ABSTRACT
In 30 patients after myocardial infarctum with actual silent ischemia (no pain during last 12 months) mononitrate (Olicard 40) was administered and red blood cell deformability was determined. Clinical improvement and decrease of aforementioned deformability were observed after mononitrate therapy.
Subject(s)
Coronary Vessels/drug effects , Erythrocytes/drug effects , Isosorbide Dinitrate/analogs & derivatives , Myocardial Infarction/drug therapy , Vasodilator Agents/adverse effects , Adult , Aged , Female , Humans , Isosorbide Dinitrate/adverse effects , Male , Middle Aged , Treatment OutcomeABSTRACT
Progress in the investigations upon factors influencing the course of the ischemic heart disease focused our attention on the deformability of erythrocytes. That attribute of the red blood cells (RBC) is described by their susceptibility to changes in shape without changing volume. Because of that feature, RBC can reach the smallest capillaries of the circulatory system. The aim of the study was to determine the influence of mononitrates (Olicard Ret.) on the deformability of RBC (EDI) in correlation to the clinical course of the ischemic heart disease and to evaluate the role of catecholamines in the course of the disease and their influence upon EDI. 30 patients (pts) treated with mononitrates for 4 weeks were enrolled into the study. In 27 pts clinical improvement was recorded, as evaluated by the results of repeated exercise tests and changes in the number of anginal attacks. Mean weekly number of anginal attacks decreased from 6.2 to 2.1 (p < 0.05), and parameters of exercise tests improved: DP/Wmac decreased from 0.694 to 0.479 (p < 0.001) and maximal workload attained increased from 6.8 to 9.0 METS (p < 0.001). Correspondingly to the clinical improvement, beneficial changes in RBC deformability were seen: 0.033 vs 0.040 (p < 0.01). Correlation factor for changes in EDI (r = 0.628) was higher than that for the number of anginal attacks (r = 0.589), but lower than the correlation factor for exercise test parameters (r = 0.969 for DP/Wmax and r = 0.858 for METS). There were no significant changes in the urinary output of catecholamines and no correlations were seen between urinary output of adrenaline, noradrenaline and EDI.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Erythrocyte Deformability/drug effects , Isosorbide Dinitrate/analogs & derivatives , Myocardial Ischemia/drug therapy , Vasodilator Agents/pharmacology , Adult , Aged , Catecholamines/urine , Exercise Test , Female , Follow-Up Studies , Humans , Isosorbide Dinitrate/pharmacology , Isosorbide Dinitrate/therapeutic use , Male , Middle Aged , Myocardial Ischemia/physiopathology , Nitric Oxide/physiology , Vasodilator Agents/therapeutic useABSTRACT
The purpose of the study was to describe the clinical picture in patients with ischemic heart disease (IHD) and verifying severity of ventricular arrhythmias. The study included 856 patients with IHD aged 23-88 years (mean = 55.3), including 659 men and 197 women. Holter monitoring was performed in all patients. Ventricular arrhythmias were graded according to Lown. The patients were divided into five groups: group 1-349 patients with Lown's grade 1 and 2; group 2-95 patients with grade 3; group 3-152 patients with grade 4a and 4b; group 4-11 patients with grade 5; group 5-507 patients (selected from groups 2, 3 and 4) with Lown's grade 3 and 4 or 5. Arterial hypertension was found in 17.1%, myocardial infraction in 66%, and syncope in 12.3% of the patients. The patients with complex ventricular arrhythmias versus Lown's grade 1 and 2 show significant differences especially in respect to: the frequency of previous anterior myocardial infraction, the incidence of pain at rest, loss consciousness, the frequency of ventricular tachycardia and fibrillation, anginal pain and exercise-related arrhythmias. The patients with Lown's ventricular arrhythmia grade 3-5 do not differ significantly in their clinical manifestations of IHD from the patients with ventricular arrhythmias grade from 3 to 5. The development of silent myocardial ischemia during exercise stress testing is typical also for the patients with complex ventricular arrhythmias. A decreased contractility index, ejection fraction and dyskinesis are significantly more frequent in the patients with complex ventricular arrhythmias.