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Biomedical subjects

K Wrabec

Publications and source records attributed to K Wrabec.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Chronic thromboembolic pulmonary hypertension--observation of personal case reports].

The clinical picture, differential diagnosis and prognosis in chronic thromboembolic pulmonary hypertension (CTEPH) is being discussed on the basis of a dozen of the authors' cases. The clinical course of CTEPH in 2 patients fulfilling the main criterium for pulmonary thromboendarterectomy and undergoing one year anticoagulation is examined. As a result patient with one large pulmonary vessel occlusion (a. lobaris superior sinistra) improved his clinical status as well as hemodynamic and echocardiographic outcome. In patient with multivessel pulmonary occlusion gradual clinical aggravation and hemodynamic-echocardiographic progression of CTEPH was observed.

Adult↗
PubMed1992

Long-term prazosin therapy for COPD pulmonary hypertension.

A 51-year-old patient with COPD, obesity, and pulmonary hypertension underwent long-term prazosin therapy after a successful hemodynamic response to 1 mg of oral prazosin. The 18-month administration of prazosin, in a dose of 3 mg a day, resulted in continued hemodynamic and echocardiographic benefits.

Humans↗
PubMed1992

[Chronic obstructive lung disease: does accompanying arrhythmia have any clinical significance?].

Clinical significance of cardiac arrhythmias in patients with advanced and stable chronic obstructive pulmonary disease was assessed 22-24 hour Holter monitoring revealed supraventricular and ventricular arrhythmias in all 65 patients. There was a great variation of arrhythmia quality and quantity in the study group. Among others, 1808 complex ventricular extrasystoles in 33 patients and 302 episodes of nonsustained ventricular tachycardia in 19 patients were recorded. No sustained symptomatic ventricular arrhythmias were observed. We found no correlation between the intensity of ventricular and supraventricular extrasystoles and clinical parameters as assessed by echocardiography, spirometry and gasometry. However, patients with complex ventricular arrhythmias had larger right ventricular diameter in echocardiography. Of 65 studied patients, 14 (21%) died during follow-up ranging from 1 month to 3.2 years, mean 12.2 months. Two outpatients died suddenly. These 14 patients had larger right ventricle and left atrial dimension, more pronounced PaO2 decrease as well as lowered FEV1 as compared to the survivors. No differences in the incidence of cardiac arrhythmias were noted. Summarizing, despite the great prevalence of cardiac arrhythmias in patients with advanced stable COPD we found no life-threatening ventricular arrhythmias during approximately 1500 hours of holter monitoring. Cardiac arrhythmias seem not to influence the prognosis in these patients.

Adult↗
PubMed1992

[Enalapril improves hemodynamics and exercise tolerance in pulmonary heart disease caused by obstructive lung disease].

Chronic enalapril therapy was assessed in 11 patients with cor pulmonale due to chronic obstructive pulmonary disease. Enalapril was added to the maintenance dose of diuretics and digitalis and when clinical stabilisation was achieved haemodynamics, spirometry, blood gases and maximal treadmill exercise test accompanied by +pulse oximetry were performed before and after 30 days, 10-20 mg a day, enalapril therapy. Haemodynamic study showed moderate but significant decrease in mean pulmonary artery pressure, from 24 +/- 3 to 21 +/- 5 mmHg (p = 0.05). There were no substantial differences in cardiac output as well as in blood gases and spirometry after enalapril therapy. Slight decrease in oxygen delivery, on an average from 9157 +/- 3808 to 8074 +/- 3574 (p = NS), was accompanied by a concomitant fall in haemoglobin. We noted significant improvement of maximal exercise test results after enalapril therapy. Maximal workload achieved and the time of exercise increased. It was accompanied by subjective improvement as assessed by Borg scale. We observed no adverse effects of enalapril during one month therapy in patients with cor pulmonale and COPD.

Aged↗
PubMed1991

[Respiratory rehabilitation of patients with chronic obstructive lung diseases in the subjective and objective evaluation].

An intensive 14 day respiratory rehabilitation program was carried out in 24 COPD patients of mean age 66.0 +/- 10.0 yrs (FVC 1.56 +/- 0.52 L, FEV1 0.94 +/- 0.4 L/s). A statistically objective improvement was seen measured by the 100 meter tread mill test (p = 0.001) which was not seen in spirometric analysis. Seventeen patients reported a subjective improvement in their clinical state. The authors have demonstrated usefulness of the 100 meter walk test in analysis of rehabilitation processes.

