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Biomedical subjects

S Popnikolov

Publications and source records attributed to S Popnikolov.

At least 19 recordsLinked to original sources
PubMed1991

[The drug treatment of cardiogenic shock--our experience].

For the period 1970-1989 in the intensive care unit of the National Center for Cardiovascular Diseases, 178 patients with cardiogenic shock were treated and died. These patients were studied retrospectively. In all patients an acute myocardial infarction was proved clinically and post mortem. The patients were classified into two groups--group A--those treated during the period 1970-1975 and group B--those treated during the period 1985-1989. The analysis of the risk factors and the time of hospitalization since the onset of the clinical symptoms showed no differences between the two groups. In the therapeutic programme of group B new contemporary means and methods, such as dopamine, vasodilators and electrostimulation, were included. This accounts for the longer survival of the patients from this group (about 60% of the patients survived more than 24 h), which allows them a chance to overcome this fatal condition.

Aged↗
PubMed1989

[Changes in the hemoglobin A2 level of patients with ischemic heart disease].

40 patients with ischemic heart disease were studied. In 60% of them a higher content of HbA2 was found. These data for higher frequency of HbA2 among the patients with ischemic heart disease do not correspond with the average incidence of the genetically determined anomaly A2-beta-thalassemia among the Bulgarian population. The negative data for increased methemoglobin, the shift of the oxygen dissociation curve to the right toward increased oxygen release from the hemoglobin molecule, the normalization of HbA2 after several days, the lack of anomalous fraction in the analyses lead to the conclusion that HbA2 plays a compensatory role in patients with ischemic heart disease and its dynamic changes could be used as a diagnostic test for ischemia.

Adult↗
PubMed1987

[Choice of the effective electrical power in cardioversion].

On the base of his own studies, the author established that the effective quantity of electric energy for cardioversion is from 150 to 350 W/s. A greater quantity of energy (285.6 +/- 53.8 W/s) is necessary in patients with idiopathic cardiomyopathy than in patients with heart defects, ischemic heart disease and idiopathic rhythm disorder (273.72 +/- 49.1 W/s). In patients with mitral stenosis and prostheses, the quantity used is greater as compared with that in valvulotomized patients and those with mitral-aortic defect. In ventricular tachycardia the mean quantity of electric energy used for the restoration of sinus rhythm proved to be the smallest (182.9 +/- 37.5 W/s), followed by auricular fibrillation (229.5 +/- 40.7 W/s), paroxysmal supraventricular tachycardia (246.3 +/- 57.8 W/s) and auricular flutter--the most (278.8 +/- 51.7 W/s). A correlation has been established between height, body mass, chest measurement and the quantity of electric energy used. It has been proved that when the body mass is smaller then the difference between height and chest measurement, less quantity of energy is necessary for cardioversion, and when it is greater than that difference--the quantity of energy used is greater. The premedication with quinidine does not reduce the quantity of electric energy used.

Body Height↗
PubMed1986

[Electroshock (cardioversion) treatment problems in rhythm disorders].

Some problems associated with the results from the electroshock treatment of 1027 patients with rhythm disorders are discussed, as well as the choice of the necessary quantity of electric energy and the way of preparation of the patients. It was established, that sinus rhythm restoration was attained in 90.1% under planned conditions, and in emergency cases--in 86.9%. The highest percentage of positive results were obtained with atrial fibrillation (95.6), and the lowest--with paroxysmal supraventricular tachycardia (97.7). The results is identical (88%) with ventricular tachycardia and atrial flutter. The duration of the rhythm disorder is of importance for the result, being the best up to the third month after the origination of the disorder, but good results had been obtained with a longer duration. The quantity of energy from 200 to 300 W/s (median 250 W/s) was outlined as optimal. The mean quantity of electric energy used in atrial flutter was 278.8 +/- 51.7, in paroxysmal supraventricular tachycardia--246.3 +/- 57.8 in atrial fibrillation--229.5 +/- 40.7 and in ventricular tachycardia--182.9 +/- 37.5 W/s. The anticoagulant prophylaxis is carried out in the patients with a longer duration of the rhythm disorder, in the patients with heart defects and those with ischemic heart disease (with eventual aneurysm). There was a single pre-treatment with quinidine--0.20 or 0.40.

