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Biomedical subjects

V B Sergienko

Publications and source records attributed to V B Sergienko.

At least 19 recordsLinked to original sources
PubMed2004

[Cerebrovascular complications in metabolic syndrome: possible approaches to decrease risk].

AIM: To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH). MATERIAL AND METHODS: Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined. RESULTS: Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2. CONCLUSION: Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.

Adult↗
PubMed2004

[Impairment of cardiac sympathetic function in patients with acute myocardial infarction and unstable angina].

AIM: To assess the state of sympathetic innervation of the heart in patients with acute coronary syndrome. MATERIAL: Patients with Q-myocardial infarction (MI, n=36), non-Q-MI (n=13), and unstable angina (UA, n=9). METHODS: Each subject underwent single-photon emission computed tomography (SPECT) and planar scintigraphy using iodine-123 metaiodobenzylguanidine ((123)I-MIBG) for assessment of cardiac sympathetic function. We analyzed early (15 minutes) and delayed (4 hours) images after (123)I-MIBG administration. Resting (99m)Tc-MIBI myocardial scintigraphy was performed for evaluation of myocardial perfusion. Location, extent (%) and severity (Un.) of defects were determined using < > program. (123)I-MIBG did not accumulate in myocardium of 3.5% patients. All other patients demonstrated (123)I-MIBG accumulation defects. These defects were colocolized with (99m)Tc-MIBI uptake abnormalities. However both extent and severity of sympathetic innervation defects exceeded those of perfusion defects in all patients. Mean extent and severity of sympathetic neuronal damage areas were the greatest in patients with Q-MI (41+/-8% and 1119+/-377 Un. respectively) and the least in patients with UA (22+/-12% and 602+/-353 Un., respectively). On the contrary the mean extent of areas with sympathetic endings dysfunction but normal perfusion was the largest in UA group and the least in Q-MI group (18+/-11 and 10+/-7%, respectively, p<0,05). CONCLUSION: Impairment of cardiac sympathetic function in patients with acute coronary syndrome could be detected by SPECT with (123)I-MIBG. Locations of (123)I-MIBG and (99m)Tc-MIBI defects were similar but sympathetic dysfunction areas were larger than areas with reduced perfusion. This result suggests higher sensitivity of sympathetic endings to ischemia compared with cardiomyocytes. Myocardial areas with sympathetic endings dysfunction but normal perfusion can be defined as myocardium at risk.

3-Iodobenzylguanidine↗
PubMed2004

[Comparative effectiveness of different methods of diagnosis and correction of impaired portal circulation].

The diagnostic effectiveness of X-ray radionuclide and ultrasound determination of portal blood flow and the impact of different treatments on the blood flow were evaluated in 76 patients with hepatic cirrhosis. The treatment regimens were used propranolol (Group 1), isosorbide-5-mononitrate (monosan) (Group 2), and a combined therapy with propranolol in combination with diuretics and a course of intravenous laser irradiation (Group 3). In terms of both clinical and laboratory parameters and the status of portal circulation, the highest effect was observed in the patients receiving the combined therapy.

Antihypertensive Agents↗
PubMed2003

[Evaluation of myocardial perfusion in patients with hypertrophic cardiomyopathy in comparison with clinical and echocardiographic data].

AIM: To study peculiarities of myocardial perfusion in patients with hypertrophic cardiomyopathy (HCMP) in correlation with clinical and echocardiographic data. MATERIAL AND METHODS: 62 patients with HCMP (23 females and 39 males, mean age 44.4 +/- 11.2 years, the disease duration 13.0 +/- 10.4 years) have undergone ECG, 24-h ECG monitoring, echocardiography, perfusion scintigraphy of the myocardium with 99m-TcMIBI at rest and in combination with bicycle ergometry. The patients were divided into two groups: 35 patients of group 1 had moderate left ventricular hypertrophy (the septal thickness in diastole under 20 mm; 27 patients of group 2 had severe hypertrophy (the thickness was over 20 mm). RESULTS: Dyspnea and syncopal states occurred more frequently in patients from group 2. They also had a higher functional class of heart failure (2.0 +/- 0.8 and 1.2 +/- 0.7 for group 1 and 2, respectively, p < 0.05). Cardiac performance was significantly higher in patients of group 1. The size of the left atrium, left ventricular myocardium mass, the septal thickness and thickness of posterior wall of the left ventricle, gradient of pressure in the outflow tract of the left ventricle proved higher in patients of group 2. Deep stable defects of myocardial perfusion were detected in 5 (15%) patients of group 1 and 10 (37%) patients of group 2. Transient defects of myocardial perfusion were found in 9 (26%) patients of group 1 and 12 (44%) patients of group 2. The index of myocardial ischemia in group 1 patients was significantly lower than in patients of group 2 (3.5 +/- 2.2 and 8.3 +/- 2.5, respectively, p < 0.05). CONCLUSION: Patients with severe hypertrophy of the left ventricle had severe clinical picture, low exercise tolerance, marked hemodynamic changes, more frequent defects of left ventricular perfusion defects compared to patients with moderate hypertrophy of the left ventricular myocardium.

