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Biomedical subjects

I E Chazova

Publications and source records attributed to I E Chazova.

At least 19 recordsLinked to original sources
PubMed2007

Cognitive function and the emotional state of stroke patients on antihypertensive therapy.

Combined antihypertensive therapy based on 2.5-5 mg of cilazapril (an angiotensin-converting enzyme inhibitor) to normalize arterial pressure (ABP) was studied in 22 patients (12 male, 10 female) aged 49-74 years (mean 63 +/- 7 years) with stroke (18 patients) or transient ischemic attacks (three patients). Magnetic resonance tomography (MRT) including perfusion studies, along with neuropsychological studies and assessment of emotional status (Beck depression inventory, Spielberger anxiety scale), were performed before and after treatment. After six months of treatment, patients showed normalization of ABP (systolic pressure decreased from 154.7 +/- 12 to 128 +/- 23 mmHg, diastolic from 90.3 +/- 9.6 to 79.4 +/- 23 mmHg). There were no side effects and no patient experienced stroke. MRT revealed no signs of new foci and there were no significant changes in brain blood flow. By the end of treatment, improvements in cognitive functions were noted on the Mini Mental State Examination, the 10-word memory test, the Boston naming test, or the Wisconsin card-sorting test, though there were no changes in the patients' emotional status.

Aged↗
PubMed2006

[Metabolic syndrome diagnosis in patients with arterial hypertension and obesity].

AIM: To develop a universal method of metabolic syndrome (MS) diagnosis which is valid irrespective of the version in patients with documented arterial hypertension (AH) and obesity. MATERIAL AND METHODS: MS was diagnosed according to two versions (WHO and ATPIII) in 517 males and 1041 females aged 20 to 75 years. All the patients had documented obesity and hypertension. RESULTS: Two versions used (WHO and ATPIII) provided the same results only in 44% patients: MS was confirmed in 16% and rejected in 28%. The rest 56% patients had MS only by one of the versions. A computer program has been created for making decision about MS presence in obese patients with hypertension. CONCLUSION: A diagnostic rule has been elaborated for MS diagnosis by associated disorders with accuracy of 94% even in the absence of information about such key components of MS as HDLP and triglycerides.

Adult↗
PubMed2006

[New approaches to treatment of bradyarrhythmia in patients with obstructive sleep apnea syndrome].

AIM: To confirm or reject effects of CPAP on sleep asystole and to elucidate possible dependence on correction of respiratory disorders. MATERIAL AND METHODS: Thirteen patients (11 males and 2 females aged 19 to 66 years) with bradyarrhythmia (BA) arising in sleep participated in the study. BA was caused by transient atrioventricular block of the degree II-III in 9 cases (69%), episodes of sinus node arrest and/or synoatrial block in 6 (46%) cases. Two (15%) patients had combination of BA forms. To diagnose sleep respiratory disorders, polysomnography (PSG) was made. Diagnostic criteria of sleep obstructive apnea syndrome (SOAS) were apnea/hypopnea index (AHI) more than 5 episodes for 1 hour sleep. The patients were divided into two groups. Individual selection of therapeutic pressure under PSG control was performed in SOAS patients (the study group). CPAP-therapy was effective in AHI < 5. In the control group (AHI < 5) such selection was made too. CPAP-therapy was effective in the controls if episodes of apnea/hypopnea were not registered through the night of monitoring. RESULTS: In the study group CPAP-therapy was effective. The AHI decreased from 73.2 to 4.4, oxygen saturation of arterial blood increased from 74 to 85%, mean duration of asystoles fell from 5.2 to 1.3 s, pauses with duration more than 2 s disappeared. In the control group sleep apnea/hypopnea episodes disappeared but in asystole CPAP was uneffective. CONCLUSION: CPAP-therapy is effective and pathogenetically sound method of treating patients with nocturnal bradyarrhythmia associated with sleep respiratory disorders.

Adult↗
PubMed2006

[The role of telmisartan in the treatment of metabolic syndrome].

