Biomedical subjects
Z Durakovic
Publications and source records attributed to Z Durakovic.
Effects of postmyocardial infarction scar size, cardiac function, and severity of coronary artery disease on QT interval dispersion as a risk factor for complex ventricular arrhythmia.
The aim of the study was to determine the relation between QT dispersion and ventricular arrhythmia after myocardial infarction, as well as the effects of postinfarction scar size, cardiac function, and severity of coronary artery disease on QT dispersion. Three hundred three patients, 3 months after myocardial infarction, and a group of 21 healthy subjects were evaluated. QT dispersion was the difference between maximal and minimal QT interval in 12-ECG leads. Postinfarction scar size was determined by Selvester's QRS scoring system. Cardiac function was evaluated by echocardiography and exercise stress test, and the severity of coronary artery disease by the number and degree of coronary artery stenoses. QT dispersion increased significantly in relation to the severity of arrhythmia (< 50 premature ventricular complexes vs ventricular tachycardia; 61.6 [+/- 12.3] vs 84.8 [+/- 16.4] ms, P < 0.001). QT dispersion > 80 ms was associated with ventricular tachycardia with the sensitivity of 68% and specificity of 88%. QT dispersion also increased significantly, dependent on the postinfarction scar size (0% vs > or = 33% of left ventricular myocardium; 61.8 [+/- 16.4] vs 74.7 [+/- 16] ms, P < 0.001), as well as in the case of significantly impaired cardiac function. Although QT dispersion increased with the number of diseased vessels and the degree of stenoses, the differences were not significant (P > 0.05). In conclusion, QT dispersion is a risk marker of complex ventricular arrhythmia in the chronic stage of myocardial infarction. Multiple regression analysis indicates that only the postinfarction scar size has an independent effect on QT dispersion (R2 = 0.39, P < 0.05).
QT dispersion, daily variations, QT interval adaptation and late potentials as risk markers for ventricular tachycardia.
AIMS: The aim of the study was to determine the value and correlation between QT dispersion, daily variations in the QT interval and late potentials as risk markers for ventricular tachycardia. METHODS AND RESULTS: QT dispersion was defined as the difference between the longest and the shortest QT interval in 12 electrocardiographic leads, QTc variability as the difference between the maximal and minimal QTc interval during 24-h Holter monitoring and QT interval adaptation as the regression line between heart rate and the uncorrected QT interval. One hundred and forty-five patients, 3 months after myocardial infarction were included in the study. QT dispersion significantly increased with the severity of arrhythmia (modified Lown's classification; P< 0.001). The level of 80 ms was associated with ventricular tachycardia with a sensitivity of 72.7% and a specificity of 86.4%. The greater daily variability of the QTc interval in patients with ventricular tachycardia was insignificant (P > 0.05). QT interval adaptation did not discriminate between patients with ventricular tachycardia from those in other groups. Late potentials were associated with ventricular tachycardia with a sensitivity of 50% and a specificity of 90.3%. CONCLUSION: Large QT dispersion and late potentials were risk markers for ventricular tachycardia, but there was no correlation between QT dispersion, daily variations in the QT interval and late potentials in patients 3 months after myocardial infarction.
The influence of atenolol and propafenone on QT interval dispersion in patients 3 months after myocardial infarction.
UNLABELLED: The aim of the study was to determine changes in QTc dispersion and QTc interval during the administration of atenolol and propafenone. METHODS: Eighty-five patients, 3 months after myocardial infarction, were randomized in 2 groups. The first group (n = 46) received atenolol 50 mg daily during 7 days and the second group (n = 39) propafenone 300 mg per os twice a day. QT interval was measured in 12 ECG leads before and after the treatment after 100% strip enlargement on a photocopy machine. For correction we used Bazett's formula. QTc dispersion was defined as the difference between the longest and the shortest QTc interval in 12 ECG leads. RESULTS: QTc dispersion increased significantly with the severity of arrhythmia (< 50 premature ventricular complexes vs. ventricular tachycardia, 82.3 (18.1) vs. 110.0 (9.0) ms (p < 0.001)). QTc dispersion significantly decreases with the administration of atenolol (72.7 (14.8) vs. 63.6 (15.3)) (p < 0.001) as well as with propafenone (75.0 (17.7) vs. 63.2 (16.4)) (p < 0.001). QTc interval also decreases with atenolol (451 (28) vs. 431 (32)) (p < 0.01) while it does not change with propafenone administration (441 (26) vs. 444 (26)). CONCLUSION: QTc dispersion is associated with ventricular tachycardia. Both atenolol and propafenone significantly decrease QTc dispersion. Atenolol also decreases QTc interval, while with propafenone it does not change.
Oleander poisoning treated by resin haemoperfusion.
Explore the source record for details and available documents.
Combined hemoperfusion and hemodialysis treatment of poisoning with cholinesterase inhibitors.
Three patients with cholinesterase inhibitor poisoning have been presented. The patients were in a deep coma and, in one of them, artificial mechanical respiration was instituted. All three cases were treated by a procedure combining hemodialysis and hemoperfusion with Amberlite resin (XAD-4), and the clinical picture improved over a short period of time. After the end of procedure, the platelet count was approximately 41% of normal. Some aspects of these intoxications are discussed.
Ethylene glycol poisoning treated by haemodialysis.
Explore the source record for details and available documents.
Poisoning with 2,4-dichlorophenoxyacetic acid treated by hemodialysis.
