Biomedical subjects

D Timiş

Publications and source records attributed to D Timiş.

8 recordsLinked to original sources

PubMedDate not supplied

Chlamydia pneumoniae antibodies and inflammatory reaction in patients with ischemic heart disease.

We studied the relationship between Chlamydia pneumoniae antibodies, C-reactive protein (CRP) and interleukine 8 (IL-8) in 87 patients with ischemic heart disease: 29 patients with acute myocardial infarction, 18 patients with unstable angina pectoris and 40 patients with stable effort angina. We determined in all patients IgG and IgA antibodies to Chlamydia pneumoniae, CRP and IL-8. Species specific antibodies to Chlamydia pneumoniae (IgG and IgA) were detected by indirect ELISA technique (Savyon Diagnostics Ltd, Israel). Interleukine-8 measured by a commercially available ELISA kit (CLB, Amsterdam, The Netherlands). CRP was determined by radial immunodiffusion (Mancini). The IgG antibodies were present in 25 patients (29%), the greatest percentage being noted in patients with unstable angina pectoris (50%). The IgA antibodies were present, as a sign of chronic Chlamydia pneumoniae infection, in 56% of the patients with IgG antibodies. CRP was positive in 52% of the 25 patients with positive IgG antibodies, but in only 34% of the 62 patients without IgG antibodies (p < 0.01). IL-8 was positive in 12% of the patients with IgG antibodies, and in 21% of the patients without IgG antibodies but the difference is not significant (p > 0.05). It is concluded that there is a relationship between the presence of the Chlamydia pneumoniae infection and inflammatory reaction in patients with ischemic heart disease, but the neutrophils are not implied in this process.

Adult↗

PubMedDate not supplied

Does ischemic preconditioning occur during rehabilitation of ischemic patients?

Ischemic preconditioning is generally a short duration phenomenon, but during acute myocardial infarction a better inhospital outcome of patients with previous angina suggests that the effect of ischemic preconditioning could be longer than it was considered until now. It was also demonstrated that during successive exercise stress testings (ET) ST depression became lesser as a consequence of ischemic preconditioning. We investigated the possible occurrence of ischemic preconditioning during rehabilitation of ischemic patients. There were studied 43p with old myocardial infarction or stable effort angina, 29 men and 14 women, aged 33-68 years, divided in two groups: group I (19p) was included in a cardiac rehabilitation programme (15-20 sessions) and group II (24p) was not. All the patients were submitted to two ET at a month interval, for group I before and after cardiac rehabilitation programme. The peak-effort level was significantly greater for group I (80.26 +/- 7.2w vs 93.42 +/- 8.3w p < 0.05) but not for group II (65.5 +/- 5.8w vs 72.91 +/- 6.5w p > 0.05) during the two ET. The double product (21.573 +/- 3122 vs 24.168 +/- 3423 for group I and 23.551 +/- 3100 vs 21.000 +/- 2752 for group II) was not significantly different (p > 0.05) during the two ET. The same unsignificant modification was noted for maximal ST depression for group II (1.458 +/- 0.32 vs 1.166 +/- 0.21 mm p > 0.05) but not for group I patients in which maximal ST depression during the second ET was significantly less than during the first ET (1.52 +/- 0.23 vs 0.736 +/- 0.12 mm p < 0.05). Because cardiac rehabilitation does not influence the ischemic threshold and because the lesser maximal ST depression during the second ET was noted at the same, or even greater, double product (MVO2), we consider that it can be attributed to ischemic preconditioning.

Adult↗

PubMedDate not supplied

The acute effect of perindopril upon effort capacity in congestive heart failure.

A number of 21 patients with congestive heart failure (CHF) of various etiologies were studied. All patients were subjected to a classical exercise testing (ET) on cycloergometer. The ET was repeated 24 hrs later, 6 hrs after the administration of 2 mg Perindopril (Coversyl). No statistically significant differences in duration and intensity of ET before and after Perindopril were noted for the whole group. But in 9 patients (42.8%) at least one effort level was gained. In these patients the peak double product (DP) was similar before and after Perindopril, but at submaximal effort DP was, at each level, lesser after Perindopril, suggesting a mechanism of afterload reduction in the improvement of effort capacity.

Adult↗

PubMedDate not supplied

Exercise testing in patients with valvular diseases.

