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Jarosław Drozdz

Publications and source records attributed to Jarosław Drozdz.

At least 19 recordsLinked to original sources
PubMed2006

The utility of pulsed tissue Doppler parameters for the diagnosis of advanced left ventricular diastolic dysfunction.

OBJECTIVE: The evaluation of diagnostic value of pulsed tissue Doppler (TD) parameters (calculated from six points of mitral annulus and separately measured in the lateral part of mitral annulus) for the detection of pseudonormal mitral inflow pattern. METHODS AND RESULTS: Among 200 persons examined by transthoracic echocardiography group with E/A value between 1 and 2 was selected and divided to normal (54 subjects, early wave deceleration time, Edt > or = 150 msec) and pseudonormal (23 patients, Edt < 150 msec together with prolonged difference between duration of atrial reversal flow in pulmonary vein and mitral flow in atrial phase, delta Ar > or = 20 msec) inflow. Wide spectrum of TD parameters was compared between the selected groups. In normal inflow, average peak velocities of early and atrial phase of diastolic mitral annulus motion were significantly higher: 11.0 +/- 2.6 versus 8.9 +/- 3.5 cm/sec; (P = 0.005) and 12.0 +/- 2.2 versus 10.0 +/- 3.0 cm/sec; (P = 0.002), respectively. Ratio of peak early mitral wave velocity to peak velocity of annulus motion in early phase (Ev/E'v avr) was higher in the pseudonormal pattern: 9.8 +/- 3.7 versus 7.0 +/- 2.0, respectively (P < 0.001). For the value of Ev/E'v avr > 10.2, 70% accuracy for the diagnosis of pseudonormalization was detected. For the parameters measured in the lateral part of mitral annulus similar relationships in the early filling phase were detected but did not reach statistical significance in the atrial phase. CONCLUSIONS: Pulsed TD offers good accuracy for the diagnosis of pseudonormalization with increased ratio of peak early mitral wave velocity to peak velocity of mitral annulus being the optimal predictor of advanced diastolic dysfunction.

Blood Flow Velocity↗
PubMed2006

[Giant aneurysm of the descending aorta mimicking extracardiac mass].

The case report presents a giant aneurysm of the descending aorta in a 79- year-old female. The echocardiographic study of the patient was substantially impeded, since aortic pathology obscured the left atrium in standard views and produced images mimicking extracardiac mass. Modified imaging planes were necessary to complete the correct echocardiographic visualisation of the heart and the aorta and to establish diagnosis.

Aged↗
PubMed2006

Prognostic factors in patients with advanced multi-vessel coronary artery disease.

BACKGROUND: Multivessel coronary artery disease (CAD) not suitable for revascularisation remains a challenge for present cardiology. Due to high mortality and difficulties in pharmacological therapy patients with this particular disease constitute a group of great interest. AIM: To define the main unfavourable prognostic factors in patients with clinically stable multivessel CAD who do not qualify for percutaneous or surgical revascularisation. METHODS: The analysed group consisted of 106 patients (79 men, 66+/-8 years) with multi-vessel CAD, confirmed in coronary angiography, who were primarily disqualified from interventional treatment. Thirty-eight (36%) of them had diabetes and 5 (5%) had a previous stroke. The left ventricular ejection fraction was 37+/-15%, and mean Gensini score - 72+/-34. RESULTS: During 7.4+/-4 years of follow-up, 19 (18%) patients died. Predicting factors of mortality included older age (p=0.014), higher heart rate (p=0.02), diabetes (0.003), renal failure (p=0.0003), heart failure (p=0.013), past stroke (p=0.006) and lower left ventricular ejection fraction (p=0.0012). In multivariate logistic analysis the only significant parameter related to prognosis was decreased level of haemoglobin (p=0.007) and elevated leucocytosis (p=0.002). The ROC curves analysis showed that decreased Hgb (<12.3 g/dl) and increased leucocytosis (>11.3 t/mm3) were significantly associated with higher mortality (HR 6.3). CONCLUSIONS: In patients with multi-vessel CAD not amendable revascularization the haemoglobin level and leucocytosis seem to be at least as important as well known risk factors. More intensive complex pharmacotherapy and innovative cell and gene therapeutic methods may improve the prognosis in this group of patients.

Aged↗
PubMed2005

Tissue Doppler echocardiographic identification of ischemic etiology in patients with dilated cardiomyopathy.

