scholarly journals The Efficacy of Little Lovely Dentist, Dental Song, and Tell-Show-Do Techniques in Alleviating Dental Anxiety in Paediatric Patients: A Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hira Abbasi ◽  
Muhammad Saqib ◽  
Rizwan Jouhar ◽  
Abhishek Lal ◽  
Naseer Ahmed ◽  
...  
Keyword(s):  
Heart Rate ◽  
Dental Anxiety ◽  
Facial Image ◽  
Paediatric Patients ◽  
Scale Scores ◽  
Group 3 ◽  
Anxiety Levels ◽  
Group 2 ◽  
Facial Image Scale ◽  
Group 1

Introduction. Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient’s anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application “little lovely dentist,” group II: YouTube® “dental video songs,” group III “tell-show-do,” and group IV “control.” Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient’s education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t -test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant. Results. The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group. Conclusion. The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, “little lovely dentist,” and “dental songs” can alleviate dental anxiety experienced by paediatric patients. The “tell-show-do” technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

scholarly journals Possibilities of cardioselective beta - blocker bisoprolol therapy in patients having coronary artery disease and bronchial asthma

2019 ◽  
Vol 91 (9) ◽  
pp. 26-31
Author(s):  
N Y Grigorieva ◽  
T P Ilyushina ◽  
E M Yashina
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Calcium Antagonist ◽  
Beta Blocker ◽  
Ventricular Extrasystoles ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim: to compare the antianginal and pulse slowing effects, the impact on the ectopic myocardial activity as well as the safety of the treatment with beta - adrenoblocker bisoprolol, calcium antagonist verapamil and the combination of bisoprolol with amlodipine in patients with stable angina (SA) and bronchial asthma (BA). Materials and methods. The study included 90 patients with SA II-III functional class (FC) having concomitant persistent asthma of moderate severity, controlled, without exacerbation. The patients were divided into three groups with 30 individuals in each one depending on the main antianginal drug prescribed. Group 1 patients received a cardio - selective beta - adrenergic blocker bisoprolol (Concor) at the dose of 5 mg/day, patients of group 2 were treated by a calcium antagonist verapamil at the dose of 240 mg/day, patients of group 3 received combined therapy with bisoprolol at the dose of 5 mg/day and amlodipine at the dose of 5 mg/day given as a fixed combination (Concor AM 5/5). All the patients were investigated by the methods of daily ECG monitoring and respiratory function study (RFS) in addition to physical examination at baseline and after 4 weeks of treatment. Results. After 4 weeks of treatment, patients of group 1 and group 3 did not complain of angina attacks and did not use nitroglycerin unlike patients of group 2. The achieved heart rate (HR) in group 1 patients was 68.6±8.5 beats/min, in group 2 - 74.3±5.6 beats/min, in group 3 - 67.3±4.8 beats/min. A significant decrease in the number of supraventricular and ventricular extrasystoles occurred in patients of group 1 and group 3 only. Thus, the pulse slowing, antianginal, antiischemic and antiarrhythmic effect of the calcium antagonist verapamil, even at the dose of 240 mg/day, is not always sufficient for the patients with SA II-III FC and concomitant BA, unlike therapy with the inclusion of beta - blocker bisoprolol. During the study there was no registered deterioration in the indices of bronchial patency according to the RFS data in the patients of all three groups. Conclusion. In patients with coronary artery disease and concomitant asthma, all three types of pulse slowing therapy do not have any negative effects on bronchial patency. Therapy with the inclusion of beta - blockers (bisoprolol or its combination with amlodipine), in contrast to verapamil, reliably reduces heart rate and the number of supraventricular and ventricular extrasystoles in addition to a good antianginal effect.

scholarly journals Combined use of stress echocardiography and cardiopulmonary exercise testing to assess exercise intolerance in patients treated for acute myocardial infarction

