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Biomedical subjects

R Ilia

Publications and source records attributed to R Ilia.

At least 37 records · Page 2Linked to original sources
PubMed1998

Coronary collaterals in patients with normal and impaired left ventricular systolic function.

One hundred and twenty consecutive patients with significant coronary artery disease, normal left ventricular systolic function and coronary collaterals (group A) were compared to 120 patients with the same characteristics but with left ventricular systolic dysfunction (group B). No significant differences were found between the two groups on age, hypertension, diabetes mellitus and smoking. The left ventricular end diastolic pressure was 16+/-7 in group A, and 24+/-9 in group B (P<0.01). The number of diseased vessels was similar in both groups. More completely occluded vessels were found in group B (155 vs. 101 in group A). No significant difference was detected between the two groups in the distribution of the diseased vessels. In both groups, the richest collateral supply was to the right coronary artery, followed by collaterals to the left anterior descending. The poorest supply was to the left circumflex. In conclusion, patients with normal and abnormal left ventricular systolic function have similar coronary collateral characteristics.

Aged↗
PubMed1998

Exaggerated blood pressure response at exercise in normotensive subjects: demographic and stress performance characteristics.

BACKGROUND: Exercise testing is an important diagnostic and prognostic procedure in the assessment of patients with hypertension. An exaggerated blood pressure response to exercise among normotensive subjects was found to be one of the best predictors of future hypertension. The demographic characteristics of patients with an exaggerated blood pressure response during exercise have not been adequately described. METHODS AND RESULTS: The demographic and stress performance characteristics of 2 groups of normotensive patients referred for exercise testing, one composed of patients with an exaggerated blood pressure response (group I, n=146) and a group of patients with a normal blood pressure response (group II, n=439) were prospectively compared. Patients in group I were older than those in group II (54+/-12 vs 51+/-13 years, P < .05). More men than women were found in both groups, yet significantly more in group I than in group II (83% vs 69% P < .001). Significantly more among the patients in group I had a higher level of education and were of Western origin than those in group II (P < .01). The resting systolic and diastolic blood pressures were higher in group I than in group II (131+/-18 vs 119+/-14 mm Hg, P< .001, and 81+/-8 vs 76+/-7 mm Hg, P < .001, respectively). The patients in group I achieved a higher percentage of the maximal predicted heart rate (88+/-7 vs 85+/-9 beats/min, P < .01). No significant differences were found between the groups in the duration of stress test and effort ischemia. CONCLUSIONS: Patients with a hypertensive blood pressure response during stress testing have specific demographic and exercise characteristics.

Adult↗
PubMed1998

Patients with coronary collaterals and normal left ventricular systolic function: clinical, hemodynamic, and angiographic characteristics.

One hundred and twenty consecutive patients with significant coronary artery disease, normal left ventricular systolic function, and coronary collaterals were compared with 111 patients with the same characteristics but with no collaterals. No significant differences were found between the two groups in hypertension, diabetes mellitus, and smoking. The left ventricular end diastolic pressure was 16.4+/-7 in the study group and 16.9+/-6.9 in the controls (NS). Significantly more diseased vessels were observed in the study group than in the control group (2.1+/-0.6 versus 1.7+/-0.6, p=<0.001). One hundred and one totally occluded vessels were found in the study group but only two in the control group. The richest collateral supply was to the right coronary artery: 94 sources to 85 diseased vessels (111%) including 66 sources to 52 totally occluded arteries (127%); to the left anterior descending: 59 sources to 89 diseased vessels (66%) including 37 sources to 33 totally occluded arteries (112%). The poorest supply was to the left circumflex: 17 sources to 69 diseased vessels (25%), including nine sources to 16 totally occluded arteries (56%). No collaterals were observed in 14 totally occluded vessels in the study group and in two of the controls, while the systolic function at rest was still normal. It is suggested that coronary collaterals are important in preserving left ventricular systolic and diastolic performance at least at rest. Not readily visible collaterals may also prevent systolic dysfunction.

