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ABSTRACT: Papillary fibroelastomas are rare, primary, benign cardiac tumors most frequently located in the heart valves. They are a potential cause of systemic embolization and may be associated with myocardial ischaemia, transient ischaemic attacks, strokes, or sudden death. We describe the case of 75-year-old woman with diagnosed aortic insufficiency who was admitted to hospital with acute coronary syndrome. The fibroelastoma of the anterior mitral leaflet was diagnosed using transthoracic and transoesophageal echocardiography. We provide a differential diagnosis and review of the literature concerning the pathologic intracardiac masses affecting cardiac valves.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 11/2009; 27(161):393-6.
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ABSTRACT: Cardiovascular diseases (CVDs) are the main cause of death and disability in Poland. There are many risk factors of CVD which are modifiable due to preventive strategies. Knowledge about these factors among population at risk of CVD is the most important condition for success of them.
To evaluate the knowledge of CVD risk factors among soldiers of the Polish Army and try to identify a demographic factors influenced on them.
Authors investigated the level of knowledge about CVD risk factors among 644 soldiers (aged between 18 to 62 years) using the special questionnaire. Whole group was analyzed according to a place of origin: city, town and village and according to a function: professionals and conscripts.
Soldiers achieved a total score of 58.4% correct answers. Commonly known risk factors of CVD (average 82% of correct answers) in studied group were: obesity, tobacco smoking, high level of cholesterol and hypertension. Knowledge about above risk factors was significantly higher (p < 0.01) than about other. Lesser known risk factors (average 54% of correct answers) were: male gender, abnormal diet, sedentary lifestyle, family history of CVDs, diabetes, family history of heart infarction below 55 yrs and peripheral atherosclerosis. residents achieved 64.5% correct answers, town--61.5%, and village--58%. Professionals achieved 65.1% vs. 58.8% for conscripts. The level of knowledge about CVD risk factors are significantly higher among professionals than in urban population.
Our data confirm the need of continuation and developing new CVDs preventive strategies in Poland, especially among poor educated and village populations. There is a need to emphasize the role of lesser known, modifiable CVD risk factors (e.g., obesity, sedentary lifestyle) in existing and future health programs.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2009; 27(160):273-8.
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ABSTRACT: Severe aortic regurgitation and stenosis are urgent indication for aortic valve replacement in patients with left ventricular dysfunction, however the effect of cardiac surgery may differ in both groups. The aim of the study was to evaluate the early changes of haemodynamic parameters of heart: ejection fraction, endsystolic and enddiastolic left ventricle diameters, endsystolic and enddiastolic left ventricular wall thickness and left atrium diameter, depending on ejection fraction value (EF), in patients undergoing aortic valve replacement due to isolated aortic stenosis or regurgitation.
250 patients engaged to the study were subjected to the mechanical aortic valve replacement in Cardiac Surgery Department in Lodz. All patients were divided into two groups--patients operated due to aortic regurgitation and aortic stenosis. Then each group, depending on EF volume before operation, was divided into two subgroups (A - EF between 35 and 50%; B - EF below 35%).
Comparing the pre- and early postoperative period, ejection fraction rose markedly in both subgroups of patients with aortic stenosis and the highest increase was ascertained in subgroups A. Analyzing endsystolic and enddiastolic left ventricle diameters we observed the reduction of left ventricle diameters in all groups. Evaluating endsystolic left ventricular wall thickness we observed the increase of wall thickness in both subgroups B. Analogically enddiastolic left ventricular wall thickness increased in all analyzing groups, whereas in groups with lowest fraction the rise was essential.
Aortic valve replacement both due to aortic stenosis and regurgitation is associated with improved haemodynamic status in early postoperative period.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2006; 20(120):642-5.
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ABSTRACT: The aim of the study was to evaluate the degree of membrane lipid peroxidation, internal microviscosity, activity of both total and Na+, K+ membrane ATP-ase and markers of oxidative damage of membrane protein in erythrocytes of elderly people with primary hypertension.