Sixty-eight patients with valvular diseases (VD) were subjected to maximal, symptoms limited, exercise testing (ET) using a cycloergometer. The exercise was limited in 82% of the valvular patients by dyspnea attributed to pulmonary capillary pressure rising, even if in the 20 patients with mitral stenosis the relation between the effort intensity and mitral valve area (MVA) (echo) was absent (r = 0.26). Myocardial aerobic impairment (MAI) was absent in 17%, mild in 41%, moderate in 39% and severe in 3% of the patients with VD. It was considered overestimated, the effort being stopped, in 2/3 of the patients, before a heart rate of 85% of maximal heart rate (MxHR) was reached. This suggests that the patients with VD unlike coronary patients, still have a reserve of increasing MVO2 when exercise is stopped. Even in the above condition, the average difference between functional aerobic impairment (FAI) and MAI was 6% for NYHA I, 10.6% for NYHA II and 17% for NYHA III showing a physical deterioration in patients above the limit imposed by the valvular disease itself. ST segment depression of 1 mm or more at 0.08 s after J point was registered in 30% of the patients. Due to the insufficient rise of the heart rate (HR) in the majority (2/3) of the patients with VD, these data probably underestimate the myocardial ischemia. Consequently other stress testings whose main action is not the increase of HR and MVO2 i.e., dypiridamole and adenosine, are preferred in the investigation of myocardial ischemia in the patients with VD.

Aortic Valve↗

PubMedDate not supplied

Comparative value of effort and adenosine-testing in the evaluation of patients with old myocardial infarction.

Exercise testing (ET) and adenosine testing (AT) coupled with ECG were applied in 25 patients with old myocardial infarction. ET was positive in 8 (32%) and AT in 10 (40%) patients, the sensitivity of the latter being slightly superior to the former but inferior to the sensitivity reported in the literature for AT-echocardiography. One should also notice the positivity of AT-ECG in 6 (24%) patients, with negative or inconclusive ET, and the double product (DP) at ischemic threshold which was twice as low for AT-ECG as for ET-ECG, proving that AT induced ischemia by decreasing O2 myocardial input. It is concluded that AT-ECG is useful in myocardial ischemia detection in association with ET or in patients who cannot perform ET for different reasons.

Adenosine↗

PubMedDate not supplied

The correlation between Doppler data and effort capacity in mitral stenosis.

UNLABELLED: The data concerning the relation between mitral valve area (MVA), estimated invasively or by 2 D-echo and effort capacity in mitral stenosis (MS) are still controversial. Consequently we have studied the same relation, using the Doppler indices. METHODS: 19 patients with MS were submitted to a Doppler examination--MVA, pressure half time (PHT), mean pressure gradient (MPG)--and to a symptoms limited exercise testing on cycloergometer--effort intensity (Watts, METs) functional aerobic impairment (FAI), myocardial aerobic impairment (MAI). The "r" correlation index between these parameters was calculated. The results show no significant correlation between Doppler estimated severity of mitral stenosis and the effort capacity of the patients, even if a weak negative correlation ("r" = - 0.32) is noted between effort intensity and MPG and a weak positive correlation ("r" = + 0.41) between FAI and PHT. The conclusion is that effort capacity of patients with mitral stenosis cannot predict the severity of the disease which is to be established through other methods.

Adult↗

PubMedDate not supplied

The effect of handgrip upon Doppler data in mitral stenosis.

UNLABELLED: The usefulness of physical rehabilitation in patients with valvular heart disease is now well established. But, mainly in mitral stenosis, the isometric exercises are under question, because of the risk of sudden rise in capillary pulmonary pressure. In order to clarify this aspect we have studied the effect of isometric exercise upon Doppler data in mitral stenosis. METHODS: in 25 patients with mitral stenosis the Doppler indices of severity-mitral valve area (MVA), pressure half time (PHT), maximal velocity (MxV), mean pressure gradient (MPG)-were determined before and after 3-4 minutes of handgrip performed with a dynamometer at 30% of the maximal voluntary contraction (MVC). There are no significant differences of Doppler parameters before and during handgrip: MVA (1.56 +/- 0.30/1.49 +/- 0.53 cm2), PHT (171 +/- 72/150 +/- 58 ms) MPG (7.07 +/- 2.61/7.21 +/- 1.8 mmHg), MxV (2.186 +/- 0.79/2.276 +/- 0.73 m/s). The results suggest that mild isometric exercise does not alter hemodynamic parameters in mitral stenosis. Consequently isometric exercise can be included in physical programmes of rehabilitation for this category of patients.

Adult↗

PubMedDate not supplied

The echo Doppler study of mitral and aortic prostheses function.

Doppler echography is now the most accurate noninvasive method for studying valvular prostheses, but the values considered to prove a normal function are still controversial. We studied by echo Doppler 95 valvular mechanical (M) and biological (B) prostheses, in mitral (Mi) and aortic (Ao) position in patients without clinical signs of prosthetic dysfunction. The data obtained for Ao prostheses (maximal transprosthetic gradient (MxG): M-20.47 mmHg, B-7.95 mmHg; mean transprosthetic gradient (MG): M-7.98 mmHg, B-3.9 mmHg) are in agreement or even better than literature data. For Mi prostheses the prosthetic area (PA) and pressure half time (PHT) values are in normal limits but the MG (M-5.087 mmHg, B-5.9 mmHg) is slightly superior to the data reported in the literature. Proving the value of echo Doppler for the study of valvular prostheses our results suggest to adopt larger limits of normality for mitral prostheses. They also sustain the necessity of a first Doppler examination before the patient is discharged from the hospital after valvular replacement.

Adult↗