Adult↗
PubMed2003

[Preliminary data on combined assessment of tolerance to exercise, left ventricular contractile function in ischemic heart disease patients taking bradycardic agents].

AIM: To study effects of bradicardia induced by atenolol, diltiazem and ivabradin on exercise tolerance, myocardial perfusion and left ventricular contractile function in patients with stable angina pectoris. MATERIAL AND METHODS: The trial included 7 male patients aged 57 +/- 2.6 years with coronary heart disease, stable angina of functional class II free of cardiac failure and severe arterial hypertension, with a positive and reproducible VEM test after therapy discontinuation. For 10 consecutive days with 5-day intervals, all the patients received atenolol, diltiazem, ivabradin in doses lowering heart rate at rest by 20% from the initial level. Before the treatment all the patients were studied with VEM test, perfusion synchronized single-photon emission computerized tomoscintigraphy of the myocardium (PSSPECT) at rest and exercise. On day 10 of each drug intake PSSPECT and VEM test were performed if the expected heart rate was achieved. RESULTS: Each of the studied drugs resulted in a 22-24% reduction in the heart rate at rest accompanied by a significant rise in exercise tolerance, improvement of performance and myocardial perfusion. There were no significant changes in left ventricular contractility. CONCLUSION: A 20% reduction in resting heart rate due to monotherapy with drugs having a bradicardic effect leads to positive changes in exercise tolerance and myocardial perfusion.

Atenolol↗
PubMed2003

[Effect of restoration of coronary blood flow on dynamics of myocardial perfusion and function in patients with acute myocardial infarction. Data of gated technetium-99m-sestamibi SPECT].

Effects of coronary blood flow restoration on dynamics of myocardial perfusion and function were studied in 50 patients with acute myocardial infarction during 6-month follow-up. Gated SPECT with 99mTc-MIBI (G-SPECT) was performed before onset of reperfusion procedures, in 24 hours, 10 days, 1 and 6 months. In patients with successful reperfusion (n=36) perfusion defect (PD) size decreased by 6.78+/-0.97% (p<0.001) and its severity by 221.3+/-85 std (p<0.001) in 24 hours. In 10 days PD size decreased by 3.9+/-0.88% (r<0.05) and severity by 149+/-39 std (p<0.05), whereas in 1 month PD size decreased by 2,18+/-1,4% (p<0.05), PD severity by 146.3+/-67 std (p<0.05). Successful reperfusion was associated with improvement of contractility: left ventricular ejection fraction increased by 3% (p<0.05) on day 10 of the disease. In patients with failed reperfusion PD size and severity decreased in 10 days by 4.8+/-4.2%, p<0.05, and 276+/-75 std, p<0.05, respectively, in 6 months PD size decreased by 3.1+/-0.9%, p<0.05, left ventricular ejection fraction did not change during follow-up. We conclude that successful reperfusion therapy promotes restoration of myocardial perfusion and improvement of its contractility.

Angioplasty, Balloon, Coronary↗
PubMed2002

[Viable myocardium: comparative evaluation of surgical and pharmacological treatment of patients with ischemic heart disease, post-infarct cardiosclerosis and chronic cardiac failure].

AIM: To compare surgical and drug therapies of viable myocardium in IHD patients with left ventricular dysfunction (LVD), to show how to choose between them basing on the presence or absence of viable myocardium in the dyssenergy zones in such patients. MATERIAL AND METHODS: The study enrolled 55 IHD patients with postinfarction cardiosclerosis, left ventricular ejection fraction under 35%, circulatory disorder class I-III (NYHA classification). Coronary artery bypass operation (CABO) was made in 24 patients, 31 patients received drugs. The examination included dobutamin echo-CG, perfusion myocardial scintigraphy. Viability of the myocardium was assessed before and 6 months after the treatment. RESULTS: The patients were divided by the treatment and number of segments of viable myocardium: group 1--patients with viable myocardium subjected to CABO, group 2--patients with non-viable myocardium subjected to CABO, group 3--patients with viable myocardium treated with drugs, group 4--patients with non-viable myocardium treated with drugs. The greatest rise in LV EF, reduction of the end diastolic volume, end systolic volume of the left ventricle and functional class was observed in group 1. In group 2 these parameters changed less than in group 3. Patients of groups 2 and 4 were similar by parameters of LV global contractility. CONCLUSION: Improvement of central hemodynamics and functional class was the greatest in IHD patients after CABO having viable myocardium. If myocardium is not viable surgical treatment has no advantage over conservative in improvement of the pump cardiac function and is inferior to pharmacological treatment in effect on myocardium function in patients with viable myocardium in dyssynergia zones.

