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Biomedical subjects

A Cosovanu

Publications and source records attributed to A Cosovanu.

32 records · Page 2Linked to original sources
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[The association of ventricular pre-excitation--acute myocardial infarct. The dysrhythmic outcomes].

The clinical manifestations of ventricular preexcitation, generally considered benign, may sometimes show the most unpredictable and severe evolution. Although ventricular tachyarrhythmias (those of ventricular aspect excepted) are extremely uncommon in ventricular preexcitation, cases of sudden death were nevertheless reported, their mechanism being the ventricular fibrillation. The authors have followed up the evolution of 12 patients (11 males, age between 38 and 72 years with a mean of 56 years) with acute myocardial infarction and coexistent ventricular preexcitation, previously depressed or newly detected, admitted during the last 10 years at the Coronary Unit of Iaşi. It is concluded that the association ventricular preexcitation--acute myocardial infarction represents a severe risk factor by sensibly increasing the arrhythmogenic potential.

Adult↗
PubMedDate not supplied

[The efficacy of electroversion in the treatment of tachyarrhythmia complications of the heart valves].

The results of electric cardioversion in the treatment of tachyarrhythmias in a series of 431 patients with valve diseases of the left heart admitted during the last 10 years are presented. Most patients presented atrial fibrillation (71.4%), the atrial flutter and paroxysmal tachycardia necessitating electric cardioversion in 24.5% and 4.1% of the cases, respectively. The restoration of sinusal rhythm was obtained in 90% of the cases, a single shock being delivered in most of them (74.5%). The patients' age, type of arrhythmia and the causal valvular heart disease did not influence the results, the essential factors of restoration and especially of maintaining the sinusal rhythm failure being the age of the valvular heart disease, the quality of atrial myocardium (which depends on the size of the enlargement and age of arrhythmia) and the association of a coronary or myocardial alcohol induced affection. The importance of estimating the resumption of atrial mechanic activity is underlined. The "regulation" embolism was rare (5 cases), while an embolism occurring during the preparation period raises the possibility of a possible coincidence between the embolic accident and the recurrence of atrial mechanical systole after electric cardioversion.

Adult↗
PubMedDate not supplied

[The cardioprotective action of captopril during atrial electrostimulation].

The presence of R-A-A system components in all organs (heart included) has suggested a possible cardio-protective effect of the angiotensin conversion enzyme inhibitors as a result of coronary flow improvement. This effect would act irrespective of the well-known peripheral vascular effects: vasodilation, blood pressure decrease, pre- and postload reduction. By using the atrial pacing in the quantitative assessment of the anginal threshold and of the associated ECG alterations before and after the i.v. administration of 25 mg of captopril we could immediately evaluate the coronary reserves by estimating the efficiency of captopril in the patients with angina pectoris. The atrial pacing has been performed, by using the method suggested by Sowton, in 18 patients with typical angina. The increase of heart tolerance at exercise, the systolic dynamics improvement and the ejection fraction increase as well as the raising of the anginal threshold have been noticed in 15 of the patients. The blood pressure has evidenced no significant changes. After the administration of captopril, the ischemic ECG alterations have been less marked and their postpacing remains shorter. Our findings plead for a direct action of captopril on cardiac intrinsic R-A-A system in the normotensive patients suffering from angina pectoris.

Adult↗
PubMedDate not supplied

[The effect of captopril on the coronary circulation in a clinical and experimental study].

Taking into account the well-known angiotensin II-induced coronary constriction, in a first series of experiments the effects of captopril were studied upon the rabbit, guinea pig and rat coronary circulation during perfusion with oxygenated Krebs-Henseleit solution at 37 degrees C under constant pressure and variable flow according to the Langendorf technique. The inhibition of angiotensin I to angiotensin II conversion enzyme with captopril (5-500 microgr./ml) resulted in a coronary dose dependent dilation as a consequence of a reduction in the basal coronary tonus. Testing the coronary distensibility by using pressure and flow variations revealed a significantly increased distensibility when the conversion enzyme was specifically blocked with captopril. The anginal threshold of the atrial electrostimulation was increased after captopril (25-50 mg i.v.) in 15 out of 18 patients with coronary insufficiency by a mean value of 17%, white the systolic dynamics was significantly better. The obtained results bring new arguments in favour of the intrinsic renin-angiotensin system participation in maintaining the basal vascular tonus and of the increased coronary distensibility in the presence of captopril as an inhibitor of the local synthesis of the vasoconstrictor angiotensin II.

Adult↗
PubMedDate not supplied

[Neurological manifestations on collagenoses].

Collagen diseases are precipitated by very different etiologic factors, but have a common pathogenic mechanism--autoimmune, which evolves chronically and progressively involving new territories. The initial and main pathologic lesions are vascular arterial ischemic (and, according to the prevalently involved territory, the type of disease results: PAN--medium-sized and small arterioles; scleroderma--small arterioles and capillaries), and the secondary ones are the result of ischemia with plurivisceral involvement. Neurological dysfunctions were detected in about 50% of collagen diseases diagnosed during a 25 year interval in the IIIrd Medical Clinic of Iaşi. The neurological manifestations were inaugural in 10% (in SLE) to 46.4% (in PAN) of the cases, the remainder occurring during the course of collagenosis, more commonly at 3-5 years and before death. Peripheral nervous system involvement (mainly polyneuritis) has prevailed, the central nervous system involvement being more rare and often fatal. Long-term corticosteroid therapy was followed by full or partial remission of peripheral nervous dysfunctions, but had transient effects or was ineffective on the central nervous ones.

Collagen Diseases↗