ABSTRACT
AIM: To study coronary-myocardial reserve in patients with a programmed pacemaker. MATERIALS AND METHODS: Stress-echocardiography was performed in 64 patients with coronary heart disease (CHD). The stress was induced by a gradual increase in the frequency of electrostimulation (ES) by 10 imp/min from initial 90 imp/min to threshold value which was defined as the frequency threshold of myocardial ischemia induction (FT). RESULTS: Registration of defects in local left ventricular contractility and cardiodynamics in frequent heart ES identified patients with predominant coronary and myocardial failure. Low FT (100-110 imp/min) indicates poor coronary reserve while a considerable rise of the end diastolic pressure in the left ventricle indicates limited myocardial reserve. Positive results of the test in isolated ventricular ES were obtained in 90.9%, in atrial ES in 72.7% of patients. CONCLUSION: As a highly informative and reproducible method, stress echocardiography can be employed for optimization of antianginal therapy in CHD patients with a pacemaker.
Subject(s)
Angina Pectoris/diagnostic imaging , Cardiac Complexes, Premature/therapy , Coronary Artery Disease/diagnostic imaging , Echocardiography , Pacemaker, Artificial , Adult , Aged , Angina Pectoris/complications , Angina Pectoris/physiopathology , Cardiac Complexes, Premature/complications , Cardiac Complexes, Premature/physiopathology , Coronary Artery Disease/complications , Coronary Artery Disease/physiopathology , Coronary Circulation/physiology , Exercise Test/methods , Female , Heart Rate , Humans , Male , Middle Aged , Myocardial Contraction/physiology , PrognosisSubject(s)
Digoxin/therapeutic use , Heart Diseases/therapy , Heart Failure/prevention & control , Hemodynamics/drug effects , Pacemaker, Artificial , Adult , Aged , Combined Modality Therapy , Depression, Chemical , Digoxin/adverse effects , Heart Diseases/physiopathology , Heart Failure/chemically induced , Hemodynamics/physiology , Humans , Middle Aged , Stimulation, ChemicalABSTRACT
An experience with prophylactics of wound complications and recurrences in treatment of 92 patients with great ventral hernias is analyzed. The incidence of wound complications was decreased from 34% to 9.5%, recurrences from 14% to 2.4%.
