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Biomedical subjects

E Malamov

Publications and source records attributed to E Malamov.

13 recordsLinked to original sources

[Assessment of the information value of pain and ST depression in the exercise electrocardiographic test].

200 patients (181 men and 19 women) with stable stenocardia were examined by the exercise tolerance test. The patients were loaded by the step by step method on veloergometer or threadmill up to 80% of the maximal pulse rate. 126 of the tests were evaluated as positive. False positive were 10 tests and 19 tests were false negative. The coefficient of sensitivity (independently of the limiting factor) was 82.2%, the specificity was 80%, the prognostic value of the positive test was 91.6%, of the negative test--68.3%. The sensitivity coefficient was: in the patients with one affected arterial branch--81.3%; in the patients with two affected arterial branches--80.4%, in the patients with three affected arterial branches--92.5% and in the patients with affection of the main arterial stem--87.5%. The patients were classified into three groups according to the expression of the limiting factors: I group with limiting factor pain (98 patients) with sensitivity coefficient 74.3%, specificity--77.8%, prognostic value of the positive test--89.1% and of the negative test--55.5%. II group with limiting factor ST-depression (83 patients) with sensitivity coefficient 71.3%, specificity--91.7%, prognostic value of the positive test--95% and of the negative test--61.1%. III group with limiting factors both pain and ST-depression with sensitivity coefficient 45.4%, specificity--91.7%, prognostic value of the positive test--95% and of the negative test--61.1%. The main conclusion from the study is that the limiting factor ST-depression as a basic objective sign of myocardial ischemia has high enough specificity and prognostic value and should be considered as a limiting factor with greatest informatory value.

Angina Pectoris

Haemodynamic effects of Isodinit (isosorbide dinitrate) in acute myocardial infarction.

In 26 patients with acute transmural myocardial infarction, the authors studied the effect of sublingual Isodinit (isosorbide dinitrate) on haemodynamic indicators: in 12 patients on heart rate, pulmonary and peripheral arterial pressure, in 14 (of whom 6 with normal and 8 with elevated diastolic pulmonary pressure) moreover on cardiac output and peripheral vascular resistance. The results showed a decrease in pulmonary arterial pressure by 35%, in peripheral arterial pressure by 10-14%, and a slighter fall in peripheral vascular resistance; the heart rate did not substantially change. In patients with normal diastolic pulmonary artery pressure, the cardiac and stroke index and the stroke work index decreased, whereas in patients with elevated pulmonary pressure these indicators did not significantly change. The effect of sublingual Isodinit occurs 5-7 min after its administration and reaches its maximum between the 15th--45th min; after 2 hrs the effect ceases. The preparation is suitable for the treatment of congestive heart failure in acute myocardial infarction.

Adult

[Prognostic value of the ST elevation of the electrocardiogram in the acute stage of myocardial infarct].

The prognostic value of ST segment elevation on electrocardiograms is studied in 400 patients with acute myocardial infarction, 138 of them deceased. A close correlation was established between the degree of ST segment elevation and mortality rate. The average value of ST elevation in all deceased is 5.22 +/- 0.20 mm, und in all survived the acute stage--3.39 +/- 0.15 mm. Those values are higher in anterior infarction--5.55 +/- 0.23 mm and 3.99 +/- 0.15 mm and lower in posterior infarction 4.45 +/- 0.25 mm and 2.65 +/- 0.10 mm. The ST segment elevation over the average values in the deceased is a poor prognostic sign and an elevation slightly lower than the average values in the recovered is a favourable prognostic sign.

Acute Disease

[Some problems in rheumatic valvular defects].

The post-mortem examined rheumatic valvular diseases are confronted for the period 1961-1967 and 1968-1973. Advanced age with one decade is established in the deceased during the second period, as well as increased per cent of thromboembolic complications and chronic cardiac insufficiency and decreased per cent of rheumatic activity. A considerable per cent of rheumatic activity is observed in the deceased during the fourth and fifth decade. No difference concerning sex and valvular lesions are established in both groups.

Adult