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Biomedical subjects

A N Rogoza

Publications and source records attributed to A N Rogoza.

At least 19 recordsLinked to original sources
PubMed2006

[Comparative efficacy and tolerance of atenolol and midodrine in patients with vasovagal syncopes].

AIM: To compare efficacy and tolerance of atenolol and midodrine in patients with vasovagal syncopes (VVS). MATERIAL AND METHODS: The trial included 35 patients with recurrent VVS confirmed at long passive head-up tilt table test (HTTT) or maximal load bicycle exercise test (MET). These tests were also used for assessing efficacy of atenolol and midodrine in cases when syncopes occur in repeated tests. If recurrent induction of VVS was absent, efficacy of the drugs was assessed by long-term (up to 12 months) clinical observation. Long-term administration of atenolol and midodrine was continued in patients with effect by HTTT and/or MET. Eighteen patients were randomized to take atenolol in a daily dose up to 50 mg, seventeen--to take midodrine in a daily dose up to 15 mg. RESULTS: Efficacy of atenolol by HTTT and MET was 8%, midodrine--57% (p = 0.01). All the patients benefited from the drugs in their long-term regimen. Long-term administration of atenolol induced remission of VVS in 82% cases, midodrine--in 89% (insignificant). Overall efficacy of atenolol was 44%, of midodrine--70% (insignificant). In 5 of 6 patients resistant to atenolol and midodrine monotherapy, combined use of the drugs was effective. Treatment with atenolol, midodrine and their combination prevented VVS in 89% patients. Both short- and long-term courses of atenolol and midodrine were safe in terms of side effects. CONCLUSION: Atenolol and midodrine as well as their combination were highly effective and well tolerated in the treatment of VVS patients.

Adolescent↗
PubMed2006

[The problem of indexation of left ventricular myocardial mass by body size in obese patients].

AIM: To assess efficacy of different ECG-criteria of left ventricular myocardial hypertrophy (LVH) in hypertensive patients as regards body mass (obesity). MATERIAL AND METHOD: Data on 100 patients (42 males and 58 females, age 19-79 years) with diagnosis of hypertension of the first-second degree were analysed. ECG was registered in 12 leads. LVH was determined by ECG by the following criteria: Sokolov-Lion (S-L): Sv1+Rv5(v6) > 35 mm; Cornell voltage (Crn-V): R avL+Sv3 > 28 mm (> 20 mm for women); Cornell product (Crn-P). According to the body mass the patients were divided into 3 groups: with normal weight, overweight and obesity. Crn = P criterion was most sensitive in all the three groups. RESULTS: In the groups sensitivity of ECG criteria depends on several factors: on the method of indexation and on the gender and body mass index. CONCLUSION: Informative value of ECG criteria of LVH depends on the method of indexation and on the amount of the excessive body mass.

Adult↗
PubMed2005

Angiotensin II receptor blocker telmisartan: effect on blood pressure profile and left ventricular hypertrophy in patients with arterial hypertension.

In this open-label, non-comparative study, the anti-hypertensive efficacy and effect on left ventricular hypertrophy (LVH) of 24 weeks' treatment with once-daily telmisartan 40-80 mg was evaluated in 24 patients with mild-to-moderate hypertension and LVH. Patients were titrated to the higher dose of study drug at week 4 if they did not achieve blood pressure normalization (i.e. systolic blood pressure [SBP]/diastolic blood pressure [DBP] remained > or = 140/90 mmHg). The anti-hypertensive action of telmisartan was assessed using clinic cuff measurements and 24-h ambulatory blood pressure monitoring, and left ventricular mass index (LVMI) was determined by two-dimensional echocardiography at baseline and after 24 weeks of therapy. Telmisartan significantly reduced mean 24-h, daytime and night-time SBP and DBP compared with baseline after 12 and 24 weeks of therapy. Target blood pressure levels, defined as SBP/DBP < 140/90 mm Hg, were achieved in 16 (69.6%) patients at the end of the treatment period. After 24 weeks of telmisartan treatment, LVMI decreased from 151.6 +/- 5.4 to 135.1 +/- 5.9 g/m2. In conclusion, anti-hypertensive treatment with telmisartan for 24 weeks produced significant reductions in blood pressure and regression of LVH, as assessed by LVMI, in patients with hypertension and LVH.

Administration, Oral↗
PubMed2005

[Effects of isosorbide-5-mononitrate on clinical condition, bicycle ergometry results, endothelium-dependent vasodilation in patients with ischemic heart disease with stable effort angina].

