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Biomedical subjects

A V Foniakin

Publications and source records attributed to A V Foniakin.

16 recordsLinked to original sources
PubMed2003

[Risk of recurrent cerebral embolism in isolated and combined cardial pathology in patients with cardio-embolic stroke].

To study cerebral microembolism and focal impairment of the brain in patients with isolated and combined cardiac affection, we examined 84 patients who had survived cardioembolic stroke (CES). The examination included computed tomography of the head, echocardiography and transcranialdopplerographic monitoring of microembolic signals (MES). Group 1 consisted of 53 (63.1%) patients with one source of cardiocerebral embolism, group 2-31 (36.9%) patients with two potential causes of cardial embolic complications. In group 2 average number of documented MES (3[1;5]) and average number of cerebral ischemic foci (2[1;2]) were greater than those of group 1-2[1;4] and 1[1;1], respectively. As to the size of the lesion, it was found that small, middle-size and large foci were also visualized in group 2 more frequently. Thus, combination of two sources of cerebral embolism observed in 1/3 of CES enhances cardiogenic embologenic potential and probability of microembolism transformation into cerebral focal lesion as a result of potentiation of different ways of thrombogenesis.

Adolescent↗
PubMed2003

[Cerebral perfusion in patients with arterial hypertension and chronic forms of brain vascular pathology].

AIM: To examine cerebral perfusion in patients with dyscirculatory encephalopathy and residual disorders of cerebral circulation in arterial hypertension. MATERIAL AND METHODS: Duplex scanning of extra- and intracranial arteries, computed tomography of the head were performed in 26 hypertensive patients with chronic vascular pathology of the brain. Cerebral perfusion was studied by the evidence obtained at single-photon emission computed tomography. RESULTS: Impaired segmental perfusion of the brain, primarily of frontal and temporal location, was detected in 88.5% patients. Occlusive lesions of extra- and intracranial arteries were accompanied by significant deterioration of the perfusion while visualization of leukoaraosis was associated with high perfusion in the anterior frontal compartments indirectly pointing to defects in autoregulation of cerebral circulation. It was found that different correlations exist between perfusion of various segments of the brain and systemic arterial pressure. This is explained by functional and hemodynamic heterogenicity of different brain regions. CONCLUSION: Specific features of cerebral perfusion in patients with chronic forms of vascular brain pathology should be considered in planning antihypertensive therapy because of the risk of focal hypoxia and even ischemia in an inadequate fall of arterial pressure.

Aged↗
PubMed2002

[Cardiac pathology in various in various pathogenetic subtypes of ischemic stroke].

Heart pathology was studied in various pathogenetic subtypes of ischemic stroke. A total of 330 stroke patients were divided into 4 groups. Group 1 consisted of 104 (31.5%) patients with cardioembolic stroke, group 2--of 72 (21.8%) with hemodynamic, group 3--of 71 (21.5%) patients with atherothrombotic and group 4--of 83 (25.2%) patients with lacunar stroke. Cardiac pathology was found in all patients of group 1 (ischemic heart disease-50.0%, inflammatory-infectious lesions-27.9%, other lesions-22.1%), in 49 (68.1%) patients of group 2, 36 (50.7%) of group 3 and 31 (37.3%) of group 4. Ischemic heart disease was prevalent (85.7, 86.1, 83.9% vs group 1). Potential sources of cardiogenic cerebral embolia were found in patients of all the groups: 100, 62.5, 43.7 and 33.7%, respectively. Thus, most patients with ischemic stroke have different heart defects related to the subtype of ischemic stroke. Potential causes of cardiocerebral embolism can be detected in any subtype of ischemic stroke.

Adolescent↗
PubMed2002

[Echocardiographic alteration in patients with hemodynamic stroke].