OBJECTIVE: To compare the left ventricular function in patients with ischemic and nonischemic cardiomyopathy using tissue Doppler echocardiography (TDE). METHODS: We studied 30 patients after myocardial infarction (MI group), 30 patients with dilated cardiomyopathy (DCM group) and 60 healthy volunteers in corresponding control groups. TDE velocities, time intervals of cardiac cycle were measured and dispersion index of TDE parameters was calculated. RESULTS: Early diastolic velocities were lower in MI group than in DCM group, with similar systolic and late diastolic velocities. The dispersion index of systolic velocities was significantly higher in MI than in DCM group and in controls (respectively 33.1+/-6.0% vs 12.6+/-3.7% vs 15.9+/-5.6%; p < 0.001) and differentiated ischemic from idiopathic dilated cardiomyopathy. In MI group, preejection period was shorter and isovolumic relaxation and diastasis time were longer than in DCM group, with no differences in dispersion index of time intervals between the groups. CONCLUSIONS: TDE parameters: early diastolic velocity, preejection period, isovolumic relaxation time and the dispersion index of systolic velocities differentiate ischemic and nonischemic etiology of dilated cardiomyopathy.

Adult↗
PubMed2004

[Implication of probability analysis for diagnosis of stable coronary diseases. Comparison of non-invasive diagnostic tests].

UNLABELLED: A prospective collection of clinical (history), electrocardiography (ECG), exercise electrocardiography (EE), dobutamine stress echocardiography (SE) and catheterization data was performed in 551 patients with chest pain regarded as definite or probable stable angina pectoris. All patients (65% male) without prior history of myocardial infarction undergone clinical evaluation: chest pain classification according to Diamond, ECG, EE (regarded as positive on the basis of > or = 1 mm ST-depression), SE (ischemia was defined as new or worsening wall motion abnormalities using a 16-segment model) and coronary angiography (CA):CAD was defined as > or = 50% narrowing of at least one major vessel. Sensitivity and specificity of ECG, EE, SE was calculated: and results are as follows respectively: 23% and 87%, 93% and 21%, 85% and 69%. On the basis of these results with implication of probability analysis two algorithms were developed by computer program. They incorporated pretest variables: age, gender, chest pain classification, ECG and results of one or two non-invasive tests: EE and (or) SE. The sensitivity and specificity of the algorithm is 96% and 44%. CONCLUSIONS: 1. Chest pain characteristics remains an effective tool for estimating probability of CAD. 2. The diagnostic value of resting electrocardiography in stable CAD is low. 3. SE has comparably sensitivity but significantly higher specificity than EE. 4. We demonstrated that when the likelihood of CAD is high on the basis of initial evaluation, diagnostic non-invasive testing is not indicated before CA. 5. When the probability is intermediate or low, implementation of first choice test should be different in women (SE) and men (EE).

Adult↗
PubMed2004

[Intravascular ultrasound imaging and histological evaluation of the aorta].

UNLABELLED: It has been shown in several in-vitro studies that IVUS images correlate well with histology and angioscopy. The existing data on intravascular imaging of large-diameter elastic arteries are scant. The aim of this study was to compare the IVUS images of aorta with the reference method--histological section by evaluating the accuracy of measurements performed at corresponding aortic segments. MATERIALS AND METHODS: 15 human aortic specimens were derived from post-mortem examination and in-vitro IVUS imaging was performed, including measurements of vessel diameters and cross-sectional areas in three specified areas. Corresponding regions of interest obtained with histology were subsequently evaluated and parameters matched to those by IVUS were calculated. RESULTS: Total of 45 pairs of measurement were compared. Mean vessel internal diameter on IVUS was 14.4 mm (SD 2.7 mm) and intima thickness was 0.6 mm (SD 0.8 mm). The corresponding aortic internal diameter observed with histology was 13.2 (SD 2.6 mm) and intima thickness--0.3 mm (SD 0.03). An overall agreement between IVUS and histology specimens was high, yelling correlation ratio of 0.99. The highest level of agreement was observed for external vessel area validation--correlation ratio 0.98. The largest discrepancy was observed for intima and media thickness, with correlation ratios of 0.61 and 0.72, respectively. CONCLUSIONS: Our data suggest that examination of aorta with intravascular ultrasound is feasible and may provide additional information in assessment of cardiovascular pathology. More complete risk stratification, which includes IVUS examination of aorta, is an important factor to determine the necessity for early preventive treatment, especially in patients with normal coronary arteries.

Aorta↗
PubMed2004

[Regional aortic function studied by three-dimensional echocardiography].

