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Thyroid hormone (TH) is critical in cardiac cell differentiation (regulating contractile proteins and cell geometry) and this effect could be potentially exploited therapeutically in reversing the process of de-differentiation which underlies postischemic cardiac remodeling. Acute myocardial infarction was induced in male Wistar rats by ligating left coronary artery (AMI, n=8), while sham operated animals served as control (SHAM, n=8). 13 weeks after AMI, TH was administered in a group of animals for 4 weeks (AMI-THYR, n=9). TH significantly increased ß-MHC and decreased -MHC expression in the myocardium. This response was accompanied by changes in cardiac geometry: sphericity index, (SI, long to short axis ratio) was found to be 1.95 (SEM, 0.02) in SHAM, 1.51(0.03) in AMI and 1.64(0.03) in AMI-THYR, p<0.05. As a consequence, cardiac function was significantly improved: left ventricular ejection fraction (EF%) was 74.5% (SEM, 2.8) in SHAM vs 29.5% (2.1) in AMI, and 40.0% in AMI-THYR, p<0.05. Furthermore, +dp/dt and -dp/dt were 4250 (127) and 2278 (55) in SHAM vs 2737(233) and 1508 (95) in AMI vs 3866 (310) and 2137(111) in AMI -THYR, respectively, p<0.05. TH treatment partially reverses cardiac dysfunction in rats with old myocardial infarction by favorably changing cardiac chamber geometry and expression of myosin isoforms. Thyroid hormone, unlike current treatments, appears to be a paradigm of therapeutic intervention which aims at restoring cardiac geometry and may prove new effective treatment for heart failure.
Background. Cardiovascular diseases are the leading cause of death worldwide. In Ukraine, cardiovascular mortality is 66.7%. Material and methods. We examined 371 patients with myocardial infarction ( MI) with comorbid pathology who had undergone 90 days of rehabilitation. We studied the possibility of quantitative estimation of comorbid pathology, the condition of functional reserves in patients with MI, their connection with clinical markers of reduced exercise tolerance and comorbidity index. Results. We established close correlations between the six-minute walk tests conducted on the 10th, 30th and 90th days of rehabilitation (6MWT10, 6MWT30 and 6MWT90) with age of patients (r6MWT10 = -0.199; r6MWT30 = -0.287; r6MWT90 = -0.410 P < 0.05), SpO₂ (r6MWT10 = -0.399; r6MWT30 = -0.265; r6MWT90 = -0.248; P < 0.05), left ventricular ejection fraction (r6MWT10 = 0.706; r6MWT30 = -0.670; r6MWT90 = -0.583; P < 0.0001), troponin levels (r6MWT10 = -0.210; r6MWT30 = -0.312; P < 0.05); creatinine (r6MWT10 = -0.148; P < 0,05) and Charlson comorbidity index (r6MWT10 = -0.323; r6MWT30 = -0.398; r6MWT90 = -0.427; P < 0.0001). Conclusions. Markers of reduced exercise tolerance in patients with MI were age, SpO₂, ejection fraction, levels of troponin, creatinine, lymphocytes, Charlson comorbidity index.
Prostate Specific Antigen (PSA), a member of kallikrein family, is a specific serine protease of prostatic tissue. In some case reports, changes in PSA levels after acute myocardial infarction (AMI) have been reported. In this study we evaluated variations in PSA levels post-AMI. Twenty-six male patients who had PSA levels within reference limits were included in the study. The diagnosis of AMI was confirmed by clinical findings, ECG (electrocardiogram) and cardiac marker studies. Serum total PSA (tPSA) and free PSA (fPSA) levels were measured at days 0 (day of admission), 1, 2 and 3 after AMI. PSA/albumin ratio was also calculated in order to evaluate the effect of dilution. A statistical analysis of the results of all patients revealed significant decrease in tPSA levels and tPSA/Albumin ratio at day 2 when compared to days 0 and 3, which showed a similar pattern. Changes of fPSA and fPSA/ Albumin ratio according to days were not found significant. In only four patients we found increased levels of tPSA and increased fPSA levels in three of them. These patients displayed severe problems such as renal failure, cardiac failure, ventricular aneurysm and cerebral ischemia due to cardiac arrest. The lower tPSA levels on day 2 suggest that tPSA can be eliminated rapidly from the circulation on days 1 and 2, probably through the formation of complexes of tPSA with acute phase proteins.
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