AIM: Assessment of efficacy of treatment of coronary heart disease (CHD) patients suffering from stable effort angina of functional class II-III with the drug isosorbide-5-mononitrate Mono Mac 50 depo (MM 50 D). MATERIAL AND METHODS: Clinical indices, exercise tolerance, endothelial function (the study of brachial artery in reactive hyperemia and sublingual intake of nitroglycerin) were studied in 30 patients with stable angina FC II-III before the treatment, 1 and 3 months after the treatment. RESULTS: MM 50D significantly widens diameter of the brachial artery (by 11.6%), lowers nitroglycerin-dependent vasodilation (from 16% to 10.4% in a month and to 10.2% in 3 months) and blood flow speed in reactive hyperemia. An absolute increment of the brachial artery diameter in reactive hyperemia test remained unchanged. The ratio flow-dependent vasodilation/nitroglycerin-dependent vasodilation increased in the course of therapy from 0.67 to 0.91. The drug produced clinical improvement (anginal attacks rate diminished by 70 and 85%, respectively) and increased exercise tolerance (the threshold performance rose by 28%, total load time--by 30%). CONCLUSION: It is important to use complex assessment of hemodynamic component of endothelial function in the treatment with nitrates.

Adult↗
PubMed2004

[First experience with "live" three-dimensional echocardiography in Russia].

Revival of interest to three-dimensional echocardiography during recent years was invoked by introduction of essentially novel ultrasound technology of "live" three-dimensional imaging. We introduce here the first experience of the use of < > three-dimensional echocardiography in Russia comprising examination of 74 patients with various pathology of the heart. Positions and sections are described allowing best visualization of pathology of cardiac valves and other intracardiac structures. Our experience shows that at present < > three-dimensional echocardiography should be considered to be an important supplement to standard echocardiography. However in some < > cases it can be the only non-invasive technique able to provide complete information on the size of ventricular and atrial septal defects, valvular and other cardiac pathology.

Echocardiography↗
PubMed2004

[Methodological approaches to estimation of morning urge of arterial pressure in essential hypertensives].

AIM: To estimate the time intervals of a morning arterial pressure urge (MAPU) and MAPU characteristics in patients with essential hypertension (EH). MATERIAL AND METHODS: The study enrolled 70 patients (50 male and 20 female) with EH of the first (n = 41) and second (n = 20) degrees aged 34-65 years (mean age 50.4 +/- 0.9 years). The control group consisted of 9 healthy men. Morning dynamics of arterial pressure (AP) and heart rate (HR) was studied basing on the data of 24-h AP monitoring (Spacelabs-90207, USA). RESULTS: Dynamics of AP from nocturnal to diurnal patterns in both hypertensive and normotensive subjects falls into 3 phases: a premorning urge (from 4-5 a.m. to waking up) with a characteristic slow rise in AP and HR; a morning urge (from waking up for 4-5 hours) with a characteristic forced AP and HR rise); a diurnal urge (from 11 a.m. to 13-14 p.m.) with characteristic slowing down of AP and HR rise. Patients with EH of the first and second degree vs normotensive subjects had unfavourable changes in morning dynamics of AP and HR: a significant progressive growth of maximal systolic and diastolic pressure proportional to mean circadian AP levels; a rise of morning hours index of AP which characterizes amplitude-speed features of AP and HR. CONCLUSION: To characterize MAPU most completely it is recommended to estimate the following parameters: wave index (to assess AP conversion from one level to another), mean rate of AP change per hour (to prevent influence of random factors on the rate of MAPU); relative maximal values of AP (to estimate maximal AP values in morning hours and nocturnal mean AP).

Blood Pressure↗
PubMed2004

[Characteristics of hypotensive effect in patients with arterial hypertension and desaturation signs of obstructive sleep apnea syndrome during sleep].

AIM: To estimate the efficacy of 8-week antihypertensive monotherapy in patients with arterial hypertension (AH) regarding the presence of obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: We analysed the results of 24-h blood pressure (BP) monitoring of 26 inpatients (mean age 54 +/- 2 years) with mild (n = 18) and moderate (n = 8) AH before and after 8 weeks of treatment with 5-10 mg amlodipine or 50-100 mg of losartan once daily to assess blood pressure profile parameters. The patients underwent nocturnal monitoring of arterial oxygen saturation (pulsoximeter NONIN-8500 M, USA). The presence of OSAS was confirmed when a characteristic clinical picture was combined with the presence of significant (> 4%) sleep desaturation episodes > 15 episodes per hour or the presence of group desaturation episodes below 90%. Seven hypertensive patients with OSAS were assigned to group 1, nineteen patients without OSAS--to group 2. The differences in estimated parameters between the groups were tested by Mann-Whitney U test, the dynamics of BP profile parameters--by Wilcoxon matched pairs test. RESULTS: In group 1 there were no significant differences by most of BP profile parameters before and after antihypertensive treatment, except mean nocturnal systolic BP. In group 2 a significant hypotensive effect was seen by all parameters of BP profile except BP variability. Hypotensive efficacy in group 2 was 1.5-2 times higher vs group 1, but the difficulties were not significant. CONCLUSION: Antihypertensive therapy in hypertensive patients with OSAS is less effective than in those without OSAS but it is not uneffective.

