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Biomedical subjects

R S Karpov

Publications and source records attributed to R S Karpov.

At least 19 recordsLinked to original sources
PubMed2006

[Effect of 6-month therapy with simvastatin on lipid transport function of the blood and the state of endothelium in patients with diabetes and hypertension].

The state of lipid transport function of the blood, blood contents of stable nitrogen metabolites, and proinflammatory cytokines (TNF-a and IL-1b) during therapy with simvastatin were studied in 29 patients receiving combination antihypertensive therapy with angiotensin converting enzyme inhibitors (ACEI) and verapamil. Lipid lowering action of simvastatin was realized just in 1 month of treatment and remained sustained for half a year (average duration). 6 months after addition of simvastatin to antihypertensive therapy substantial (58.4%, p=0.044) rise of plasma content of stable nitrogen metabolites took place. At the same time therapy with metoprolol in a similar group of patients exerted no considerable effect on blood plasma concentration of nitrate and nitrite anions. Lowering of median values of TNF-alpha from 20.13 (12.67-52.80) to 11.34 (3.31-31.29) pg/ml (p<0.0038) was also noted at the background of combination antihypertensive therapy. This happened without distinct affair with degree of lipid lowering action of simvastatin. The results of the study document positive effect of half year treatment of patients with concomitant hypertension and diabetes with simvastatin (10-20 mg/day) in combination with ACEI and verapamil on metabolism of nitric oxide and plasma content of TNF-alpha which realizes independently from degree of hypolipidemic action of simvastatin.

Biomarkers↗
PubMed2006

[The clinical conditions of the manifestation of hyperinsulinemia in patients with coronary heart disease].

The purpose of the study was to determine the conditions under which hyperinsulinemia (HI) is manifested in patients with coronary heart disease (CHD). Such factors as clinical manifestations of CHD, coronary atherosclerosis severity, and myocardial dysfunction severity, were taken into account. The subjects were 201 men aged 47.3 +/- 1.5 years, suffering from CHD. The condition of coronary and intracardial hemodynamics, as well as insulin and glucose blood levels were compared, and correlations between these parameters and the stage, severity, and type of coronary insufficiency (CI) were studied. Two clinical groups were formed. Group I consisted of 74 CHD patients with no myocardial infarction (MI) background; group II consisted of 127 patients with postinfarction myocardial dysfunction (PIMD). Subgroups of patients with acute coronary syndrome (ACS), including subjects with newly developed stenocardia (NDS) and subjects with progressive stenocardia (PS), were formed. In all cases of ACS the basal insulin levels were increased: by 197.4% in patients with NDS, by 167% in patients with PS and no MI background, and by 114,3% in PIMD subgroup (p < 0.05). Some of the ACS patients developed a short-term moderate hyperglycemia (up to 7 mmol/l), that was coped with after 1 to 3 days of antischemic therapy and protective therapeutic regimen. The extent of HI correlated with the severity of coronary atherosclerosis as well as the degree of intracardial and coronary hemodynamic disturbances, and myocardial dysfunction. The results show that HI in CHD patients manifests itself under the condition of CI progression and may be used as a diagnostic marker of residual myocardial ischemia; the degree of HI at different stages of the disease is determined by the severity of CI and myocardial insufficiency, as well as, probably, by the organism's compensatory capacity.

Adult↗
PubMed2006

[Phenazine methosulfate system-induced membrane hyperpolarization in the human erythrocytes].

Erythrocyte membrane potential was recorded via measurement of pH of the incubation medium in presence ofprothonophore. The increase of intracellular calcium concentration in presence of calcium ionophore A23187 and addition of the artificial redox-system ascorbate-phenazine methosulfate led to membrane hyperpolarization due to opening of Ca(2+)-activated potassium channels that are regulated by multiple signaling pathways. The opening of the Ca(2+)-activated potassium channels in presence of artificial redox-system ascorbate-phenazine methosulfate is mediated at least by two mechanisms including an increase in affinity of channels to calcium ions and involvement of the protein SH-groups and the components of the respiratory circuit which have beer found in erythrocyte membrane.

Ascorbic Acid↗
PubMed2006

[The influence of hyperventilation in combination with active orthostasis on the condition of vegetative homeostasis in young men with atherosclerosis risk factors and endothelial dysfunction].

