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Kalina Kawecka-Jaszcz

Publications and source records attributed to Kalina Kawecka-Jaszcz.

At least 19 recordsLinked to original sources
PubMed2007

Nontraditional atherosclerotic risk factors and extent of coronary atherosclerosis in patients with combined impaired fasting glucose and impaired glucose tolerance.

Partially inconsistent data exist on mutual relations between nontraditional atherosclerotic risk factors, including the magnitude of insulin resistance (IR), as well as on their relevance for atherogenesis in the metabolic syndrome. Subjects exhibiting combined impaired fasting glucose and impaired glucose tolerance (IFG/IGT) are exposed to an exceptionally high risk for atherogenesis and development of type 2 diabetes mellitus. Because of islet Beta-cell dysfunction, the usefulness of commonly used indices of IR is limited in IFG/IGT. Our aim was to assess the relationship between extent of angiographic coronary artery disease (CAD) and nontraditional atherosclerotic risk factors (including IR by a clamp-based golden standard method) in IFG/IGT. Fifty-three subjects (32 men, 21 women; mean age, 55 +/- 11 years) with stable angina, preserved left ventricular systolic function, and IFG/IGT were divided into 3 groups: group A (no coronary stenoses >50%, n = 22), group B (1-vessel CAD, n = 15), and group C (2/3-vessel CAD, n = 16). Insulin sensitivity was quantified by a hyperinsulinemic euglycemic clamp technique and expressed as M. M value, plasma homocysteine (Hcy) level, and asymmetric dimethyl-L-arginine (ADMA)/L-arginine ratio were independent determinants of CAD extent as shown by forward stepwise discriminant function analysis. Compared with group A (M = 32.7 +/- 9.3 micromol/kg fat-free mass [FFM] per minute; Hcy, 8.1 +/- 1.4 micromol/L), lower M and higher Hcy levels were found in group B (M = 16.9 +/- 8.2 micromol/kg FFM per minute, P < .001; Hcy, 11.2 +/- 2.9 micromol/L, P = .003) and C (M = 16.4 +/- 7.8 micromol/kg FFM per minute, P < .001; Hcy, 12.8 +/- 3.9 micromol/L, P < .001). The ADMA/L-arginine ratio was increased in group C (0.0078 +/- 0.0011) compared with group A (0.0063 +/- 0.0013, P = .03) and B (0.0058 +/- 0.0012, P = .01). Multivariate correlates (P < .05) of plasma Hcy concentrations were M (beta = -.34 +/- .12, P = .008), creatinine clearance (beta = -.23 +/- .10, P = .03) and fasting insulin (beta = .25 +/- .12, P = .04). This indicates an additive contribution of IR, plasma Hcy, and elevated ADMA/L-arginine ratio to the extent of angiographic CAD in combined IFG/IGT.

Adult↗
PubMed2007

-391 C to G substitution in the regulator of G-protein signalling-2 promoter increases susceptibility to the metabolic syndrome in white European men: consistency between molecular and epidemiological studies.

BACKGROUND: The regulator of G-protein signalling-2 (RGS2) is a key factor in adipogenesis. We hypothesized that the metabolic syndrome, of which obesity is an important component, might be related to genetic variation in RGS2. METHODS AND RESULTS: We screened the human RGS2 gene. We tested the functionality of a common genetic variant in vitro, ex vivo, and in epidemiological study involving six European populations. The C to G substitution at position -391 in the RGS2 promoter was associated with enhanced RGS2 expression in vitro in transfected 3T3-L1 adipocytes and Chinese hamster cells and ex vivo in adipocytes from male, but not female, volunteers. In 2732 relatives from 512 families and 348 unrelated individuals, randomly recruited from six European populations, the prevalence of GG homozygosity was 54.1%. The metabolic syndrome score, a composite of six continuous traits making up this clinical entity, was 0.27 standardized units higher (P < 0.001) in 795 GG homozygous men compared with 683 men carrying the C allele. Transmission of the -391 G allele to male offspring was associated with a 0.20 unit increase in the score (P=0.039). These epidemiological relations were not significant in 1602 women. CONCLUSIONS: The C to G substitution at position -391 in the RGS2 promoter increases RGS2 expression in adipocytes and is associated with the metabolic syndrome in white European men. Further experimental and clinical research should establish whether this common polymorphism might be a target for preventive or therapeutic intervention.

