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Biomedical subjects

S N Tereshchenko

Publications and source records attributed to S N Tereshchenko.

At least 19 recordsLinked to original sources
PubMed2006

[Trimetazidine in complex therapy of acute myocardial infarction at the background of diabetes mellitus type 2.].

Patients (n=52) with acute myocardial infarction (MI) and diabetes mellitus type 2 older than 18 years were distributed within first 24 hours of MI into 2 groups. In patients of group 1 (n=28) standard therapy was supplemented with trimetazidine (70 mg/day) for 30 days, patients of group 2 received only standard therapy. The following parameters were assessed: rate of recurrent MIs, inhospital mortality, dynamics of MB CR, rate of development and progression of heart failure, dynamics of brain natriuretic peptide, parameters of echocardiogram. Mortality in group 1 at the background of thrombolytic therapy (TLT) was 5.9% (n=1) what was significantly lower than in group 2 where this parameter was equal to 35.7% (n=5), p=0.006. A tendency was noted to lowering of rate of recurrent MIs (17.6 and 21.4% in groups 1 and 2, respectively). Analogous parameters did not differ significantly between subgroups of patients not treated with TLT. In group 1 significant 31% lowering of MB CK level was noted in TLT treated patients. In group 2 level of MB CK after 27-30 hours significantly increased by 30.16% compared with initial level (p=0.001). At analysis of analogous parameters in subgroups not treated with TLT significant differences were not obtained. There were no significant differences between groups according to echocardiography data, however ejection fraction in group 1 was 12.6% higher than in group 2 (p>0.05).

Acute Disease↗
PubMed2006

[Brain natriuretic peptide in patients with ST segment elevation myocardial infarction. Prognostic significance].

AIM: To study changes in the level of brain natriuretic peptide (BNP) in patients with ST segment elevation myocardial infarction (MI) to assess prognostic value of this marker and validity of its use as a criterion of therapy effects. MATERIAL AND METHODS: The trial enrolled 217 patients (102 males and 15 females, mean age 63.96 +/- 0.73 years) admitted to hospital on MI day 1. Plasmic level of BNP (Nt-proBNP) was measured 1, 7, 21 days, 8 weeks and 6 months after MI. RESULTS: The severity of chronic cardiac failure (CCF) correlated with peptide content in the blood: it was by 46.6% higher in patients with chronic heart failure (CHF) functional class (FC) IV than in those with CHF FC I (p = 0.047), in FC III by 27.5% higher (p = 0.003) and in FCII--by 13.1% (p = 0.485). Initially high levels of BNP correlated with early development of CHF (R2 = 0.9058), with hospital lethality (in the deceased--1040.0 +/- 65.8 fmol/ml, in the survivors--461.4 +/- 26.2 fmol/ml, r = 0.35, p < 0.001) and overall lethality. A more pronounced decrease in the peptide level was seen in patients after 3 week intake of beta-adrenoblocker esmolol than in those who did not take it (by 125.2 vs 74.1 fmol/ml, respectively, p < 0.05). By BNP level, efficacy of perindopril vs captopris was studied (group 1 and group 2, respectively), in patients with ejection fraction under 40%. Initially, BNP levels were elevated and did not differ among the groups. On MI week 8 there was a decrease in the level of BNP by 25.4% (p = 0.004), 19.1% (p = 0.06) in groups 1 and 2, respectively. Six months after MI patients of group 1 had normal levels of BNP (up to 269.6 +/- 18.3 fmol/l). CONCLUSION: Measurements of BNP levels are useful for prediction of poor prognosis in MI patients and evaluating efficacy of the treatment.

Adult↗
PubMed2006

[Comparative efficacy of carvedilol and capoten in the treatment of an uncomplicated hypertensive crisis].

AIM: Efficacy and tolerability of carvedilol vs captopril were studied at 24-h monitoring of blood pressure (BP) in hypertensive patients with an uncompletated hypertensive crisis (HC). MATERIAL AND METHODS: The trial included 43 patients (23 males and 20 females aged 58 +/- 4.1 years) with an uncomplicated HC (duration of hypertension 9.4 +/- 1.1 years). Twenty patients of group 1 received oral carvedilol (25 mg), 23 patients of group 2--oral captopril (25 mg). The criterion of efficacy was a 15-25% decrease of BP within 60-120 min. RESULTS: Attenuation of HC symptoms and tolerability was the same in both groups. Forty five minutes after the drug intake systolic pressure lowered by 11.1% (p = 0.039) and 10.9% (p = 0.042) in group 1 and 2, respectively; diastolic pressure--by 14.9% (p = 0.037) and 17.9% (p = 0.018), respectively. Heart rate diminished significantly only in group 1 (by 10.9%, p = 0.043) 30 min after carvedilol intake. A maximal BP fall in group 1 occurred 180 min after the drug intake: systolic by 23.5% (p = 0.0001), diastolic by 26.9% (p < 0.0001). In group 2 the BP fall was 23.3% (p < 0.0001) and 29.1% (p < 0.0001) on min 165 and 150, respectively. Systolic and diastolic pressures lowered faster in group 1. The effect of carvedilol lasted longer--372.6 +/- 19.3 min and 245.1 +/- 13.7 min, respectively, p = 0. 0001. CONCLUSION: A hypotensive effect of carvedilol and captopril in hypertensive patients with an uncomplicated HC was the same. Carvedilol produced a longer and a more stable effect.

