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ABSTRACT: There is a wide interpersonal difference to dobutamine response during dobutamine stress echocardiography (DSE). The aim of this study was to determine an association between GNB3 825C>T gene polymorphism, encoding the β3-subunit of G protein, and heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) response to dobutamine during DSE. The study involved 119 patients with clinical indications for DSE. Genotyping of GNB3 825C>T (rs5443) polymorphism was based on PCR-RFLP method with BseDI restriction enzyme. Significantly higher levels of both resting SBP and DBP in 825T allele carriers vs. 825CC patients were revealed. HR of 825CC vs. CT + TT subjects was slower along the test period reaching marked difference at dobutamine level 30 μg/kg/min (109 ± 20 vs. 116 ± 18 bpm, respectively, p = 0.047). SBP and DBP were markedly lower in 825CC homozygotes compared to 825T allele carriers throughout DSE. It can be concluded that GNB3 825C>T polymorphism is associated with resting SBP and DBP in Polish Caucasian patients subjected for diagnostic DSE. The polymorphism also modulate HR, SBP and DBP response during DSE.
Pharmacological reports: PR 01/2012; 64(1):123-8. · 2.44 Impact Factor
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ABSTRACT: The aim of this study was to determine an association between the ADRB1 1165C>G and 145A>G polymorphisms and hemodynamic response [heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure] to dobutamine during dobutamine stress echocardiography (DSE).
The study involved 144 patients with clinical indications for DSE. The PCR-restriction fragment length polymorphism method was used to identify the ADRB1 1165C>G and 145A>G polymorphisms.
Heart rate during DSE increased in all analyzed study groups. Patients with the ADRB1 1165CC and 1165CG+GG polymorphisms demonstrated similar HR, including magnitude of response [change in heart rate (ΔHR 0-30): 42.1 ± 17.5 vs. 46.1 ± 15.5 bpm, respectively]. HR and ΔHR 0-30 were comparable in ADRB1145AA and 145AG subjects in the course of DSE. SBP and DBP at all stages of DSE were similar in subjects with either polymorphism and did not differentiate patients with the ADRB1 145AA polymorphism from those with the ADRB1 145AG polymorphism, nor those with the ADRB1 1165CC polymorphism from those with the ADRB1 1165CG+GG polymorphism. No differences were noted in the magnitude of response, with the increase in SBP and DBP comparable in all genotypes. Similar observations were made in patients (25/144 studied) with atropine requirements during DSE.
The ADRB1 1165C>G and 145A>G polymorphisms are not associated with the HR, SBP and DBP responses in Polish Caucasian patients requiring diagnostic dobutamine stress echocardiography.
European Journal of Clinical Pharmacology 02/2011; 67(5):477-82. · 2.85 Impact Factor
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ABSTRACT: High-dose statins are used in acute coronary syndromes (ACS) to reduce inflammation. The aim of the study was the evaluation of the influence of low-dose atorvastatin (20 mg) on selected inflammatory parameters and clinical outcomes after ACS.
Seventy eight patients (pts) with ACS were randomly divided into group A (39 pts) taking atorvastatin, and group NA (39 pts) not taking any statin for the following six weeks. C-reactive protein (CRP), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor alpha (TNFa) levels were measured on the first and the fifth days and six weeks after ACS.
There was no significant CRP and IL-6 level decrease in group A (CRP--62%; IL-6-73%) or group NA (CRP-44%; IL-6-62%). There was also no significant change in TNFa levels. The MCP-1 level finally reached the level of significant difference (p < 0.04). Cardiovascular events (MACE) and the restenosis rates did not differ between the groups.
Low-dose atorvastatin does not have a significant influence on cooling down inflammation in ACS, and MCP-1 can be used as an early indicator of statin anti-inflammatory activity. Furthermore, it does not reduce MACE or restenosis rates despite its influence on MCP-1 levels.
Cardiology journal 01/2008; 15(4):357-64. · 1.31 Impact Factor
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ABSTRACT: The increasing role of percutaneous coronary interventions (PCI) in the treatment of coronary artery disease and relatively high restenosis rate following PCI require the introduction of available, easy to perform and cost-effective tests that would enable detection of restenosis after PTCA and identification of patients at particularly high risk of restenosis.
To estimate the predictive value of early dobutamine stress echocardiography (DSE) for the assessment of risk of coronary restenosis.
Thirty-nine patients with a single coronary vessel disease after PCI were enrolled in this study. DSE was performed twice--2 to 3 days after the procedure and repeated after 8 to 12 months. All patients underwent coronary angiography after one-year follow-up.