3T3-L1 Cells↗
PubMed2006

Electrophysiological study in a patient with Fabry disease and a short PQ interval.

A short PQ interval is a common finding in patients with Fabry disease. However, there have been few electrophysiological studies in Fabry disease, and it is not clear whether the short PQ interval that is present in this disease results from preexcitation or enhanced atrioventricular nodal conduction. We present a case of a 43-year-old man with syncope, sick sinus syndrome, a PQ interval of 80 ms, and palpitations. Electrophysiological study showed PA, AH, and HV intervals of 24, 32, and 34 ms, respectively, and features of enhanced atrioventricular nodal conduction. The presence of an atrioventricular accessory pathway was excluded. We conclude that the short PQ interval in Fabry disease can result from accelerated conduction in the atrioventricular node.

Adult↗
PubMed2006

Arterial characteristics in normotensive offspring of parents with or without a history of hypertension.

BACKGROUND: In this study we compared the arterial characteristics and blood pressure (BP) of normotensive offspring of two normotensive parents (OFF/NT) and normotensive offspring who had at least one hypertensive parent (OFF/HT). METHODS: A total of 174 OFF/HT (17 to 40 years of age) and 59 OFF/NT (16 to 34 years) were recruited in Cracow, Poland (n = 138) and Pilsen, Czech Republic (n = 95). Peripheral pulse pressure (PPp) was determined from conventional and 24-h ambulatory BP. A SphygmoCor device was used to measure the central (CAIx) and peripheral (PAIx) systolic augmentation indexes, central pulse pressure (PPc), and the aortic pulse wave velocity (PWV). In multivariate analyses family clusters and significant covariates were accounted for. RESULTS: The OFF/HT had higher (.14 < P < .0007) conventional BP and PPp on conventional BP measurement (121/75 v 114/71 mm Hg and 46 v 42 mm Hg) as well as on 24-h ambulatory monitoring (118/70 v 114/67 mm Hg and 48 v 47 mm Hg). OFF/HT, compared with OFF/NT, also had higher (.05 < P < .0008) PPc (28 v 26 mm Hg), PAIx (54.7% v 44.9%), CAIx (108.8% v 99.8%), and PWV (7.4 v 6.6 m/sec). However, complex adjustment including mean arterial pressure and age removed the differences between the offspring in the PAIx, CAIx, and PWV. CONCLUSIONS: Large-artery properties are altered in OFF/HT compared with OFF/NT. The findings from this cross-sectional study suggest that the alterations in arterial function in subjects with a family history of hypertension are determined mainly by an increased BP and age-related hemodynamic changes.

Adolescent↗
PubMed2006

Rilmenidine--its antihypertensive efficacy, safety and impact on quality of life in perimenopausal women with mild to moderate essential hypertension.

OBJECTIVES: A prospective, open-labeled study to assess the antihypertensive effect of monotherapy with rilmenidine and its impact on quality of life (QoL), as well as on biochemical parameters in perimenopausal women with essential hypertension. DESIGN AND METHODS: Fifty-five perimenopausal women with mild to moderate essential hypertension (mean age 51.4+/-2.4 years) were enrolled. At baseline and after 12-week monotherapy with rilmenidine, we assessed: systolic (SBP) and diastolic (DBP) blood pressure (BP), heart rate (HR), fasting glucose, serum creatinine and total cholesterol levels. QoL was also assessed at baseline and at 12 weeks by two standardized questionnaires: the Short Form - 36 (SF-36) and the Subjective Symptoms Assessment Profile (SSAP). Statistical analysis was performed using Student's t-test to compare changes in BP, QoL and biochemical parameters during therapy with rilmenidine. RESULTS: After 12 weeks of therapy, there was a significant decrease in BP and HR. Normalization of BP was observed in 46 (84%) women. Rilmenidine did not influence serum creatinine, fasting glucose and lipid profile. Treatment was very well tolerated by the patients and no side-effects were noted. Both the SF-36 and the SSAP demonstrated improvement in general QoL. We observed a significant improvement in all SF-36 subscales. In the SSAP, a similar significant improvement was found, except dizziness subscale. Improvement in QoL was not related to reduction of BP. CONCLUSIONS: Monotherapy with rilmenidine is safe and effective in BP treatment and significantly improves QoL in perimenopausal women with essential hypertension.

