Kardiologiya
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Review Case Reports
[Anticoagulant therapy in connection with cardioversion in patients with atrial fibrillation].
We present data on possibility of anticoagulant therapy in conjunction with electrical cardioversion in patients with atrial fibrillation using novel anticoagulant - dabigatran - and a case of successful lysis of thrombus in the left ventricular cavity at the background of its administration.
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Aim of the study was determination of physiological limits of QT-intervals and its derivative values in healthy children and adolescents during graded exercise tests. We examined 100 healthy boys and girls aged 11-15 years (mean age 13.4+/-2.1 years) and performed electrocardiography at rest and standard veloergometry (VEM) in all of them. We analyzed corrected intervals according to Bazett (QTc=QT/RR) and Fredericia (FQTc/3RR) formulas. ⋯ Maximal QTc lengthening in the process of test did not exceed 50 ms in any of the examined persons. Hysteresis of QTc interval was equal to 21+/-6 (15-25) ms. The conclusion was made that algorithm of assessment of QT interval changes during exercise test should include initial values of QTc calculated according to the Bazett formula, maximal QTc value, level of exercise at which it was registered, maximal increase of QTc during exercise, and QTc interval hysteresis.
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Bisoprolol (bisoprolol fumarate) - -cardioselective blocker, does not possess intrinsic sympathomimetic and membrane stabilizing activity. The main indications for bisoprolol are arterial hypertension (AH) and heart failure. This article provides an overview of the literature on the potential uses of bisoprolol in the treatment of hypertension. ⋯ Proofs of the high efficiency of antianginal bisoprola and justified the use of the drug in patients with hypertension and coronary heart disease. The capabilities of bisoprolol in the perioperative correction of hypertension. The data and pharmacoeconomic properties of bisoprolol generic counterparts.
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Review
[Pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery].
More than 230 million surgical operations are performed yearly in the world and this number is continually growing. Thirty days mortality in moderate and high risk non-cardiac surgery is about 2% and exceeds 5% in patients with high cardiac risk. ⋯ This allows to avoid unjustified investigations and drug therapy in operations with low cardiac risk and stresses significance of perioperative medical treatment. This review contains an analysis questioning some statements of the novel ESC guidelines such as reduction of preoperative cardiac tests and prophylactic revascularization of coronary arteries before operations with intermediate and high risk of cardiac complications.
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Tobacco smoking is a major risk factor of the development of atherosclerosis and thrombosis. Components of tobacco smoke induce changes in the function of thrombocytes, endothelium, macrophages and smooth muscle cells of blood vessels. ⋯ The compounds of tobacco smoke also promote atherogenesis by affecting gene expression. Aim of the present article is to review published data about molecular mechanisms underlying harmful effects of ingredients of tobacco smoke such as nicotine and tar on the progression of atherosclerosis.