AIM: To evaluate telmisartan effects on 24-h blood pressure profile, sensitivity to insulin, carbohydrate and lipid metabolism in patients with metabolic syndrome (MS) and arterial hypertension (AH). MATERIAL AND METHODS: Twenty patients with MS and AH of the degree I-II received telmisartan in a dose 80 mg/day. 24-h BP monitoring, tests for total cholesterol, HDLP, LDLP cholesterol, triglycerides, glucose, glucose tolerance test were made before and 24 weeks after the treatment. RESULTS: Telmisartan reduced all the study parameters of blood pressure, body mass, fasting and post-prandial hyperglycemia, postprandial hyperinsulinemia. Telmisartan raised peripheral tissue sensitivity to insulin, normalized phases of insulin secretion. Total cholesterol, LDLP cholesterol diminished while HDLP went up. CONCLUSION: Telmisartan has a specific ability to partially activate receptors stimulating proliferation of peroxisomes and improve regulation of carbohydrate and lipid metabolism, to reduce body mass.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2005

[Lifespan of patients with primary pulmonary hypertension].

AIM: To design a mathematical express model of expected lifespan of patients with primary pulmonary hypertension (PPH). MATERIAL AND METHODS: A retrospective analysis of 418 case histories of 132 PPH patients (81 females, 51 males, age 16-57 years). Ninety one of them were hospitalized at least twice. The following characteristics of the patients were registered: a PPH form, age at onset, gender, morphological structure of the lung, date of the first visit to doctor. Relationship of these factors with lifespan was analysed and the express formula of expected lifespan was calculated using the multifactorial analysis of variance with standard computer statistical programs. RESULTS: Lifespan was studied for dependence on static factors free of therapy effects (gender, age, form of PPH). The presence of a factor named "duration of the disease development" (DDD) is suggested. A correlation was found between DDD and lifespan in PPH patients explaining survival by 84.5%. The formula of the prognosis was derived for patients with known morphological structure of the lung in whom the above dependence explains survival by 93.5%. CONCLUSION: Among effect modifiers, of significance for survival are age, PPH form, morphological structure of the lung. An artificial index DDD was used for deriving a formula for prognosis of survival for a newly hospitalized PPH patient.

Adolescent↗
PubMed2005

[Body mass loss due to orlistat therapy and multiple factors of cardiovascular risk].

AIM: To study effects of body mass loss due to orlistat on carbohydrate and lipid metabolism, insulin resistance, 24-h profile of arterial pressure (AP), left ventricular myocardial hypertrophy, brain perfusion in patients with metabolic syndrome (MS). MATERIAL AND METHODS: Thirty middle-aged patients with MS entered the trial. They received orlistat in a dose 120 mg twice a day for 24 weeks. Before and after the treatment the patients' carbohydrate and lipid metabolism, insulin resistance were studied, 24-h monitoring of arterial pressure, echo-cardiography were made. Brain perfusion was studied with single-photon emission computed tomography in 18 patients. Results. All the patients lost much weight. This was accompanied with improved indices of AP profile, metabolism of carbohydrates and lipids, insulin resistance, left ventricular hypertrophy, brain perfusion. Conclusion. Orlistat treatment weakens basic factors of cardiovascular risk.

Adult↗
PubMed2005

[Primary pulmonary hypertension: activation of sympathico-adrenal system and free radical oxidation. Positive effects of carvedilol therapy].

AIM: To study the condition of the sympathico-adrenal system (SAS), synthesis of cAMP dependent on beta2-adrenoreceptors and parameters of free radical oxidation in patients with primary pulmonary hypertension (PPH); to examine efficacy of non-selective beta- and alpha1-adrenoblocker carvedilol in PPH patients. MATERIAL AND METHODS: Twenty patients with PPH had 6-minute walk test, ECG monitoring with assessment of heart rhythm variability (HRV). Tests for noradrenalin and adrenalin concentration in blood plasma, cAMP synthesis by blood lymphocytes in basal conditions and under stimulation with isoproterenol and forskolin, free radical oxidation were made initially, 1 and 6 months later. Ten patients received carvedilol in addition to standard therapy, 10 patients served control. RESULTS: PPH patients had higher NA in the blood, low cAMP synthesis, high malonic aldehyde, low activity of glutathionperoxidase, increased activity of superoxidedismutase and catalase of erythrocytes. The most pronounced changes in the above parameters were observed in patients with PPH FC III-IV. HRV declined in progression of cardiac failure. 6-months of combined treatment with carvedilol increased the distance of 6-min walk. Carvedilol had no effect on HRV, it reduced NA, stimulated cAMP synthesis, demonstrated no antioxidant activity. CONCLUSION: In PPH there is activation of SAS and desensitization of beta2-AR cells, oxidative stress develops. Addition of carvedilol to standard therapy with PPH improves clinical condition due to adrenoblocking properties of the drug.

