PubMed Health⌕ Search

Biomedical subjects

A M Shutov

Publications and source records attributed to A M Shutov.

At least 19 recordsLinked to original sources
PubMed2006

[Structural-functional alterations in the heart affecting dynamics of transmitral blood flow during a hemodialysis session].

AIM: To study dynamics of transmitral circulation (TMC) during a hemodialysis (HD) session in patients with chronic renal failure (CRF) regarding structural-functional alterations of the heart and baseline condition of the diastolic function of left ventricular (LV) myocardium. MATERIAL AND METHODS: Sixty one patients (34 females and 27 males, mean age 47 +/- 11 years) on programmed HD free of heart valvular disease, ischemic heart disease, acute myocardial infarction, atrial fibrillation. Before and after HD session the patients underwent echocardiography, including Doppler regime. RESULTS: Normal LV geometry was detected in 3 (4.9%) patients, concentric remodeling - in 9 (14.8%), concentric LV hypertrophy (LVH) - in 37 (60.7%), excentric LVH - in 12 (19.7%) patients. The ejection fraction was under 45% in 5 (8.2%) patients. Diastolic dysfunction of LV myocardium was found in 42 (68.9%) patients, TMC characteristic of slow relaxation was registered most frequently (47.6%). A pseudonormal type of TMC was recorded in 16 (38.1%) patients. HD did not change TMC significantly in patients with normal diastolic function (before HD E peak velocity was 88.7 +/- 19.8 cm/s, after - 80.0 +/- 24.6 cm/s, p > 0.05). In patients with initially disturbed relaxation the velocity of early diastolic flow (Vp) (color M-mode Doppler) increased (before HD, Vp was 67.6 +/- 17.1 cm/s, after - 72.9 +/- 15.7 cm/s, p < 0.05), E/Vp reduced (before HDm E/Vp was 1.2 +/- 0.4, after 1.0 +/- 0.4, p < 0.05). The subgroup with initially pseudonormal TMC showed decreased velocity in the E peak (before HD - 103.4 +/- 13.5 cm/s, after - 76.8 +/- 24.0 cm/s, p < 0.001). In restrictive TMC this velocity also decreased - 129.0 +/- 17.8 cm/s and 108.8 +/- 14.7 cm/s, p < 0.05, respectively). CONCLUSION: TMC alteration during a HD session depends more on initial type of diastolic dysfunction than on LV geometry. A HD session improves intracardiac hemodynamics in patients with pseudonormal TMC.

Diastole↗
PubMed2005

[Possibilities of Doppler echocardiography application in a patient on program hemodialysis].

The aim of the study was to investigate the significance of Doppler echocardiography (echoCG) for assessment of "dry weight" in hemodialysis patients. 43 dialysis patients (20 men and 23 women aged 49 +/- 11 years), receiving 4-hour bicarbonate hemodialysis (HD) 3 times a week, were studied prior to and after HD procedures. M-mode echoCG was performed and left ventricular mass index (LVMI) and ejection fraction (EF) were calculated. Transmitral flow was assessed by Doppler echoCG. Peak velocity of early (E) and late (A) filling, E/A ratio, isovolumic relaxation time (IVRT) and early deceleration time (DT) were detected. Left ventricular hypertrophy (LVH) was detected in 37 (86.0%) patients. EF was lower than 45% in 4 patients. There was significant positive correlation between the amount of ultrafiltration (evaluated in per cents of body mass after HD) and deltaE (r = 0.59; p = 0.001), and there was found no correlation between the amount of ultrafiltration and deltaA. Patients with intradialytic hypotension had substantially higher DT than patients without one (238.7 +/- 64.3 vs. 168.6 +/- 51.2 mc, respectively, p < 0.001). "Dry weight" is associated with increase of early DT over the level normal for the age in hemodialysis patients with left ventricular hypertrophy. Patients with increased early DT are exposed to the high risk of intradialytic hypotension development.

Diastole↗
PubMed2004

[Structural and functional cardiac changes and sex hormone levels in men with sexual dysfunctions].

