PubMed Health⌕ Search

Biomedical subjects

Maria Olszowska

Publications and source records attributed to Maria Olszowska.

At least 19 recordsLinked to original sources
PubMed2004

The value of myocardial contrast echocardiography compared with SPECT in detecting myocardial perfusion abnormalities in patients with anterior acute myocardial infarction.

BACKGROUND: Microvasculature damage after myocardial infarction (MI), known as "no-reflow" phenomenon, may occur in some patients with acute MI in spite of invasive treatment and opened infarct-related coronary artery. There are several non-invasive and invasive methods used for the coronary flow assessment at the tissue level. AIM: To compare the value of intravenous contrast echocardiography (MCE) in detecting myocardial perfusion defects in patients with acute MI with (99m)Tc MIBI SPECT study. METHODS: Sixteen patients (11 males, 5 females, mean age 55.4+/-10.2 years) underwent primary coronary angioplasty or facilitated angioplasty (with reduced dose of a fibrinolytic drug and glycoprotein IIb/IIIa inhibitor) (PCI) for acute anterior MI. TIMI grade flow, TIMI Myocardial Perfusion Grade (TMPG), corrected TIMI frame count (cTFC), wall motion score index (WMSI) and segmental perfusion by myocardial contrast echocardiography (MCE) were estimated in real time before and immediately after PCI. MCE was repeated on the third day after PCI. All patients underwent (99m)Tc MIBI SPECT study (SPECT) while at rest on the third day after PCI. The area at risk was defined as the number of segments with no perfusion before angioplasty. Reflow was defined as an increase in contrast score in the same segments after angioplasty. RESULTS: Baseline MCE showed 95 segments with perfusion defects. Immediately after PCI, 77 segments were found with perfusion defect; in 10 patients improvement of myocardial perfusion was observed whereas in 6 patients perfusion defect remained unchanged. On the third day further improvement was observed in 8 patients. The number of segments with perfusion defect decreased to 53. SPECT detected perfusion defect in 54 segments. The agreement between MCE and SPECT for detecting perfusion abnormality was 98% (kappa 0.94). CONCLUSIONS: MCE is a safe technique for detecting myocardial perfusion in patients with acute MI. MCE proves that both primary and facilitated angioplasty improve myocardial perfusion in two thirds of patients with acute MI. Serial MCE allows identification of patients with both early and late improvement of myocardial perfusion. There is a very strong correlation between MCE and SPECT in the assessment of perfusion defects.

Aged↗
PubMed2004

Vena contracta width as a simple method of assessing mitral valve regurgitation. Comparison with Doppler quantitative methods.

BACKGROUND AND AIM OF THE STUDY: Quantitative Doppler echocardiography and proximal flow convergence methods facilitate quantification of regurgitant volume (RV), regurgitant fraction (RF) and the measurement of effective regurgitant orifice (ERO) to define mitral regurgitation (MR) severity. Vena contracta width (VCW) has been proposed as a simple, accurate marker of MR, and is instrumental in predicting the angiographic severity of valvular regurgitation. The study aim was to compare VCW with quantitative Doppler methods and angiography for assessing MR. METHODS: Sixty-four patients with MR (50 males; mean age 54 +/- 8 years; range: 34-84 years) were included. The etiology of MR was coronary artery disease, infective endocarditis, rheumatic disease, dilated cardiomyopathy or mitral valve prolapse. Exclusion criteria included aortic stenosis and/or aortic insufficiency, mitral stenosis, mechanical prostheses and atrial fibrillation. RV and ERO estimated by the proximal isovelocity surface area method (PISA), and RF calculated by Doppler, were compared with VCW measured by color Doppler. The angiographic severity of MR was classified on a four-point scale, in compliance with Sellers' criteria. RESULTS: A good correlation was found between VCW and ERO (r2 = 0.70, p <0.001), RV (r2 = 0.73, p <0.001), RF (r2 = 0.71, p <0.001) and angiographic grade (r2 = 0.72, p <0.001). CONCLUSION: VCW measured by color Doppler correlates well with MR severity. In addition, VCW is a simple, reproducible quantitative measurement of MR, and is recommended for use in the non-invasive assessment of the condition.

Adult↗
PubMed2003

Assessment of myocardial perfusion in patients with coronary artery disease. Comparison of myocardial contrast echocardiography and 99mTc MIBI single photon emission computed tomography.