Adrenergic Agents↗
PubMed2005

[Cerebral perfusion in patients with metabolic syndrome].

Cerebral perfusion was studied in patients with arterial hypertension combined with metabolic syndrome and diabetes mellitus type II. The data is compared to the results obtained for patients with a single disorder--metabolic syndrome, diabetes mellitus type II and arterial hypertension without metabolic alterations. It is shown that patients with disregulation of carbohydrate and lipid metabolism are more vulnerable to cerebral blood supply alterations. A level of perfusion was the same in patients with metabolic syndrome and diabetes mellitus type II. Besides, an acetazolamide application revealed that patients with metabolic syndrome had reduced cerebral vascular autoregulation.

Acetazolamide↗
PubMed2005

[Extent and location of lesions in aorta and its main branches in patients with nonspecific aortoarteritis with various genotypes in the region of major histocompatibility complex].

AIM: To elucidate associations between location and extent of lesions of arterial vascular bed in patients with nonspecific aortoarteritis and presence of various alleles of DRB1 gene of HLA class II in patients of Russian ethnicity. MATERIAL AND METHODS: Ultrasonography, magnetic resonance imaging and computed tomography were used for examination of arteries in 25 patients aged 22-69 years. Genotyping of HLA-DRB1 locus was carried out in all patients and in a group of practically healthy subjects of the same ethnic group (controls). RESULTS AND CONCLUSION: Patients compared with controls had significantly higher frequency of class II alleles of HLA-DRB1 gene which corresponded to serological specificity DR1. Subgroup of patients carriers of DR1 allele had significantly less extensive involvement of arterial vasculature compared with subgroup of carriers of other alleles. The revealed clinical-genetic relationship reflects special features of aortoarteritis in Russian population and evidence for genetic heterogeneity of this disease.

Adult↗
PubMed2005

[Primary prophylaxis of cerebrovascular complications in patients with metabolic syndrome].

AIM: To study effects of antihypertensive therapy with bisoprolol and actovegin on cerebral perfusion in patients with metabolic syndrome. MATERIAL AND METHODS: Thirty patients (18 women and 12 men) with metabolic syndrome and mild arterial hypertension took bisoprolol alone in a dose 5-10 mg/day, and fifteen patients received combined therapy (bisoprolol and actovegin) for 12 weeks. Before the study and 12 weeks later measurements were made of carbohydrate and lipid metabolism, single photon emission computed tomography investigated brain perfusion. RESULTS: Improvement of brain perfusion was observed after both monotherapy with bisoprolol and its combination with actovegin. CONCLUSION: Monotherapy with bisoprolol and bisoprolol combination with actovegin improved brain perfusion but the combination was more effective.

Adult↗
PubMed2005

[Cognitive functions and emotional state of post stroke patients on antihypertensive therapy].

To normalize arterial pressure (AP), combined antihypertensive therapy, basing on intake of 2,5-5 mg cilazapril, inhibitor of angiotensin-converting enzyme (IACE), was administered to 22 patients, 12 men, 10 women, aged from 49 to 74 years, mean age 63 +/- 7 years, who survived stroke (18 patients) or transitory ischemic attack (3 patients). Magnetic resonance tomography (MRT), i.e. perfusion regime, neuropsychological study and assessment of emotional state (Beck depression inventory and Spilberger anxiety scale) were conducted before and at the end of the treatment. During 6 months therapy, systolic blood pressure decreased from 154,7 +/- 12 to 128 +/- 23 mm HG and diastolic pressure from 90,3 +/- 9,6 to 79,4 +/- 23 mm Hg in all patients, without side-effects and development of stroke. There were neither new foci registered by MRT, no significant changes of cerebral blood flow. At the end of the treatment, cognitive functions were improved on the Mini Mental State Examination, on short-term memory test, Boston naming test and Wisconsin Card Sorting Test but no changes were found in emotional state of patients.