Data analysis of direct pre- and postprocedural echocardiography showed that the wall motion score index decreased significantly (p <0.0001), whereas ejection fraction increased significantly after the intervention when compared with baseline (p <0.0001). Restenosis was detected in 8 out of 10 subjects with positive DSE test and in 3 out of 29 subjects with negative DSE test. In a group of 11 patients with restenosis confirmed in the coronary angiography, one-year follow-up DSE was found positive in 9 patients (80% test sensitivity) but in two cases results were false negative. Negative test was observed in 27 out of 28 individuals without restenosis (90% test specificity).
DSE is highly sensitive and specific in prediction and detection of restenosis after PCI. DSE performed early after PCI is safe.
Kardiologia polska 03/2007; 65(3):254-9; discussion 260-1. · 0.51 Impact Factor
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ABSTRACT: The aim of the study was to analyze the functional and structural changes in the echocardiographic parameters of the left ventricle (LV) in adult patients (pts) with growth hormone deficiency (GHD) without any treatment in childhood before and after one year long somatropin treatment.
Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week has been continued for 1 year. Both groups were examined with echocardiography Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6): with indiopatic GHD (n = 10, age from 29 to 46 years; M/F: 6/4) and with Sheehan syndrome (n = 2, age from 46 to 61 years; M/F: 0/2) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week (till 50 percentyl of blood IGF-1 concentration for age and sex norm ) has been continued for 1 year. Both groups were examined with echocardiography.
On echocardiography, in the group GHD-1 pts compared to GHD-2 pts, had lower LVM and LVMI were lower (adequately (138.4 +/- 39.8 vs. 153.1 +/- 49.5, p < 0.036), lower and LVMI (87.3 +/- 19.7 vs. 96 +/- 23.7, p < 0.05). There was no Therapy had no significant therapy effect on systolic LV function. The diastolic function of LV did not differ between both GHD-1 and GHD-2 groups (E/A: 1.4 +/- 0.2 vs. 1.3 +/- 0.3 ; E: 79 +/- 17; A: 59 +/- 16 vs. 58 +/- 10, ns), but DT increased significantly from 132 +/- 21 vs. 147 +/- 30, p < 0.05). There was only significant correlation between LV systolic dimension after one year and IGF plasma basal concentration (r = 0.7, p < 0.01).
One year medical therapy with rhGH (somatropin) is associated with a significant positive effect on LVM and LVMI but no significant effect on systolic LV function, as assessed by echocardiography in adults with GHD. Significant decrease of DT after therapy may suggest an influence of GH therapy on diastolic LV function. The level of IGF did correlate with LV systolic diameter after therapy.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(118):386-9.
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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: Endurance sports are associated with structural and functional changes in the myocardium. Physiologic changes representing cardiac adaptation to training are termed "athletic heart".
We compared the incidence of arrhythmias and conduction abnormalities in athletes of static and dynamic sports using resting and 24 hour electrocardiography. We also studied the effect of physiologic left ventricular hypertrophy on the incidence of arrhythmias and conduction abnormalities in athletes, as well as of training duration on electrocardiographic parameters.
We enrolled 40 male athletes of static and 40 of dynamic sports, as well as 30 normally active males. A 12-lead resting ECG, 24 hour ECG, and echocardiography were done.
The resting heart reate in athletes was significantly slower (p < 0.0001). No intervals longer than 3s, bundle branch or atrioventricular blocks were disclosed. The finding of left ventricular bypertrophy and training duration had no significant effect on the presence and number of supraventricular and ventricular arrhythmias or blocks.
Resting ECG, echocardiography, and 24 hour ECG provide valuable cardiologic information in athletes. The heart rate was slower in all athletes and the PQ interval was longer as compared with controls. No serious arrhythmias or conduction abnormalities were noted. The duration of training and the presence of myocardial hypertrophy had no effect on electrocardiographic parameters.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(118):390-4.
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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.
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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: Cardiovascular system involvement is the third most common reason of death in patients with systemic lupus erythematosus (SLE). The aim of this study was to assess the cardiac involvement in the SLE patients with a regard to clinical, serological and environmental risk factors.
103 patients were included into the study, 91 women and 12 men, aged 16-74 yrs, the control group included 25 subjects. Physical examination, two-dimensional guided M-mode and Doppler echocardiographic recordings were performed. The tests for the presence of ANA, ENA, antiphospholipid antibodies (aCL, LA, anti-beta2GPI and antiprothrombin antibodies), ANCA (anti-neutrophil cytoplasm antibodies), AECA (anti endothelial cell antibodies) were carried out.
The following pathologies were significantly more common in the SLE patients: pericardial involvement (58%), organic changes of the mitral valve cusps (54%), organic changes of the aortic valve cusps (36%), widening of the aortal lumen (35%), enlargement of the left atrium (18%), hypokinesis of the left ventricle myocardial muscle (15%). Ultrasound cardiac pathologies were associated with presence of antiphospholipid antibodies, ANCA, anti-hitone antibodies and AECA. High activity of SLE increased risk of pericarditis and ascending aortic wall thickening. Cardiovascular manifestations occurred most frequently in patients with short time duration of SLE.