Echocardiography was made in 330 patients with ischemic stroke. Group 1 consisted of 72(21.8%) patients with hemodynamic stroke, the rest 258(78.2%) patients (group 2) had other pathogenetic subtypes of stroke. Chronic cardiac pathology was represented by postinfarction cardiosclerosis (38.9 and 17.8% for groups 1 and 2, respectively, p < 0.001) and continuous atrial fibrillation (15.3 and 15.1%, respectively, p > 0.05). Stroke volume of the left ventricle (LV), cardiac output and ejection fraction of the LV were significantly less than in group 2 and in control group but within normal range. The number of group 1 patients having local LV dyskinesia and transitory painless myocardial ischemia was significantly higher than in group 2 (p < 0.001). Painless ischemia correlated with local dyskinesia of the LV (p < 0.02). As transitory myocardial ischemia may deteriorate LV contractility and provoke excessive fall of blood pressure, local LV dyskinesia caused by postinfarction changes seems to be a principal and stable echocardiographic sign of developing hemodynamic stroke.

Adolescent↗
PubMed2002

[Cardiac arrhythmia in cardiac embolism].

To study cardiac arrhythmia in patients with cardiocerebral embolism, we examined 330 patients with ischemic stroke using ECG and Holter monitoring. 33 patients were control. Group 1 consisted of 104(31.5%) patients with cardioembolic stroke, group 2--of 226(68.5%) patients with other pathogenetic stroke subtypes. Number of patients with rare and frequent supra- and ventricular extrasystole in groups 1 and 2 was not essentially different. Paroxysms of supra- and ventricular tachycardia, variants of sick sinus syndrome (SSS) and transitory atrioventricular block (AV block) of the second and third degree were identified with comparable frequency in groups 1 and 2 (0.9 to 5.8% patients). Paroxysmal atrial fibrillation (AF) was registered in 31.8% of group 1 patients and 15.9% of group 2 patients. Permanent AF occurred in 31.8 and 7.5% patients of groups 1 and 2, respectively (p < 0.00001). Thus, cardiocerebral embolism is observed most frequently in paroxysmal and permanent forms of AF. Variants of extrasystole, paroxysmal supra- and ventricular tachycardia, SSS and AV-block are not associated with embolic complications.

Adolescent↗
PubMed2002

[Perpetual cardiac fibrillation and predictors of sudden cardiac arrhythmic death in patients with ischemic stroke].

AIM: To study predictors of sudden cardiac arrhythmic death in patients with perpetual cardiac fibrillation (PCF) and ischemic stroke. MATERIAL AND METHODS: 230 patients with ischemic stroke were examined. 22 (9.6%) patients of them (group 1) had PCF, 208 (90.4%) patients (group 2) had sinus rhythm. The groups were matched by sex, stage of ischemic stroke, presence of ischemic heart disease. Echocardiography and Holter monitoring were made in all the examinees. RESULTS: Zones of left ventricular dyskinesia and high-grade extrasystoles occurred more frequently in group 1. Ventricular extrasystoles were also frequent in this group. A close correlation was found between the zones of left ventricular dyskinesis and ventricular extrasystoles of high gradations. CONCLUSION: Thus, most of the patients with ischemic stroke and PCF have ventricular arrhythmia resultant from systolic dysfunction of the left ventricle and related to the risk of sudden cardiac death.

Adolescent↗
PubMed2002

[Pathogenetic assessment of cardiac arrhythmia and myocardial ischemia in hemodynamic stroke].

330 patients with ischemic stroke entered the trial. They were divided into two groups: 72 (21.8%) patients with hemodynamic stroke (group 1) and the rest 258 (78.2%) patients with other pathogenetic subtypes of stroke (group 2). Heart rhythm and myocardial ischemia were studied using ECG and Holter monitoring. Electrocardiographically, hemodynamic stroke is characterized by frequent ventricular extrasystole, sick sinus syndrome and transient atrioventricular block of the second and third degree with pauses 2 s and longer, ventricular fibrillation and painless myocardial ischemia. Perpetual and paroxysmal atrial fibrillation and paroxysmal ventricular tachycardia are not pathognomonic for hemodynamic stroke though these disorders can be also considered as independent pathogenetic factors of hemodynamic cerebral focal lesion.

Adolescent↗
PubMed2002

[Comparative assessment of persistent and paroxysmal atrial fibrillation as causes of cardiocerebral embolism].

