Publications (13)21.45 Total impact
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Article: [Radiofrequency ablation of electrical storm using an epicardial approach in a patient with ischaemic cardiomyopathy].
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ABSTRACT: We describe a case of a 63 year-old male who underwent successful RF ablation of recurrent ventricular tachycardia using epicardial approach.Kardiologia polska 01/2011; 69(8):863-6. · 0.51 Impact Factor -
Article: Exudative pericarditis in a pregnant woman as the first sign of non-Hodgkin's lymphoma.
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ABSTRACT: This case report presents a 25 year-old pregnant female diagnosed with exudative pericarditis which was the first sign of cardiac lymphoma. Such a manifestation of this disease is rare and it represents a significant diagnostic and therapeutic problem in pregnant women.Kardiologia polska 01/2011; 69(8):825-6. · 0.51 Impact Factor -
Article: Leptin and inflammation in patients with chronic heart failure.
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ABSTRACT: There is an increasing interest in the role of leptin in cardiovascular pathophysiology, including proinflammatory effects. Many studies have reported elevated leptin levels in non-cachectic patients with chronic heart failure (CHF), however, the role of leptin in CHF remains unclear. To assess the relationship between leptin levels in patients with CHF and left ventricular (LV) systolic dysfunction in relation to ventilatory response to exercise and hsCRP levels. The study group consisted of 41 patients (mean age 50.2 ± 9.3 years) with stable CHF and LV ejection fraction < 45% and eight healthy controls (mean age 43.6 ± 14.7 years). Sixteen (39%) patients had coronary artery disease. All subjects underwent anthropometric measurements (weight, height, and waist circumference), standard echocardiography, and maximal cardiopulmonary exercise treadmill test. Biochemical analysis included the assessment of leptin and hsCRP levels as well as white blood count (WBC) and erythrocyte sedimention rate. Leptin levels, including body mass index (BMI)-adjusted leptin levels, were significantly higher in the CHF patients than in the controls (9.2 ± 7.5 vs 2.9 ± 1.25 ng/mL; p = 0.005). We found significantly higher WBC, neutrophil count, lymphocyte percentage and BNP levels in the CHF group vs controls. There were significant correlations in the CHF group between leptin levels and BMI (r = 0.55; p < 0.05), waist circumference (r = 0.49; p < 0.05), leukocyte count (r = 0.41; p < 0.05), hsCRP levels (r = 0.34; p < 0.05), and peak VO₂ (r = -0.34; p < 0.05). Multivariate step forward regression analysis showed that peak VO₂ was significantly related with leptin levels. After adding VE/VCO₂ slope to the multivariate regression analysis model, only VE/VCO₂ slope was independently associated with leptin levels. There is a significant relationship between serum leptin levels and peak VO₂, VE/VCO₂ slope and levels of inflammatory markers in patients with CHF.Kardiologia polska 11/2010; 68(11):1243-7. · 0.51 Impact Factor -
Article: Evaluation of exercise capacity with cardiopulmonary exercise testing and BNP levels in adult patients with single or systemic right ventricles.