Adult↗
PubMed2004

[Results of midodrin treatment of vasovagal syncope].

AIM: To elicit efficacy of midodrin in patients with vasovagal syncope. MATERIAL AND METHODS: 50 patients with recurrent vasovagal syncope documented by head-up tilt tests or bicycle exercise stress tests participated in the study. These tests controlled the effects of midodrin if syncopes occurred again in repetition of the tests. In the other patients the effect of the drug was assessed clinically. All the patients received midodrin in daily dose up to 15 mg. RESULTS: Mirodrin effectively prevented syncope in 13 (72%) patients as shown by the tilt test, in 10 (59%) patients as shown by the exercise stress tests and in 14 (93%) patients as controlled clinically. Total efficacy of midodrin was 74% (37 of 50 patients). CONCLUSION: Midodrin demonstrated high efficacy in prevention of vasovagal syncope. Side effects were not serious therefore the drug is well tolerated.

Adolescent↗
PubMed2004

[Successful midodrin treatment for vasovagal syncopes accompanied by asystole].

Vasovagal syncopes (WS) are fainting fits whose manifestations are systemic vasodilation and bradycardia. The development of WS is frequently accompanied by short-term cardiac arrest. Recent data show that implantation of a cardiac pacemaker fails to prevent the development of fainting fits in these patients. On the basis of the pathogenesis of WS, the use of alpha-adrenomimetic midodrine is justifiable. The presented case demonstrates the successful use of the agent in the treatment of vasovagal syncope accompanied by asystole.

Adrenergic alpha-Agonists↗
PubMed2004

[Long-term orthostatic and bicycle ergometry exercise tests in differential diagnosis of syncopal conditions of unclear origin].

AIM: To study efficiency of bicycle exercise test and long-term orthostatic test in differential diagnosis of syncopes. MATERIAL AND METHODS: The study included 113 patients suffering from recurrent syncopes of unclear origin. Twelve healthy volunteers were selected for assessment of the tests specificity. All the patients and controls were examined by means of long-term orthostatic test (LTOT) and bicycle exercise test (BET). RESULTS: Specificity of both tests was 100%. In LTOT syncopes were observed in 52 (46%) cases, including vasovagal syncopes (51 patients), epileptic seizure (1 patient). BET induced vasovagal syncopes in 54 (48%) patients. The results of both tests by inducing syncopes coincided in 30 (26%) cases. In 24 (21%) patients syncopes occurred only in BET while LTOT appeared uninformative. In 21 (18.6%) cases syncopes occurred only in LTOT while BET produced a negative result. 38 (34%) patients had syncopes neither in LTOT nor BET. Both tests induced syncopes in 75 (66%) patients. No complications were observed. CONCLUSION: LTOT and BET are safe and complementary methods in differential diagnosis of syncopes.

Adolescent↗
PubMed2003

Dynamics of interrelationships between the content of lipoprotein particles, fibrinogen, and leukocyte count in the plasma from patients with coronary heart disease treated with Kwai.

The hypolipidemic effect of Kwai, a preparation based on garlic powder (Allium sativum), depended on the initial content of cholesterol and/or triglycerides. This effect was most pronounced in patients with coronary heart disease with initial cholesterol >7.0 mmol/liter and triglyceride >1.92 mmol/liter. After treatment with Kwai the correlation between triglyceride content and leukocyte count remained unchanged, the correlation between cholesterol content and leukocyte count disappeared, fibrinogen concentration decreased by 11%, and no correlation was found between fibrinogen content and leukocyte count.

Adult↗
PubMed2003

[Prognostic value of the degree of night decrease of systolic pressure in patients with mild and moderate forms of hypertension (7-9-year prospective study)].

