Biomedical subjects

Zoltán Jambrik

Publications and source records attributed to Zoltán Jambrik.

6 recordsLinked to original sources

PubMed2005

Lack of prognostic value of normalized integrated backscatter analysis of myocardium in patients with thalassemia major: a long-term follow-up study.

BACKGROUND: Patients with beta-thalassemia major often present with severe anemia and must undergo continuous transfusion therapy, consequently developing iron overload leading to hemochromatosis. Because of these the iron deposits and/or secondary structural changes, patients develop an increase in myocardial integrated backscatter (IB). AIM: To investigate the prognostic value of analyzing acoustic quantitative properties of the myocardium in patients with beta-thalassemia major. PATIENTS AND METHODS: Between 1989 and 1990, 38 patients (mean age: 18 years, range: 7-26, 21 males) with beta-thalassemia major and without clinical signs of cardiac failure were enrolled prospectively. All patients were on chelation therapy (desferroxiamine). To obtain quantitative operator-independent measurement of the IB signal of the left ventricular septum and posterior wall, the ultrasonic radiofrequency signal integrated values were normalized to the pericardial interface and expressed in percentage (IB%). RESULTS: Follow-up was 122 +/- 36 months, during which 15 events (7 cardiac deaths and 8 heart failures) occurred. The event-free survival was comparable in patients with normal and abnormal IB%. Septal IB% was 33 +/- 14 in the 15 patients with events, and 33 +/- 12 in the 25 patients without events (P = ns). The %IB had no prognostic value in this population. A prognostic value was found in multivariate analysis for patient refusal/noncompliance of chelation therapy (P = 0.02, OR: 4.37, 95% CI: 1.72-16.9) and also body mass index (P = 0.04, OR: 1.2, 95% CI: 1.0-1.4). CONCLUSION: Analysis of end-diastolic IB% of myocardium in patients with beta-thalassemia and iron overload was not predictive of adverse cardiac events during long-term follow-up in this study.

Acoustics↗

PubMed2004

[Mechanism of cough syncope].

Cough induced syncope belongs to the heterogenous group of situational syncopes. The mechanism of tussive syncope is demonstrated by presenting an illustrative case. A 79 year old male with underlying COPD was evaluated because of repeated cough related syncopal episodes. The nature of fainting was elucidated by haemodynamic monitoring of an induced cough attack. As documented by continuous blood pressure and middle cerebral artery blood flow velocity recordings, fainting was the result of the equalization of arterial and central venous pressures, with concomitant decrease in cerebral blood flow. Analogies and differences between haemodynamic responses induced by cough and Valsalva straining are highlighted. The typical lack of prodromal symptoms in cough syncope are well explained by the rapidly developing cerebral hypoperfusion.

Aged↗

PubMed2004

Does hypnotizability modulate the stress-related endothelial dysfunction?

Previous studies suggest that hypnotizability represents a protective factor against the cardiac effects of cognitive stress and that hypnosis prevents vascular stress-induced modifications in highly hypnotizable individuals. The aim of the experiment was to investigate whether a similar effect at vascular level is present in awake subjects with a high (Highs) and a low (Lows) hypnotic susceptibility. Thus, brachial artery post-ischaemic flow-mediated vascular dilation (FMD) was evaluated non-invasively by ultrasound methodology during cognitive stress (mental computation) in Highs and Lows. Results showed that Highs, similarly to that previously observed in hypnotized Highs and in contrast with Lows, did not exhibit any stress-related endothelial dysfunction (FMD decrement). Thus, hypnotizability should be considered a protective factor against vascular disease.

Adult↗

PubMed2004

Traditional acupuncture does not modulate the endothelial dysfunction induced by mental stress.