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255682
Author(s):  
Krzysztof Smarz ◽  
Tomasz Jaxa-Chamiec ◽  
Beata Zaborska ◽  
Maciej Tysarowski ◽  
Andrzej Budaj
Keyword(s):  
Heart Rate ◽  
Stroke Volume ◽  
Stress Echocardiography ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
Cardiopulmonary Exercise ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Exercise intolerance after acute myocardial infarction (AMI) is a predictor of worse prognosis, but its causes are complex and poorly studied. This study assessed the determinants of exercise intolerance using combined stress echocardiography and cardiopulmonary exercise testing (CPET-SE) in patients treated for AMI. We prospectively enrolled patients with left ventricular ejection fraction (LV EF) ≥40% for more than 4 weeks after the first AMI. Stroke volume, heart rate, and arteriovenous oxygen difference (A-VO2Diff) were assessed during symptom-limited CPET-SE. Patients were divided into four groups according to the percentage of predicted oxygen uptake (VO2) (Group 1, <50%; Group 2, 50–74%; Group 3, 75–99%; and Group 4, ≥100%). Among 81 patients (70% male, mean age 58 ± 11 years, 47% ST-segment elevation AMI) mean peak VO2 was 19.5 ± 5.4 mL/kg/min. A better exercise capacity was related to a higher percent predicted heart rate (Group 2 vs. Group 4, p <0.01), higher peak A-VO2Diff (Group 1 vs. Group 3, p <0.01) but without differences in stroke volume. Peak VO2 and percent predicted VO2 had a significant positive correlation with percent predicted heart rate at peak exercise (r = 0.28, p = 0.01 and r = 0.46, p < 0.001) and peak A-VO2Diff (r = 0.68, p <0.001 and r = 0.36, p = 0.001) but not with peak stroke volume. Exercise capacity in patients treated for AMI with LV EF ≥40% is related to heart rate response during exercise and peak peripheral oxygen extraction. CPET-SE enables non-invasive assessment of the mechanisms of exercise intolerance.

scholarly journals THE PROPORTION OF PATIENTS WITH HYPERTENSION IN THE GROUPS OF TERMS PROLONGED QTc INTERVALS PER DAY DATA OF AMBULATORY ECG MONITORING IN DEPENDENCE FROM CLINICAL SIGNS

2018 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Rate ◽  
Coronary Heart Disease ◽  
Clinical Signs ◽  
Qtc Interval ◽  
Ecg Monitoring ◽  
Ambulatory Ecg Monitoring ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The study of the proportion of patients in 82 patients with hypertension in groups of different periods of prolonged QTc per day was performed based on the data of the AM of the ECG, depending on the clinical signs. Depending on the duration of prolonged QTc per day, the patients were assigned to one of three groups: group 1 – the term extended by day of the interval QTc from 0 to 33.3 %, group 2 – from 33.4 to 66.6 %, group 3 – from 66.6 to 100 %. The proportion of patients with hypertension was determined in the groups of the prolonged QTc interval depending on age, sex, weight of patients, type of circadian heart rate index, stage, degree and prescription of EH, presence of coronary heart disease, FC and stage of CHF and diabetes mellitus. According to the AM ECG, an prolonged QTc interval occurs in each patient with hypertension, with an increase of 0 to 33.3 % per day, it is detected in 76 %, from 33.4 to 66.6 % – in 16 % and with 66.7 to 100 % – in 8 % of patients. The existence of a prolonged QTc interval in each patient indicates that in its analysis it is necessary to base on the data of the AM of the ECG taking into account, except for the elongation and lengthening for a day.

scholarly journals A Comparative Study of 0.25% Levobupivacaine, 0.25% Ropivacaine, and 0.25% Bupivacaine in Paediatric Single Shot Caudal Block