UNLABELLED: Aortic pulsation is caused by the arterial blood pressure variation during the cardiac cycle. Thickening of arterial intima, as well as the presence of atherosclerotic plaques may influence vessel pulsation by increasing wall stiffness. There is no data available concerning regional changes in aortic elasticity in relation with local wall thickness and the magnitude of atherosclerosis. The study group comprised 36 patients (27 men, 9 women, mean age 53 +/- 10 years) referred to our echocardiographic laboratory for transesophageal echocardiography (TEE). TEE probe was placed at the depth of 35 cm. The spatial interval between acquired images was 3 degrees. The reconstructed data sets were reviewed and the border between the aortic wall, plaque and lumen was determined. The reconstruction of a two-centimeter-long segment of aorta was divided by coaxial planes into four longitudinal sections. Thereafter the diastolic and systolic radius of each section, thickness of atherosclerotic plaques and intima-media thickness in each section were measured. The regional beta-index was calculated as Ln (systolic pressure/diastolic pressure)/relative change in regional aortic lumen, where relative change in regional aortic lumen was calculated as the difference between aortic lumen volume in systole and diastole divided by aortic lumen volume in diastole. In total, 144 aortic sections were analyzed. The volume of two-centimeter-long segments of descending aorta ranged from 6.9 cm3 to 31.5 cm3 (mean 12.8 +/- 5.2 cm3) in systole and from 4.9 cm3 to 29.2 cm3 (mean 11.2 +/- 4.9 cm3) in diastole. The volume of the examined sections of the aortic segments ranged from 1.3 cm3 to 10.6 cm3 (mean 3.2 +/- 2.6 cm3) in systole and from 1.1 cm3 to 8.7 cm3 (mean 2.8 +/- 1.5 cm3) in diastole. The pulsation of the aortic sections varied from 0.01 cm3 to 2.7 cm3 (mean 0.4 +/- 0.3 cm3), which constituted 0 to 37% (mean 13 +/- 8%) of the section volume. The thickness of atherosclerotic plaques in the studied aortic sections ranged from 0.0 mm to 1.1 mm (mean 0.3 +/- 0.2 mm) and the intima-media thickness was within the range 1.3 mm to 2.5 mm (mean 1.9 +/- 0.3 mm). The regional beta-index of the individual section ranged from 1.1 to 253.9 (mean 9.3 +/- 24.3). The regional beta-index was statistically significantly dependent on the intima-media thickness (p=0.02). We found no significant correlation between beta-index and the thickness of atherosclerotic plaques in the studied segments (p=0.38). CONCLUSIONS: Transoesophageal three-dimensional echocardiography facilitates quantitative analysis of aortic wall stiffness and regional beta-index measurements. The local variability of beta-index is correlated with intima-media thickness, whereas the correlation with the thickness of atherosclerotic plaques is not statistically significant. These measurements may be of importance in the assessment of the degree of atherosclerosis advancement. It forms new perspectives in diagnostics with the ability to evaluate the influence of pharmacotherapy and life-style modifications.

Aorta↗
PubMed2004

[Prognostic value of the parameters of left ventricular systolic function in patients with heart failure].

UNLABELLED: There are several parameters of left ventricular (LV) systolic function assessment. The calculation of the ejection fraction (EF) strongly relates to the preload and afterload conditions. Wall motion score index (WMSI) seems to be to impractical as the semi-quantitative method. Measurement of the LV pressure rise by Doppler evaluation of mitral regurgitation is a reproducible and an accurate method for dP/dt evaluation. As a method for LV systolic function estimation it does not depend on loading conditions. We have compared the prognostic value of these three methods in patients with a broad spectrum of systolic dysfunction. The study group consisted of 75 patients evaluated by all these methods in years 1995-1999 in our echocardiographic laboratory (73%--men, mean 54 +/- 12 years). In 13 patients the coronary artery disease was diagnosed but LV function was apparently normal, in 35--regional dysfunction after myocardial infarction was described, and in 27--global dysfunction due to idiopathic dilated cardiomyopathy. The EF ranged from 11% to 70% (mean 34 +/- 14%), WMSI--from 1 to 3.6 points (mean 2.2 +/- 0.7), and dP/dt from 235 to 4000 mmHg/s (mean 1108 +/- 698 mmHg/s). The closest relationship was noted between EF and dP/dt (R2=0.50). During 38 +/- 19 months of follow-up, 40 patients died (53%). In the multivariate logistic analysis the only significant parameter related to prognosis was EF (p=0.001). WMSI (p=0.12) and dP/dt (p=0.16) were not statistically significant correlated to death. CONCLUSION: The left ventricular ejection fraction still remains the most important parameter for the evaluation of prognosis in patients with depressed systolic function. Left ventricular pressure rise describes the systolic function but does not have impact on the prognostic evaluation.

