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Marianna Janion

Publications and source records attributed to Marianna Janion.

At least 19 recordsLinked to original sources
PubMed2006

[Acute aortic dissection in a 34 year old pregnant woman--a case report].

A case of a 34 year old pregnant woman at 38 weeks gestation, who was admitted to the hospital with acute chest pain, is presented. Electrocardiogram showed ST segment changes suggestive of acute myocardial infarction. Echocardiography, however, revealed acute aortic dissection. The patient was transferred to another hospital where caesarean section followed by cardiac surgery were successfully performed. A subsequent one-year follow-up period was uneventful, both for mother and child. Diagnosis and treatment of acute aortic dissection during pregnancy are discussed.

Acute Disease↗
PubMed2006

[Long QT syndrome due to olanzapine administration].

A case of a 53 year old female with olanzapine-induced QT interval prolongation and ventricular fibrillation is described. The relationship between neuroleptic drugs and the risk of sudden cardiac death is discussed.

Antipsychotic Agents↗
PubMed2005

Atrial natriuretic peptide for monitoring cardiovascular system performance following pacemaker implantation.

BACKGROUND: The effects of different modes of pacing on cardiac performance have been investigated in a few small studies, and the results are not conclusive. AIM: To assess the effects of different modes of pacing on atrial natriuretic peptide (ANP) plasma concentration and left ventricular ejection fraction (LVEF). METHODS: The study group consisted of 55 subjects without symptomatic CHF. Forty patients were in sinus rhythm and had a-v block. Twenty of them, aged 71-90 years, mean 77.5+/-5.9 years, received VVI pacemaker, and the remaining 20 patients aged 49-81 years, mean 68.9+/-11.9 years, received DDD or VDD pacemakers. The control group consisted of 15 healthy volunteers aged 58-80 years, mean 72.6+/-2.8 years. Blood samples for alpha ANP concentration were taken before pacemaker implantation and 7 as well as 30 days after pacemaker implantation. In controls, a single alpha ANP measurement was performed. Transthoracic echocardiography was performed in all patients and controls at the same time-points as ANP assessment in order to calculate LVEF. RESULTS: Before pacemaker implantation, ANP plasma concentration was the highest in VVI patients and was significantly greater in patients than in controls. Following VVI pacemaker implantation, ANP level significantly decreased, both 7 and 30 days after implantation when compared with baseline values. Also following implantation of dual-chamber pacing system, ANP concentration significantly decreased. The baseline LVEF values were significantly higher in patients than in controls. In patients with VVI pacemakers, LVEF significantly increased, both 7 and 30 days after implantation. In patients with dual-chamber pacemakers, LVEF tended to increase 7 days after implantation and slightly decreased 30 days after implantation, however, the differences were not significant. CONCLUSIONS: ANP level decreases following pacemaker implantation in patients with advanced a-v block which suggests an improvement of cardiac performance. Assessment of ANP may be useful in selection of pacing mode.

Aged↗
PubMed2005

[Postinfarction left ventricular pseudoaneurysm].

Left ventricular pseudoaneurysm is a rare complication of heart rupture as a result of acute myocardial infarction, tumour infiltration or infective pericarditis. This pathology is often diagnosed accidentally because of non-specific clinical manifestations such as congestive heart failure or no symptoms at all. Diagnosis of pseudoaneurysm should result in an urgent surgical treatment as the risk of sudden death due to aneurysm rupture is high. In this report we present a patient who underwent successful surgical treatment of left ventricular pseudoaneurysm as a complication of myocardial infarction.

Aneurysm, False↗
PubMed2005

[Acute inferior and right ventricular myocardial infarction in a patient with congenital secundum atrial septal defect].

We are presenting the case of a forty-six-year old patient, with a previously undiagnosed congenital secundum atrial septal defect, admitted to the intensive care ward because of an acute inferior and right ventricular myocardial infarction. He was randomised to Gusto V Trial and intravenous therapy of reteplase and abciximab was administered, which resulted in electrocardiographic reperfusion. After several hours of right ventricular failure his condition improved. No complications were observed throughout the convalescence. During the routine TTE examination a secundum ASD was diagnosed and confirmed afterwards in the TEE examination. Patient was qualified for coronarography which revealed a critical lesion in the right coronary artery; successful PCI was conducted. He is now waiting for surgical correction of a secundum atrial septal defect.

