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Biomedical subjects

Y Drory

Publications and source records attributed to Y Drory.

At least 37 records · Page 2Linked to original sources
PubMed1996

Ventricular arrhythmias during sexual activity in patients with coronary artery disease.

STUDY OBJECTIVE: Information on appearance or increase of ventricular arrhythmias during intercourse in patients with coronary disease is still inadequate. This prospective study analyzes patients' rhythm disturbances on sexual activity and compares them with occurrences during daily activities and stress testing. PATIENTS: The study included 88 male outpatients with stable coronary disease; ages ranged from 36 to 66 years (mean, 52 years). INTERVENTIONS: Patients underwent ambulatory ECG monitoring, which included sexual activity, and a near-maximal ergometric test. RESULTS: Arrhythmia was found during intercourse in 56% of patients, compared to 38% at exercise. Occurrence or exacerbation of ectopic activity was the dominant pattern in patients with arrhythmia at exercise testing (89%), but this exacerbation was found only in 11% of patients during intercourse. Complex ventricular arrhythmia during sex was detected in 12.5% of patients. CONCLUSIONS: Two main observations may be drawn from the study. First, rhythm disturbances were not exacerbated during intercourse in most patients. Second, if ventricular ectopic activity occurred on intercourse, it was most often simple and essentially similar to disturbances in daily activity.

Activities of Daily Living↗
PubMed1993

Left ventricular dynamics during strenuous isometric exercise in marathon runners, weight lifters and healthy sedentary men: comparative echocardiographic study.

Global and segmental left ventricular dynamics during strenuous large-muscle isometric exercise were compared between endurance and static type professional athletes and sedentary men. Using a trunk dynamometer and supine echocardiography, only the weight lifters manifested increased (p < 0.01) wall thickness during both diastole and systole, resulting in decreased left ventricular volume at end systole. These group-related differences would suggest a causal relationship between chronic intensive weight-lifting training and efficient myocardial dynamics at the time of strenuous isometric exercise.

Adult↗
PubMed1993

Onset of intolerance symptoms during exercise testing is a reproducible threshold for evaluation of cardiac function.

Twenty-one male patients with a history of myocardial infarction underwent bicycle cardiopulmonary exercise testing. The onset of leg pain or dyspnea, which reflects anaerobic metabolism, was termed anaerobic exercise symptom threshold (AEST). Our aims were (1) to evaluate the temporal relationship between AEST and the ventilatory anaerobic threshold (VAT) and (2) to determine whether heart rate, rate-pressure product, exercise time, and the ventilatory parameters at AEST are reproducible and correlate with the same parameters at VAT. AEST overlapped VAT in 4 patients and lagged behind VAT in 15. AEST never preceded VAT. The mean exercise time at VAT was 4.1 +/- 1.2 min and at AEST 5.6 +/- 1.6 min (p < 0.0001); the mean heart rate was 97 +/- 10 and 107 +/- 12, respectively (p < 0.001). The mean values of the rate-pressure product and the oxygen consumption at AEST were significantly higher than at VAT. The correlation coefficient ranged from r = 0.74 to r = 0.93. Fifteen patients were examined twice within 1 month; the above parameters were reproducible at AEST, VAT, and peak exercise. In conclusion, AEST, which is easily recorded during bicycle exercise testing, is useful as a reference point for evaluation and follow-up of the cardiac aerobic function.

Anaerobic Threshold↗
PubMed1992

Usefulness of heavy isometric exercise echocardiography for assessing left ventricular wall motion patterns late (> or = 6 months) after acute myocardial infarction.

The aim of this prospective study was to determine the effects of heavy isometric exercise on left ventricular (LV) wall motion patterns in patients who have had myocardial infarction, and to compare heavy isometric exercise with dynamic exercise for competence in eliciting LV wall motion abnormalities at equivalent rate-pressure products. Echocardiography was performed in 42 patients during supine bicycle ergometry and during heavy dynamometer stretching at 50% of maximal voluntary contraction. Systemic vascular resistance increased from 1,484 to 1,649 dynes s cm-5 (p < 0.05) during isometric exercise, and decreased significantly during dynamic exercise. Wall motion abnormalities or new asynergy were induced by isometric exercise in 120 segments, 107 of which (89%) showed significant stenosis of the perfusing coronary artery. Hypokinesia was the dominant pattern in the range of 76 to 90% narrowing; akinesia was dominant at 91 to 100% narrowing. Wall motion abnormalities were also documented in 13 segments (11%) assumed to be supplied by vessels with nonsignificant stenosis. Dyskinesia, seen in 7% of the segments, was equally distributed between both groups with significant stenosis. Sensitivity and positive predictive value in identifying specific coronary vessel disease was similar for both isometric and dynamic exercise. In conclusion, heavy isometric exercise in patients who have had myocardial infarction induces wall motion abnormalities of a severity proportional to the degree of coronary narrowing. This exercise method is similar to dynamic exercise for ability in identifying obstructions in a specific vessel. Furthermore, when compared at near-equal rate-pressure products, heavy isometric exercise is far superior in sensitivity to dynamic exercise.