Antihypertensive Agents↗
PubMed2006

Sodium excretion as a modulator of genetic associations with cardiovascular phenotypes in the European Project on Genes in Hypertension.

Hypertension is a chronic age-related disorder, affecting nearly 20% of all adult Europeans. This disease entails debilitating cardiovascular complications and is the leading cause for drug prescriptions in Europeans older than 50 years. Intensive research over the past two decades has so far failed to identify common genetic polymorphisms with a major impact on blood pressure or associated cardiovascular phenotypes, suggesting that multiple genes each with a minor impact, along with gene-gene and gene-environment interactions, play a role. The European Project on Genes in Hypertension (EPOGH) is a large-scale, family-based study in which participants from seven different populations were phenotyped and genotyped according to standardized procedures. This review article summarizes the initial 5-year findings and puts these observations into perspective against other published studies. The EPOGH demonstrated that phenotype-genotype relations strongly depend on host factors such as gender and lifestyle, in particular salt intake as reflected by the 24-h urinary excretion of sodium. The EPOGH therefore highlights the concept that phenotype-genotype relations can only be studied within a defined ecogenetic context.

Blood Pressure↗
PubMed2006

Reference values in white Europeans for the arterial pulse wave recorded by means of the SphygmoCor device.

Measurement of blood pressure together with applanation tonometry at the radial artery allows the reproducible assessment of various indexes of arterial stiffness, including the peripheral (PPp) and central pulse pressures (PPc) and the peripheral (Alp) and central augmentation indexes (Alc). We defined preliminary diagnostic thresholds, using the distributional characteristics of these hemodynamic measurements in a reference population. We randomly recruited 870 subjects from 3 European populations. PPp was the average difference between systolic and diastolic blood pressure measured five times at one home visit. For measurement of PPc, Alp and Alc, we used the SphygmoCor device. We selected subjects without hypertension, diabetes, dyslipidemia in need of medical treatment or previous or concomitant cardiovascular disease. The study population included 228 men and 306 women (mean age 34.9 years). All hemodynamic measurements were curvilinearly related to age, and Alp and Alc were lower in men than in women. In men at age 40, the upper 95% prediction bands of the relations of the hemodynamic measurements with age approximated 60 mmHg for PPp, 40 mmHg for PPc, 90% for Alp, and 30% for Alc. For PPc, Alp and Alc, these thresholds must be adjusted for age, leading to lower and higher thresholds at younger and older age, respectively. In addition, in women of any age, the Alp and Alc thresholds must be increased by 10% and 7%, respectively. Pending validation in prospective outcome studies, distributional characteristics of arterial stiffness indexes in a reference population can be used to generate operational thresholds for use in clinical practice.

Adolescent↗
PubMed2006

[Recurrent cardiac arrest due to electro-mechanical dissociation in a patient with variant angina -- a case report].

We present a case of a 44-year-old male with recurrent episodes of cardiac arrest in the course of Prinzmetal's angina. Episodes of variant angina can be life threatening due to episodes of advanced atrioventricular block, asystole, ventricular tachycardia or ventricular fibrillation. It has been suggested to implant an ICD in all patients with variant angina after cardiac arrest. This patient received an ICD, however, he died suddenly 6 months later. The possible mechanism of cardiac arrest was an electromechanical dissociation.

Adult↗
PubMed2006

Increased levels of inflammatory markers in hypertensives with target organ damage.

