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J Wodniecki

Publications and source records attributed to J Wodniecki.

At least 19 recordsLinked to original sources
PubMed2003

Circulating electronegatively charged low-density lipoprotein in patients with angiographically documented coronary artery disease.

UNLABELLED: There is growing experimental evidence to suggest the role of oxidatively modified low-density lipoprotein (LDL) in the initiation and progression of atherosclerosis. The oxidation of lipoprotein moiety causes modification of positively charged lysine residues and results in negative net charge of lipoprotein particles. OBJECTIVE: To measure the amount of circulating electronegatively charged LDL particles (LDL-) in plasma of patients with angiographically documented coronary artery disease (CAD). METHODS: Thirty patients were assigned to the study group (CAD+) and 10 patients to the control group (Ctrl). LDL- was quantitated in homogeneous LDL fractions obtained by ultracentrifugation, using ion exchange high performance liquid chromatography. Plasma lipids were measured using enzymatic kits. RESULTS: The CAD+ group had significantly higher levels of LDL- in the whole LDL fraction (7.66+/-1.92 vs. 5.14+/-0.84%, p=0.0003). Moreover the CAD+ group had significantly higher levels of total cholesterol (255.4+/-35.1 vs. 210.4+/-22.4 mg/dL), LDL cholesterol (154.5+/-26.9 vs. 122.4+/-21.1 mg/dL) and significantly lower levels of high-density lipoprotein (HDL) cholesterol (40.4+/-9.4 vs. 51.0+/-11.5 mg/dL). LDL- remained significantly higher in the CAD+ group after adjustment for total cholesterol, LDL cholesterol and HDL cholesterol (6.3 vs. 5.14% at p=0.0095). There is a trend towards a positive correlation between LDL- levels and LDL cholesterol in the control group (Spearman R=0.55 at p=0.098). CONCLUSIONS: Electronegatively charged LDL appears to be an additional hallmark of coronary artery disease, independently of established lipid risk factors. The trend towards a positive correlation between LDL cholesterol concentration and the level of LDL- in the control group may reflect the susceptibility of LDL cholesterol to autoxidation, Moreover, this may indicate other oxidative mechanisms in coronary artery disease. Nonetheless, further studies assessing the prognostic value of electronegatively charged LDLs are necessary.

Coronary Angiography↗
PubMed2002

Selectin-P and interleukin-8 plasma levels in coronary heart disease patients.

BACKGROUND: Alterations of the immune system are now believed to play crucial role in the pathogenesis of atherosclerosis. The aim of this study was analysis of soluble forms of selectin-P and interleukin-8 levels in patients with different form of coronary heart disease. MATERIALS AND METHODS: In the study took part 18 patients with stable coronary heart disease, 20 patients with unstable coronary heart disease and 15 healthy persons from control group. Soluble selectin-P and interleukin-8 levels were measured in EDTA plasma with the use of enzyme immunoassay ELISA. RESULTS: The level of soluble selectin-P was significantly higher in unstable coronary heart disease patients in comparison to the stable coronary heart disease patients (P < or = 0.01) and nonsignificantly higher in comparison to the control group. The level of interleukin-8 were significantly higher in unstable coronary heart disease patients in comparison to the stable coronary heart disease patients (P < or = 0.01) and in comparison to the control group (P < or = 0.02). CONCLUSION: Our findings suggest that soluble form of selectin-P and interleukin-8 may be useful clinical predictors of unstable coronary heart disease. The assessment of the risk for the development of coronary heart disease requires further serial investigation.

Aged↗
PubMed2001

Randomized, placebo-controlled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy: two-year follow-up results.

