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Biomedical subjects

E V Erina

Publications and source records attributed to E V Erina.

At least 19 recordsLinked to original sources
PubMed1989

[Hypotensive and hemodynamic effects of guanfacine in arterial hypertension].

The therapeutic efficacy of guanfacine was investigated in a group of 32 hypertensive patients. Guanfacine caused a marked decrease in total peripheral vascular resistance (by 19.8%, p less than 0.001) and, hence, in blood pressure (by 19.4%), p less than 0.001). A slight reduction in the heart rate (by 9.8%, p less than 0.01) was compensated by an increase in stroke volume (by 11.8%, p less than 0.05) so that cardiac output remained constant or was even slightly raised. After 4 weeks of treatment there was a regression of the left ventricular wall thickness and mass (by 7.43 +/- 2.44 g, p less than 0.05). Guanfacine monotherapy was effective in 75% of patients with moderate hypertension (using low doses 1-3 mg/day). In severe hypertensive disease a satisfactory therapeutic response was mostly achieved by a combination of Guanfacine (3-5 mg/day) with a beta-blocker, diuretic or vasodilator. Guanfacine is a promising agent in the long-term treatment of stable hypertension, particularly in patients, whom diuretics or beta-blockers are contraindicated.

Adult↗
PubMed1986

[Prolonged use of beta-blockers in patients with essential hypertension and different degrees of severity of left ventricular hypertrophy].

The paper is concerned with analysis of the results of therapy with beta-blockers of different classes of 56 patients (over 2.5-3 yrs) with essential hypertension and analysis of the time course of the structural-functional states of the left ventricular myocardium with various degree of expression of left ventricular hypertrophy (LVH). The patients were divided into 3 groups: the 1st group--14 persons (the left ventricular myocardial mass/LVMM/up to 150 g); the 2nd group--19 persons (the LVMM up to 200 g); the 3rd group--23 persons (the LVMM over 200 g). Patients in all the groups showed a significant decrease in BP from 19/15 up to 26/22% (p less than 0.001), the cardiac index (CI) from 14.4 up to 18.5% (p less than 0.001), and HR from 16.5 to 19.1% (p less than 0.001). The stroke index (SI) did not change significantly. The total peripheral vascular resistance (TPVR) in all the groups showed a tendency to a decrease, in the 3rd group only it decreased significantly. In the patients of the 1st and 2nd groups end-systolic sizes (ESS) increased by 4.1 and 3.1% (p less than 0.05) and volumes (ESV) by 9.7 and 7.4% (p less than 0.05), and in the 3rd group a tendency to a decrease was observed. End-diastolic sizes and volumes in all the groups did not change significantly. The myocardial contractility index (VCF) decreased significantly in the 1st and 2nd groups of patients. The value of intramyocardial tension ("sigma max") decreased in all the groups from 15 to 20% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1986

[Long-term use of prazosin alone and combined with propranolol in patients with essential hypertension].

Therapeutic efficiency and hemodynamic effects of prazosin were examined in 42 patients with essential hypertension in the course of prolonged treatment. Where the adrenoblocker showed low efficiency, the beta-blocker propranolol was added to the treatment scheme. The mechanism of the hypotensive effect was shown to be dependent on correlations between arteriolo- and venodilatation. In the presence of prevailing precapillary dilatation, BP dropped owing to reduced total and regional vascular resistance. If venodilatation was more pronounced, the hypotensive effect was due to reduced minute volume. The addition of propranolol eliminated the manifestations of sympathetic stimulation, enhanced the hypotensive effect and improved general condition of the patients. Combined treatment is indicated particularly in those cases of stable hypertension where prazosin alone has failed to produce an adequate effect.

Adult↗
PubMed1986

[Clinical use of chloranolol (tobanum) in essential hypertension patients].

A clinical study of the efficiency of a new beta-blocker, chloranolol (Tobanum, Hungary), was carried out in 24 patients with second-stage essential hypertension. Central and intracardiac hemodynamics, left-ventricular myocardial function (echocardiography) and regional hemodynamics (occlusion plethysmography) were assessed in 14 patients before treatment and on days 10-15 and 25-30 of chloranolol administration. During the fourth or fifth week of chloranolol treatment, arterial BP diminished by 12/10% (p less than 0.01) owing to an 11.5% reduction in the cardiac index and a 15.7% reduction in heart rate (p less than 0.001), while the stroke index and total peripheral resistance showed no significant change. No basic changes in end diastolic and systolic left-ventricular size and volume, nor in the ejection fraction were seen during treatment. Myocardial contractility dropped by 9.8% (p less than 0.05), and intramyocardial tension, by 14% (p less than 0.001), while the thickness of the interventricular septum declined by 7% (p less than 0.001), and that of left-ventricular posterior wall, by 4.2% (p less than 0.005). Chloranolol treatment was particularly efficient in moderately hypertensive patients and also in some highly-hypertensive ones that had not responded to propranolol.