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Jagdeep Sharma ◽  
Ruchi Gupta ◽  
Anita Kumari ◽  
Lakshmi Mahajan ◽  
Jasveer Singh
Keyword(s):  
Postoperative Pain ◽  
Demographic Data ◽  
Single Shot ◽  
Haemodynamic Parameter ◽  
Paediatric Patients ◽  
Parametric Data ◽  
Intergroup Comparison ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. There are limited data comparing levobupivacaine, ropivacaine, and bupivacaine in paediatric patients. So, this study was performed to evaluate the caudal effectiveness of all the three drugs in paediatric patients undergoing infraumbilical surgeries and associated complications with these drugs. Material and Methods. 90 patients of ASA grade I and II posted for elective infraumbilical surgeries were randomly divided into three groups of 30 each. A standardized anaesthetic protocol was used. Patients received 0.25% levobupivacaine in group 1, 0.25% ropivacaine in group 2, and 0.25% bupivacaine in group 3. The effectiveness of block was assessed using caudal effectiveness score. Postoperative pain relief was assessed with modified Hannallah pain score. Haemodynamic parameter monitoring was done. The duration of analgesia and associated complications were studied. Statistical analysis was done using the chi-square test for nonparametric data. Parametric data were analysed using ANOVA for intergroup comparison and Tukey’s HSD for intragroup comparison. Results. Demographic data were comparable. Haemodynamic parameters remained within normal range. Mean caudal effectiveness score in all the three groups was statistically insignificant (p>0.05). The duration of analgesia provided by bupivacaine (145.31 ± 26.17 min) was longer than levobupivacaine (126.15 ± 15.15 min) and ropivacaine (114.68 ± 11.32 min) (p<0.01). Mean postoperative pain scores were lower in group 3 as compared to group 1 and group 2. Conclusion. We conclude that levobupivacaine and ropivacaine provide similar intraoperative quality with minimal haemodynamic variability and shorter duration of postoperative analgesia without any significant complications when compared with racemic bupivacaine. This trial is registered with CTRI/2018/03/012402.

Effects of Timing of Coil Embolization after Aneurysmal Subarachnoid Hemorrhage on Procedural Morbidity and Outcomes

Neurosurgery ◽  
2000 ◽  
Vol 47 (6) ◽  
pp. 1320-1331 ◽  
Author(s):  
Gerasimos S. Baltsavias ◽  
James V. Byrne ◽  
Jim Halsey ◽  
Stuart C. Coley ◽  
Min-Joo Sohn ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Coil Embolization ◽  
Glasgow Outcome Scale ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
World Federation ◽  
Treatment Groups ◽  
Scale Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT OBJECTIVE To elucidate the effect of treatment timing on procedural clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH) for patients treated by endosaccular coil embolization. METHODS A group of 327 patients who were consecutively treated, during a 46-month period, for ruptured intracranial aneurysms by coil embolization within 30 days after SAH were evaluated. Outcomes were assessed by comparing immediate pretreatment World Federation of Neurological Surgeons (WFNS) grades, 72-hour posttreatment WFNS grades, and modified Glasgow Outcome Scale scores at 6 months for patients treated within 48 hours (Group 1), 3 to 10 days (Group 2), or 11 to 30 days (Group 3) after SAH. RESULTS The three interval-to-treatment groups included 33, 38, and 29% of the patients, respectively. Before treatment, 70% of the patients in Group 1, 78% of those in Group 2, and 83% of those in Group 3 were in good clinical grades (i.e., WFNS Grade 1 or 2). After coil embolization, the WFNS grades were either unchanged or improved for 93.5% of the patients in Group 1, 89.5% of those in Group 2, and 91.5% of those in Group 3. After 6 months, 81.3% of the patients in Group 1 experienced good outcomes (modified Glasgow Outcome Scale scores of 1 or 2), as did 84% of those in Group 2 and 80% of those in Group 3. No statistical difference was demonstrated between the three groups when they were compared for these two variables. CONCLUSION The interval between endovascular treatment and SAH did not affect periprocedural morbidity rates or 6-month outcomes. Coil embolization should therefore be performed as early as possible after aneurysmal SAH, to prevent aneurysmal rerupture.

