PubMed Health⌕ Search

Biomedical subjects

A Savova

Publications and source records attributed to A Savova.

At least 19 recordsLinked to original sources
PubMed1990

[The early bicycle ergometry test in drug-stabilized patients with unstable angina pectoris--the correlation with coronary angiography].

The relation between the results of the early submaximal symptom-limited bicycle ergometry [correction of veloergometric] test and coronary angiography were examined in 127 patients with unstable angina pectoris stabilized by medicaments. In 19 (15.0%) patients the test was negative and in 108 (85%) patients the test was positive (angina pectoris and/or ST depression greater than or equal to 0.1 mV at 80 ms after the point J of the ECG). Between the results of the early bicycle ergometry [correction of veloergometric] test and the coronary angiography, performed soon after the test, there was a close correlation. By using strict criteria or a combination of criteria for assessment of residual ischemia the test can with great accuracy differentiate the patients with multivascular from those with monovascular disease or with healthy coronary vessels.

Adult↗
PubMed1990

[The effect of an aortocoronary bypass on the physical capacity of drug-stabilized patients with unstable angina pectoris].

To 51 patients with unstable angina pectoris a submaximum symptom-limited bicycle ergometry [correction of veloergometric] test was performed 3 to 6 days after stabilization by medicamentous treatment was achieved and 2 to 6 months after an aortocoronary bypass had been accomplished. During the first veloergometric test myocardial ischemia was induced in all patients--9 patients were in the IV, 18--in the III and 24--in the II functional class according to NYHA. During the second veloergometric test myocardial ischemia was induced only in 5 patients. At the end of the first year after the aortocoronary bypass had been performed 45 (88.2%) of the patients were without complaints. The predictive value of the positive veloergometric test after an aortocoronary bypass for a poor prognosis is 80% and that of the veloergometric test without induced myocardial ischemia for a favorable prognosis is 95.6%. Aortocoronary bypass in combination with medicamentous treatment improves the symptomatic state, physical capacity and the prognosis of patients with unstable angina pectoris up to the end of the first year to a considerably greater degree than the medicamentous treatment alone.

Angina, Unstable↗
PubMed1989

[Determination of the transaortic valve gradient in aortic stenosis by continuous Doppler echocardiography].

A correlative study was carried out between the transvalvular aortic gradient determined by continuous wave Doppler echocardiography and by cardiac catheterization (retrograde or transseptal) in 41 patients with proved by invasive methods aortic valvular stenosis of different degree with or without accompanying aortic incompetence (light, moderate or severe). A considerable correlation was found between the transvalvular aortic gradient determined by the two methods (r = 0.75). In spite of that in considerable number of cases there is overestimation or underestimation of the transvalvular aortic gradient determined by Doppler echocardiography compared with the one determined by cardiac catheterization. The overestimation of the transvalvular aortic gradient determined by Doppler echocardiography is due to the accompanying aortic incompetence of greater degree and to the condition that the gradient determined by Doppler echocardiography is maximum instantaneous while the one determined by cardiac catheterization is peak to peak and is principally of lower values. The underestimation of the transvalvular aortic gradient is due to the presence of considerable left ventricular dysfunction and technical faults in the Doppler echocardiographic examination.

Adult↗
PubMed1988

[Indications for and the postoperative results of mitral valve prosthesis].

The influence of 20 hemodynamic and clinical indices on the postoperative results was studied in 528 patients with mitral valve prosthetics. One year after the operation 78.7% of the patients are with improved functional capacity, 18.8% are without change and 2.5% are in worse condition. The lack of improvement correlates moderately with the postoperative complications (r = 0.4701) and to a larger degree with the number of patients in the II functional class before the operations (r = 0.7342). The deterioration of the functional capacity is in relation to the complications by operations on the tricuspid valve (r = 0.8773), but there is also considerable correlation with the low ejection fraction (r = 0.6425), previous commisurotomy (r = 0.5871) and uncorrected tricuspid valvular disease (r = 0.6314). The operative lethality rate is 6.25%.

Adult↗
PubMed1984

Determinants of the left ventricular function in patients with coronary heart disease: a multivariate approach.

251 patients with coronary heart disease (CHD) and a control group of 32 normal persons were examined with the purpose of establishing the determinants of the left ventricular function and comparing these determinants with the functional significance of coronary stenosis. The subjects were divided into four groups: I--controls; II--patients with normal left ventricular function (EF more than 60%); III--patients with impaired LV function (EF less than 60%) and Group IV--patients with left ventricular aneurysm. Nine parameters were obtained by multivariate discriminant analysis, which characterize and classify the left ventricular function: the ejection fraction (EF), angina pectoris, exercise ECG, left ventricular end-diastolic pressure, mean velocity of circumferential fibre shortening, left ventricular functional index, longitudinal shortening, LV systolic pressure/systolic volume ratio, and coronary index. On the basis of these parameters, all the normal persons, 88% of Group II, 92% of Group III and 72% of Group IV were classified correctly. The study proves that there is a good correlation between the EF and the haemodynamic and angiocardiographic parameters. The complex left ventricular function index facilitates the prognosis of surgical results. Abnormalities in left ventricular function cannot be reliably assessed by the coronary index values alone.

Adult↗
PubMed1984

[Left atrial myxoma descending deeply into the cavity of the left ventricle].

A female patient, aged 59 is reported with a myxoma of the left auricle, pedunculated deep in left cardiac ventricle. Myxoma was echocardiographically diagnosed and confirmed by left atriography. On the fourth day after the diagnosis of myxoma, with a high efficiency of all examinations and organizational measures the patients was successfully operated.

