PubMed Health⌕ Search

Biomedical subjects

A Kranidis

Publications and source records attributed to A Kranidis.

32 records · Page 2Linked to original sources
PubMed1995

Significance of echocardiographic atrioventricular plane displacement for the evaluation of left ventricular filling and end-diastolic pressure in patients with coronary artery disease.

The aim of this study is to assess the left ventricular filling and estimate the end-diastolic pressure of the left ventricle in patients with coronary artery disease (CAD) by echocardiographic measurement of the atrioventricular plane displacement (AVPD). In 101 patients (mean age 59 +/- 12 years) with CAD, a complete transthoracic echocardiographic study was performed, just prior to cardiac catheterization. The AVPD was recorded by M-mode echocardiography, from apical four and two chamber views. The recordings were obtained at four sites, corresponding to the septal, lateral, anterior and inferior walls of the left ventricle. The mean AVPD resulting from atrial systole (At), the mean total (T) diastolic AVPD, the ratio At/T(%) and the ratio of mitral annulus excursion during early and late diastole [(T-At)/At] were calculated. Firty-two age-matched healthy subjects served as control group. Both At and At/T were significantly greater in patients with CAD than in the controls (6.06 +/- 0.94 vs 5.53 +/- 0.55 mm, p < 0.01 and 43.4 +/- 5.9% vs 33.49 +/- 4.45%, p < 0.001 respectively). The ratio [(T-At)/At] correlated with the E/A ratio of transmitral flow, both in healthy subjects (r = 0.850, p < 0.001) and in patients with CAD (r = 0.722, p < 0.001). Correlation also existed both in patients with segmental wall motion abnormality (SWMA) (r = 0.691, p < 0.001) and in patients with SWMA (r = 0.818, p < 0.001). In patients with CAD, At/T further correlated with the left ventricular end-diastolic pressure (r = 0.517, p < 0.001). In patients with SWMA and in patients without, a correlation was also found (r = 0.516, p < 0.001 and r = 0.566, p < 0.001 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗
PubMed1995

Evaluation of left ventricular filling by echocardiographic atrioventricular plane displacement in patients with coronary artery disease.

Mean atrioventricular (AV) plane displacement which resulted from left atrial systole and its ratio to the total diastolic displacement, were determined by echocardiography in 101 patients with coronary artery disease. Ratio of motion of the AV plane caused by left atrial systole to the total diastolic displacement was correlated with late-to-early mitral flow peak velocity index (r = 0.7). Selecting a value of this ratio of the AV plane displacement > or = 44% to define Doppler characteristics indicating impaired left ventricular relaxation, resulted in a high sensitivity, specificity and predictive value. Its value was also validated in another prospectively examined group of coronary artery disease patients. In conclusion echocardiographic assessment of AV plane displacement can be used for the estimation of left ventricular filling in patients with coronary artery disease and particularly in detecting impaired left ventricular relaxation.

Aged↗
PubMed1995

Correlation of clinical and electrocardiography variables with coronary lesions in unstable angina pectoris.

The relation of clinical and electrocardiographic variables to the severity of coronary lesions in unstable angina was studied in 84 men and 8 women, aged thirty-nine to seventy-five, who were subjected to coronary arteriography within two weeks. Eighty-seven patients (94.6%) had significant stenosis (50% of the diameter) of at least one vessel, whereas 5 (5.4%) had normal coronary arteries. Eleven (12%) had one-vessel disease, 13 (14%) had two-vessel, and 63 (68.5%) had three-vessel disease. Twelve (13%) had also significant left main stem stenosis. Except for 1 patient with artificial pacemaker, three-vessel and/or left main stem disease was present in 20 (100%) patients with ST segment deviation > or = 0.2mV as compared with 20 of 36 patients (55.5%) with ST segment deviation of 0.1-0.19 mV and 24 of the 35 (68.6%) with no additional ECG changes or with T wave inversion only (P < 0.005). The direction of ST segment deviation (elevation or depression) made no difference. Preexisting angina or infarction was associated with three-vessel disease and/or left main stem disease in 74.1% and 81.4%, respectively, as compared with 45.5% (P = 0.05) of the patients with angina of recent onset. Pain at rest persisting for more than forty-eight hours was associated with three-vessel and/or main stem disease in 93.1% of the patients as compared with 60.3% of patients in whom rest angina subsided within forty-eight hours (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Analysis of left atrioventricular plane movement during diastole in ischemic heart disease.

