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Andrzej Biederman

Publications and source records attributed to Andrzej Biederman.

16 recordsLinked to original sources
PubMed2006

Reduced myocardial expression of calcium handling protein in patients with severe chronic mitral regurgitation.

OBJECTIVE: Left ventricle (LV) function was shown to be a principal determinant of morbidity and mortality in both uncorrected and surgically corrected mitral regurgitation (MR). However, the cellular mechanisms that develop in the LV remodeling secondary to volume overload in chronic severe MR is still not well defined. In single ventricular myocyte, a reduced contraction and slowed relaxation have been mainly attributed to defective intracellular Ca2+ currents. Between several Ca2+ handling proteins, sarcoplasmic reticulum Ca2+-ATPase 2 (SERCA2) expression and activity determines not only the extent and rate of relaxation, but also the rate and amplitude of contraction. The aim of the study was to determine whether modifications of SERCA2 gene expression occurs in LV wall remodeling process secondary to chronic severe MR. METHODS: The LV samples were obtained from 12 patients presented LV wall remodeling (LV: diastolic/systolic diameter-70+/-7 mm vs 46+/-10 mm; diastolic/systolic volume-260+/-65 ml vs 102+/-68 ml) due to chronic, severe MR. Expressions of SERCA2 isoforms-SERCA2a and 2b mRNAs were estimated by semiquantitative RT-PCR and normalized to GAPDH. The protein levels of SERCA2 were determined by Western blot after normalization to actin. Results were compared with samples from non-failing human hearts (NFH). RESULTS: On SERCA2 mRNA levels, important reduction on both SERCA isoforms SERCA2a (-40%) and SERCA2b (-49%) compared to NFH, together with significant correlation between isoforms (r = 0.89; p = 0.01) were observed. SERCA2 protein levels were decreased (-38%) in MR compared to NFH. Also significant correlations between SERCA2a/2b and SERCA2 protein expression (r = 0.83, p = 0.017; r = 0.68, p = 0.05, respectively) were observed. Moreover, a negative correlation between protein levels of SERCA2 (r = -0.64, p = 0.053) and left ventricular diastolic diameter was observed. CONCLUSIONS: In chronic volume overload the down-regulation of SERCA2a and 2b at the mRNA and SERCA2 protein levels exist. Moreover, protein levels of SERCA2 tend to correlate to the grade of left ventricular diastolic dilatation and suggest an important role LV remodeling.

Adult↗
PubMed2006

Thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy.

AIMS: Incidence and clinical presentation of thromboembolic complications in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) were analysed. In reports on ARVD/C, thromboembolism is rarely mentioned. The possible risk factors are: right ventricle (RV) dilatation, aneurysms, and wall motion abnormalities. METHODS AND RESULTS: A group of 126 patients (89 male, 37 female, aged 43.6+/-14.3) with ARVD/C was retrospectively analysed for the presence of thromboembolic complications. The mean follow-up period was 99+/-64 months. Thromboembolic complications, i.e. pulmonary embolism (n=2), RV outflow tract thrombosis with severe RV failure (n=1), and cerebrovascular accident associated with atrial fibrillation (n=2) were observed in 4% of the patients. Spontaneous echogenic contrast was observed in seven patients with severe damage to RV. In four of them supraventricular arrhythmias resulting in heart failure were reported. Annual incidence of thromboembolic complications was 0.5/100 patients. CONCLUSIONS: (i) ARVD/C may be complicated by thrombosis. Annual incidence of such complications is significantly lower than reported for left ventricle failure. (ii) Anticoagulation should be used in ARVD/C patients with large, hypokinetic RV and slow blood flow. (iii) Patients with severe forms of ARVD/C, thrombus formation in the RV and/or spontaneous echocardiographic contrast are at higher risk of a poor outcome.

Adult↗
PubMed2005

[Infective endocarditis in a patient with multiple myeloma. A case report].

A case of a 59 year old male with infective endocarditis is presented. Antibiotic therapy seemed effective, however, inflammation laboratory parameters increased two weeks after clinical improvement and body temperature normalisation. Subsequent extensive laboratory investigations revealed multiple myeloma. The patient underwent successful aortic valve replacement and received pharmacological therapy for multiple myeloma. Difficulties in diagnosing and treatment of patients with infective endocarditis who have other concomitant diseases, are discussed.

Diagnosis, Differential↗
PubMed2004

The coexistence of acute aortic dissection with autosomal dominant polycystic kidney disease--description of two hypertensive patients.

