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Biomedical subjects

V I Makolkin

Publications and source records attributed to V I Makolkin.

At least 19 recordsLinked to original sources
PubMed2006

[Electrical instability of the myocardium in patients with acquired heart defects.].

Aim of the study was to investigate electrophysiological state of the myocardium and conduct comparative analysis of informative power of methods of dipole electrocardiography and signal averaged ECG with detection of late ventricular potentials for prognostication of ventricular heart rhythm disturbances in patients with acquired heart defects. Examination of 43 patients with acquired heart defects showed that patients with high grade ventricular extrasystoles significantly more often had late ventricular potentials, prolonged interval corresponding to maximal values of activation area, area of fresh activation, and diminished vector of repolarization acceleration and its components.

Arrhythmias, Cardiac↗
PubMed2006

[Why it is necessary to reduce heart rate in the treatment of stable angina?].

The article is devoted to the role of heart rate (HR) as a risk factor of cardiovascular morbidity and mortality in patients with stable angina. It includes data from epidemiological surveys showing the value of elevated HR as a risk factor in many cardiovascular diseases. HR reducing therapy as one of cornerstone principles of stable angina treatment has been recently reinforced by the innovative medicine--selective and specific I(f) current inhibitor ivabradine (Coraxan). Results of a clinical development program demonstrated high anti-ischemic and antianginal efficacy of Coraxan in treatment of patients with stable angina.

Adrenergic beta-Antagonists↗
PubMed2004

[Effect of high doses of broncholytics on the state of cardiovascular system during treatment of sever exacerbation of bronchial asthma].

UNLABELLED: The use of broncholytic drugs through nebulizer is a standard treatment for acute episodes of bronchial asthma. However doses of these drugs administered by nebulizer can be much higher than those applied when metered dose inhaler is used. These doses have a potential of cardiotoxic effects. MATERIAL: Patients (n=75) with severe exacerbation of bronchial asthma. METHODS: All patients received broncholytic drugs through nebulizer. Doses were adjusted according to age and concomitant pathology among which prevailed ischemic heart disease (21.3%) and hypertension (53.3%). Nebulized beclomethasone was an alternative to systemic corticosteroids. Safety of therapy was controlled with electrocardiography, 24-hour electrocardiography, measurements of serum potassium level, registration of subjective signs (palpitation, tremor) and objective data (heart rate, blood pressure). RESULTS: Clinical improvement occurred in all patients. By the end of nebulizer therapy arterial blood O(2) saturation increased 4.66% from initial level (p=0.04). Peak expiratory rate and forced expiratory volume in 1 sec also rose (p <0.05). Termination of nebulizer therapy was associated with decrease of number of both supraventricular and ventricular premature beats. Moderate widening of of QT interval above 460 ms was registered in 4 patients, 3 of whom had ischemic heart disease. There were no significant changes of serum potassium levels. CONCLUSION: Broncholytic drugs administered by nebulizer in therapeutic doses selected with consideration of age and concomitant diseases did not produce cardiotoxic effects.

Adrenergic beta-Agonists↗
PubMed2004

[Changes in indices of inflammatory activity in patients with rheumatoid arthritis during early stages of basic therapy with leflunomide].

AIM: To assess leflunomide efficacy and tolerance in patients with rheumatoid arthritis (RA) during the first four months of the treatment. MATERIAL AND METHODS: The study included 200 RA patients treated in four Moscow clinical centers. Leflunomide was given in a dose of 100 mg/day for 3 days, then 20 mg/day for 16 weeks. The activity of the disease according to the criterion DAS 28 was assessed before the treatment and 4, 8, 12 and 16 weeks after the treatment start. RESULTS: RA activity diminished considerably after one month of leflunomide treatment. Later, the articular syndrome continued to improve. A significant improvement by DAS 28 was observed after 16 weeks of the treatment in 65% (129 of 200) patients, high RA activity persisted only in 17 of 90 patients. CONCLUSION: Leflunomide reduces articular inflammation and raises RA patients' quality of life at early stages of the treatment. This reduction continued for 4 months of the study. Therefore, adequate assessment of leflunomide efficacy should be made only after 4-6 months of therapy.

Adult↗
PubMed2004

[Peripheral hemodynamics in neurocirculatory dystonia].