Acupuncture is a useful tool to treat many diseases, including cardiovascular disorders, but its modulation of stress-related responses is still debated. Aim of this study was to estimate whether the traditional Chinese acupuncture affected the transient impairment of the brachial artery flow-mediated dilation (FMD) produced by acute mental stress. In addition, since a high susceptibility to hypnosis attenuates the endothelial dysfunction elicited by mental calculation, the possible interaction between acupuncture and hypnotizability was investigated. Five low-to-medium and five medium-to-high hypnotizable healthy subjects joined two experimental sessions, for real and sham acupuncture. FMD and heart rate were measured in three conditions: baseline (PRE), after the real or sham acupuncture (ACU) and after mental calculation (MS). Needles were inserted into specific acupoints for real acupuncture and into non-acupoints, corresponding to the same spinal segment, for sham acupuncture. Results showed that the stress-related endothelial dysfunction was not modulated by acupuncture, but influenced by hypnotizability. In fact, highly hypnotizable subjects did not present any dysfunction, at variance with non-susceptible individuals that exhibited the expected stress-related FMD reduction (Mean +/- SD; PRE, 12.10 +/- 2.59; ACU, 10.73 +/- 3.45; MS, 6.48 +/- 1.72). Thus, hypnotizability appears more effective than acupuncture in contrasting the stress effects on the endothelial function. In conclusion, our study indicates the importance of patients' psychological evaluation in order to choose proper relaxation techniques and to evaluate therapeutic results and the necessity to integrate the alternative medicine practice with scientific research.

Acupuncture Therapy↗

PubMed2003

[Role of echocardiographic assessment of the left atrial appendage in clinical practice].

BACKGROUND: It is known for a long-while that the left atrial appendage is a frequent source of cardiac thrombus formation associated with systemic embolism. Transesophageal echocardiography made it possible to evaluate accurately the left atrial appendage in vivo. Albeit the most important part of transesophageal echocardiographic evaluation of left atrial appendage is the exclusion of thrombi, growing evidence support that several other clinically important informations can be achieved with its detailed ultrasonographic assessment. AIM: The purpose of authors was to summarize the data available in the literature on the echocardiographic evaluation of left atrial appendage. RESULTS AND CONCLUSIONS: Beyond transesophageal detection of left atrial appendage thrombus it is possible to assess the anatomic variations, dimensions, prethrombotic states and specific flow patterns of the appendage that may have clinically important diagnostic and prognostic impact.

Atrial Appendage↗

PubMed2002

Plasma levels of IL-6 correlate with hemodynamic abnormalities in acute pancreatitis in rabbits.

OBJECTIVE: To examine the relationship between plasma cytokine levels and cardiac and hemodynamic function. DESIGN: Measurement of cytokines and the systolic (left ventricular dimensions, heart rate, and cardiac output) and diastolic (early and late transmitral peak flow velocity: E and A-waves and their ratio) functions of the left ventricle (assessed by echocardiography) in rabbits. SETTING AND INTERVENTIONS: Laboratory and echocardiographic analyses were performed at baseline and at 1, 3, 6, 12, and 24 h after acute necrotizing pancreatitis induction (Group ANP), in rabbits after somatostatin pretreatment (Group S-ANP) and in sham-operated controls (Group C). MEASUREMENTS AND RESULTS: Left ventricular dilatation occurred at 6 h and cardiac output was increased 3 h after induction of acute necrotizing pancreatitis. Somatostatin pretreatment mitigated the left ventricular enlargement and filling abnormalities. Plasma level of IL-6 was increased significantly 3 h after pancreatitis induction, but to a lesser extent in Group S-ANP, while somatostatin prevented TNFalpha release (IL-6: Group ANP: 0, 0, 518+/-139, 956+/-125, 373+/-48, and 122+/-37 pg/ml; Group S-ANP: 0, 0, 191+/-68, 261+/-49, 23+/-13, and 0 pg/ml; TNFalpha: Group ANP: 88+/-42, 371+/-40, 2963+/-291, 276+/-30, 197+/-106, and 23+/-14 U/l; Group S-ANP: 91+/-34, 41+/-25, 68+/-42, 25+/-9, 0, and 0 U/ml). The increase in plasma level of IL-6 correlated significantly with left ventricular end-diastolic diameter and volume, cardiac output, and diastolic dysfunction. CONCLUSIONS: Plasma levels of IL-6, but not TNFalpha correlate with cardiac output and left ventricular filling characteristics in acute pancreatitis. Somatostatin pretreatment improves the cardiac and hemodynamic changes, probably through the decrease in cytokine release.

Animals↗