Adult↗
PubMed2004

[Persistent left superior vena cava].

Persistent left superior vena cava -- a case report. A case of a 72-year-old female admitted for pacemaker implantation is presented. During the procedure, persistent left superior vena cava was found. Pacemaker was inserted via right subclavicular vein.

Aged↗
PubMed2004

Real-time three-dimensional echocardiography: still a research tool or an imaging technique ready for daily routine practice? A pilot feasibility study in a tertiary cardiology centre.

BACKGROUND: The majority of studies demonstrating the diagnostic potential of three-dimensional (3D) echocardiography have been conducted on selected series of patients in research laboratories. AIM: To investigate the feasibility and usefulness of real-time 3D transthoracic echocardiography (RT 3D TTE) in daily routine practice. METHODS: The study group consisted of 35 consecutive patients referred to our echocardiographic laboratory. All subjects underwent standard 2D TTE and RT 3D TTE with the use of a commercially available ultrasound system (Sonos 7500, Philips Medical Systems). The quality of 3D acquisitions and post-processed images was graded as: insufficient, satisfactory, good or demo. RESULTS: 3D TTE of the study group yielded 298 acquisitions. 87,2% of acquisitions required post-processing. The quality of 3D datasets was graded as insufficient in 8,0%, satisfactory in 31,4%, good in 37,2% and demo in 23,4% of all acquisitions and reconstructions. Mean time required for 3D TTE, including post-processing, was 12 minutes. 3D reconstructions were particularly helpful in patients with valvular disease or prostheses (n=13), enabling detailed qualitative analysis of leaflets morphology and mobility. In cases of mitral valve prolapse (n=4) 3D TTE allowed identification of the prolapsing scallops. 3D color Doppler flow mapping enabled complete visualization of the regurgitant jets. "En face" reconstructions of atrial septal defects (n=2) facilitated assessment of the morphology of the defects and the tissue rims. In patients with cardiac pacemaker (n=4) 3D TTE allowed excellent visualization of the ventricular lead along with its tip. In patients with ischemic heart disease (n=14) 3D TTE failed to provide additional, clinically relevant information. CONCLUSIONS: RT 3D TTE may be used in clinical settings with high feasibility rate and provides additional, clinically relevant qualitative information. The lack of on-board quantitative analysis tools is the main limitation of the currently available system.

Academic Medical Centers↗
PubMed2003

The assessment of mitral inflow propagation velocity in the diagnosis of advanced left ventricular diastolic dysfunction.

BACKGROUND: The echocardiographic assessment of left ventricular diastolic function is usually based on mitral inflow parameters. The main limitation of this method is caused by pseudonormalisation of mitral inflow profile in advanced stages of diastolic dysfunction. AIM: To evaluate the value of propagation velocity (Vp) of early and atrial mitral inflow wave in the diagnosis of pseudonormalisation. METHODS: We examined 180 subjects (104 males, mean age 58+/-11) by transthoracic echocardiography with the assessment of propagation velocity in colour-M-mode. The studied group consisted of 120 patients with coronary artery disease and 60 healthy controls. The values of E/A (ratio of early to atrial mitral inflow peak velocity) were calculated and subjects with normal (early wave deceleration time, Edt > or =150 ms) and pseudonormal (Edt <150 ms) mitral inflow patterns were identified. Propagation velocities were compared between groups with normal and pseudonormal mitral inflow profiles and optimal cut-off values were estimated. RESULTS: In the pseudonormal group, velocities of early and atrial propagation were significantly lower than those in the normal group: 25+/-11 vs 46+/-8 cm/s (p<0.001) and 33+/-10 vs 43+/-11 cm/s, (p<0.01), respectively. Both parameters showed the same optimal cut-off value for the diagnosis of pseudonormalisation which was < or =31 cm/s. Sensitivity, specificity and accuracy for the detection of pseudonormal mitral inflow pattern for early wave propagation were 87, 96 and 94%, and for atrial wave propagation - 60, 83 and 78%, respectively. CONCLUSIONS: Decreased value of mitral inflow early wave propagation velocity offers high sensitivity and specificity for the diagnosis of mitral inflow pseudonormalisation. Atrial wave propagation velocity has also potential value for advanced quantitative assessment of diastolic function.

Aged↗