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Biomedical subjects

V I Metelitsa

Publications and source records attributed to V I Metelitsa.

At least 37 records · Page 2Linked to original sources
PubMed1996

[The emergence of silent myocardial ischemia as the manifestation of the nitrate withdrawal syndrome in patients with ischemic heart disease].

The aim of the study was to evaluate feasibility of emergence of nitrate withdrawal syndrome consequently to discontinuation of short-term nitrate administration for coronary heart disease. 12 males with stable effort angina functional class III were subjected to 24-h Holter ECG monitoring. In a randomized cross-over trial each patient received for 3 days isosorbide dinitrate (10-30 mg 4 times a day) followed by 3-day course of placebo. The monitoring was performed on day 3 of the drug or placebo administration and on the first day of their withdrawal. Isosorbide dinitrate discontinuation had no negative effects on the patients' condition though significantly increased the number and duration of episodes of asymptomatic myocardial ischemia. 4 patients developed episodes of asymptomatic myocardial ischemia at rest which were not observed in placebo application. It is believed that much caution should be used in planning interrupted regimes of nitrates therapy in patients with severe angina pectoris.

Aged↗
PubMed1996

[The Multicenter Captopril and the Quality of Life Study: the effect of antihypertensive agents from the basic groups on the quality of life of patients in different populations. The working group of the Multicenter Captopril and the Quality of Life Study].

This multicenter trial included 205 males aged 30-60 years with stable mild and moderate hypertension. 140 patients were from Moscow (140 patients), St. Petersburg, Kursk, Rostov (Russia); Kharkov, Donetsk (Ukraine); Baku (Azerbaijan). Group 1 patients received captopril, group 2 nifedipine, group 3 hydrochlorothiazide, group 4 propranolol.

Antihypertensive Agents↗
PubMed1995

[The effect of long-term monotherapy with preparations from the 4 basic groups of antihypertensive agents on the quality of life in patients with mild and moderate arterial hypertension. The Multicenter Captopril and the Quality of Life Study. The working group of the Multicenter Captopril and the Quality of Life Study].

A multicenter, controlled, open, randomized trial of antihypertensive and life quality (LQ) effects of monotherapy with captopril vs propranolol, hydrochlorothiazide and nifedipine included 345 males aged 35-60 years with mild and moderate hypertension. The results of 8-month treatment provided the conclusions: the drugs were much alike by antihypertensive efficacy, LQ parameters proved more beneficial in the group on captopril than those on nifedipine and propranolol, hydrochlorothiazide failed to improve life quality, captopril is an effective and safe antihypertensive drug superior to the drugs of 3 other antihypertensive drug groups by positively affecting LQ.

Adult↗
PubMed1995

[The long-term monotherapy with preparations from the 4 basic groups of antihypertensive agents of patients with mild and moderate arterial hypertension. The Multicenter Captopril and the Quality of Life Study. The working group of the Multicenter Captopril and the Quality of Life Study].

A multicenter randomized controlled trial was performed to compare antihypertensive effects and tolerance of captopril monotherapy with those of reference drugs from three other main groups of antihypertensive drugs: propranolol, hydrochlorothiazide, nifedipine. The trial included 345 males with essential hypertension stage I-II by WHO criteria. Evaluable patients after 8 months of treatment comprised 85.8%. 8-month monotherapy with captopril, nifedipine, hydrochlorothiazide and propranolol was completed by 53.49%, 75.28%, 45.78% of patients, respectively. An antihypertensive effect was reached in 57.97% of patients on monotherapy. Normalization of arterial pressure took place in 51.3%. The 4 drugs in the given doses produced a significant and similar effect in relation to the action on arterial pressure (absolute value). As for individual effects (complete and partial), captopril and propranolol were equal, nifedipine was more beneficial than hydrochlorothiazide. Side effects in captopril monotherapy arose 1.5-2 times less frequently than in response to propranolol or nifedipine and were similar to those of hydrochlorothiazide.

Adult↗
PubMed1995

[The nifedipine withdrawal syndrome in patients with stable stenocardia of effort].

The effect of abrupt discontinuation of nifedipine (N) on exercise tolerance and myocardial ischemia was studied in 7 patients with stable angina pectoris of effort (AP). N was administered in a dose of 20 mg 4 times a day for 34 days. Exercise treadmill tests were performed before N therapy in placebo treatment, on N treatment day 1, 28, on the first day after abrupt N discontinuation and 8 days after the latter. Upon acute and regular administration N produced a significant improvement in exercise tolerance before the onset of AP, development of moderate AP and up to 1 mm depression of ST-segment. Abrupt N discontinuation resulted in substantial deterioration in exercise performance pronounced more definitely on hour 21 and 24 after the last dose intake. A substantial increase in the sum of ST-segment depression at the onset of AP and at the development of AP of moderate severity occurred on the first day of N withdrawal. 8 days after N cessation all the exercise parameters returned to the baseline levels. We conclude that abrupt cessation of regular N therapy may cause a withdrawal syndrome which manifested with a decrease in the exercise tolerance and an increase in exercise-induced myocardial ischemia.

