction in the early periods of the disease (on days 20 to 26). The intensity of TLAP and BE was increased up to the threshold and submaximal levels according to the conventional criteria. Among the patients, RMI was detected in 71% with TLAP and in 55% with BE (p less than greater than 0.01). Thus, this suggests that TLAP has advantages over BE in the detection of RMI in patients with myocardial infarction in the early periods of the disease.
[Functional state of the sinoatrial node in patients with intraventricular block].
The function of sinus node (SN) was studied in 101 subjects with intraventricular blocks (IVB) and 30 controls. The patients with IVB showed a significant increase in the corrected time of SN function recovery and that of sinoatrial conduction both before and after medicamentous++ autonomic block, as compared to the controls. In general, signs of SN dysfunction were detected in 47 (46.5%) subjects with IVB. In 18.8% of the examinees, SN dysfunction was due to abnormal autonomic exposures, 27.7% had abnormalities in SN proper or perinodal tissue. ++Tachy-bradycardia was found in 53.5% patients with the sick sinus syndrome and IVB, 25% had concurrent atrioventricular conduction disturbances. A concomitant SN lesion was common in patients with IVB. One should take into account a type of this syndrome and the status of atrioventricular conduction when the optimal conditions of continuous electrical cardiostimulation are applied to patients with IVB and clinical signs of the sick sinus syndrome.
[Clinico-electrocardiographic variants of combined lesions of the sinoatrial and atrioventricular nodes].
A study of 71 patients with atrioventricular blocks and 57 patients with the sick-sinus syndrome (SSS) revealed electrophysiologic evidence of sinus dysfunction in 38 (53.5%) patients with atrioventricular blocks. Sinus dysfunction was due to pathologic vegetative effects in 15 (21.1%) patients with AV blocks, and a pathology of the sinus node itself in 23 (32.4%). Impaired atrioventricular conductivity, was registered in 29 (38.7%) patients with the SSS. A disorder of atrioventricular automatism was detected in 38 patients, and was combined with impaired AV conductivity in 19 of those. Five clinico-electrocardiographic variants of binodal heart disease have been identified, and possible therapies are discussed for each of those.
[Use of transesophageal stimulation of the left atrium in the diagnosis of ischemia and cicatricial myocardial changes in patients with complete block of the left fascicle of the bundle of His].
Transesophageal stimulation of the left atrium was performed in 52 patients who had signs of complete left bundle branch block as evidenced by ECG, 48 patients having sustained block, 4, intermittent one. In 42 (80.8%) patients, the block was temporarily arrested during and/or after discontinuation of the electric stimulation, in 28 of them, the block was stopped during the stimulation without any drugs, in 1, only after obsidan, and in 13, following obsidan and atropine. When the block was being arrested, 13 patients showed ECG ischemic changes, 7 exhibited myocardial scarring alterations, 8 had nonspecific T wave alterations, 8 displayed signs of left ventricular hypertrophy with impaired repolarization. No ECG changes were found in 7 patients. The use of transesophageal electrical stimulation of the left atrium to temporarily abolish complete left bundle branch block may contribute to elucidation of the etiology of the block and choice of the most adequate therapy.
[Cardiorespiratory function of workers in the electric steel smelting shop of the Sibelektrostal' Plant].
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[Sinus node function of ischemic heart disease patients with chronotropic incompetence].
Forty-five (17.6%) of 256 coronary patients showed inadequately small heart rate augmentation in response to rationed exercise ("chronotropic incompetence"). To assess their sinoatrial node function, esophageal atrial stimulation was done in all patients before and after drug-induced vegetative block, and the adjusted sinoatrial node function time and sinoatrial conduction time were determined. Electrophysiological evidence suggests that "chronotropic incompetence" is in most cases determined by abnormal sinoatrial rhythm. Rationed exercise testing can be used as a screening test for latent weak sinoatrial node syndrome in coronary patients.
[Use of a physical exertion test for the diagnosis of the sick sinus syndrome].