Aging↗
PubMed1986

[Clinico-hemodynamic changes in paroxysmal cardiac arrhythmias].

The stroke and minute volumes, according to the method of Fick and formula of Staar, were studied with a view to the necessity of objectivization of some hemodynamic indices for the needs of clinical practice. Based on the good results, obtained by the formula of Staar, the stroke volume was calculated according to the same mode in patients with rhythm disorders. The stroke volume was established to reveal a dependence on heart rate, type of rhythm disorder and character of the basic disease. The manifested clinical signs of congestive cardiac insufficiency originate at a certain cardical rate (different in atrial flutter and paroxysmal supraventricular tachycardia), the type of the basic disease being with the highest significance (myocardial state). A viewpoint is presented on the expedience of one universally accessible, non-invasive study on the hemodynamics of patients with paroxysmal disorders of cardiac rhythm.

Adult↗
PubMed1984

[Cardiological problems in pheochromocytoma patients].

The course of the disease of six cases with pheochromocytoma was analyzed in patients, aged from 19 to 65, with manifestations mainly of the cardiovascular system. The diagnosis was verified in five of them at necropsy and in one of them--intraoperatively. The arterial hypertension accompanied by distinct vegetative symptomatics were the basic clinical signs and in some of the cases--disturbances in the carbohydrate metabolism. In four patients the arterial hypertension was permanent, in two of them--with paroxysmal elevation opresf blood pressure. In the other two--with hypertonic crises on the background normal blood pressure. The duration of the hypertension--from a single hypertonic crisis during pheochromocytoma attack, had a lethal end, till the fifth year. In three of the patients rhythm disorders (supraventricular tachycardia or tachyarrhythmia) originated in a pheochromocytoma paroxysm and in three--acute left ventricular insufficiency (gallop rhythm, pulmonary edema). The clinical picture resembles heart defect, myocardial infarction with congestive cardiac insufficiency and rhythm disorders, renal insufficiency with symptomatic arterial hypertension and decompensated hypertonic heart, epilepsy, coggagenosis . The authors admit that the development of acute left ventricular failure in hypertonic patients, that could hardly be explained only by the increase of the heart afterloading (in advanced age, not enlarged and no data about grve heart lesions) or the origination of severe rhythm disorders, not coped by the modern antirhythm agents, are signs, indicating, the existence of pheochromocytoma. The catecholamine affection of myocardium, that was found in three of the deceased patients, very likely, contributes to the origination of left ventricular failure.

Adrenal Gland Neoplasms↗
PubMed1982

[Determination of the effect of furanthril on myocardial infarct lesion size according to precordial electrocardiogram (mapping) and enzyme activity findings].

The ECG Mapping from 30 precordial points in 56 patients with recent anterior transmural infarctions was followed up as well as the level of the enzymes, acid phosphokinase, SGOT and LDH-iso during the first 6 days after the origination of the cardiac infarction. Thirty six patients were treated according to the generally adopted treatment schedule of cardiac infarction (group without furanthril) and 20 patients were administered, in addition to the generally adopted schedule, one tablet furanthril daily during the first six days (group with furanthril. Though no manifested discrepancies were observed in the indices studied in both groups (without and with furanthril)--in patients administered furanthril systematically--a better manifested drop was found in ECG Mapping indices and the enzyme activity in the course of the cardiac infarction, as compared with the group without furanthril. In some of the cases that tendency was with a statistical significance. According to clinical data, extensive lesion of myocardium and cardiac rupture were more frequently found in the group without furanthril whereas grave rhythm disorders were more frequent in the group with furanthril. The systematic administration of furanthril, in the first several days after the origination of the cardiac infarction, revealed some favorable tendencies in its course (possible restriction of lesion zone according to ECG Mapping data, restriction of necrosis according to enzyme activity data), but, at the same time, the unfavourable arrhythmia became more frequent, necessitating the control of rhythm and electrolytes as well as timely antirhythm treatment.

