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Biomedical subjects

I Tomov

Publications and source records attributed to I Tomov.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Treatment of chronic congestive failure with vasodilators (acute trial with prazosin and erythrityl tetranitrate)].

An acute clinical experiment was carried out with 34 patients with chronic refractory cardiac insufficiency with stasis and idiopathic dilating (stasis) cardiomyopathy so as to follow up the hemodynamic effect of the vasodilators prazosin and erythrityl tetranitrate. The values of the central and peripheral vascular hemodynamics were followed up before and one hour after the peroral intake of 2 mg prazosin and half an hour after the peroral intake of 40 mg erythrityl tetranitrate. The results indicate that a statistically significant decrease of the arterial pressure and the total peripheral vascular resistance developed after prazosin intake. The systolic arterial pressure was decreased from 121,80 +/- 3,52 to 102,40 +/- 3,71 (p less than 0,001) and the diastolic--from 80,20 +/- 2,41 to 68,20 +/- 2,56 (p less than 0,01). The values of the total peripheral vascular resistance were decreased from 2629,65 +/- 174 to 1865,53 +/- 153 (p less than 0,001). The indices of the pump function--Stl and SI were increased (Stl from 22,74 +/- 1,85 to 30,37 +/- 2,14 with p less than 0,025 and Sl--from 1,90 +/- 0,08 to 2,64 +/- 0,19; p less than 0,02). The indices of the pressure in the left ventricular filling had no statistically significant change. After the administration of erythrityl tetranitrate, a statistically significant improvement of the indices of the cardiac output was also observed as well as of the total peripheral vascular resistance. The systolic index grew from 1,74 +/- 0,20 to 2,70 +/- 0,16 (p less than 0,01); stroke index--from 18,35 +/- 2,82 to 32,99 +/- 2,88 (p less than 0,01), and the total peripheral vascular resistance was decreased from 2897,0 +/- 186,0 to 1556,0 +/- 154,0 (p less than 0,001). Prazosin and erythrityl tetranitrate led to a considerable decrease of the counter load of the heart and improvement of the pump function of left ventricle in an acute experiment in case of chronic cardiac insufficiency with stasis.

Adult↗
PubMed1982

[Clinical and hemodynamic effect of molsidomine in patients with unstable angina pectoris].

In 30 patients with a grave form of ischemic heart disease--unstable angina pectoris, peroral treatment with molsidomin (Corvaton) was carried out in a dose I table of 20 mg, three times daily, in the course of 33 days at an average. The incidence, intensity and duration of stenocardiac paroxysms were followed up as well as the nitroglycerine need- and electrocardiographic changes. The main hemodynamic indices, prior to and post treatment, were also determined. The stenocardiac paroxysms were established to disappear after molsidomin treatment in 30 per cent of the cases as well as reduction of anginose symptomatics in more than 50 per cent in 50 per cent of the patients, reduction of stenocardiac symptomatics to 50 per cent in 3.3 per cent of the cases and no effect in 16.7 per cent of the patients. The hemodynamic molsidomin effect was conditioned by the increase of the volume of the venous vascular system, due to which the venous flow to the heart was diminished--a reduction of the overloaded myocardium and its oxygen needs occurred.

Angina Pectoris↗
PubMed1982

[Clinical and hemodynamic characteristics of the decompensation syndrome in patients with congestive cardiomyopathy].

Thirty seven patients were clinically and hemodynamically studied under hospital conditions. The stage of cardiomegaly, the stasis in the pulmonary and systemic circulations were followed up as well as the presence of manifestations of pulse deficit, incidence of gallop rhythm manifestation. It was established that in the patients with II-A stage of decompensation of circulation, a decreased cardiac output was found, enhanced peripheral resistance and normovolemia. In the patients with II-B stage of circulation decompensation, further decrease of stroke and minute volume was found as well as moderately slowed down blood flow in the pulmonary and systemic circulation and normal peripheral vascular resistance. Conclusions were drawn, on the base of the data obtained, about the optimal treatment depending on the circulation decompensation stage.