The examination was performed on 50 people. The first group (HA) consisted of 15 elderly people with primary hypertension (mean age 71, 3 years old). The reference groups were formed with healthy elderly people (K1) (15 people, mean age 72, 4 years old) and younger healthy people (K2) (20 people, mean age 55, 3 years old).
Membrane lipid peroxidation of red blood cells was significantly increased in the group of elderly people with primary hypertension (HA). The lowest level of lipid peroxidation was observed in the (K2) normotensive group of younger people. Erythrocyte internal microviscosity was significantly higher in the group of healthy elderly people (K1) compared with the group of healthy younger people (K2). In HA group additional essential increase in microviscosity was observed in comparison with K1 and K2. The activity of both total and Na+, K+ membrane ATP-ase was significantly the highest in the group of younger people and the lowest in the group of elderly people with primary hypertension. In HA group increased damage of membrane protein was observed that was indicated by the reduced -SH group content and the increased value of W/S parameter in comparison with K1 and K2 groups.
The obtained results indicate that in the elderly people with accompanying primary hypertension the whole-body oxidative stress is increased, which may be indicated by structural and functional oxidative damage of red blood cells. These observations may be significant in the pathogenesis of hypertension complications. This observation may be important in the pathogenesis of hypertension complications in this period of life.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2006; 20(120):646-50.
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ABSTRACT: The recent studies revealed the relation between depression and the prevalence of cardio-vascular diseases, as well as their complications. However the correlation between the risk factors of coronary artery disease and depression in patients suffering from cardio-vascular disorders hasn't been sufficiently examined. The history of myocardial infarction (MI) is a well known factor, which increases mortality. The aim of the study was to determine if there was any relation between the history of myocardial infarction and depression rate in patients with cardio-vascular diseases.
The study involved 163 patients, 75 women and 88 men, aged 29 to 86 years (mean age 60.75 +/- 11.01), hospitalised for the purpose of undergoing coronary angiography or percutaneous transluminal coronary angioplasty (PTCA). Before the procedure, the symptoms of depression were evaluated in all the patients. Each of them filled the Beck's scale inquiry-sheet. Two groups of patients were detached: group A consisted of patients with the history of MI (n = 96), group B-of patients with negative history of MI, diabetes who had never undergone PCI, or coronary artery bypass graft (CABG) before (n = 42). The control group (group C) consisted of 75 individuals, aged 20 to 80 (mean age 45 +/- 11.14 y), who felt healthy according to WHO criteria, weren't on any medication, hadn't been hospitalised in previous 5 years (at any reason) and in whom cardio-vascular diseases and their modificable risk factors were excluded.
The median of the Beck's score of depression for group A (9 points) was significantly higher (Wilcoxon test), than for group B (6.5 points), p < 0.02 and for the group C (3 points), p < 0.05. (tab. 1).
In patients with cardio-vascular disorders depression is more frequent, than in health individuals. History of MI increases the prevalence of depression.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(118):382-5.
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ABSTRACT: The effect of the changing weather conditions on the incidence of the paroxysmal atrial fibrillation (PAF) has not been documented before.
This analysis retrospectively assessed the influence of the weather conditions on 1153 PAF cases over the period of 10 years. The average age of the studied population was 64.9 +/- 9.2 years. There was 60% males in the group. The majority (84%) had an existing heart disease, the remaining part was diagnosed as the lone PAF.
The following factors favoured the FAP occurrence: high air temperature (> 25 Centigrade) for more than 3 days, low temperature (< 8 Centigrade), water vapor pressure > 16.5 kPa, accelerated increase of the air pressure > 8hPa over 2 days.
The following weather conditions such as: temperature, air humidity and pressure have a definite impact on the occurrence of the paroxysmal atrial fibrillation episodes in 87% of patients especially those with co-existing coronary heart disease, hypertension or older age.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):265-9.
