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Biomedical subjects

S Tyagi

Publications and source records attributed to S Tyagi.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Randomised two way crossover comparison of the effects of six weeks propranolol and acebutolol therapy on plasma lipid profiles in patients with hypertension or ischaemic heart disease.

The effect of propranolol and acebutolol therapy on serum lipoproteins was studied in thirty patients (mean age 43.9 +/- 8.7 years) with essential hypertension and/or stable myocardial ischaemia. Patients received six weeks therapy with propranolol (80-160 mg per day) and acebutolol (400-800 mg per day) each in random order and were changed over from one to the other beta-blocker after 6 weeks therapy. On propranolol treatment there was no significant effect on total cholesterol and LDL-cholesterol but the concentration of serum triglycerides (94.2 +/- 37.7 to 129.1 +/- 41.2 mg/dl) and VLDL cholesterol (18.9 +/- 7.8 to 26.1 +/- 8.1 mg/dl) significantly increased, concentration of HDL cholesterol (49.5 +/- 9.4 to 42.4 +/- 8.7 mg/dl) significantly decreased (p less than 0.01). Atherogenic index also worsened from 4.17 +/- 0.48 to 5.15 +/- 0.54 (p less than 0.05) on propranolol therapy. Acebutolol therapy, on the other hand, produced no significant change in the concentration of total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol and VLDL cholesterol.

Acebutolol↗
PubMedDate not supplied

Percutaneous transluminal angioplasty for ischaemic arterial disease of the lower extremities.

We attempted percutaneous transluminal angioplasty (PTA) in 43 patients with limb-threatening ischaemia (rest pain, nonhealing ulcer or gangrene) or lifestyle-limiting claudication. Of the 51 lesions dilated, 31 were in iliac, 12 in femoral, 6 in popliteal and 2 in tibial arteries. Overall primary success rate was 90.2 percent (46/51); 96.8 percent (30/31) in iliac, 83.3 percent (10/12) femoral, 66.7 percent (4/6) popliteal and 100 percent (2/2) in tibial arteries. Marked relief of ischaemic symptoms and increase in ankle-arm pressure index from 0.45 +/- 0.14 to 0.94 +/- 0.23 (P less than 0.005) were seen in the 39 patients with initial technical success. Three (6.9%) patients had minor complications. On 1-33 (mean 13.4 +/- 7.5) months follow up, 89.5 percent patients showed continued clinical improvement as well as improvement in noninvasive parameters of lower limb perfusion. We conclude that angioplasty of iliac, femoral, popliteal and tibial arteries is a highly effective and safe procedure to revascularize the ischaemic lower extremity.

Adult↗
PubMedDate not supplied

Evaluation of aortic aneurysms and dissection of aorta by intravenous digital subtraction angiography.

Intravenous (IV) digital subtraction angiography (DSA) was performed in 12 patients with suspected aortic aneurysm/dissection. Bolus injection of 30-40 ml of contrast in mid right atrium/main pulmonary artery at a flow rate of 18-20 ml/sec. during DSA accurately localised the site and extent in all 7 patients of aortic aneurysm and in 4 patients of aortic dissection. In one patient, radiological opacity was unrelated to aorta. There were no complications. IV-DSA should be the preferred mode of evaluation for aortic aneurysm and dissection of aorta.

Adult↗
PubMedDate not supplied

Prevalence and clinical significance of coronary artery ectasia (an angiographic study).

Coronary cine-angiograms of 1,042 patients were reviewed for the presence of ectasia of major coronary arteries. Ectasia or irregular dilatation of the coronary artery was defined as 1.5 times diffuse or segmental dilatation as compared to segment of normal caliber coronary artery. Forty-one (3.9%) patients were found to have diffuse or localised coronary artery dilatations with segments of normal caliber throughout the length of major vessels. Mean age of the patients was 52 years, and majority were males (39, 95%). Right coronary artery (RCA) and left circumflex (Cx) were involved in 23 (56%) each, left anterior descending (LAD) in 15 (37%), obtuse marginal in 4 (10%) and left main in 2 (5%). Multiple vessel involvement was present in 21 (51%). Evidence of myocardial infarction was present in 21 (51%). Major risk factors were not different from the patients with coronary artery disease without ectasia.