scholarly journals P330 Blunted heart rate reserve during vasodilator stress echocardiography in diabetic and renal failure patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Bellino ◽  
D Ferraro ◽  
A Silverio ◽  
A P Peluso ◽  
L Soriente ◽  
...  
Keyword(s):  
Heart Rate ◽  
Renal Failure ◽  
Renal Function ◽  
Autonomic Dysfunction ◽  
Wall Motion ◽  
Beta Blockers ◽  
Cardiac Autonomic Dysfunction ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements None Background A blunted heart rate reserve (HRR) during dipyridamole stress echo (SE) is a marker of cardiac autonomic dysfunction associated with poor outcome, independently of inducible ischemia, underlying coronary artery disease (CAD) and beta-blocker therapy. Patients with diabetes and/or renal failure have higher prevalence of underlying autonomic dysfunction. Aim. To assess the value of HRR in patients undergoing dipyridamole SE. Methods We prospectively recruited a sample of 61 patients with known or suspected CAD (mean age 75 ± 10 years; 34 males, 55,7%; 50% on beta-blockers at the time of testing). Coexistent atrial fibrillation or previous pacemaker implantation were considered as exclusion criteria. Three groups were identified a priori: non-diabetic with normal renal function (n = 43, Group 1); diabetics, with normal renal function (n = 14, Group 2); severely impaired renal function on dialysis (n = 4, Group 3). All patients underwent dipyridamole SE (0.84 mg/kg in 10"). Wall motion score Index (WMSI) was calculated with a 17-segment score of left ventricle, each segment scored from 1= normal to 4= dyskinetic. HRR was measured by ECG as the peak/rest HR ratio. Results A positive SE (stress WMSI&gt; rest WMSI) was present in 2 patients of Group 1 (4.7%), 4 of Group 2 (28.6%) and no patient in Group 3. Heart rate was different, although not significant, among the 3 groups both at rest (66.1 ± 11.1 vs 64.6 ± 8.5 vs 79.0 ± 8.0, p = 0.050) and at peak stress (83.8 ± 12.6 vs 75.3 ± 10.3 vs 86.5 ± 11.1, p = 0.059). Of note, HRR was statistically different among groups (1.29 ± 0.20 vs 1.19 ± 0.14 vs 1.09 ± 0.06, p &lt; 0.047; see figure). There was no difference in HRR between patients off and on-beta-blockers (1.19 ± 0.16 vs 1.24 ± 0.24, p = 0.421) and with or without positive SE (1.20 ± 0.14 vs 1.25 ± 0.20, p = 0.530). Overall, HRR ≤ 1.17 (median value) was reported in 39.5% of Group 1, 71.4% of Group 2, and 100% of Group 3 pts (p = 0.024). No significant correlations between HRR and peak WMSI (p = 0.183) or age (0.062) were reported. Conclusion HRR is frequently abnormal in patients referred for SE testing, especially in presence of concomitant diabetes and advanced renal failure. The blunted chronotropic response is a simple, imaging independent marker of cardiac autonomic dysfunction and may usefully complement the conventional evaluation with regional wall motion abnormalities during vasodilator SE. Abstract P330 Figure title: HRR box plots

