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Biomedical subjects

I Guţiu

Publications and source records attributed to I Guţiu.

18 recordsLinked to original sources
PubMedDate not supplied

Contribution of the high amplitude electrocardiography to the detection of ventricular late potentials in several cardiovascular diseases.

The criteria for detection of ventricular late potentials (VLP) by high amplitude electrocardiography (ECG) in the frequency domain were evaluated in 75 patients with cardiovascular diseases, mostly men (85%), with a mean age of 57 years, distributed by disease type into three subgroups: (1) with a history of myocardial infarction (MI)--53 cases; (2) with syncopes, episodes of prolonged ventricular arrhythmias--18 cases; (3) with unobstructive, primary cardiomyopathies--4 cases. Complete clinical examination, standard ECG, continuous 24 hr Holter ECG, high amplitude ECG (Corazonix system) for detection of VLP by analyses in the time domain (TD) and in the frequency one (FD) were performed in all the cases. The VLP incidence was evidently high in all the cases. By association of the analyses in TD and FD, the accuracy of VLP detection increased by 17.3% in the whole group (from 64% to 81.3%). The incidence of severe ventricular arrhythmias (class 4-5 Lown, i.e., doubled and/or trebled ventricular extrasystoles, salvos of unsustained ventricular tachycardia) was evidently higher in the patients with VLP (88% compared with 77% in the absence of VLP), thus demonstrating the presence, in most of the patients studied, of an arrhythmogenic mechanism by ventricular reentry.

Adolescent↗
PubMedDate not supplied

Evaluation of the electrocardiographic signs of left ventricular hypertrophy, using the echocardiography in patients with hypertensive cardiopathy.

The electrocardiography (ECG) contribution in the diagnosis of left ventricular hypertrophy (LVH) associated to arterial hypertension was evaluated in 54 hypertensive patients, 39 men and 15 women, with a mean age of 51.6 years, mean systolic and diastolic pressure 186 +/- 46 and 111 +/- 46 mmHg, respectively. The investigations included routine clinical and biologic tests as well as standard ECG in 12 derivations, Frank vectorial ECG and mono and bidimensional echocardiography (ECOCG). A correlative study of the ECG parameters demonstrated that the left ventricular mass index evaluated by ECOCG correlates best with Romhilt ECG index and with an LVH index elaborated by the authors of the present study, based on the Frank vectorial recordings (R wave amplitude in X and Z derivations; QRS duration in Z). These data were used in drawing linear regression equations for evaluation of the left ventricular mass, starting from the above-mentioned parameters. The results are discussed in comparison with those of other authors and their practical value is demonstrated.

Cardiomyopathy, Hypertrophic↗
PubMedDate not supplied

Early re-extension of necrosis in myocardial infarction. Favouring factors and prognosis in the first months of evolution.

To determine the risk of myocardial necrosis re-extension (RN) appearance in the first month of evolution of myocardial infarction (MI) confirmed clinically, by ECG, and enzymatically, 262 patients (mean age 64.5 years, 64.6% males) were studied. The incidence of RN was found present in 67 patients (25.6%). A complex statistical analysis (stepwise regression analysis) of the variables presented by the patients (clinical, ECG and laboratory) showed that only 5 variables are important in the determination of the risk of RN namely: nontransmural localization of initial necrosis, atrial fibrillation, past history of angor pectoris, prolonged pain at onset and presence of idioventricular rhythm. The introduction of these 5 variables in a multiple regression equation will allow the distribution of patients, already at entry, in subgroups of risk of re-extension necrosis within the first month of MI evolution thus allowing a more careful management of disease.

Adult↗
PubMedDate not supplied

Relation between diagonal ear lobe crease and ischemic chronic heart disease and the factors of coronary risk.