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ABSTRACT: The aim of the study was to evaluate exercise capacity using cardiopulmonary exercise test (CpET) and serum B-type natriuretic peptide (BNP) levels in patients with single or systemic right ventricles. The study group included 40 patients (16 males) - 17 with transposition of the great arteries after Senning operation, 13 with corrected transposition of the great arteries and 10 with single ventricle after Fontan operation, aged 19-55 years (mean 28.8 ±9.5 years). The control group included 22 healthy individuals (10 males) aged 23-49 years (mean 30.6 ±6.1 years). The majority of patients reported good exercise tolerance - accordingly 27 were classified in NYHA class I (67.5%), 12 (30%) in class II, and only 1 (0.5%) in class III. Cardiopulmonary exercise test revealed significantly lower exercise capacity in study patients than in control subjects. In the study vs. control group VO(2max) was 21.7 ±5.9 vs. 34.2 ±7.4 ml/kg/min (p = 0.00001), maximum heart rate at peak exercise (HRmax) 152.5 ±32.3 vs. 187.2 ±15.6 bpm (p = 0.00001), VE/VCO(2) slope 34.8 ±7.1 vs. 25.7 ±3.2 (p = 0.00001), forced vital capacity (FVC) 3.7 ±0.9l vs. 4.6 ±0.3 (p = 0.03), forced expiratory volume in 1 s (FEV(1)) 3.0 ±0.7 vs. 3.7 ±0.9l (p = 0.0002) respectively. Serum BNP concentrations were higher in study patients than in control subjects; 71.8 ±74.4 vs. 10.7 ±8.1 (pg/ml) respectively (p = 0.00001). No significant correlations between BNP levels and CpET parameters were found. Patients with a morphological right ventricle serving the systemic circulation and those with common ventricle physiology after Fontan operation show markedly reduced exercise capacity. They are also characterized by higher serum BNP concentrations, which do not however correlate with CpET parameters.Archives of medical science : AMS. 04/2010; 6(2):192-7. -
Article: Oxygen uptake efficiency slope correlates with brain natriuretic peptide in patients with heart failure.
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ABSTRACT: Cardiopulmonary exercise testing is a well-established tool for clinical and prognostic assessment of patients with chronic heart failure (CHF). Recently, a new parameter of this examination--oxygen uptake efficiency slope (OUES)--has been described and proposed as a new prognostic factor in patients with CHF. Brain natriuretic peptide (BNP) is an established prognostic factor in CHF. The purpose of the study was to assess OUES in patients with CHF in relation to other cardiopulmonary parameters and BNP levels. The study group consisted of 42 patients with CHF and left ventricular ejection fraction (LVEF) < 45% (mean age 50.2 +/- 9.3 years, mean ejection fraction 26.1 +/- 8.1% and NYHA functional class - 2.5 +/- 0.8) and eight healthy controls (age 43.6 +/- 14.7 years). Coronary artery disease was diagnosed in 16 patients (38%). All underwent maximal cardiopulmonary exercise treadmill test. BNP level was measured using Abbott AxSYM Immunoassay system. There were significant (p < 0.001) differences between the patients and controls in BNP levels (350 +/- 520 vs 14 +/- 19 pg/mL), OUES (1.7 +/- 0.4 vs 2.7 +/- 0.5), peak VO(2) (17.1 +/- +/- 5.1 vs 36.9 +/- 4.9 mL/kg/min), O(2) pulse (10.9 +/- 3.3 vs 15.9 +/- 2.7) and VE/VCO(2) slope (35.7 +/- 7.8 vs 25.7 +/- 2.7). In patients, OUES was significantly (p < 0.001) correlated with LVEF (r = 0.54), BNP levels (r = -0.49), peak VO(2) (r = 0.80), VO(2) AT (r = 0.65) and VE/VCO(2) slope (r = -0.59). BNP was independently related to OUES in multivariate regression analysis. Oxygen uptake efficiency slope is significantly reduced in patients with CHF and correlates with peak VO(2) and other parameters of cardiopulmonary exercise treadmill test. It is not related to age. BNP is an independent marker of OUES in patients with CHF.Cardiology journal 01/2010; 17(4):362-6. · 1.31 Impact Factor -
Article: Coronary artery disease in a competitive athlete. Is running always healthy?
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ABSTRACT: This case report presents a marathon runner who was diagnosed with coronary artery disease. We discuss the issue of evaluation of such patients with respect to continuation of competitive physical activity. The reported case shows that continued training involving above class IA-IIA sports is possible (however, long-distance running as well?) if a subject with single vessel disease after an effective PCI maintains close contact with his/her doctor and obeys the rules of safe training. On the other hand, it supports the thesis that regular working out, even in professional athletes, does not guarantee 'healthy' coronary arteries.Kardiologia polska 12/2009; 67(12):1424-7. · 0.51 Impact Factor -
Article: Evaluation of exercise capacity with cardiopulmonary exercise test and B-type natriuretic peptide in adults with congenital heart disease.