In this paper four patients are presented who had been poisoned by 2,4-dichlorophenoxyacetic acid (2,4-D). The first patient, aged 51 years, had attempted to commit suicide by taking orally 400 ml of a 40% solution of 2,4-D. He was admitted in a coma, 6.5 h after poisoning. Extracorporal hemodialysis was performed and the course of the illness was satisfactory. The second patient, aged 80 years, had accidentally drunk 100 ml of a 40% solution of 2,4-D. He was admitted in a coma a few hours after poisoning. Hemodialysis and resin hemoperfusion were performed and the course of the illness was satisfactory. Prior to the above therapy the patient had a 2,4-D serum concentration of 177 mg/100 ml. 2,4-D clearance was 56.3 ml/min during this therapy. The third patient, aged 24 years, had drunk 200 ml of a 40% solution of 2,4-D in a suicide attempt, and paraquat poisoning was also suspected. He was admitted 10 h after poisoning and immediately hemodialysis and hemoperfusion were carried out: the course of the illness was satisfactory. On admittance the concentration of 2,4-D in serum was 122.5 mg/100 ml, and clearance was 72.9 ml/min during treatment. The fourth patient, aged 50 years, had accidentally drunk 100-200 ml of a 40% solution of 2,4-D. He was admitted in a coma 3 h after poisoning. Hemodialysis was performed and the course of the illness was satisfactory. On admittance the concentration of 2,4-D in serum was 37 mg/100 ml and clearance was 68.7 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)
[Echocardiographic analysis of changes in the heart in patients with systemic lupus erythematosus].
Fifty-six patients, 49 females and 7 males, with the confirmed diagnosis of systemic lupus erythematosus were examined by M-mode, 2--D and Doppler echocardiography. Pericardial effusion was found in 15 patients (27%), while pericardial thickening was suspected in 6 additional patients (37.5% altogether). Two patients had the signs of a pericardial tamponade, but both of them were uraemic. Libman-Sacks endocarditis was suspected in 4 patients (7.5%) because of verrucous changes in the aortic or mitral valve and regurgitant jet. Slight to moderate left ventricular hypocontractility was present in 3 patients (5%), while 3 additional patients had borderline values of the left ventricular contractility parameters. Left ventricular hypertrophy, usually mild, was found in 21 patients (37.5%). Echocardiographic signs of pulmonary hypertension were present in 2 patients (3.6%). It has been concluded that pericardial affection is frequent during the course of systemic lupus erystematosus, while a diffuse myocardial involvement is rare, except the consequences of arterial hypertension and accelerated coronary atherosclerosis. Libman-Sacks endocarditis still represents a diagnostic problem. For a more precise definition of cardiac involvement in systemic lupus erythematosus, a comparative analysis of the disease activity and immunosuppressive therapy is needed.
Digoxin-like substance in the serum of uremic patients before and after hemodialysis.
Digoxin concentrations in serum samples were measured before and after hemodialysis of 31 uremic patients (pts) who either never took digoxin or who had not taken digoxin for at least 1 year. False positive digoxin was found in 22 of 31 patients (71%) before hemodialysis and in 14 of 31 patients (45%) after hemodialysis. The concentrations ranged from 0.1 to 0.5 nmol/L, mean value was 0.20 +/- 0.16 before hemodialysis and after hemodialysis ranged 0.1 to 0.4 nmol/L mean value was 0.11 +/- 0.14 nmol/L. The difference before and after hemodialysis is statistically significant. Some of the patients had a constant value before and after hemodialysis. None had a higher value after hemodialysis than they did before. Eight patients, who had positive serum digoxin before hemodialysis with concentrations up to 0.5 nmol/L, became negative after hemodialysis. Our results indicate that a digoxinlike substance in uremic serum could be at least partly dialyzable.
The effect of rosemary oil on Candida albicans.
Explore the source record for details and available documents.
Electrocardiographic changes in rats after inhalation of dichlorotetrafluoroethane, Arcton 114, C2Cl2F4.
The effects of dichlorotetrafluoroethane, Arcton 114, on the heart of rats were examined in 17 white rats. The animals inhaled dichlorotetrafluoroethane for 1 or 1.5 min. Severe electrocardiographic changes including marked bardycardia, atrioventricular heart block of the second degree and complete heart block were registered. Cardiac standstill appearing 11 to 31 min after inhalation was a death cause in all rats. These results are similar to our previous results concerning the effects of dichlorodifluoromethane (Arcton 12) on the heart of rats.
The lack of clinical value of laboratory parameters in predicting outcome in acute renal failure.
In 55 patients with either the oliguric and nonoliguric form of acute renal failure, some laboratory parameters for the analysis of prerenal and intrinsic types of acute renal failure were examined. The parameters were analyzed within 7 days of the clinically known beginning of the illness. The parameters were analyzed as follows: sodium in urine, creatinine urine/plasma ratio, urine osmolality, osmolality urine/plasma ratio, renal failure index, and fractional excretion of filtered sodium. Hemodialysis was performed in 29 of the 55 patients. The oliguric form of acute renal failure was present in 49 of the 55 patients. In relation to renal failure index, prerenal acute renal failure was present in 7 patients and intrinsic acute renal failure in 48. It appears that in patients with a clinical diagnosis of prerenal acute renal failure, the urinary parameters do not separate them from those with acute tubular necrosis. It also appears that in patients with laboratory diagnosis of prerenal acute renal failure (i.e., a RFT less than 1.0), the response to treatment is unpredictable and in fact may have a worse prognosis than in those with a RFI greater than 1.0 (5/7 deaths vs 10/48 deaths).
Poisoning with a large dose of digitalis.
Explore the source record for details and available documents.