BACKGROUND: Myocardial perfusion (MP) can be assessed in real time when using a low mechanical index (MI) and harmonic imaging following an intravenous injection of contrast agent. The aim of the study was to determine the feasibility and accuracy of the real-time imaging of contrast echocardiography (MCE) for detecting myocardial perfusion defects at rest and during dobutamine stress echocardiography (DE) compared with 99m Tc MIBI SPECT. The study group consisted of 44 patients (24 men, 20 women, mean age 58.9+/-7.8) with suspected coronary artery disease (CAD). All patients underwent DE. Wall motion (WM) and segmental perfusion were estimated in real time before and at peak stress using a low MI (0.4) after 0.3 ml bolus injections of intravenous Optison. All patients underwent a rest and exercise 99mTc MIBI SPECT study (SPECT). A 16-segment model of the left ventricle was used for the analysis of MP, WM and SPECT by a blinded reviewer. All patients underwent coronary angiography. Significant coronary artery disease was defined as >60% luminal diameter stenosis. RESULTS: All patients had significant CAD. Twenty-nine patients had single-vessel and 15 patients had double-vessel disease. For all patients, agreement between MCE and SPECT was 89%, between MCE and WM -86%, and between SPECT and WM -82%. The agreement between MCE and SPECT for LAD, RCA and Cx territories was 81, 91 and 73%, respectively. The sensitivity of MCE and SPECT for detecting perfusion defects due to significant CAD (confirmed angiographically) was 97% and 93%, respectively, and the specificity was 93 and 84%, respectively. CONCLUSION: MCE in real-time imaging with Optison has significant potential for the identification of MP abnormalities. MCE correlates very well with SPECT images.

Aged↗
PubMed2003

Prognostic value of nitrate enhanced Tc99m MIBI SPECT study in detecting viable myocardium in patients with coronary artery disease.

BACKGROUND: Assessing the viability in akinetic myocardium is vital for predicting functional recovery after therapeutic management in patients with chronic coronary artery disease (CAD) and depressed left ventricular (LV) function. The present study aimed to evaluate the efficacy of Tc99m MIBI SPECT enhanced with nitroglycerine infusion in detecting myocardial viability, as well as to asses the relationship between the myocardial viability and the subsequent treatment and outcome of patients. METHODS AND RESULTS: Sixty-seven consecutive patients with CAD and LV dysfunction (LV ejection fraction 36.6 +/- 8.4%) underwent Tc99m MIBI imaging--at rest and during intravenous nitroglycerine infusion--for viability assessment. Fourteen patients were treated pharmacologically (Group I), and fifty-three (Group II) were submitted to coronary revascularization (PTCR or CABG). Fifteen major cardiac events were observed during 25 months of the follow-up. A significantly worse event-free survival was registered in the subjects of Group I than in Group II subjects. The prognostic predictors of cardiac events were: (1) the number of viable, non-revascularized segments in perfusion imaging (p < 0.001), (2) the severity of the disease assessed by coronary angiography (p < 0.05). CONCLUSIONS: Viability detection in nitroglycerine infusion enhanced Tc99m MIBI imaging offers significant prognostic value in patients with CAD after myocardial infarction. Patients with preserved viability showed better prognosis after revascularization than those treated pharmacologically.

Coronary Artery Disease↗
PubMed2003

Myocardial ischemia assessed by Tc99m MIBI SPECT and left ventricle regional systolic and diastolic function evaluated by tissue Doppler echocardiography.

BACKGROUND: Tc99m MIBI single-photon emission computed tomography (SPECT) study facilitates the evaluation of the regional myocardial perfusion and tissue Doppler echocardiography imaging facilitates the quantitative assessment of the regional systolic and diastolic function of the myocardium. The aim of the study was an assessment of the correlation between regional rest myocardial perfusion defects and regional rest systolic and diastolic myocardial velocities in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: In 40 IHD patients (33 men, 7 women) aged 43-74 years (mean 56 years) rest SPECT imaging with Tc99m MIBI and rest tissue Doppler examinations were performed. The control group consisted of 35 healthy sex and age matched pesons. The left ventricle was divided into 13 segments. The number of non-perfused segments in three myocardial perfusion regions (left anterior descending artery, circumflex artery, right coronary artery) was assessed in IHD patients. During tissue Doppler examination the maximal systolic and maximal early diastolic velocity of the myocardium in each segment were established in both examined groups. RESULTS: The systolic and diastolic myocardial velocities were significantly lower in IHD group as compared to control group. In the IHD group statistically significant decrease of systolic and diastolic velocities in relation to the number of non-perfused segments was found. In comparing the linear regression slopes for systolic and for diastolic myocardial velocities in terms of intensification of perfusion defects, a more pronounced decrease in diastolic velocity was encountered. CONCLUSIONS: Both systolic and diastolic myocardial velocities are decreased in the myocardial regions with perfusion defects, but the reduction of the diastolic velocity is higher than the reduction of the systolic velocities. Thus our results indicate a good correlation between the intensity of perfusion abnormalities and myocardial velocities. The levels of diastolic dysfunction is more pronounced than the level of systolic dysfunction in the ischemic myocardium.

