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Anna Klisiewicz

Publications and source records attributed to Anna Klisiewicz.

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↗
PubMed2005

[Double-orifice mitral valve -- case report].

A case of 16 year old male with an initial diagnosis of the mitral stenosis is presented. The transthoracic echocardiography showed the complete bridge type double-orifice mitral valve with a larger medial orifice.

Adolescent↗
PubMed2004

[Univentricular heart, common atrium, single atrio-ventricular valve--is it possible in humans?].

Two extremely rare cases of adults with univentricular hearts of right ventricular morphology are presented. Pathogenesis and pathophysiology of univentricular circulation as well as anatomic variants, short information on prognosis and management are briefly discussed. Echocardiographic diagnosis of univentricular heart is described. The first case was a 23-year-old housewife with univentricular heart, functionally common atrium, single atrio-ventricular valve of tricuspid morphology, transposition of great arteries and significant subvalvular pulmonary stenosis. The second case was a 19-year-old student with univentricular heart with moderately depressed systolic function, common atrium, single atrio-ventricular valve of tricuspid morphology, mitral atresia, and non-communication residual left ventricle. Both patients led a normal life with little to moderate limitations of everyday activity.

Adult↗
PubMed2004

[Ultrasound stethoscope in the rapid assessment of left ventricular systolic function and valvular regurgitation--personal experience].

BACKGROUND: Recent technological advances enabled miniaturization of echocardiographic machines and construction of portable "ultrasound stethoscopes", which enable rapid two-dimensional and color-Doppler imaging and supplement clinical examination of the heart. We present the results of systematic assessment of these devices in comparison with standard echocardiographic machines. METHODS: We prospectively examined with both ultrasound stethoscopes and standard echocardiographic machines 60 patients referred to our laboratory for routine echocardiographic examination. Image quality (score: 1 to 4; best to worst), accuracy in qualitative evaluation of valvular regurgitation and left ventricular function (ejection fraction) were directly compared. Color Doppler assessment of valvular regurgitation was graded on a standard four point scale. A two or more point difference was considered major. Ejection fraction was estimated (the ultrasound stethoscope is not equipped with appropriate software). RESULTS: Image quality was significantly worse in the case of ultrasound stethoscope (2.6 vs 2.1; p<0.0001). Major differences in the assessment of regurgitant jets were present in 3 cases (5%) (1 mitral and 2 tricuspid). The degree of agreement was good in the case of mitral and pulmonary regurgitation (kappa=0.61 and 0.74 respectively), very good in the case of aortic regurgitation (kappa=0.80) and moderate in the case of tricuspid regurgitation (kappa=0.48). The differences in the assessment of aortic and mitral regurgitant jets correlated with the image quality (p<0.05). A Bland-Altman graph comparing the results of ejection fraction assessment revealed good agreement between methods. CONCLUSIONS: Results of the systematic evaluation of the use of ultrasound stethoscopes in the rapid evaluation of left ventricular systolic function and valvular regurgitation. Although image quality achieved with the hand-held stethoscope was worse, nevertheless it was adequate for the purpose of performing rapid limited assessment of cardiac and valvular function.

Adult↗
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

Changes in the response of hibernated myocardium to inotropic stimulation after angioplasty: a Doppler myocardial imaging study.

BACKGROUND: Angioplasty of an infarct related artery (IRA) performed several weeks or months after myocardial infarction (MI) may improve myocardial function. HYPOTHESIS: We hypothesized that, as Doppler myocardial imaging (DMI) allows for the quantitative assessment of the systolic movement of myocardial segments, it may be a sensitive method for assessing changes in regional myocardial contraction and contractile reserve pre and post angioplasty of the IRA. METHODS: In all, 39 patients (30 men, mean age 53.4 +/- 8.3 years), 1 to 6 months after MI, who qualified for IRA angioplasty on the basis of myocardial viability in the infarcted zone as demonstrated by dobutamine stress echocardiography, were included in the study. Peak regional myocardial systolic velocities (S wave) of the infarcted segments were measured at rest and during low-dose dobutamine infusion (15 microg/kg/min) 1 day before angioplasty (Exam 1), 2 to 5 days (Exam 2), and 30 days (Exam 3) after successful angioplasty. The long-axis movement of the mitral annulus and of the basal and medial segments of the posterior (20 patients), anterior (17 patients), and lateral walls (2 patients) was evaluated. RESULTS: At rest, S-wave velocity of the infarcted segments increased between Exams 1 and 2, without further improvement between Exams 2 and 3 (4.9 +/- 1.2 vs. 5.6 +/- 1.3 cm/s, p < 0.05 and 5.6 +/- 1.3 vs. 5.5 +/- 1.3 cm/s, NS, respectively). However, S-wave velocities measured during low-dose dobutamine infusion differed significantly both between Exams 1 and 2, and 2 and 3 (7.0 +/- 1.5 vs. 7.8 +/- 1.8 cm/s; p < 0.01; 7.8 +/- 1.8 vs. 8.5 +/- 1.6 cm/s; p < 0.05). CONCLUSIONS: Resting contractility at an infarct zone demonstrated rapid initial improvement after angioplasty of the IRA with no further change, whereas contractile reserve improved not only immediately after angioplasty but also during the next month.

Angioplasty, Balloon, Coronary↗
PubMed2002

[Evaluation of left ventricular diastolic function with tissue doppler echocardiography (TDI) in patients after angioplasty of the artery responsible for infarction].

UNLABELLED: To assess the ability of left ventricular (LV) diastolic function to improve following angioplasty of an infarct related artery (IRA), 39 patients were evaluated with the Tissue Doppler Imaging (TDI). Studied group comprised of 30 males and 9 females (age 53.3 +/- 8.3 yrs), who were 1 to 6 months after myocardial infarction (MI). They qualified for angioplasty of IRA if dobutamine stress echocardiography proved viability of the affected myocardium. Regional wall diastolic function was assessed by TDI 1 day before (exam 1), 1-3 days (exam 2) and 30 days (exam 3) after successful angioplasty. TDI myocardial diastolic velocities (Em and Am wave, Em/Am ratio) and time intervals (isovolumic relaxation time IVRT, rapid filling time RFT, atrial filling time AFT) were measured in the long axis of posterior (20 pts), anterior (17 pts) and lateral (2 pts) walls. Regional E wave velocity was increased between exam 1 and 3 (6.0 +/- 1.5 cm/s vs 6.7 +/- 1.7 cm/s, p < 0.05), the same as Em/Am ratio (1.0 +/- 0.4 vs 1.3 +/- 0.9, p < 0.05). There was no significant change in Am wave velocity. The regional RFT was prolonged between exam 1 and 2 (151 +/- 39 ms vs 170 +/- 30 ms, p < 0.01), whereas IVRT was shortened (103 +/- 21 ms vs 87 +/- 20 ms, p < 0.001). CONCLUSIONS: Regional diastolic function showed improvement as assessed by TDI after successful angioplasty of IRA. TDI allows the assessment of regional diastolic performance and its dynamics.

Angioplasty, Balloon, Coronary↗