The aim of the study was to evaluate the effects of hyperventilation test (HVT), active orthostatic position test (AOPT), and their combination on the vegetative homeostasis in male students with risk factors of atherosclerosis (RFA) and endothelial dysfunction (ED). The mentioned tests and their combination were performed in 142 male students with RFA and ED, and 54 male students without them during brachial arterial rheovasography and cardiointervalography. Hyperactivation of the central regulatory circuit and a spastic hemodynamic condition at rest were found in subjects with FRA and ED. The sympathetic functional reserve was overstrained according to AOPT, distinctly decreased according to HVT, and exhausted when both tests were performed. The combination of HVT and AOPT is an informative stress test for pre-clinical evaluation of disturbances in adaptation mechanisms and vegetative homeostasis tensity in young men with RFA and ED. A "high value" of adaptation and the vegetative homeostasis overstrain in male students with FRA and ED indicate a premorbid condition in them.

Adolescent↗
PubMed2006

[The long-term results of coronary artery bypass grafting in patients with type II diabetes].

A three-year follow-up of patients with coronary heart disease (CHD) and type II diabetes after coronary artery bypass grafting, shows that the following pathologic conditions are significantly more frequent: arterial hypertension, visceral obesity, marked disturbances of blood lipid spectrum, an increases CHD duration, and an increased rate of myocardial reinfarction and revascularizations. The study shows that the presence of diabetes mellitus in CHD patients undergoing coronary artery bypass grafting, is associated with pronounced disturbances in blood lipid spectrum, and is an important risk factor of coronary event progression.

Coronary Artery Bypass↗
PubMed2006

[Possible role of hyperinsulinemia in pathogenesis of acute and chronic cardiac failure in patients with ischemic heart disease (data of clinical studies)].

Changes of blood insulin content were studied in patients with ischemic heart disease with various functional classes of acute and chronic heart failure and at different disease stages. It was established that latent hyperinsulinemia which became evident at induced myocardial ischemia was present on all stages of development of ischemic heart disease. In acute heart failure due to developed myocardial infarction hyperinsulinemia manifested in 58.3% of patients. Amount of insulin in blood increased almost 3 times. During progression of chronic heart failure insulin content significantly decreased, probably because of exhaustion of insulin producing function and development of its relative or absolute deficit. At terminal stage of congestive heart failure insulin level was < or = 1 microU/ml. The authors believe that severity of clinical signs of acute and chronic heart failure are determined by sensitivity of myocardium to insulin, content of insulin in blood, and also depends on compensatory possibilities of insulin producing function at each stage of development of the disease.

Acute Disease↗
PubMed2006

[Preclinical assessment of disturbances of vascular and vegetative reactivity of peripheral blood circulation in young men (students) with risk factors of atherosclerosis].

Hemodynamics of forearm and neurovegetative status were studied in 142 clinically healthy male students with risk factors of atherosclerosis and in 54 male students without risk factors of atherosclerosis at rest and during test with reactive hyperemia. Rheovasography of forearm, cardiointervalography, Doppler examination of brachial artery, and test with reactive hyperemia were undertaken in all subjects. The results testify to the fact that endothelial dysfunction leads to spastic state of regional hemodynamics and hyperactivity of sympathetic nervous system at rest as well as during reactive hyperemia which has a "delayed" character.

Adolescent↗
PubMed2006

[Clinical experience of the use of autologous mononuclear bone marrow cells in patients with ischemic heart disease and dilated cardiomyopathy].

Between March 2003 and February 2005 cell therapy with mononuclear bone marrow cells (MBMC) was used in 38 and 4 patients with ischemic heart disease and dilated cardiomyopathy, respectively. Intracardiac administration of MBMC (87+/-12 millions) was carried out during coronary artery bypass surgery and/or left ventricular aneurysm resection (n=25) or in cardiac catheterization laboratory (n=17). For verification of cells fixation they were labeled with "Ceretec" 99mTc-HMPAO. Accumulation of labeled cells after 24 hours was 1.6+/-0.001%. After 6 months parameters of intracardiac hemodynamics and transitory myocardial perfusion defects improved significantly in all patients with ischemic heart disease.

Adult↗
PubMed2006

[Dynamics of left ventricular longitudinal function in patients with arterial hypertension during therapy with angiotensin converting enzyme inhibitor moexipril].

AIM: To assess left ventricular longitudinal systolic and diastolic function in patients with arterial hypertension in whom regression of left ventricular (LV) hypertrophy (LVH) occurred at the background of long term therapy with angiotensin converting enzyme inhibitor moexipril and hydrochlorothiazide. MATERIAL AND METHODS: Analysis was fulfilled in 44 patients (age 51.76+/-5.58 years) with regression of concentric LVH after 12 months of therapy. Complex examination included tissue Doppler imaging of myocardium and 24-hour blood pressure monitoring. RESULTS: Decrease of myocardial mass (mean 60.26+/-35.92 g) was accompanied with positive dynamics of parameters of 24-hour blood pressure monitoring. We observed decrease of ivrtm from fibrous annulus of mitral valve at the site of interventricular septum, posterior, inferior, and anterior LV walls--in 38 patients (86.4%); increase of motion velocity of mitral valve fibrous annulus during early LV filling at the site of interventricular septum, inferior and lateral LV walls--in 32 patients (72.72%); elevation of systolic velocity of mitral valve fibrous annulus movement at the site of interventricular septum-- in 21 patients (47.73%), and at the site of LV posterior wall--in 28 patients (63.64%). In 35 patients (79.54%) number of segments with e/a <1.0 decreased from 11.41+/-4.42 to 7.92+/-2.81 (p=0.01). In 39 patients (88.64%) number of segments with ivrt >90 ms decreased from 12.73+/-3.67 to 7.33+/-3.54 (p=0.008). In 34 patients (77.27%) regression of LVH was accompanied with elevation of systolic velocity in basal and middle segments of lateral and inferior left ventricular walls.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2006