AIM: To assess the state of peripheral hemodynamics in patients with neurocirculatory dystonia and elucidate its relation to disease duration and clinical presentation. MATERIAL AND METHODS: Laser doppler flowmetry was used for the study of microcirculation in 25 healthy subjects and 91 patients with neurocirculatory dystonia. RESULTS: Most healthy subjects (73.7%) had normocirculatory type of microcirculation. Hyperemic type was most frequent (36.7%) in patients with mild neurocirculatory dystonia, while majority (57.4%) of patients with moderate severity and severe neurocirculatory dystonia had congestive-stasical type of microcirculation. Hyperkinetic syndrome predominated in patients with hyperemic type of microcirculation, while hyperventilatory, astenic and asteno-neurotic syndromes were characteristic for those with congestive-stasical type. Moreover patients with congestive-stasical type had longer disease duration. CONCLUSION: Changes of microcirculation observed in patients with neurocirculatory dystonia evidence for the presence of relationship between clinical signs and disease duration. Patients with congestive-stasical type of microcirculation were characterized by unfavorable course and longer disease duration.

Dystonia↗
PubMed2004

[Effective control of a severe exacerbation of bronchial asthma].

AIM: To evaluate effectiveness and safety of nebulizer therapy (NT) with broncholytics and pulmicort suspension (PS) in patients with a severe exacerbation of bronchial asthma (BA). MATERIAL AND METHODS: 75 patients with a severe BA exacerbation received broncholytic NT with consideration of comorbid pathology and age. Nebulized PS was used as an alternative to systemic glucocorticosteroids (SGCS). NT efficacy was assessed by changes in clinical symptoms, in the peak expiration velocity (PEV) and spirometry parameters. Safety was controlled by 24-h ECG monitoring, pulsoximetry. PS was examined for effect on adrenal cortex, calcium metabolism, oral infection with Candida. Side effects were registered. RESULTS: Clinical improvement was recorded in all the patients. NT reduced the number of additional inhalations of short-acting beta2-agonists 4-5 times, on the average. In the end of NT there was a 4.66% increase in SaO2 vs the initial value (p = 0.04). PEV and FEV1 increased. Plasm levels of hydrocortisone and its urine excretion did not lower vs initial values. CONCLUSION: The results of the study point to efficacy and safety of combined NT with broncholytics and PS in a severe exacerbation of BA.

Administration, Inhalation↗
PubMed2004

[Assessment of efficacy of combined therapy with antihypertensive agents and biguanides in patients with metabolic syndrome].

To compare effects of antihypertensive and combined therapy on 24-hour blood pressure, biochemical parameters and chronic hyperinsulinemia in patients with metabolic syndrome. 54 patients with metabolic syndrome were observed during 8 weeks. 28 patients (group A) were treated with antihypertensive agents (calcium antagonists, and when required -- ACE inhibitors and diuretics). 26 patients (group B) received the same therapy plus metformin. There were no significant changes in parameters of lipid and carbohydrate metabolism in group A. In group B we found significant decrease in C-peptide (p<0.05) and triglyceride (p<0.1) levels and increase in high density lipoprotein cholesterol levels (p<0.01). The combined antihypertensive and metformin therapy has a significant effect on carbohydrate and lipid metabolism.

Adult↗
PubMed2003

[Microcirculation in hypertension].

Changes of microcirculatory vascular bed play important role in pathogenesis of essential hypertension. All components of the system of microcirculation including vessels and circulating blood are involved into pathological process. Resistance to blood flow is mostly formed in this system. Resistance depends on length, diameter of microvessels and viscosity of blood. In the process of the disease development the following signs of remodeling at the level of microcirculation emerge: decrease of density of vasculature, modification of the media/lumen ratio, increase of blood viscosity, slowing of angiogenesis, impairment of endothelial function. These phenomena can be both cause and consequence of hypertensive disease. Their heterogeneity depends on a variety of factors (duration, stage of the disease, etc.). It seems feasible to differentiate therapy in accordance with character and severity of changes in the system of microcirculation.

Animals↗
PubMed2003

[Is there an alternative to traditional stress tests? (One more time about transesophageal cardiac pacing)].