Angina Pectoris↗
PubMed1993

Withdrawal phenomenon after abrupt cessation of nifedipine in stable angina pectoris.

We investigated the effect of abrupt cessation of nifedipine after regular administration (20 mg, four times daily) for 5 weeks in seven patients with stable angina pectoris. A rebound decrease in exercise tolerance and increase of exercise-induced myocardial ischaemia were registered on the first day of nifedipine withdrawal.

Angina Pectoris↗
PubMed1993

[The single-dose screening of nitrates, calcium antagonists, beta-adrenoblockaders and their combinations in patients with stenocardia of effort by using the paired bicycle ergometry method].

Fifteen males with stable angina pectoris were screened for efficacy of antianginal drugs in single doses (isosorbide dinitrate, 10 mg; nifedipine, 20 mg; propranolol, 40 mg) and in combinations (ID+Pr, ID+Nf, Nf+Pr, Nf+Pr+ID). The findings at paired bicycle ergometries indicated that ID was most beneficial in monotherapy. Only two combinations (Nf+Pr and Nf+Pr+ID) were superior when compared to single drugs. Combinations ID+Pr and ID+Nf had the same efficacy as ID. Interaction of the drugs assessed with two-dimensional variance analysis was insignificant in all the combinations. Nf+Pr+ID combination had no advantages over two-drug combinations and induced worse tolerance.

Adrenergic beta-Antagonists↗
PubMed1993

[Differences in hemodynamic effects of the cardioselective beta-adrenoblocker acebutolol and non-selective beta-adrenoblocker propranolol in long-term antihypertensive therapy].

The cardioselective beta-adrenoblocker acebutolol used as a course therapy for 12 weeks was found to be a highly beneficial antihypertensive agent. The antihypertensive effect of the agent given in doses of 400-800 mg/day was as pronounced and prolonged as that of propranolol, 80-160 mg/day, though there is a tendency for acebutolol to show its complete or partial antihypertensive effect rather at the end of monotherapy than propranolol. At the same time the bradycardiac effect was more pronounced in propranolol therapy. The antihypertensive effect of acebutolol, 400-800 mg/day, was revealed after 2 weeks of its use and persisted within the entire 12 weeks of therapy. The drug was well tolerated. In contrast to propranolol, a non-selective beta-adrenoblocker having no intrinsic sympathomimetic activity, acebutolol failed to produce adverse effects, such as by decreasing cardiac output and increasing total peripheral vascular resistance. The agent had a less negative chronotropic effect.

Acebutolol↗
PubMed1993

[Methodologic approaches to evaluation of interaction of anti-anginal agents in their combined use in patients with exercise-induced angina].

The paper shows methodological approaches to assessing the interaction (antagonism and synergism) of antianginal agents in their combination used in 15 patients with stable angina. Each patient underwent paired bicycle ergometry with placebo, isosorbide dinitrate, 10 mg (ID), nifedipine, 20 mg (N), propranolol, 40 mg (P), and a combination of the drugs: ID, 10 mg, +P, 40 mg; N, 20 mg, +P, 40 mg; ID, 10 mg+N, 20 mg. The results were processed by two-dimensional dispersion analysis. Based on the findings, it was concluded that the interaction of drugs in all combinations was statistically insignificant in patients. At the same time the developed individual criteria for assessing the interaction allowed patients both with synergic and antagonistic interaction of antianginal drugs to be revealed.

Angina Pectoris↗
PubMed1993

[The effect of monotherapy with nifedipine and hydrochlorothiazide on the psychological characteristics and quality of life of hypertension patients].

The study comprised 25 males with Stages I-II hypertensive disease whose age was 35 to 60 years and diastolic blood pressure was 96-114 mm Hg. After 4-week administration of placebo, two groups of treatment were randomized: (1) nifedipine (corinfar), 15-80 mg daily, and (2) hydrochlorothiazide (triampur), 25-100 mg daily, for 12 weeks with subsequent crossover: between therapy course, the patients received placebo during 4 weeks. The psychological examination was performed before the patients' inclusion into the study, at the end of placebo use, 4 and 12 weeks after monotherapy with one of the active drug, by using the "Lifestyle" questionnaire, SMOL and HPPQ. The study showed that a course of therapy with the calcium antagonist nifedipine produced a beneficial effect on the mental status and lifestyle in patients with hypertensive disease, by promoting the improvement of relations between the patients and all those present. Hydrochlorothiazide monotherapy deteriorated the lifestyle in patients by restricting smoking and sexual life and enhanced neurotization in patients, especially in subjects who had no benefits. It has been ascertained that the efficacy of antihypertensive therapy depends on the baseline mental status of hypertensives: higher neurotization may be regarded as a predictor of inefficiency of treatment.

Adult↗
PubMed1993

[Treatment of patients with stable angina by combination of trinitrolong and propranolol].

