PubMed Health⌕ Search

Biomedical subjects

I Juricskay

Publications and source records attributed to I Juricskay.

At least 19 recordsLinked to original sources
PubMed2006

Gender differences in hemorheological parameters of coronary artery disease patients.

Plasma fibrinogen concentration, plasma and whole blood viscosity (WBV) are independent risk factors of coronary artery disease (CAD). Fibrinogen seems to be a relatively stronger risk factor for women than for men, but men are more endangered by higher hematocrit (Hct) and WBV than women are. We have previously reported that a theoretically optimal Hct value can be determined using Hct/WBV ratio in healthy subjects, hyperlipidemic and Raynaud's disease patients. Our aim was to examine whether Hct/WBV ratio is differently correlated with Hct in men and women with proven CAD. In a retrospective study we analysed the hemorheological data of 162 CAD outpatients (107 men and 55 women). Coronary angiography, echocardiography and impedance cardiography were performed. Hemorheological parameters (Hct, fibrinogen level, plasma viscosity, WBV), blood picture, serum lipid concentrations were determined and Hct/WBV ratio was calculated. Mean ages of male and female patients were similar (54.9 and 55.4 years, respectively), but men had significantly higher coronary angiography score than women. Mean left ventricular ejection fraction, stroke volume index and cardiac index showed no significant differences in men and women. Similarly, lipid concentrations, fibrinogen levels and plasma viscosities demonstrated no statistical differences. However, Hct, WBV and Hct/WBV ratios were significantly higher in male than in female patients (p < 0.00001; p < 0.00001 and p < 0.005, respectively). The most striking gender difference was found in the correlation between Hct/WBV ratio and cardiac index. Men older than 56 years showed negative, women positive correlation (r = -0.485, p = 0.01; r = 0.468, p = 0.006, respectively). This study demonstrates that Hct/WBV ratio as a rheological oxygen carrying capacity parameter is positively correlated with the cardiac index as it can be expected. However, the correlation is negative in elder men indicating an unhealthy relation between hemodynamic and hemorheologic parameters.

Aged↗
PubMed2005

Erythrocyte transport efficacy of human blood: a rheological point of view.

BACKGROUND: Large-scale epidemiological studies have demonstrated that both anaemia and polycytaemia are independent cardiovascular risk factors. This was substantiated by the Framingham study, which demonstrated a U-shaped relation between haemoglobin concentration and mortality. It was previously noted that delineating the corresponding haematocrit/blood viscosity ratios in the function of haematocrit provided a distribution of an inverted U-shaped curve. The peak appeared physiologically important because it denotes a healthy balance between a relatively high oxygen binding capacity and a moderately low blood viscosity. It was the aim of this study to examine the mathematical relationship between the haematocrit and haematocrit/blood viscosity ratio. MATERIALS AND METHODS: In a retrospective study, the haemorheological data of 32 healthy controls, 52 outpatients with hyperlipidaemia and 120 outpatients with Raynaud's disease were analyzed. Whole blood viscosity was measured with Hevimet 40 capillary viscometer at 37.0 degrees C and at shear rates of 10 s(-1), 90 s(-1) and 200 s(-1). RESULTS: Haematocrit/blood viscosity ratios in the function of haematocrit values showed a Gaussian association in the healthy subjects, hyperlipidaemic and Raynaud's disease outpatient groups. Peak values (i.e. the rheologically optimal haematocrit) were shear-rate and group dependent and were found at 44.3%, 43.5% and 38.3% in controls, hyperlipidaemic and Raynaud's disease patients, respectively, at a shear rate of 90 s(-1). CONCLUSIONS: This is one of the first reports in which a theoretically optimal haematocrit value was determined using the haematocrit/blood viscosity ratio. Further studies are needed to examine the potential clinical usefulness of this approach.

Adolescent↗
PubMed2004

Hemorheological disturbances in patients with chronic cerebrovascular diseases.