BACKGROUND: Acute aortic dissection is a rare but potentially lethal disease characterized by high early mortality when left untreated. However, survival may be significantly improved by the timely institution of appropriate medical and/or surgical therapy. Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders, accounting for 8-10% of the cases of end-stage renal disease. Hypertension occurs frequently and is an early manifestation of ADPKD in approximately 50-70% of non-azotemic patients. ADPKD, often caused by mutations in the PKD1 gene, is associated with life-threatening vascular abnormalities that are commonly attributed to the frequent occurrence of hypertension. METHODS: We present two cases of hypertensive patients with acute aortic dissection (type A Stanford) coexisting with ADPKD. RESULTS: A 54-year-old male hypertensive patient and a 47-year-old male hypertensive patient, both with known ADPKD were diagnosed and operated with acute dissection of ascending aorta. Both patients were characterized by severe hypertension; therefore, in both cases, degree of hypertension is likely to be causative for this vascular complication. However, since ADPKD is associated with the vascular complications mentioned above, abnormality of the structure of the arterial wall of the thoracic aorta cannot be ruled out. CONCLUSION: Aortic dissection is a rare but potentially disastrous complication, and clinicians should always consider this when dealing with patients with ADPKD who present with chest pain or collapse.

Aortic Dissection↗
PubMed2004

[Pulmonary thrombendarterectomy in a patient with chronic thromboembolic pulmonary hypertension (CTEPH) and chronic renal failure due to diabetic nephropathy--case report].

A case of 63-years old man suffering from CTEPH and chronic renal failure due to diabetic nephropathy is presented. First diagnosis of pulmonary hypertension was made at the beginning of 2000. Then the secondary anticoagulant prophylaxis were introduced. Despite such treatment there was no improvement and level of pulmonary hypertension increased. Finally, the pulmonary thrombectomy was considered because of proximal location of thromboembolic obstruction in pulmonary artery. Before surgery, the hemodialysis was started. Pulmonary thrombendarterectomy along with right coronary artery bypass grafting were performed in November 2001. The procedure was conducted successfully. The patient's condition improved and pulmonary pressure dropped substantially. During follow-up anticoagulant prophylaxis and hemodialysis are continued. It might be conducted that pulmonary thrombendarterectomy can be successfully performed also in patients with complex coexisting conditions.

Diabetic Nephropathies↗
PubMed2004

[Favorable reverse remodelling of the left ventricle in elderly patients following aortic valve replacement].

UNLABELLED: Progress of surgical technique and anaesthesia enabled aortic valve replacement in the very elderly patients. However both valvular heart disease and ageing are associated with myocardial fibrosis. It is not known whether reverse remodelling and regression of hypertrophy, observed in the young patients after aortic valve surgery is possible also in the elderly. The aim of the study was to evaluate the changes of left ventricular structure and function in the elderly patients subjected to aortic valve replacement for aortic stenosis. Echocardiographic examinations were performed prior to surgery, approximately 4 weeks after the procedure and after an average of 32 months of follow-up. Left ventricular end-systolic (LVESV) and end-diastolic volumes (LVEDV) and ejection fraction (LVEF) were measured, as well as interventricular septum (IVSD) and posterior wall thickness (PWD). 43 patients over 74 years old (range 74-83), with aortic stenosis and transvalvular aortic gradient of 60-150 mmHg (mean 104 mm Hg), were included in the analysis. 17 patients received biological and 26 mechanical prosthesis. During the long term follow up LVEDV decreased from 143 ml to 114 ml, LVESV from 59 ml to 36 ml and EF increased from 59% to 68% (all p<0.05). Significant regression of left ventricular wall hypertrophy was observed (IVSD from 1.53 cm to 1.32 cm and PWD from 1.4 cm to 1.28 cm, all p<0.05). IN CONCLUSION: the improvement of physical efficiency were observed. Favorable reverse remodelling of the left ventricle is observed also in elderly patients following valve replacement.

Aged↗
PubMed2004

[Which echocardiographically unrecognised complications of native aortic valve endocarditis may be found during operation?].

The aim of the study was to determine the type and localisation of complications of aortic valve endocarditis, that have not been recognised on transthoracic (TTE) and/or transesophageal (TEE) echocardiographic study. The echocardiographic findings were retrospectively compared and contrasted with direct surgical inspection in 156 consecutive adults operated on native aortic valve endocarditis in our institute during the last 8 years. We analysed recognition of abscess, pseudoaneurysm, fistula and cusp rupture. Periannular complications were detected at operation in 51 pts, cusp rupture in 97 pts. Sensitivity of TTE in recognition of abscesses was 55%, TEE--60%; pseudoaneurysm--TTE--64%, TEE--100%; fistula--TTE 60%, TEE 100%; cusp rupture--TTE 65%, TEE 81%. Both echocardiographic methods have some inherent limitations while diagnosing complications of aortic valve endocarditis. In particular, these include small abscesses and cusp rupture. Using both modalities in a complementary way seems to offer the best approach in overall definition of the extent of inflammation.