In 66 patients with embolic stroke of cardiac origin (33 with persistent and 33 with paroxysmal atrial fibrillation) transthoracic and transesophageal (21 patients, 31.2%) echocardiography was used for detection of atrial thrombosis. Lone atrial fibrillation was significantly more frequent among patients with paroxysmal atrial fibrillation. Frequency of thrombosis of left atrial appendage was similar in patients with nonrheumatic persistent and paroxysmal atrial fibrillation.

Aged↗
PubMed2002

[Echocardiographic changes associated with risk of developing embolic complications in patients with ischemic stroke].

AIM: To study echocardiographic parameters associated with embolic complications in patients with cardioembolic and other pathogenetic subtypes of ischemic stroke. MATERIAL AND METHODS: 330 patients with ischemic stroke (IS) were examined. Transthoracal echocardiography was made in all the patients, transesophageal echocardiography was performed in 53 (16.1%) patients. The patients were divided into two groups: 104 (31.5%) patients who survived cardiocerebral embolism (group 1), 226 (68.5%) patients with other pathogenetic subtypes of stroke (group 2). RESULTS: Cardiac pathology was detected in 220 of 330 (66.7%) examinees with ischemic heart disease in 50.0% and 51.3% patients of group 1 and 2, respectively; infectious-inflammatory diseases--in 27.9 and 4.4%, respectively (p < 0.0001), other diseases (mitral prolapse, aneurysm and interatrial defect, idiopathic arhythmia) in 25.0 and 5.3% patients, respectively (p < 0.0001). Left atrial myxoma was diagnosed in 1.9% patients of group 1. CONCLUSION: Echocardiographic changes associated with a risk of embolic complications were visualized in all pathogenetic subtypes of ischemic stroke. In cardioembolic stroke echocardiography detected most frequently prolapse with myxomatous degeneration of the cusps and mitral vegetations, mitral failure, calcinosis of the mitral ring, local hypokinesia of the left ventricle, dilation and thrombosis of the left atrium. Rare changes, indicating cerebral embolism, include replaced aortic and mitral valves, mitral stenosis, cardiac tumor, aneurysm and defect of the interatrial septum.

Adolescent↗
PubMed2002

[Characteristics of cerebral microembolic signals and focal lesions of the brain in different causes of cardiogenic embolism].

To study quantitative and qualitative characteristics of microembolic signals (MES) and specific features of a focal damage to the brain depending on the site of the embolic substrate in patients with cardioembolic stroke (CES), we examined 84 patients who survived CES. 38 (45.2%) of them had an acute stage, 46 (54.8%)--a residual stage. Group 1 comprised 42 patients with cardial pathology characterized by intrachamber formation of the embolus and 2 patients with an open oval window. Group 2 consisted of 40 (48%) patients with diseases promoting formation of emboli on the cardiac valves. The highest frequency, intensity and duration of MES in CES were registered in patients of group 2 while the number of ischemic focuses was greater in patients of group 1. This may be explained by the fact that intensity and duration of cardiogenic MES depend more on acoustic density of the embolus than on its size. Therefore, the site of the embologenic substrate together with quantitative and qualitative MES characteristics is the key factor of a high risk of cardiocerebral embolic complications.

Acute Disease↗
PubMed2001

[Transesophageal echocardiography in ischemic stroke: the detection of disorders and the indication for the procedure].

The authors present the results of transthoracic and transesophageal echocardiographic examination (TEE) of 53 survivors of ischemic stroke (IS). The following indications for TEE in IS patients were determined: the presence of permanent or paroxysmal arrhythmia of different etiology for verification of intracavitary thrombosis and its risk factors; identification and assessment of embologenic risk of cardial changes detectable at TEE genesis of which is not still clear; the presence of cryptogenic stroke.

Adult↗
PubMed2001

[Reactivity of cerebral vessels in patients with circulatory encephalopathy, arterial hypertension and cerebral hypoperfusion risk].