44 men with chronic prostatitis were examined for structural-functional heart alterations with reference to severity of erectile dysfunction (ED). Sex hormones were also estimated. Control group consisted of 20 healthy men. Doppler echocardiography, 24-h monitoring of arterial pressure (AP) and ECG, finger and ultrasound investigation of the prostatic gland and microscopy of its secretion were made. Blood plasm testosteron, prolactin and dehydroepiandrosterone-sulphate were estimated by enzyme immunoassay. Erectile function was assessed by the questionnaire "International index of erectile function". Thus, sexual hormone changes associated with sexual dysfunction in men promote left ventricular diastolic dysfunction. The type of intracardiac hemodynamics in this case is, as a rule, restrictive.

Adult↗
PubMed2004

[Impact of a hemodialysis session on cardiac function in patients with chronic renal failure].

AIM: To determine the impact of hemodialysis (HD) session on cardiac function in patients with chronic renal failure. MATERIAL AND METHODS: Thirty patients (17 male, 13 female, mean age 49 +/- 11 years) on bicarbonate HD were studied. M-mode echocardiography was performed and ejection fraction (EF) was estimated. Transmitral flow was assessed by Doppler echocardiography. Peak velocity of early (E) and late (A) filling, E/A ratio, isovolumic relaxation time (IVRT) and early deceleration time (DT) were estimated. All the estimations were made one hour before and immediately after HD by one investigator. Flow propagation velocity of early diastolic flow was assessed by color M-mode Doppler echocardiography. RESULTS: A significant decrease of the ejection fraction (delta EF) was observed only in patients with intradialytic hypotension. Hemodialysis resulted in a decrease of early flow velocity from 99.2 +/- 23.8 to 80.6 + 26.0 cm/s (p = 0.0000) and E/A ratio from 1.23 +/- 0.57 to 0.98 +/- 0.43 (p = 0.006). IVRT and DT showed no significant difference. There was a significant positive correlation between the amount of ultrafiltration and deltaE (r = 0.46; p = 0.01), there was no correlation between the amount of ultrafiltration and delta Vp (r = -0.01; p = 0.9). CONCLUSION: The results show that a hemodialysis session influences cardiac function in patients with chronic renal failure. Early diastolic filling considerably decreased in correlation with ultrafiltration. A significant decrease in an ejection fraction was detected only in patients with intradialytic hypotension. Ultrafiltration had no impact on flow propagation velocity of early diastolic flow of the left ventricle assessed by color M-mode Doppler echocardiography.

Adult↗
PubMed2003

[Diagnosis of left-ventricular diastolic dysfunction in patients with predialysis chronic renal failure].

AIM: To specify effectiveness of different methods for assessment of diastolic function in patients with pre-dialysis chronic renal failure (CRF). MATERIAL AND METHODS: Forty non-diabetic pre-dialysis CRF patients (20 males and 20 females, mean age 51 +/- 11 years) were studied. Serum creatinine was 209.3 +/- 117.4 mcmol/l. 19 patients had chronic heart failure (CHF) of NYHA class I-III. M-mode echocardiography and Doppler echocardiography were performed. Transmitral and pulmonary venous flows were assessed by Doppler echocardiography and the flow propagation velocity (Vp) was estimated by color M-mode Doppler echocardiography. The ratio of peak E-wave velocity of transmitral flow to Vp (E/Vp) was calculated. All the patients had preserved systolic function (ejection fraction > 45%). RESULTS: Interpretation of transmitral flow was difficult in 16 (40.0%) patients. During Valsalva's manoeuvre the E-wave peak velocities, the A-wave velocities and the ratio E/A were decreasing. However, we did not reveal any correlation between E/A and NYHA class of heart failure (r = 0.18; p = 0.32). Interpretation of pulmonary venous flow was possible only in 24 (60.0%) patients. Vp estimation by color M-mode Doppler echocardiography improved evaluation of diastolic function in 15 of 16 patients with problems of transmitral flow assessment. A negative correlation was revealed between NYHA class and Vp (r = -0.39; p = 0.013) and a positive correlation was between NYHA class and E/Vp (r = 0.45; p = 0.004). CONCLUSION: Vp assessed by color M-mode Doppler echocardiography improves the diagnosis of diastolic dysfunction in patients with chronic renal insufficiency. This method has an advantage over pulmonary venous flow investigation. The Valsalva's manoeuvre is low-effective for differential diagnosis of transmitral flow types.