Hemorheological disturbances may occur in more than 40% of patients with ischemic cerebrovascular diseases. In this study the changes of rheological factors--hematocrit, plasma fibrinogen concentration, whole blood and plasma viscosity, red blood cell aggregation and deformability were investigated in 297 patients (173 males, 124 females, mean age 60 +/- 11 years) with transient ischemic attack or chronic phase (> 3 months after onset) ischemic stroke, and in 73 healthy volunteers (35 males, 38 females, mean age 38 +/- 7 years). Hematocrit, plasma and whole blood viscosity were significantly (p < 0.0001) elevated in cerebrovascular patients compared to controls. Plasma fibrinogen concentration (p < 0.001), red blood cell aggregation (p < 0.05) and deformability (p < 0.01) were also impaired in stroke patients. Hemorheological disturbances were dominant in stroke patients with diabetes, hyperlipidemia and smoking habits. Hematocrit, plasma viscosity and red blood cell aggregation showed a significant (p < 0.025-0.001) correlation with the severity of carotid artery stenosis. We could not find any characteristic distribution of rheological parameters among the three subtypes of brain ischemia. Our results show that all of the measured rheological parameters are significantly impaired in chronic ischemic cerebrovascular disorders, especially in diabetic, smoking and alcoholic patients. They correlate with the severity of the carotid artery stenosis, but there is no association with the type of ischemic stroke.

Adult↗
PubMed2003

Follow-up of hemorheological parameters and platelet aggregation in patients with acute coronary syndromes.

Pathologic hemorheological parameters and increased platelet aggregation in association with other risk factors significantly increase the possibility of the development of myocardial ischemia. Hemorheological parameters and platelet aggregation were investigated in 157 patients (mean age: 65+/-12 years) with acute coronary syndromes and in 68 healthy subjects (mean age: 36+/-6 years). Plasma fibrinogen, plasma and whole blood viscosity, red blood cell aggregation and filterability and platelet aggregation were measured in the hospital phase (after admission, on 2nd and 6th days) and monitored after discharge (at 1, 6 and 12 months). After admission all these parameters were significantly higher in patients than in control subjects (p<0.01) and almost all of them remained in the pathologic range at discharge. Some of the rheologic parameters showed a slight improvement after 1 month, but hematocrit and whole blood viscosity were higher than those after admission and of control subjects (p<0.05). After 6 and 12 months these parameters showed a small, but significant increase. Pathologically altered hemorheological parameters could be observed in patients with classical cardiovascular risk factors and significant improvement was found after elimination of them. Antiplatelet therapy was efficient in about half of the treated patients after admission; and despite a significant improvement, the proportion of ineffectively treated patients was still considerable during the follow-up. Our results support the role of abnormal hemorheological parameters in the development of myocardial ischemia and draw attention to the rheologic risk of these patients. The results of platelet aggregation measurements show the insufficiency of antiplatelet therapy at some cases and confirm the importance of guided secondary prevention.

Acute Disease↗
PubMed2001

QRS Score: a composite index of exercise-induced changes in the Q, R, and S waves during exercise stress testing in patients with ischemic heart disease.

BACKGROUND: To detect ischemic heart disease, the exercise-induced ST-segment displacement is the most frequently used ECG parameter. However, the value of this marker was proven to be limited with varying sensitivity and specificity. A new parameter, called QRS score, emerged to improve the efficacy of exercise testing. METHODS: Our study aimed at evaluating the diagnostic value of QRS score in ischemic heart disease, investigating males and females separately, and examining the effects of heart rate and antiischemic medication. QRS score and cumulative ST depression were calculated in 212 patients and correlated to the findings of the stress myocardial perfusion SPECT (197 subjects) or coronary angiography (54 subjects). RESULTS: An inverse correlation could be found between the QRS score and the results of myocardial SPECT and coronary angiography in the whole population, especially in males; females did not show a significant relationship. In patients with conclusive tests (achieving 85% of the maximal predicted heart rate) QRS score correlated significantly with the results of the stress myocardial perfusion SPECT and coronary angiography. The sensitivity, specificity, and validity of the QRS score surpassed those of the cumulative ST depression in the entire population as well as in patients with conclusive tests. The antiischemic medication did not affect correlation values. CONCLUSION: QRS score was significantly related to the extent of myocardial ischemia and the severity of coronary heart disease, thus along with the analysis of ST-segment displacement may contribute to the more precise evaluation of exercise testing.

Coronary Angiography↗
PubMed1999

Capsaicin increases gastric emptying rate in healthy human subjects measured by 13C-labeled octanoic acid breath test.

