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Z Anger

Publications and source records attributed to Z Anger.

10 recordsLinked to original sources
PubMed2006

[Primary prevention of ischemic heart disease in middle-aged men living in Prague: results of twenty-year research].

INTRODUCTION: Ischemic Heart Disease (IHD) represents the most frequent cause of mortality and morbidity in the Czech Republic. The aim of this study is to analyze long-term mortality of cardiovascular disease (CVD), identify its predictors and verify the validity of Framingham risk function for Czech patients. DESIGN AND METHODS: The twenty-year study (STULONG) of primary prevention of risk factors of atherosclerosis in 1419 men aged 38 to 53 years living in Prague was started in 1975. RESULTS: CVD mortality analysis showed a higher risk of death for heavy smokers vs. non-smokers or light smokers (p < 0.0001), hypertensive patients vs. patients with normal blood pressure (p < 0.0001), men with hypercholesterolemia vs. men with normal cholesterol level (p = 0.0432), and a lower risk for university graduates vs. men with elementary education (p = 0.0006). Between 1980 and 1984, age-specific CVD mortality rates of men from STULONG study were higher (p = 0.0132) than national CVD mortality rates; between 1985 and 1994, they were insignificantly lower. Framingham risk function underestimated absolute ten-year risk of IHD in all risk quintiles (p < 0.0001) with discrimination of 63%. CONCLUSION: CVD mortality observed within STULONG study was significantly affected by known risk factors (hypertension, smoking, hypercholesterolemia, lower education); Framingham risk function underestimated absolute ten-year risk of IHD.

Coronary Artery Disease↗
PubMed2005

Primary prevention of coronary artery disease among middle aged men in Prague: twenty-year follow-up results.

BACKGROUND: Coronary artery disease (CAD) represents the most common cause of morbidity and mortality in the Czech Republic. The aim of this study is to analyze long-term cardiovascular diseases (CVD) mortality, identify predictors of outcome and to validate the Framingham risk function in men from the Czech Republic. DESIGN AND METHODS: A 20-year primary prevention study of atherosclerosis risk factors in 1417 men from Prague aged 38-53 years was launched in 1975 (STULONG). RESULTS: When analyzing CVD mortality, heavy smokers had hazard higher than non-smokers and light smokers (p < 0.0001); hypertensives higher than normotensives (p < 0.0001); men with hypercholesterolemia higher than those with normal cholesterol (p = 0.0432), and university-educated men lower than elementary-educated men (p = 0.0006). In 1980-1984, the age specific mortality from CVD in men from STULONG was higher (p = 0.0132) than in the Czech Republic, in 1985-1994 insignificantly lower. The Framingham risk function underestimated the absolute 10-year risk of CAD across the quintile of the risk (p < 0.0001), with 63% discrimination. CONCLUSION: In STULONG, the mortality from CVD was significantly associated with known risk factors (hypertension, smoking, hypercholesterolemia, education); the Framingham risk function underestimated the absolute 10-year risk of CAD.

Adult↗
PubMed2002

[ECG mapping in clinical practice].

First the authors present a review of important cornerstones in the history of the electrocardiogram (ECG) and ECG mapping. The first to describe the electric cardiac field based on twenty ECGs was A.D. Waller in 1889. The decisive cornerstone for practical use was the introduction of a string galvanometer in 1901 by W. Einthoven and his triaxial lead system. Another very important cornerstone in the development of ECG were the findings of F.N. Wilson. Merits as regards the development and application of ECG mapping are due to B. Taccardi. Workers of the Second Medical Clinic in Prague enhanced after 15 years of studies and comparison of ECG maps with coronarographic findings in subjects with ischaemic heart disease (IHD) and microvascular coronary dysfunction (syndrome X--SyX) substantially the specificity of this method in impaired myocardial vascularization. Better diagnosis was achieved by introduction of diagnostic tests which influence coronary vascularization such as e.g. hyperventilation, as well as other tests. After their application progression of chronic myocardial ischaemia occurs, e.g. by the mechanism of the "steal phenomenon" or restriction of the microcirculation after hyperventilation in patients with SyX. Furthermore the authors present examples of ECG maps after PTCA, after application of diagnostic tests in IHD and SyX and also regression of myocardial ischaemia after marked reduction of total cholesterol.

