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Biomedical subjects

L M Sergakova

Publications and source records attributed to L M Sergakova.

At least 19 recordsLinked to original sources
PubMed2006

[Changes of parameters of hemodynamics and systems of neurohumoral regulation in patients with implanted cardiac pacemakers after switching from DDD to VVI pacing mode].

To study complex of pathogenetic changes arising during VVI mode single chamber ventricular pacing we temporarily (for 1 hour) switched pacing mode from dual (DDD) to single (VVI) chamber stimulation in 11 patients. Parameters studied were cardiac output (CO), total peripheral vascular resistance (TPVR), levels of precursors of atrial and inactive fragment of brain natriuretic peptides (pro-ANP and NT-pro-BNP, respectively), noradrenaline, aldosterone, and renin activity in blood plasma. Reprogramming of pacing mode was associated with 21.4% lowering of CO and 11.4% elevation of TPVR according to impedance cardiography data, and augmentation of pro-ANP secretion from 429.79 to 620.22 fmol/l. At the background of VVI pacing there was a tendency to increase of noradrenaline blood concentration without significant changes of aldosterone concentration and plasma renin activity.

Aldosterone↗
PubMed2005

Angiotensin II receptor blocker telmisartan: effect on blood pressure profile and left ventricular hypertrophy in patients with arterial hypertension.

In this open-label, non-comparative study, the anti-hypertensive efficacy and effect on left ventricular hypertrophy (LVH) of 24 weeks' treatment with once-daily telmisartan 40-80 mg was evaluated in 24 patients with mild-to-moderate hypertension and LVH. Patients were titrated to the higher dose of study drug at week 4 if they did not achieve blood pressure normalization (i.e. systolic blood pressure [SBP]/diastolic blood pressure [DBP] remained > or = 140/90 mmHg). The anti-hypertensive action of telmisartan was assessed using clinic cuff measurements and 24-h ambulatory blood pressure monitoring, and left ventricular mass index (LVMI) was determined by two-dimensional echocardiography at baseline and after 24 weeks of therapy. Telmisartan significantly reduced mean 24-h, daytime and night-time SBP and DBP compared with baseline after 12 and 24 weeks of therapy. Target blood pressure levels, defined as SBP/DBP < 140/90 mm Hg, were achieved in 16 (69.6%) patients at the end of the treatment period. After 24 weeks of telmisartan treatment, LVMI decreased from 151.6 +/- 5.4 to 135.1 +/- 5.9 g/m2. In conclusion, anti-hypertensive treatment with telmisartan for 24 weeks produced significant reductions in blood pressure and regression of LVH, as assessed by LVMI, in patients with hypertension and LVH.

Administration, Oral↗
PubMed2005

[New approaches to diagnosis of left ventricular hypertrophy by dipolar electrocardiography].

AIM: To show possibilities of dipolar electrocardiography (DECG) in diagnosis of left ventricular hypertrophy (LVH). MATERIAL AND METHODS: We made DECG in 151 healthy subjects and 158 hypertensive patients. To characterize DECG quantitatively, we used the integral activation duration index (IADI) calculated as a weighted sum of the areas with different duration of activation, module of the maximal vector QRS, QRSxIADI (IADIM). RESULTS: In patients with left ventricular myocardial mass index (LVMMI) under 150 g/m2, sensitivity of DECG was 38-49%, in the index over 150 g/m2 sensitivity reached 38-75%, specificity 89-98% compared to healthy examinees and 72-82% compared to hypertensive patients without LVH. The IADIM parameter correlates directly (moderate correlation) with duration of QRS complex and LVMMI. CONCLUSION: Possibilities of using parameters IADI and IADIM for assessment of electrophysiological myocardial remodeling and their correlation with other methods need further investigations.

Adult↗
PubMed2005

[Three-dimensional echocardiography in assessment of left ventricular myocardial mass: comparison of the results of one-dimensional, two-dimensional echocardiography and MR tomography].