Cardiac involvement is a frequent and early systemic complication of SLE and it is the most commonly related to pericardium and valvular apparatus. Cardiovascular manifestations in SLE patients are the most frequently related to the presence of serological risk factors, mainly antiphospholipid antibodies. It suggests their major role in the pathogenesis of the cardiovascular involvement in SLE. Pericarditis are markers of high activity of SLE.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):305-8.
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ABSTRACT: Cardiovascular involvement in the course of ankylosing spondylitis (AS) is a very important problem. The aim was to assess the influence of the activity of the disease on echocardiographic abnormalities in ankylosing spondylitis.
We studied 38 AS patients. Activity of the disease was assessed according to the ESR and following indexes: BASMI, BASFI, BASDAI, BASG-t, BASG-6. Using 2-dimensional echo Doppler (Acuson 128XP) the heart dimensions were determined according to the American Society of Echocardiography guidelines.
Patients with mitral valve prolapse compared with the group of the AS patients without this abnormality had significant higher (p = 0.05) activity of the disease assessed by ESR. Patients with aortic incompetence compared with the group of the AS patients without this abnormality, had significant (p = 0.04) lower disease activity assessed by BASG-6. We found significant negative correlation between EF and disease duration, and significant lower disease activity assessed by BA SG-6. Patients with pericardial effusion compared with group without this had significant shorter (p = 0.05) disease duration.
There was no significant influence of the following indexes: BASMI, BASFI, BASDAI, BASG-t, BASG-6 of the activity of the disease on echocardiographic abnormalities in ankylosing spondylitis.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(117):296-8.
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ABSTRACT: We present a case of a 58 years old patient with extremely severe mitral stenosis. Several years ago she denied surgical treatment despite qualification by cardiologists. At present hospitalisation mitral valve area was calculated as 0.5 cm(2) with systolic right ventricular systolic pressure of 125 mmHg. Right ventricle was hypertrophied and extremely enlarged as well as both atria. Surprisingly she was still in sinus rhythm and had no thrombi in the left atrium. Patient died before scheduled surgery because of cardiac decompensation and renal insufficiency.
Kardiologia polska 02/2006; 64(1):93-5. · 0.51 Impact Factor
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ABSTRACT: The antiphospholipid syndrome (APS) manifests itself with circulating anticardiolipid antibodies (aCL) and/or lupus anticoagulant (LA) associated with thrombi and emboli or with recurrent complications of pregnancy.
We present a case of a 50-year-old man who was diagnosed with the antiphospholipid syndrome on the basis of serologic findings and results of diagnostic imaging. Neurological symptoms in the form of memory deficits, disorders of orientation, and pyramidal-type bilateral hemiparesis more evident on the left side were reported by the patient over a period of two years. Magnetic resonance imaging (MRI) of the head revealed numerous vascular foci located in the cortical-subcortical areas of the brain. Ultrasound (USG) disclosed a large, irregular thrombus adhering to the margins of the mitral valve with signs of inflammation. aCL (high titers in both classes), LA, and anti-beta2-glycoprotein I antibodies (a-beta2GPI) were found in serum. a-beta2GPI and anti-nDNA antibodies were disclosed in the cerebrospinal fluid.
Combined anticoagulant and anti-aggregation therapy was unsuccessful. It was then decided to use immunosuppression with intravenous cyclophosphamide and methylprednisone pulses every 4 weeks (7 cycles). USG at follow-up showed marked regression of the mitral thrombus with swollen margins of the mitral valve. MRI of the brain confirmed progression of the lesions described previously.
The diagnosis of secondary antiphospholipid syndrome associated most probably with systemic lupus erythematosus (SLE) was made. It should be remembered, however, that diagnostic criteria for APL and SLE partially overlap.
Annales Academiae Medicae Stetinensis 02/2006; 52 Suppl 2:75-9.
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ABSTRACT: The aim of this study was to perform a retrospective analysis of selected risk factors and their variability in a 10 years period of observation in patients with ischemic heart disease (IHD).
We reviewed 5219 questionares of patients hospitalized at internal wards of the Internal Medicine Institute of the Pomeranian Medical University in Szczecin. Among the participants 1709 were females with mean age 56.3 +/- 7.1 and 3510 males with mean age 54.46 +/- 7.96. Multivariate logistic regression analysis of the relationship between the: analysed risk factors and the hospitalization year, age and sex of patients was used.