Blood Flow Velocity↗
PubMed2002

[Use of recombinant interleukin-2 in hemorrhagic fever with renal syndrome].

The study enrolled male patients with fever admitted to Ulyanovsk city hospital in November-December 2000 with diagnosis of hemorrhagic fever with renal syndrome (HFRS). The diagnosis was confirmed serologically. 10 patients received recombinant interleukin 2 (rIL-2) in a dose 250,000 IU/day for 5 days. rIL-2 was not given to 10 control patients. Both groups received intravenous prednisolone in a dose 90 mg/day. The response was assessed by minimal diuresis, maximal serum concentrations of urea and creatinine. No lethal outcomes occurred. Minimal diuresis was higher, creatinine and urea levels lower in patients on rIL-2 (647.0 +/- 268.6 mg/day vs 422.0 +/- 198.2 ml/day, p < 0.05; 221.8 +/- 98.1 mcmol/l vs 398.9 +/- 234.9 mcmol/l, p < 0.05; 14.9 +/- 5.1 mcmol/l vs 22.0 +/- 9.0 mmol/l, p < 0.05). Thus, it is evident that rIL-2 reduces symptoms of acute renal failure in HFRS patients. Further investigations of rIL-2 treatment in HFRS are needed.

Adult↗
PubMed2002

[Impact of day-to-day arterial pressure variability on the left ventricle geometry in patients with predialysis chronic kidney insufficiency].

AIM: To estimate the impact of day-to-day variability of blood pressure (BP) on left ventricular geometry in pre-dialysis patients. MATERIAL AND METHODS: We estimate the impact of day-to-day variability of BP on left ventricular geometry in 42 non-diabetic pre-dialysis patients (22 F, 20 M, mean age 47 +/- 12 years) with arterial hypertension (> 140 and 90 mm Hg). Serum creatinine was 286.2 +/- 176.8 micromol/l. BP was measured in the morning during 12 days and M +/- SD and delta systolic blood pressure (dSBP = SBPmax - SBPmin) was calculated. Echocardiography was performed and left ventricular mass index and relative wall thickness (RWT) was estimated. RESULTS: LVH was detected in 35(83.3%) patients. Multiple stepwise regression analysis revealed that mean SBP is a stronger predictor of LVH than clinical SBP (R2 = 0.59; p = 0.000001 and R2 = 0.35; p = 0.0007, resp.). Standard deviation of mean SBP correlated with RWT (R2 = 0.30; p = 0.006). dSBP > 30 mmHg was associated with an increase of RWT. CONCLUSION: Mean SBP during 12 days is a stronger predictor of LVH than clinical SBP. Day-to-day variability of SBP with dSBP > 30 mm Hg was associated with development of concentric LVH.

Adult↗
PubMed2001

[Effects of arterial compliance on geometry of the left ventricle in patients with pre-dialysis chronic renal failure].

AIM: To examine relationships between left ventricular geometry and general arterial compliance (GAC) in patients with predialysis chronic renal failure (CRF). 102 patients with predialysis CRF unrelated to diabetes mellitus (males 46, females 56, mean age 49.1 +/- 18.3 years). CRF was caused by chronic glomerulonephritis and essential hypertension (77.4%). 92 (90.2%) patients were hypertensive. Serum creatinin was 432.1 +/- 165.3 mcmol/l. GAC was defined as stroke volume/pulse arterial pressure. Echocardiography determined the index of the left ventricular myocardial mass (ILVMM), relative thickness of the left ventricular wall (RTW). Left ventricular hypertrophy (LVH) was diagnosed in 86 (84.3%) patients. In 64 patients it was concentric and in 22 patients--excentric). Multivariance regression analysis showed that systolic arterial pressure and anemia have a direct independent effect on ILVMM (p = 0.004). Independent inverse relationship was between GAC and RTW. Patients with concentric LVH had GAC lower than those with excentric LVH (p = 0.003). Reduction of GAC is an independent factor influencing the development of concentric LVH in patients with predialysis CRF.

