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Biomedical subjects

O Iu At'kov

Publications and source records attributed to O Iu At'kov.

At least 19 recordsLinked to original sources

[Effect of granulocyte-macrophage colony stimulating factor on the function and regeneration of myocardium in rats with experimental infarction].

To test the reparative capacity of stromal cells in myocardial infarction, rats were injected with granulocyte-monocyte-colony stimulating factor (GM-CSF) (leukomax), a cytokine known by its ability to raise a level of stromal cells in the blood, during first three days after coronary artery ligation. Only 10 of 17 rats (59%) survived 4 weeks in this group compared with 16 of 24 (67%) among rats not treated with leukomax. Echocardiographic and electromanometric studies showed that in both groups ventricular (LV) dilatation which developed during first hours after surgery persisted throughout 6-8 weeks and was combined with decreased ejection fraction and elevated LV end diastolic pressure. These alterations correlated with infarct size which varied from 0 to 28% of left ventricular weight in both groups. There were no statistically significant differences in functional and morphometric measurements between groups receiving and not receiving GM-CSF. However this result may be inconclusive due to small number of investigated animals and broad variation of ischemic zone size in each group.

Animals↗

[Structural and functional changes of coronary and carotid arteries in patients with ischemic heart disease].

AIM: To assess prevalence of atherosclerotic changes in coronary arteries by computed tomography (CT) and carotid arteries by ultrasound duplex scanning (UDS) in patients with ischemic heart disease (IHD); to analyse viscoelastic properties of the walls of the common carotid arteries and their correlation with the results of carotid artery UDS and coronary artery CT. MATERIAL AND METHODS: CT and UDS were made in 100 patients with clinically and coronarographycally verified diagnosis of IHD. RESULTS: Calcinates in coronary arteries were found in 96% patients. The mean coronary calcium index (MCCI) was 544.8 +/- 718.5 units (from 0 to 3954 units). Atherosclerotic affection of carotid arteries was registered in 89% patients. Mean thickness of intima-media complex (IMT) of the common carotid arteries was 0.96 +/- 0.02 mm (0.60 mm - 1.87 mm). A correlation was found between coronary MCCI and IMT of the common carotid arteries. The stepwide regression analysis determined such predictors of coronary calcinosis as increased value of IMT of the common carotid arteries and atherosclerotic plaques (ASP) in carotid arteries. Viscoelasticity of the walls of the common carotid arteries in IHD patients differ from that of healthy subjects. This demonstrates stiffness of arterial wall in patients with IHD. There is a correlation between these parameters and IMT of the common carotid arteries. CONCLUSION: Combination of UDS with CT in diagnosis of atherosclerotic lesions of different arteries provides more complete information about structural-functional changes in patients with IHD. Such non-invasive tests as measurement of IMT of common carotid arteries and detection of ASP in carotid arteries by UDS, determination of coronary MCCI may serve screening parameters in diagnosis of coronary atherosclerosis.

Adult↗

[Long-term therapy with anticoagulants in patients with nonvalvular atrial fibrillation (prospective follow-up). Part I. Effect of 12-month therapy with acenocoumarol on content of d-dimer, frequency of thrombosis and parameters of hemodynamics of left auricle].

AIM: To assess frequency of left auricular thrombosis and effect of long-term therapy with acenocoumarol on auricular hemodynamics and system of hemostasis and to elucidate predictors of effective therapy with acenocoumarol in patients with nonvalvular atrial fibrillation. MATERIAL: Patients (n=100) with nonvalvular atrial fibrillation and at least 1 risk factor of thromboembolic complications. METHODS: Transesophageal echocardiography and measurement of blood D-dimer levels were carried out before and after 1 year of acenocoumarol therapy. RESULTS: Initial prevalence of left auricular thrombosis was 75%. The use of acenocoumarol for 12 months resulted in significant reduction of frequency of left auricular thrombosis. This was associated with improvement of parameters of intraatrial hemodynamics and lowering of elevated blood D-dimer levels. Clinical-instrumental predictors of presence of left auricular thrombosis and its dynamics during therapy with acenocoumarol were also elucidated.

Acenocoumarol↗

[Long-Term Therapy With Indirect Anticoagulants in Patients With Nonvalvular Atrial Fibrillation (Prospective Follow-Up Study). Part II. Effectiveness and Safety].

AIM: To assess efficacy and safety of long-term international normalized ratio (INR) guided therapy with acenocoumarol in patients with nonvalvular atrial fibrillation. MATERIAL: Patients (n=100) with nonvalvular atrial fibrillation and at least 1 risk factor of thromboembolic complications. METHODS: Ischemic strokes, episodes of systemic thromboembolism and hemorrhagic complications were registered during 3 years of treatment with acenocoumarol (target INR 2.0-3.0). RESULTS: Annual rates of ischemic strokes, hemorrhagic complications and major bleeding were 0.7, 14.4 and 1.1%, respectively. No episodes of thromboembolism were registered in patients with history of thromboembolic complications. Basing on data collected predictors of bleeding complications in patients with atrial fibrillation during long term treatment with acenocoumarol were elucidated.

