Biomedical subjects

Andrzej Cwetsch

Publications and source records attributed to Andrzej Cwetsch.

4 recordsLinked to original sources

PubMed2006

[Detection of patients at risk for paroxysmal atrial fibrillation (PAF) by signal averaged P wave, standard ECG and echocardiography].

UNLABELLED: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Amiodarone↗

PubMed2006

[Right ventricle pacing site optimization guided by intracardiac echocardiography].

UNLABELLED: Right ventricle outflow tract (RVOT) is an alternative pacing site to right ventricle apex (RVA). Intracardiac echocardiography (ICE) is a new method for intracardiac structures visualization. THE AIM: is comparison of functional effects of DDD permanent ventricular pacing in patients with lead implanted in RVA or in RVOT with the use of traditional fluoroscopy or in RVOT guided by ICE. MATERIAL AND METHODS: 33 patients with AV block grade I/III no older than 75 y (mean age 65,9+/-0,3 years). Group 1: 10 patients with RVA lead implantation. Group II: 12 patients with leads implanted in RVOT with the use of ICE. Group IlI: 11 patients with lead positioned in RVOT with the use of fluoroscopy. High septum was established as an target pacing site for RVOT implantation. On 3 day and 3 months after implantation the following parameters were collected: VO2 max, 6-minute walking test distance, level of NT-proBNP. The comparison of relative changes was done, 3 month vs. 3 day for each parameter. RESULTS: Statistically significant greater decrease in NT-proBNP was found in Group II in comparison with both Group I and Ill (respectively p = 0.021 and p _ 0.034). Significantly greater increase in VO2 max was detected in patients Group II comparing to Group I (p = 0.047). Moreover it was found that ICE guided implantation is most effective in precise lead positioning. CONCLUSION: ICE guided lead localization on high interventricular septum seems to have better functional characteristics than other right ventricle pacing sites.

Aged↗

PubMed2003

[Left ventricular function in rheumatoid arthritis patients].

BACKGROUND: The disproportion between the 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. THE AIM OF THE STUDY WAS: Echocardiographic assessment of the effect of rheumatoid process on left ventricular structure, and systolic and diastolic function in patients with RA without clinically overt features of heart disease. METHODS: The study was conducted in 50 patients with RA diagnosed on the basis of the 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. RESULTS: The authors found that: in RA, the involvement of the myocardium by the pathological process was manifested as increased wall thickness, increased mass and mass index of the left ventricle with impairment of its diastolic function and normal systolic function. With progressing rheumatoid process, left ventricular systolic function impairment was observed. Left ventricular diastolic dysfunction in the course of rheumatoid arthritis usually was not manifested clinically.

Arthritis, Rheumatoid↗

PubMed2002

Autonomic nervous system and left ventricular hypertrophy in essential hypertension.

BACKGROUND: Patients with essential hypertension (EH) and left ventricular hypertrophy (LVH) have an increased risk of cardio-vascular complications. Alterations in the autonomic nervous system (ANS) activity may play a role in the development of serious cardiac arrhythmias and mortality in these patients. AIM: To examine the activity of ANS in patients with established EH in relation to the presence of LVH. METHODS: The study group consisted of 70 subjects: 50 patients with untreated EH (mean age 44.4+/-12.7 years, 28 patients without LVH and 22 with LVH), and 20 age-matched healthy volunteers. ANS reactivity was assessed using heart rate variability (HRV) analysed during tilt table testing at 60 degrees. The following 5-min time-periods were analysed: (A) before tilting (supine position), (B) initial period of tilting, (C) last 5 min of tilting, and (D) immediately after completion of tilt test (after return to supine position). RESULTS: Patients with EH without LVH had a higher increase of LF/HF values (period B versus period C) compared with controls (p<0.05). The change from tilt to supine position caused significantly lower change in lnHF values in patients with EH and LVH than in controls (p<0.01) or patients with EH without LVH (p<0.005). In patients with EH and LVH a significant correlation between HF and LVmass/height (r=-0.5, p<0.01) was noted. Compared with healthy controls, patients with EH and LVH had significantly lower HRV parameters [lnLF values were significantly lower in all analysed periods, (p<0.05), and lnHF - during period D, (p<0.01)] whereas LF/HF ratio assessed during period D was significantly higher (p<0.05). CONCLUSIONS: In patients with EH without LVH a relative dominance of sympathetic activity is present. LVH in EH leads to a decrease in vagal drive and progressive inhibition of parasympathetic activity, both of which decrease HRV. These changes may play an important role in the electrical instability of hypertrophied myocardium.

Journal Article↗