Arrhythmias, Cardiac↗
PubMed1981

[Vasodilator treatment of chronic heart failure: a chronic double-blind trial with prazosin and erythrityl tetranitrate].

A chronic double-blind experiment was carried out with 32 patients with severe chronic stasis cardiac insufficiency, with concomitant idiopathic congestive cardiomyopathy and ischemic heart disease, in assessing the effect of vasodilators prazosin or erythrityl tetranitrate upon the decompensation symptomatics and hemodynamic indices. The clinical indices of cardiac insufficiency with hemodynamic signs of pre-loading, myocardial contractility and postloading of left ventricle were followed up. Besides vasodilators the patients were administered the ordinary maintenance therapy with digoxin and diuretics. The experiment was a double blind one, controlled by placebo-periods and covered a 6 months follow-up period. The combined venous-arteriolar vasodilator prazosin was reduced pre and post-loading, it increased the cardiac output, without essential changes in functional capacity of the patients with chronic cardiac insufficiency. Erythrityl tetranitrate, however, has no substantial effect on the clinical and hemodynamic indices of statis cardiac insufficiency even in higher doses. That suggests the necessity of the chronic cardiac insufficiency treatment to be carried out with vasodilators with venous and arteriolar effect.

Chronic Disease↗
PubMed1981

[Intracardiac hemodynamic characteristics in high-degree mitral stenosis and an assessment of the indications for its surgical treatment].

The data from the right cardiac catheterization, echocardiography M-type and radiocardiography were juxtaposed in 54 patients with "pure" or predominating severe mitral stenosis (MS)(mitral valvular opening under 1 cm2)--confirmed at operation, in the determination of their functional and hemodynamic characteristics. The patients were grouped into three groups depending on the degree of pulmonary--capillary pressure increase (PC)--greater than 2.666, greater than 3.999 and 4.132 kPa(greater than 20, greater than 30 and less than 31 mmHg). The first group covering 28 per cent of the patients with a mean PC--2,399 +/- 0.257 kPa = (18 +/- 1.93 mmHg) are of particular interest. A light to moderate increase of pulmonary arterial pressure, elevated TPVR, absence of right ventricular insufficiency with reduced M. V SI resp. were established in them. It was assessed as a group with hypovolemia and proper preoperation preparation but requiring attention as regards the eventual hypotension, intra- or post operation. The third group covers 22 per cent of the patients and is characterized with increased TPVR, high hypertension in pulmonary artery, elevated telediastolic pressure in right ventricle and normal or lightly increased MO, assessed as a group with an inadequate diuretic therapy pre-operatively. The second group is with typical hemodynamic characteristics of severe MS and includes 50 per cent of the patients. The analysis forces the conclusion, that for an adequate evaluation of hemodynamics and MS severity, the PC pressure is necessary to be always discussed in connection with blood volume and flow, as well as with the other hemodynamic indices, in order to avoid the omissions as regards MS operability.

Adult↗
PubMed1980

[Echocardiographic evaluation of left ventricular function in mitral insufficiency].

The potentialities of M-type echocardiography (EchoCG) for the evaluation of left ventricle function and the diagnosis of mitral regurgitation are studied in 76 patients with isolated, "pure" mitral insufficiency, confirmed at the clinic and by instrumental non-invasive and invasive examinations (right and left cardiac catherterization and left ventricle angiography). All EchoCG-alterations found have a non-specific character and are a manifestation of volume loading of the left ventricle and left auricle--increased volume and velocity of mitral blood flow. The presence of some of the following functional indices is of highest significance for EchoCG-diagnosis of mitral insufficiency: determination of regurgitation volume, regurgitation fraction and regurgitation index of left ventricle resp., growth of the telemetric size and volume, beat and minute volume of left ventricle, increased indices for the total and local contraction function of left ventricle, increased dimensions of left auricle, slightly elevated velocity and amplitude diastolic indices of anterior cusp of the mitral valve. The high-degree mitral insufficiency often masks EchoCG-manifestation of left ventricle contractility insufficiency. That is the reason why in case of significant mitral insufficiency, the normal or lightly diminished values of contractility indices--fraction of shortening, fraction of expulsion and average velocity of contraction of the circumferential fibres, are a manifestation of reduced contractability of left ventricle. The values of those EchoCG-indices significantly decrease only in mitral insufficiency with severe left ventricle dysfunction. EchoCG enables an approximate evaluation of the degree of mitral insufficiency, differentiating the light and moderate from severe mitral regurgitation with a relative accuracy. The extent of the regurgitation volume, fraction and index, the diastolic size and volume, beat and minute volume of left ventricle and the size of left auricle are of highest importance for the determination of the degree of mitral insufficiency. With light mitral insufficiency, EchoCG could be absolutely normal.