BACKGROUND: Previous studies have shown disappointing results for immunosuppressive treatment in patients with dilated cardiomyopathy. Therefore, we studied the effectiveness of such therapy in patients with HLA upregulation on biopsy. METHODS AND RESULTS: Of 202 patients with dilated cardiomyopathy, 84 patients with increased HLA expression were randomized to receive either immunosuppression or placebo for 3 months; they were then followed for 2 years. After 2 years, there were no significant differences in the primary end point (a composite of death, heart transplantation, and hospital readmission) between the 2 study groups (22.8% for the immunosuppression group and 20.5% for the placebo). The secondary efficacy end point included changes in ejection fraction, end-diastolic diameter, end-diastolic volume, end-systolic volume and NYHA class; left ventricular ejection fraction increased significantly in the immunosuppression group compared with the placebo group (95% CI, 4.20 to 13.12; P<0.001) after 3 months of follow-up. The early favorable effects of immunosuppressive therapy on left ventricular volume, left ventricular diastolic dimension, and New York Heart Association class were also present. This improvement was maintained in the immunosuppression group at 2 years (ejection fraction: 95% CI, 6.94 to 19.04; P<0.001). In addition, on the basis of the protocol-specified definition of improvement, 71.8% patients in the immunosuppression group versus 20.9% patients in the placebo group met the criteria of improvement after 3 months (P<0.001). At the end of the follow-up period, 71.4% patients from the immunosuppression group versus 30.8% patients from the placebo group were improved (P=0.001). CONCLUSIONS: These data demonstrate a long-term benefit of immunosuppressive therapy in patients with dilated cardiomyopathy and HLA upregulation on biopsy specimens. Thus, restoration of immunosuppressive therapy for such patients should be considered.

Adult↗
PubMed2001

[Statistical analysis of decision making in the treatment in two-vessel coronary artery disease].

The objective of this paper was to analyze the choice of treatment in two-vessel coronary artery disease and to evaluate the effectiveness of the chosen treatment. The data of sixty-five patients with two-vessel coronary artery disease was analyzed. Two-vessel coronary artery disease was recognized when critical stenoses were present in two arteries with a diameter no less than 2 mm across. Patients who had a CABG were excluded. Patients were divided into three groups according to their treatment: those treated with CABG (29 patients), those treated with coronary angioplasty (20 patients), and those treated conservatively (16 patients). The mean follow-up was 29.3 months (12-48 mo). There were two groups of data collected. The first group consisted of data which might have influenced the decision-making and state of the patients after they had been introduced to the selected treatment. The second group consisted of data necessary to evaluate the state of the patients during the follow-up period. The statistical analysis was divided into three stages. In the first stage, clinical data connected to the selected treatments was studied. In the second, the effects of the chosen treatment were examined. During the third stage of analysis, variables which influenced the effectiveness of the specific treatment were evaluated. Decision-making in patients with two-vessel coronary artery disease depended on the co-existence of hypertension, diabetes, lower-limb ischemia and earlier-performed coronary angioplasty. The only statistically important angiographic feature was the condition of the proximal LAD. Objective improvements in the states of patients (evaluated by exercise tests) were frequently connected to CABG treatment. Subjective improvements in the states of patients were more often connected to conservative treatment. Elevated cholesterol levels were connected to the progression of the disease both in those treated conservatively and interventionally.

Attitude to Health↗
PubMed2000

[Genetic changes and clinical management in familial hypertrophic cardiomyopathy].

Hypertrophic cardiomyopathy (HCM) is phenotypically and genotypically heterogeneous disease of heart. Nine chromosomal loci responsible for this condition have been identified: beta-myosin heavy chain, essential and regulatory myosin light chains, troponin T and I subunits, alpha-tropomosin, cardiac myosin binding protein C, cardiac actin and titin. These genes code for proteins involved in the contraction mechanism or in the control of contraction, therefore HCM has been classified as a disease of cardiac sarcomere. Over 107 mutations have been identified. More then half of them have been detected in the beta-myosin heavy chain gene (beta-MHC). Some mutations in beta-MHC gene are associated with a benign prognosis, other are associated with high incidence of sudden cardiac death (SCD) and severe hypertrophy. Mutations in myosin binding protein C are associated with mild, delayed expression of cardiac hypertrophy and benign prognosis. Mutations in cardiac troponinT are associated with a mild degree of hypertrophy but a high incidence of SCD. Study of genes responsible for HCM will assume role in the context of clinical management of HCM, in particular regarding diagnosis and prognosis patients and families with HCM.