Trinitrolong (TNL), a long-acting nitroglycerin for application on the gingiva, was comparatively assessed for effect on stable angina pectoris in monotherapy and in combination with beta-adrenoblocker propranolol. A total of 11 anginal patients received the combination the efficacy of which was verified by paired bicycle ergometry. A high antianginal effect of TNL was established. However, its combination with propranolol entails neither higher exercise tolerance nor less frequent anginal attacks. An increment in the effect was not seen either when the combination was used in single and course doses in one-third of the patients.

Adult↗
PubMed1993

[The problem of tolerance to nitrates and the means to resolve it in patients with exertional stenocardia].

The problem of nitrates tolerance and resistance has been studied for 10 years in a number of clinical pharmacological cross-over studies in patients with stable angina of effort by specially devised pharmacodynamic and pharmacokinetic methods. Both single doses in different medicinal forms and long-term course intake of nitrates were investigated. The results led the authors to the following conclusions: 1) tolerance to isosorbide dinitrate arises in 58% of the patients for 6-12 weeks under regular administration of the drug; 2) transdermal nitroglycerin (nitroderm) and in a less degree oral sustak under long-term treatment regimens become tolerable, whereas a buccal form (trinitrolong) secures a prolonged stable effect; 3) tolerance develops in 2-month administration of oral isosorbide-5-mononitrate; 4) donors of SH-group (methionine) and inhibitors of angiotensin-converting enzyme with SH-group and without it (captopril and perindopril, respectively) in single doses potentiate an antianginal effect of isosorbide dinitrate (even in initial resistance to nitrate), being ineffective in its absence; 5) molsidomine is promising in long-term regimens as an antianginal drug alternative to nitrates.

Angina Pectoris↗
PubMed1993

[Effect of long-term monotherapy with propranolol and nifedipine on the quality of life and psychological status of patients with hypertension].

WHO criteria of quality of life and psychological status were employed in a randomized placebo-controlled cross-over trial of relevant effects induced by propranolol and nifedipine. Forty patients with essential hypertension (EH) stage I-II aged 35-60, males with diastolic pressure 96-114 mm Hg, entered the trial. Monotherapy with calcium antagonist nifedipine produced a beneficial effect on EH patients' quality of life, they became more sociable and active. Propranolol, beta-adrenoblocker, given for 4 weeks resulted in psychosocial dysadaptation, hypochondriasis, depressions. It is concluded that an antihypertensive effect of the above drugs was related to the EH patients' initial status: one can predict psychological benefit of nifedipine in patients without neurotic symptoms, while propranolol is more effective in neurotic EH subjects.

Adult↗
PubMed1993

[Left ventricular myocardial hypertrophy in patients with arterial hypertension: the clinical characteristics and prognostic significance].

Blood pressures in the out- and inpatient settings, ECG findings and 24-hour Holter monitoring data, hemodynamic parameters, exercise test results, carbohydrate tolerance, blood lipid levels, and renal function were studied in 21 males with arterial hypertension and left ventricular hypertrophy as evidenced by echocardiography and 20 patients of the same age who had the same disease length. The patients with left ventricular hypertrophy generally showed a more severe course of arterial hypertension: more elevated and stable blood pressure, more renal affliction than those without left ventricular hypertrophy. ECG monitoring indicated that they had ventricular premature contraction and atypical episodes of ST-segment depression. These patients displayed lower heart rate and its lower increment, but higher diastolic blood pressure at the peak of exercise. A five-year follow-up suggests that the patients with left ventricular hypertrophy (38.1%) have higher incidence rate of cardiovascular events than those without this abnormality (5%) (p < 0.01).

Adult↗
PubMed1992

Enhancement of the efficacy of isosorbide dinitrate by captopril in stable angina pectoris.

This study was designed to assess whether the angiotensin-converting enzyme inhibitor captopril could potentiate the efficacy of a single dose of oral isosorbide dinitrate (ISDN) in patients with coronary artery disease. Fourteen men (mean age 53 years) with stable angina pectoris were studied. In each patient the efficacy of placebo, captopril (50 to 100 mg), ISDN (10 mg), and a combination of captopril (50 to 100 mg) and ISDN (10 mg) was assessed by repeated exercise treadmill tests performed before and 1, 2, 3 and 6 hours after administration of a single dose. A single-blind, randomized technique was applied. According to the mean data in the whole group of 14 patients, captopril alone produced no improvement in exercise duration to the onset of angina and to angina of moderate severity compared with placebo. The magnitude of ST-segment depression did not significantly change after captopril administration. ISDN alone significantly increased exercise duration to onset of angina and to angina of moderate severity (antianginal effect) and decreased the magnitude of ST-segment depression (antiischemic effect) 1 to 3 hours after administration. Combined administration of ISDN and captopril resulted in more expressed antianginal and antiischemic effects; at 2, 3 and 6 hours these effects with ISDN plus captopril were significantly more pronounced than those with ISDN alone. According to individual data, the most marked potentiation of ISDN efficacy was observed in patients who had poor response to ISDN alone. In all 6 patients in whom ISDN alone was ineffective, after the addition of captopril the desired antianginal effect was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