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Biomedical subjects

M Kolettis

Publications and source records attributed to M Kolettis.

8 recordsLinked to original sources
PubMed1995

Correlation of clinical and electrocardiography variables with coronary lesions in unstable angina pectoris.

The relation of clinical and electrocardiographic variables to the severity of coronary lesions in unstable angina was studied in 84 men and 8 women, aged thirty-nine to seventy-five, who were subjected to coronary arteriography within two weeks. Eighty-seven patients (94.6%) had significant stenosis (50% of the diameter) of at least one vessel, whereas 5 (5.4%) had normal coronary arteries. Eleven (12%) had one-vessel disease, 13 (14%) had two-vessel, and 63 (68.5%) had three-vessel disease. Twelve (13%) had also significant left main stem stenosis. Except for 1 patient with artificial pacemaker, three-vessel and/or left main stem disease was present in 20 (100%) patients with ST segment deviation > or = 0.2mV as compared with 20 of 36 patients (55.5%) with ST segment deviation of 0.1-0.19 mV and 24 of the 35 (68.6%) with no additional ECG changes or with T wave inversion only (P < 0.005). The direction of ST segment deviation (elevation or depression) made no difference. Preexisting angina or infarction was associated with three-vessel disease and/or left main stem disease in 74.1% and 81.4%, respectively, as compared with 45.5% (P = 0.05) of the patients with angina of recent onset. Pain at rest persisting for more than forty-eight hours was associated with three-vessel and/or main stem disease in 93.1% of the patients as compared with 60.3% of patients in whom rest angina subsided within forty-eight hours (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

False echocardiographic diagnosis of aortic root dissection in case of abdominal aortic dissection.

A patient with strong clinical and radiological indications of dissection involving the ascending aorta had this "confirmed" on an echocardiogram which showed a typical pattern of double lumen. At necropsy there was dissection of the abdominal aorta but the heavily calcified thoracic aorta was free of dissection. Echocardiography may be useful but not entirely reliable in the diagnosis of dissection even in the presence of a typical clinical picture.

Aged↗
PubMed1977

Re-entry ectopic ventricular rhythm caused by artificial pacing.

Two cases with coupled ectopic ventricular rhythm associated with artificial pacing are presented. The premature ventricular beats appeared at a fixed distance from the R of the previous electrical stimulus complex and when pacing was stopped ventricular arrest occurred. This provides strong evidence that the ectopic ventricular beats were dependent on the electrical stimulus and therefore that they were produced by its re-entry. It was observed that the re-entry phenomenon occurred at low rates. This arrhythmia even persisted after the permanent pacing and was successfully suppressed by procainamide in both cases.

Aged↗
PubMed1976

Assessment of left ventricular function by indices derived from aortic flow velocity.

The velocity and acceleration of aortic blood flow were measured by means of a catheter velocity probe in 40 patients during routine diagnostic cardiac catheterization. Ten different variables were derived from the aortic velocity measurements, and their ability to discriminate between good and bad left ventricular (LV) function was tested. By means of eight conventional indices of LV function derived from pressure, mean flow, and quantitative cineangiography, the patients were divided into 3 groups: group 1, good LV function; group 2, moderate LV function; group 3, poor LV function. Aortic peak velocity and maximal acceleration correlated well with stroke volume and were thus indices of LV pump function. Aortic peak velocity also showed a significant correlation with LV stroke work. Both aortic peak velocity and maximal acceleration failed to discriminate between the three groups of patients, and correlated poorly with conventional indices of LV function. The mean values of stroke volume differed significantly between groups 1 and 2, and between groups 1 and 3, and also correlated better with the conventional functional indices. The best discrimination between normal and abnormal LV function was provided by dividing stroke volume by maximal acceleration, but stroke volume divided by peak velocity discriminated better than stroke volume alone. Stroke volume divided by maximal acceleration also gave more significant individual correlations with the conventional functional indices than did any other variable derived from aortic velocity.

Adult↗
PubMed1976

Haemodynamic alterations of the left ventricle during right atrial pacing.

The left ventricular haemodynamic alterations during right atrial pacing were studied in 12 cases. Cardiac index varied little: during maximal rate however, its mean value was slightly lower than the resting one. Stroke index decreased inversely to the heart rate. The course of these indices did not separate the normal from abnormal cases. Ventricular function curves (VFCs) were constructed by relating the changes of left ventricular (LV) end-diastolic pressure (EDP) to those of stroke index (SI). In 4 normal cases the curves were steep, showing a fall of EDP with relatively large decrease of SI; in 3 cases of congestive myocardiopathy they were flat, showing fall of EDP in two and increase in one, with relatively small decrease of SI; in 5 patients with effort angina LVEDP initially decreased. This initial fall of VFCs was steep in two with normal and flattened in three with impaired resting LV function. Increase of EDP, evidently due to development of ischaemia, followed in all; it exceeded resting EDP in two out of three cases developing angina and in one out of two not developing angina. Our findings support the view that the increase of LVEDP is due to decrease of both myocardial contractility and compliance.

Adult↗
PubMed1976

Mechanical alterations of the left ventricle during right atrial pacing.

The effect of increasing heart rate by right atrial pacing on the peak value of the first derivative of left ventricular (LV) pressure(dp/dt) and the maximal velocity of the contractile element (KVmax) was studied in 12 cases. Peak dp/dt was poor as regards its sensitivity in reflecting the changes of contractility, due to its strong dependence on LV end-diastolic (EDP) and systolic pressure. KVmax increased constantly in the 4 normals and in 2 cases of ischaemic heart disease which did not develop angina; the increase exceeded 90 ml sec-1 in the former and one of the latter cases in which resting LV function was normal. In contrast, it decreased during the development of ischaemia in two of the three cases which developed angina; in the third case, in which also resting LV function was seriously impaired, the course of KVmax was almost flat. A similar flat course was observed in the three cases of congestive myocardiopathy. the above alterations of KV max were independent of the EDP and proportional to the basic contractility and its anticipated changes during pacing.

Adult↗
PubMed1975

The significance of intraventricular electrocardiogram in artificial heart pacing. Observations made on 232 patients.

From 1972-1975, 232 consecutive patients suffering from A/V block were paced intravenously in the Cardiac Department. Medical School, University of Athens. Of these, 124 were female and 108 male. Their age range was between 49 and 85 years. Besides fluoroscopic and threshold control, the intraventricular electrocardiogram (E.C.G.)., recorded from the tip of the electrode, was used as a guide for the accurate positioning of the catheter-electrode in the right ventricle. An injury pattern with an elevation of the ST segment of at least 3 mV and characteristic and steady morphology was obtained when the electrode tip was satisfactorily impacted in the right position. As a consequence of this, an initial stimulation threshold below 0.7 mA was obtained in all cases and pacing failure, due to catheter displacement was noted in only 11 cases (5%), without any apparent increase in the incidence of right ventricular perforation.

Action Potentials↗