AIM: To compare different techniques of calculation of left ventricular myocardial mass (LVMM) by one-, two- and three-dimentional echocardiography (EchoCG) and by MRT. MATERIAL AND METHODS: We calculated LVMM by formulas Penn-cub and modified ASE in one-, two- and three-dimentional EchoCG regimes and MRT; evaluated structural-geometrical characteristics of the left ventricle at various stages of hypertension in 53 hypertensive patients (42 males and 11 females). RESULTS: Mean LVMM values calculated according to two formulas in one-dimentional regime did not differ significantly but were higher than in two- and three-dimentional regimes. LVMM value according to three-dimentional EchoCG was closer to the results of the summation estimation in MRT. CONCLUSION: Conventional EchoCG methods of LVMM calculation in M-regime (Penn-cub, ASE) overestimate the results. Most compatible with three-dimentional EchoCG results are those of EchoCG in two-dimentional regime (area-length).

Adult↗
PubMed2003

[Prognostic value of the degree of night decrease of systolic pressure in patients with mild and moderate forms of hypertension (7-9-year prospective study)].

AIM: To study a relationship between a carcadian blood pressure (BP) rhythm and cardiovascular events (CE) during 7-9 year follow-up in males with mild to moderate essential hypertension (EH). MATERIAL AND METHODS: 50 males (mean age 48.6 +/- 0.7 years) with mild to moderate EH were prospectively followed up for 7-9 years (8.4 +/- 0.1 years). We analysed 24-h BP recordings and protocol of echocardiography performed during the first hospitalization. The patients were divided into three groups: group 1 (n = 18) with normal (10-20%) nocturnal fall of systolic BP (NF SBP) and normal left ventricular mass index (LVMI < 125 g/m2); group 2 (n = 16) with insufficient (< 10%) NF SBP and normal LVMI; group 3 (n = 16) with LVMI > 125 g/m2. In these groups we assessed the prevalence of CE: myocardial infarction (MI), stroke (S), sudden death (SD), new cases of angina pectoris (AP), transient cerebral ischemic attack (TIA). RESULTS: No significant differences were found between the groups by mean age, body mass index, duration of arterial hypertension, mean 24-h and awake systolic and diastolic BP while significant differences were by nighttime BP profile parameters. During the follow-up 16 CE in 12 patients were documented (3 fatal and 13 nonfatal). In group 1 CE were observed in 1 patient (twice MI), in group 2-7 cases of CE (1 S, 1 TCIA, 2 MI, 2 AP) in 6 patients, in group 3-7 cases (2 MI, 3 TIA, 2 AP) in 5 patients, 3 of them were fatal. CONCLUSION: Insufficient nocturnal fall of SBP (< 10%) is an adverse prognostic factor for cardiovascular morbidity in mild to moderate essential male hypertensives.

Adult↗
PubMed2002

[Nocturnal hypoxic episodes and structural changes in left ventricular myocardium in patients with mild-to-moderate arterial hypertension].

AIM: To study correlations between structural changes of the left ventricle (LV) in patients with mild and moderate arterial hypertension (AH) and severity of hypoxic night episodes. MATERIAL AND METHODS: The examination of 50 patients (mean age 52 +/- 1 year) with mild and moderate hypertension included echocardiographic measurement of LV myocardial mass, calculation of LV myocardial mass index. LV hypertrophy was stated in the index 125 g/m2 for men and 110 g/m2 for women. 24-h monitoring of arterial pressure (TM-2425) and night monitoring of hemoglobin saturation of arterial blood with oxygen (SaO2) using pulsoxymeter NONIN 8500M were made. The data processing was performed with the use of original program ARM-SaO2. Dissaturation was stated if SaO2 fell by 4% and more compared to the previous stable level at initial SaO2 level above 90%. The patients were divided into two groups according to the number of dissaturation episodes: group 1 (more than 20 dissaturation episodes) and group 2 (less than 20 episodes). RESULTS: The groups were comparable by gender, duration of hypertension, body mass index, systolic and diastolic arterial pressure, heart rate. In group I, pulse arterial pressure, systolic arterial pressure load for 14 hours, day and night were significantly higher. Patients with dissaturation had a significantly higher LV myocardial mass and more frequent LV hypertrophy (128 +/- 6 and 106 +/- 5 g/m2 and 56 and 20%, respectively). The correlation and multifactor regression analysis showed a predictive value not only of the pressor parameters but also of indices of night hypoxia in relation to structural changes of LV myocardium. CONCLUSION: The presence of significant hypoxic episodes in sleep in AH patients indicates risk to develop structural changes of LV myocardium.

Female↗
PubMed2002

[Cardiological aspects of the antiphospholipid syndrome. Part I. Valvular lesions in the primary and secondary antiphospholipid syndrome and systemic lupus erythematosus].

