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Biomedical subjects

V B Sergienko

Publications and source records attributed to V B Sergienko.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1992

[Renal scintigraphy with captopril in the diagnosis of renovascular hypertension].

Altogether 16 patients with arterial hypertension (AH) were examined. Of these, 11 were with stenosis of renal arteries, 4 had essential hypertension (EH) and I with nephrogenous parenchymatous AH. To estimate the influence of captopril on the total and separate renal function in patients with and without stenosis of renal arteries and the possibility of the use of the given pharmacological test in the diagnosis of renovascular hypertension (RVH), all the patients underwent renal scintigraphy with 99Tc-DTPA on admission to the hospital and 1-7 days after a single intake of 25 mg captopril per os. Later on in the operated patients the results of the test were compared with the hypotensive effect of the surgery. The rate of glomerular filtration (RGF) was measured according to the Gates method. In patients with stenosis of renal arteries and EH, the total filtration renal function remained unchanged after the intake of a single dose of captopril. In patients with stenosis of renal arteries, there was a significant decrease of the RGF on the side of stenosis made for by an insignificant elevation of the RGF in the contralateral kidney, which was accompanied by an increase of asymmetry of the renograms. In patients with no hypotensive effect of the surgery, the test with captopril was negative, which supports the possibility of this test application in the diagnosis of RVH.

Adolescent↗
PubMed1992

[Hypertension and "silent" myocardial ischemia. I. The results of stress scintigraphy of the myocardium in patients].

As many as 24 patients suffering from essential hypertension (EH) were examined. The patients were subjected to Holter ECG monitoring, echocardiography, coronary angiography, exercise scintigraphy of the myocardium with transesophageal pacing of the atria and the dipyridamole test. The patients manifested defects of thallium accumulation during exercise scintigraphy of the myocardium. They were transitory defects of accumulation with clearance impairment recorded in EH patients with atherosclerosis of the coronary arteries; transitory defects of accumulation without clearance impairment recorded in EH patients with the angiographically unchanged coronary arteries. In Holter ECG monitoring, the patients with a silent depression of the ST segment demonstrated transitory defects of thallium accumulation by the myocardium in all the cases during exercise scintigraphy of the myocardium.

Adult↗
PubMed1992

[The radionuclide diagnosis of dilated cardiomyopathy: a new approach to assessing myocardial perfusion function by 201Tl scintigraphic data at rest and during the performance of the dipyridamole test].

A method for quantitative determination of the percentage of left ventricular myocardial 201Tl isotope uptake at rest and during dipyridamole test was first used in patients with dilated cardiomyopathy and coronary heart disease complicated by circulatory insufficiency or chronic myocarditis. This method makes it possible to judge the level of myocardial blood flow and perfusion reserve in these diseases. The most common differences were found between patients with coronary heart disease and those with chronic myocarditis. The patients with chronic myocarditis exhibited the greatest sizes of perfusion defects, highest values of 201Tl uptake at rest and a lower myocardial perfusion reserve during dipyridamole test. In response to exercise, most patients with chronic myocarditis had diminished perfusion defects, whereas those with coronary heart disease displayed increased defects. The myocardial perfusion was varied in patients with dilated cardiomyopathy. Some patients had a scintigraphic pattern close to that in patients with chronic myocarditis and others had a pattern identical to that in patients with coronary heart disease.

Adolescent↗
PubMed1992

[Clinical and prognostic value of myocardial scintigraphy using technetium Tc 99m pyrophosphate in patients with unstable stenocardia].

The clinical and predictive value of 99mTc pyrophosphate myocardial scintigraphy was studied in 164 patients with various clinical courses of unstable angina pectoris. Some patients with the unstable anginal syndrome proceeding with prolonged pain attacks were shown to have irreversible myocardial lesions detectable by 99mTc pyrophosphate myocardial scintigraphy. However, the study indicated that the presence of small myocardial necrotic foci in this case was of insignificant predictive value.

Adult↗
PubMed1991

[A rapid radionuclide method for clinical assessment of gastric juice proteolytic activity and acidity].

A new method for radionuclide measurement of gastric juice proteolytic activity (GJPA) is described. GJPA is determined according to the time of dissolution of the protein capsule filled with 99mTc-pertechnetate solution. In vitro experiments made with 342 samples of gastric juice revealed a correlation (p1 less than 0.01) between the time of dissolution of the 99mTc-pertechnetate capsule and proteolytic activity measured according to Metta's method. No correlation was established between GJPA (measured by Metta's method and by radionuclide method) and gastric juice acidity (p greater than 0.05). In 63 patients examined, the time of capsule dissolution was 15 to 18 minutes with GJPA being normal, 8 to 14 minutes (p less than 0.01) with elevated parameters of GJPA, and 19 to 37 minutes (p less than 0.01) with GJPA being reduced. The given method is a physiological one, sufficiently precise and can be recommended for a screening analysis of GJPA.