The aim of the present study was to investigate the properties of diastolic left atrioventricular plane displacement (AVPD) in coronary artery disease (CAD) patients. In 125 patients (mean age 58.7 +/- 13.7) with CAD and in 51 age-matched healthy subjects, a complete transthoracic echocardiographic study was performed. The AVPD was recorded by M-mode echocardiography, from apical four and two chamber views at four sites corresponding to the septal, lateral, anterior and inferior walls of the left ventricle. Mean AVPD in early diastole (E-AVPD), mean AVPD from atrial systole (A-AVPD) and the ratio A-AVPD/E-AVPD were determined. In normal subjects, such as in 35 patients without left ventricular segmental wall motion abnormalities (SWMA), stepwise multiple regression analysis showed none of these factors to be significantly related to E-AVPD or A-AVPD. Aging was correlated negatively to the E-AVPD/A-AVPD ratio (p < 0.05). In 90 patients with left ventricular SWMA, stepwise multiple regression analysis showed that indices of left ventricular systolic function correlated positively to E-AVPD (p < 0.001) and A-AVPD (p < 0.001). The E-AVPD/A-AVPD ratio was correlated to left ventricular ejection fraction and heart rate (p < 0.005). Mean E-AVPD was significantly lower in CAD patients than in normal subjects (p 0.001), while A-AVPD was higher in patients without left ventricular SWMA in comparison to normal subjects (p = 0.02). Also, mean A-AVPD/E-AVPD was higher in CAD patients than in the control group (p < 0.001). Mean E-AVPD/A-AVPD was correlated to the E/A ratio of transmitral flow in CAD patients with (r = 0.669) and without (r = 0.771) SWMA. The E-AVPD and A-AVPD in CAD patients with SWMA is reduced according to the deterioration of left ventricular systolic function. The atrial contribution to the longitudinal distension of the left ventricle is increased in CAD patients. In CAD patients, especially those without left ventricular SWMA, the E-AVPD/A-AVPD ratio has a good correlation to left ventricular filling behavior.

Age Factors↗
PubMed1995

Left systolic atrioventricular plane displacement in the assessment of myocardial viability in patients with previous myocardial infarction.

UNLABELLED: In order to detect myocardial viability in coronary artery disease patients (CAD) with a previous myocardial infarction and dysfunction of the left ventricle (LV), the reliability of the left atrioventricular plane displacement (LAVPD) during low dose dobutamine stress echocardiography (DSE), was validated. The study population consisted of 70 CAD patients and 35 age and sex matched healthy subjects. From the apical four and two chamber views the LAVPD was recorded and measured by M-mode echocardiography, at four sites corresponding to the septal, lateral, anterior and inferior walls of the LV, prior and during the DSE (5-10 micrograms/kg/min). All patients underwent exercise SPECT Thallium-201 with four-hour redistribution and rest-reinjection, in order to determine tissue viability. Intraobserver and interobserver variability for the LAVPD was insignificant (5.8% and 7.2%, respectively). Healthy subjects exhibited a significant and equally distributed maximal increase of the LAVPD, at all sites during dobutamine infusion (DI) (p < 0.001). Patients also, showed a significant maximal increase of the LAVPD during DI, at all asynergic sites in which viable tissue was found (p < 0.001). However, in the asynergic sites without viable tissue the LAVPD did not significantly change (p < 0.05). Selecting a LAVPD increase of > 2 mm to detect viable myocardium at any asynergic site of LV, resulted in a sensitivity of 91% and specificity of 89%. When DSE was used for the detection of viable myocardium, sensitivity and specificity were found to be 80% and 87% respectively. The proportion of agreement between the two above mentioned methods was 82%. When the two methods were in agreement, the positive and negative predictive values were 94% and 97%, respectively. The validity of the above mentioned increase of the LAVPD was also prospectively examined in a similar group of 35 CAD patients exhibiting myocardial dysfunction as a result of a previous myocardial infarction (sensitivity 85% and specificity 90%, respectively). CONCLUSIONS: 1) The assessment of left LAVPD during DI is a new quantitative, accurate method with a low intraobserver and interobserver variability, in detecting viable myocardium. 2) Combination of this method and DSE proved good diagnostic markers of myocardial viability.