Cardiomyopathy, Hypertrophic↗
PubMed2000

[Viscosity of blood and plasma in patients with single- and multi-vascular coronary heart disease].

The aim of this study was to establish a connection between rheological disturbances and extensiveness of atherosclerotic changes in coronary angiogram. Patients were classified into two groups: group I--with multivascular atherosclerotic lesions (45 subjects at age of 58 +/- 11 years), group II--with univascular atherosclerotic lesions (18 subjects at age of 55 +/- 9 years). Blood samples were drawn from the cubital vein prior to the angiogram. Blood viscosity measurements were performed using low-shear Contraves viscometer-100 at 0.116; 1.0; 4.59 s-1 shear rates and Brokfield Cone/Plate Viscometer at 150 s-1. The plasma viscosity was measured by means of Ubbelohde's capilary viscometer. Besides the viscometric examinations the total cholesterol. LDL-cholesterol, HDL-cholesterol, triglycerides, glucose and fibrinogen as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. The results of studies indicate that in patients with multivascular coronary disease whole blood viscosity at all examined shear rates was significantly greater then in univascular patients. It was found that the LDL-lipoproteins concentration was significantly elevated in the I group. Other examined parameters did not differ significantly. The examinations indicate that there exists the connection between hemorheological disturbances and the extensiveness of coronary heart disease.

Aged↗
PubMed1999

[Troponin T--is it a marker of restenosis after transluminal percutaneous angioplasty in unstable angina patients?].

Troponin T (TpT) is a protein implicated in skeletal muscle contractions, including myocardium. It was shown that the presence of troponin TpT in unstable angina patients' blood is associated with poor prognosis. In the present study amongst 25 patients with unstable angina 12 were found to have TpT present in their blood. TpT concentration was higher in patients with III and IVo CCS symptoms in comparison with class I and IIo CCS symptoms: 0.207 +/- 0.275 and 0.144 +/- 0.186 ng/mL respectively (p = 0.053; nonparametric Kolmogorow-Smirnov test). Patients were subjected to percutaneous transluminal coronary angioplasty (PTCA). After 3 months of follow up 17 patients (the rest of them dropped out) were assigned to two groups: A (n = 8)--without and B (n = 9)--with clinical and electrocardiographic signs of restenosis. Retrospective analysis revealed the presence of TpT before PTCA in 6 group B patients and 2 group A patients. Relative risk of stenocardia recurrence was calculated as 2.25. TpT was present in the blood of 20 patients in the first 24 hours after PTCA, and group B patients had higher mean TpT concentration; that could result from reperfusion of more ischaemic myocardium. It seems that the presence of TpT in unstable angina patients' blood may be an important factor characterizing patients with more serious prognosis.

Angina, Unstable↗
PubMed1999

[Results of promoting fibrinolytic therapy for myocardial infarction in the Katowice Province from 1996-1998].

The action promoting fibrinolytic treatment of myocardial infarction and questionnaire-based follow up of the results was carried out over a four million people area. 5262 questionnaires, in which physicians answered a number of questions, were received. The poll revealed that 79% of patients received fibrinolytic treatment. The authors estimate the overall percent of patients, treated in hospital wards, at about 27.7%. The mortality rate in the group of patients, who received streptokinase, was 8.61% and in the group of patients, who did not receive the treatment, was 16.28%. The signs of reperfusion were present in 60.38% of patients. The authors conclude that the increase in the number of patients administered fibrinolytic treatment should be aimed, and the results obtained in this group of patients come close to published data. Exercise tests are performed in too small number of myocardial infarction patients and only little proportion of them undergoes further coronary angiography.

Adult↗
PubMed1999

[Blood and serum viscosity in cardiologic X syndrome].