Aged↗
PubMed1981

[Effect of korvatone on hemodynamics in the acute stage of myocardial infarct].

The pressure in pulmonary and brachial arteries, cardiac output and the period of isovolumetric contraction of left ventricle were measured prior to and by 15, 30 and 60 min post 4 mg corvaton sublingual administration in 20 patients with acute cardiac infarction by the third day after the disease onset (12--with normal diastolic pressure in pulmonary artery--under 1.87 kPa (14 mm Hg)--group I and 8--with elevated pressure--group II). The mean pressure in brachial artery was established to decrease more pronouncedly in group I (from 12.24 +/- 1.79 kPa (91.8 +/- 13.4 mm Hg to 10.45 +/- 1.61 kPa/78.4 +/- 12.1 mm Hg)--p less than 0.002) than in group II (from 11.96 +/- 1.49 kPa (89.11.2 mm Hg) to 11.22 +/- 1.32 kPa (84.2 +/- 9.9 mm Hg)--p less than 0.10). Heart rate was slightly accelerated in group I (from 83.6 +/- 6.21. min1 to 89.8 +/- 20.8.min-1--p less than 0.05) and in group II--an initial tendency to slow down (from 80.7 +/- 20.0.min-1 to 76.7 +/- 20.7.min61 beats, every 15 min, p less than 0.025). The pressure in pulmonary artery was slightly decreased in group I (average pressure--from 1.93 +/- 0.28 kPa (14.5 +/- 2.1 mm Hg) to 1.64 +/- 0.37 kPa (12.3 +/- 2.8 mm Hg, p less than 0.01), the decrease in group II was more manifested [average--from 3.96 +/- 0.61 kPa (29.7 +/- 4.6 mm Hg) to 3.29 +/- 0.77 kPa (24.7 +/- 5.8 mm Hg)--p less than 0.002 and diastolic--from 2.80 +/- 0.53 kPa (21.0 +/- 4.0 mm Hg) to 2.45 +/- 0.69 kPa (18.4 +/- 5.2 mm Hg)--p less than 0.01]. Those changes were accompanied by manifested reduction of cardiac index (from 3.02 +/- 1.06 to 2.47 +/- 0.61 1/min/m2, p less than 0.025), stroke index (from 36.2 +/- 10.4 to 29.1 +/- 6.9 cm3/m2, p less than 0.01) and stroke working index (from 42.1 +/- 14.7 to 29.2 +/- 9.0 g.m/m2, p less than 0.001) in group I, whereas in group II those indices under went no substantial changes (cardiac index--from 1.96 +/- 0.62 to 1.89 +/- 0.53 l/min/m3, stroke index--from 27.6 +/- 9.7 to 27.6 +/- 9.8 cm3/m2 and stroke working index--from 25.3 +/- 10.8 to 24.1 +/- 9.6 g.m/m2, p less than 00,1). The systemic vascular resitence and delta P/delta T of the left ventricle did not change in both groups (p less than 0,01). The changes in the hemodynamics developed gradually and were best manifested by the 60 min, but 50 per cent of the maximum effect was realized as early as the 15th min. Corvaton, was concluded, by the authors, to be useful in the treatment of the originated stasis cardiac insufficiency in those patients.

Antihypertensive Agents↗
PubMed1981

[Diagnostic value of the spatial velocity electrocardiogram in myocardial infarct].

The object of the study were 220 patients with a myocardial infarction, confirmed clinically, enzymatically and electrocardiographically. Seventeen indices were studied, processed via variation analysis with 8 sites of the infarction alterations. The results were compared with those in subjects with intact hearts, examined and described by the authors in another study with the aid of the same devices. The size of the maximum space velocity is most significantly decreased in all myocardial sites. The results, summed up for anterior and posterior-inferior sites are also presented. The sensitivity of some of the indices was determined as well as the correlation dependence with the level of serum creatine-phosphokinase. Highest proved to be the sensitivity of the maximum space velocity (100%), an index correlating with the level of serum creatine-phosphokinase between --0.60 and --0.64. Conclusions were drawn referring to some potentialities for a further application of the method.

