Biomedical subjects
Publications and source records attributed to Z G Bondareva.
The study shows that the extent of atherosclerotic changes in the coronary arteries, revealed during coronaroangiography, has a significant correlation with the serum level of total cholesterol (TC). In patients with normal (less than 5.2 mmol/ l) TC the number of involved arteries and the number of stenotic segments are significantly smaller than those in patients with a TC level higher than 6.5 mmol/l.
The study demonstrates that arterial hypertension itself, judging by main anthropometric variables such as body weight index and waist to hip ratio, together with the estrogen-producing function of the ovaries, evaluated by measuring follicle-stimulating hormone levels, contributes substantially to the forming of abdominal obesity in normo- and hypertensive women. All the above confirms close correlation between hemodynamic and metabolic disturbances which eventually result in coronary heart disease in young and middle-aged women.
Levels of basal insulinemia, malondialdehyde (an index of oxidative stress) and some metabolic parameters were studied in 143 men and 83 women aged 48.3+/-0.7 years with incomplete metabolic syndrome: hypertension, abdominal obesity, dyslipoproteinemia with normoglycemia. Basal insulinemia correlated significantly with malondialdehyde levels both in men and women. Slose relationship was also found between basal insulinemia and waist circumference.
The course of myocardial infarction (MI) in women, especially 60 years of age and older, is characterized by such severe complications as cardiorrhexis, hypovolemic cardiogenic shock, asystole, recurrent ventricular fibrillation and electromechanic dissociation responsible for the majority of lethal outcomes. Especially high MI lethality is in women at the age 70-79 years who have also the highest incidence of recurrent macrofocal MI while small-focal MI occurs in women over 80 years of age (80-89) more frequently than in 60-year-olds and younger. Dominating MI risk factors in women were the following: arterial hypertension detected in 81% patients under 60 and 90.8% cases over 60 years; abnormal lipid spectrum of blood including hypercholesterolemia (HCE), hypertriglyceridemia (HTE) and low concentration of HDLP cholesterol. HCE and HTE closely correlated with abdominal obesity irrespectively of age. Early menopause in women under 60 and diabetes mellitus of type 2 in older women, accumulation of two and more factors of risk contribute to development of coronary heart disease and MI, in females.
AIM: To clarify informative value of secretory ability of pancreatic beta-cells and correspondence of insulin values to glycemia in the course of standard glucose tolerance test (GTT) in detection of insulin-resistance in patients with arterial hypertension (AH) to verify metabolic syndrome (MS). MATERIAL AND METHODS: Correlation and factor analyses were performed of correlations between glycemia, immunoreactive insulin (IRI), C-peptide, glucose/IRI in the course of GTT in 111 AH patients divided into groups by the sum of metabolic disturbances. RESULTS: The greatest number of correlations were seen for glucose/IRI fasting index. According to the factor analysis, changed sensitivity to insulin and hyperinsulinemia are the first stage of metabolic disturbances in AH irrespective of body mass. In obesity the number of the above correlations is maximal. Multivariance analysis has shown significant differences between AH patients and healthy subjects irrespective of body mass and glucose tolerance. CONCLUSION: Basal index glucose/IRI < 6 relative units is informative in all the studied variants of metabolic syndrome as regards insulin resistance.
The following conditions in patients with alcoholic cardiac involvement predispose to recurrences of atrial fibrillation: atrial dilatation, shortening of refractory period, slowing of atrial conduction, increased vulnerability to extra stimuli, appearance of fragmented electrical activity i.e. late atrial potentials on high resolution ECG, autonomic influences on the heart, hypokalemia and hypomagnesemia.
128 patients with primary mitral prolapse and 72 healthy controls were examined using noninvasive methods. The analysis of the findings revealed predictors of electric myocardial unstability: reduced variability of cardiac rhythm, diastolic left ventricular dysfunction, late ventricular potentials and growing dispersion of the Q-T interval. Detection of mitral regurgitation correlates with development of ventricular arrhythmia.
The study of 46 patients suffering from dilated cardiomyopathy has shown that both ventricular tachycardias detected at 24-h ECG monitoring and late ventricular potentials are essential predictors of sudden arrhythmic death. These predictors depend neither on severity of left ventricular systolic and diastolic dysfunction nor on severity of cardiac decompensation.
Recently, high lethality of critical conditions in diabetes mellitus patients has been attributed to the presence of hyperosmolarity syndrome. The authors consider this problem in terms of plasm osmolarity parameters, pathogenesis and diagnostic criteria of hyperosmolarity. Present-day clinical variants of hyperosmolarity syndrome are characterized.
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A survey of 180 patients with unstable angina pectoris has demonstrated that transient hypermyoglobinemia detected in 58% of patients is a more informative parameter than those obtained with electrographic and enzyme immunoassay used in the diagnosis of focal alterations in the heart muscle in the disease. Measurement of serum myoglobin levels by rapid radioimmunoassay in these patients is of predictive value as it allows a group of subjects at high risk for myocardial infarction to be identified.
Serum cholesterol (SC), HDL SC and triglycerides were measured in 303 senile patients aged 75-89 and 77 long-livers aged over 90. The concentrations obtained were low in healthy long-livers compared to senile subjects. SC, triglycerides and atherogenic index reached the highest values in senile subjects and long-livers with coronary heart disease and abnormal cerebral circulation. Lower levels of HDL SC appeared in the same diseases in senile males and female long-livers against healthy subjects of the relevant age group.
Changes in skin vascular responsiveness (VR) to six vasoactive agents were examined in 25 patients with myocardial infarction during its acute period. In small myocardial infarction, there was a synchronous increase in all VR types on days 1-7 followed by its normalization on day 14. VR synchronization was also observed in transmural myocardial infarction, yet increased VR to vasoconstrictive agents such as noradrenaline, adrenaline, and angiotensin II remained until the end of the fourth week without showing a tendency to normalization. Abnormal VR was seen in the most severe fatal cases. The synchronous and cyclic VR changes observed in myocardial infarction were absent in patients with unstable angina that did not result in myocardial infarction.
A study was made of the content of total cholesterol (TCh), high-density lipoprotein cholesterol and triglycerides (TG) in 109 persons aged 75-89 years of both sexes depending on tobacco smoking (14 persons), prolonged alcohol abuse (15 persons), and on hypodynamia (30 persons). A positive correlation was obtained between the content of TCh in blood serum and hypodynamia, between the content of TG, alcohol abuse, tobacco smoking and hypodynamia. Meanwhile a negative correlation was established between the content of high density lipoprotein cholesterol and hypodynamia and tobacco smoking.
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The questioning of highly-qualified cardiologists, using the expert assessment technique, demonstrated that 4 groups of signs could be identified in unstable angina which differed significantly (p less than 0.01) with respect to the risk of myocardial infarction. Nine of 18 signs, associated with the poorest prognosis are listed in order of significance. There is no basic agreement among highly qualified cardiologists as to the assessment of risk signalled by the individual signs. Patients with unstable angina are not a homogeneous sample as regards the short-term prognosis of myocardial infarction where infarction risks seem to increase at a relatively even pace rather than by peaks. Therefore, the assessment of myocardial infarction risks requires that more than 2 groups be identified. Patients with different types of unstable angina may have similar prognosis. The prognosis tended to be particularly poor in patients with spontaneous angina.
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