[Cardiomyoplasty with autological mononuclear cells of the bone marrow in patients with acute myocardial infarction].

AIM: To study efficacy and safety of transplantation of bone marrow autologous mononuclear cells (BMAMC) in patients with acute myocardial infarction; to examine BMAMC distribution in the human body after intracoronary introduction. MATERIAL AND METHODS: The open controlled trial investigated 26 AMI patients (16 entered the study group and 10 were controls). Cell cardiomyoplasty with BMAMC was performed by intracoronary injection of the cells after stenting the coronary artery supplying blood to the infarction zone on AMI day 7-21. BMAMC were isolated by gradient centrifugation. Distribution of mononuclear cells was studied with radionuclear indication of the cells 99m-Tc-HMPAO. All the patients were examined with Tl-199 perfusion scintigraphy of the heart 2 weeks and 6 months after the treatment, echocardiography, 24-h ECG monitoring, 6-min walk test. RESULTS: All the patients were followed up for 6 months. Two patients (one in each group) developed recurrent myocardial infarction 3 months after the first. Radionuclide investigations revealed fixation of labelled mononuclear cells in the heart both in initial hours after the treatment and 24 hours after it. As shown by myocardial scintigraphy, intracoronary administration of the cells with short-term arterial occlusion was followed by much greater number of labeled cells. By follow-up month 6, in the study group, left ventricular ejection fraction increased more: 12.7 +/- 3.2% versus 10.4 +/- 2.5% in the control group (p = 0.09); moreover, a stable defect of myocardial perfusion reduced more (by 29 +/- 24% against 20 +/- 18%, respectively, p = 0.1). Malignant arrhythmia, complications during and after bone marrow aspiration, intracoronary administration of cell suspension were not registered. CONCLUSION: Intracoronary administration of BMAMC in AMI patients is safe and provides their transfer and fixation in the myocardium. BMAMC transplantation has a positive effect on recovery of perfusion and contractile function of left ventricular myocardium in AMI patients.

Bone Marrow Cells↗
PubMed2005

Effect of insulin on NO production by monocytes from patients with metabolic cardiovascular syndrome.

Basal and insulin-induced production of NO by monocytes significantly increased in patients with metabolic cardiovascular syndrome. Plasma insulin concentration in these patients was below the control. No intergroup differences were found in C-peptide concentration. A negative correlation was revealed between insulin-induced NO production by monocytes and C-peptide/insulin ratio in patients. The role of monocytes on the regulation of vascular tone via NO production in patients with metabolic cardiovascular syndrome is discussed.

Humans↗
PubMed2005

Effect of insulin on Ca(2+)-dependent hyperpolarization in erythrocytes from healthy donors and patients with type 2 diabetes mellitus accompanied by arterial hypertension.

Insulin decreased A23187-induced hyperpolarization of the erythrocyte membrane in healthy donors. These data indicate that insulin plays a role in the regulation of Ca(2+)-activated potassium channels in human erythrocytes. However, insulin had little effect on hyperpolarization response of cells induced by artificial ascorbate--phenazine methosulfate donor-acceptor system. Addition of insulin to cell suspension from patients with type 2 diabetes mellitus did not modulate hyperpolarization of the erythrocyte membrane induced by A23187 or ascorbate-phenazine methosulfate, which reflects impairment of regulatory mechanisms for Ca(2+)-activated potassium channels in erythrocytes.

Arteries↗
PubMed2005

[Segmental left ventricular function in patients with syndrome X].