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ABSTRACT: Practising a record-seeking sport may in consequence lead to morphological and functional changes in a heart muscle. The physiological changes which are result of heart's adaptation to a greater physical effort are called "sportsman's heart". AIM OF THE THESIS: The value of echocardiographic tests in detecting and designating frequency of occurrence of heart abnormalities in sportsmen. The comparison of echocardiographic, functional and morphological adaptation changes in a group of sportsmen of both static and dynamic disciplines. The safety of practising football and bodybuilding. The influence of length of time when the sport is practised on the quantity of echocardiographic parameters.
The material analysed in the doctor's thesis consists of a group of 40 men practising a static sport and a group of 40 men subjected to dynamic effort, as well as a control group of 30 men who do not practise any sport. In all the examined men the analysis comprises echocardiographic examination. The analysis deals with morphology and function of heart's structures: the left and the right ventricles, atrium and valves, on the basis of echocardiography The data is evaluated in each group of sportsmen (frequency of occurrence of heart abnormalities in sportsmen) and compared both between the record-seekers practising two kinds of training, and between the record-seekers and the control group.
Adaptation changes of the left ventricle in the sportsmen practising static disciplines showed thickening of walls of the left ventricle with the lessening of its inner size, so called concentric hypertrophy. Thickness of walls of the left ventricle did not exceed 12 mm in diastole in 97% of the examined. In the dynamic group a slight growth in thickness of the walls with the delatation of the left ventricle's cavity was observed in relation to the sportsmen of the static group (p < 0.002). In both groups of sportsmen a significantly higher than in the control group mass index of the left ventricle was noted, (however, it did not exceed 130g/m2) and the size of the left atrium (p < 0.05) and of right ventricle (p < 0.05).
The left ventricle's adaptation changes to static and dynamic effort differ. In the group of static effort there is noted a larger growth of walls' thickness with the smaller size of the left ventricle in comparison with the dynamic effort group. However, hypertrophy of the left ventricle walls occurs rarely and is usually small, more intense in the group subjected to static effort. Some parameters of the right ventricle's morphology differed significantly statistically in both groups of sportsmen. Nevertheless, physical effort causes changes in the right ventricle's morphology, irrespectively of the sort of the practised sport. Record-seeking football and bodybuilding turned out to be safe in the examined group. The length of time when the sport was practised does not affect the quantity of the monitored echocardiographic parameters.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):274-8.
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ABSTRACT: Release of prostaglandin E2 (PGE2) and leukotrien B4 (LTB4) in vitro by resting and PHA-stimulated peripheral blood mononuclear cells (PBMNC) in the presence of three concentrations of myoinositol (30, 300, 600 micromol/l) was investigated.
We examinated 10 uremic patients on regular hemodialysis treatment and 10 healthy subjects (control group).
Release of PGE2 and LTB4 by resting and PHA-stimulated PBMNC was significantly lower in the presence of myoinositol in concentrations generally obserwed in the blood serum of chronic uraemic patients on regular hemodialysis treatment (600 micromol/l) in both investigated groups, while it remained unchanged in the presence of myoinositol in the concentration observed in normal blood serum (30 micromol/l).
The results seem to indicate that myoinositol, in the concentrations found in uremic blood serum, may possibly exert antiinflammatory actions.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 03/2006; 20(116):180-3.
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ABSTRACT: The aim of this study was to evaluate whether analysis of signal averaged P wave, together with left atrial diameter (LA) and P wave duration in surface ECG lead II (PII) allow to predict the risk of PAF.
Patients with coronary heart disease and/or hypertension were examined (n=145). They were divided into two groups 110 patients with PAF were compared with 35 patients without PAF Age (60,5 vs. 57,4 years) and LA size (39,8 vs. 3,7 mm) were similar in two groups.
The root mean square voltage (RMS) for the last 10,20, 30 ms were calculated and for all of the filtered P wave (RMSW) were measured RMS ratio (RMSR) were calculated according to RMSW/ RMS20. Filtered P wave duration (PWD) and difference befteen PWD and P II (PWD-PII) were established. Most of the analyzed parameters were statistically significant (p<0,05). The statistical analyses made it possible to outline the score index evaluating how PAF reacts parameters.