Adult↗
PubMed1980

[Clinical characteristics, immediate therapeutic results and the outcome in rhythm and conductivity disturbances in myocardial infarct].

Certain rhythm and conduction disorders in 252 patients with myocardial infarction were studied. Twenty one of them had auricular fibrillation, influenced by medicaments, with the exception of one, six had relapses and 4 of the patients died. Ventricular extrasystoles (frequent, polytopic, more than three one after the other, R of T) were found in 48 patients. Regardless of the reported good result from the treatment of ventricular extrasystoles, ventricular tachycardia originated in 10 and ventricular fibrillation--in 9 patients. Ventricular fibrillation (a total of 29 patients) was more frequent in patients with cardiac insufficiency (25%) as compared with those (6.1%). With the combination of cardiac insufficiency and ventricular extrasystole, a very high risk group is formed--every third patient develops ventricular fibrillation. Four patient out of 22 patients, were discharged with timely initiated treatment of the ventricular fibrillation. Complete atrioventricular block was recorded in 12 of the patients with a lethality of 50%. Conclusions are drawn as regards the duration of prophylaxis and treatment of rhythm and conduction disorders and in-patient days of the patients in the intensive care unit.

Aged↗
PubMed1979

[Treatment of cardiac insufficiency in the acute stage of cardiac infarct].

The studies on Strophantin effect upon the hemodynamics in the acute stage of cardiac infarction has revealed that it elevates the pressure in pulmonary artery and reduces the cardiac output, in certain cases deteriorating the patient's state. Furanthril and Droperidol reduce the cardiac output but at the same time diminish the pressure in the pulmonary artery and reduce the pulmonary resistance, thus having a favourable effect on the patient's state. Proceeding from the results obtained, a treatment scheme, including Furanthril, Droperidol and Strophantin, is recommended for the cardiac insufficiency treatment in the acute stage of cardiac infarction depending on the disease onset and the degree of cardiac insufficiency manifested.

Acute Disease↗
PubMed1978

[Comparison of precordial electrocartography with pathologicoanatomic data on 20 patients with recent myocardial infarct].

In 20 patients with recent myocardial infarction, that died till the 40th day after the onset of the disease, a comparison is made of the data from the pathologoanatomical findings with the indices from the precordial electromapping. The changes in the ST segment of the precordial electromapping correlate, to a significant extent, to the weight of the infarction zone in patients with interior site of the myocardial infarction (sigmaST r = 0.89, p less than or equal to 0.01; nST r = 0.62, p less than or equal to 0.01). The indices from the precordial electromapping characterizing the changes in depolarization, are with a considerable less degree of correlation dependence to the weight of the enfarcted zone in the same patients (nQS r = 0.62, p less than or equal to 0.62, p less than or equal to 0.05; sigmaAR r/0.45, p less than or equal to 0.05). In patients with posterior and/or inferior site of the infarction the correlation dependence to the indices from the precordial electromapping is less manifested.

Adult↗
PubMed1978

[Precordial electrocartography (mapping) in cardiac infarct].

After a detailed literature survey the authors share the results from the precordial electromapping with the registration of 30 points upon the chest in 34 patients with ischemic heart disease (30 with transmural infarction and 4 with intermediary syndrome). The following indices were followed up: sigmaST (the sum of the elevation of ST segment measured at 60 msec of the S deflection recording) and the index nST (the sum of the points with an elevation greater than 0.1 mV/1 mm). Both indices well correlate to the level of blood creatine phosphokinase, determined 24 hours after the examination. Due to the close degree of correlation dependence, the two indices are interchangable for the practice. The precordial electromapping reflects the degree of extent of the "myocardial hypoxia" as well as the degree of the disturbed biological activity of the tissues, affected by the myocardial infarction.

Acute Disease↗