Adolescent↗
PubMed1991

[Anti-anginal effects of calcium antagonists and intra-cardiac hemodynamics].

The intracardiac hemodynamics was studied in 33 patients with exertional angina pectoris undergoing an acute drug test with verapamil (n-15) and nifedipine (n-18) by using radionuclide ventriculography both at rest and during exercise. All the patients were divided into 2 groups by the increase in exercise duration with the two drugs: 1) those who exhibited a marked antianginal effect and 2) those without it. At rest, the calcium antagonists enhanced ejection fraction in the two groups. Exercise ejection fraction also increased, but in a subgroup of patients who displayed no higher exercise tolerance with verapamil. Verapamil and nifedipine in Group 1 patients resulted in lower left ventricular end diastolic volume. It is suggested that the antianginal effect of calcium antagonists is to a certain degree associated with decreased afterload, as manifested by diminished left ventricular end systolic volume.

Adult↗
PubMed1991

[The use of the phase-image method for noninvasive topical diagnosis in certain forms of heart rhythm disorders].

The authors describe the results of mapping additional conduction pathways in WPW syndrome and ectopic sources of the ventricular rhythm with the aid of phasic images (PI). The mapping data were compared to the readings of 12 ECG leads and to the electrophysiological findings. The mapping with the aid of PI turned out informative in both patients' groups. The PI method demonstrated the possibility of Kent's bundle mapping in latent WPW syndrome. The use of the PI method is suggested to be the first stage in the mapping of Kent's bundle in WPW patients suffering from supraventricular tachycardias as well as of pathological rhythm sources in ventricular tachycardias refractory to drug therapy in patients who are to undergo surgical treatment.

Adolescent↗
PubMed1990

[Calcium antagonists and the regional contractility of the left ventricle in stenocardia patients].

The overall and regional left ventricular ejection fraction (EF) was assessed by rest-exercise equilibrium radionuclide ventriculography in 33 patients (mean age 52.3 +/- 10.3 years) given a single dose of calcium-channel blockers (CCB). Of these, 18 patients were administered 20 mg of nifedipine and 15 patients received 80 mg of verapamil. According to the antianginal effects (AE) of nifedipine and verapamil at exercise all the patients were divided into 4 groups: 9 were on nifedipine, 10 on verapamil with AE (groups I and 3), 9 were on nifedipine, 5 on verapamil without AE (groups 2 and 4). After administration of a single dose of nifedipine and verapamil the overall rest EF increased in group I from 55.5 +/- 6.1 to 65.0 +/- 7.7%, in group 3, from 59.8 +/- 4.8 to 67.4 +/- 5.4%, in group 2, from 55.5 +/- 9.8 to 60.9 +/- 9.9%, and in group 4, from 54.8 +/- 5.4 to 59.6 +/- 4.5%. The exercise EF increased only in patients with AE of CCB (from 51.5 +/- 4.2 to 64.6 +/- 7.9%, group 1) and from 54.8 +/- 6.2 to 61.1 +/- 5.7%, group 4). In patients with AE of CCB (groups 1 and 3), the baseline values of the regional EF before drug administration decreased from rest to exercise in ischemic segments and that decrease ranged from 9 to 17%, while in patients of groups 2 and 4, from 1 to 8%. After administration of CCB insignificant improvement of the regional rest-exercise EF was recorded in groups 1 and 3 in the formerly ischemic segments.

Adult↗
PubMed1990

[Comparative analysis of parametric images in patients with dilated cardiomyopathy and coronary heart disease by radionuclide ventriculography].

After equiponderant radionuclide ventriculography the parametric images (phasic and amplitude) of heart function were estimated in 20 patients with dilated cardiomyopathy and in 17 patients with coronary heart disease associated with cardiomegaly. The patients with dilated cardiomyopathy and those with coronary heart disease showed principal differences in local disturbances of the amplitude of movements of left ventricle myocardium walls. While assessing synchronism of myocardial contraction in the patients with dilated cardiomyopathy the presence of the zones of myocardial asynchronism appeared to be a suggestive sign. At the same time the phenomena of asynchronism were not directly connected with impairment of heart conduction and became aggravated as dilatation of the left ventricle progressed, being often coupled with the ECG signs of cicatrical alterations in the myocardium, which came on the phasic images in the form of dyssynergia areas.

Adult↗