Adrenergic beta-Antagonists↗
PubMed2002

[Atenolol induced bradycardia in patients with stable angina: effects on exercise tolerance, myocardial perfusion and left ventricular contractility].

AIM: To assess effects of atenolol-induced heart rate decrease on myocardial perfusion, left ventricular contractility and tolerance to exercise in patients with chronic coronary artery disease. MATERIAL AND METHODS: Twenty eight men (mean age 54,5-/+9,2 years) with stable class I-III angina and positive reproducible result of bicycle exercise test underwent rest/stress 99mTc-MIIBI gated single-photon emission computed tomography (SPECT) before and after 10 days of administration of atenolol (20 patients) or placebo (8 patients). Dose of atenolol was titrated to achieve at least 15% decrease of heart rate from baseline. RESULTS: After 10 days of treatment with atenolol heart rate decreased from 78-/+3.1 to 59-/+1.1 bpm (p=0.01), whereas in placebo group there were no significant changes. Compared with placebo, treatment with atenolol was associated with significant decreases in extent and severity of perfusion defects, ischemic score and number of ischemic segments. No significant changes of parameters of left ventricular contractility occurred. Treatment with atenolol was associated with symptomatic improvement and increase of the total exercise time. CONCLUSION: Heart rate lowering during monotherapy with atenolol was associated with improvement of myocardial perfusion and tolerance to exercise.

Adrenergic beta-Antagonists↗
PubMed2001

[Myocardial microcirculation in patients with systemic lupus erythematosus].

AIM: To examine myocardial microcirculation in patients with SLE. MATERIAL AND METHODS: Examination of 21 SLE patients consisted of perfusion tomoscintigraphy of the myocardium with Tl-201 at rest and in combination with bicycle exercise. Various protocols were used. RESULTS: The majority of SLE patients had resting disorders of myocardial perfusion: 5 had macrofocal scar lesion of the myocardium, 12 had disorders typical for small-focal myocardial fibrosis. Normal distribution of the perfusion occurred in 4 cases. Tomoscintigraphy performed in combination with exercise test revealed in 11 of 15 patients transient perfusion disturbances reflecting transient myocardial ischemia. One third of the patients had changes characteristic of myocardial ischemia due to coronary atherosclerosis. CONCLUSION: SLE patients have disorders of myocardial perfusion including those characteristic of scar lesion, small-focal cardiofibrosis and transient myocardial ischemia of different genesis: due to disorders in microcirculation and atherosclerotic lesion of major coronary arteries.

Adult↗
PubMed1999

[Efficiency of antiarrhythmic therapy and resistance to it in patients with malignant ventricular tachyarrhythmias: formulation of prognosis].

AIM: To study feasibility of predicting results of drug antiarrhythmic therapy in patients with malignant ventricular arrhythmias (MVA) basing on the results of clinical and device examinations. MATERIALS AND METHODS: 136 patients with documented MVA entered the study. 100 patients were in the retrospective analysis group, 36 patients comprised the study group. All the patients underwent physical examination, resting ECG, chest x-ray, radionuclide ventriculography. Intracardiac electrophysiological examination, Holter 24-h ECG monitoring and bicycle exercise provided data for diagnosis of MVA and control over effects of antiarrhythmic drugs. The mathematical model was derived using discriminant analysis. RESULTS: Significant differences were obtained in patients with positive and negative results of drug testing by the number and recurrence time of ventricular tachycardia (VT) for 3 years, survival, cardiac and sudden death, some other parameters. A mathematic model has been designed which allows prognosis of the results of antiarrhythmic therapy (AAT) in patients with MVA. 7 independent predictors of AAT efficiency are shown: left ventricular ejection fraction, duration of P-Q interval, cardiac failure, left ventricular aneurysm, age, number of VT morphologies, insufficiency of aortic valve. Verification of the model on the study group patients showed that prognostic accuracy of the model was 82%. CONCLUSION: The results of the drug tests predict life span of MVA patients. The developed mathematical model allows prediction of AAT results in such patients before the pharmacological test with accuracy 82-87%. The model can help objectivize indications to use of non-pharmacological methods for each patient basing on prognosis of resistance to drug AAT.