Adult↗
PubMed1992

Neurocirculatory asthenia revisited: elevated arterial pressure at presentation is a marker for subsequent hypertension.

Neurocirculatory asthenia (NCA) is a fairly common functional disorder often encountered among military recruits. Symptoms in NCA tend to appear in waves, and are believed to disappear completely with the passage of time. Elevated arterial pressure is known to occur as part of the various haemodynamic manifestations of NCA. However, the exact prevalence of hypertension, as well as its long-term prognosis, is still unknown. The present case-control study was designed to address these two issues. The target population consisted of 370 patients with NCA representing two separate cohorts: patients diagnosed in 1979, 10 years prior to this study, and patients diagnosed in 1983-84, 5 years prior to the study. An overall 20% prevalence rate of mild hypertension at diagnosis was calculated for the entire study population. In total, 100 patients representing equal numbers of hypertensive and matched normotensive subjects from each cohort were re-evaluated. At follow-up, hypertension was present in 27% (1979 cohort) and 30% (1983-84 cohort) of patients originally considered to be hypertensive. Hypertension was either non-existent (1979 cohort) or limited to a single case (1983-84 cohort) among originally normotensive individuals. In parallel, resting heart rate was higher in the hypertensive subjects of the 1979 cohort both at presentation (85.5 +/- 3.2 vs. 73.7 +/- 2.4 beats min-1; P less than 0.005) and at follow-up (79.6 +/- 3.2 vs. 70.0 +/- 2.5 beats min-1; P less than 0.01). These results indicate that hypertension complicates the diagnosis of NCA in 20% of patients and that, contrary to common belief, it cannot be regarded as another transient manifestation of this condition. Thus hypertension in this context is, as in the younger members of the population in general, a major risk factor for lifelong hypertension, rather than an inconsequential phenomenon.

Adolescent↗
PubMed1992

Menopause-related changes in left ventricular function in healthy women.

Using technetium scans, this study was aimed at examining possible changes in left ventricular function related to the natural process of cessation of ovarian estrogen production. Fourteen healthy postmenopausal women, divided into two groups according to the time-lapse from menopause (A > 3 years; B < 5 years), underwent a technetium heart scan. The two groups did not differ in heart rate, blood pressure, double product, systemic vascular resistance and cardiac index. The mean end-systolic volume in group A was 14.9 and 25.7 ml/m2 in group B (p = 0.003). The mean pressure/volume ratio was significantly higher in group A than in group B (8.6 vs. 4.7 mm Hg/ml/m2, p = 0.02). Peak ejection rate and peak filling rate were also significantly greater in group A compared to group B (3.3 vs. 2.8 end-diastolic volumes/s, p = 0.02; 2.8 vs. 2.1 end-diastolic volumes/s, p = 0.001, respectively). Our findings suggest that women at an early phase of menopause have a higher degree of myocardial contractility than women of a similar age whose menopause is of longer duration.

Female↗
PubMed1992

Influence of ocular tropicamide on exercise testing.

This study was aimed to evaluate the effects of tropicamide 0.5% eye drops on cardiovascular parameters during exercise testing. The study group included 154 healthy subjects (mean age: 44.7 +/- 8 years). The subjects were divided into three groups according to the size of the pupils at the onset of exercise: A: pupils not dilated (n = 27), B: pupils partially dilated (n = 90) and C: pupils widely dilated (n = 37). They were compared to 66 healthy controls (age 43.8 +/- 8) who did not receive the drops. Rest and exercise parameters were affected in groups A and B, while the results of group C resembled those of the controls: (a) resting heart rate -66.7, 66.6, 70.9 and 69.3, respectively (p = 0.03); (b) heart rate at 50 and 100 W - 104, 107, 110 and 111 (p = 0.01) and 131, 131, 137, 139, respectively (p = 0.01); and (c) peak systolic blood pressure - 192, 186, 183, 175; respectively (p = 0.004). Reanalyzing the data by scoring of visual impairment gave identical results. As a whole, the study group achieved higher work loads than the controls (126 vs. 119 W; p = 0.03). We conclude that the instillation of ocular tropicamide has definite effects on cardiovascular parameters, both at rest and during exercise. Mainly, patients showed a lower heart rate at the initial levels of exercise. However, at symptom-limited level, tropicamide does not influence a patient's ability to achieve the target heart rate, and stress testing results are not altered by the drug.

