Biomedical subjects

Edvardas Vaicekavicius

Publications and source records attributed to Edvardas Vaicekavicius.

9 recordsLinked to original sources

PubMed2005

Prediction of decrease in myocardial perfusion defect size and severity during a 3-month follow-up by the degree of acute resolution of electrocardiographic changes.

Myocardial perfusion in infarct-related artery (IRA) distribution improves progressively until a few months after successful reperfusion therapy. We assessed the rate of electrocardiographic (ECG) stage dynamics to predict perfusion improvement after mechanical, thrombolytic, or spontaneous recanalization of IRA. Thirteen patients were divided into group A (n = 8, with > or = 2 ECG stages per 2-day change rate) and group B (n = 5, no rapid change of ECG stages). There were no significant technetium Tc 99m sestamibi scintigraphic differences between the groups 3 days after recanalization; however, after 3 months, perfusion deficit size (2.8 +/- 1.8 vs 4.8 +/- 1.2, P < or = .03) and severity (1.8 +/- 0.9 vs 3.0 +/- 0, P < or = .03) were smaller in group A vs group B. The prediction sensitivity of the method was 87.5% for decrease in size and 100% for decrease in severity of perfusion defect; the specificity was 80% and 100%, respectively. A change rate of 2 or more ECG stages per 2 days predicts follow-up improvement of myocardial perfusion after IRA recanalization.

Coronary Circulation↗

PubMed2005

[The diagnostic value of non-invasive tests for determining idiopathic dilated, ischemic and hypertensive cardiomyopathies].

UNLABELLED: The objectives of this study were to detect regional myocardial perfusion defects performing 99mTc-MIBI myocardial perfusion imaging and to compare the results with echocardiography for differential diagnostics of the idiopathic dilated, ischemic and hypertensive cardiomyopathies until coronary angiography will be performed. MATERIAL AND METHODS: In total 90 patients with cardiomegaly have been evaluated: 30 patients with idiopathic dilated cardiomyopathy (group I), 30 with ischemic cardiomyopathy (group II) and 30 with hypertensive cardiomyopathy (group III). All patients underwent 2D echocardiography examination and 99mTc-MIBI myocardial perfusion imaging before coronary angiography was done. RESULTS: Informative complex findings (age, thickness of the interventricular septum, thickness of the left ventricle posterior wall, the wall motion score index in the region of the right coronary artery and the left anterior descending branch and the degree of distress of myocardial perfusion in the area of right coronary artery circulation) selected by variable logic model enabled to differentiate patients with idiopathic dilated, ischemic and hypertensive cardiomyopathies with an accuracy of 92.0%, 86.2% and 79.2%, respectively. CONCLUSION: Informative echocardiographic indices (thickness of the interventricular septum and left ventricle posterior wall, the mass of the myocardium, the wall motion score index in the region of the right coronary artery and left anterior descending branch, ejection fraction) selected by discriminative analysis enabled to differentiate patients with idiopathic dilated, ischemic and hypertensive cardiomyopathies with an accuracy of 62.1%, 75.2% and 80.0%, respectively.

Adult↗

PubMed2004

[JT interval changes in acute myocardial infarction following coronary angioplasty].

OBJECTIVE: The aim of the study was to determine the influence of early reperfusion on the behavior of JT interval in patients with acute myocardial infarction undergoing percutaneous transluminal coronary angioplasty. MATERIAL AND METHODS: Coronary angiography and percutaneous transluminal coronary angioplasty were done for 14 acute myocardial infarction patients. Measurements were performed from 12-lead surface electrocardiogram with "Kaunas-Load" equipment before percutaneous transluminal coronary angioplasty, 5 minutes and 24 hours after it. RESULTS: Immediately after percutaneous transluminal coronary angioplasty there were shortenings of JT and JT dispersion (JTd) and after 24 hours in all the patients prolongation of JT and JTd intervals was observed. CONCLUSIONS: Changes of the repolarization during percutaneous transluminal coronary angioplasty could be related with ischemic myocardial lesion. Early reperfusion has positive impact on the ventricular repolarization.

Adult↗

PubMed2004

[Results of percutaneous coronary angioplasty in patients with stable and unstable angina].

Percutaneous coronary angioplasty is very well known percutaneous revascularization procedure. Results of the percutaneous coronary angioplasty vary according to the stage of ischemic heart disease. The aim of our study was to evaluate and to compare the results of percutaneous coronary angioplasty in patients with stable and unstable angina. We analyzed data from 1148 patients in both groups. The extent of atherosclerosis was significantly higher in unstable angina group, however there was no significant difference in procedural as well in in-hospital outcomes between two groups. Success rate was 86% in unstable angina group and 83.3% in stable angina group. Major adverse cardiac events occurred in 1.48% patients with no difference in both groups. Left ventricular ejection fraction and end-diastolic diameter improved more in unstable angina group.