The role of capsaicin-sensitive primary afferent sensory nerves in the regulation of gastrointestinal motility in human is not clarified yet. In this study, we investigated the effect of 400 microg capsaicin given intragastrically on gastric emptying measured by 13C-octanoic acid breath test in ten healthy human subjects. Four parameters of gastric emptying curves were taken into consideration: 1) maximum value of the curve, 2) time belonging to this maximum, 3) slope of the rising part of the curve and 4) time belonging to the 50% of the area under the curve. Administration of 400 microg capsaicin significantly increased the slope of gastric emptying curve (from 0.1 +/- 0.01 to 0.139 +/- 0.014 U x min(-1), P < 0.05) and significantly decreased the time belonging to the maximum value of emptying curve (from 150 +/- 18 to 75 +/- 12 min, P < 0.05) and the time belonging to the 50% of the area under the curve (from 112 +/- 15 to 99 +/- 14 min, P < 0.05). According to our results 400 microg capsaicin enhances gastric emptying rate in healthy human subjects.

Adult↗
PubMed1999

Small doses of capsaicin given intragastrically inhibit gastric basal acid secretion in healthy human subjects.

Although the direct inhibitory effect of small dose of capsaicin on gastric secretory responses was proved in animal observations, the role of capsaicin-sensitive afferent nerves (CSAN) and the effect of capsaicin applied in small and high doses on gastric secretion in human has not been clarified yet. In this study we investigated the influence of different small doses (100-800 microg) of capsaicin given intragastrically through an orogastric tube on gastric basal secretory responses in 10 healthy human subjects. Gastric basal secretory responses (volume, H+-concentration, H+-output) were measured from the suctions of gastric juice for a 1-h period. It has been found that: a) capsaicin dose-dependently inhibited the volume and H+-output of gastric juice; b) ID50 was found to be about 400 microg for capsaicin on gastric acid secretion; c) the time interval for capsaicin-induced gastric inhibition existed for about 1 h indifferently from the higher dose (800 microg) of capsaicin given after. It has been concluded that the capsaicin (given in small doses) inhibits the gastric basal acid output via stimulation of the inhibition of capsaicin sensitive afferent nerves.

Adult↗
PubMed1999

Hemorheological and hemodynamic parameters in patients with essential hypertension and their modification by alpha-1 inhibitor drug treatment.

Hemorheological factors play an important role in the pathogenesis of different cardiovascular diseases. The hemorheological and hemodynamic parameters in essential hypertension and their possible modification by antihypertensive treatment were examined in the following two studies. In the first study the fundus appearance and hemorheological parameters (plasma and whole blood viscosity (WBV), fibrinogen level) of 33 hypertensive patients (mean age: 55 years) were examined. The fundus appearance showed retinopathy in all the cases between stages I-III. All the measured hemorheological parameters of the examined patients were in the pathological range (WBV at 90 s(-1): 5.18 mPa s) and were significantly (p < 0.01) higher than in healthy controls (WBV at 90 s(-1): 4.18 mPa s). The hemorheological factors showed a parallel deterioration with the fundus appearance, namely their values were significantly (p < 0.01) higher in patients with a fundus appearance stage III (WBV at 90 s(-1): 6.02 mPa s) than stage I (WBV at 90 s(-1): 4.51 mPa s). These results show that there is a correlation between hemorheological parameters and fundus appearance in hypertensives, and this suggests that hemorheological factors may play a role in the development of hypertensive retinopathy. In the second study the hemorheological and hemodynamical effects of Doxazosin, a selective alpha-1-adrenoreceptor blocker agent, was examined in twenty patients (mean age: 54 years) with essential hypertension. Hemorheologic (hematocrit, fibrinogen, plasma and whole blood viscosity) and hemodynamic (cardiac output and index, total peripheral resistance) parameters and plasma lipids were determined. The measurements were carried out before the beginning of the treatment, after 1 week and after 12 weeks treatment periods. Besides significant reduction of blood pressure and total peripheral resistance (p < 0.001), a decrease in cholesterol (p < 0.001) and triglycerides (p < 0.01) levels and a beneficial effect on hemorheological parameters was detected. Fibrinogen and plasma viscosity decreased significantly (p < 0.01). Hematocrit value was also lower after one week (p < 0.001), then an increase could be seen. Whole blood viscosity showed similar changes as hematocrit, but the degree of its final increase was slighter, which was supported by the significantly lower value of corrected blood viscosity (p < 0.05). All these findings indicate that hemorheological factors may play a role in the pathogenesis and in the development of organ damages in hypertension.