Administration, Inhalation↗
PubMed1990

[Clinical and hemodynamic evaluation of 6-week treatment of pulmonary hypertension in chronic obstructive lung diseases (COLD) with low dose of prazosin].

The value of vasodilatatory treatment of pulmonary hypertension due to chronic obturative pulmonary disease (c.o.p.d.) is still controversial. However in patients with c.o.p.d. causal treatment as well as chronic domestic oxygen therapy have a wide range of limitations. Among vasodilator alpha-1 blockers show less vasodilator-related adverse effects, and as known from acute trials they exert a potent effect on pulmonary circulation in patients with pulmonary hypertension and c.o.p.d. Prazosin was studied in 11 patients (10 men, 1 women) aged 63 +/- 7 years with advanced c.o.p.d. (FVC 1.8 +/- 0.41, FEV1 0.99 +/- 0.55 l) (s) after their clinical stabilisation. In 4 of them prazosin was added to the maintenance dose of diuretics and digitalis. Subjective status, NYHA functional class, spirometric (FVC, FEV1) and gaseous (PaO2, PCO2) parameters, weight, systemic blood pressure, and heart rate were noted. During Swan-Ganz catheterization mean pulmonary artery pressure (MPAP), right ventricular end-diastolic pressure (RVEDP), pulmonary wedge pressure (PCWP), cardiac output (CO), systemic (SVR) and pulmonary (PVR) vascular resistance were measured. The acute trial with 1 mg prazosin taken orally was followed by 2- and 6-week of 3 mg prazosin treatment assessment. After a single dose of 1 mg prazosin there was a significant decrease in MPAP from 36 +/- 9 to 28 +/- 10 (p = 0.001) and 44% decrease in RVEDP (p = 0.05). CO increased by 16% (p = 0.01). The fall in PVR (30%, p = 0.01) exceeded that in SVR (17%, NS). No adverse effects were observed. During 2-week 3 mg a day prazosin therapy 2 patients were excluded following dyspnea and systemic hypotonia.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1990

[Effect of resuming work after myocardial infarction on its recurrence and mortality in long-term observations].

60 to 95% pts in the age group below 60 return to work after having* suffered the first M.I. Up to the present moment, it has not been proved whether such return influences in any (positive or negative) way the recurrence of M.I. or the mortality rate. Two groups of pts who underwent M.I. in the years 1976-84 were included in the long term questionnaire observation: 1. 222 men (mean age 49.3 +/- 3.8 yrs) who resumed work and; 2. 153 men (mean age 50.7 +/- 8.4 yrs) who did not return to work after the first M.I. All pts were sent the questionnaires by post annually. The aim of the questionnaire was to establish whether the patient is alive, if he underwent reinfarction and, in case of death--what was its cause. Until 1985 reinfarction occurred in 25%, and until 1989--in 33% of the pts who resumed work, and 42% of pts who did not. The mean value of reinfarction was about 1.4 in the first group and 1.5 in the latter. Until 1985 the death rate was respectively 15% and 12%. Until 1989--the death rate was 28% and 30%. Thus, the differences between those two groups were statistically insignificant. In conclusion, it may--indirectly--speak in favour of resuming work after the first M.I., showing that, although it does not decrease the reinfarction and mortality rates, it also does not increase the risk.

Adult↗
PubMed1989

[Left ventricular mural thrombi in myocardial infarction in echocardiographic studies and clinical observations].

Examinations were performed in 153 consecutive patients with myocardial infarction (MS), which were divided into two groups. Group I (21 persons) consisted of patients with echocardiographically diagnosed left ventricular mural thrombus, and in group II were patients without evidence of thrombi. Significantly more patients with anterior myocardial infarction were in the the group I, whereas those with inferior MI in the group II. Increased left ventricular wall contractility index and considerably percentage of dyskinesis, mostly of the apex region were stated in the group I. 15 patients (71%) of the group I were treated with heparin, but only 4 of them within 4 hours from the beginning of angina pain. In 4 patients of the group I (19%) thromboembolic complications occurred: in 1 patient during proper anticoagulant therapy and in 3 others without treatment with heparin. Thus mural thrombi were observed in majority in patients with anterior myocardial infarction and were localized in a diskinetic region. Echocardiograms of patients with mural thrombi testified to greater than in others left ventricular function impairment. Heparin administration during first hours of myocardial infarction seemed to lower the incidence of mural thrombi and probably thrombembolic complications.

Adult↗