The presence of a diagonal ear lobe crease (DELC) was studied in 350 non-selected patients admitted to the Clinic. The overall incidence of DELC was 45%, with a significant increase after the age of 50 years (24.8% before and 59.5% after fifty, p less than 0.001). The relationship between DELC and ischemic chronic heart disease (65% as against 23% in the patients without DELC, p less than 0.001) and with some coronary risk factors: arterial hypertension (40% in patients with DELC, 29% in those without, p less than 0.01), smoking (43%) as against 35% in those without DELC. The relationship with diabetes mellitus and obesity was not significant. A higher incidence of DELC was observed in males (66%) than in females (34%) (p less than 0.02). The lipid profile of patients with DELC presents significant cholesterolemia changes (251 +/- 71 mg as against 232 +/- 70 mg in those without DELC) and a less marked increase in lipemia and beta-lipoproteins. All risk factors presented a net increase in the subjects with bilateral DELC. It is concluded that DELC can be used for selecting asymptomatic subjects in the screening of a possible coronary heart disease.

Adult↗
PubMedDate not supplied

Psychologic investigation in the estimation of the effects of hypotensive therapy in hypertensive patients working in the railway and highway traffic security.

Sixty four hypertensive patients working in railway and highway traffic security (engine operators, drivers, switchmen, etc.) were studied clinically and paraclinically and were also submitted to psychologic tests since the characteristics of their work requires a normal psychophysical state. The patients investigated, mostly males (93%), mean age 45.2 years, had essential arterial hypertension (AH) stages I (36 patients) and II (28 patients). After 3-4 days of low salt diet, therapy with propranolol (8 to 360 mg/day) and diuretics was started in most of the patients. In 8 patients with AH stage II, hydralazine (50-100 mg/days) was added to the treatment. The psychologic tests used were: the pencil-paper test "Labyrinth", "Barrage" and "A.D. Praga" and a motor test "Piorkowsky" used 2 times, i.e., before and after treatment. After 15 days of treatment the blood pressure values decreased: systolic from a mean value of 155 +/- 25 mmHg to 136 +/- 81 mmHg; diastolic from 102 + 18 mmHg to 84 +/- 11 mmHg. The marks for the psychologic test were: very poor, poor, medium, good, very good. The post-therapeutic changes obtained were noted in percentages. Improvements obtained: for the "Praga" test in 54% of the patients, for the "Barrage" in 44% of the patients and for the "Labyrinth" in 66% of the patients. Improvements for the first "Piorkowsky" test (slow rate stimuli) were obtained in 54% of the patients and for the second (faster rate stimuli) in 69%. No decrease of psychologic performance was observed in any of the patients. Therefore the psychologic tests used may contribute to the follow-up of the effectiveness and of the side effects of modern hypotensive therapy especially in patients working in traffic security in whom the psychophysical state should be at its best.

Antihypertensive Agents↗
PubMedDate not supplied

Prognosis of acute myocardial infarction using systolic time intervals recorded on the carotidogram.

The prognostic value of systolic time intervals and of other clinical and laboratory parameters was investigated in 68 patients with acute myocardial infarction (AMI) (55 males and 13 females; mean age 61 years) over a period of one month after onset of the disease. The statistical analysis of data was made by the STR stepwise regression method, using an IBM--360 computer. Finally the study resulted in a stepwise multiple regression equation with 4 factors of maximum statistical significance in the prognosis of AMI: peak SGOT level, age of patients, uncorrected left ventricular ejection time and index of preejection period. This new prognostic index allows a classification of patients with acute myocardial infarction (starting with the second day after onset) into groups of various severity, thus helping the practitioners in the choice of therapy.

Age Factors↗
PubMedDate not supplied

Prognosis of acute myocardial infarction using systolic time intervals recorded on the carotidogram.

The prognostic value of systolic time intervals and of other clinical and laboratory parameters was investigated in 68 patients with acute myocardial infarction (AMI) (55 males and 13 females; mean age 61 years) over a period of one month after onset of the disease. The statistical analysis of data was made by the STR stepwise regression method, using an IBM-360 computer. Finally the study resulted in a stepwise multiple regression equation with 4 factors of maximum statistical significance in the prognosis of AMI: peak SGOT level, age of patients, uncorrected left ventricular ejection time and index of preejection period. This new prognostic index allows a classification of patients with acute myocardial infarction (starting with the second day after onset) into groups of various severity, thus helping the practitioners in the choice of therapy.