INTRODUCTION: Inflammatory markers have been reported to be elevated in hypertension. AIM: We compared levels of inflammatory markers between hypertensives (HT) with target organ damage (TOD) but without associated clinical conditions (ACC), n=55, HT with ACC, n=42, HT without TOD/ACC, n=22 and normotensive controls, n=41. METHODS: Serum levels of CRP, fibrinogen, TNF-alpha and anti-HSP60 antibodies were measured. Hypertensive complications were assessed on the basis of clinical history and the following investigations: M-mode echocardiography (left ventricular hypertrophy), Doppler: mitral and pulmonary vein flow and isovolumetric relaxation time (diastolic dysfunction), vascular ultrasound (common carotid artery intima-media thickness--IMT), pulse wave velocity (carotid-femoral arterial stiffness) and creatinine concentration (renal function). RESULTS: HT with TOD had higher concentrations of CRP than controls (1.71 vs 0.76 mg/l, p <0.0001); higher fibrinogen and TNF-a vs controls and also vs HT without TOD/ACC (2.80 vs 2.53 vs 2.49 g/l, p <0.0001) and (2.49 vs 2.00 vs 1.83 pg/ml, p=0.04), respectively. HT without TOD/ACC did not differ from the control group in inflammatory marker concentrations. HT with ACC did not differ from HT with TOD in inflammatory marker concentrations. There were no differences in anti-HSP60 antibody concentrations between all groups. In multiple regression analysis only IMT was influenced by inflammatory markers: fibrinogen (beta=0.2, p=0.02) and TNF-alpha, (beta=0.17, p=0.05). CONCLUSIONS: We conclude that inflammatory markers are elevated in HT with TOD and are not elevated in uncomplicated HT without TOD.

Aged↗
PubMed2006

HEARTFAID: A knowledge based platform of services for supporting medical-clinical management of heart failure within elderly population.

HEARTFAID is a research and development project aimed at devising, developing and validating an innovative knowledge based platform of services, able to improve early diagnosis and to make more effective the medical-clinical management of heart diseases within elderly population. Chronic Heart Failure is one of the most remarkable health problems for prevalence and morbidity, especially in the developed western countries, with a strong impact in terms of social and economic effects. All these aspects are typically emphasized within the elderly population, with very frequent hospital admissions and a significant increase of medical costs. Recent studies and experiences have demonstrated that accurate heart failure management programs, based on a suitable integration of inpatient and outpatient clinical procedures, might prevent and reduce hospital admissions, improving clinical status and reducing costs. HEARTFAID aims at defining efficient and effective health care delivery organization and management models for the "optimal" management of the care in the field of cardiovascular diseases. The HEARTFAID innovative computerized system will improve the processes of diagnosis, prognosis and therapy provision, providing the following services: * electronic health record for easy and ubiquitous access to heterogeneous patients data;* integrated services for healthcare professionals, including patient telemonitoring, signal and image processing, alert and alarm system;* clinical decision support in the heart failure domain, based on pattern recognition in historical data, knowledge discovery analysis and inferences on patients' clinical data.The formalization of the pre-existing clinical knowledge and the discovery of new elicited knowledge represent the core of the HEARTFAID platform.

Aged↗
PubMed2006

[Markers of inflammation and large artery compliance in patients with chronic renal failure].

