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Biomedical subjects

T Daskalov

Publications and source records attributed to T Daskalov.

At least 19 recordsLinked to original sources
PubMed1995

Inhibition of atrial electrical activity by ventricular pacing mediated by vagal stimulation.

In the absence of retrograde (VA) conduction, ventricular pacing does not exert any appreciable effect upon atrial electrical activity. We report three patients (2 with complete AV block and 1 with preserved AV conduction) in which, during EP study, no VA conduction was present and, in spite of that, excessive suppression (for more than 15 secs in the first patient) of sinus (atrial) electrical activity during RV pacing was observed. The sinus node suppression was reproducible in two patients. In all patients the suppression phenomenon was not observed after intravenous administration of atropine, which suggests that it was mediated by enhanced vagal tone.

Adolescent↗
PubMed1990

[Hemodynamic correction of patients with acute myocardial infarct in hemodynamic subgroup III by plasma-exchange expansion with low-molecular dextran].

To 20 patients with acute myocardial infarction from the III hemodynamic group catheterized with a microcatheter or a balloon thermodilution catheter 332 (from 100 up to 500) ml of a 10% solution dextran 40 were infused intravenously with mean velocity of 33 ml/min. The cardiac index was measured by the dye or thermodilution methods. The left ventricular filling pressure (LVFP) increased with 47% (from 1.7 +/- 0.4 to 2.5 +/- 0.5 kPa), the cardiac index--15.8% (from 2.02 +/- 0.8 to to 2.34 +/- 0.37 l/min/m2), systolic and diastolic arterial pressure with 7.7%, stroke index--with 10.2% stroke working index--with 10.7%, total pulmonary resistance--with 37.9% (il all, p less than 0.001), cardiac rate--with 4.7% (p less than 0.05) but the systemic arterial resistance did not change (p greater than 0.10). The increase of the cardiac index for an increase of LVFP with I KPa was almost equal in the patients with different initial LVFP but was due mainly to the increase of the stroke index by LVFP below 1.3 kPa and to an increase of the heart rate by LVFP above 2.0 kPa. The cardiac index increased above 2.2 l/min/m2 in 45% of the patients (87% by LVFP below 1.3 kPa, 56% by LVFP 1.4-1.9 kPa and 0% by LVFP above 2 kPa). The cardiac rate remained increased up to the 4th hour after the infusion. The arterial pressure fell below its initial value after 30 min and remained low up to the 12 h. The LVFP decreased progressively according to the dependence: LVFP = -5.06 + 2.09 1g T.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[The problems of treating acute critical states in diffuse connective tissue diseases].

Critical conditions had been established in 21 (23.1%) of 91 patients with systemic connective tissue diseases for a 12 year period: renal failure (most often), sepsis, pericarditis with cardiac tamponade, hemorrhagic diathesis, terminal arteritis with gangrene, gastrointestinal perforations with peritonitis, etc. The corticosteroids applied in high doses and predominantly parenterally and the immunosuppressors are the main drugs used in the treatment of these conditions. Plasmapheresis when possible is a useful supplement. The prognosis of the acute critical conditions depends mainly on the affected organ (more favorable in pericarditis with tamponade and unfavorable in renal failure and gastrointestinal perforations with peritonitis (and on the basic disease) more optimistic in systemic lupus erythematodes and very pessimistic in nodal periarteritis and other allergic vasculitis).

Acute Disease↗
PubMed1988

[Hemodynamic action of isosorbide-5-mononitrate during rapid venous administration in patients with acute myocardial infarct].

20 patients with acute myocardial infarction were catheterized with a balloon thermodilution catheter and the hemodynamic changes following a rapid i.v. administration of 10 mg of isosorbide-5-mononitrate were studied up to the 4th hour. The drug causes a fall of the left ventricular filling pressure with 20%, of the arterial pressure with 5%, of the cardiac index with 9%, of the stroke index and of the stroke driving index and a slight increase of the systemic arterial vascular resistance without influencing the cardiac rate and the total pulmonary-vascular resistance. The drug action begins immediately, it is best expressed between the 3d and 30th minute and lasts 1-2 h. The hemodynamic changes are unidirectional in patients with left ventricular filling pressure below and above 1.9 kPa. The i.v. administration of isosorbide-5-mononitrate is indicated in the treatment of acute left cardiac failure in patients with acute myocardial infarction for the rapid reduction of pulmonary congestion and is suited for patients with a tendency toward arterial hypotension.

Adult↗
PubMed1982

[Comparison between the loading test and selective coronary angiography in stenocardia].

The results from the step-wise loading test to 75 per cent of the age maximum pulse rate, performed by veloergemeter or thread-mill in 52 patients (9 females and 43 males, II of them with atypical chest pain and II with stenocardia) were juxtaposed to the data from the selective coronarography. It was established that the a reduction of ST segment greater than I mm and the appearance of precordial pain, degree III by the five-grade scale, have almost identical specificity (70% and 64% resp) and a predicting value of the positive result (68% and 70% resp) and a slightly higher sensitivity to pain (68% and 84% resp) in the detection of coronary stenosis greater than 50 per cent of the diameter of a main coronary vessel. The combination of the signs precordial pain degree III and/or ST reduction greater than I mm and/or elevation of ST greater than 2 mm, with same predicting value (67%) maintained, but with a considerably enhanced sensitivity (96%) proved to be most adequate as a criterion of the positive test. A reduction of ST segment greater than 22 mm is characterized by decrease of sensitivity (40%) but with a considerable increase of specificity (96%). The positivation of that sign suggests the presence mainly of a multibranch disease. The patients with coronary stenosis greater than 50%, rarely reach a physical capacity over 100 wt (7 x oxygen consumption) and a product of the maximum reached pulse rate and systolic blood pressure over 20 000 as compared with those without stenosis, but no difference among the patients with one-branch and multi-branch disease was established. The electrocardiographic changes in the patients with a true positive test with loading is more often retained after 4th minute of the rehabilitation phase as compared with those of the patients with false-positive test. Evidence exists to admit that the predicting value of the positive test is poorer in the patients with atypical pains and females.