Electrocardiography↗
PubMed2000

[Heart remodeling in patients with predialysis phase of chronic renal failure].

AIM: To investigate remodeling of the heart in patients with predialysis phase of chronic renal failure (CRF). MATERIAL AND METHODS: Patients with predialysis phase of CRF (n = 61; serum creatinine 412.4 +/- 242.69 mumol/l), essential hypertension (EH) (n = 35) and healthy volunteers (n = 20) were assessed with echocardiography. The patients were not significantly different by the level of systolic and diastolic blood pressure, age and gender. RESULTS: Left ventricular mass index (LVMI) was increased in 53(86.9%) patients with CRF. LVMI was not different in patients with CRF and EH (189.9 +/- 71.35 vs. 165.0 +/- 41.83 g/m2; p = 0.3). Relative wall thickness was similar in patients with serum creatinine < 200 mumol/l and patients with more elevated serum creatinine (57.2 +/- 10.33 vs 58.31 +/- 13.33; p = 0.9). The ejection fraction lower than 50% was detected in 14(22.9%) patients with CRF. Multivariate regression analysis showed that LVMI was independently related to systolic blood pressure (p = 0.004) and level of hemoglobin (p = 0.004). Diastolic dysfunction (early and atrial peak filling velocities ratio < 1.0) was detected in 13(50%) from 26 investigated patients with CRF. The independent influence of hemoglobin on isovolumic relaxation time (p = 0.04) and early and atrial peak filling velocities ratio (p = 0.02) are shown. CONCLUSION: In patients with predialysis phase of CRF left ventricular hypertrophy (LVH) is extremely common including patients with mildly elevated serum creatinine. The treatment of patients with renal pathology and normal function must include measures not only to correct renal process but also to prevent development of LVH.

Adolescent↗
PubMed1998

[Differential diagnosis of hematuria on the basis of morphology of stained erythrocytes].

Glomerular and nonglomerular hematuria was differentiated in 40 patients by the morphology of erythrocytes stained with floxin in buffer solution. Glomerular hematuria was correctly diagnosed in 91.0%, nonglomerular in 88.9% of patients. The results of diagnosis of hematuria by floxin staining and by phase-contrast microscopy coincided; both methods are superior to the Right staining technique. The proposed method is easily available for any laboratory and is suggested for tentative diagnosis, in order to improve the diagnostic process.

Adolescent↗
PubMed1997

[The course and outcome of acute kidney failure in patients treated by hemodialysis].

In 1989-1995 229 patients with acute renal failure were treated by hemodialysis. A total of 1470 procedures have been performed, 8.8 +/- 1.5, on the average. 61 patients (26.6%) died. There is no significant relation between duration of oliguria, maximum BUN, creatinine level and lethality. The latter is associated with the patient's age, acute respiratory failure, sepsis, coma, hyperbilirubinemia and hypoproteinemia. Lethality was higher at failure of two and more organs and poor prognosis defined by a simplified acute physiology score (SAPS). 10 patients (5.9%) were discharged with increased creatinine level. Conventional hemodialysis is recommended as a basic technique of dialysis for patients with mono-organ failure and relatively good prognosis according to SAPS scale.

APACHE↗
PubMed1996

[The diagnostic importance of determining antibodies in the urine to the virus of hemorrhagic fever with renal syndrome].

Blood sera and concentrated urine were tested for antibodies to HFRS virus. 18 patients were in acute period and 16 had suffered from HFRS 16 years before. Indirect IFA test revealed antibodies in urine of 16 (88.9%) patients with HFRS. Urine antibodies disappeared for 9-22 days. There were no antibodies in the urine of patients with the history of HFRS, though it was registered in high titre in the blood serum. Thus, if the patient has antibodies to HFRS both in the blood and urine, it says about acute stage of the disease and can be used for earlier diagnosis of HFRS.

Adolescent↗
PubMed1987

[Methods of plasty in meningocele in children].

The authors describe their original method of fascio-aponeurotic plasty of the bone defect in meningocele in children. The method was used in 25 children and gave positive results.

Bone and Bones↗