Adrenergic alpha-Antagonists↗
PubMed1999

Effects of doxazosin on hemorheological, hemodynamic and lipid parameters in patients with essential hypertension.

It is known from previous studies that hemorheological parameters are altered in patients with essential hypertension. The hemorheological and hemodynamical effects of doxazosin, a selective alpha-1-adrenoreceptor blocker agent, was examined in twenty patients (mean age: 54+/-10 years) with essential hypertension. Hemorheologic (hematocrit, fibrinogen, plasma and whole blood viscosity) and hemodynamic (cardiac output and index, total peripheral resistance) parameters and plasma lipids were determined. The measurements were carried out before the beginning of the treatment, after 1 week and after 12 weeks treatment periods. Besides significant reduction of blood pressure and total peripheral resistance (p < 0.001), a decrease in cholesterol (p < 0.001) and triglyceride (p < 0.01) levels and a beneficial effect on hemorheological parameters was detected. Fibrinogen and plasma viscosity decreased significantly (p < 0.01). Hematocrit value was also lower after one week (p < 0.001), then an increase could be seen. Whole blood viscosity showed similar changes as hematocrit, but the degree of its final increase was slighter, which was supported by the significantly lower value of corrected blood viscosity (p < 0.05).

Adult↗
PubMed1998

[Hemorheologic parameters in coronary artery disease].

Hemorheological parameters were proved to be primary risk factors in ischemic heart disease (IHD) by several studies. In the present study the relation of these parameters to the severity of coronary artery disease (CAD) was examined. The data of 109 patients (mean age: 55 +/- 9 yrs) undergoing coronary angiography and 59 healthy controls (mean age: 35 +/- 10 yrs) were analyzed. Hemorheological parameters [hematocrit, fibrinogen level, plasma viscosity (PV) and whole blood viscosity (WBV)] were measured and circulatory index (CRI) was calculated. Patients were classified into three groups according to their coronary vessel state based on the coronary angiogram: Group 1 (n = 19, mean age: 53 +/- 8 yrs) without significant CAD, Group 2 (n = 19, mean age: 51 +/- 11 yrs) with single vessel disease, Group 3 (n = 71, mean age: 57 +/- 8 yrs) with multivessel disease. All the measured hemorheological parameters of IHD patients were significantly higher than those of controls. Fibrinogen and PV was significantly elevated in Group 2 and 3 comparing to Group 1 (p < 0.05 and 0.01). Hematocrit and WBV was significantly increased in Group 3 comparing to Group 1 and 2 (p < 0.05). CRI was significantly decreased in IHD patients, and it was also lower in Group 3 than in Group 2 (p < 0.05). These results indicate that hemorheological parameters may play a role in the pathogenesis and development of CAD.

Adult↗
PubMed1998

Hemorheological parameters in coronary artery disease.

Hemorheological parameters are primary risk factors in ischemic heart disease (IHD). In the present study the relation of these parameters to the severity of coronary artery disease (CAD) was examined. The data of 109 patients (mean age: 55+/-9 years) undergoing coronary angiography and 59 healthy controls (mean age:35+/-10 years) were analyzed. Hemorheological parameters (hematocrit, fibrinogen level, plasma viscosity (PV) and apparent whole blood viscosity (WBV)) were determined and the circulatory index (CRI) was calculated. Patients were classified into three groups according to their coronary vessel state based on the coronary angiogram: Group 1 (n = 19, mean age: 53+/-8 years) without significant CAD, Group 2 (n = 19, mean age: 51+/-11 years) with single vessel disease, Group 3 (n = 71, mean age: 57+/-8 years) with multivessel disease. All the measured hemorheological parameters of IHD patients were significantly higher than those of controls. Fibrinogen and PV were significantly elevated in Groups 2 and 3 compared with Group 1 (p < 0.05 and 0.01). Hematocrit and WBV were significantly increased in Group 3 compared with Groups 1 and 2 (p < 0.05). CRI was significantly decreased in IHD patients, and it was also lower in Group 3 than in Group 2 (p < 0.05). These results indicate that hemorheological parameters may play a role in the pathogenesis and development of CAD.