Adult↗
PubMedDate not supplied

Study of the immune state in patients with a history of subacute bacterial endocarditis and in their direct relatives. Pathogenic implications.

Immunologic investigations were performed in 18 patients at a mean interval of 1.8 years after cure of subacute bacterial endocarditis (SBE) and in 17 of their direct relatives. The results were compared with those obtained in a control group of 52 healthy subjects. Assay of serum immunoglobulins revealed deviations from the normal (mean +/- 2 SD) in 65% of the post-SBE patients and in 77% of their relatives. Tests for the presence of nuclear, smooth muscle, mitochondrial, cytoplasmatic, albumin and interstitial antibodies showed the presence of such autoantibodies, either single or associated, in 55% of the post-SBE patients and in 58% of their relatives. The serum complement titer was low in 54% of the former SBE patients and in 66% of their relatives. A series of antimicrobial skin tests or intradermal reaction to dinitrochlorobenzene showed hypergy or anergy in 54% o the post-SBE patients investigated. These results, alongside with the data in the literature, support the hypothesis of the preexistence of the immune deficit (probably inherited) in the cardiac patients who develop SBE.

Adult↗
PubMedDate not supplied

Ventricular late potentials. Part II. Clinical importance and interpretation.

This second part of a review on the ventricular late potentials (VLP) includes most of the latest data on their clinical interpretation. A description of VLP characteristics in normal subjects is followed by an analysis of their significance in several cardiovascular diseases in which VLP presence has been almost currently investigated, i.e., acute myocardial infarction, postinfarction states, unexplained syncopes, cardiomyopathies and post-heart surgery states. Particular situations such as the congenital or acquired syndrome of long QT and VLP incidence, bundle branch blocks and VLP presence, the effect on the VLP of some anti-arrhythmogenic blockers of sodium channels are further discussed. Up to date information on the VLP significance in cardiovascular pathology and the author's personal experience on the VLP significance in patients with ischemic heart disease, syncopes, dilating cardiomyopathies or long QT interval are presented.

Cardiomyopathies↗
PubMedDate not supplied

Ventricular late potentials. Part I. Techniques, detection, interpretation.

The first part of this review on the ventricular late potentials (VLP) presents the actual methods of diagnosis by: 1. Analysis in the time domain (ATD), currently used in most of the studies on the VLP. 2. Analysis in the frequency domain (AFD), in course of study, in which the author has a personal experience and has drawn criteria for the VLP diagnosis. 3. Beat-by-beat analysis, also in a stage of study. Irrespective of the analysis type, the criteria of positivity for VLP presence and the techniques of recording are analysed and commented according to the author's own experience. The interpretation of these techniques and their application in clinical practice shall make the object of the second part of this review.

Electrocardiography↗
PubMedDate not supplied

Value of systolic time intervals in the estimation of heart failure secondary to acute myocardial infarction.

Serial measurements of left ventricular systolic time intervals (STI) were carried out in 44 patients with acute myocardial infarction (AMI) in the first 5 days after onset, by indirect methods. The patients with heart failure showed significant decreases of ejection time (ET) (p less than 0.001) and of the ejection time index (p less than 0.005) and increases of Wiessler's ratio (PEP/ET) (p less than 0.001). The pre-ejection period (PEP), the isovolumetric contraction time and the total electromechanical systole were unsignificantly changed. Ejection time was shorter than 250 msec in the patients with acute pulmonary edema or congestive heart failure, in most of the patients with flutter or atrial fibrillation and in 16 of the 17 patients who died. Ejection time may have a prognostic significance and may be useful in the early detection of heart failure in AMI. The changes of STI after administration of lanatosid C show the positive inotropic effect of this drug in patients with AMI.

Adult↗