Adult↗
PubMed1986

[Condition of the tissue oxygen regime of patients with essential hypertension with different types of hemodynamics].

Systemic and regional hemodynamic parameters were investigated using echocardiography, venous-occlusion plethysomography, and tissue oxygen regimen was studied polargraphically, in 51 patients with essential hypertension. Tissue oxygen supply becomes increasingly inadequate as the disease progresses, as reflected in limited oxygen delivery to tissues, its reduced utilization, and smaller reserve capacities of oxygen transport at the microcirculatory level. In patients with hyperkinetic circulation, increased blood stroke volume was combined with a significant increase in baseline tissue oxygen tension and the capillary-to-tissue oxygen diffusion rate, while changes in the resistive vascular element were basically functional. Changes in regional hemodynamics and tissue oxygen supply were particularly severe in patients with hypokinetic circulation.

Adolescent↗
PubMed1986

[Treatment of hypertension with the calcium antagonist korinfar and its combination with obzidan].

A hypotensive effect of corinfar and its effect on the indices of the central and peripheral hemodynamics were studied in 50 patients with stage II hypertension. In 3 weeks BP was lowered at the expense of a considerable decrease in the total peripheral vascular resistance (TPVR) (by 29.6%) and regional vascular resistance (by 48%). It was accompanied by an increase in the peripheral blood flow (by 61%), a reflex activation of the sympathetic-adrenal system with an increase in heart rate and cardiac output (by 22%, p less than 0.001). An index of vein distensibility remained unchanged. The addition of propranolol removed signs of the sympathetic stimulation of the cardiac activity, improved vasodilatator tolerance, enhanced a hypotensive effect of corinfar causing a transient increase in TPVR and tension of the resistive vessels only. By the end of the 4th month of therapy these indices significantly decreased. A prolonged combined therapy with corinfar and propranolol resulted in a significant decrease in the resistance of resistive vessels in maximum vasodilatation characterizing the regression of arteriole structural changes. Besides there was a decrease in the wall thickness (p less than 0.01) and left ventricular myocardial mass (by 7.88 +/- 2.66 g, p less than 0.05) that was interpreted as a tendency to a decrease in a degree of hypertrophy of the left ventricle. The efficacy of corinfar therapy was higher in the patients with hypertension with a high initial tension of the peripheral vessels.

Adult↗
PubMed1986

[Long-term observation (8-10 years) of patients with mild forms of arterial hypertension].

The nature of a course of "mild" arterial hypertension was studied in 126 patients for 8-10 yrs. It was shown that in 13.2% of the cases arterial pressure returned to normal values during a "natural" course of disease; border-line arterial hypertension was revealed in 9.4%. Stage II hypertension was diagnosed in 77.4% of the cases after 7-10 yrs. Progression of arterial hypertension was noted in this group in 1/3 of the cases (30.2%). Aggravated heredity and an initial morphological state of the kidneys (according to the results of intravital morphological investigation) were shown to be predictors of prognosis of arterial hypertension. The initial picture of the fundus of the eye and electrocardiographic signs of myocardial hypertrophy reflected the nature of a course of hypertension being not factors determining prognosis of arterial hypertension stabilization.

Adolescent↗
PubMed1985

[Use of captopril (capoten) in arterial hypertension].

Capoten (captopril) treatment was conducted in 39 patients with essential hypertension of stage IIA-IIB and in 4 patients with idiopathic hyperplasia of the adrenals. In 35 patients the hypotensive effect was evaluated following a single administration of captopril in a dose of 12.5, 25 and 50 mg. Twelve patients were treated with this drug alone while in 23 patients it was combined with saluretics. Captopril monotherapy elicited a good and moderate hypotensive effect in 70% of patients with a high and stable hypertension. Both mono- and combined therapy was associated with a decrease in adrenaline and noradrenaline excretion and an increase in uterine kallikrein excretion. The examination of the regional circulation revealed a significant reduction in the resistance and tonus of the arterioles and an enhancement of the blood flow in the forearm as well as an increase in venous tensility. When captopril was combined with diuretics these changes were less marked.

Adult↗
PubMed1985

[Venous distensibility in essential hypertension].

Using venous occlusive plethysmography, venous distensibility was examined in 85 hypertensive patients and in 21 normal men. Venous distensibility in the hypertensive versus normal subjects was significantly lower, being inversely depended on the blood pressure level. Venous distensibility depended directly on the blood flow in the forearm and inversely on the resistance of the resistive vessels at rest. This may indicate that the reduction of venous distensibility was caused by both functional and structural changes characteristic of both resistive and capacitance vessels. It appears that functional and structural alterations in the system of low pressure, along with an elevated resistance of the arterioles, were actively involved in changes of the peripheral resistance and the development of a hypertensive state.

