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Biomedical subjects

J Wodniecki

Publications and source records attributed to J Wodniecki.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Effects of long term oxygen therapy in patients with idiopathic pulmonary fibrosis. II. Effect of oxygen therapy on function of heart ventricles].

The aim of this study was to assess the effect of chronic home oxygen therapy on cardiac function in patients with idiopathic interstitial lung fibrosis. Ten patients (Group A) received standard pharmacological treatment (prednisone 10-15 mg/day) and supplementary home oxygen therapy (mean 16.4 h/day) for the period of 4 years. Eight patients (Group B) received pharmacological treatment alone for the same period of time. Left ventricular ejection fraction was measured with a scintillation probe. Right and left ventricular function was also assessed by means of echocardiography. All measurements were taken at the beginning of study and repeated at the end of the 4 year follow-up. Anatomical and functional deterioration was slower in group A than in group B. Statistically significant differences between the groups at follow-up were found with respect to the right ventricle-early inflow velocity and tricuspid E/A ratio. Changes in left ventricular function were also different between the groups. A significant decrease in ejection fraction and mitral E/A ratio was observed in group B, while the corresponding changes in group A were not significant. These results suggest that chronic home oxygen therapy attenuates cardiac dysfunction in patients with idiopathic interstitial lung fibrosis.

Adult↗
PubMed1994

[Changes in levels of noradrenaline and adrenaline in blood after exercise testing and transesophageal atrial pacing in patients with ischemic heart disease].

13 patients with ischaemic heart disease and 8 healthy subjects underwent exercise testing and transesophageal atrial pacing. Alternations in plasma noradrenaline, adrenaline as well as systolic and diastolic blood pressure were determined. Mean plasma noradrenaline significantly increased after exercise effort in both groups of patients and it significantly correlated with the increase in systolic blood pressure. The essential increase in mean plasma noradrenaline was found after atrial pacing but the degree of increment was significantly higher after the exercise testing in both groups. The plasma adrenaline level showed a significant increase only during exercise in the ischaemic group. Considering to a more noticeable adrenergic response it can be concluded that exercise test is a more helpful method in diagnosis of ischaemic heart disease than transesophageal atrial pacing.

Adult↗
PubMed1993

The acute response of left ventricular filling dynamics to intravenous verapamil predicts the changes in exercise tolerance after oral verapamil therapy in patients with hypertrophic cardiomyopathy.

We studied the correlation between changes in left ventricular filling dynamics induced by acute intravenous administration of verapamil and the changes in exercise tolerance induced by oral administration of the agent in 30 patients with hypertrophic cardiomyopathy. Diastolic cardiac function was measured by means of a nuclear stethoscope before and 10 min after intravenous administration of verapamil, 0.15 mg.kg-1 over 2 min. Treadmill exercise tests using a modified Bruce protocol were performed before the initiation of oral verapamil treatment and after 4 weeks of oral therapy at a dose of 320-360 mg.day-1 (mean +/- SD 332 +/- 17 mg.day-1). Peak filling rate (PFR) increased in 21 patients, 18 of whom (86%) also had an increase in exercise duration, PFR showed no increase in nine patients, eight of whom (89%) had no change in exercise duration (sensitivity 95%, specificity 73%, predictive value of the positive result 86%, predictive value of the negative result 89%). Acute changes in time from the beginning of rapid filling to PFR (t-PFR) and in left ventricular end-diastolic volume (EDV) were less useful in predicting improvement in exercise tolerance. In 19 patients the changes in PFR and EDV paralleled. Twelve of the 13 patients (92%) with an increase in both parameters also had an increase in exercise duration, whereas all six in whom these parameters were reduced showed no increase in exercise duration (sensitivity 100%, specificity 86%, predictive value of positive results 92%, and predictive value of negative results 100%).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

Effect of sotalol on arrhythmias and exercise tolerance in patients with hypertrophic cardiomyopathy.