Adult↗

PubMed2004

[Percutaneous revascularization of myocardium: extent, application and treatment strategy of acute coronary syndromes].

UNLABELLED: The comparative value of different factors of reperfusion technique and strategy in restoring of myocardial function is underestimated. The aim of this study is to assess the value of reperfusion strategy for restoring of myocardial function in follow-up period. MATERIAL AND METHODS: From 1999 to 2001, 4260 patients with acute coronary syndromes were analyzed. Coronarography was performed for 2990 patients and percutaneous coronary interventions - for 1257 patients. QRS score was calculated; electrocardiogram and echocardiograms were done for 248 patients with acute myocardial infarction after reperfusion therapy by percutaneous transluminal coronary angioplasty (PTCA) (228 patients) and by stenting (20 patients). Urgent PTCA was used for 114 patients, urgent stenting for 14 patients, delayed PTCA for 114 patients and delayed stenting for 6 patients. RESULTS: Coronarography was performed for 66% of all hospitalized patients; percutaneous coronary interventions - for 825 (45.6%) of patients with acute myocardial infarction and only for 11.7% of patients with unstable angina pectoris. In hospital period QRS score increased for all patients with the exception of patients with delayed stenting (p from 0.05 to 0.001). LVEF had tendency to increase in all groups of patients during 3 months. CONCLUSIONS: Coronarography can be performed for 65-70% of hospitalized patients with acute coronary syndromes and percutaneous coronary interventions for 45% of patients with acute myocardial infarction. Differences in reperfusion strategy do not have manifest value on restoring of left ventricle function.

Acute Disease↗

PubMed2004

[Early results of primary percutaneous transluminal coronary angioplasty: evaluation of myocardial reperfusion].

UNLABELLED: The purpose of the study was to determine the prognostic value of simultaneous evaluation of angiographic (TIMI flow) and ECG (ST segment resolution) changes on hospital results in primary percutaneous transluminal coronary angioplasty patients. METHODS AND PATIENTS: The primary percutaneous transluminal coronary angioplasty was performed in 250 patients with the first acute myocardial infarction. All the patient were divided into four groups according the restored TIMI flow and the resolution of ST segment changes. Group A (44 pts) - TIMI or=50%, group C (99 pts) - TIMI>2, ST resolution <50%, and group D (94 pts) - TIMI>2, ST resolution >or=50%. RESULTS: The study has revealed that in hospital mortality was 15.9%, 6.1% and 1.1% in group A, group C and group D, respectively. The higher proportion of patients with not adequate sufficient myocardial perfusion (less complete ST segment resolution) had myocardial infarction in left anterior descending artery region. The higher proportion of patients with adequate myocardial perfusion had no atherosclerotic injury in coronary arteries except infarct related artery. CONCLUSION: The achieving of TIMI flow grade 3 and perfect resolution of ST segment elevation after primary percutaneous transluminal coronary angioplasty has beneficial effect on in - hospital mortality. The effective restoration of flow in infarct related artery not always accompanies full and rapid ST segment normalization suggesting the presence of incomplete myocardial perfusion.

Aged↗

PubMed2002

[Impact of the effectiveness of myocardial reperfusion after thrombolytic and spontaneous recanalization of infarct related artery on myocardial recovery in the future].

OBJECTIVE: To assess the efficiency of myocardial reperfusion after thrombolytic and spontaneous recanalization of infarct related artery (IRA) by the serial 12 lead ECG data and its impact on subsequent myocardial recovery. MATERIAL AND METHODS: We examined 25 patients with a first Q wave myocardial infarction at hospital and after 1 and 3 years from discharge (13 treated with intravenous thrombolysis, 12 treated conservatively). Four patients treated using thrombolysis and 3 patients treated conservatively were excluded from the analysis due to reocclusion or another myocardial infarction and coronary bypass surgery. The efficiency of myocardial reperfusion was assessed by our original method, based on the intensity of changes in ECG stages. The myocardial recovery was analyzed by quantitative changes in clinical, radiographic, echocardiographic and ECG (the Selvester-Wagner QRS score) data. RESULTS: Clinical and radiographic signs of heart failure decreased in cases of sufficient myocardial reperfusion after thrombolytic and spontaneous recanalization, but increased--in cases of insufficient myocardial reperfusion. Echocardiographic dyssynergic score decreased after 3 years from discharge (79, 67 after 1 and 3 yrs/at discharge (%), respectively, p < 0.00005) in cases of thrombolysis with sufficient myocardial reperfusion but the tendency for increasing (113, 183 after 1 and 3 yrs/at discharge (%), respectively, p = 0.07) was shown in cases of insufficient myocardial reperfusion; although, the QRS score decreased in both subgroups of thrombolysis (89, 36 after 1 and 3 yrs/at discharge (%), respectively, p < 0.01,--with sufficient myocardial reperfusion; 73, 62 after 1 and 3 yrs/at discharge (%), respectively, p < 0.005,--with insufficient myocardial reperfusion). CONCLUSIONS: The QRS score normalization after myocardial infarction predicts myocardial functional recovery only in patients with sufficient myocardial reperfusion. Thrombolysis gives positive impact on subsequent myocardial functional recovery only in cases of sufficient myocardial reperfusion; spontaneous recanalization of IRA may give positive impact on myocardial functional recovery in cases of sufficient myocardial reperfusion. Our method of serial ECG interpretation provides the possibility to detect insufficient myocardial reperfusion after thrombolytic and spontaneous recanalization and then the additional mechanical methods of recanalization should be applied.