AIM: To study a relationship between a carcadian blood pressure (BP) rhythm and cardiovascular events (CE) during 7-9 year follow-up in males with mild to moderate essential hypertension (EH). MATERIAL AND METHODS: 50 males (mean age 48.6 +/- 0.7 years) with mild to moderate EH were prospectively followed up for 7-9 years (8.4 +/- 0.1 years). We analysed 24-h BP recordings and protocol of echocardiography performed during the first hospitalization. The patients were divided into three groups: group 1 (n = 18) with normal (10-20%) nocturnal fall of systolic BP (NF SBP) and normal left ventricular mass index (LVMI < 125 g/m2); group 2 (n = 16) with insufficient (< 10%) NF SBP and normal LVMI; group 3 (n = 16) with LVMI > 125 g/m2. In these groups we assessed the prevalence of CE: myocardial infarction (MI), stroke (S), sudden death (SD), new cases of angina pectoris (AP), transient cerebral ischemic attack (TIA). RESULTS: No significant differences were found between the groups by mean age, body mass index, duration of arterial hypertension, mean 24-h and awake systolic and diastolic BP while significant differences were by nighttime BP profile parameters. During the follow-up 16 CE in 12 patients were documented (3 fatal and 13 nonfatal). In group 1 CE were observed in 1 patient (twice MI), in group 2-7 cases of CE (1 S, 1 TCIA, 2 MI, 2 AP) in 6 patients, in group 3-7 cases (2 MI, 3 TIA, 2 AP) in 5 patients, 3 of them were fatal. CONCLUSION: Insufficient nocturnal fall of SBP (< 10%) is an adverse prognostic factor for cardiovascular morbidity in mild to moderate essential male hypertensives.

Adult↗
PubMed2002

[Nocturnal hypoxic episodes and structural changes in left ventricular myocardium in patients with mild-to-moderate arterial hypertension].

AIM: To study correlations between structural changes of the left ventricle (LV) in patients with mild and moderate arterial hypertension (AH) and severity of hypoxic night episodes. MATERIAL AND METHODS: The examination of 50 patients (mean age 52 +/- 1 year) with mild and moderate hypertension included echocardiographic measurement of LV myocardial mass, calculation of LV myocardial mass index. LV hypertrophy was stated in the index 125 g/m2 for men and 110 g/m2 for women. 24-h monitoring of arterial pressure (TM-2425) and night monitoring of hemoglobin saturation of arterial blood with oxygen (SaO2) using pulsoxymeter NONIN 8500M were made. The data processing was performed with the use of original program ARM-SaO2. Dissaturation was stated if SaO2 fell by 4% and more compared to the previous stable level at initial SaO2 level above 90%. The patients were divided into two groups according to the number of dissaturation episodes: group 1 (more than 20 dissaturation episodes) and group 2 (less than 20 episodes). RESULTS: The groups were comparable by gender, duration of hypertension, body mass index, systolic and diastolic arterial pressure, heart rate. In group I, pulse arterial pressure, systolic arterial pressure load for 14 hours, day and night were significantly higher. Patients with dissaturation had a significantly higher LV myocardial mass and more frequent LV hypertrophy (128 +/- 6 and 106 +/- 5 g/m2 and 56 and 20%, respectively). The correlation and multifactor regression analysis showed a predictive value not only of the pressor parameters but also of indices of night hypoxia in relation to structural changes of LV myocardium. CONCLUSION: The presence of significant hypoxic episodes in sleep in AH patients indicates risk to develop structural changes of LV myocardium.

Female↗
PubMed2002

[24-hour blood pressure rhythm: clinical and predictive value].

Clinical and predictive value of 24-hour blood pressure rhythm is reviewed. Insufficient nocturnal blood pressure lowering induces augmented pressure load on target organs. On the other hand it reflects dysregulatory changes due to target-organ involvement. Lack of adequate nocturnal blood pressure lowering is considered by some investigators as independent risk factor of target-organ damage. This dictates necessity of registration of parameters of 24-hour blood pressure profile in evaluation of patients with hypertension.

Adolescent↗
PubMed2002

[Angiotensin II receptor blocker telmisartan: effect on 24-hour blood pressure profile and left ventricular hypertrophy in patients with hypertension].

AIM: To study antihypertensive efficacy of monotherapy with telmisartan and its action on left ventricular myocardium remodeling in patients with hypertension. MATERIAL AND METHODS: Telmisartan (40-80 mg/day) was given for 24 weeks to 24 patients aged 37-69 years with I-II degree of blood pressure (BP) elevation and hypertrophy of left ventricular myocardium. Antihypertensive action of telmisartan was assessed by 24-hour BP monitoring. Left ventricular myocardial mass was estimated by echocardiography before and after 24 weeks of therapy. RESULTS: Telmisartan equally decreased both diurnal and nocturnal systolic and diastolic BP (by10.4-11.7%), lowered maximal BP during morning hours, and restored initially disturbed 24-hour BP rhythm. Target BP levels were achieved in 16 patients (70%). Therapy with telmisartan was associated with significant 10.9% reduction of left ventricular myocardial mass index (from 151.6-/+5.4 to 135.1-/+5.9 g/m2, p=0,02) at the account of decreased thickness of left ventricular wall. CONCLUSION: These results give reason for the use of telmisartan for the treatment of patients with hypertensive disease and left ventricular hypertrophy.

Adult↗