The effect of sotalol on exercise tolerance and incidence of arrhythmias was studied in 30 patients with hypertrophic cardiomyopathy (HCM). In this short-term, double-blind, cross-over study, exercise time on sotalol (320 mg/day) was significantly longer than on placebo (10.6 +/- 4.0 vs. 9.4 +/- 3.6 min; p < 0.01). Sotalol eliminated supraventricular arrhythmias in 6 of 7 patients (p < 0.03) and suppressed ventricular arrhythmias in 7 of 13 patients in whom they were present on placebo (p < 0.05). Ventricular tachycardia was abolished in 4 of 8 patients, but appeared during sotalol treatment in 1 patient who was free of repetitive arrhythmias on placebo. Twenty-five patients who had better exercise tolerance on sotalol than on placebo and did not experience aggravation of arrhythmia entered a 6-month prospective, open-label treatment with sotalol (160-480 mg/day, mean +/- SD 377 +/- 94). One patient was withdrawn after 1 month because of bronchospasm. Mean exercise time improved from 9.8 +/- 3.6 min on placebo to 12.7 +/- 3.2 min (p < 0.01) after 6 months of treatment with sotalol. During the prospective follow-up, sotalol abolished ventricular tachycardia in all 6 patients after 1 month (p = 0.022), and in 4 of 6 patients (p > 0.2) after 6 months of treatment. It is concluded that sotalol significantly improves exercise tolerance and is effective in suppressing both supraventricular and ventricular arrhythmias in patients with HCM.

Adolescent↗
PubMed1993

[Analysis of usefulness for quantitative methods determining segmental mobility in assessing contrast ventriculography of the left ventricle].

The aim of this study was to compare two different quantitative methods used to determine left ventricular regional wall motions. Circumferential and radial methods were used to distinguish between normo- and hypokinesia of the 5 segments proposed by AHA for RAO position. One hundred ventriculograms were analyzed. Fifty cases with normal wall motion and ejection fraction greater than 55% were chosen as a base to enumerate normokinetic values of regional contractility. The other fifty cases represented hypokinesia of different segments. Respective values for the radial method were 61.42 vs 38.10 for antero-basal segment, 73.8 vs 58.5 for antero-lateral segment, 67.74 vs 42.5 for apical segment, 69.88 vs 47.70 for postero-lateral segment and 41.72 vs 33.4 for postero-lateral segment. The values obtained with the circumferential method were 12.27 vs 10.21, 20.06 vs 16.21, 22.19 vs 18.78, 17.08 vs 11.39 and 8.50 vs 8.15, respectively. These results suggest that the radical method allows to better differentiate between hypo- and normokinesia. Postero-basal segment proved to be most difficult to assess. Both methods fail to make a clear distinction in these cases.

Evaluation Studies as Topic↗
PubMed1993

[A new multipolar transesophageal electrode for assessment of activation sequence in the left atrium].

A new multipolar transoesophageal electrode is described. Two patients were analysed. One with recurrent coronary sinus rhythm and the other with concealed WPW syndrome. Obtained recordings showed difference of sequence of left atrial depolarisation during recovery of the sinus rhythm after its overdrive suppression and during provoked tachycardia. Results are very promising and require further investigation.

Arrhythmia, Sinus↗
PubMed1992

[Does the appearance of pro-arrhythmic response to anti-arrhythmic drugs have prognostic significance?].