Dobutamine↗
PubMed1994

Apical hypertrophic cardiomyopathy with unusual features in a Greek woman.

We present a Mediterranean female patient with abnormal electrocardiographic findings and a history of shortness of breath during excessive effort (NYHA I) in whom apical hypertrophic cardiomyopathy with unusual features was detected by echocardiography and magnetic resonance imaging. There was a single fused apical hypertrophic papillary muscle and akinesia of the left ventricular apical segment. Abnormal left ventricular filling was also detected by Doppler echocardiography.

Adult↗
PubMed1994

The contribution of cavernous body biopsy in the diagnosis and treatment of male impotence.

This study concerns the results of penile biopsies in 50 patients aged 27 to 80, with secondary impotence removed with a biopty gun or during penile surgery. The biopty gun specimens were equally representative as the open biopsy ones. The cause and the degree of erectile dysfunction were determined by clinical and laboratorial investigation. The histological study of the cavernous bodies in the patients with psychogenic impotence revealed normal erectile tissue. In patients with organic impotence, histological lesions were graded as mild, moderate or severe. The most severe lesions were observed in the erectile tissue and in particular in the smooth muscle of the trabeculae and the helicine arteries, which had been reduced and replaced by connective tissue. Histological lesions were found not only in the arterial but also in the venous leak cases. There was a correlation between their severity and the degree of impotence, although of no statistical significance. The penile biopsy determines the condition (state) of the functional cavernous smooth muscle tissue, the integrity of which is essential for the erectile mechanism as well as for the action of the vasoactive drugs and the results of vascular surgery. Its important role is evident as it contributes not only to the diagnosis of the cause, but also to the choice of treatment of male impotence.

Adult↗
PubMed1993

Clinical implications of left atrial spontaneous echo contrast in mitral valve disease.

The aim of this study was to investigate the factors related to the presence of left atrial spontaneous echo contrast in mitral valve disease, and to ascertain whether it is a predictor of thromboembolism. One hundred and one patients (47 men, 54 women) with a mean age of 57.04 +/- 10.6 years who underwent transthoracic and transesophageal echocardiography were included in the study. Forty-five (44.5%) had isolated or predominant mitral valve stenosis, 12 (11.9%) predominant mitral insufficiency and 44 (43.6%) had had previous mitral valve replacement. Left atrial spontaneous echo contrast was detected by transesophageal echocardiography in 58 patients, while the transthoracic approach detected it in only 15 (14.9%) (P < 0.0001). An atrial thrombus was found in six cases, with a history of recent systemic embolism in three of them. There was no thrombus in the left atria of a further nine patients, despite definitive histories of recent systemic embolism. The finding of left atrial spontaneous echo contrast was related to the presence of atrial fibrillation or enlarged left atrium, the severity of mitral stenosis and the absence of significant mitral insufficiency. Anticoagulant therapy was not significantly associated with spontaneous left atrial echo contrast, but a stepwise linear regression analysis showed that its presence was the only independent predictor of thromboembolism (p < 0.0001). We conclude that left atrial spontaneous echo contrast in mitral valve disease can be discovered mainly by transesophageal echocardiography, and is correlated with factors which are associated with low left atrial blood flow velocity such as atrial fibrillation, enlarged left atrium, mitral stenosis of increased severity and the absence of significant mitral insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Acenocoumarol↗
PubMed1993

Mitral regurgitation from papillary muscle rupture: role of transesophageal echocardiography.