Score index evaluating of the PAF occurrence and its influence is statistically significant with sensitivity 86%, specificity 83,5% and index positive predictor 82,7% and index negative predictor 83,7%. The most significant parameters which detect the patients with the occurrence of PAF are PWD > or =130ms, RMS20<3, microV, RMS10<2,2 microV and PWD-PII > or =40 ms.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2006; 20(115):69-72.
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ABSTRACT: The free radical theory of aging assumes that aging process leads to lost of oxidative balance. Oxidative stress induces structural and functional changes in red blood cell. The Q10 coenzyme is known as a compound which may partially prevent those changes in erythrocytes, due to its antioxidative properties and the important role it plays in the cell. The content of the coenzyme in human body decreases with age. The aim of the research was to evaluate the degree of membrane lipid peroxidation, internal microviscosity, activity of membrane ATP-ase and oxidative damage markers of erythrocyte membrane protein in elderly people before and after Q10 coenzyme therapy.
The examination was performed on 35 people. The examined group consisted of elderly people (older than 65 years old). The reference group was formed with people at the age between 51 and 59. In both groups the initial parameters of red blood cells were evaluated. In the elderly people the investigated parameters were also controlled after three and six weeks of Q10 coenzyme intake.
The Q10 coenzyme supplementation in elderly people produced the increase in the -SH group contents and reduction of W/S parameter. After supplementation of Q 10 coenzyme the decrease of lipid peroxidation products and internal microviscosity of erythrocytes and increase of the activity of membrane ATP-ase (total and Na+,K+) were observed.
The obtained results may indicate the intensification of oxidative stress in elderly and point to beneficial effect of supplementation-metabolic therapy with Q10 coenzyme on structural and functional parameters of red blood cells in elderly people.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2006; 20(115):57-61.
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ABSTRACT: Percutaneous coronary intervention is a proven method of treatment of significant number of patients with coronary artery disease. Sometimes it is accompanied by increases of troponin levels. Frequency and degree of these phenomena are not well known.
of the present study was to establish frequency and a degree of the increase of cardiac troponin I (cTnI) in patients with stable coronary artery disease who underwent elective PTCA without complications during hospitalization.
Our study included 99 patients fulfilling the above mentioned criteria. Average patients' age was 58,7 years (range 37-82 years). In 67 patients PTCA was performed on one artery, in 27 on two and in five on 3 arteries. In 36 patients standard stents were implanted, in the remaining (63 patients) only PTCA was performed. In the group with stents 29 patients had 1 stent implanted, 6 patients had 2 stents and one had 3 stents implanted. In all the patients cTnI (Abbott AxSYM Immunoassay) were determined before PTCA, 12 and 24 hours after PTCA.
After 12 hours percentage of cTnI results above 1.22 microg/L (cut-point for spontaneous infarction according to the new definition of heart infarction) amounted to 35% and above 2.0 microg/L (cut-off according WHO infarction definition) 28%. After 24 hours the percentages were similar. Typical cTnI results (90%) after PTCA were below 10 microg/L. cTnI levels were weakly but statistically significantly correlated with number of vessels, which underwent PTCA.
Moderate increases in troponin I after PTCA seem to correspond to minimal, in general, cardiac injury.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 01/2006; 19(114):739-42.