Adult↗
PubMed1992

Long-term effects of hormone replacement therapy on Doppler-derived parameters of aortic flow in postmenopausal women.

Eighteen postmenopausal women were examined by Doppler echocardiography before initiation of HRT (T1), then after ten weeks (T2) and one year (T3). This study group was compared with another in which HRT was not used. Flow velocity integral, which correlates with SV, and MA, an indicator of cardiac contractility, were calculated. In the study group, PFV was 107 +/- 18 cm/s at T1 and increased significantly at T2 and T3. Ejection time, which was prolonged at T2 compared to T1, returned to its basal value at T3. Flow velocity integral increased at T2, but this change was only partially sustained at T3. Mean acceleration maintained its increase throughout T2 to T3. None of the Doppler parameters showed a significant change in the controls from T1 to T3. Our results suggest that the peripheral hemodynamic effects of HRT, such as vasodilatation, are transient, whereas the central effects (increased inotropism) are long-lasting.

Aorta↗
PubMed1991

Sudden unexpected death in persons less than 40 years of age.

This study retrospectively assesses the underlying causes of sudden unexpected death and the occurrence of prodromal symptoms in 162 subjects (aged 9 to 39 years) over a 10-year period (1976 to 1985). Underlying cardiac diseases accounted for sudden death in 73% and noncardiac causes in 15% of subjects. In 12% of subjects, the causes were unidentifiable. Myocarditis (22%), hypertrophic cardiomyopathy (22%) and conduction system abnormalities (13%) were the major causes in 32 subjects aged less than 20 years. Major causes of 46 deaths in subjects 20 to 29 years were atherosclerotic coronary artery disease (24%), myocarditis (22%) and hypertrophic cardiomyopathy (13%). The largest number of deaths in 84 subjects aged greater than or equal to 30 years was attributed to coronary artery disease (58%), followed by myocarditis (11%). Among noncardiac causes of sudden death, intracranial hemorrhage was the most frequent (5%), followed by infectious disease (4%). Prodromal symptoms were reported by 54% of subjects; most frequent were chest pain (25%) in subjects aged greater than or equal to 20 years, and dizziness (16%) in those aged less than 20. Sudden death, which occurred during routine daily activity in 49% and during sleep in 23% of subjects, was related to physical exercise in 23% and emotional upset in 6%. Sudden unexpected death in the young is still an unresolved medical problem. The early recognition of prodromal symptoms could be crucial in the prevention of sudden death, specifically when exercise-related.

Adult↗
PubMed1991

Pronounced reduction of aortic flow velocity and acceleration during heavy isometric exercise in coronary artery disease.

Doppler-derived parameters of aortic flow were examined during heavy isometric exercise in 48 men with coronary artery disease (CAD) and in 48 gender- and age-matched healthy controls. The aim was to determine which parameters best separated the groups and to look for a possible relation between exercise-induced Doppler patterns and the extent of CAD. Isometric exercise was performed with a 2-hand bar dynamometer, and the subjects were required to perform 50% of maximal voluntary contraction for 2 minutes. Examination was performed with a pulsed Doppler transducer positioned at the suprasternal notch. Resting peak flow velocity, acceleration time, stroke volume index and cardiac index did not show significant differences between the groups. However, mean acceleration and stroke work were significantly lower in patients with CAD. In this group, exercise peak flow velocity decreased from 98 +/- 13 to 55 +/- 12 cm/s, flow velocity integral from 14 +/- 3 to 7 +/- 3 cm, mean acceleration from 11 +/- 0.9 to 4.7 +/- 1 m/s/s, and stroke volume index from 41 +/- 6 to 23 +/- 4 ml/m2 (p less than 0.001 for all). Cardiac index decreased from 2.7 +/- 0.4 to 2 +/- 0.2 liters/min/m2 (p less than 0.05). Acceleration time increased from 82 +/- 6 to 116 +/- 7 ms. In most of the indexes, the directional changes induced by isometric exercise were similar in patients with CAD and in normal control subjects. The differences compared with the rest values were significantly greater in the CAD group, and especially in patients presenting with 3-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