Administration, Oral↗
PubMed2006

[Special features of pathogenesis and pharmacotherapy of chronic heart failure in women].

At present in Europe number of deaths due to diseases of cardiovascular system in women has exceeded number of deaths in men. It has been established that process of cardiac remodeling proceeds differently in women and men. This determines different prognosis of the course of chronic heart failure. So after acute myocardial infarction in women more often develops chronic heart failure with preserved systolic left ventricular function while in men prevails chronic heart failure with systolic dysfunction. Substantial differences exist in efficacy of pharmacotherapy: for instance thrombolysis in women is less effective than in men, women are less sensitive to angiotensin converting enzyme inhibitors, administration of digoxin, some antiarrhythmic drugs cause complications in women more often than in men.

Adrenergic beta-Antagonists↗
PubMed2005

[The use of esmolol in patients with myocardial infarction complicated with acute left ventricular failure].

Forty patients with acute Q-wave myocardial infarction and Killip class I-II heart failure were randomized to treatment with esmolol (n=22) or just to standard therapy (n=18) and followed up for 30 days. Esmolol treated patients had significantly lower in-hospital mortality (p<0.02), less frequently had postinfarction angina (p<0.05) and heart failure progression (p<0.01) and demonstrated significant decrease of brain natriuretic peptide level (by 25%, p<0.05). Incidence of heart rhythm disturbances and values of parameters of echocardiogram were similar in both groups.

Adrenergic beta-Antagonists↗
PubMed2002

[Polymorphism of the ACE gene, structural-functional state of the left ventricle in patients with post-infarction cardiac failure and effects of the ACE-inhibitor Perindopril].

AIM: To evaluate relationships between structural-functional state of the left ventricle (LV) and genotype of angiotensin converting enzyme (ACE) gene in patients with postinfarction chronic cardiac failure (CCF) and effects of ACE inhibitor perindopril on hemodynamics depending on ACE gene polymorphism. MATERIAL AND METHODS: In 52 patients with CCF (functional class III-IV by NYHA criteria) who had survived macrofocal myocardial infarction we studied ACE gene using thermostable DNA-polymerase Taq. Isolation of genome DNA from human venous blood was made by phenolchloroform extraction with the use of chelate polymer Chelex-100. Polymerase chain reaction was conducted on amplificator PHC-2 or PolyChain II. LV contractile function was studied on echocardiograph "Toshiba SSH-160A (Japan). Echocardiography was performed before intake of perindopril, in the end of titration phase, on therapy month 6 and 12. RESULTS: Genotype II of ACE gene was detected in 11(21.1%) patients, ID genotype--in 20(38.5%), DD genotype--in 21(40.4%). Patients with ACE gene genotype II and ID have no differences by parameters of central hemodynamics. They were divided into two groups: group 1--patients with genotypes II and ID of ACE gene, group 2--patients with genotype DD. End diastolic volume (EDV), end systolic volume (ESV), index of LV myocardial mass were significantly less in group 1 than in group 2 (by 45.7, 81.6 and 31.2%, respectively). In group 1 ejection fraction (EF) and %delta S were higher by 35.3 and 35.7%, respectively. The hemodynamic effect of perindopril was higher in group 2. A month therapy resulted in a 8.7 and 14.8% reduction in group 2 EDV and ESV, respectively (p < 0.05). This entailed an increase in EF and %delta S by 18.3% (p < 0.05) and 19.8% (p < 0.05). Later, perindopril retained influence on central hemodynamics. Diastolic function to the end of therapy in both groups differed insignificantly. CONCLUSION: In CCF patients functional class III-IV with the history of myocardial infarction, structural-functional LV parameters depend on genotype of ACE gene. Perindopril is most effective in DD-genotype of ACE gene.

Aged↗
PubMed2001

[Hypotension followed the first dose of angiotensin-converting enzyme inhibitor in patients with heart failure (a multicenter clinical trial)].

AIM: To study the hypotensive effect of the first dose in administration of perindopril and enalapril in patients with chronic cardiac failure (CCF). MATERIAL AND METHODS: The trial enrolled 213 patients with CCF of functional class II-III (mean age 57 +/- 1.4 years, 155 males and 58 females). The patients were randomized into 2 groups. Group 1 received perindopril in a dose 2 mg, group 2 received enalapril. Arterial pressure was measured for 10 hours with a 30-min interval, in the last 3 hours--once an hour. First dose hypotension was stated if systolic pressure was < 90 mmHg, diastolic under 60 mmHg, mean pressure < 75 mmHg after the first intake of the drug. RESULTS: Significant differences in the baseline pressure between the groups were absent. None of the patients demanded therapy of arterial hypotension. Side effects of hypotension were absent. In group 1 systolic pressure fell under 90 mmHg in 8(7.7%) patients, in group 2--in 24(22.0%) patients (p = 0.004), diastolic pressure fell under 60 mmHg in 47(45.2%) and 60(55.1%) patients, respectively (p = 0.151). Mean arterial pressure was < 75 mmHg in 42(40.4%) and 62(56.9%) patients, respectively, (p = 0.016). Multivariate correlation analysis has revealed a direct correlation between the first dose hypotension and age (r = 0.159, p < 0.01) and age > 70 years (r = 0.258, p < 0.01), acute myocardial infarction (r = 0.244, p < 0.01) and inverse correlation with the initial arterial pressure (r = -0.208, p < 0.01).

Angiotensin-Converting Enzyme Inhibitors↗