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ABSTRACT: Adult patients with congenital heart disease (CHD) usually find their exercise capacity satisfactory. However, objective evaluation is important for diagnostic and prognostic purposes. The aim of this study was to evaluate exercise capacity using cardiopulmonary exercise tests and measurement of serum B-type natriuretic peptide (BNP) levels in adult patients with CHDs, both in the entire study cohort and in subjects with individual types of cardiac lesions, as well as to verify the relation between BNP level and cardiac performance. The study group included 265 patients (136 males; mean age 34.4 +/- 11.6 years) 173 of whom were operated on at the mean age of 9.2 +/- 7.3 years. They represented the following types of CHD: 72 patients--surgically corrected coarctation of the aorta, 62--surgically corrected tetralogy of Fallot, 28--Ebstein anomaly, 26--patent atrial septal defect, 24--Eisenmenger syndrome, 20--uncorrected or palliated complex cyanotic lesions, 11--corrected transposition of the great arteries (TGA), 14--TGA after Senning operation, and 8--common ventricle after Fontana operation. The control group consisted of 39 healthy individuals (17 males) with a mean age of 35.8 +/- 9.3 years. According to NYHA classification, 207 patients were recognized as representing class I symptoms, 47 subjects class II, and 11 class III. Cardiopulmonary exercise revealed significantly reduced exercise capacity in adults with CHD in general, compared to control subjects: maximal oxygen uptake (VO2max) was 23.3 +/- 6.9 vs. 33.6 +/- 7.2 mL/kg/min, respectively (p = 0.00001); maximum heart rate at peak exercise (HRmax) -161.1 +/- 33.2 vs. 179.6 +/- 12.3 bpm (p = 0.00001); respiratory workload (VE/VCO2slope) - 35.7 +/- 9.7 vs. 26.3 +/- 3.1 (p = 0.00001); and forced vital capacity (FVC) - 3.8 +/- 1.1 vs. 4.6 +/- 0.7 L (p = 0.00003). Various degrees of peak VO2max reduction were observed across the spectrum of CHD. Patients after repair of aortic coarctation demonstrated the highest VO2max (26.8 +/- 6.6 mL/kg/min), and the lowest was demonstrated by patients with Eisenmenger syndrome (12.8 +/- 4.8; ANOVA p = 0.00001). Serum BNP levels in the study group were higher than in the controls: 55.4 +/- 67.5 vs. 13.9 +/- 13.7 pg/mL, respectively (p = 0.00001). Various degrees of BNP level increase were found across the spectrum of CHD. Patients after repair of aortic coarctation demonstrated the lowest BNP level (24.8 pg/mL), and the highest level was found in patients with cyanotic defects (120.7 pg/mL; ANOVA p = 0.00001). BNP levels across the NYHA classes were as follows: I--35.7 pg/mL, II--94.1 pg/mL, and III--225.6 pg/mL. BNP levels showed negative correlation with VO2max (r = -0.525, p = 0.0001), FVC (r = -0.349, p = 0.00001), FEV1 (r = -0.335, p = 0.00001), and positive correlation with VE/VCO2slope (r = 0.447, p = 0.00001). The exercise capacity of patients with CHD is, in general, compromised, most strikingly in patients suffering from pulmonary hypertension and cyanosis. Serum BNP levels in these subjects are increased and correlate well with exercise capacity. BNP level is higher in patients with cyanotic CHDs.Cardiology journal 02/2009; 16(2):133-41. · 1.31 Impact Factor -
Article: Risk factors of supraventricular arrhythmia in adults with congenital heart disease.