Forty-three patients with the sick sinus syndrome (SSS) and 74 normal persons were examined. All the patients were subjected to bicycle ergometry. The lower limits of normal for the heart rate (HR) (in men and women separately) were established during exercise of varying intensity. In 66.7% of patients with the SSS, the HR during exercise was under normal. In a significant part of SSS patients, the reduction of the HR after exercise proceeded more rapidly than in normal subjects. The authors suggest a heart rate retardation index (HRRI) for recognizing the SSS, the diagnostic importance of which rises with an increase in the exercise intensity. The total sensitivity of both indices (the HR at the end of exercise and the HRRI) reaches 100%. It is concluded that the exercise test can be used for preliminary screening of patients with the SSS.
[Physical work capacity of patients with ischemic heart disease and reduced chronotropic reserve].
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[Diagnostic value of the atropine test in the sick sinus syndrome].
Altogether 63 patients with clinical signs of the SNWS (the 1st group), 16 patients with coronary heart disease and the latent SNWS (the 2nd group), 26 patients with heart coronary disease without disorder of sinus node function (the 3rd conventionally control group) and 60 healthy persons (the 4th control group) were examined. Atropine was administered i. v. to them all at a a dose of 0.02 mg/kg of the body mass. The heart beat rate (HBR) was measured before atropine injection as well as its increment after atropine injection. The HBR after atropine injection in the patients of the 1st group was significantly higher than that in the 2nd-4th groups; in the patients of the 2nd group the HBR was significantly less than that in the 3rd-4th groups. In the 3rd group the HBR was significantly less than that in the 4th group. An increased percentage of the HBR in the patients with clinical signs of the SNWS and in the healthy persons did not differ significantly (46.6 +/- 3.7% and 51 +/- 2.4% P greater than 0.2). The sensitivity of the atropine test in the patients of the 1st group was 76.3%. The test specificity was 93.3%. Among the patients with coronary heart disease the atropine test specificity was much less (65.4%).
[Rise in the ST segment on the ECG in chronic coronary heart disease].
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[Work capacity evaluation of patients with sick sinus syndrome].
Thirty-four normal subjects, 30 patients with sinoatrial node weakness (SANW), and 129 patients with coronary heart disease (CHD) without the signs of sinoatrial node involvement were examined. The work fitness was studied with the aid of indirect estimates (PWC 170, maximal oxygen consumption per kg bw, double product), spiroergometry (oxygen pulse, rest quotient) and central hemodynamic data (cardiac and stroke indices). The work fitness in SANW patients was low, depending on the disease etiology and chronotropic reserves of the heart. PWC 170, maximal oxygen consumption per kg bw, oxygen pulse were found to overestimate the genuine level of the SANW patients' physical status. In view of this fact these estimates cannot be used for its evaluation. It is inferred that the power of the threshold loading, the rest quotient, the cardiac index, and double product adequately reflect the work fitness of SANW patients.
[Hyperplasia of the gastric mucosa in complicated and uncomplicated duodneal ulcer].
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[Pre-infarct condition].
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[Angina pectoris of the Prinzmetal type].
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[Intraventricular blocks in myocardial infarct].
The examination was carried out in 787 patients with macrofocal myocardial infarction. The most frequently encountered variant of intraventricular block in males was the right bundle branch block, in females--the left bundle branch block. The rarest variant of intraventricular conductivity disorders in myocardial infarction was the left-posterior hemiblock. The prognostically severest variant of bilateral block consists in a combination of the right bundle branch block with the left-posterior hemiblock. The leading causes of death among the patients with myocardial infarction and intraventricular blocks were acute (cardiogenic shock, pulmonary oedema) and chronic cardiac insufficiency. In patients with bilateral blocks the frequent causes of death were, along with cardiac insufficiency, also arrhythmias (ventricular fibrillation, asystole).
[Auricular fibrillation in myocardial infarct].
Auricular fibrillation was observed in 17.8% of patients with large-focal myocardial infarction, mainly in females (p 0.01). The localization of myocardial infarction had no impact on the incidence of auricular fibrillation. The precursors of auricular fibrillation included atrial extrasystoli and an elevated electrolyte coefficient of the blood NaeKe. In the group of patients with myocardial infarction and auricular fibrillation mortality was more common among the females. Auricular fibrillation developing beyond the first postinfarction day worsened the prognosis considerably. The outcome of myocardial infarction did not much depend on the duration of auricular fibrillation and on the cardiac contraction frequency.
[Intensified Kay's histamine test in the study of gastric secretion].
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