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Biomedical subjects

B Bednarz

Publications and source records attributed to B Bednarz.

At least 19 recordsLinked to original sources
PubMed2001

Clinical characteristics of patients with increased urinary excretion of adrenaline in mild to moderate heart failure.

BACKGROUND: We have previously demonstrated that adrenaline (AD) is released into the circulation during acute myocardial infarction and is associated with a more severe clinical course. The role of elevated AD levels in congestive heart failure is not known. HYPOTHESIS: The study aimed to determine whether increased daily AD excretion is associated with more severe clinical symptoms and a more complicated clinical course in patients with exacerbation of congestive heart failure (CHF). METHODS: Urinary excretion of AD, noradrenaline, magnesium (Mg), and potassium (K), serum levels of aldosterone, K, and Mg, as well as the incidence of arrhythmias (24-h Holter) were assessed in 49 patients with CHF New York Heart Association (NYHA) class II-III. The patients were allocated to two groups, with normal (Group 1) and increased (Group 2) excretion of AD. RESULTS: Groups 1 and 2 did not differ in respect of age, etiology of CHF, or the medication used. Also, left ventricular ejection fraction was similar in the two groups. However, left ventricular end-diastolic dimension was greater in Group 2 (61+/-9 vs. 55+/-11 mm, p<0.05), as was the proportion of patients in NYHA class III (74 vs. 40%). Group 2 was also characterized by increased urinary excretion of Mg (60+/-24 vs. 43+/-16 mg/24 h, p < 0.007) and the presence of more complex and numerous ventricular arrhythmias (74 vs. 37% and 68 vs. 33% of patients, respectively). CONCLUSIONS: Urinary excretion of AD is increased only in a subgroup of patients with CHF. These patients are characterized by a more advanced NYHA class, increased end-diastolic left ventricular diameter, and increased urinary excretion of magnesium. It is likely that all these factors contribute to the presence of more complex and numerous ventricular arrhythmias in this subgroup of patients.

Aged↗
PubMed2001

Event-free survival in patients after an acute coronary event with exercise-induced normalization of the T-wave.

BACKGROUND: Risk stratification of patients with unstable angina or non-Q-wave myocardial infarction (MI) is an unresolved clinical problem. The prognostic value of T-wave normalization (TWN) during exercise has not been studied in this group of patients. HYPOTHESIS: Event-free survival in clinically stable patients after an acute coronary event without ST-segment elevation can be predicted by the presence of exercise-induced TWN. METHODS: Sixty-five patients (43 men and 22 women, mean age 62+/-10 years) entered the study. The diagnosis of unstable angina and non-Q-wave MI was made in 40 and 25 patients, respectively. A treadmill exercise test was performed in all patients after clinical stabilization. The patients were divided into three groups: those with negative baseline T waves and exercise-induced TWN (Group 1); those with negative baseline T waves, but without TWN (Group 2); and those with positive baseline T waves (Group 3). The patients were followed up for 6 months. RESULTS: During follow-up, serious cardiovascular complications occurred in 15 (23%) patients. These included exacerbation of ischemic heart disease (14 patients) and acute MI (1 patient). Event-free survival was greater in patients in Group 1 (95%) than in those in Group 2 (68%, p < 0.034) or Group 3 (71%, NS). Among all patients studied, exercise-induced TWN was predictive of event-free survival with a sensitivity of 38% and a specificity of 93%. CONCLUSIONS: In clinically stable patients after an acute coronary event without ST-segment elevation, exercise-induced TWN is a specific but n ot sensitive predictor of event-free survival after 6 months.

Acute Disease↗
PubMed2000

Effects of oral L-arginine supplementation on exercise-induced QT dispersion and exercise tolerance in stable angina pectoris.

We assessed the effects of L-arginine (an endogenous precursor of nitric oxide) on the magnitude of exercise-induced QT dispersion in patients with coronary artery disease. The study had a randomized double-blind cross-over design. Twenty-five patients with stable coronary artery disease underwent two separate exercise tests: after oral administration of L-arginine (6 g/24 h for 3 days) or placebo. Indications for cessation of exercise included: pulse limit, exhaustion, chest pain, ST segment depression >2 mm. We found that arginine significantly increased exercise duration from 604+/-146 to 647+/-159 s (P<0.03). However, it had no effect on the sum of exercise-induced ST segment depressions (1.9+/-2.3 and 2.4+/-3.3 on and off arginine, respectively, NS). Exercise shortened QT interval to a similar extent in patients treated with placebo or arginine. QT dispersion changed during exercise from 55+/-21 to 60+/-19 ms (NS) and from 60+/-21 to 53+/-17 ms (NS), respectively. We conclude that, in patients with coronary artery disease, oral supplementation of L-arginine does not affect exercise-induced changes in QT interval duration, QT dispersion or the magnitude of ST segment depression. However, it significantly increases exercise tolerance, most likely due to improved peripheral vasomotion. These results may be of clinical and therapeutic importance.

Aged↗
PubMed2000

[Comparison of the therapeutic efficacy of spironolactone and furosemide in patients with severe congestive heart failure].