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ABSTRACT: Supraventricular arrhythmia (SVA) is a frequent clinical complication in adult patients with congenital heart disease (CHD). The aim of this study is prognostic evaluation of congenital heart defect complexity, performed cardiac surgery, initial functional impairment of the heart - NYHA > I, cyanosis, age and sex of the adult patients with CHD, presenting for the first time to an outpatient clinic, on SVA occurrence during long-term observation. We looked at 1,304 patients (586 men), aged 18-72 years (mean 29.4 +/- 10.6 years), and followed-up from 1995 to 2004. The mean observation period was 3.52 +/- 1.83 years. SVA in the form of atrial flutter/fibrillation (FA/FLA) and supraventricular tachycardia was observed in 133 patients, 10.3% of the study population. Ten-year follow-up showed that the likelihood of SVA occurrence in the whole studied population after two years was 5.2%, and 14.4% after ten years. Univariate analysis proved that the incidence of SVA is greater in patients with complex heart defects (p = 0.0001), those not previously operated upon (p = 0.0001), those with baseline impairment of cardiac function (NYHA > I; p = 0.0001) and those with cyanosis (0.0001). The patient's sex seems to have little significance. Cox regression analysis showed that baseline heart failure is the strongest risk factor for SVA (HR = 4.66). Congenital heart defect complexity (HR = 2.31) and the patient's age are also significant prognostic factors of this arrhythmia (HR = 1.32). Cardiac surgery, cyanosis and patient sex are not significant in prognosis. Baseline impairment of heart function, heart defect complexity and patient's age all increase the risk of SVA in the population of adults with congenital heart disease. Cyanosis and the lack of cardiac surgery in the past led to a higher incidence of the analyzed arrhythmia but are not risk factors for its occurrence. Gender has no prognostic significance for SVA.Cardiology journal 01/2009; 16(3):218-26. · 1.31 Impact Factor -
Article: Cardiopulmonary exercise test in the evaluation of exercise capacity, arterial hypertension, and degree of descending aorta stenosis in adults after repair of coarctation of the aorta.
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ABSTRACT: Background: Despite effective repair of coarctation of the aorta (CoAo), arterial hypertension (AH) and early coronary artery disease that may result in heart failure. The aim of the study was to evaluate exercise capacity by a cardiopulmonary exercise test in patients after of CoAo repair, and to determine relations between these parameters and the presence of AH, residual stenosis of the descending aorta (AoD) and the patient's age at the time of the surgery. Methods: 74 patients at mean age 31.2 +/- 9.8 years. The controls: 30 at mean age 32.2 +/- 6.6. Descending aorta (AoD) gradient was evaluated by echocardiography. The group with residual AoD stenosis: >/= 25 mm Hg (AoD+) 32 patients and AoD-: 41 patients. Subgroups without AH (AH-, n = 32), exercise-induced AH (AHex, n = 10), persistent AH (AH+, n = 32). The maximum exercise test was performed. Results: A comparison of the study and control groups: VO(2)max: p = 0.0001), VO(2)max%: p=0.0001 and VE/VCO(2): p = 0.001. Negative correlation: between VO(2)max and the age at the time of surgery: p = 0.004) and a positive: between VE/VCO(2) and age at surgery: p = 0.005. No differences were observed between the AoD+ and AoD- groups with respect to cardiopulmonary parameters. A comparison of the AH+ and AH- groups revealed: VO(2)max: p = 0.01, VO(2)max%: p = 0.02 and VE/VCO(2): p = 0.003. A comparison of the AHex and AH- groups showed VE/VCO(2): p = 0.01. Conclusions: The exercise capacity of adults after surgical CoAo repair is reduced. This is more pronounced in patients with AH and those operated on at a more advanced age, but not in AoD+. (Cardiol J 2007; 14: 76-82).Cardiology journal 01/2007; 14(1):76-82. · 1.31 Impact Factor -
Article: Adults with Ebstein's anomaly--Cardiopulmonary exercise testing and BNP levels exercise capacity and BNP in adults with Ebstein's anomaly.
