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Biomedical subjects

B Umman

Publications and source records attributed to B Umman.

7 recordsLinked to original sources
PubMed2004

New support for clarifying the relation between ST segment resolution and microvascular function: degree of ST segment resolution correlates with the pressure derived collateral flow index.

OBJECTIVE: To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis and the pressure derived collateral flow index (CFIp), determined using an intracoronary pressure measurement technique in patients with recent myocardial infarction. METHODS: 33 patients were studied. TIMI grade III flow was achieved in the infarct related artery by thrombolysis. A surface ECG was obtained on admission and 90 minutes later. The sum of ST segment elevations was measured by summing all leads with ST elevation on the baseline ECG and on the 90 minute ECG (after thrombolysis) and calculating the percentage recovery. The study population was divided into two groups, with good STR (> or = 50%; group 1) or poor STR (< 50%; group 2). After angiography, a fibreoptic pressure monitoring guidewire was advanced to the stenosis to be dilated. The CFIp was determined as the ratio [coronary wedge pressure - central venous pressure]/[mean aortic pressure - central venous pressure]. RESULTS: The mean STR on the surface ECG was 54.6% and mean (SD) CFIp was 0.25 (0.12) (range 0.10-0.41). There was an inverse correlation between the individually calculated percentage of STR and CFIp (r = -0.64, p < 0.01). The mean CFIp was lower in patients with a good STR than in those with a poor STR (0.18 (0.07) v 0.27 (0.10), p < 0.02). CONCLUSIONS: Although TIMI grade III flow was achieved after thrombolysis, a worse STR on the surface ECG was associated with higher CFIp measured in the infarct related artery. CFIp appears to reflect the degree of microvascular obstruction by quantifying impedance of the microvasculature.

Blood Pressure↗
PubMed2003

Bilateral renal artery stenosis after abdominal radiotherapy for Hodgkin's disease.

A 49-year-old woman was admitted with fatigue, dyspnoea, pretibial oedema and decreased daily urination. Seven years ago she was treated with doxorubicin, bleomycin, vinblastine and dacarbazine, alternating with mechlorethamine, vincristine, procarbazine and prednisone and 80 Gy abdominal radiotherapy for Hodgkin's disease. Two years later, malignant hypertension was diagnosed. Angiotensin-2 antagonist and beta-blocker treatment was given. After increased serum creatinine levels were determined, renal angiography was performed and total obstruction in the left renal artery and near total obstruction in the right side was observed. She was admitted to our clinic with oliguria, and acute renal failure was diagnosed. Balloon angioplasty and stent implantation was performed to the right renal artery. After a polyuric period, serum creatinine reduced to near normal levels. Angiotensin-2 antagonist treatment worsened the course in this patient. Patients with resistant hypertension occurring years after abdominal radiotherapy should be evaluated for renal artery stenosis.

Abdominal Neoplasms↗
PubMed2003

Renovascular hypertension secondary to spontaneous renal artery dissection and treatment with stenting.

Renovascular disease is the cause of less than 1% of patients with hypertension; within this group aneurysm and dissection in renal artery are even rarer causes. It may be not only iatrogenic or traumatic, but may also develop spontaneously from fibromuscular disease or atherosclerotic lesions. We present a 26-year-old male patient with recently developed and progressive hypertension in whom renal angiography showed aneurysmal dilatation and dissection of the right renal artery. With the implantation of two stents in the true lumen, normal renal blood flow and thrombosis of the aneurysmal sac was established. As a result, stent implantation to renal artery dissection is effective, reliable and easy and can be an alternative to surgical treatment.

Adult↗
PubMed1998

Left ventricular geometric patterns and QT dispersion in untreated essential hypertension.

The spectrum of left ventricular adaptation to hypertension, different types of hypertrophy patterns, and QT dispersion in different types of hypertrophy was investigated in 107 patients with untreated essential hypertension and 30 age- and gender-matched normal adults studied by 12-derivation electrocardiogram (ECG), two-dimensional, and M-mode echocardiography. Left ventricular mass (LVM), body mass index, total peripheral resistance (TPR), relative wall thickness (RWT), and QT dispersion were found to be statistically significantly higher in the hypertension group (P < .001 for all). Among hypertensive patients, 41.1% had both normal LVM and RWT, here called normal left ventricle in hypertension; 10.3% had concentric hypertrophy with increased LVM and RWT; 14.95% had eccentric hypertrophy with increased LVM and normal RWT; and 32.7% had concentric remodeling with normal LVM and increased RWT. Echocardiographically derived cardiac index was higher in the concentric hypertrophy and eccentric hypertrophy patterns (P = .002 and P < .0001, respectively), whereas TPR was higher in the concentric hypertrophy and concentric remodeling patterns (P = .017 and .02, respectively). QT dispersion values were found to be increased in the hypertensive group (P = .001), whereas similar values were calculated for different types of hypertrophy patterns. We conclude that the more common types of ventricular adaptation to essential hypertension are eccentric hypertrophy and concentric remodeling. Concentric hypertrophy is found to be associated with both volume and pressure overload, whereas eccentric hypertrophy is associated with volume overload only and concentric remodeling is associated with pressure overload. But different left ventricular geometric patterns seem to have similar effects on QT dispersion.

Echocardiography↗
PubMedDate not supplied

Left ventricular diastolic function abnormalities in hypopituitary patients with GH deficiency: evidence for a subclinical cardiomyopathy.

The aim of this study was to evaluate cardiac performance, in particular diastolic function, in adult patients with adulthood onset GH deficiency. The study group was composed of 19 GH deficient adult hypopituitary patients with at-least 3 additional pituitary hormone deficits and 19 age, sex and BMI matched healthy controls. Mean duration of hypopituitarism was 108.6 +/- 77.0 months. None of the patients and controls presented with or had previous diagnosis of concomitant diseases that could affect cardiac function. All hormone deficiencies, except for GH, were appropriately replaced in the patients. Left ventricular function and geometry were evaluated by two-dimensional, M-mode and Doppler echocardiography. Body composition was evaluated by bioelectrical impedance analysis. Not significant differences were observed with respect to left heart dimensions and left ventricular systolic function between patients and controls. Nevertheless 2 of the left ventricular diastolic function parameters, deceleration time and isovolumetric relaxation time, were significantly prolonged in the patients compared with controls (247.88 +/- 70.65 vs 143.26 +/- 31.70 milliseconds (ms) and 122.31 +/- 18.24 vs 89.47 +/- 12.12 ms respectively, p<0.001). Duration of hypopituitarism was significantly correlated with percent body fat mass (r=0.6119, p<0.01) and percent lean body mass (r=-0.5949, p<0.01). It is concluded that in adults affected by hypopituitarism, GH deficiency predominantly impairs diastolic function while systolic function at rest is spared. This observation might indicate a preclinical stage of a cardiomyopathy.

Adult↗