21 patients with NYHA class III to IV congestive heart failure were randomised to Aldactone (200 mg i.v., 11 pts) or furosemide (20 mg i.v., 10 pts). The mean urine volume in 24 hours in Aldactone group was 1145 ml (range 600 to 2500 ml) and 1678 ml (range 1000 to 3500 ml) in furosemide group (NS). Reduction of magnesium plasma level in furosemide group 24 hours after treatment (from 2.16 +/- 0.18 to 2.01 +/- 0.12 mg/dl, p < 0.05) and slight elevation in Aldactone group (from 1.96 +/- 0.3 to 2.11 +/- 0.18, NS) were observed. Ventricular arrhythmias detected on 24 hour Holter monitoring didn't differ between the study groups.

Aged↗
PubMed1993

Increase of R-wave in pre-discharge ergometric test after myocardial infarction indicates advanced left ventricular injury, latent serious arrhythmias and worse prognosis.

Changes in R-wave amplitude during exercise tests performed soon after myocardial infarction (15-31 days, mean 22) were analyzed in 78 men in relation to left ventricular injury (determined by 2-D echocardiography), ventricular arrhythmias (24-h Holter monitoring) and survival after myocardial infarction. It has been found that in patients with mild left ventricular injury (n = 51, Heger index < or = 3) the sum of the R-wave amplitude in 15 precordial leads recorded immediately after exercise decreased by 3.7 +/- 10% in comparison with resting values. In the patients with major left ventricular injury (n = 26, Heger Index > 3) the sum of R-wave amplitude after exercise increased by 12.9 +/- 17.5% (P < 0.001). Positive linear correlation (r = 0.35, P < 0.01) was observed between the level of left ventricular wall motion disturbances and R-wave amplitude changes. In patients with normal or slightly disturbed cardiac rhythm (n = 42, Lown scale 0-2) the sum of the R-wave amplitude after exercise decreased by 5 +/- 18% as compared to resting values, whereas in the patients with complex arrhythmias (n = 23, Lown scale 3-5) the sum of R-wave amplitude increased amounting to 9.9 +/- 17% (P < 0.001). Out of 17 patients who died during 5-year follow up, 16 displayed an increase or no change of the sum of R-wave amplitude. The same kind of relations between R-wave amplitude changes and left ventricular injury or cardiac arrhythmias were noted in patients with anterior and inferior myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Mobile Intensive Cardiological Care Unit. 12-month experience].

Authors presented the organization of Mobile Intensive Cardiological Care Unit (MICCU) and discussed its interventions during the first year of activity. In 1987 the total number of interventions was 3333 (mean 9 per day), including 150 in acute myocardial infarction, 142 in acute rhythm or conduction disorders, 56 in acute heart failure and 36 in cardiac arrest. Efficacy of MICCV work recommended the the circulatory system.

Cardiovascular Diseases↗
PubMed1989

[A map for recording of 15 precordial leads improves the sensitivity of the exercise test].

Authors analyzed ecg recordings of 112 exercise tests performed in males aged 29-62. 15 precordial leads map (inclusive of V1-V6 standard leads) was used to record ecg tracings. In 22 patients (19.5%) ischemic, electrocardiographic changes were only observed at non-standard leads. Obtained data indicate higher sensitivity of the exercise test with ecg recordings enriched by additional leads.

Adult↗
PubMed1989

[Early exercise test after myocardial infarction. Our experience-- results of the examinations of 102 patients].

The paper presented results of early exercise tests performed after myocardial infarction in 102 patients. Examinations were performed on the average, 22 days after the onset of myocardial infarction symptoms. In 52 patients a positive results of the exercise test was stated: lowering of ST-T segment (n = 25), ventricular arrhythmias (n = 16), ST-T segment elevation (n = 15), angina pain (n = 5), and a fall of systolic arterial pressure (n = 4). Two of above mentioned symptoms were observed in some patients. Exercise test was limited by a pulse rate (70% of predictive, maximal pulse rate and) or the work load (up to 125 Watts). No significant complications were observed.

Adult↗
PubMed1987

ST 567 compared with propranolol in stable angina.

UNLABELLED: The aim of this study was to investigate the effectiveness of ST 567 in patients suffering from ischaemic heart disease and to compare the effects of this drug with those of propranolol. The study group consisted of 48 male patients, mean age 53, with stable, exercise-induced angina pectoris. After a two-week run-in-placebo period, the patients were randomized to treatment with ST 567 3 X 30 mg (N = 24) and propranolol, 3 X 40 mg (N = 24). The drugs were administered in a double blind fashion during four weeks. Heart rate at rest was decreased by ST 567 from 76 to 65 (P less than 0.005) by propranolol from 76 to 62 (P less than 0.001). Systolic blood pressure was lowered by ST 567 from 131 to 121 (NS) and by propranolol from 133 to 118 (P less than 0.05). Exercise tolerance was increased by ST 567 from 20 X 10(3) to 34 X 10(3) J (P less than 0.05), by propranolol from 26 X 10(3) to 32 X 10(3) J (P less than 0.01) (mean values). Anginal attacks (no. per week) were reduced by ST 567 from 14 to 7 (P less than 0.05) and by propranolol from 14 to 5 (P less than 0.01). Nitroglycerin consumption in no. of tablets per week decreased in ST 567 from 12 to 7 (P less than 0.01), in propranolol from 11 to 4 (P less than 0.0). There were 7 drop outs during treatment with ST 567:2 cases of myocardial infarction, exacerbation of angina in 2 patients, visual disturbances in 2 patients, vertigo in 1 patient. With propranolol we observed worsening of angina in 1 patient, with disturbances in sexual potency in 1. IN CONCLUSION: ST 567 is an effective agent in chronic angina but slightly less effective than propranolol in the dosages studied.

Angina Pectoris↗