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ABSTRACT: Ebstein's anomaly is defined as the significant apical displacement of the part of the tricuspid valve causing significant tricuspid regurgitation and reduction of the functional right ventricle. The aim of the study was to evaluate exercise capacity with cardiopulmonary stress testing and to determine plasma BNP levels in adults with Ebstein's anomaly, and to establish their relation with echocardiogaphic grading of the lesion severity. Study group consisted of 21 patients (16 males, aged 40.3+/-11.5 years). The control group: 19 healthy individuals (13 males, aged mean 39.9+/-9.3 years). On echocardiography the grade of the lesion severity was calculated (EGE) and used to define the following four groups: I < 0.5, II: 0.5-0.9, III: 1.0-1.49, IV > 1.5. The forced vital capacity (FVC), first second forced expiratory volume (FEV1), peak oxygen uptake (peak VO2), and VE/VCO2 slope were assessed with cardiopulmonary stress test and plasma BNP levels measured with radioimmunometric assay. In the studied group VO2 was lower than in control (21.9+/-5.4 vs. 33.6+/-8.3 mL/kg/min [p = 0.00001]), VE/VCO2 slope was higher in Ebstein's group (40.1+/-8.1, p = 0.00001). BNP levels were higher in the Ebstein group then in controls (35.9+/-25.0 vs. 17.2+/-9.9 pg/mL [p = 0.0002]) and did not differ significantly between EGE groups. PeakVO2 of 24.5+/-3.9 in patients from II EGE group were higher than in patients from EGE groups: III (17.2+/-5.2 p = 0.007) and IV (22.9+/-4.7 p = 0.05). Exercise capacity of adults with Ebstein's anomaly is significantly reduced and plasma BNP levels are higher compared to healthy individuals. Exercise capacity in patients with Ebstein's anomaly becomes gradually lower alongside the EGE severity; however, BNP levels do not correlate significantly with this parameter.International Journal of Cardiology 07/2006; 111(1):92-7. · 7.08 Impact Factor -
Article: The BNP concentrations and exercise capacity assessment with cardiopulmonary stress test in patients after surgical repair of Fallot's tetralogy.
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ABSTRACT: Adult patients after surgical repair of Fallot's tetralogy usually present with satisfactory exercise capacity years after the original procedure, though they never tolerate as high levels of exercise as their healthy counterparts. The aim of the study was to assess exercise capacity with cardiopulmonary stress test and BNP levels in adult survivors of surgical repair of Fallot's tetralogy. We studied 60 patients with no or only mild symptoms (including 29 males), at the mean age of 27.6+/-8.2 years at the time of follow-up screening, operated on at the age of 7.5+/-5.3 years. In 34 patients moderate to severe pulmonary regurgitation (PR+) was observed. Control group consisted of 28 healthy volunteers (13 males), aged 28.7+/-5.1 years. Peak oxygen uptake (VO2) in studied group was found to be significantly lower than in control group (24.7+/-5.5 vs. 36.6+/-7.6 ml/kg/min, p=0.00001), VE/VCO2 slope, the marker of respiratory effort, was higher in surgical treatment group as compared to the control group (36.5+/-6.3 vs. 29.7+/-4.7, p=0.004). In patients with PR+, peak VO2% was higher than in PR- individuals (69.6+/-11.8% vs. 58.5+/-12.1%, p=0.0005). The BNP concentration in the studied group (34.8+/-27.1 pg/ml) was higher than in healthy subjects (11.5+/-6.5 pg/ml, p=0.00001). Levels of BNP correlated inversely with peak VO2 (r=-0.286, p=0.03), FVC (r=-0.265 p=0.04) and positively with VE/VCO2 (r=0.361, p=0.005). Additionally the levels of BNP correlated positively with the age of patients at the time of surgical repair (r=0.250, p=0.04). We concluded that exercise capacity in adults after repair of Fallot's tetralogy, especially those PR+, was lower than in healthy volunteers. Concentrations of BNP in surgical treatment survivors were higher and correlated well with cardiopulmonary stress study parameters.International Journal of Cardiology 07/2006; 110(1):86-92. · 7.08 Impact Factor -
Article: [The risk of mitral pathology in marphanoid female basketball players].
