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Biomedical subjects

A Jović

Publications and source records attributed to A Jović.

9 recordsLinked to original sources
PubMed1997

Recovery of atrial systolic function after pharmacological conversion of chronic atrial fibrillation to sinus rhythm: a Doppler echocardiographic study.

OBJECTIVE: To evaluate the time course of the recovery of atrial mechanical function after pharmacological cardioversion of chronic atrial fibrillation to sinus rhythm. PATIENTS AND METHODS: 21 patients (12 male, 9 female, aged 37-77 years) with chronic atrial fibrillation (< 6 months) were followed up by serial transmitral pulsed Doppler echocardiography. Echocardiographic studies were performed within the first 24 hours and on day 8, 15, and 30 after cardioversion. RESULTS: There was a significant increase (mean (SD)) in the peak A-wave velocity (from 0.35 (0.10) on day 1 to 0.50 (1.73) on day 8, and thereafter a gradual increase to 0.61 (0.14) m/s on day 30). Similarly, integrated late atrial velocities increased from 4.50 (1.46) on day 1 to 5.61 (1.73) on day 8 and 5.97 (1.47) cm/s2 on day 30. The atrial contribution to total transmitral flow increased significantly from 26 (7)% immediately after conversion of atrial fibrillation to sinus rhythm to 34 (7)% on day 30, indicating the haemodynamic benefit of the restoration of sinus rhythm. Left atrial diameter decreased but not significantly, from 4.11 (0.37) to 3.98 (0.34) cm (P < 0.005). CONCLUSIONS: These results suggest that restoration of atrial mechanical function after pharmacological cardioversion in patients with chronic atrial fibrillation is slow and gradual, as it is after electrical DC restoration of sinus rhythm. This time course may have important implications for determining how long treatment with anticoagulants and antiarrhythmic agents needs to continue in individual patients. It will also influence the clinical assessment of the haemodynamic benefit of restoring sinus rhythm in patients with chronic atrial fibrillation.

Adult↗
PubMedDate not supplied

[Factors contributing to the onset of heart rupture in acute infarct].

The aim of this study was to find out the contributing factors for cardiac rupture in the course of acute myocardial infarction (AMI). Past medical histories and autopsy data of 80 patients were analyzed. The first group consisted of 30 patients who died due to heart rupture in the course of AMI and the control group of 50 patients who died from the other, more common complications of AMI. There was no difference between the groups according to age and sex of the patients. All patients who died from the rupture of the heart had a history of heavy chest pain, while it was lacking in 30% of the patients of the control group (p less than 0.01). All the first group patients showed electrocardiograms diagnostic for AMI, while it was lacking in 14% of the second group patients (p less than 0.05). Almost a half of the second group patients (47%) were in the class I of the Killip's classification, while only 20% of the control group did not developed left ventricular failure. Pathological study showed that the rupture of the heart most commonly occurred in the course of an anterior myocardial infarction. There was no difference according to the size of infarctions between observed groups, but the thickness of the left ventricular wall was significantly less (p less than 0.05) in the control group, and the heart weights were higher (p less than 0.05) in the control group. There was advanced atherosclerosis of the coronary arteries and about two thirds of the first group patients showed acute coronary thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Fatal rupture of an echinococcal cyst into the right atrium].

The case of a man 32 years of age with echinococcosis of the heart who died due to rupture of a pericardial echinococcal cyst into the right atrium with the range into the pulmonary circulation and fatal embolism of the branch of pulmonary artery is presented. Such localization of echinococcus is extremely unusual as well as the complication it caused, and promoted this report which is very instructive for a clinician, the more so that the patient was surgically treated, but irregularly followed up, and the disease had a poor outcome. Prophylaxis with albendazole over a period of one month and more frequent control examinations by means of adequate diagnostic methods in such cases is stressed.

Adult↗
PubMedDate not supplied

[Transesophageal atrial stimulation--a test for myocardial ischemia].

The aim of the present study was to determine clinical value and the feasibility of transesophageal atrial pacing (TAP) in diagnosing myocardial ischemia in patients with coronary artery disease (CAD). Forty patients with CAD and with significant ST-segment depression in a standard 12-lead ECG during bicycle-stress testing underwent TAP. Rapid atrial stimulation was performed by using a very flexible six-polar polyurethane pacing lead introduced through the nares into the esophagus and connected to the stimulator allowing selection of rate, output voltage and pulse duration. The satisfactory atrial pacing was obtained by 28 +/- 6 V output and 7 +/- 1 ms pulse duration. Of 40 patients who underwent TAP, ischemic ECG changes were induced in 35 (u = 2,24 p < 0,05) and were very similar to those that occurred during bicycle-stress testing according to their intensity and distribution and affected ECG leads with comparable peak rate-pressure products. This suggests comparable sensitivity of TAP and bicycle-stress testing in discovering myocardial ischemia in CAD patients. Four patients had negative test for myocardial ischemia and in one TAP was discontinued because of intolerable chest discomfort. In conclusion, TAP is a reliable alternative technique for the assessment of coronary artery disease. In combination with some other noninvasive methods (echocardiography, scintigraphy, i.v. digital angiography), it has become a routine diagnostic procedure in cardiac patients.

Adult↗
PubMedDate not supplied

[The tilt-table test in the diagnosis of vasovagal or neurocardiogenic syncope].

Syncope is a common clinical problem, and diagnostic evaluation and treatment of the patient with syncope is often a particularly complex task. As many episodes of unexplained syncope are neurocardiogenic or vasovagal, head-up tilt-table testing is a valuable method for identifying individuals with recurrent loss of consciousness. Although over the past several years much has been learned about pathophysiologic mechanism involved, much of the disorder remains incompletely understood. Optimal standardization of head-up titl-table testing protocols is very important for clinical experience exchanges and for comparison of different therapeutic modalities. Medical therapy is often the first choice and a number of pharmacological treatments have been developed. Exceptionally, has to be combined with dual-chamber cardiac pacing. Head-up tilt-table test is a basic diagnostic procedure in the evaluation of the patient with syncope and should be performed in all cardiac and neurophysiologic laboratories.

Humans↗