Study was undertaken to assess whether proarrhythmic response to antiarrhythmic drug is a risk factor for cardiac death in patients (pts) with ischaemic heart disease (IHD). In 782 pts with IHD and frequent and/or complex ventricular ectopic beats (VEB) 1041 drug tests guided by 24 hour Holter monitoring were conducted. The following drugs were assessed: propranolol, disopyramide, mexiletine, amiodarone. Pro-arrhythmia was defined according to Velebit: 1/greater than or equal to 4-fold increase in VEBs, 2/greater than or equal to 10-fold increase in repetitive forms of 3/new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). Proarrhythmic effect was observed in 8.4% of pts and in 7.9% of drug tests. The frequency with individual drugs ranged from 5.7% to 9%. No drug was completely free of this type of reaction. Antiarrhythmic drugs inducing arrhythmogenic response were eliminated. Pts were followed-up for a mean of 22 months (range 1-49). Chronic antiarrhythmic treatment was conducted. Pts were discharged taking the agent deemed most effective for suppression of arrhythmia. Follow-up visits were made every 6-12 months. All cases of death were verified. In long-term observation cardiac death and sudden death occurred in 53 and 32 pts. With actuarial analysis (Kaplan-Meler method, log rank test) there was significant difference in cardiac death (p less than 0.05) of pro-arrhythmia (+) compared with ++pro-arrhythmia (-) pts at yr (11% v 4%, 7% v 3%) and 3 yr (24% x 11%, 16% v 7%). The relative importance of baseline clinical variables in predicting survival was assessed with a stepwise Cox regression.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗
PubMed1991

Evolution of the electrocardiographic changes in patients with hypertrophic cardiomyopathy.

In 75 patients with hypertrophic cardiomopathy (HCM) followed for a mean period of 5.5 years (range 2-20 years), evolution of the electrocardiographic (EKG) changes was assessed. Progression of EKG abnormalities occurred in 35 patients (47%). It was manifested by an increase in precordial QRS voltage in 33 patients, development of new P-wave mitral in 11 patients, and development or disappearance of pathologic Q waves in 14 patients. With follow-up times greater than 5 years, 5-8 years, and greater than 8 years, EKG progression was present in 27, 41, and 80% of patients, respectively. Age less than 30 years at the beginning of study and left ventricular outflow obstruction predisposed to EKG progression within 5-8 years. Patients with progressive EKG changes were more prone to experience clinical deterioration than those without EKG progression (63 vs. 15%, p less than 0.001). With chronic verapamil administration, progression of EKG abnormalities occurred insignificantly less often than with propranolol treatment (35 vs. 64%, p = 0.20). It is concluded that with long-term follow-up, HCM tends to progress in a significant proportion of adult patients.

Adolescent↗
PubMed1991

Proarrhythmic response to antiarrhythmic drug as a risk factor for sudden cardiac death in patients with ischemic heart disease.

The prognostic significance of arrhythmogenic response to an antiarrhythmic drug was studied. In 782 patients with ischemic heart disease (IHD) and frequent and/or complex ventricular premature beats (VPBs), 1,041 drug tests guided by 24-hour Holter monitoring were conducted. The following drugs were assessed: beta blockers, disopyramide, mexiletine, amiodarone. Proarrhythmia was defined as: (1) greater than 4-fold increase in VPBs, (2) greater than 10-fold increase in repetitive forms, or (3) new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). During a follow-up of 1-49 months (mean 22) patients were treated with antiarrhythmic drugs found to be safe in control Holter monitoring. Proarrhythmic effects were observed in 8.4% of patients. No drug was completely free of this type of reaction. In long-term observation, cardiac death and sudden death occurred in 53 and 32 patients, respectively. With actuarial analysis (Kaplan-Meier method, log-rank test) there was a significant difference in cardiac death (P less than 0.01) and sudden death rate (P less than 0.05) of proarrhythmia (+) compared with proarrhythmia (-) patients at 1 year (11% vs 4%, 7% vs 3%) and 3 years (24% vs 11%, 16% vs 7%). Proarrhythmic response was an independent risk factor apart from myocardial infarction, VT/VF, ejection fraction less than 40% and QTc greater than 440 msec. Arrhythmogenic response to antiarrhythmic drugs seems to be an additional predictor of sudden death in IHD.

Anti-Arrhythmia Agents↗
PubMed1991

[Verapamil and nifedipine limit hemodynamic changes in pulmonary circulation in rats with hypoxia].