UNLABELLED: The aim of this study was to explore if are there blood rheological disturbances in cardiac syndrome X. Two groups were examined: 23 patients (aged 41 divided by 72 years) suffering from cardiac syndrome X (typical anginal pain positive stress test and no lesion in coronary angiograms) and 20 healthy (aged 32 divided by 57 years). Blood samples were drawn from the cubital vein prior to the angiogram. Blood viscosity measurements were performed using the Brookfield Cone/Plate Viscosimeter at 150 s-1 shear rate, and by means of low-shear Contraves viscometer at 1 s-1 (a)nd 4.59 s-1 shear rates. The plasma viscosity was measured by means of Ubbelohde's capillary viscometer. Besides the viscometric examinations the total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and glucose plasma concentration as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. It was stated that blood and plasma viscosity were significantly elevated in syndrome X compared with the control group (p < 0.001). CONCLUSION: The examinations indicate that in patients suffering from Cardiological Syndrome X the whole blood and plasma viscosity are increased.

Adult↗
PubMed1998

Immunohistological diagnosis of myocarditis. Potential role of sarcolemmal induction of the MHC and ICAM-1 in the detection of autoimmune mediated myocyte injury.

AIMS: The aim of this study was to characterize the up-regulation of major histocompatibility complex antigens class I (HLA-A, B, C) and class II (HLA-DR), and intercellular adhesion molecule-1 with special emphasis on de novo induction of these molecules on cardiac myocytes in patients with suspected myocarditis. METHODS: Endomyocardial biopsy specimens were obtained from 83 consecutive patients. Specimens were subdivided into two groups according to clinical presentation of the disease: Group A, 58 patients with idiopathic congestive heart failure and Group B, 25 patients without heart failure. In group A, 15% of patients had active myocarditis, 36% had borderline and 48% no myocarditis according to Dallas criteria. In group B, myocarditis distribution was 12%, 36% and 52%, respectively. The major histocompatibility complex was considered to be positive when the immunoreactivity index was > or = 3+; intercellular adhesion molecules were considered positive when the score was > or = 2+. RESULTS: We observed two characteristic staining patterns of the HLA molecules on cardiac myocytes: (i) multifocal sarcolemmal staining at the sites of mononuclear inflammatory infiltration, (ii) linear sarcolemmal staining with otherwise normal endomyocardium. Positive immunoreactivity was observed in 60% of patients in group A, and in 44% of patients in group B. We found no correlation between a histopathological diagnosis of myocarditis or left ventricular systolic function and positive immunoreactivity. CONCLUSION: The lack of correlation between immunohistological signs of active inflammation and clinical symptoms in patients with myocarditis may indicate independence of an immunological mechanism. The lack of correlation between immunoreactivity and histopathological diagnosis of myocarditis may suggest low sensitivity of traditional histological evaluation. In our opinion, the induction of major histocompatibility and intercellular adhesion molecules on cardiac myocytes may indicate an autoimmune inflammatory response in patients with inflammatory myocardial disease. Immunohistochemical methods may be helpful in selecting patients for immunosuppressive therapy.

Adult↗
PubMed1998

[Use of fourier row as a method for analyzing the course of circadian heart rate in patients with left ventricular ejection fraction impairment].

The circadian heart rate course was assessed in 3 groups of patients with left ventricular ejection fraction (LVEF) 10-15%, 20-25% and 30-35%. The study comprised 36 persons. In 9 patients heart failure was due to MI and in 17--to dilated cardiomyopathy. Those with atrial fibrillation, ventricular tachycardia, supraventricular tachycardia, diabetes, valvular heart diseases and with central system disorders were excluded from the study. Left ventricular ejection fraction was evaluated by echocardiography. Heart rate, calculated as a mean value every 5 minutes, was taken in patients during 24 hour recordings. For each patient separately, mean value of all measurement was calculated. Then a ratio of each actual value to the mean value was calculated. This ratio was defined as relative heart rate; [formula: see text] Circadian heart rate courses were approximated by Fourier row: [formula: see text]. The 24 harmonics were analyzed. Statistically significant differences in circadian courses were closed to amplitudes of 1st, 12th, 13th, 14th, 16th, 18th harmonics. Using test of variance homogeneity it has been demonstrated that variability of amplitudes of 12th and 17th harmonics as well as phase of 5th harmonic depend on left ventricular ejection fraction.