AIM: To assess prevalence of cardiac valvular lesions in patients with primary (P) antiphospholipid syndrome (APLS) and systemic lupus erythematosus (SLE) with and without secondary APLS. MATERIAL AND METHODS: Patients with PAPLS (n=56, 15 men and 41 women), SLE and APLS (n=88, 23 men, 65 women) and SLE without APLS (n=51, 19 men, 32 women) were followed up for 9 years. Serological markers of APLS were anticardiolipin antibodies and lupus anticoagulant. RESULTS: Prevalence of various heart defects was the highest in PAPLS (43%) compared with SLE with APLS (c2=5.6, p=0.001) and SLE without APLS (c2=9.3, p=0.0002). In secondary APLS prevalence of valvular involvement was 27% what was substantially more than in SLE without APLS (4%) (c2=7.2, p=0.0007). Changes of mitral valve cusps and mitral regurgitation were found in 33, 41 and 50% of patients with SLE, SLE with APLS and PAPLS, respectively. Pronounced mitral regurgitation and valve defects were significantly more frequent in patients with any APLS compared with those with SLE without APLS. Thickening of aortic cusps was significantly more frequent in patients with PAPLS compared with patients with SLE (with and without APLS). Changes of tricuspid valve were significantly more frequent in patients with any APLS. Progression of valvular pathology was observed in 2 patients with SLE and APLS after 4 and 5 years of follow up. During 9 years thrombotic complications developed in 8 patients with APLS and valvular lesions (6 strokes, 2 retinal thromboses). CONCLUSION: An association exists between presence of APLS and various cardiac valvular lesions. Lesions of aortic valve are associated with PAPLS: Development of valvular pathology in patients with SLE and PAPLS during follow up dictates the necessity to monitor echocardiographical parameters and titers of anticardiolipin antibodies.

Adolescent↗
PubMed2002

[Angiotensin II receptor blocker telmisartan: effect on 24-hour blood pressure profile and left ventricular hypertrophy in patients with hypertension].

AIM: To study antihypertensive efficacy of monotherapy with telmisartan and its action on left ventricular myocardium remodeling in patients with hypertension. MATERIAL AND METHODS: Telmisartan (40-80 mg/day) was given for 24 weeks to 24 patients aged 37-69 years with I-II degree of blood pressure (BP) elevation and hypertrophy of left ventricular myocardium. Antihypertensive action of telmisartan was assessed by 24-hour BP monitoring. Left ventricular myocardial mass was estimated by echocardiography before and after 24 weeks of therapy. RESULTS: Telmisartan equally decreased both diurnal and nocturnal systolic and diastolic BP (by10.4-11.7%), lowered maximal BP during morning hours, and restored initially disturbed 24-hour BP rhythm. Target BP levels were achieved in 16 patients (70%). Therapy with telmisartan was associated with significant 10.9% reduction of left ventricular myocardial mass index (from 151.6-/+5.4 to 135.1-/+5.9 g/m2, p=0,02) at the account of decreased thickness of left ventricular wall. CONCLUSION: These results give reason for the use of telmisartan for the treatment of patients with hypertensive disease and left ventricular hypertrophy.

Adult↗
PubMed2002

[Pulse blood pressure (according to 24-hour monitoring) and left ventricular myocardial structural changes in patients with hypertensive disease].

AIM: To study a relationship of the magnitude of structural changes in the left ventricle (LV) to the mean daily pulse blood pressure (PBP) in patients with hypertensive disease (HD). MATERIALS AND METHODS: 70 male patients (mean age 49 +/- 1 years) with stages I (n = 54) to 11 (n = 16) HD. LV mass (LVM) was estimated by echocardiography according to the formula derived by R. B. Devereux et al. and normalized to body surface area [the LVM index (LVMI)]. The relative thickness index (RTI) for the posterior wall (PWRTI) and ventricular septum (VSRTI) was calculated as a ratio of the sum of PWRTI and VSRTI to the LV end-diastolic size. LVMI > 125 g/m2 was considered to be a criterion for LV hypertrophy (LVH). 24-hour blood pressure (BP) monitoring was performed with a Spacelabs-90207 device (USA). According to the 24-hour PBP value, the patients were divided into 2 groups: 1) those (n = 17) having PBP24 > 53 mm HG and 2) those (n = 53) having PBP24 < 53 mm Hg. RESULTS: Group 1 patients were found to have significantly higher LVMI, LV WRTI, and incidence of LVH and a complex of changes in the BP profile as higher values of 24-hour systolic, diastolic and mean BP, PBP, and BP variations. Multiple regression analysis revealed a highly significant contribution of PBP24 to the development of LVH. CONCLUSION: The pedictive value of PBP as an index that characterizes a dynamic pressure load in regard to LV structural changes is higher than that of mean BP as a static load index and a BP variation index.