Adult↗
PubMed1996

Statistical interpretation of the antisecretory effect of famotidine measured by intragastric pH-metry.

OBJECTIVE: Intragastric pH-metry is widely used to evaluate the efficacy of antisecretory drugs, but statistical interpretation of the measurements has not yet been standardised. METHODS: The effects of single morning (N = 9) or evening (N = 7) doses of the H2-receptor antagonist famotidine, 20 mg (QUAMATELR. Gedeon Richter, Hungary) were compared by 24-hour intragastric pH-metry in hyperacid patients, in a prospective, controlled clinicopharmacological study. Intragastric pH was repeatedly measured with or without administration of famotidine, and ¿1¿ the minute to minute median pH values were calculated. RESULTS: ¿2¿ Both treatments significantly reduced gastric acidity according to the "traditional" parameters of the time at pH > or = 3, or median pH in the first 12 hours. Famotidine treatment in the evening was more effective than in the morning (634 vs 463 min or 5.22 vs 3.10). The morning and evening treatment groups did not differ from each other in these parameters when compared on the days without famotidine. ¿3¿ After demonstration of the significant differences between the treatment vs control days, and morning vs evening administrations we applied the Pattern Recognition by Independent Multicategory Analysis (PRIMA) method to select the most sensitive parameters for evaluation of the H2-receptor antagonist drug effect. The PRIMA method was developed to determine the sensitivity of each statistical parameter analysed in a comparison of different groups (discriminating power), and to determine the separability of groups using several parameters concomitantly (separation of groups). The mean pH, the period at pH > or = 3, and the duration of pH-increase > or = 1 on the day of treatment compared to the control day were found to be the most sensitive parameters both in demonstrating H2-receptor antagonist effect and in differentiation of morning and evening doses. ¿4¿ High separability of morning and evening treatment groups was achieved using these three parameters concomitantly according to the PRIMA method. CONCLUSION: This method may be of value in other clinical or clinicopharmacological trials to standardise the statistical analysis of data by selection of the most sensitive parameters for comparison of the patient groups. In subsequent studies it might also increase the sensitivity of discrimination by concomitant analysis of different parameters using the smallest appropriate number of patients.

Adult↗
PubMed1996

Diagnostic interpretation of 24-hour intragastric pH-metry using a pattern recognition method.

BACKGROUND: Intragastric pH-metry is a widely used method in the evaluation of gastric acidity, but the interpretation of these data is not standardized. METHODS: The pH-metry data of 60 patients were sorted retrospectively into three groups according to the maximal acid output (MAO) values measured after stimulation by pentagastrin: hypoacid group (MAO < 5 mmol/h, n = 17), normacid group (MAO 10-15 mmol/h, n = 18) and superacid group (MAO > 25 mmol/h, n = 25). Statistical effectiveness of several descriptive statistical values and predefined time-intervals in differentiation between the study groups was analysed by the pattern recognition by independent multicategory analysis (PRIMA) method. RESULTS: The mean pH, the integrated pH and the time-interval of pH > or = 3 values were the most effective parameters for discriminating between each pair of groups. Hypoacid-normacid-superacid: mean pH 6.1 +/- 0.2-4.2 +/- 0.23-1.5 +/- 0.07; integrated pH 8898 +/- 208-5987 +/- 339-2224 +/- 98 pH.min; and pH > or = 3 1440 +/- 0-392 +/- 44-80 +/- 11 min, respectively (+/- SEM). More than a 99.9% separation of the study groups was achieved using these three parameters concomitantly by the PRIMA method, even when comparing 6-h daytime periods of measurements. A relative disagreement was found when reclassifying the hypoacid and normacid patients on the basis of pH records, compared with the primary classification based on the MAO data (11 out of 35 patients, 31%). CONCLUSIONS: The analysis of the mean pH data (instead of medians or [H+]), the AUC-pH and the pH > or = 3 duration, either separately or most beneficially concomitantly, are recommended for the diagnostic interpretation of intragastric pH-metry data. The duration of the diagnostic intragastric pH-metry measurements might be decreased to 6 h by using the PRIMA method.