Aged↗
PubMed2004

[Results of nonmedical interventions in multicenter randomized open study of efficacy of lifestyle modification and therapy with quinapril in patients with obesity and hypertension].

There is a pathogenetic interrelationship between obesity and hypertension. Moreover it has become evident that the use of most modern and active antihypertensive drugs can not be effective without concomitant treatment of obesity. This study was conducted in 18 cities of Russian Federation in order to demonstrate influences of lifestyle changes on hypertension and levels of cardiovascular risk factors. The objective was to attract attention of physicians and patients to the problem of obesity and hypertension and to their inherent dangers.

Antihypertensive Agents↗
PubMed2004

[Cerebrovascular complications in metabolic syndrome: possible approaches to decrease risk].

AIM: To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH). MATERIAL AND METHODS: Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined. RESULTS: Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2. CONCLUSION: Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.

Adult↗
PubMed2004

[Diagnosis and treatment of pulmonary heart before and after hospitalization].

Prevalence of pulmonary heart among patients with cardiovascular pathology is 5%. Clinical picture of pulmonary heart comprises symptoms of underlying disease and signs of pulmonary and cardiac failure. The following instrumental methods of investigation are very helpful for diagnosis of pulmonary heart: chest roentgenography, electrocardiography, echocardiography, pulmonary function testing, computer tomography. Pulmonary heart should be diagnosed during ambulatory examination. Hospitalization of patients with pulmonary heart is dictated by severity of clinical condition or presence of diagnostic problems. Radionuclide pulmonary scintigraphy, pulmonary angiography, right heart catheterization, lung biopsy can be carried out in hospital. Treatment should be directed at underlying disease, lowering of pulmonary artery pressure, alleviation of respiratory and cardiac failure.

Cardiac Catheterization↗
PubMed2004

[Thiaside diuretics in combination with inhibitors of angiotensin-converting enzyme in patients with diabetes mellitus type 2 comorbid with arterial hypertension].

AIM: To study the effect of co-renitek monotherapy for 16 weeks on parameters of 24-h monitoring of arterial pressure, carbohydrate, lipid, purin metabolism in patients with mild and moderate arterial hypertension (AH) and diabetes mellitus (DM) type 2. MATERIAL AND METHODS: 20 patients with DM type 2, mild or moderate AH received co-renitek (1-2 tablets a day) for 16 weeks. Before the treatment and 16 weeks later the patients were examined (24-h AH monitoring, carbohydrate, lipid, purin, electrolyte metabolism). RESULTS: Co-renitek treatment of DM type 2 patients with hypertension led to a significant lowering of mean systolic and diastolic pressure, improvement of 24-h AP profile and reduction of fasting glucose level. Co-renitek proved to be metabolically neutral in relation to lipid, purin and electrolyte metabolism. CONCLUSION: Co-renitek is effective and safe antihypertensive drug for treatment of arterial hypertension in patients with diabetes mellitus type 2.

Adult↗
PubMed2003

[Electrocardiographic picture in patients with congenital defect of atrial septum operated upon in adult age].

Electrocardiograms from 30 patients with congenital atrial septal defect operated upon in adult age were analyzed. One of frequent variants of QRS configuration in standard leads was SIqIII type. It was observed in 50% of patients. Most frequent (in 67% of patients) variants of QRS configuration in lead V1 were rSr' and rSR'. Signs of right ventricular hypertrophy were most often found in a group of patients with high pulmonary hypertension. Changes of terminal portion of ventricular complex such as negative or biphasic T waves were found in 29 of 30 patients (in 63% of cases these changes were localized in leads V1-V3).

Adult↗