The effect of hypobaric hypoxia on right ventricular pressure, right ventricular mass and hematocrit was assessed in Wistar rats divided into 4 groups. Group I comprised 20 control animals, kept in normal conditions. Groups II, III and IV consisted of 34-40 rats each at the beginning of the experiment. The animals were exposed to intermittent hypobaric hypoxia (380 mmHg, 10-12% O2, temperature 22 degrees C) 8 hours a day, 6 days a week, for 5 consecutive weeks. In group II no medication was given, in group III verapamil (Isoptin-Knoll) was administered in the drinking water at 30 mg/kg body mass/day, and in group IV nifedipine (Corotrend--Siegfried) was applied at 6 mg/kg body mass/day. Control animals were injected with i.p. nembutal (35 mg/kg) and then a polyethylene cannula was inserted in the right ventricle via external jugular vein, with consecutive measurement of right ventricular pressure. Hematocrit was measured in the arterial blood. After the animals had been sacrificed, the heart was isolated, right ventricle was excised and its mass was assessed as the ratio to mass of left ventricle-interventricular septum block. In groups II, III and IV right ventricular pressures were measured on days 10, 20 and 30 of the exposure to hypoxia. The hematocrit and ventricular mass were obtained at termination of the experiment. In the control group, mean right ventricular pressure was 28.5 +/- 3.5 mmHg, hematocrit 43.4 +/- 1.75% and right/left ventricular mass ratio was 0.267 +/- 0.03.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Percutaneous transluminal coronary angioplasty--personal experience].

Percutaneous transluminal coronary angioplasty was employed in a group of 178 patients (151 males and 27 females) aged 24 to 68 years (mean 42 +/- 12 years). Stable angina was diagnosed in 136 patients, unstable angina in 38, and an acute infarct in 4. In 150 patients there was one, in 25 two and in 5 patients 3 target stenoses. Lesions were localised in the left anterior descending artery in 130 cases, in the circumflex artery in 32 cases and in the right coronary artery in 49 cases. The attempts to dilate 78 stenoses with a fixed-wire, non-guided system was successful in 78% of cases. Success rate with the over-the-wire system was 85%. In total, we successfully dilated 173 patients, i.e. 82%. The highest success rate, 85%, was achieved in lesions localized in the left anterior descending artery and lowest in lesions localized in the left circumflex artery. Success rate in the groups with stable and unstable coronary artery disease was similar. Complications occurred in 6% of the cases. Experience of the operators involved in PTCA is an important factor influencing the success rate. In the first year of using this technique, good results were achieved in 48% of patients, in the second year in 63%. During the next two years 86% of the stenoses were successfully dilated.

Adult↗
PubMed1990

[Ventricular arrhythmias and QT/QS2 index in patients with ischemic heart disease].

This multicenter study comprised a group of 900 patients (207 females and 693 males, aged 23-68 years, mean 53) with ischaemic heart disease. Go medications other than nitrates, nifedipine and diuretics were administered at the time of study. In all patients a simultaneous standard 12-lead ecg and a phonocardiogram was registered. QT and QS2 intervals were then measured, and the QT/QS2 index calculated. QT/QS2 ratio 1.0 was considered as a normal one. A 24-h Holter ecg monitoring was performed in each patients, and ectopic ventricular activity was graded according to the Lown's classification. For patients with each class of arrhythmia the mean value of QT/QS2 was calculated. All means were similar, with values 1.0. Proportion of patients with abnormal values of QT/QS2 index was similar in patients showing different Lown classes of arrhythmia. Since a 24-hour monitoring does not give a full information about the arrhythmic events, patients with the history of VT/VF were analyzed separately. In this group an increase of QT/QS2 index was observed significantly more frequently than in other patients (37% vs 19%, p = 0.016). It is concluded that no close relationship exists between QT/QS2 index and the type of ventricular arrhythmia found on the Holter monitoring. However, pathologic QT/QS2 values seem to characterize the patients with increase risk of VT/VF.

Adult↗
PubMed1990

[Value of endomyocardial biopsy in the assessment of the degree of the changes in myocarditis].

