Sigmental right ventricular contractile function in patients with ischemic heart disease

Segmental right ventricular function was assessed by dobutamine stress echocardiography in 101 patients with ischemic heart disease and multiple coronary artery lesions. At rest local wall motion abnormalities were found in 69% of patients. Overall 505 segments of the right ventricle were analyzed (5 per patient). At baseline 34% of segments were asynergic (31% - hypokinetic and 3% akinetic), right ventricular wall motion score index was 1.38+/-0.04. Low dose dobutamine infusion resulted in decrease of portion of asynergic segments (to 6%) and lowering of wall motion score index (to 1.09+/-0.02, p<0.001 vs baseline). The use of stress doses of dobutamine was associated with appearance of ischemic changes of the right ventricle accompanied with typical anginal attacks and ST-segment depressions; increases of portions of asynergic segments (up to 53% including 43% hypokinetic and 10% akinetic), and of patients with abnormalities of local contractility (up to 90%); rise of wall motion score index (up to 1.64+/-0.05, p<0.001 vs low dose dobutamine). Segmental right ventricular wall motion abnormalities reflected mostly reversible myocardial dysfunction (hibernating myocardium was revealed in 28, scar - in 6, and zone at risk of ischemia - in 47% of all segments). Right ventricular myocardial dysfunction developed in patients with predominant involvement of the right coronary artery or anterior interventricular branch.     

ECG-triggered skeletal muscle stimulation improves hemodynamics and physical performance of heart failure patients

BACKGROUND: Muscular counterpulsation (MCP) was developed for circulatory assistance by stimulation of peripheral skeletal muscles. We report on a clinical MCP study in patients with and without chronic heart failure (CHF). METHODS AND RESULTS: MCP treatment was applied (30 patients treated, 25 controls, all under optimal therapy) for 30 minutes during eight days by an ECG-triggered, battery-powered, portable pulse generator with skin electrodes inducing light contractions of calf and thigh muscles, sequentially stimulated at early diastole. Hemodynamic parameters (ECG, blood pressure and echocardiography) were measured one day before and one day after the treatment period in two groups: Group 1 (9 MCP, 11 no MCP) with ejection fraction (EF) above 40% and Group 2 (21 MCP, 14 no MCP) below 40%. In Group 2 (all patients suffering from CHF) mean EF increased by 21% (p<0.001) and stroke volume by 13% (p<0.001), while end systolic volume decreased by 23% (p<0.001). In Group 1, the increase in EF (6%) and stroke volume (8%) was also significant (p<0.05) but less pronounced than in Group 2. Physical exercise duration and walking distance increased in Group 2 by 56% and 72%, respectively. CONCLUSIONS: Noninvasive MCP treatment for eight days substantially improves cardiac function and physical performance in patients with CHF.     

Influence of Cardiopulmonary Bypass on the State of Cognitive Functions in Patients with Ischemic Heart Disease

Forty patients with ischemic heart disease and undergoing aortocoronary shunting surgery with cardiopulmonary bypass were studied. All patients were subjected to neuropsychological assessment and immunochemical analysis of the production of chemokines (IL-8, IP-10, MCP-1, MCP-3, MIP-1β, SDF-1α) and cytokines (TNF-α and IL-10). The aims of the study were to assess the presence and severity of cognitive deficit developing after surgery with cardiopulmonary bypass and to assess the effects of intraoperative Trasylol on its severity. Cognitive deficit on day 9 after coronary shunting with cardiopulmonary bypass was seen as impairments of attention, hearing-speech memory, visual memory, and dynamic praxis. Trasylol had a marked neuroprotective effect and suppressed the systemic inflammatory response. Patients given intraoperative Trasylol had no clinically significant cognitive deficit in the early post-operative period. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 105, No. 1, pp. 30–35, January, 2005.     

Plasmonic colloidal Au nanoparticles in DMSO: a facile synthesis and characterisation

We report a new pathway for the synthesis of plasmonic gold nanoparticles (Au NPs) in a bio-compatible medium. A modified room temperature approach based on the standard Turkevich synthesis, using sodium citrate as a reducing and stabilizing agent, results in a highly stable colloidal suspension of Au NPs in dimethyl sulfoxide (DMSO). The mean NP size of about 15 nm with a fairly low size distribution is revealed by scanning electron microscopy. The stability test through UV-vis absorption spectroscopy indicates no sign of aggregation for months. The Au NPs are also characterized by X-ray photoelectron, Raman scattering, and FTIR spectroscopies. The stabilisation mechanism of the Au NPs in DMSO is concluded to be similar to that of NPs synthesized in water. The Au NPs obtained in this work are applicable as SERS substrates, as proved by common analytes. In terms of bio-applications, they do not possess such side-effects as pronounced antibacterial activity, based on the tests performed on non-pathogenic Gram-positive or Gram-negative bacteria.

We report on the synthesis of stable plasmonic gold nanoparticles (Au NPs) in dimethyl sulfoxide (DMSO) and demonstrate that the AU NPs are biocompatible and function as SERS-active substrates.     

Characteristics of coronary artery lesions in patients with painless myocardial ischemia

AIM: To assess extent and localization of coronary artery lesions in patients with painless myocardial ischemia. MATERIAL AND METHODS: Tredmill stress-echocardiograghy, Holter ECG monitoring and coronary angiography were carried out in 59 male patients (age 30-72, mean 54.5 years) with either angina pectoris or painless ischemia. RESULTS: Among patients with painless ischemia 50% had 2-vessel disease, mostly with right coronary artery involvement (87.5%) and there was no case of left main stenosis. Patients with angina were characterized by significantly higher index of obstruction (p<0.005) and often had multivessel coronary artery disease (48.8%). CONCLUSION: Patients with effort angina compared with those with painless ischemia had more extensive and severe coronary artery involvement while the latter more often had right coronary artery stenoses.     

Ischemic heart disease in patients with renovascular hypertension: clinical picture, diagnosis and choice of a suitable method of treatment

The article analyses the results of examination of 234 patients with vasorenal hypertension and ischemic heart disease. The specific features of the clinical picture, electrocardiographic picture, the results of the bicycle ergometry test, scintigraphy of the myocardium with 201Te at the peak of the exercise, and aorto- and coronarography were revealed and described. The results of the captopril test in these patients were substantiated and analysed and on basis of the obtained data stage-by-stage operative treatment was recommended. It was proved that aorto-coronary shunt must be formed in such patients along with dilatation or operative correction of stenosis of the renal arteries. The first results of operative treatment are reported.