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ABSTRACT: The abnormal amino acid profile and altered distribution of some amino acids between the extra- and intracellular compartments is currently recognized as a part of metabolism abnormalities in hemodialyzed uremic patients associated with prognosis. The aim of this study was to investigate the pattern of HD influence on the extra- and intracellular amino acid concentrations in neutrophil homogenates and in blood serum. Before HD, the concentrations of arginine (64 vs 33 micromol/l) and cysteine (70 vs 40 micromol/l) were significantly higher in the uremic blood serum, but the concentrations of five amino acids, i.e. serine, threonine, alanine, proline, and valine, were significantly decreased in the uremic serum. The concentrations of arginine (7.95 vs 5.2 micromol/l), tyrosine (14.3 vs 12.5 micromol/l) and phenylalanine (10.7 vs 9.5 micromol/l) were significantly elevated in neutrophil homogenate from uremic patients before HD and after HD for arginine (8.73 micromol/l). We found a substantial increase of blood serum arginine concentration at all evaluated time points of HD from 64 to 191 micromol/l. The concentration of 8 amino acids were found to be significantly decreased in blood serum during HD. We may assume amino acid concentration changes in chronic uremia partly attributed to malnutrition, may be actually associated with inflammatory pathomechanisms, the hypothesis worth verifying in further studies.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 01/2006; 19(114):769-73.
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ABSTRACT: Disturbances in extracellular matrix changes underlie many diseases. Metalloproteinases (MMP) are thought to play a very important role in the maintenance of proper balance between degradation and regeneration of tissue basic substance. MMP is a group of enzymes capable of digesting almost all extracellular matrix (ECM) components. Extracellular matrix of the tissues not only constitutes the support for its cells but also participates in cell metabolism regulation. Any disturbance in the balance between matrix degradation and regeneration is the clue to pathophysiology of many diseases. Metalloproteinases of ECM are a big family of zinc-dependent enzymes that include, among others, interstitial collagenases, matrix lysines, gelatinases, elastases and membrane-type matrix metalloproteinases (MT-MMP). Studies performed in animal models with MMP deficiency that have been carried out in the last few years have supplied a unique tool for the analysis of the role of gelatinase in physiological and pathophysiological development processes. However, the studies have proved complexity of the problem revealing not only protective but also destructive role of MMP depending on the experimental animal model which leaves a wide area for further investigations not only in animals but also patients with chronic kidney diseases. In the later part of our study we would like to focus on previous results of studies and views on the influence of MMP on kidney pathophysiology on the basis of available literature.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 01/2006; 19(114):812-5.
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ABSTRACT: The aim of this study was to assess the utility, safety and prognostic value of echocardiographic stress test (EST) in non-invasive diagnosis of ischemic heart disease in patients (pts) with implanted pacemaker, with and without left ventricle hypertrophy.
EST was performed in 40 patients (mean age 60+/-10 years, from 43 to 78) with pacemaker. Using external programming system heart rate was accelerated by 10 beats in every 3 minute till reaching maximal heart rate. The examination was conducted only in patients with physiological stimulation of right atrium by AAI mode. Angiographically significant coronary artery stenosis size was accepted as over 50% artery diameter. Mean duration time of performed examination was 13+/-4 min.
No adverse events were observed. The quality of stress echo visualization was good in every case. Heart rate at rest and at maximal stimulation were respectively 68+/-8 and 132+/-13 per minute (p<0.0001) and systolic blood pressure pressure 140+/-13 and 142+/-13 mmHg (ns). In 10 (25%) pts the result was positive, in 24 (60%) negative, and in 6 (15%) - non-diagnostic. Non-diagnostic result of the test was due to pacemaker limitation (1 pts), and achieving Wenckebach point (5 pts). Test specificity was 95%, sensitivity 69%, accuracy - 85%. Significant occlusion in coronary angiography were observed in 40% pts (including 1-vessel disease - 12,5%). In left ventricle hypertrophy group (n=19), the EST accuracy was 87% (without significant difference with non-hypertrophy group). In the group with beta blockers therapy (n=16) the observed accuracy was 93%. The follow-up time was 963+/-497 days. The prognostic value of positive EST result for cardiac events was 80%, and for negative - 100%. None of the pts with negative stress echo result suffered any cardiac event.
EST is a safe, short lasting examination with good quality of echo visualization. This method seems to be of important value in diagnosing the ischaemic heart disease in pts with pacemaker, also with left ventricle hypertrophy and obligatory beta blockers medication.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2005; 19(109):10-5.