A case of a 61 year old male with lateral myocardial infarction, congestive heart failure and fever of days is presented. The exact etiology of this patient's heart failure was established with the application of transesophageal echocardiography. The transthoracic two-dimensional and Doppler echo showed a mobile echogenic density attached to the tip of the anterior mitral leaflet accompanied by moderate mitral regurgitation. Transesophageal echocardiography attributed this echogenic density to a ruptured head of the anterolateral papillary muscle, resulting in severe mitral regurgitation. Cardiac catheterization confirmed the severe mitral regurgitation and uncovered significant stenotic lesions of the coronary arteries. The resultant surgical treatment for the replacement of the mitral valve and coronary artery by-pass confirmed the rupture of the head of the anterolateral papillary muscle. It is suggested that transesophageal echocardiography is particularly capable of providing a definitive and prompt diagnosis of papillary muscle rupture.

Coronary Artery Bypass↗
PubMed1989

Ureterolithotripsy: report of 1000 cases.

A series of 1000 patients with calculi of the ureter at various levels were treated by ureteroscopy and lithotripsy over a period of 27 months. The overall success rate was 88.8%. Stones in the upper third of the ureter were removed in 15 of 39 patients. Calculi in the middle third were successfully removed in 52 of 102 patients. A success rate of 95.5% was achieved for calculi of the lower ureter. Per-operative complications included 10 ureteric perforations, 4 of which were treated surgically and 6 conservatively. Urography, performed in 520 patients 3 months post-operatively, showed 12 ureteric strictures; 9 of these were treated by insertion of a self-retaining pig-tail catheter and 3 required an operation. Ureterolithotripsy appears to be the method of choice in the management of ureteric calculi.

Adolescent↗
PubMedDate not supplied

Leptin serum levels in cachectic heart failure patients. Relationship with tumor necrosis factor-alpha system.

Cachexia is a strong predictor for mortality in patients with congestive heart failure. To investigate the role of leptin and regulators of apoptosis in cardiac cachexia we compared leptin concentrations and their relation to the TNF system, interleukin 1-beta (IL-1b), and soluble Fas in patients with heart failure with and without cachexia. Patients with cardiac cachexia have increased levels of interleukin-1b compared to non-cachectic heart failure patients [mean(S.E.)=1.11(0.62) vs. 0.02(0.02), P=0.01] and decreased concentrations of leptin [10.79(3.93) vs. 23.24 (8.35), P=0.1]. Leptin levels correlate with TNF-RI in cachectic heart failure patients (r=0.58, P=0.018). The TNF-RI levels were also correlated with Fas, both in all the patients taken together (r=0.5, P=0.006) and in those with cachexia (r=0.52, P=0.036). Our data indicate that more prospective studies are needed to clarify the role of leptin in the pathophysiology of heart failure cachexia.

Aged↗
PubMedDate not supplied

Prostate cancer vs hyperplasia: relationships with prostatic and adipose tissue fatty acid composition.

The objective of the present study was to study whether adipose tissue and prostatic tissue fatty acid composition differentiates between prostate cancer and benign hyperplasia patients. In addition, the present investigation aimed at exploring the extent to which prostatic tissue fatty acid composition differentiates between prostate-confined cancer and extraprostatic disease including possible metastasis. The subjects were 71 male patients from the island of Crete. Half the patients (n=35) had been diagnosed with benign hyperplasia of the prostate, half with prostatic malignancy (n=36). Patients were examined at the outpatient clinic of the urology unit, University Hospital, Medical School, University of Crete. Relative to benign hyperplasia patients, cancer patients had elevated adipose tissue saturated and reduced monounsaturated fatty acid levels. Cancer patients had reduced prostate tissue stearic to oleic acid ratios and stearic acid levels as opposed to hyperplasia patients. The most pronounced difference between cancer patients and hyperplasia patients was a 3-fold elevated prostatic palmitoleic acid in the former group. Relative to benign hyperplasia patients, cancer patients had reduced prostate tissue arachidonic and docosahexaenoic acid levels. Finally, there was a significantly reduced omega-3/omega-6 polyunsaturated fatty acid ratio in the prostate cancer patient as opposed to the benign hyperplasia group. The pronounced elevations in prostatic tissue palmitoleic acid in cancer patients highlight a possible role of this fatty acid in neoplastic processes. The decreased arachidonic acid levels in cancer patients possibly stem from enhanced metabolism of arachidonic acid via lipoxygenase and cyclooxygenase pathways, and the formation of derivatives such as 5-HETE, 15-HETE, 12(S)-HETE and PGE(2).