Adult↗
PubMed2002

[Contrast echocardiography in the assessment of left ventricular function and myocardial perfusion].

Myocardial contrast echocardiography is a non-invasive method used to detect coronary artery disease. It was first described in 1968. New contrast agents which can go through the pulmonary vessels were discovered in the last years. Contrast echocardiography is useful in improving the endocardial border delineation and left ventricular cavity visualisation especially in patients with suboptimal acoustic windows. As the contrast passes further into the coronary artery normal myocardium perfusion is enhanced while ischaemic areas lack enhancement. Analysis of perfusion allows indirect identification of narrowed coronary arteries. Left ventricular function and its myocardium perfusion are made with contrast echocardiography at rest and during pharmacological stress tests. These examinations allow for detection patient with coronary artery disease as well as estimating efficacy of revascularisation procedures.

Contrast Media↗
PubMed2002

[Heart rate variability in patients treated with percutaneous transluminal coronary angioplasty].

UNLABELLED: Decreased heart rate variability (HRV) is an independent risk factor for sudden cardiac death in patients with coronary artery disease (CAD) and previous myocardial infarction. The influence of myocardial revascularization on HRV parameters has been investigated for the past few years. However, little is known about HRV behaviour in patients with CAD treated with percutaneous transluminal coronary angioplasty (PTCA). The purpose of this study was to estimate HRV parameters before PTCA and during a one year follow-up. We examined 65 patients (47 men, 18 women; mean age 51.2 +/- 7.6), who underwent successful and uncomplicated PTCA. Thirty eight patients had a prior myocardial infarction. The mean left ventricular ejection fraction was 59.8 +/- 8.1%. Thirty-nine patients had a single-vessel disease, 25 patients had a double-vessel disease and one patient had a triple-vessel disease. Serial 24-hour Holter monitoring (before PTCA, 14 days, 3, 6, 12 months after PTCA) was performed in all patients. The following time domain measures of HRV were calculated from each recording, for 24-hours: pNN50, SDNN, SDANN and rMSSD. During the one year follow-up, a significant increase of pNN50, SDNN and SDANN was observed. We noted, that the statistically significant increase of the above-mentioned parameters occurred during the first 3 month follow-up. The results of the next serial recordings (6 and 12 months after PTCA) demonstrated no additional changes in HRV values, however they were still significantly higher than before procedure. Mean values of HRV parameters before PTCA and 3 months after were as follows: pNN50: 8.8 +/- 6.8%, vs 11.7 +/- 9.4% (p < 0.05), SDNN: 121.2 +/- 33.5 ms vs 148.2 +/- 29.3 ms (p < 0.05), SDANN: 113.6 +/- 16.2 ms vs 125.1 +/- 22.3 ms (p < 0.05). Parameter rMSSD did not change significantly during the whole observation. CONCLUSIONS: 1. Myocardial revascularisation with successful PTCA leads to an improvement in the autonomic modulation of heart rate. 2. The increase in parasympathetic control of the heart rate is already being observed 2 weeks after successful PTCA. 3. Beneficial increased influence of both parts of the autonomic nervous system on heart rate persists for 12 months after coronary angioplasty.

Adult↗
PubMed2002

[Comparison of quantitative echocardiographic methods with angiography for assessment of mitral regulation].

UNLABELLED: The aim of this study was to compare echocardiographic assessment of the severity of mitral regurgitation (MR) with angiographic grading. MATERIAL: 51 patients (patients) with MR (43 men and 8 women), aged from 38 to 75 (mean 56 +/- 9 years), were used in the study. The etiology of MR was: Coronary artery disease (28 pts), infective endocarditis (3 patients), rheumatic disease (5 patients), dilated cardiomyopathy (7 patients), mitral valve prolapse (8 patients). EXCLUSION CRITERIA: Aortic stenosis and/or aortic insufficiency, mitral stenosis, mechanical prostheses and atrial fibrillation. METHODS: The mitral regurgitant volume (RV) and effective regurgitant orifice (ERO) were estimated by the proximal convergence method (PISA), regurgitant fraction (RF) and vena contracta width (VCW) by color Doppler quantitative method and compared to the cine ventriculographic grades. The angio-graphic severity of MR was classified as 1 to 4 grades according to the Sellers criteria. RESULTS: There was a good correlation between the angiographic grading and ERO (r = 0.855, p < 0.001), RV (r = 0.868, p < 0.001), RF (r = 0.923, p < 0.001) and VCW (r = 0.846, p < 0.001). CONCLUSIONS: 1. PISA method is clinically useful in routine evaluation of the severity of MR. 2. VCW provides a simple method for the identification of patients with severe MR. 3. These methods offer an alternative approach in quantifying MR noninvasively.

Adult↗