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Dariusz Michałkiewicz,
Piotr Hendzel,
Leszek Gryszko,
Katarzyna Jacewicz, Robert Olszewski,
Mirosław Dziuk,
Karol Makowski,
Wojciech Marciniak,
Marian Cholewa,
Jerzy Adamus,
Anna Gniłka,
Wiktor Piechota
Kardiologia polska 06/2005; 62(5):500-3. · 0.51 Impact Factor
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ABSTRACT: The disproportion between absence of clinical manifestations of circulatory system involvement and serious lesions in the heart found on post mortem examinations, more frequently diagnosed congestive circulatory failure and also higher mortality rate of patients with rheumatoid arthritis (RA), encouraged the authors to study the subject.
Echocardiographic assessment of the effect of rheumatoid process on the heart in patients with RA without clinically overt features of heart disease.
The study was conducted in 50 patients with RA diagnosed on the basis of the American College of Rheumatology (ACR) criteria and in 50 persons matched with the patients with respect to age, gender, body area and body mass index, heart rate and arterial pressure. Persons with manifestations and/or history of cardiovascular diseases were excluded from the study.
The authors found that: in rheumatoid arthritis, the involvement of the heart by the pathological process is manifested as degenerative changes of valve leaflets, and these lesions correlate with interventricular septum thickness and the mass and mass index of the left ventricle.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 06/2005; 18(107):496-8.
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ABSTRACT: The aim of the study was to assess oxidative stress biomarkers considering the simplicity of their determination, invasiveness of material collection and their specificity. The following oxidative stress markers were evaluated: malonyldialdehyde, thiobarbituric acid reactive lipid peroxidation products, prostaglandin F2alpha, nitric oxide derivatives, nucleic acid damage products, advanced oxidation protein products and gas components in exhaled air: nitric oxide, hydrocarbons, isoprene, ethane. Analysis of the selected biomarkers indicates the usefulness of the determination of prostaglandin F2alpha, nucleic acid damage products, advanced oxidation protein products and gas components in the exhaled air as oxidative stress biomarkers in patients with chronic renal failure.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2005; 18(105):358-61.
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ABSTRACT: Etiopathogenesis of vascular complications in diabetes is complex and multifactorial. One of the factors that is connected both with chronic complications of diabetes and intensification of oxidative stress is long-term hyperglicaemia. It has been noted that control improvement of glicaemia delays and/or inhibits the development of further complications. The aim of the study was to evaluate selected parameters of oxidative stress in patients with metabolic compensated or decompensated diabetes by means of marking in red blood cells of the patients in question the activity of antioaxidative enzymes such as: superoxide dysmutase (SOD-1) and catalase (CAT) and concentration of malondialdehyde (MDA). 61 diabetic patients took part in the research, 31 of which met the criteria of metabolic compensation whereas 30 were metabolically decompensated. The reference group (K) consisted of 40 healthy men. The activity of SOD-1 was marked by Misra and Fridovich's method, the activity of CAT by Beers and Sizer's method and the concentration of MDA in red blood cells was indicated by Placer et al. The activity of evaluated antioxidative enzymes SOD-1 and CAT in the erythrocytes of diabetes type 2 patients was statistically lower as compared with the control group. The highest activity of SOD-1 and CAT was noted in metabolic decompensated diabetes type 2 group. The concentration of MDA in diabetes type 2 patients red blood cells was significantly higher as compared with the control group. Significantly higher concentration of MDA was noted in metabolically decompensated diabetic patients comparing to patients with proper metabolically compensated diabetes. The obtained results confirm the toxicity of glucose. Long-term hyperglicaemia through activation of different metabolic paths leads to the intensification of free radical processes and attenuation of antioxidative mechanisms.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 03/2005; 18(104):196-9.