Echocardiography↗
PubMed1982

[Comparison between the loading test and selective coronary angiography in stenocardia].

The results from the step-wise loading test to 75 per cent of the age maximum pulse rate, performed by veloergemeter or thread-mill in 52 patients (9 females and 43 males, II of them with atypical chest pain and II with stenocardia) were juxtaposed to the data from the selective coronarography. It was established that the a reduction of ST segment greater than I mm and the appearance of precordial pain, degree III by the five-grade scale, have almost identical specificity (70% and 64% resp) and a predicting value of the positive result (68% and 70% resp) and a slightly higher sensitivity to pain (68% and 84% resp) in the detection of coronary stenosis greater than 50 per cent of the diameter of a main coronary vessel. The combination of the signs precordial pain degree III and/or ST reduction greater than I mm and/or elevation of ST greater than 2 mm, with same predicting value (67%) maintained, but with a considerably enhanced sensitivity (96%) proved to be most adequate as a criterion of the positive test. A reduction of ST segment greater than 22 mm is characterized by decrease of sensitivity (40%) but with a considerable increase of specificity (96%). The positivation of that sign suggests the presence mainly of a multibranch disease. The patients with coronary stenosis greater than 50%, rarely reach a physical capacity over 100 wt (7 x oxygen consumption) and a product of the maximum reached pulse rate and systolic blood pressure over 20 000 as compared with those without stenosis, but no difference among the patients with one-branch and multi-branch disease was established. The electrocardiographic changes in the patients with a true positive test with loading is more often retained after 4th minute of the rehabilitation phase as compared with those of the patients with false-positive test. Evidence exists to admit that the predicting value of the positive test is poorer in the patients with atypical pains and females.

Adult↗
PubMed1981

[Echocardiographic diagnosis of congestive cardiomyopathy associated with mitral regurgitation].

Echocardiographic findings are comparatively analyzed in 25 patients with congestive cardiopathy, combined with mitral regurgitation, a control group of healthy and 10 patients with volume loaded left ventricle with rheumatic "pure" mitral insufficiency. Some discrepancies were established in the usual echocardiographic characteristics of congestive cardiomyopathy in the patients with CCMP, combined with significant mitral insufficiency: normal, even increased amplitude of movement of the interventricular septum in the absence of systolic increase of the septal thickness. The differentiation between the rheumatic mitral insufficiency and mitral insufficiency in case of congestive myocardiopathy is difficult, due to the considerable differences in the functional Echo-C characteristics of left ventricle and morphological characteristic features in mitral echogram.

Adult↗
PubMed1980

[Hemodynamic study of postinfarct left ventricular aneurysm].

With a view to the determination of the effect of the size and localization of cardiac aneurysm upon left-ventricular function and the indications for surgical treatment--35 patients with aneurysms of anterior and posterior walls were complexly examined--hemodynamically, angiocardiographically and coronarographically. A method was applied for the determination of the area of anterior aneurysms. The hemodynamics and cardiac functions were established to be pathologically changed in cardiac aneurysm with an area over 25% of the ventricular surface, with a quickly growing risk for surgical treatment with a surface over 60%. The gravest changes were established in case of anterior aneurysms. The possibilities of faults are discussed as well as of the limited significance of the generally accepted parameters of left ventricular function--end diastolic pressure, end diastolic volume, expulsion fraction and the mean velocity of circumferential contraction along the equatorial plane--in the patients with cardiac aneurysm. The high significance of the changes in the local kinetics is confirmed (percentage contraction of the three main axes and their six semi-axes), both for the residual myocardium and aneurysm. Critical values for the parameters applied are proposed, when the surgical treatment is contraindicated or is with a high risk.

Adult↗
PubMed1977

[Functional characteristics of hypertrophic cardiomyopathy].

The hemodynamics was studies in 59 patients with hypertrophic cardiopathy: obstructive (33 cases) and non-obstructive (26 cases). The diagnosis was made and the hemodynamics studied by left and right ventricle catheterization, left ventriculography and echocardiography. A general hyperkinetism of the left ventricle pump function was established--increased fraction of forcing, per cent of the systolic shortening and contraction rate of the circumferential fibres with a not adequately large beat and minute volume. The regional functional of the left ventricle is characterized by hypokinetism of the interventricular septum and considerable hypercontractility of the left ventricle free wall. The diastolic filling of the left ventricle is impeded due to the decreased telediastolic size and volume and diminished extensibility. That leads to the increase of the final diastolic pressure in the left ventricle and the pulmonary artery, manifested especially after physical loading. The subaortic constriction is a result mainly of the systolic shifting of the posterior papillaris muscle forward and upward towards the hypertrophic interventricular septum. Subaortic stenosis shows considerable deviations and changes during the dynamic observations of the patients.

Adolescent↗
PubMed1977

[Possibility of studying the specific stimulation-conduction system of the heart].

The author carried out a survey on a new method for functional diagnostics--recording of the Hiss bundle potentials. The investigation method is described as well as the normal values of electrogram of the Hiss bundle. The clinical significance of the most important indications for the investigation are discussed, namely: 1. Various forms of atrio-ventricular and ventricular disorders of the stimulation-conductivity process. 2. Indistinct rhythm disorders. 3. Diagnostics of the paranodal stimulation conductivity. 4. Pharmacological studies.

Arrhythmias, Cardiac↗