Adult↗

PubMed2002

[Transcatheter renal arterial embolization in malignant renal neoplasms: clinical results and indications for use of the method in multi-profile hospitals].

The authors analyse the long-term and in-hospital results of treatment 29 patients with renal neoplasms, who underwent transcatheter renal arterial embolization and also discuss the benefits of transcatheter renal arterial embolization in other clinical situations. Transcatheter renal arterial embolization was performed with embosil for 23 patients (79.3%) and with concentrated alcohol for 6 patients (20.7%) before nephrectomy of advance renal tumour in 21 patients. Transcatheter renal arterial embolization was performed as palliative treatment in 8 patients. Complete embolization was achieved in 27 patients (93.1%), incomplete--in 2 patients (6.9%). Nephrectomy was performed after 22.14 +/- 9.28 days. The most evident post procedural reactions were moderately elevated temperature in 22 patients (75.9%), highly elevated temperature (> 38 degrees) in 7 patients (24.1%) and pain. Only 6 patients (20.7%) didn't feel pain. One hematoma was noticed in puncture region. After 5 years, 4 patients of 10 analysed patients are still alive (all-pT3, size of tumor 6.5-9 cm.). Two patients were not operated due to very big tumor and technical inoperability. Remaining 4 patients died during 2-3 years. As exclusion was one patient with inoperable renal tumor and lung metastases. After transcatheter renal arterial embolization he was alive 4 years. In conclusion, transcatheter renal arterial embolization was effective in diminishing the technical difficulties to remove advance tumors and in treatment of inoperable patients. It's rational to supply transcatheter renal arterial embolization with embolization and chemoembolization of primary and metastatic lesions.

Aged↗

PubMed2002

[Quantitative assessment of acute myocardial infarction size. Impact of early mechanical recanalization of infarct related artery].

UNLABELLED: The aim of investigation: 1) to determine the diagnostic value of QRS score and LV echocardiography in assessment of the size of myocardial infarction in acute stage, 2) to establish the impact of infarct related artery recanalization on myocardial infarction size. METHODS AND MATERIAL: In order to investigate whether infarct size could be estimated by QRS scoring system soon after reperfusion we evaluated QRS score obtained serially before and twice after reperfusion, and the echocardiographic global EF in 57 patients with acute myocardial infarction who underwent successful mechanical recanalization of infarct related artery. Coronary flow in infarct related artery was evaluated by the Thrombolysis in Myocardial Infarction trial (TIMI) criteria. QRS scores were calculated according to the method of Wagner (37 criteria and 29 points). The electrocardiographic ejection fractions (EFECG) were calculated according to Roubin method, and the global echocardiographic ejection fractions (EFECHO) were calculated according to Simpson method. All patients were divided into 3 groups according to the quality of myocardial reperfusion expressed as intensity in change of electrocardiographic phases at the time of infarct related artery recanalization (1 gr.--the change of ECG phases > or = 2; 2 gr.--the change of ECG phases through 1; and 3 gr.--with no changes of ECG stages). All patients had an effective infarct-related artery recanalization expressed as 2 or 3 TIMI grade. RESULTS: A low and insignificant correlation was observed between EFECG and EFECHO for patients with anterior myocardial infarction (r = 0.35) and for patients with posterior myocardial infarction (r = 0.12). The EFECG had a tendency to be lower in patients with worse myocardial reperfusion (from 59.06 +/- 6.12 in 1 gr. to 50.93 +/- 10.87 in 3 gr). At this time the EFECHO was almost the same in all groups of patients. Additionally, the EFECHO was significantly lower than EFEKG in all groups of patients (p = 0.000017-0.001). The QRS score had general tendency to increase after infarct-related artery recanalization, however the most evident increase was obtained in 1 gr. of patients with rapid change of ECG stages. A significant correlation (r = 0.87 for patients with anterior myocardial infarction and r = 0.85 for patients with posterior myocardial infarction) was observed between QRS scores obtained after infarct related artery recanalization and that obtained after 10-12 days. In conclusion, QRS score and EFEKG better than EFECHO reflects the myocardial infarction size in acute stage. Increasing of the myocardial infarction size after infarct-related artery recanalization is connected with reperfusional injury more expressed in patients with more effective myocardial reperfusion.

Adult↗