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ABSTRACT: Recently much research has been done focusing on the problem of athlete's heart as a physiological phenomenon as well as a cause of morbidity or even mortality. The question rises whether pathology discovered in some athletes was primary or developed after professional excessive training program. We studied a group of young female athletes (basketball players) to test the hypothesis that marfanoid habitus, favorable in this sport, could bear predisposition for pathology of the heart. We studied 38 young female athletes, mean age 15 (+/- 1.8) years, participants of special education program for talented sportsmen from all over Poland. Athletes were included on the basis of outstanding results and participating at least one year in professional basketball. Complete echocardiographic examination was performed according to protocol which included M-mode, 2D and color Doppler. Systolic and diastolic morphologic and functional parameters were assessed and compared to normal values related to the age. Stature of studied athletes exceeded the 95 percentile. There were no significant differences in morphological parameters of the heart. Mitral incompetence (at least II grade) was a common finding in this group (37%). In the group exhibiting marphanoid habitus, mitral incompetence was present in all except one case (89%). Tall stature being favorable in basketball promotes athletes with marphanoid habitus which have higher risk of mitral incompetence.Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):299-301. -
Article: [Cardiopulmonary exercise test in the evaluation of exercise capacity in patients with Ebstein anomaly and patent ostium secundum atrial septal defect aged over 30 years].
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ABSTRACT: There are few data available on applying the cardiopulmonary exercise test for evaluation of cardiac exercise capacity in adult patients with congenital heart diseases. The aim of the study was to perform this test in adults with Ebstein anomaly and patients with patent ASD II (atrial septal defect) and determination of potential relationships between these parameters and echocardiographically assessed hemodynamic indices. Twenty patients with Ebstein anomaly mean aged 40.3 +/- 12.3 years were studied. Control group consisted of 19 individuals at mean age of 39.9 years. Echocardiography was performed for the evaluation of severity of the disease. Additionally, 36 patients with ASD II were included, mean age 44.7 +/- 8.2 years. The control group consisted of 25 individuals at mean age of 45.6 years. Maximum exercise treadmill test was carried out and resting and exercise spirometry. Ebstein anomaly. Maximum oxygen uptake, minute ventilation, maximum heart rate and blood pressure at peak exercise were significantly lower in study patients than in control group. VE/VCO2 was increased. No differences were observed between groups with respect to spirometric parameters. Oxygen uptake decreased along with the severity of the disease. ASD II. Maximum oxygen uptake, minute ventilation, maximum heart rate and blood pressure at peak exercise and spirometric parameters were significantly lower in study patients than in control group. Significant negative correlations were shown for VO2 (maximum oxygen uptake) and Qp:Qs (pulmonary to systemic flow ratio) (p = 0.004), maximum heart rate - HRmax and HRmax% and RV (end-diastolic right ventricular diameter) (p = 0.02 i p = 0.01), RV and systolic pressure at peak exercise (p = 0.03), obstruction marker FEV1 and RV (p = 0.04) and between RVSP (right ventricular end-systolic pressure) (p = 0.01). Negative correlation was observed between RQ (respiratory quotient) and RVSP (p = 0.004), and positive correlation between HRmax and VO2 (p = 0.005). The exercise capacity of adults with Ebstein anomaly and those with patent ASD II is significantly reduced. It decreases along with the echocardiographic severity of the disease in Ebstein anomaly patients and it seems to result from the right ventricular volume overload in patients with patent ASD II.Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):293-5.
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2006–2011
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Poznan University of Medical Sciences
- • Department of Clinical Pharmacology
- • Department of Cardiology
Poznań, Greater Poland Voivodeship, Poland
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