Right ventricular diagnostic biopsy was performed in 25 patients (12 females and 13 males) aged 19-48 (mean 32) with suspicion of acute or subacute myocarditis for definitive diagnosis verification and to determine indications for therapy with corticosteroids or azathioprine. 3-4 specimens taken from different sites of ventricle were estimated under the light microscope according to Dallas classification distinguishing active myocarditis with or without fibrosis from borderline myocarditis with inflammatory infiltration not causing myocytes damage. Routine clinical and laboratory tests, echocardiographic examination, ECG Holter monitoring and nuclear examination to evaluate left ventricular ejection fraction were performed in all patients. 6 patients underwent coronarography to exclude atherosclerotic changes in coronary arteries. Bioptic examination result confirmed myocarditis suspicion in all patients. Active inflammation was stated in 18 patients including 7 with coexisting fibrosis. Borderline myocarditis was stated in 7 cases. Comparison of clinical examination results with those of pathomorphologic study made possible to state, that tachycardia, cardiac murmur, arrhythmias and left ventricular function impairment were frequent observed in the group of active myocarditis. Ejection fraction less than 30% was observed only in patients with active myocarditis and mainly in those with coexisting fibrosis. Based on performed study we consider that myocardial biopsy allows not only to diagnose myocarditis but also is helpful for lesion extent assessment in myocardium with all clinical implications.

Acute Disease↗
PubMed1989

Assessment of the intracardiac left to right shunts with a single scintillation probe.

In order to assess the accuracy of pulmonary time-activity curves obtained at bedside with a single scintillation probe and Technetium-99m-labelled erythrocytes, pulmonary to systemic flow ratio (Qp:Qs) was calculated for radionuclide and hemodynamic investigations in 104 patients with suspected intracardiac left to right shunts. Cardiac catheterization confirmed the presence of shunts in 76 patients. Pulmonary time-activity curve was 100% sensitive, 88% specific, and 96% accurate in detecting the shunt. Correlation between the radionuclide and hemodynamic Qp:Qs was excellent (r = 0.93). Results were classified in four quantitative categories according to the Qp:Qs values. In 76 patients (73%) radionuclide and hemodynamic data fell in the same category. We conclude that radionuclide pulmonary time-activity curves generated with a scintillation probe is a reliable method in quantitative assessment of intracardiac left to right shunts.

Adolescent↗
PubMed1989

[Relation between echocardiographic image and the electrocardiogram in hypertrophic cardiomyopathy].

Authors analyzed the correlation between anatomic changes estimated by echocardiographic examination and electrocardiographic recordings in group of 104 patients with hypertrophic cardiomyopathy. It was stated that morphological type III by Maron (8) is characterized, in comparison with other types, by significantly lower percentage of right ventricular hypertrophy and higher percentage of QTc interval prolongation, whereas percentage of patients with mitral or left ventricular hypertrophy was insignificantly higher. P Mitrale was significantly more often observed in patients with left ventricular diastolic dimension less than 35 mm. Generally ecg recordings had no distinct markers of the extent and localization of hypertrophic changes. Authors conclude that the unmistakable recognition of the anatomical type of hypertrophy basing on electrocardiogram is possible.

Adolescent↗
PubMed1989

[Possibilities of echocardiographic evaluation of hemodynamic disorders in hypertrophic cardiomyopathy].

In a group of 59 patients with hypertrophic cardiomyopathy relationship between echocardiographic parameters (interventricular septal thickness, left ventrical diastolic diameter, presence of SAM, distribution of hypertrophy) and certain hemodynamic measurements (diastolic compliance, left ventricular end-diastolic pressure, intraventricular pressure gradient, mean wall thickness and left ventricular mass index) were assessed. Substantial elevation of left ventricular end-diastolic pressure (LVEDP greater than 20 mmHg) was significantly more prevalent among patients with small left ventricular diameter and gross septal hypertrophy. Extensive ventricular hypertrophy (Maron type III) was not characterized by any distinctive hemodynamic pattern. Presence of SAM reaching interventricular septum was indicative of left ventricular outflow obstruction.

Adolescent↗