Adolescent↗
PubMed1980

[Echocardiographic (EchoC) assessment of left ventricular function in aortic insufficiency].

In 31 patients with non-invasive and invasive confirmation of "pure" aortic insufficiency, signs for volume loading of left ventricle were establishing by M-type echocardiography (EchoCG)--namely--extended telediastolic deminsion, telediastolic volume and stroke volume of left ventricle, tendency to hypercontractility of interventricular septum and light hypertrophy of left ventricular myocardium. In case of aortic insufficiency with left ventricular insufficiency, decreased values of contractile EchoCG-indices of left ventricle were established--fraction of shortening (FS), fraction of expulsion (EF), mean velocity of contraction of the circumferential fibres (mVcf) and extended dimension of left ventricle. The echocardiography enables the approximate evaluation of the stage of the aortic insufficiency, properly differentiating more cases of light and moderate than severe aortic regurgitation. Most significant, in that respect, are the diastolic volulume, stroke volume and contractility indices of left ventricle as well as the extend of the regurgitation volume of left auricle as well.

Adolescent↗
PubMed1979

[Echocardiographic changes in tricuspid insufficiency].

The following echocardiographic changes were found in 42 patients with catheterization data for tricuspid insufficiency: all echocardiographic dimensions of the right ventricle and right auricle are considerably increased; the interventricular septum reveals paradoxical movements in 38 per cent of the cases; the tricuspid echogram shows unspecific changes in the speed and amplitude parameters of the anterior tricuspid cusp--increased speed (D--E) and amplitude (C--E) of opening, increased speed of backward movement in an early diastole (E-F), increased speed of closing (A--C),increased duration of the final diastolic intervals A--C and Q--C, the difference between the Q--C interval duration of the tricuspidal valve and Q--C interval of the mitral echogram is pathologically increased, the ratio between the speed of E--F segment of the tricuspid valve and E--F segment of the mitral valve is also increased. The diagnostic sensitivity of those changes of the tricuspid echogram is about 75 per cent. EchoC-diagnosis of the tricuspid insufficiency is based on the combination of considerably increased EchoC-dimensions of the right ventricle and the right auricle, paradoxical movements of the interventricular septum and the changes of the speed and amplitude parameters of the tricuspid echogram.

Adolescent↗
PubMed1979

[Echocardiographic indices of the pumping and contractile functions of the left ventricle and left ventricular cardiac insufficiency].

EchoC-indices for the left ventricle function and the degree of left ventricular insufficiency are confronted in 148 patients with various degree of left ventricular insufficiency determined by clinical and instrumental non-invasive examination, right and/or left heart catheterization and the method of dye dilution. It was established that in the differentiation of the initial left ventricular insufficiency, EchoC-indices of the pump and contractility function of the left ventricle have a diagnostic sensitivity of 94 per cent and give a relatively low false positive (12%) and false negative results (6%). EchoC-indices, which are with the highest diagnostic sensitivity in the determination of the initial left-ventricular insufficiency, are the telediastolic size and left ventricular volume; the fraction of shortening, average rate of contraction of the circumferential fibrils and the fraction of forcing out.

Adult↗