Impulse tissue Doppler study of the left ventricle was carried out in 44 patients with cardiac syndrome X (age 47.15+/-6.27 years) and 46 healthy volunteers aged 35-55 years. Maximal peak velocities "s", "e", "a", "e/a" ratio and segmental isovolumic relaxation time "ivrt" were evaluated for each of 18 selected left ventricular segments. Criteria of disturbed segmental diastolic left ventricular function were e/a ratio <1.0 and ivrt >85 ms. Left ventricular filling was abnormal (E/A (min) <1.0) in 18 (40.9%) patients all of whom had segments with e/a <1.0. According to e/a values 18 of 26 patients (69,23%) with E/A (min) >1.0 had segmental dysfunction while 8 patients (30,77%) had intact segmental diastolic function. Patients with and without segmental diastolic dysfunction had different exercise tolerance, nocturnal blood pressure fall, blood levels of glucose and low density lipoprotein cholesterol. Patients with abnormal (IVRT >90 ms) and normal (IVRT 40-80 ms) left ventricular relaxation had similar numbers of dysfunctional segments. Patients with IVRT 80-40 ms and with (n=21) or without (n=4) disturbances of segmental relaxation had different age, left ventricular myocardial mass index and magnitude of myocardial hypoperfusion.

Adult↗
PubMed2005

[Hyperinsulinemia in patients with microvascular coronary artery lesion as a possible diagnostic criterion of coronary heart disease].

The purpose of the study was to investigate the character of clinical and functional manifestations of ischemic cardiac dysfunction in patients with idiopathic coronary microangiopathy, and their correlation with insulin level, as a possible diagnostic criterion of coronary heart disease (CHD). The subjects were 115 men, including 35 individuals (mean age 41.8 +/- 1.2 years) with microvascular form (MVF) of coronary artery lesion, 60 patients with CHD with postinfarction cardiosclerosis (PICS), and 20 healthy individuals. Patients with glucose tolerance disorder, diabetes mellitus, arterial hypertension, and other severe pathology were not included in the study. The diagnostic tests included selective coronaroventriculography with right ventricle endomyocardium biopsy, and myocardial perfusion scintigraphy. Parameters of coronary, intracardial and system hemodynamics were evaluated; insulin and glucose serum levels were measured at rest and during stress-tests with physical exercise. Endocardial biopsy in MVF patients found plastic insufficiency of the endothelium of hemocapillars, prearteriols and cardiomyocytes. Alterations in the parameters of metabolism, intracardial and system hemodynamics, and physical exercise tolerance were found to be comparable in MVF and PICS patients. Insulin level at rest in both groups was equal to that in the control group. At threshold physical load during veloergometry insulin levels in MVF and PICS patients demonstrated comparable elevation (222.8% and 201%, respectively; p < 0.05-0.01). Glucose concentrations in patients with microangiopathy decreased by 28% (p < 0.05), while in patients with CHD it increased significantly by 27.3% (p < 0.05). The study shows that structural and functional lesion of hemocapillar endothelium underlies cardiac syndrome X It results in perfusion ability impairment, chronic hypoxia, impairment of myocardial contractility under the conditions of physical activity. Hyperinsulinemia, manifesting when ischemia is induced, is not caused by insulinresistence. Probably, it presents and adaptive and compensatory reaction to increase of myocardial glucose requirement, and may be one of early CHD markers.

Adult↗
PubMed2005

[Revascularization interventions in the left coronary artery system: transesophageal Doppler ultrasound study].

AIM: To elucidate the role of evaluation of coronary reserve in coronary sinus by transesophageal doppler for assessment of efficacy of various revascularization interventions. MATERIAL AND METHODS: Patients with isolated stenoses of either left anterior descending or circumflex coronary artery subjected to stenting (n=14) and with two vessel disease subjected to bypass surgery (n=20). Dipyridamole was used as a stress agent. Coronary reserve was calculated as ratio of peak hyperemic to baseline antegrade coronary sinus blood flow velocity (CR(P)) and as ratio of hyperemic to baseline antegrade coronary sinus volume blood flow (CR(VBF)). RESULTS: In patients with atherosclerotic lesions in the system of left coronary artery normalization of CR(P) after stenting of single vessel stenoses and of CR(VBF) after bypass surgery in two vessel disease were markers of efficacy of revascularization with sensitivity 75 and 71%, respectively.

Coronary Artery Bypass↗
PubMed2005

[Transesophageal and transthoracic ultrasound study of coronary arteries in diagnosis of atherosclerosis and assessment of coronary reserve].

The lecture deals with methodological aspects and diagnostic potential of the use of novel ultrasound technologies -- transesophageal and transthoracic doppler ultrasonography of coronary arteries for noninvasive assessment of coronary blood flow and coronary reserve. It contains detailed description of technique of visualization of coronary arteries from transesophageal and from transthoracic approaches and interpretation of dopplero-graphic parameters of laminar and turbulent coronary flows. Diagnostic role of the use of contrast echo imaging of coronary arteries is also discussed and dopplero-graphic criteria of occlusion and hemodynamically significant coronary artery stenosis as well as characteristics of normal and lowered coronary reserve are presented.

Coronary Artery Disease↗