Adolescent↗
PubMed1996

[Myocardial tomoscintigraphy with 201Tl in the diagnosis of cardiac involvement in systemic scleroderma].

Myocardial microcirculation was assessed in 23 scleroderma systematica patients using 201Tl tomoscintigraphy at rest (23 patients) and upon dipyridamole vasodilation (6 patients). Most patients were found to have impaired blood supply of the myocardium with sites of myocardiofibrosis. In response to dipyridamole introduction improved myocardial perfusion was registered in 4 out of 6 patients, 1 patient showed signs of transient myocardial ischemia, 1 patient had stable defects of myocardial blood supply. It is suggested that some sclerodermic patients may benefit from vasodilators.

Adult↗
PubMed1993

[State of myocardial perfusion in patients with primary hypothyroidism as evidenced by myocardial Tl-201 scintigraphy].

To study the myocardial perfusion in primary hypothyroidism accompanied by cardiac pain feelings, a total of 21 patients aged 30-60 years were examined by using resting 201Tl myocardial scintigraphy and in combination with bicycle ergometric testing. At rest all the patients showed impaired myocardial perfusion. A decrease in 201Tl accumulation, which corresponded to the areas of impaired perfusion, was observed in 54% of segments. A severe impairment of myocardial 201Tl washout was recorded in all the patients. During exercise 201Tl myocardial scintigraphy, steady-state myocardial perfusion impairments with normal washout were recorded in most patients. Areas of transient myocardial ischemia were revealed in 3 patients during scintigraphy in combination with bicycle ergometric testing. The findings suggest that patients with primary hypothyroidism have myocardial perfusion impairments which are likely to be reflected by dystrophic processes. Along with these abnormalities, exercise myocardial scintigraphy makes it possible to detect transient perfusion alterations in some patients, which indicates that they have myocardial ischemia.

Adult↗
PubMed1993

[The myocardial blood supply in chronic alcoholism patients studied by myocardial scintigraphy with 201Tl].

To study myocardial perfusion, 201Tl myocardial scintigraphy was used to examine 25 patients with chronic alcoholism and alcoholic damage to the heart. 201Tl myocardial scintigraphy was performed at rest and repeatedly 3-7 days later by using the bicycle ergometer exercise test. The total 201Tl uptake at rest was 2.3 +/- 0.2%. The resting scintigrams of the patients showed a profound irregularity of 201Tl distribution and a diffuse decrease in its washout. The increment of 201Tl uptake in response to exercise was 20.6%. Exercise scintigrams displayed steady perfusion defects mainly of anteroseptal site. There was an improvement of tracer washout in the exercise test as compared at rest. Thus, 201Tl myocardial scintigraphy allows perfusion disturbances to be detected in patients with alcoholic damage to the heart. Myocardial scintigraphy performed at the peak of exercise records a decreased increment of 201Tl extraction, suggesting a lower perfusion reserve in patients with alcoholic heart damage.

Adult↗
PubMed1992

[Effect of captopril on myocardial ischemia, intracardiac hemodynamics and regional left-ventricular contractility in patients with stenocardia].

Technetium-99m pertechnetate equilibrium ventriculography was used to evaluate the effects of captopril in a single dose of 50 mg on the changes in ST segment depression during the identical bicycle ergometer exercise, as well as on systemic and regional hemodynamic parameters in 10 patients (mean age 52 years) with Functional Classes II-III exercise-induced angina pectoris. During exercise performed 45 and 90 minutes after captopril, ST segment depression decreased by 30 +/- 0 (p less than 0.05), and 32 +/- 10% (p less than 0.02), respectively as compared to baseline ST segment displacement. Following 90 minutes after the drug administration, end-systolic volume reduced both at rest and during exercise, resting stroke volume increased from 71 +/- 4 to 76 +/- 4 ml (p less than 0.01), whereas exercise stroke volume rose from 69 +/- 3 to 74 +/- 3 ml (p less than 0.03); with the drug, ejection fraction showed a 5% increase (p less than 0.02) at rest and a 4% increase (p less than 0.02) on exercise. Thus, captopril had a beneficial effect on the hemodynamics and reduced myocardial ischemia in patients with exercise induced angina.

Adult↗