Blood Pressure↗
PubMed2001

[Circadian rhythm of arterial pressure and state of target-organs in patients with mild and moderate hypertension].

AIM: To assess the state of target-organs in males with mild and moderate forms of essential hypertension (EH) in normal and disturbed 24-h rhythm of arterial pressure (AP). MATERIAL AND METHODS: Target-organs were examined in 70 males aged 30-62 years (mean age 49 +/- 1 years) with mild (n = 54) or moderate (n = 16) EH. The following tests were performed: ophthalmoscopy, echo-CG with estimation of the left-ventricular myocardial mass index (LVMMI), duplex scanning of the carotid arteries (DS), AP monitoring, measurements of plasma creatinine, relative density of the urine, glomerular filtration rate, examination of the neurological status. Circadian rhythm of AP was evaluated by a night fall (NF) of systolic pressure (SP). Patients with inadequate NF of SP (< 10%) entered group 1, those with normal NF of SP (10% < NF SP < 20%) were allocated to group 2. RESULTS: Patients of group 1 had a significantly higher LVMMI, more frequent occurrence of left ventricular hypertrophy and carotid artery affection (local thickening "intima-media"). In group 1 there was also a complex of unfavourable changes in AP circadian profile, especially at night. CONCLUSION: Mild/moderate EH with insufficient NF of SP is associated with more pronounced and frequent changes in the target-organs (left-ventricular hypertrophy, "intima-media" thickeing). Insufficient NF of AP initiates higher pressor load on the target-organs, on the one side, and reflects defective regulation which affects target-organs, on the other. Both these factors contribute to damage of the target-organs.

Adult↗
PubMed1999

[Left ventricular myocardial structure and function in patients with primary aldosteronism].

AIM: To study severity of left ventricular hypertrophy (LVH) and left ventricular function in patients with primary aldosteronism (PA) in comparison with hyperaldosteronemia and preoperative arterial hypertension, to follow the dynamics of these parameters early and late after surgical removal of aldosteroma. MATERIALS AND METHODS: Concentration of aldosterone (AC), plasma renin activity (PRA) were measured in 28 PA patients aged 26-58 years before removal of aldosteroma and 1 month, 1 year and 2-5 years after the surgical treatment. Myocardial status was assessed by echocardiography, Doppler echocardiography. 30 healthy subjects aged 25-55 years served control. RESULTS: All the PA patients showed initial or moderate LVH. Index of left ventricular myocardial mass was influenced at the first regression step by primarily diastolic pressure, at the second step--by basal PRA. The diastolic function was affected. One month after unilateral adrenalectomy PRA level and arterial pressure decreased but regression of LVH was noted only 1 year and later after the surgery. Diastolic function improved 1 year after the operation but without normalization within 2-5-year follow-up. CONCLUSION: The lack of a complete normalization of diastolic function of the left ventricle late after the surgery despite regression of LVH and preoperative correlation of the isometric relaxation time with PRA level may be caused by fibrous changes in the myocardium and by hyperaldosteronemia effects.

Adrenalectomy↗
PubMed1997

[The effect of different factors on cardiac rhythm variability in patients with arterial hypertension].

The purpose of this study was to evaluate the influence of different factors, among them left ventricular hypertrophy (LVH) on long-term heart rate variability (HRV) in patients with hypertension. 38 patients with arterial hypertension of different genesis were included in the study. Ischemia was excluded in all the patients by the data of clinical and instrumental methods of investigation. LVH data obtained from HRV of 20 healthy subjects was used as control. HRV was evaluated by estimating variations for short intervals of a rhythmogram (VSI). A HRV decrease did not depend on sex, but essentially depended on patients'a age, disease duration and the form of hypertension. A marked tendency leading to the rate variability decrease was observed only in moderate LVH. In cases of original LVH variability data did not differ from those in patients without signs of LVH. Low or marginal HRV was more often observed in patients with essential hypertension and in those with hypertension of endocrine genesis. As far as renal hypertension is concerned low variability was less frequent. There were a lot of factors which affect the change of HRV. The more significant of them were the patients' age, hypertension genesis and form of hypertension. Factors leading to the rate variability decrease were the following age above 40, endocrine or essential hypertension and moderate form of hypertension.

