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Magdalena Kostkiewicz

Publications and source records attributed to Magdalena Kostkiewicz.

25 records · Page 2Linked to original sources
PubMed2002

[Cardiopulmonary exercise capacity in adult patients with atrial septal defect].

UNLABELLED: The aim of the study was to evaluate cardiopulmonary exercise capacity (WTS) in adult patients with atrial septal defect (ASD). After excluding 10 patients with additional cardiac, pulmonary or muscle diseases, 53 patients with ASD (Gr-ASD; mean age 37.8 +/- 14.9 years; 35 women, 19 men) were enrolled in our study. In addition, we evaluated 22 healthy age and gender matched control subjects (Gr-K; mean age 36.6 +/- 14.9 years; 13 women, 9 men). First, all subjects underwent resting spirometry and forced vital capacity--(FVC; % of predicted value), one-second forced expiratory volume--(FEV1; % of predicted value) and FEV1/FVC (%) were determined. Then each subject performed a symptom-limited, incremental exercise test (modo Bruce). We evaluated the following parameters of resting metabolism: respiratory rate--(RR; L/min), minute ventilation--(VE; L/min), tidal volume--(Vt; L), oxygen uptake--(VO2; ml/kg/min), end-tidal carbon dioxide pressure--(PET CO2; mmHg), end tidal oxygen pressure--(PET O2; mmHg), ventilatory equivalent for carbon dioxide--(VE/VCO2) and ventilatory equivalent for oxygen--(VE/VO2). The following exercise parameters were analysed: peak oxygen uptake--(VO2 peak; ml/kg/min), VO2 peak expressed as % of predicted value--(VO2 %N), anaerobic threshold--(AT; % VO2 max), ventilatory equivalent for carbon dioxide--(VE/VCO2), end-tidal carbon dioxide pressure--(PET CO2; mmHg), O2 pulse, time of exercise--(T; min) and time to AT--(TAT; min). In addition, we performed a subgroup analysis for ASD patients below and > or = 40 years of age. All values were expressed as mean +/- SD. RESULTS: Although there was no significant difference in FVC, FEV1, FEV1/FVC, VO2, VE, Vt, RR between ASD patients and controls, the ASD patients aged 40 or older showed significantly lower FEV1/FVC and significantly higher RR. Expiratory gas exchange analysis showed significant differences between the ASD patients and controls (higher VE/VCO2, VE/VO2, PET CO2, and lower PET O2 respectively). Moreover, VO2 peak, VO2%N, AT, PET CO2 and O2 pulse were significantly lower while VE/VCO2 was significantly higher in ASD patients than in normal subjects. On average, VO2%N in ASD patients was only 61% of the predicted value for age and sex. Total time of exercise and time to AT were significantly shorter in ASD patients as well. CONCLUSIONS: WTS allows appropriate evaluation of cardiopulmonary capacity in ASD patients, though the mechanisms underlying ventilatory and hemodynamic abnormalities are still not fully understood. Adult patients with ASD reveal ventilatory abnormalities with an age-related trend towards deterioration. Cardiopulmonary exercise capacity in adults with ASD is markedly reduced in comparison with healthy population and deteriorates with age. WTS complements echocardiographic and hemodynamic evaluation of patients with ASD, and is helpful in indicating patients for ASD closure and their follow up.

Adult↗
PubMed2002

[Prognostic value of results from clinical tests, echocardiographic, electrocardiographic and spiro-ergometric exercise test examinations in patients with heart failure].

UNLABELLED: The aim of this study was to assess the importance of the non invasive procedures in determinating prognosis of patients with heart failure (HF). MATERIAL AND METHODS: We investigated 110 patients with a mean age of 52.1 (65 patients--59%) with chronic (HF) due to coronary artery diseases and dilated cardiomyopathy (45 patients--41%). All the patients underwent baseline evaluations including a clinical status, echocardiography, Holter monitoring and a cardiopulmonary exercise test (CPX). After the mean follow-up period of 28.5 +/- 12 months, the patients were divided into 2 groups: Group I--in which 78 patients survived without heart transplantation (HTX) and Group II--in which 20 patients died and 12 underwent HTX. The relationship between the variables derived from noninvasive procedures was assessed using multivariate Cox proportional hazards models. RESULTS: Compared to group I, Group II had a significantly higher number of patients that were classified into NYHA class III. In addition, a third heart tone was identified more often in group II and an increased number of HF etiology was due to ischemia. Electrocardiographic recording showed an increased frequency of left bundle branch block and complex ventricular arrythmias. Markedly increased values of WSLK, OKSLK, WLP, OKRLK and FW were found in group II, as compared to group I. Cardiopulmonary exercise tests in group II revealed lower values of T, VO2AT, SBPpeak, VO2peak, VO2peak%N, PETCO2peak as well as VD/VTpeak, VE/VO2peak, and VE/VCO2peak. After multivariate analysis lope VE/VCO2peak (p = 0.009), peak oxygen uptake VO2peak-%N (p = 0.035), (p = 0.036), left ventricle end systolic volume (p = 0.045) and left bundle branch block (p = 0.046) were independent predictors of survival without heart transplantation. CONCLUSION: On multivariate analysis by the Cox proportional hazards method, the variables: VE/VCO2peak, VO2peak%N, etiology--CAD, OKSLK, and left bundle branch block were independent prognostic predictors. The echocardio-graphic evaluation play a significant role in the assessment of prognosis in patients, with HF. The ejection fraction of the left ventricle was not confirmed as an independent prognostic factor in HF.

Adult↗
PubMed2002

[Assessment of myocardial perfusion using myocardial contrast echocardiography--case report].

A 58-year-old woman with symptoms of angina underwent coronary angioplasty, which showed critical narrowing of the right coronary artery (80%) and borderline narrowing of the left anterior descending coronary artery (50%). We decided to analyse myocardial perfusion in this patient to estimate the degree of atherosclerosis in the target arteries. She underwent myocardial contrast echocardiography at rest and during dobutamine stress. The examination showed a transient perfusion defect in the right coronary bed and in the left anterior descending coronary. A similar perfusion defect was revealed in scintigraphy. We carried out a successful two vessel percutaneous coronary revascularisation.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Comparison between (99m)Tc-MIBI myocardial perfusion SPECT and multi-slice computed tomography for identifying and assessing coronary artery disease.

Imaging atherosclerotic changes allows us to identify the incidence and to predict the extent of coronary artery disease (CAD). In this study we have examined whether the changes in coronary vessels assessed by multi-slice computed tomography (MSCT) reflected those in myocardial perfusion determined by the methyl-iso-butyl isonitryl ((99m)Tc-MIBI) (99m)Tc labeled SPECT study. Seventy-two patients with established CAD underwent the MSCT and the (99m)Tc-MIBI SPECT tests. The correlation between coronary artery calcium scoring (CS) and the extent of CAD in coronary angiography was determined. No correlation between total CS and the score of the reversible and non-reversible perfusion defects in (99m)Tc-MIBI SPECT was found. Following the analysis for the 3 main coronary arteries separately, and the number of reversible perfusion defects, a significant correlation was observed between LAD and RCA vessels (p<0.008 and p<0.004, respectively). MSCT can identify the patients with CAD, only when CS exceeds 300-400; other diagnostic procedures such as (99m)Tc-MuIotaBetaIota SPECT and coronary angiography are recommended.

Journal Article↗