scholarly journals Inappropriate sinus tachycardia in post-covid-19 Syndrome

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Arano Llach ◽  
VBG Victor Bazan ◽  
GLL Gemma Llados ◽  
RA Raquel Adelino ◽  
MJ Maria Jesus Dominguez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Acute Phase ◽  
Sinus Tachycardia ◽  
Exercise Intolerance ◽  
Inappropriate Sinus Tachycardia ◽  
Persistent Symptoms ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Background Persistent symptoms after the acute phase of SARS-CoV-2 infection are referred to as "post-COVID-19 syndrome" (PCS), with a reported incidence ranging between 35% and 87%. Fatigue, palpitations and exercise intolerance are common complains among PCS patients in whom unexplained sinus tachycardia, occasionally exacerbated by postural changes, is a frequent observation that remains poorly characterized. Purpose We sought to characterize the prevalence of inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia (POTS) in a consecutive and prospective population of patients with PCS. Methods Consecutive patients with persistent symptoms 3 months after an acute SARS-CoV-2 infection were prospectively evaluated at a multi-disciplinary PCS unit. All patients were screened for IST or POTS and those with confirmed criteria underwent comprehensive cardiovascular examination including echocardiography, 24-hour Holter, Minnesota Living with Heart Failure Questionnaire (MLHFQ), six-minute walking test (6MWT) and inflammation and myocardial biomarkers. Two control patients, matched by age and gender, were assigned to each case: one with previous SARS-CoV-2 infection without PCS (group 2) and one without prior SARS-CoV-2 infection (group 3). Results IST or POTS criteria were met in 34 out of the 200 PCS patients (17%). The mean age was 39 ± 10 years, with 29 women (91%). The interval from the index COVID-19 disease to the PCS diagnosis was 71 ± 17 days, with a majority of patients (n = 29,85%) not requiring hospital admission during the acute phase. At physical examination, the mean heart rate was 96 ± 3bpm at supine and 112 ± 17bpm at the upright position, with 8 patients fulfilling diagnostic criteria of POTS. No underlying structural heart disease, pro-inflammatory state, myocyte injury or hypoxia were identified among our patient population. The 6MWT showed a significantly diminished exercise capacity with a 59% of the estimated distance after adjustment by age, sex and body mass index; an impaired quality of life was also identified, as suggested by a median MLFHQ total score of 67 out of 105 points. The 24-hour Holter showed an increase in HR predominantly during daytime in group 1 (mean daytime HR of 94 ± 3bpm), an altered heart rate variability with a decrease in time domain parameters [PNN50 4 ± 4 in group 1 (vs. 11 ± 9 in group 2 and 18 ± 9 in group 3; p &lt; 0.002)respectively; SD 100 ± 20 (vs. 127 ± 38 and 136 ± 13; p = 0.009) and a decrease in frequency domain parameters [LF 751 ± 450 (vs. 1721 ± 1009 and 2199 ± 920; p = 0.01), HF 336 ± 280 (vs. 823 ± 1200 and 1229 ± 630; p = 0.01)]. Conclusions IST and its POTS variant are a prevalent condition among PCS patients and may at least partially explain the common symptoms of fatigue, impaired exercise and palpitations that characterize the PCS. Cardiac autonomic nervous system imbalance may account as a plausible pathophysiological mechanism of IST in PCS patients.

scholarly journals Evaluation of anxiety levels of pregnant women with gestational diabetes mellitus

2020 ◽  
Vol 28 (2) ◽  
pp. 89-94
Author(s):  
Aşkın Evren Güler ◽  
Zeliha Çiğdem Demirel Güler ◽  
Asil Budak ◽  
Buket Koparal ◽  
Özge Şehirli Kıncı
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Control Group ◽  
Significant Difference ◽  
Group 3 ◽  
Anxiety Levels ◽  
Group 2 ◽  
Group 1

Objective The aim of this study was to investigate the anxiety levels of pregnant women with gestational diabetes mellitus (GDM) followed by different treatment methods. Methods Our study was carried out with 141 cases whose pregnancy follow ups were made in Gynecology and Obstetrics Clinic. Cases which had GDM screening with 75-g oral glucose tolerance test (OGTT) were divided into 3 groups. Group 1 (control group) consisted of 50 cases with 75-g OGTT results in normal range, Group 2 consisted of 50 cases which had significant 75-g OGTT results and followed up by diet (A1), and Group 3 consisted of 41 cases which were diagnosed with GDM as a result of 75-g OGTT and received diet as well as medical therapy (A2). Beck anxiety inventory (BAI) was administered to the patients in Group 1 in 24th week, and to patients in Groups 2 and 3 in the 24th and 32nd weeks. Results In the first evaluation of the patients, BAI scores of the control group were statistically found to be significantly lower than the patients with GDM (p=0.001). There was no significant difference in BAI scores among patients diagnosed with GDM, and high anxiety scores were found in both groups. There was a significant decrease in anxiety levels in the Groups 2 and 3 after the treatment (p<0.01). In the Group 2, the BAI scores were observed to decrease from 51.76±4.47 to 45.62±3.65, and from 51.73±5.27 to 41.48±3.29 in the Group 3 (p<0.001). Conclusion In addition to the metabolic disorders brought by the disease itself, GDM can cause various problems by increasing the levels of anxiety in patients. With an effective treatment for glycemic control, anxiety levels of patients can be reduced.