Cineangiography↗
PubMedDate not supplied

Follow-up of balloon aortic valvuloplasty in young adults--a combined hemodynamic and Doppler echocardiographic study.

Percutaneous Balloon Valvuloplasty was performed in 25 patients with severe aortic stenosis (Aortic valve area index: 0.23 to 0.70, mean 0.36 +/- 0.11 cm2/m2). The mean age was 23 +/- 15 (range 6-66) years, and majority (n = 18) had noncalcific valves. Valve morphology was bicuspid in 14, tricuspid in 6 and indeterminate in 5. Valvuloplasty resulted in a fall of peak systolic gradient (PSG) from 112 +/- 35 to 34 +/- 16 mmHg (p less than 0.001), and an increase in aortic valve area (index) (AVAI) from 0.36 +/- 0.11 to 0.82 +/- 0.43 cm2/m2 (p less than 0.001). Follow-up data at 16 +/- 6 months were available for 18 patients, 80 per cent of whom registered symptomatic improvement. Repeat catheterization, performed in 12 cases, showed increase of PSG to 53 +/- 22 mmHg and a fall in AVA (1) to 0.62 +/- 0.24 cm2/m2, as compared to the results immediately following the procedure. In addition, 3 patients had their valve areas estimated by doppler echocardiography. Forty-six per cent of these 15 patients (n = 7) showed evidence of restenosis. Four out of these 7 cases had calcific valves, whereas none of the patients who had sustained improvement had calcification. Tricuspid morphology was present in 50 per cent of the group with sustained improvement, as compared to 20 per cent of the group that restenosed. Our preliminary data shows sustained hemodynamic improvement after balloon dilatation in young patients with severe aortic stenosis with noncalcific and tricuspid aortic valve.

Adolescent↗
PubMedDate not supplied

An arteriographic assessment of renal vasculature in young patients with essential hypertension.

Twenty-five patients below the age of 40 years with Uncomplicated hypertension underwent selective renal arteriography to assess the involvement of interlobar and arcuate arteries. Renal vasculature was abnormal in all 25 patients. Patients with severe hypertension had markedly abnormal renal vasculature. None of the patients with mild hypertension had severe vascular involvement. Functional significance of these arteriographic abnormalities is discussed.

Adolescent↗
PubMedDate not supplied

Detection, frequency and clinical significance of silent myocardial ischaemia in patients with chronic stable angina.

Forty-two patients (mean age 50 years) with chronic stable angina pectoris were subjected to exercise treadmill testing, coronary arteriography and left ventricular cineangiography. Twenty-one of these patients also underwent Holter monitoring for 24 hours. On exercise treadmill testing, angina was the endpoint in 24 (57%), while 18 (43%) developed significant ST segment depression without symptoms. Holter monitoring in 27 patients revealed a total of 248 episodes of myocardial ischaemia of which 210 (84%) were asymptomatic. ST segment depression at 80 mS from J point varied from 1 to 4 mm, and the average duration of ischaemic episodes during Holter monitoring was 9 minutes (range 30 seconds to 1 hour). Heart rate during the ischaemic episodes varied between 65-85 beats/minute. Coronary angiography revealed triple vessel disease in 22 (52%) and double vessel and single vessel involvement in 10 (24%) each. Left ventricular ejection fraction was less than 50% in only 3 (7%) patients. Thus silent myocardial ischaemia is detected frequently in patients with angina pectoris. It occurs during routine daily activity, and on exercise. Heart rate at which silent myocardial ischaemia occurs is much less during daily activity as compared to exercise induced ischaemia. All patients who were detected to have silent myocardial ischaemia had significant coronary artery disease. These findings are of prognostic and therapeutic value.

Angina Pectoris↗