Anticoagulants↗

[Atorvastatin in the treatment of patients with hereditary hypercholesterolemia].

Efficacy and tolerability of atorvastatin (20 mg/day) were assessed in a 3 month study on 19 patients (5 men, 14 women, mean age 52.3 years) with familial hypercholesterolemia. Average baseline levels of total cholesterol (CH) and low density lipoprotein (LDL) CH were 10.7 and 8.6 mmol/l, respectively. By the end of 3 months levels of CH, LDL CH, triglycerides and atherogeneity index decreased by 32, 41, 16 and 45%, respectively. This was accompanied by 21% increase of high density lipoprotein CH level. There were no cases of AST or ALT activity elevation above 3 upper limits of normal values. However 1 patient had asymptomatic elevation of ALT activity up to 53 U/l which did not cause interruption of therapy. Creatine kinase remained normal throughout the study period. Three patients (16%) stopped taking atorvastatin because of side effects. Thus in patients with familial hypercholesterolemia the dose of atorvastatin 20 mg/day was sufficiently well tolerated and provided effective control of lipid levels.

Adult↗

[Effect of atorvastatin on endothelial function in patients with familial hypercholesterolemia].

AIM: To study the influence of treatment with HMG-CoA reductase inhibitor atorvastatin on endothelial function in patients with familial hypercholesterolemia type IIa. MATERIALS AND METHODS: Sixteen patients (5m/11w, 51-/+3 years) with familial hypercholesterolemia were studied before and after 3 months of therapy with atorvastatin 20 mg/day. EDRF release test (D.Celermajer, 1992) was used to assess flow-mediated endothelium-dependent vasodilatation (FMD) of the brachial artery in response to reactive hyperemia. Plasma nitrite/nitrate (NOx) levels were measured as an indirect index of nitric oxide (NO) production in vivo using HPLC. RESULTS: Atorvastatin treatment resulted in a 32% reduction in total serum cholesterol (CH), 41% reduction in low density lipoprotein (LDL) CH, 16% reduction in triglycerides and a 21% increase in high density lipoprotein CH. Flow mediated dilatation (FMD) was impaired at baseline (5.8-/+0.9%) and significantly improved up to 9.5-/+0.9% after 3 month atorvastatin therapy (p<0.002). Change in FMD inversely correlated with baseline FMD (r = -0.58, p<0.05). There was no significant correlation between FMD and neither total serum CH nor LDL CH levels at baseline. During atorvastatin therapy significant reduction of plasma NOx levels occurred from 53.4-/+5.1 mcmol/l at baseline (range 42.6-86.2 mcmol/l) to 35.5-/+5.1 mcmol/l (18.4-46.0 mcmol/l) after treatment (p<0.02, n=7). CONCLUSION: In patients with familial hypercholesterolemia atorvastatin produced beneficial effect on endothelial function (increase in flow-mediated dilatation, decrease in NOx).

Adult↗

[Noninvasive investigation of endothelial function in patients with hypertension and hypercholesterolemia (HCE)].

AIM: Functional assessment of endothelium by endothelium-dependent and non-endothelium dependent response of the brachial artery (BA) in patients with risk factors for atherosclerosis. MATERIALS AND METHODS: The ACUSON 128 XP/10 unit furnished with linear meter with phase grid (7.0 MHz) was employed in two-direction scanning mode to measure BA diameter at rest, under reactive hyperemia (endothelium-dependent response) and after sublingual intake of 0.01 mg of nitroglycerin (non-endothelium-dependent response) in 12 patients with blood hypertension (group 3), 10 subjects with family hypercholesterolemia (group 2) and 10 healthy subjects (group 1, control). RESULTS: The flow-dependent dilatation remained unchanged in BH patients (9.4%) and lowered in HCE patients (3.0%) compared to controls (9.5%). Nitroglycerin-induced dilatation was not significantly different in patients with family hypercholesterolemia (16.6%), hypertensive subjects (14.5%) and healthy controls (20.5%). CONCLUSION: The ultrasound method of detection of endothelial dysfunction is demonstrated. Endothelial dysfunction in patients with familial hypercholesterolemia may contribute to development of atherosclerosis.

Adolescent↗

[Blood pressure variability (based on 24-hour monitoring data) in mild arterial hypertension].

To evaluate the condition of target organs in patients with mild arterial hypertension (MAH) under normal and high arterial pressure variability (APV), the authors examined 84 MAH males aged 40-60 and 14 matched healthy controls. At 24-h monitoring it was revealed that 32% of MAH patients had high variability of daytime and night arterial pressure which occurred more frequently in atherosclerotic lesion of extracranial carotid artery portions. MAH patients with high APV against those with normal APV develop carotid artery atherosclerosis 3.5 times more frequently, vascular disorders of the fundus of the eye stage II with angiosclerosis and thickening of the interventricular septum 2.5 and 1.8 times more frequently, respectively.