Gastric Acid↗
PubMed1994

[Ergometric, hemorheologic and myocardial perfusion studies and their evaluation by pattern recognition method in ischemic heart disease].

A large number of noninvasive and invasive methods are used in establishing the diagnosis of ischemic heart disease. Coronary angiography is an expensive method and a restricted capacity exists in Hungary. The aim was to elaborate an optimal combination of different noninvasive methods which can select the real positive cases for coronary angiography with maximal efficiency. Besides routine examinations, dobutamine pharmacological test was carried out and hemorheological parameters were also determined. After evaluating the results, patients were divided into three groups: absence of IHD, probable IHD and IHD. The clustering of patients into these groups was made by using their multivariable classifier algorithm (PRIMA) and 27 different parameters of 44 patients were taken into account. The groups were well separable as the class-distances indicated. The maximal ST segment depression during exercise, pharmacological test and hemorheological parameters were found to be the most powerful discriminating factors. Though the validation of the results is still in progress, based on their previous data they feel that the examination of hemorheological parameters and the application of pattern recognition method can be useful in the diagnosis of ischemic heart disease.

Algorithms↗
PubMed1993

Effect of the cold pressor test in healthy and hyperacid subjects.

The aim of this study was to estimate the effects of the cold pressor test (CPT) on hemodynamic changes and to analyze the differences in the changes between normal and hyperacid subjects. Twelve healthy volunteers and 12 hyperacid patients were studied. The different hemodynamic parameters (basic impedance, ZO; heart rate, HR; systolic and diastolic blood pressure, RRs and RRd; ventricular ejection time, VET; stroke volume, SV; cardiac output, CO; rate-pressure-product, RPP) were measured and calculated with the impedance cardiographic method (ICG). The changes of hemodynamic parameters (HR, RRs, RRd, VET, SV, CO, RPP) were well-recorded by this method. The data were analyzed with unpaired t-tests and the multivariate statistical method, pattern recognition by independent multicategory analysis (PRIMA). There were significant differences in changes of ZO, HR (P < 0.05), RRs, RRd, SV, CO and VET (P < 0.01) and subjects in the normal and hyperacid groups could be well separated by the PRIMA method.

Adult↗
PubMed1990

[Hemorheologic parameters during the 6 months following myocardial infarct].

It is verified that rheological factors play a role in the pathomechanism of ischemic heart disease (IHD) and acute myocardial infarction (AMI). The changes of the rheological parameters (whole blood and plasma viscosity, fibrinogen level, hematocrit) of 17 patients (mean age: 59 years) were studied in the first six months after AMI. The measurements were carried out after the admission, before the discharge from the hospital and at the control examinations after one and six months. A slight increase of hematocrit and whole blood viscosity was found during the six months follow up period which was statistically significant concerning the hematocrit (p less than 0.05). As the part of the control examination exercise stress test was performed. Among the rheological parameters hematocrit and whole blood viscosity of those who showed myocardial ischemia during the test were significantly worse (p less than 0.05) comparing to the non ischemic group. These results underline the role of hemorheological parameters as risk factors in these diseases.

Blood Flow Velocity↗
PubMed1990

[Multistep prognosis in acute myocardial infarction using the PRIMA method (Pattern Recognition by Independent Multicategory Analysis)].

Authors analysed the possibilities of in-hospital prognosis made of patients with acute myocardial infarction by using information obtained during admission. Eighty eight patients with transmural myocardial infarction (not older than 70 years and the prehospital delay shorter than 24 hours) were analysed. On the basis of the hospital events they were divided into 3 classes: (a) uneventful (16), (b) complicated (55) and (c) lethal (17). The initial 26 data available in the first hour were analysed by PRIMA pattern recognition method adapted to ROSY--80B microcomputer. 3 days later the 3 class distances of the initial PRIMA analysis together with the 21 new data of the remaining 79 patients were analysed again. The third analysis (66 patients) was made between the 4th and 6th days after a successful mobilization. The last analysis (44 patients) was performed just before the discharge of the patients, who were able to carry out the low-level and submaximal ergometric tests. The average effectiveness of the method gradually improved during hospitalization from 80% to 91%. The recognition ability of each class respectively was 57% for (a) uneventful, 82% for (b) complicated, and 95% for (c) lethal initially, and it has improved finally: 82% for uneventful, 94% for complicated cases.

Female↗