[73. The diagnostic value of the work load ECG in ischemic heart disease].
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Biomedical subjects
Publications and source records attributed to M Todorova.
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The diagnostic value of ST-T changes in working ECG on veloergometer with submaximal loading is assessed in 286 cases--83 with coronary disease, 44--healthy, 112 with indistinct precordial pains and neurovegetative dystonia and 46 with some other non-coronary heart diseases. The reduction of ST-segment 1 mm with horizontal or descending form is the most accurate criterium in the differentiation of pathological and normal ECG-reactions. An appropriate criterium for coronary disease diagnosis is also the negative T wave with an amplitude of 2 mm or more in at least three leads, regardless of its form and time of appearance. The reduction of ST segment with ascending form gives a considerable opportunity for positive false diagnosis. The false negative diagnosis is 24%. The causes are to be found in the appearance of rhythm and lead disturbances and insufficient loading.
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The sensitivity, specificity and diagnostic accuracy of 34 ECG-indices for right ventricular hypertrophy was checked up in 131 individuals--40 healthy, 59 with post mortem confirmed right ventricular hypertrophy and 32 with clinical and X-ray data for right ventricular hypertrophy. The following indices showed the best diagnostic value: AQSR to the right of + 90 degrees (in adults over 30); RV1 greater than or equal to 5 mm; SV5 or V6 greater than or equal to 7 mm: R/SV1 greater than or equal to 1 and/or R/SV5, V6 less than or equal to 1: RV1 + + SV5 or V6 greater than 10,5 mm; SV1 less than 2 mm: pathological progression of R/S in precordial leads to the right of the intermediate zone; R/S less than 1 and S greater than 4 mm in 1 st lead: TV1--V3--negative; P-pulmonale. That complex reveals accurately 60--70 per cent of the cases wi h right ventricular hypertrophy in mitral stenosis and chronic right heart. The false positive diagnosis is 5--10 per cent.
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Diabetic neuropathy is a very common complication of diabetes mellitus, and animal studies have contributed tremendously to its understanding. The aim of this study was to estimate the neuropathic alterations in the Otsuka Long-Evans Tokushima fatty (OLETF) rats, an animal model of human type 2 diabetes mellitus. For this purpose, four groups of animals were used: untreated OLETF rats, sucrose-fed for 2 months OLETF rats, untreated Long-Evans Tokushima Otsuka (LETO) nondiabetic rats as genetic controls of OLETF, and sucrose-fed LETO rats. All were examined at baseline, at the end of the sucrose treatment, and during a washout period. The following parameters were evaluated: motor nerve conduction velocity (MNCV), sensitivity to noxious thermal and mechanical stimuli using the tail-flick (TF) and tail-pressure (TP) tests, and blood glucose (BG) and HbA1c levels. Our results showed that BG and HbA1c were significantly higher in OLETF rats when compared with those in control LETO rats. Sucrose caused remarkable increase of BG and HbA1c in the OLETF rats, but not in the sucrose-fed LETO rats. MNCV and thermal nociception significantly decreased in OLETF rats in their 10th month, while the values of the TP test did not differ compared with those from LETO rats. Sucrose administration significantly decreased the MNCV, and increased the pain threshold evaluated by the TF and TP tests, compared with those in the control OLETF rats. The studied parameters were not significantly altered in sucrose-fed LETO rats. In conclusion, our findings show that signs of diabetic neuropathy appear late in the individual development of the OLETF rats, and MNCV and thermal nociception are selectively affected in this strain. Sucrose deteriorated the diabetic state, decreased MNCV, and caused thermal and mechanical hypoalgesia.
The aerial parts of Achillea setacea afforded, in addition of a rare monoterpene triol and 12 known sesquiterpene lactones, a new guaianolide containing an endoperoxide ring. Its structure was elucidated by spectral methods.
The aerial parts of A. chrysocoma and A. coarctata afforded 22 and 9 sesquiterpene lactones, respectively. All the compounds described are new for the studied species. The lactones 5, 6 and 12 are new for the genus Achillea.