Adult↗
PubMed1998

Utility of short-term heart rate variability for prediction of sudden cardiac death after acute myocardial infarction.

Heart rate variability (HRV) computed from 24-hour ECG recording has been associated with an increased risk of malignant arrhythmias after MI. To make HRV analysis more practical, we evaluated prospectively prognostic role of short-term HRV in comparison with other risk stratifiers. Study population consisted of 48 patients with acute MI (mean age 59.6 +/- 10.6 years, 38 males), who were off betablockers. All patients underwent 30-minute ECG recording at supine rest on day 2 and 5 after admission, between 9 and 11 a.m. One ECG channel from a commercial bedside monitor was A/D converted, and subsequently analysed using a purpose-built interactive software. Short-term HRV was computed as the standard deviation of all normal-to-normal RR intervals (SDNN) as well as the square root of the mean of the sum of the squares of differences between adjacent normal RR intervals (rMSSD). Left ventricular ejection fraction (LVEF, in %) was determined using 2D-echocardiography. During one-year follow up, 5 patients (10.4%) died of sudden cardiac death (SCD) and one of non-cardiac death. Subjects who died of SCD presented with significantly lower SDNN parameter on day 5 (28.8 +/- 4.3 vs 39 +/- 18.4, p < 0.006) and similar trend was revealed for rMSSD (12.22.8 vs 24.321, N.S.). Similarly, LVEF was significantly decreased in these patients (35.4 +/- 5.5 vs 49.7 +/- 11.3, p < 0.007). Positive predictive accuracy for prediction of SCD was 17% for rMSSD, 20% for SDNN, 29% for LVEF, and 40% for combination of depressed SDNN (< or = 33 ms) and LVEF (< or = 40). In conclusion, depressed HRV computed from short-term predischarge ECG recordings obtained under standardised conditions is associated with an increased risk of SCD. Such predictive power is substantially increased in combination with depressed LVEF, and this approach seems to be effective as a simple screening method to identify high risk subjects.

Arrhythmias, Cardiac↗
PubMed1996

Evaluation of body surface potential mapping changes after successful percutaneous transluminal coronary angioplasty.

OBJECTIVE: To assess the progress of chronic myocardial ischemia after successful percutaneous transluminal coronary angioplasty (PTCA) using body surface potential mapping (BSPM). DESIGN: For BSPM analysis the following kinds of maps were used: isopotential repolarization maps corresponding to 70% of ST-T interval's duration and isointegral maps corresponding to 0% to 20% of ST-T duration. BSPM measurements were taken before the PTCA and usually one to six days after this intervention. In 17 patients BSPM was carried out within two days after PTCA. Eleven to 14 BSPM examinations were usually carried out during six months of follow-up. Control coronary angiography was performed after six months in all but three patients. RESULTS: Substantial focal decrease of positive potential in repolarization caused by myocardial ischemia recovered gradually after successful PTCA. This appeared to be caused by the regression of "hibernating myocardium'. An increase of positive potential was statistically significant (P < 0.01) after the fifth week of PTCA intervention. There was a positive correlation between BSPM findings and chest discomfort of patients after PTCA. Chronic myocardial ischemia could be observed on isopotential and/or isointegral maps examined before the PTCA in 21 of 25 cases (sensitivity 84%).

Adult↗
PubMed1993

Analysis of ventricular activation in patients with chronic non-Q wave myocardial infarction: comparison with left ventricular asynergy and myocardial perfusion defects.