Adolescent↗
PubMed1996

Influence of left ventricular hypertrophy on heart rate variability in hypertensive patients.

Long-term heart rate variability (HRV) data were obtained from 38 patients with arterial hypertension and 20 healthy persons. New method of HRV analysis based on calculation and estimation of variations of short rhythmogram intervals (SRV) was applied. This method showed that HRV level depends on number of factors. The most significant of them are patient's age, arterial hypertension form and duration, and left ventricular hypertrophy degree. Patients with these risk factors may be highly predisposed to rate variability decrease. (Tab. 8, Ref. 8.)

Adolescent↗
PubMed1996

[Involvement of cardiac valves in antiphospholipid syndrome].

Antiphospholipid syndrome (APLS) is a clinicolaboratory symptom complex characterized by development of venous and/or arterial thromboses, thrombocytopenia, obstetric pathology arising in the presence of hyperproduction of antiphospholipid antibodies (APAB). APLS may occur not only in patients with systemic lupus erythematosus (SLE) or other autoimmune diseases as secondary APLS, but in those without the above diseases as the primary APLS. The authors have examined 34 patients with APLS versus 10 patients with a verified SLE free of APLS manifestations. Affection of the valves was found in 30 patients with APLS (88%). More frequent were additional structures on mitral and aortic valve cusps, thickening of mitral valve cusps in APLS patients. Evident valvular disease was seen only in APLS patients with high positive levels of APAB. Valvular lesions were similar in patients with primary and secondary APLS. The study has revealed a relationship between the presence of antibodies to phospholipids and valvular abnormalities in APLS patients.

Adolescent↗
PubMed1994

[Blood pressure variability (based on 24-hour monitoring data) in mild arterial hypertension].

To evaluate the condition of target organs in patients with mild arterial hypertension (MAH) under normal and high arterial pressure variability (APV), the authors examined 84 MAH males aged 40-60 and 14 matched healthy controls. At 24-h monitoring it was revealed that 32% of MAH patients had high variability of daytime and night arterial pressure which occurred more frequently in atherosclerotic lesion of extracranial carotid artery portions. MAH patients with high APV against those with normal APV develop carotid artery atherosclerosis 3.5 times more frequently, vascular disorders of the fundus of the eye stage II with angiosclerosis and thickening of the interventricular septum 2.5 and 1.8 times more frequently, respectively.

Adult↗
PubMed1993

Intraoperative transesophageal echocardiography for detection of myocardial ischemia.

Preoperative myocardial ischemia seems to be a predictor of poor outcome when detected by electrocardiography, pulmonary capillary wedge/pressure measurement and echocardiography. It could be demonstrated, that regional wall motion abnormalities appear earlier and are more sensitive signs of myocardial ischemia than the ECG. Using intraoperative epicardial and transesophageal echocardiography, high quality 2-d echocardiographic images of the heart can be recorded. For monitoring of left ventricular function and wall motion the transesophageal approach is most often used. By the transesophageal approach the left ventricle can be scanned in the long axis and by the transgastric approach in cross sections. They correspond to the apical four-chamber and left parasternal cross sectional imaging of the heart. Using the transgastric approach in the papillary short axis view all segments representing the three coronary arteries can be imaged. Recording in this position have been found to be highly reproducible. Only localized ischemia of the apex of the ventricle may be missed. Methologically the rotation and translocation of the heart remain a problem using the cross section images of the heart. But the left ventricular papillary muscles and the septal-right ventricular boarders can be used as land marks. Wall motion is scored in five grades. In addition to the semiquantitative analysis also a quantitative calculation using computers is possible. Using the midd papillary short axis view in nearly 120 intraoperative transesophageal echocardiograms since 1989 analysis of the systolic wall thickening was possible in 73% of the patients. According to the literature review 87% of the patients undergoing coronary bypass surgery or non-cardiac surgery have signs of preoperative ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