AIM: To assess diagnostic potential of transesophageal cardiac pacing in patients with ischemic heart disease. MATERIAL: One hundred patients with overt or suspected ischemic heart disease (IHD) unable to perform or complete standard exercise test. METHODS: In addition to clinical investigation and transesophageal cardiac pacing stress Doppler echocardiography was carried out in 60 and coronary angiography in 30 patients. RESULTS: Transesophageal pacing was completed in 95% of patients. Sensitivity of the test for diagnosis of IHD was 85%, specificity--77%, predictive value of positive and negative results--95 and 73%, respectively. Combined use of transesophageal pacing and Doppler echocardiography increased sensitivity of diagnosis of IHD up to 92%. Blood pressure increment during transesophageal pacing did not exceed 10 mm Hg. CONCLUSION: Transesophageal cardiac pacing is a highly informative, simple, safe and widely available selective stress test. Results of this test does not depend on concomitant pathology and physical fitness of a patient. Therefore it presents an alternative to standard stress tests and is a method of choice in many diagnostic situations.

Cardiac Pacing, Artificial↗
PubMed2003

[Clinical and metabolic effects of cardioselective beta-adrenoblockers nebivolol and metoprolol in patients with hypertension and ischemic heart disease associated with type 2 diabetes].

AIM: To compare efficacy and safety of cardioselective beta-adrenoblockers nebivolol and metoprolol in patients with hypertension and ischemic heart disease (IHD) combined with type 2 diabetes. MATERIAL AND METHODS: Patients with IHD, class II-III angina and moderately severe compensated or subcompensated type II diabetes (n=35, 29 with grade 1-2 hypertension according to WHO 1999 classification) were divided into 2 groups with similar clinical and laboratory characteristics. Patients of group 1 received metoprolol (50-100 mg/day), of group 2--nebivolol (5-7.5 mg/day) for 8 weeks. Data of physical investigation, exercise tests, 24-hour blood pressure and heart rate monitoring, analysis of lipid spectrum and glycemic profile were used for assessment of treatment efficacy. RESULTS: Decrease of number of anginal attacks and nitroglycerine requirement was more pronounced in nebivolol treated patients. The use of both drugs was associated with lowering of blood pressure and heart rate. There were no unfavorable changes of parameters of carbohydrate and lipid metabolism. Pronounced (by 19.2%) lowering of triglycerides was observed in nebivolol treated patients. Both drugs were well tolerated. CONCLUSION: Nebivolol and metoprolol are effective and safe antianginal agents in patients with IHD and hypertension combined with type 2 diabetes. However in doses used nebivolol produced more favorable metabolic and hemodynamic effects.

Adrenergic beta-Antagonists↗
PubMed2003

[Isradipine-SRO: antihypertensive efficacy, central and peripheral hemodynamic effects in patients with hypertensive disease].

AIM: To assess antihypertensive efficacy of isradipine, to study its effects on central and peripheral hemodynamics, and to investigate relationships between state of microcirculation and response to treatment. MATERIAL AND METHODS: Isradipine was given for 12 weeks to 30 patients (16 men, 14 women, mean age 50.2+/-9.8 years) with I-II stage mild and moderate hypertension. Twenty four hour blood pressure monitoring, assessment of parameters of central hemodynamics and state of microcirculation were carried out before and after 12 weeks of isradipine administration. RESULTS: Administration of isradipine was associated with improved sense of well-being and significant lowering of 24-hour, diurnal and nocturnal systolic/diastolic blood pressure (by 6.4/12.7, 7.6/9.4, 10.5/13.4%, respectively). Average 24-hour heart rate increased mainly during daytime (by 10.6%). Mean hemodynamic blood pressure was lowered by 16.3% due to reduction of total peripheral vascular resistance. There occurred redistribution of types of microcirculation with increase of proportion of normocirculatory and decrease - of spastic types. Changes of parameters of microcirculation at rest and during functional tests evidenced for resolution of baseline arteriolar spasm, stasis and venous congestion in microcirculatory vascular bed. Patients who responded to isradipine more often had spastic (50%) and congestive (35%) types of microcirculation. Patients with hyperemic type did not respond to isradipine. Most frequent side effect was flushing (23.3%) because of which 2 patients stopped taking the drug.

Adult↗