UNLABELLED: Chronic inflammation is a widely accepted pathophysiologic factor of development and progression of atherosclerosis. One of the most important consequences of atherosclerosis is accelerated arterial stiffness. The impact of chronic inflammation on arterial stiffness was not analyzed up to now in patients with end-stage renal disease treated with peritoneal dialysis (PD). The aim of the study was to evaluate the possible relationship between aortic pulse wave velocity (AoPWV), considered useful tool of aortic stiffness assessment and blood pressure parameters, anthropometric characteristics, pro-inflammatory cytokines and acute phase reactants in patients treated with PD. MATERIAL AND METHOSA: The study was performed in the group of 43 patients (19 F 24 M) with ESRD, in the mean age of 50.6 +/- 13.4 years and on dialysis for the mean period of 21.9 +/- 20.7 months. Pulse wave velocity was assessed using two pressure transducers placed on common carotid and femoral artery, connected with automatic processor. In all patients Tumor Necrosis Factor alpha (TNF alpha), interleukin 6 (IL-6), C- reactive protein and fibrinogen were assayed as 'markers of inflammation'. Blood pressure was also measured in the standardized conditions. Mean AoPWV equaled 10.7 +/- 2.1 m/s. Significant correlations were found between AoPWV, age, body weight and BMI. AoPWV was associated with systolic blood pressure, mean arterial pressure and pulse pressure. RESULTS: Significant correlations between AoPWV and serum IL-6 were shown, whereas association with CRP was close to statistical significance (p= 0,053). Associations between AoPWV, age and systolic blood pressure were also confirmed by multiple regression analysis. CONCLUSION: Chronic, uremia-dependent inflammation may be one of the factors influencing aortic stiffness in patients treated with PD.

Acute-Phase Proteins↗
PubMed2005

Effect of physical training on quality of life and oxygen consumption in patients with congestive heart failure.

AIM: To assess changes in quality of life (QoL) and oxygen consumption produced by two different patterns of physical training in patients with congestive heart failure (CHF). MATERIAL AND METHODS: 42 men (mean age 55.9+/-8.1 years) with ischaemic CHF lasting 3.1+/-1.0 years. Patients were randomised into three groups each consisting of 14 men: group A--with constant workload, group B-with progressive/increasing workload, each trained up to 6 months and group C--not trained. QoL was assessed at baseline and at 6 months by means of the Psychological General Well-being Index (PGWB) and the Subjective Symptoms Assessment Profile (SSA-P). Cardiopulmonary exercise test and echocardiography were performed twice. RESULTS: At 6 months improvement in PGWB total index was observed, both in groups A and B (p<0.01). Men from groups A and B reported less cardiac symptoms (p<0.01), emotional distress (p<0.01), peripheral circulatory symptoms (p<0.01) and dizziness (p<0.01) in SSA-P. Improvement in sexual life was observed only in group B (p<0.01). Overall improvement of QoL was greater in group B than in group A as well as oxygen uptake (p<0.01). Higher QoL correlated positively with peak VO2 only in group B (r=0.56, p<0.05). CONCLUSIONS: Physical training improves QoL in men with CHF, but only progressive/increasing workload seems to markedly improve oxygen uptake. Improvement of QoL is related to psychological well-being and physical complaints associated with CHF.

Exercise Therapy↗
PubMed2005

Ascending aortic blood pressure-derived indices are not correlated with the extent of coronary artery disease in patients with impaired left ventricular function.

BACKGROUND: Ascending aortic blood pressure-derived indices were shown to be related to coronary atherosclerosis. Unfortunately, most studies published so far included patients with preserved left ventricular function. Therefore, the aim of the present study was to investigate the relation between ascending aortic blood pressure-derived indices and the extent of coronary atherosclerosis in patients with impaired left ventricular function. METHODS: The study group consisted of 375 patients (302 men and 73 women; mean age: 59.0+/-10.1 years) with angiographically confirmed coronary artery disease and ejection fraction < or =55%. Invasive ascending aortic blood pressure during catheterization and conventional sphygmomanometer measurements were taken. RESULTS: None of the brachial or aortic blood pressure-derived indices differed between patients with one-, two- and three-vessel coronary artery disease. They were not independently related to the risk of having three-vessel coronary artery disease in none of the constructed models in logistic regression analysis. Moreover, none of the studied indices was correlated with Gensini or severity scores. We also did not find any significant correlation between blood pressure-derived indices and extent of coronary atherosclerosis in patients with ejection fraction < or =25%, 25-40% or >40%. CONCLUSION: Ascending aortic blood pressure-derived indices are not correlated with the severity of coronary atherosclerosis in patients with coronary artery disease and impaired left ventricular function.

Aorta, Thoracic↗
PubMed2005

Determinants of poor hypertension management in patients with ischaemic heart disease.