Adult↗
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↗
PubMed1980

[Comparative study of the therapeutic effect of antiangina agents].

The therapeutic effect of obsidan (25 to 250 mg/24 h), cordanum (75 to 300 mg/24 h), nitropenton (30 mg/24 h), combination of obsidan with nitropenton, prenylamin (180 mg/24 h), stenopril (180 mg/24 h), cordaron (600 mg/24h) and corvaton (4 mg/24 h) was studied according to clinical asessment in 127 patients with stenocardia and in 44 of them by loading tests (veloergometry or treadmill). According to the clinical assessment -- very good (abating of stenocardia paroxysms) and good effect (less frequent paroxysms nitroglycerin necessary every one-two days) was established in 82 per cent of those treated with obsidan, in 78 per cent of the treated with cordanum, in 86 per cent of those treated with the combination obsidan with nitropenton, in 44 per cent of the treated with nitropenton, in 42 per cent of the treated with prenylamin, in 46 per cent pf the treated with stenopril, in 7 out of 9 patients treated with cordaron as well as in 7 out of 9 patients treated with corvaton. According to the data from the loading tests--very good (increase of capacity, not limited by pain and ST depression) and good effect (considerable increase of capacity but limited by pain and ST depression) was found in 77 per cent of the patients administered obsidan, in 67 per cent of those administered cardanum and in 33 per cent of the patients administered tenopril and prenylamin. Beta--blockers significantly excel the therapeutic effect of stenopril, prenylanin and nitropenton, both according to clinical assessment (P < 0,02 to p < 0,001) and to the data from the loading tests (P < 0,02). Beta-blockers dosage was individually determined but 80 per cent of the patients with a favourable effect by obsidan or cordanum had received 60-120 mg/24 h and 150 mg/24 h respectively. The individual effect of the patients is presented so that even the small number of cases observed with cordaron and corvaton treatment shows it reasonable to include new preparations in antianginose treatment.

Aged↗
PubMed1978

[Significance of sinus rhythm for ventricular function].

The changes in hemodynamics in conditions of dosed loading prior to and post cardioversion were followed up in 21 patients with valvular defects or atherosclerotic myocardiosclerosis and absolute arrhythmia with auricular fibrillation. In conditions of auricular fibrillation all the patients showed data about a deteriorated ventricular function (increased arterial-venous difference--tachycardia), both at rest and at dosed loading. One week after the sinus rhythm restoration, a considerable improvement of ventricular function was observed, at rest and loading (normal arterial-venous difference, higner minute and beat volume), suggesting the favourable effect of the restored sinus activity. The improved ventricular function is due to the restored auricular contraction, together with the restoration of rhythmic cardiac activity.

Adult↗
PubMed1976

[Effect of furanthril on several hemodynamic indices during the acute stage of myocardial infarction].

Pulmonary arterial pressure, heart rate and peripheral arterial pressure were followed up by the 15th, 45th and 105th minute post intravenous introduction of 40 mg furanthril in patients with myocardial infarction in acute stage (in 42 cases of 12 patients with left cardiac insufficiency and in 14 cases--of 8 patients without cardiac insufficiency). Furanthril induced clearly manifested pressure decrease in the pulmonary artery in patients with left cardiac insufficiency, developing between the 15th and 45th minute and continuing till the end of the second hour and a negligible elevation of peripheral arterial pressure by the 15th minute, followed by a slight decrease of the latter under the initial value by the 45th and 105th minute. Similar tendency, but less manifested, exists and in patients without cardiac insufficiency. Heart rate is kept unchanged. Furanthril does not induce undesirable hypotonic states when applied in those doses in patients who, as a rule, arenot hyptonics.

Acute Disease↗
PubMed1975

Cardiac lesions caused by mycoplasmic pneumonia in youths according to ballistocardiographic and electrocardiographic data.

ECG and Bcg studies have been carried out on 40 youths, aged 18-23, suffering from mycoplasmic pneumonia; in 19 of them mild Bcg changes were established. The frequency of ECG changes is less - 12 patients. The pathological deflections in Ecg and Bcg in all patients normalize before the control examination, which takes place 30 days after discharge of the patients from hospital.

Adolescent↗
PubMed1975

[Our experience in using temporary and permanent electric stimulation in conduction disorders].

The results from the observation of 49 patients with complete and incomplete AV block are reported, 33 of them with attacks of MAC syndrome; asystolia 25, ventricular tachycardia and ventricular fibrillation--8. Temporary electric stimulation is carried out in 31 patients (21 with chronic complete AV block and 10 with incomplete and complete with recent cardiac infarction). In all patients with chronic AV block but one, implantation of a permanent artificial rhythm nuide was necessary. The prognosis of the patients with implanted permanent stimulator is determined by the myocardial state, out of six patients with cardiac insufficiency -- three died in a period of 1 to 12 months. Recommendations are presented for active finding out and dispensary control of patients with conduction disturbances and wider application of temporary electric stimulation in the intensive care and treatment units.

Adams-Stokes Syndrome↗