Acute Disease↗
PubMed2005

[Value of electrocardiographic treadmill test for rate control strategy in permanent atrial fibrillation].

AIM: of our study was to determine the correlation between physical activity tolerance assesed by exercise tolerance test (ETT) and dynamics of change of echocardiographic parameters of left atrium (LA) and left ventricle (LV) in standard transtoracic echocardiography (TTE) in long-term follow up of patients with persistent nonvalvular atrial fibrillation (AF). MATERIALS AND METHODS: We studied 67 patients (W/M: 23/44; mean age 63.2 +/- 7.1 years) with persistent AF lasting longer than 1 month. Rate control strategy targeted resting heart rate 70-90/min. All study subject underwent ETT in order to assess their exercise capacity. Before ETT we performed TTE in all patients and calculated the area of LA (LAar), longitudinal and saggital diameter of LA (LAlax, LAsax), LV end-diastolic diameter (LVEDD) and LV shortening fraction (FS). TTE was performed again in 2 and 12 months after beginning of observation. RESULTS: Using variation analysis we established the correlation between time of ETT in patients with persistent AF and dynamics of change of specific echocardiographic parameters in 12 months follow-up. In patients with ETT time <60 sec we observed statistically significant rise of LAar from 26.5 +/- 6.1 to 29.6 +/- 4.9 cm2 (p < 0.05; ANOVA) and deterioration of LV function assessed with FS from 35.6 +/- 5.3% on the beginning to 31.7 +/- 7.4% at the end of study (p < 0.02; ANOVA). There was no correlation between time of ETT and dynamics of change of other echocardiographic parameters in patients with time of ETT >60 sec. CONCLUSIONS: Time of exercise tolerance test limited with heart failure symptoms is an independent factor predicting dynamics of change of chosen echocardiographic parameters of left heart in long-term observation of patients with persistent atrial fibrillation.

Aged↗
PubMed2004

Efficacy of biphasic shock for transthoracic cardioversion of persistent atrial fibrillation: can we predict energy requirements?

Although electrical cardioversion of atrial fibrillation (AF) is frequently performed, initial energy requirements for cardioversion of persistent AF is still a matter of debate. The aim of the study was to determine the efficacy of biphasic shocks for transthoracic cardioversion of persistent AF and to predict adequate initial energy. A prospective study enrolled 94 consecutive patients with persistent AF, who were referred for elective cardioversion with a biphasic waveform. The paddles were placed in the anterolateral position. A step-up protocol was used to estimate the cardioversion threshold. The initial shock energy was 50 J, with subsequent increments to 100, 200, and 300 J in the event of cardioversion failure. The mean age of the study group was of about 65 years (6 +/- 11 years) and a median duration of AF was 65 days (3-324). Sixty-two out of 94 patients were men, 55% of the study population was classified as having well-controlled hypertension. The overall success rate of cardioversion was 89%, with a mean 2.2 +/- 1.4 shocks, and effective J 217.8 +/- 113 delivered during repeated cardioversions. The success rate of low energy shocks: 50 and 50 +100 J was 51%. By logistic regression analysis the only independent predictor of success at low energy shock was shorter duration of AF (r =-0.51; P = 0.02). Patients with shorter duration of AF have a higher probability for successful cardioversion with low energy. In patients with longer AF duration, a 200 J shock should be considered for cardioversion as the initial energy.

Aged↗
PubMed2004

Familial form of arrhythmogenic right ventricular cardiomyopathy.