Adult↗

[The clinical characteristics of ischemic heart disease in patients with arterial hypertension of different origins].

To study the clinical picture of coronary heart disease with concomitant arterial hypertension of various genesis, 172 patients were examined, out of them the cause of arterial hypertension was hypertensive disease in 54, chronic pyelonephritis in 40, chronic glomerulonephritis in 37, and stenotic atherosclerosis of renal arteries in 29, endocrine disease in 12 patients. The patients were divided into 2 groups: (1) 148 with stenotic atherosclerosis of coronary arteries and (2) 24 patients with intact coronary arteries. Comparison of these patient groups revealed no clear-cut correlation between the age and the detection of exercise-induced angina, as well as the duration of arterial hypertension. There was no correlation between the detection of the anginal syndrome and ECG changes. The incidence of the anginal syndrome was 62.2% in Group 1 and 47.7% in Group 2. It was established that the detection of the anginal syndrome correlated well with the severity of left ventricular hypertrophy and values of blood pressure, despite nosological entities.

Adult↗

[The baroreceptor reflex as a predictor of crises in arterial hypertension].

The sensitivity of baroreceptor reflex was determined by the "neck chamber" method at a pressure of 40 mm Hg in patients with mild, moderate and malignant arterial hypertension (AH). A 24-hour blood monitoring was performed in patients with mild and moderate AH. There was a negative correlation between the lowering values in blood pressure on baroreceptor stimulation and the incidence of hypertensive crises in all the groups. There was also a negative correlation between the baroreceptor sensitivity and the daily blood pressure variations in patients with moderate AH. The findings suggest that a decrease in baroreceptor sensitivity might be a predictor of the critical course of AH.

Adult↗

[A comparative evaluation of the importance of transesophageal electrical stimulation of the left atrium and of bicycle ergometry in the diagnosis of ischemic heart disease in patients with arterial hypertension].

To make a comparative assessment of transesophageal left atrial pacing (TLAP) and bicycle ergometry (BE) in the diagnosis of coronary heart disease (CHD) in patients with arterial hypertension (AH) of different origin, the authors examined 56 patients. The patients underwent TLAP and selective coronary angiography, of them 39 patients had BE testing. No significant differences were found in their specificity (73 and 78%) and sensitivity (92 and 81%) between TLAP and BE, respectively. The maximum heart rate in CHD patients with AH was significantly higher (130 +/- 6 per min) during TLAP than that in BE (112 +/- 5 per min, p > 0.05), ischemic changes occurring at the same value of double product despite the mode of myocardial ischemia induction in these functional tests (240 +/- 10 and 236 +/- 12 arbitrary units, respectively; p < 0.05). The mean systolic blood pressure was higher in TLAP and in BE (210 +/- 10 and 185 +/- 8 mm Hg). This follows that TLAP and BE finding are comparable and no profound changes occur in TLAP, hence it can be recommended for wide application in the diagnosis of CHD in AH patients.

Adult↗

[Transesophageal echocardiography during intraoperative evaluation of central hemodynamics in surgical treatment of ischemic heart disease].

Whether transesophageal echocardiography may be used in the assessment of central hemodynamics has been studied in 40 patients undergoing direct cardiac revascularization in extracorporeal circulation. Changes in the mean values of end diastolic area (EDA) and end-diastolic anteroposterior dimensions, end-systolic myocardial stress (ESMS), anteroposterior size shortening fraction (SF), and area decrease fraction (ADF) of cross left ventricular section are outlined in the paper. It has been indicated that at the beginning of extracorporeal circulation EDA showed, on an average, a 22% decrease (p less than 0.001), after its termination, it practically returned to the baseline values. ESMS remained high at the beginning of the operation, but at the onset of extracorporeal circulation it also dropped by 26% (p less than 0.001), being rather low until the end of the operation. The highest SF and ADF values were observed after termination of extracorporeal circulation. The changes in the parameters in question were found in hypovolemia and decreased myocardial contractility. The application of transesophageal echocardiography along with direct blood pressure monitoring correctly and fully assesses central hemodynamics.

Coronary Disease↗

[Effects of surgical treatment on hypertrophy of the myocardium of the left ventricle in patients with symptomatic arterial hypertension].

A total of 50 patients with arterial hypertension were examined. Group 1 included 28 patients with renovascular hypertension, 18 of them had unilateral renal artery stenosis, the remaining 10 had bilateral renal artery stenosis. Group 2 consisted of 16 patients with primary aldosteronism. Group 3 comprised 6 patients with pheochromocytoma. The examination was made with echocardiograph. Changes in left ventricular myocardial mass (LVMM) were studied 1 and 6 months after surgical intervention. The maximum hypertrophy was observed in the patients with primary aldosteronism, no changes occurred in any of the groups examined 1 month after surgical management. The LVMM was found to be significantly diminished by 13% in the patients with renovascular hypertension and by 23% in patients with adrenal tumors (pheochromocytoma, aldosteroma).

Adrenal Gland Neoplasms↗