UNLABELLED: Not much is known about factors influencing hypertension management in patients with ischaemic heart disease (IHD). Therefore, the aim of the study was to assess factors influencing hypertension management in patients hospitalized due to IHD. We reviewed hospital records of 1051 consecutive patients with a discharge diagnosis of myocardial infarction (MI; n = 290), unstable angina (n = 247), percutaneous coronary intervention (PCI; n = 259) or coronary artery bypass grafting (CABG; n = 255) who were hospitalized at three university (n = 533) or three community (n = 518) cardiac departments. During the follow-up interview (6-18 months after discharge) 70.2% of study participants fulfilled the criteria for a diagnosis of hypertension. Hypertension had not been diagnosed during index hospitalization in 17.5% of hypertensive participants. Overall, 7.1% of hypertensives were not treated with any blood pressure lowering agent. Irregular health checks (odds ratio, OR, 16.3, 95% confidence interval, CI, 4.1-64.0), alcohol drinking (OR 3.3, 95% CI 1.5-7.0), unstable angina (OR 2.7, 95% CI 1.3-5.8), hypertension awareness (OR 0.2, 95% CI 0.1-0.5) and blood pressure lowering drugs prescribed at discharge (OR 0.08, 95% CI 0.03-0.19) were significantly related to the probability of not being on antihypertensive medication. High blood pressure (>or=140/90 mmHg) was found in 68.9% of hypertensives; older age (OR 1.3, 95% CI 1.0-1.6) and hypertension awareness (OR 0.6, 95% 0.3-1.0) were the only significant predictors of uncontrolled hypertension. Among treated participants with uncontrolled hypertension, 33.4% were on monotherapy, 66.6% were on combination therapy, 25.5% were on three or more drugs and 14.7% were on combination of three or more drugs with diuretic. CONCLUSIONS: Hypertension management in the secondary prevention of IHD is not satisfactory. Age and hypertension awareness are the main factors related to the quality of blood pressure control in the post-discharge period.

Aged↗
PubMed2005

How to improve the assessment of 24-h blood pressure variability.

An increased 24-h blood pressure variability, expressed as SD of 24-h average ambulatory blood pressure values, is associated with target organ damage and cardiovascular risk in hypertension, while a physiological nocturnal blood pressure fall has been associated with reduced cardiovascular risk. Nocturnal blood pressure fall, however, may contribute markedly to the overall blood pressure variability. The aim of our study was to quantitatively assess the contribution of nocturnal blood pressure fall to 24-h blood pressure variability, and to propose a new method for computing 24-h blood pressure variability correcting for nocturnal blood pressure fall. From a large database of ambulatory blood pressure recordings obtained in two hypertension centres (Milan, Italy and Krakow, Poland), we selected 1995 recordings of a sufficiently high quality (> or =70% valid readings, > or =1 measure/h). We calculated (1) blood pressure variability, as SD of 24-h mean blood pressure, both directly from all 24-h individual readings and as a weighted mean of separately computed daytime and night-time blood pressure SD; and (2) the size of nocturnal blood pressure fall. The weighted mean SD of 24-h blood pressure was significantly lower than the corresponding direct 24-h SD of blood pressure. The size of the difference between direct SD and weighted mean SD was strongly correlated with the absolute size of nocturnal blood pressure fall (SD: r=0.89 and 0.86 for systolic and diastolic blood pressures, respectively, P<0.001 for all). The 24-h SD of blood pressure is markedly influenced by the size of nocturnal blood pressure fall, while the weighted mean SD is not. The inclusion of nocturnal blood pressure fall in the calculation of 24-h blood pressure variability may thus lead to the overestimating of this phenomenon. Given that blood pressure variability and fall at night may have opposite prognostic significance, it may be advisable to calculate 24-h SD as the weighted mean of daytime and night-time values, which excludes the interference of night-time blood pressure fall on overall blood pressure variability and allows a more precise assessment of the clinical value of 24-h blood pressure variability. The actual clinical relevance of this new parameter has to be assessed by longitudinal outcome studies.

Blood Pressure↗