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Biomedical subjects

B Dabrowska

Publications and source records attributed to B Dabrowska.

At least 19 recordsLinked to original sources

Influence of serum potassium on the electrocardiographic pattern of left ventricular hypertrophy in primary hyperaldosteronism.

Only a few studies deal with electrocardiographic (ECG) signs of left ventricular hypertrophy (LVH) in patients with primary hyperaldosteronism, although it may be presumed that many factors such as arterial hypertension, hypokalemia, increased blood volume, and decreased activity of the renin-angiotensin system can modify LVH pattern in this entity. For that reason, we evaluated ECG signs of LVH in 55 patients with primary hyperaldosteronism hospitalized in our department from 1971 to 1990. These data were compared with age, serum potassium level, plasma renin activity (PRA) and-in 14 patients-with left ventricular mass, measured echocardiographically. We found inverse correlation between serum potassium concentration and the Sokolow-Lyon index: SV1 + RV5/6 (r = -0.47, p < 0.001). Among 24 patients with only abnormal QRS voltage, without ST-T changes suggestive of LVH, 19 (79.2%) had hypokalemia. In multivariate analysis, potassium concentration was the single independent predictor of an abnormal QRS voltage: -0.743, p = 0.01 vs. 0.153 (age), -0.337 (PRA) and 0.454 (LV mass). Our observations suggest that hypokalemia is an important factor influencing an amplitude of QRS complexes and may be responsible for false-positive LVH diagnosis.

Adult

[Primary arterial hypertension. Treatment with captopril and function of the left heart ventricle, concentration of catecholamine in blood and activity of renin].

We evaluated the effect of captopril treatment on left ventricular mass (LVM) and function in sustained mild-to-moderate primary hypertension. In 16 men aged 34.5 +/- 6.4 yrs. M-mode echo and pulsed wave Doppler recordings were obtained prior to and after 2 months captopril treatment (50-150 mg daily). No significant changes in heart rate, systolic blood pressure, ejection fraction, fractional shortening, cardiac output, LVM and Doppler-derived indices of mitral inflow were observed. Diastolic blood pressure measured during examination fell from 102.2 +/- 13.3 to 90.3 +/- 9 mmHg (p less than 0.026). No consistent correlations between catecholamines and indexes of left ventricular function were found. Two-month captopril therapy in mild-to-moderate hypertension results in diastolic blood pressure lowering with no effect on LVM or left ventricular function.

Adult

[Left ventricular systolic function in young women with hyperkinetic syndrome--echocardiographic evaluation].

In twenty two young (mean age 31.6 years) normotensive women with hyperkinetic heart syndrome (HHS) we assessed echocardiographically left ventricular (LV) function indexes before and after 40 mg of oral propranolol. At baseline the HHS group differed from controls with respect to higher heart rate heart and diastolic blood pressure (BPs), lower systolic and systolic LV volumes, greater corrected mean circumferential fiber shortening, ejection fraction, cardiac index and contractility index (systolic blood pressure x body surface area/LV end-systolic volume ratio). Propranolol normalized nearly all analyzed indexes except for BPs which remained increased compared to controls. In young women with HHS enhanced cardiac performance is expressed by higher cardiac index and speed of blood ejection from the left ventricle, is related to tachycardia and higher contractility but not to increased preload. Results post propranolol administration speak in favour of significant role of increased beta-adrenoceptor stimulation in HHS.

Adult

[Evaluation of 24-hour ambulatory ECG recording in patients with mitral valve prolapse].

Among 1150 ambulatory 24-hour ecg recordings, those taken from 67 persons no more than 40 years old, suffering from paroxysmal unconsciousness or maladies suggesting paroxysmal arrhythmias, without clinical signs of ischaemic heart disease, valve defects, cardiomyopathies or myocarditis, were chosen for further analysis. Echocardiographic signs of mitral valve prolapse (MVP) were found in 33 persons (23 females), whereas in the next 34 persons (20 females) no evidence of MVP was noted. There were no statistical differences between ages, mean heart rates and incidences of the ST segment depression greater than or equal to 2 mm in these two groups. Prolongation of the QT interval greater than 440 ms was found in 8 persons with MVP and in 3 without MVP. Appearance of the single ventricular extrasystoles, sporadic or frequent, was almost identical in both groups. Whereas polymorphic extrasystoles and/or ventricular couplets were significantly more frequent in the MVP group. Our study shows that MVP is present in about a half of persons no more than 40 years old referring to Holter ecg because of symptoms suggesting arrhythmias, without other signs of heart disease; and that complex ventricular arrhythmias in these patients with MVP are significantly more frequent than in persons with similar complaints without MVP.

Adolescent

Effect of removal of phaeochromocytoma on diurnal variability of blood pressure, heart rhythm and excretion of catecholamines.

Ambulatory 24 hour blood pressure and ECG monitoring with simultaneous estimation of the urinary excretion of noradrenaline and adrenaline were performed in seven patients with phaeochromocytoma, before and after removal of the tumour. Mean blood pressure during eight 3-hour periods, mean heart rate, and noradrenaline and adrenaline excretion during four 6-hour periods were estimated. Mean blood pressure before surgery did not show any significant circadian changes. After surgery both systolic and diastolic blood pressures were significantly lower at night than in the daytime periods. In contrast, mean heart rate before surgery was significantly lower at night than in the morning, and this relationship was greater after surgery. Ventricular arrhythmias during 24 hour monitoring were noted in three patients before and in six after surgery. These findings suggest that profound disturbances of autonomic blood pressure regulation improve after removal of phaeochromocytoma, and that ventricular arrhythmias, except for paroxysmal symptoms, tend to be less frequent before than after surgery.

Adrenal Gland Neoplasms

The electrocardiographic diagnosis of left septal fascicular block.

In 38 anesthetized and intubated dogs QRS features were estimated after incision of the interventricular septum. The left bundle branch system of the excised heart was stained with Lugol solution to visualize the extent and localization of the fascicular section. In 7 dogs the incision reached a part of the septal network; three of them showed incomplete LBBB pattern. In 13 dogs a major part of the septal network and the posterior/anterior fascile were transected. In 6 of them the pattern of incomplete LBBB was noted. A bipolar intracavitary L-R lead was recorded in 2 of these cases and revealed disappearance of the initial q wave in both. In 7 experiments the left bundle branch was completely transected with consecutive LBBB pattern. In 8 dogs the incision failed to reach the left bundle branch system and the ECG records did not show any form of LBBB pattern. The findings suggest that incomplete LBBB may be a form of left septal fascicular block.

Animals