BACKGROUND: Arrhythmogenic right ventricular dysplasia (ARVD) is characterised by fatty and fibrous infiltration of myocardial muscle. Clinical symptoms include dangerous cardiac arrhythmias and heart failure in the advanced form of the disease. ARVD is genetically determined in at least 50% of cases and is characterised by a marked variability of clinical presentation within one family. AIM: To assess the prevalence of the familial form of ARVD in Poland, the mode of inheritance and the risk of sudden cardiac death as well as heart failure development in asymptomatic patients, in whom ARVD was detected during family screening. METHODS: 211 relatives of 40 patients with ARVD were examined. Thirty two families were identified in which at least two members had the disease. The analysed parameters included family history, physical examination, ECG, echocardiography and magnetic resonance. RESULTS: Abnormalities of the right ventricle and/or cardiac arrhythmias suggesting ARVD were found in 71 subjects (mean age 32.4 years). In 28 cases ARVD was diagnosed. From this group, one patient had aborted sudden death. In the remaining 43 subjects a borderline form of the disease was detected. Of this group, one patient died suddenly. The degree of morphological changes in cardiac muscle correlated with patients' age. CONCLUSIONS: 1. The familial form of ARVD is frequent in Poland. 2. ARVD is inherited in an autosomal dominant mode. 3. Sudden cardiac death may be the first symptom of the disease, even in subjects with borderline ARVD. 4. ARVD is a progressive disease. Concomitant left ventricular involvement is not rare and probably represents a late stage of the disease.

Adolescent↗
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

Cardiac rupture in acute myocardial infarction with ST segment elevation. Clinical course and prognosis.

INTRODUCTION: Cardiac rupture (CR), involving left ventricular free wall, interventricular septum or papillary muscles, accounts for 15% of all deaths in the acute phase of myocardial infarction (MI). After cardiac arrhythmias and cardiogenic shock, CR is the third most common cause of death in acute MI. In spite of progress in the treatment of MI, mortality due to CR did not change in recent years.Aim. To assess the incidence, clinical course and outcome in patients with acute MI complicated by CR who were treated in our centre. METHODS: The study group consisted of 697 consecutive patients who were hospitalised due to acute MI with ST segment elevation (STEMI). The in-hospital and three-month follow-up data were analysed in 27 (3.9%) patients who developed CR. In 20 patients CR occurred in the left ventricular free wall, in 5 interventricular septum, in one both of these structures, and in one papillary muscle. The diagnosis of CR was based on clinical presentation and echocardiography. RESULTS: The overall mortality in 697 patients with STEMI was 10.5%. Mortality rate in patients with CR was 55.6% (15 patients) which accounted for 20.5% of all deaths. Nine patients with CR underwent cardiac surgery whereas 18 were treated conservatively. Two (22.2%) patients from the former group and 13 (72.2%) patients from the latter group died. CONCLUSIONS: 1. Mortality due to CR was increased in patients who were treated conservatively, who received thrombolysis and those who were females. 2. Rapid and accurate diagnosis, proper correction of hemodynamical disturbances and timely introduction of cardiac surgery improve prognosis in patients with CR complicating STEMI.

Adult↗
PubMed2004

Plasma concentration of atrial natriuretic peptide is related to the duration of atrial fibrillation in patients with advanced heart failure.

BACKGROUND: Plasma concentration of atrial natriuretic peptide (ANP) is elevated in patients with atrial fibrillation (AF) and in patients with chronic heart failure (CHF).Aim. To assess ANP level in patients with permanent AF and advanced CHF. METHODS: The study group consisted of 41 patients (27 males, mean age 62+/-8 years) with AF of a mean duration of 8.8 months. Twenty six (63%) patients were in NYHA class II, and 15 (37%) - in NYHA class III or IV. All patients underwent clinical and echocardiographic evaluation as well as ANP plasma concentration assessment. Multiple regression analysis was used to identify factors which determine ANP plasma concentration. RESULTS: Mean ANP plasma concentration was 52.4+/-22.7 pg/ml in the whole study group; 38.6+/-10.8 pg/ml in NYHA class II patients and 74.9+/-18.7 pg/ml in NYHA class III-IV subjects (p<0.0001). Among echocardiographic parameters, patients with NYHA class III or IV had significantly lower left ventricular ejection fraction and greater left atrial volume than patients with NYHA class II (32% versus 56%, p<0.0001 and 101.0+/-23.8 cm(3) versus 83.4+/-16.1 cm(3), p<0.006, respectively). Multiple regression analysis revealed a significant negative correlation between AF duration and ANP level (p=0.0013) in a group of patients with NYHA class III or IV and identified AF duration as an independent predictor of ANP plasma concentration in this group of patients. CONCLUSIONS: ANP plasma concentration in patients with persistent AF and advanced CHF is determined by AF duration - the longer the AF duration the lower the ANP level.

Adult↗