Case-Control Studies↗
PubMed1997

Coronary stenting with AVE microstents in acute myocardial infarction.

Of 36 patients with acute myocardial infarction (AMI) who were referred for direct or rescue coronary angioplasty, 11 (31%) needed stent implantation. In 7 of them, the stent was implanted because of severe dissection and in 4, because of elastic recoil. All patients were discharged without clinical or electrocardiographic signs of reocclusion. No death, reinfarction or clinical evidence of ischemia occurred during up to 15 months of follow-up.

Aged↗
PubMed1997

[Angina pectoris and the severity of coronary artery stenosis].

The relationship between angina pectoris and the severity of coronary artery disease was evaluated in 146 patients with normal segmental and global, left ventricular, systolic performance. None had unstable angina or a previous myocardial infarction. A strong relationship was found between angina and the severity of coronary artery disease (p < 0.005). Significant, stable, angina pectoris as a clinical symptom indicated advanced coronary artery disease in this selected group of patients.

Angina Pectoris↗
PubMed1997

Prolonged catheter-induced coronary artery spasm mimicking fixed stenosis.

Two cases of prolonged catheter-induced right coronary artery spasm, mimicking fixed stenoses, are presented. In one case, the spasm appeared at the same place in sequential catheterizations. This angiographic finding may be easily misinterpreted as a fixed lesion, leading to unnecessary attempts at angioplasty.

Adult↗
PubMed1997

[Left atrial ball thrombus].

An 80-year-old hypertensive woman with chronic atrial fibrillation was hospitalized because of recurrent syncope. Echocardiography revealed a large left atrial ball thrombus. Operative findings confirmed the echocardiographic diagnosis.

Aged↗
PubMed1996

[Direct percutaneous transluminal coronary angioplasty].

Early reperfusion in acute myocardial infarction (AMI) effectively reduces mortality. Direct. percutaneous. transluminal coronary angioplasty (PTCA) is a recognized alternative to intravenous thrombolytic therapy in early AMI. Of 289 PTCAs performed during a year, 29 (10%) were direct PTCAs. Indications for direct PTCA in 21 patients (72%) were large infarcts, and in 8 (28%) cardiogenic shock. The left anterior descending artery was involved in 15 patients (52%), the right coronary artery in 10 (34%), the left circumflex in 3 (10%), and the left main artery in 1 (3%). Satisfactory opening of the occlusion was achieved in 26 (90%); there was partial success in 2 (7%) and failure in 1 (3%). 4 patients required stent deployment for treatment of dissection. There was no major complication. A patient in whom success was only partial, and the one in whom PTCA failed, were sent for operation. These data do not differ from our success rate in elective PTCA. It is concluded that direct PTCA is a safe procedure with a high rate of successful reperfusion in AMI.

Adult↗
PubMed1995

Relation between shortness of breath, left ventricular end diastolic pressure and severity of coronary artery disease.

The relation of shortness of breath to left ventricular end diastolic pressure and the severity of coronary artery disease was evaluated in 146 patients with normal segmental and global left ventricular systolic performance. None had chronic lung disease, cardiomyopathy, previous myocardial infarction, uncontrolled hypertension or unstable angina pectoris. A strong relationship was found between shortness of breath and elevated left ventricular end diastolic pressure, and a borderline relationship with the severity of coronary disease. Shortness of breath as a clinical symptom indicates diastolic dysfunction in this selected group of patients.

Adult↗
PubMed1995

[Severe methemoglobinemia following large dose of nitrate medication].

A 49-year-old man with ischemic heart disease attempted to commit suicide by ingesting 300 tablets (6 grams) of isosorbide dinitrate. He was admitted with shortness of breath and cyanosis. Severe methemoglobinemia was diagnosed (blood level 47 mg%). After administration of intravenous methylene blue and fluids, there was immediate improvement and he was discharged 48 hours after admission.

Fluid Therapy↗