AIM: To study cerebral vasomotor reactivity (CVR) in patients with chronic cerebrovascular disturbances caused by arterial hypertension (AH) and to determine criteria of cerebral hypoperfusion risk during antihypertensive therapy. MATERIAL AND METHODS: 80 patients with chronic cerebrovascular disturbances because of AH and 15 normotensive subjects without any neurological pathology (control group) were examined using CT of the brain, duplex scanning of extra- and intracranial arteries, echocardiography. CVR was assessed with transcranial dollperography of the blood flow velocity in both middle cerebral arteries before and after nitroglycerine provoked test. RESULTS: CVR in the patients significantly differed from that of the controls. Main factors responsible for changes in CVR ara the age, form and duration of arterial hypertension, circadian rhythm of blood pressure, occlusive extra- or intracranial arteries disease. CT signs of focal (lacunes) or diffuse (leukoaraiosis) ischemic brain damage, deformations of the neck vessels, left ventricular hypertrophy may be leading markers of severe disturbances in CVR. CONCLUSION: In patients with chronic cerebrovascular disease disturbances of CVR arise due to arterio/arteriolopathy as a result of AH. Limitation of the vasodilatation potential demonstrates cerebral autoregulation dysfunction. Thus, factors and markers of CVR impairment can be considered as risk criteria of cerebral hypoperfusion during inadequate antihypertensive treatment.

Adult↗
PubMed2001

[Cardiogenic ischemic strokes: pathogenetic aspects].

Eighty-three patients with acute ischemic stroke (56 men and 27 women, mean age 90.1 +/- 10.8 years) were examined in order to elucidate the significance of paroxysmal heart rhythm disorders and silent myocardial ischemia and determine the pattern of hemorheological changes. Traditional clinical instrumental examinations were supplemented by Holter monitoring and measurements of a wide spectrum of hemostatic and hemorheological values. Cardiogenic ischemic strokes were pathogenetically heterogeneous. Holter monitoring helped detect the significance of paroxysmal atrial fibrillation in the pathogenesis of embolic cardiogenic stroke. One of the key factors in development of hemodynamic cardiogenic stroke was transitory bradyarrhythmia and deterioration of left-ventricular contractility. Cardiogenic strokes are associated with hemostatic activation with predominant changes in the plasma hemostasis, which dictates purposeful hemocorrection.

Adult↗
PubMed1993

[State of intracardiac hemodynamics in patients with sick sinus syndrome during cardiac pacing].

A EKS-500 pacemaker was implanted in 36 patients with the sick sinus syndrome. Out of them, 18 patients had coronary heart disease, 6, hypertensive disease and myocardial hypertrophy, and 12, idiopathic arrhythmias. After surgery, equilibrium radionuclide ventriculography was performed in the patients at rest in the presence of spontaneous rhythm and pacing, as well as during exercise. In patients with idiopathic arrhythmias, cardiac output and index remained within normal ranges during sinus bradycardia, which was attained by increased stroke volume, whereas in patients with myocardial disease, the normal values of these parameters were recorded only at a rate 60 imp/min. During exercise, the patients with idiopathic arrhythmias showed a noticeable rise in cardiac output not only due to higher heart rate, but due to increased stroke volume, and those with myocardial disease displayed the increase only due to higher heart rate.

Aged↗
PubMed1993

[Radionuclide ventriculography for evaluating left ventricular myocardial contractility in patients with implanted pacemaker].

An EKC-500 pacemaker was implanted in 16 patients with coronary heart disease (CHD) and 14 idiopathic conduction disturbance for complete atrioventricular block. After surgery, the patients underwent equilibrium radionuclide ventriculography by using a nuclear stethoscope at rest and during exercise at different stimulation rates with the aim of choosing their optimal values. It was established that patients with idiopathic conduction disturbances showed improved left ventricular contractility at all stimulation rates and their optimal values ranged 60-70 per minute. In patients with CHD, the stimulation rate of 60 impulses/min was optimal at rest, and with this, exercise resulted in a significant deterioration of myocardial contractility, but only the stimulation rate of 80 impulses/min led to a slight improvement, which was due to accessory mechanisms of contractility enhancement. The peak ejection rate was the most sensitive to progressive myocardial dysfunction, yet the basic contractility index was the mean ejection rate.

Arrhythmias, Cardiac↗