Adult↗
PubMed1996

[Equivalent occlusion of the left main coronary artery--case report].

In the paper two cases are described of patients in whom during angiography coexistent occlusion of the left descending artery and left circumflex artery was found. ECG and echocardiography in both cases were not indicating such a high coronary vessel defect. In both patients angiography was performed leading in one case to development of shock with fatal outcome.

Coronary Angiography↗
PubMed1995

[Early results and many years of observing treatment of unstable angina].

Immediate effect of PTCA and CABG for unstable angina then followed-up for PTCA and CABG several years are analyzed in 112 patients selected out of 204 unstable angina patients hospitalized from 1990 to 1991. Fifty three patients, aged 25-68 (mean 51) were assigned to PTCA, fifty nine aged 33-69 (mean 53) were subjected to CABG. Both groups comprised of 72% and 83% males respectively. Nine patients with de novo angina, forty with crescendo angina and four with prolonged stenocardia were assigned to PTCA. 28% of patients have had myocardial infarction. Nine patients with de novo angina and fifty with crescendo angina were assigned to CABG. 56% of them have had myocardial infarction. Left ventricular ejection fraction (LVEF) less than 40% was found in 8 (15%) PTCA patients and in 18 (31%) patients who underwent CABG. Full revascularization was achieved in 38 (73%) patients treated with PTCA and 46 (78%) CABG patients. In 9/17% patients only critical stenosis in multivessel disease was subjected to PTCA. Four cases of myocardial infarction underwent intervention and all of these patients died: one (2%) after PTCA, and three (5%) after CABG. Fifty two patients after PTCA and fifty six after CABG were followed for one to four (mean 3) years. Thirty one percent of patients after PTCA and 41% after CABG were asymptomatic, 61% and 54% respectively had little to moderate symptoms. Left ventricular systolic function improved in most patients, predominantly in those with LVEF less than 40% (p < 0.05) treated with PTCA. Hospitalization due to anginal pain was needed in 46% of patients after PTCA and 15% after CABG (p < 0.05). Coronary artery restenosis after PTCA was successfully treated with re-PTCA or CABG in 9 (17%) patients. Venous graft stenoses were dilated in two cases. Myocardial infarction occurred in 3 (6%) patients after PTCA and 2 (4%) patients after CABG. One patient died after redilatation CABG treated patients required nonsignificantly less antianginal drugs. Four week survival rate in PTCA group and CABG group was 98% and 95% respectively; three year survival was 95% in both groups. We conclude, that unstable angina patients requiring either angioplasty or surgery may expect good procedural and long term prognosis. Remarkably good results may be expected in successfully revascularised patients with low ejection fraction.

Adult↗
PubMed1995

[Effects of long term oxygen therapy in patients with idiopathic pulmonary fibrosis. I. Effect on the course of the primary disease and on pulmonary circulation].

The study was performed in 18 patients (15 F and 3-M) aged 35-57 yers (mean 46 +/- 7) diagnosed as idiopathic lung fibrosis. Ten patients (group A) recived standard treatment (prednisone 10-15 mg/day) and supplementary home oxygen therapy (mean 16.4 h/day) for a period of 4 years. During exacerbations antibiotics, theophylline and expectorants were prescribed. Eight patients (group B) receiving the same treatment without home oxygen, served as controls. At study entry lung function test (TLC, VL, Dlco), blood gases, hematocrit, hemodynamic parameters of the pulmonary circulation and thermodilution cardiac output were measured in all patients. The measurements were repeated after 4 years of follow-up. At follow-up examination no differences in pulmonary function parameters were shown between the groups. Mean pulmonary artery pressure and pulmonary vascular resistance were significantly lower in patients receiving home oxygen therapy (group A) as compared with those treated pharmacologically only (group B). Best effects of oxygen therapy were observed in patient with lower pulmonary artery pressures at study entry.

Adult↗