Differences among Campus Groups on a Measure of Self-Actualization

1973 ◽  
Vol 32 (1) ◽  
pp. 135-140 ◽  
Author(s):  
T. Glen Reeves ◽  
Robert A. Shearer
Keyword(s):  
Personal Orientation Inventory ◽  
Group 4 ◽  
Scale Scores ◽  
Self Actualization ◽  
White Majority ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Personal Orientation ◽  
Group 1

To investigate differences in self-actualization among campus groups the Personal Orientation Inventory (POI) was administered to 192 Ss. The POI scale scores were factor analyzed. Three factors were identified and the following groups were compared on the basis of mean factor scores: Group 1—Black students ( N = 51); Group 2—white majority ( N = 72); Group 3—white, overt, non-conformists ( N = 31); Group 4—white, covert, non-conformists ( N = 22); Group 5—white, non-affiliated ( N = 16). Groups 1 and 2 scored significantly higher on Factor I (self-actualization feelings), no significant differences were found on Factor II (self-actualization thinking), and Group 1 scored significantly higher than Group 5 on Factor III (tentatively identified as a measure of self-concept).

scholarly journals Differentiated approach to the use of optimal medical therapy in patients with various clinical forms of stable ischemic heart disease

2019 ◽  
pp. 22-27 ◽  
Author(s):  
I. I. Shaposhnik ◽  
V. I. Karnot ◽  
T. M. Karandasova ◽  
O. F. Bannikova ◽  
O. G. Bocharova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Medical Therapy ◽  
Ischemic Heart ◽  
Elevated Blood ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

A total of 137 male patients with stable ischemic heart disease (SIHD), average age 62.3 ± 7.46 years, were divided into 3 groups depending on the initial measurements of blood pressure (BP) and heart rate (HR). Group 1 included patients with elevated blood pressure and/or heart rate (44.5% of patients); Group 2 included patients with normal blood pressure and/or heart rate (38.7%); Group 3 included patients with lowered blood pressure and/or heart rate (16.8%). Patients of Group 1 received beta-adrenergic blockers (BABs) or non-dihydropyridine calcium channel blockers (NDCCBs), in some cases ivabradine-containing BABs (Raenom®, Gedeon Richter) at doses required to achieve target blood pressure and heart rate. The patients of Group 2 received a limited range of drugs above listed due to their blood pressure and heart rate measurements, and the patients of Group 3 did not receive any due to the low levels of such measurements. Effectiveness of the therapy in patients of Group I was the highest. The use of trimetazidine MB (Predizin MB®, Gedeon Richter) has significantly improved the results of treatment in patients of Groups 2 and 3. Trimetazidine MB added to the therapy in patients of Group 1 improved the effectiveness of treatment. Prolongation of trimetazidine MB therapy contributed to improvement of its anti-ischemic effect. Thus, BABs, NDCCBs and ivabradine entered into the foreground, as an optimal medical therapy (OMT) in patients with elevated blood pressure and heart rate measurements. Trimetazidine MB, and ivabradine in some cases prevail in patients with normal and low blood pressure and/or heart rate. It should be stated that patients with various hemodynamic variants of SIHDa require a differentiated approach to the choice of OMT.

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