Among all risk factors, cigarette smoking appeared most frequently (43.93% of patients) followed by arterial hypertension (32.90%), lipid disturbances (25.78%), obesity (16.26%), type 2 diabetes (13.79%), family history of IHD (8.46%), impaired glucose tolerance (5.8%), hyperuricaemia (3.62%) and type 1 diabetes (1.1%). Cigarette smoking and hyperuricaemia appeared markedly more often in men in comparison to women (p < 0.0002) in whom arterial hypertension and obesity significantly dominated (p < 0.0001).
During the 10-years period of observation a significant raise of arterial hypertension, dyslipidemia, hyperuricaemia, type 2 diabetes mellitus and impaired glucose tolerance was found. Hovever, some positive changes such as a decrease in number of cigarette smokers and obesity among women were detected. In conclusion, the results of our study show that between 1983 and 1992 there was a domination of negative changes among the IHD risk factors. This was more pronounced in the studied group of females in comparison to males.
Annales Academiae Medicae Stetinensis 02/2006; 52(2):71-7.
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ABSTRACT: Thrombin injection is known as an efficient and safe method of femoral artery pseudoaneurysms treatment, however, it can be complicated by peripheral thrombosis to accidental casual thrombin injection into femoral artery. We present our own procedure modification. Before thrombin injection we inject into pseudoaneurysm a small volume of ultrasonographic contrast. Doppler signal enhancement confirms proper niddle position.
Kardiologia polska 01/2006; 63(6):649-50; discussion 651. · 0.51 Impact Factor
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ABSTRACT: The aim of our study was to evaluate the long-term prognostic value of transesophageal atrial pacing stress echocardiography (TAPSE) for the prediction of cardiovascular events (myocardial infarction) and mortality at 10-year follow-up.
TAPSE was applied as a diagnostic modality in 93 consecutive patients (mean age 45 +/- 8 years) who were diagnosed for the cause of chest pain. Long-term follow-up data were obtained from 87 (94%) patients with a mean duration of follow-up of 92 +/- 4 months. Stress echocardiography was performed using TAPSE with a mean pacing rate of 142 +/- 18/min.
Predefined cardiac events occurred during the follow-up period in 45 (52%) patients, including 24 (28%) with hard end points: 10 (12%) with nonfatal myocardial infarction and 17 who died (events overlap). Positive result of TAPSE was found in 47 (54%) patients and among those with positive TAPSE result, 16 died (94% of total mortality) and 21 had a hard event (death or infarction-88% of total prevalence). Survival free from hard events was noted in 37 (92%) patients with negative TAPSE and only in 26 (55%) of those with positive TAPSE ( P = .001). Independent predictive factors for mortality were TAPSE positivity (relative risk with 95% confidence interval [RR/CI] = 39.6 [36.3-42.9], P = .0006) and diabetes (RR/CI = 10.2 [8.6-11.8], P = .0026). Independent predictive factors for myocardial infarction were diabetes (RR/CI = 8.1 [6.3-9.9], P = .0186) and significant coronary stenosis in angiography (RR/CI = 9.0 [6.8-11.2], P = .0479). Independent predictive factors for death or nonfatal myocardial infarction were TAPSE positivity (RR/CI = 12.3 [11.1-13.3], P = .0001) and diabetes (RR/CI = 7.0 [5.8-8.2], P = .0018).
Positive TAPSE result carries long-term prognostic information regarding mortality and risk of myocardial infarction that can be used to identify patients requiring more aggressive treatment. Negative TAPSE allows highly accurate definition of low-risk population with discriminating power maintained during the 10-year period. TAPSE result and diabetes are the strongest independent predictors for long-term mortality in multivariate analysis.
Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 08/2005; 18(7):749-56. · 2.98 Impact Factor
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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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Kardiologia polska 04/2005; 62(3):275-8. · 0.51 Impact Factor
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ABSTRACT: Alcohol ablation of the interventricular septum is a well-established method of treatment in hypertrophic obstructive cardiomyopathy (HOCM). The extent of ablation-induced iatrogenic infarction is usually assessed by the use of echocardiography. The role of nuclear magnetic resonance (NMR) in this setting has not yet been well established. In this report we describe five patients with HOCM who underwent alcohol septal ablation and subsequent NMR evaluation. The usefulness of NMR in these patients is discussed and comparison with echocardiographic results is presented.
Kardiologia polska 12/2004; 61(11):461-7. · 0.51 Impact Factor
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ABSTRACT: Relapsing polychondritis is a rare, chronic disease that can involve all types of cartilage in different sites. The most common symptoms of relapsing polychondritis are features of auricular, nasal and tracheal cartilage inflammation. The authors presented two cases of relapsing polychondritis and related diagnostic and therapeutic difficulties.
Polskie archiwum medycyny wewnȩtrznej 10/2004; 112(3):1093-9. · 1.37 Impact Factor