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ABSTRACT: The experimental and clinical researches suggest important role of advanced glycation end products (AGE) and oxidative stress in pathogenesis of diabetic angiopathy also including nephropathy. It is especially pointed at by the research done on inadequately controlled long-term diabetes. The aim of the study was to asses the total antioxidant capacity of plasma as well as the concentration of low-molecular antioxidants in plasma in diabetes type 2 patients in different stage of metabolic compensation and concomitant diabetic nephropathy.
91 diabetes type 2 patients took part in the research (31 patients with metabolic compensated diabetes, 14 patients with metabolically decompensated diabetes, 14 patients with incipient and 16 patients with overt nephropathy). The control group consisted of 40 healthy men. The total antioxidant capacity was fluorometrically marked by means of ficoerythryne. The concentration of low-molecular antioxidants in plasma was marked on the basis of the time of free radicals scavenging by means of Trolox (6-hydroxy-2, 5,7, 8-tetramethethylchroman-2-carboxylic acid) of known concentration.
In patients with diabetes type 2 the total biggest antioxidant capacity was noted in metabolically compensated diabetes group and the total lowest antioxidant capacity was noted in diabetic patients with overt nephropathy. The highest mean concentration of low-molecular antioxidants was noted in metabolically compensated diabetes group and the lowest in diabetic patients with overt nephropathy. These differences were statistically significant.
In patients with diabetic nephropathy with the development of the disease significant insufficiency of plasma antioxidant barrier is noted. Diminishing of the total antioxidant capacity and depletion of plasma antioxidants noted in diabetes type 2 patients, especially inadequately metabolically controlled may constitute the essential pathogenetic factor of vascular complication in diabetes.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2005; 18(103):29-32.
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ABSTRACT: Dobutamine stress echocardiography (DSE) is widely used for diagnosis of coronary artery disease (CAD). However, data regarding the diagnosis of coronary artery disease in patients with moderately elevated maximal gradient across the stenosed aortic valve (AS) are limited. This study was designed to the value of DSE in the diagnosis of CAD in women with moderately elevated maximal gradient across the AS.
DSE was performed in 162 patients within the multicentre study. The group included 58 (mean age 61 +/- 13 years) females and 104 (mean age 58 +/- 13 years) males. DSE was performed with step-wise infusion every three minutes (5, 10, 20, 30 and 40 microg/kg/min). If the target heart rate was not reached, a further dose of 40 mcg/kg/min. together with atropine 0.25-1 mg was administered, in the absence of signs and symptoms of ischemia. Ischaemia was defined as new or worsened wall motion abnormalities at echocardiography. Coronarography was performed according to generally accepted indications. The significant coronary artery disease (>1 = 50% luminal diameter stenosis) of one of the major epicardial vessel was accepted as positive result for making the diagnosis of CAD.
There was significant difference at rest between women and men with regard to left ventricular diastolic diameter (47.7 +/- 6.5 vs 55.6 +/- 8.8 mm), systolic diameter (30.1 +/- 7.9 vs 38.1 +/- 11.5 mm), ejection fraction (67 +/- 12 vs 55 +/- 17%), wall motion score index (1.05 +/- 0.17 vs 1.22 +/- 0.36) p<0.001. There were also a significant difference in left ventricular mass index and diastolic septum diameter (131 +/- 48 vs 152 +/- 46) and (12.5 + 2.7 vs 13.5 +/- 2.6 mm). Dobutamine peak dose was 31 +/- 11 microg/kg/min. The mean heart rate, mean systolic pressure and diastolic pressure were 114 +/- 26/min, 143 +/- 26 and 81 +/- 15 mmHg respectively. Sensitivity, specificity, and accuracy of DSE for the diagnosis of CAD in women were 77.8%, 95.8% and 90.9%. Those in men were 72.7%, 78.8% and 75.6%, respectively (NS).
The diagnostic value of dobutamine stress echocardiography for the diagnosis of coronary artery disease in women with stenosed aortic valve is high. DSE is good method for the diagnosis.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 06/2004; 16(95):456-60.