Adipose Tissue↗
PubMedDate not supplied

Concurrent platinum and docetaxel chemotherapy and external radical radiotherapy in patients with invasive transitional cell bladder carcinoma. A preliminary report of tolerance and local control.

PURPOSE: The present study aims to evaluate the feasibility, toxicity, and efficacy of concurrent chemotherapy with cisplatinum and docetaxel, and external radical radiotherapy for transitional cell carcinoma of urinary bladder. MATERIALS AND METHODS: 42 patients (34 men, 8 females) with invasive bladder carcinoma (clinical stages T1-4) were treated after transurethral biopsy with chemotherapy and concomitant external radiotherapy. Chemotherapy consisting of cisplatin infusion (30 mg/m2) and Docetaxel (40 mg/m2) was given twice a week simultaneously with-irradiation during the whole treatment period (6-8 weeks) as follows: Cisplatin (D1,D8,D15,D22, D25,D36,D43,D50) and Docetaxel (D4, D11, D18, D25, D32, D39, D46, D53). An external irradiation scheme 1.8 to 2.0 Gy per fraction, 5 days a week was used up to 68-74 Gy (6MeV photons) total tumor dose. RESULTS: All but S patients completed the planned chemoradiation protocol. The complete response rate (CR-rate) assessed at 3 months after completion of combined treatment was 100%, 63.6%, 46.15% and 95% for clinical stage (c) cT1 (9/9), cT2 (7/11), cT3 (6/13) and cT4 (1/4) cases respectively. None of 9 patients with T1 tumors had any local failure at 36.1 months mean follow-up time. In total, 9 of 37 patients (24.32%) relapsed locally and/or distantly and were followed for 25.04 months (mean time), 50% of the relapses occurred at a mean time of 7.25 months. The mortality rate was 10.81% (4/37). All these patients died with a mean time of 11 months. 32 cases remain alive 19-46 months after treatment; 27 of those are with no evidence of disease with a mean follow-up time of 32.24 months. In total, there was a 78.50% (30/37) and a 75.67%, (28/37) rate of overall survival and pelvic control respectively at 25.04 months mean follow-up time. Chemotherapy was discontinued in 2 cases due to acute gastrointestinal toxicity and in 3 more, due to patient compliance. There was 1 toxic death 2 months after treatment completion due to ureteral obstruction and impaired renal function. The acute toxicity was estimated as moderate to severe and caused the interruption of treatment for 5 to 10 days in 8 of 37 patients (21.62%). Myelotoxicity appeared in 22/37 patients but febrile grade III and IV neutropenia was observed in 3 patients (8.10%) and thrombocytopenia (Grade I-III) in 8 (21.62%). Concerning late effects a sigmoid stricture, a transient small bowel obstruction, 4 patients with contracted bladder and 1 case with renal failure were found. Grade I to III hypersensitivity reactions appeared in 8/37 patients (21.62%) while stomatitis (grade I-II) and grade II skin toxicity appeared in 3 and 4 patients respectively. These and other symptoms (Grade I to II peripheral edema, transient myalgias and arthralgias in 7/37 cases), paresthesias or numbness (3/37) and peripheral motor dysfunction (1/37) were responsible for early reduction of docetaxel dose from 40 mg/m2 to 20 mg/m2. CONCLUSION: This preliminary analysis suggest that the radiosensitizing effect of cisplatin and docetaxel to megavoltage irradiation yielded a high CR-rate in transitional cell bladder carcinoma patients with medium to severe early and late side effects. The value of such a combined treatment as far as the tumor eradication is concerned requires further evaluation, because of the small number of patients, the short follow-up, and the absence of other studies using docetaxel as a radiosensitizer in urothelial cell cancer.

Aged↗