Adult↗
PubMed1984

[Evaluation of the effectiveness of the long-term treatment of hypertension patients. I. Changes in hemodynamics and myocardial function].

Altogether 106 patients with stage II essential hypertension (EH) were treated for a long time (up to 3 years) with beta-blockers belonging to different classes. In some cases beta-blockers were administered in combination with vasodilators and/or a diuretic. In 66 patients, prolonged continuous treatment led to an appreciable drop in blood pressure (BP) due to the reduction of both the cardiac index and the total peripheral vascular resistance (TPVR), particularly in patients with stage IIB essential hypertension treated with a cardioselective beta-blocker tenormine or an alpha- and beta-blocker trandate. These patients showed a significant decrease in intramyocardial tension, in the thickness of the walls and mass of the myocardium. Regression of left ventricle hypertrophy depended not only on the hemodynamic factors that determine the decrease in the load of the myocardium by the volume or pressure but also on the neurohumoral effects (mainly due to the reduced adrenergic stimulation during treatment with beta-blockers). In 40 patients with stage IIB EH treated occasionally, BP appeared to approach the initial level after 2.5-3 years. Furthermore, these patients manifested an increase in the TPVR. The myocardial mass significantly rose, mainly at the expense of the thickening of the ventricular septum.

Adrenergic beta-Antagonists↗
PubMed1984

[Therapeutic value of pratsiol and its effect on indicators of central and peripheral hemodynamics in patients with hypertension].

Thirty-eight patients with stage IIB essential hypertension have been studied to determine the therapeutic activity of prazosine (pratsiol, "Orion" company, Finland) and its influence on the parameters of the central and peripheral hemodynamics. It has been established that following the oral administration of the drug, a hypotensive effect develops in 90-120 min and lasts for about six h. After a three-week course of treatment, the arterial pressure in the majority of patients decreased due to a reduction in the total peripheral resistance and the tone of the resistant vessels (arterioles). Simultaneously, there was an increase in the heart rate, end diastolic and stroke volumes and in the cardiac output. In a smaller portion of patients, the arterial pressure decreased due to the predominant reduction in the venous tone; the elasticity of the veins increased sharply, the end diastolic stroke and minute volumes diminished. The heart rate and total peripheral resistance showed no statistically significant changes. It has been established that pratsiol acts as an arterial and venous vasodilator and that it is advisable to use the drug in combination with beta-blockers and diuretics.

Adult↗
PubMed1984

[Ambulatory treatment of hypertension with the beta-blockader corgard (nadolol)].

Fifteen outpatients with stage II essential hypertension were treated with corgard, a non-cardioselective beta-blocker, for 12-15 months. Study (in 12 patients) of the shifts in the central and intracardiac hemodynamics (by EchoCG for 3-4 months) demonstrated that a 24-25% decrease in the blood pressure occurred at the expense of a significant reduction in the cardiac index (by 25.6%) and heart rate (by 29%). The stroke index did not undergo any significant changes. This was accompanied by a moderate increase of the total peripheral vascular resistance (by 7.4%, P less than 0.05). The intramyocardial tension decreased by 18%, the thickness of the interventricular septum by 7.1% (P less than 0.001), the myocardial mass dropped by 9.5% (P less than 0.001). The rate of the shortening of the circulatory fibers of the left ventricle myocardium decreased by 10% (P less than 0.01). The ejection, the degree of a change in the anteroposterior size or in the end systolic and end diastolic sizes remained unchanged. Thus, application of corgard can be regarded as fairly advantageous since this drug produces a long-acting effect. It can be administered once or twice a day, with dosage variations being insignificant. This circumstance facilitates the regimen of a long-term outpatient treatment.

Adult↗
PubMed1983

[Comparative evaluation of the therapeutic effect of various classes of beta-blockaders in patients with hypertension].

A complex study of changes of hemodynamics and myocardial performance was conducted while treating 215 hypertensive patients with obsidan (propranolol), corgard, a cardioselective beta-blocker tenormine and alpha- and beta-blocker trandate. Different hypotensive efficiency and varying hemodynamic mechanisms of its action were found. Obsidan and corgard were mainly efficient in moderate hypertension and marked hypersympathicotonia. Tenormine and trandate produce the most marked hypotensive effect (due to reduction in the vascular tone). The signs of increase in venous blood return to the heart during trandate and obsidan therapy and decrease in venous return after long-term tenormine therapy were established. Myocardial contractility indices decreased after obsidan therapy to the more extent than after corgard and tenormine, and they did not change after trandate. The possibility of myocardial hypertrophy regression was shown (especially in the long-term treatment with tenormine and trandate). A reduction in intramyocardial tension has been stated to depend mainly on hemodynamic factors (reduction in volume or pressure overload on the myocardium) whereas the diminution of the myocardial mass also depends on neurohumoral effects.

Adrenergic beta-Antagonists↗