Adult↗
PubMed2004

[Short- and long-term follow-up of left ventricular function after surgical treatment of chronic mitral valve regurgitation].

UNLABELLED: There are conflicting data concerning late LV remodeling following mitral valve surgery due to chronic MR. We performed serial echocardiographic evaluation of 35 consecutive patients prior and following surgical treatment of mitral valve for chronic regurgitation. Studies were performed 1 week before operation (exam I), then at 1 week (exam II) and 9-13 months (exam III) (mean 11 months) after surgery. LVEDD and LVESD and LA size were recorded from parasternal long-axis view, and EF was calculated by Teichholtz formula. Statistical significance of achieved values was assessed. The study group consisted of 35 patients (25 males, 10 females, age 63 +/- 9 yrs). All pts were symptomatic due to the significant MR: NYHA II (n = 8), III (n = 25), IV (n = 2). All subjects had excluded coronary artery disease by coronary angiogram. 30 patients underwent successful mitral valve replacement without preservation of subvalvular apparatus and 5 mitral valve repair. Echo-Doppler examination before procedure discovered isolated significant MR (4+) with left ventricular dilatation (LVEDD 6.6 +/- 0.3 cm, LVESD 4.3 cm +/- 0.8), LA enlargement (6.0 +/- 1.1 cm), and pulmonary hypertension (systolic PAP 46 +/- 16 mmHg). After operation, marked decrease of LVEDD was observed (5.7 +/- 0.7 cm, p<0.0001 vs exam I) with only slight decrease of LVESD (4.0 +/- 0.6 cm, p<0.05 vs exam I) resulting in a significant decrease in EF (61 +/- 15.3% vs 57 +/- 4.8%, p<0.01). Significant reduction of LA size and PAP was noticed between exam I and III (6.0 +/- 1.1 cm vs 5.22 +/- 0.94 cm, p<0.0001, 46 +/- 16 mmHg vs 38 +/- 15 mmHg, p<0.01, respectively). CONCLUSIONS: After successful surgical treatment of mild-to-moderate symptomatic chronic MR there is a gradual fall of LVEDD implying continued ventricular remodeling over several months. However, we observed only a slight decrease of LVEDS with subsequent decrease of EF that may support the opinion of the crucial role of mitral valve apparatus in overall LV performance. EF fall did not preclude, however, reduction of pulmonary hypertension and LA diameter in long-term follow up.

Aged↗
PubMed2003

[Pulmonary thromboembolism as a late complication of mitochondrial myopathy (Kearns-Sayer syndrome ].

A case of pulmonary thromboembolism with transient pulmonary hypertension of a rare cause is presented. In 24-year-old woman myasthenia was recognised on the ground of ptosis and fixation of eyes muscles from the 14th year of age. The treatment with mestinon was ineffective. Before planned thymectomy serious disturbances of heart rhythm and conduction were confirmed. Stimulator was implanted and thymectomy was done. No improvement of neurological state was observed despite the treatment with mestinone and prednisone. When she was 30 years old disease of lung appeared with fever, cough and parenchymal and pleural lesions of right lung. Antibiotic therapy was ineffective. CT scan and US examination revealed large thrombus inside the right auricle connected with stimulator electrodes. Embolisation of right pulmonary arteria was confirmed also. Treatment with heparin was ineffective and thrombectomy was performed. Exact neurological examination stated that the patient had no typical symptoms of myasthenia and that symptoms related with eyes and heart could be result of mitochondrial myopathy. Diagnosis was confirmed by EMG examination and muscle biopsy.

Adult↗
PubMed2002

The rupture of periaortic infective aneurysm into the left atrium and the left ventricular outflow tract: preoperative diagnosis by transthoracic echocardiography.

We present a rare complication of infective endocarditis, perforated periaortic abscess with fistulous communication between the aortic root, the left atrium, and the left ventricular outflow tract. Preoperative transthoracic echocardiographic diagnosis was confirmed intraoperatively. The patient was treated successfully by aortic homograft implantation.

Adult↗
PubMed2002

[Benign tumour of aortic valve in a patient with tight aortic stenosis - a case report].

A case of 58-year-old male with aortic stenosis who was admitted due to chest pain suggesting acute myocardial infarction, is presented. Transthoracic and transesophageal echocardiography revealed the presence of aortic valve tumour and the patient underwent successful surgery. Symptomatology and treatment of cardiac tumours are discussed.

English Abstract↗