In this report, we dealt with ventricular activation abnormalities in 30 patients with previous non-Q myocardial infarction (MI) by means of the CARDIAG 128.1 device, which enables analysis of ECGs, VCGs and body surface potential maps. The diagnosis was verified by left ventriculography, echocardiography and perfusion scintigraphy. Twenty-nine healthy subjects served as the control group. Morphological findings confirmed the presence of a significant subgroup with serious left ventricular asynergy. Seven electrocardiological variables, which significantly differed from control values, disclosed that non-Q MI is responsible for localized activation time prolongation, and that inferoposterior scars tend to delay the entire activation of ventricles, and to cause disturbances of the terminal depolarization phase together with a decrease in voltage production during QRS. Lesions of the anterior wall and the apicomesial part of the inferoposterior wall affect the distribution of the Q wave more often than the posterior basal ones. The probability of such abnormalities increases with the degree of asynergy. Some VCG criteria increase the sensitivity of electrocardiological analysis. These parameters will be used for evaluating the diagnostic value of electrocardiological analysis in the chronic non-Q MI. Non-Q myocardial infarctions represent a heterogeneous group of infarctions from both electrophysiological and morphological aspects.

Adult↗
PubMed1993

The methodology of clinical analysis of electric heart field.

A brief description of the methodology of analysis of the electric heart field using electrocardiograms, vectorcardiograms, diagrams of potential maxima/minima and body surface potential maps is presented. The text is focused on the description of different kinds of isopotential and isointegral maps and their diagnostic possibilities. A detailed description of the diagram of potential maxima/minima and its place in diagnostic of different disturbances of the heart muscle and conduction defects is given.

Bundle-Branch Block↗
PubMed1992

[Diagnosis of conditions following myocardial infarct using complex analysis of electrical cardiac fields].

In 22 patients with ischaemic heart disease and conditions after infarction and angina pectoris a coronarographic examination was made as well as other auxiliary examinations incl. a complex analysis of the electrical cardiac field (KAESP) (23), using a Cardiac apparatus (manufacturer ZPA Cakovice). Using the KAESP method fibroses in the heart muscle were found in all 22 patients, while a classical electrocardiogram revealed them only in 12 patients (54.5%). Post-infarction fibrous changes on the inferior cardiac wall were detected by ECG in 10 patients, KAESP revealed this localization of changes in 17 patients. The difference was particularly marked as regards localization on the anterior cardiac wall, according to ECG it was in 2 patients, according to KAESP in 17 patients. The authors investigated also on isopotential repolarization maps focal changes caused by cardiac ischaemia associated with organic affection of the appropriate coronary artery as revealed by coronarography. Identical sites were proved in 18 patients by the two methods, i. e. in 81.8%. In the discussion the authors analyse the causes which influence the accuracy of assessment of the coronary artery in KAESP. In KAESP in addition to isopotential maps also other maps were used such as isointegral, iso-areal, asynchronic potential maxima and minima, isochronic maps, maps of negative isodivergencies, profile sections etc. (20).

Adult↗
PubMed1992

[Diagnosis of syndrome X using comprehensive analysis of the electrical field of the heart].

The authors describe the clinical picture and results of some auxiliary examinations in 18 patients with the X syndrome, i.e. with angina pectoris with a normal angiographic finding on the coronary arteries. For the diagnosis of ischemic cardiac changes, which are an integral part of this syndrome, the authors used a complex analysis of the electric cardiac field by means of a Cardiac 128.1 apparatus (manufactured by ZPA-Cakovice). In patients with the X syndrome they observed a significant reduction of some potential and integral values, as compared with an equally sized group of healthy subjects. On maps of the electric manifestation of cardiac activity on the chest surface ischemic changes were revealed on the antrior and lower cardiac wall but also in its lateral and posterior wall. These changes were older and were found in the subendocardial layer or concurrently in another area of the heart with affection of the subepicardial layer. Minor non-transmural fibroses, most frequently on the septum, in some instances spreading to the anterior and lower cardiac wall, were a surprising finding. At present it is not possible to differentiate merely by analysis of the electric cardiac field the X syndrome and ischemic heart disease. This should be made possible by further comparative studies. The present paper is the first description of ischemic and fibrous cardiac changes in X syndrome diagnosed by a complex analysis of the electric cardiac field in the professional literature published in Czechoslovakia and other countries.

Adult↗