PubMed Health⌕ Search

Biomedical subjects

Mirosław Dziuk

Publications and source records attributed to Mirosław Dziuk.

13 recordsLinked to original sources
PubMed2006

Co-registration of cardiac MRI and rest gated SPECT in the assessment of myocardial perfusion, function and viability.

PURPOSE: Myocardial perfusion is routinely measured by SPECT--this technique has a rather low spatial resolution but covers the whole myocardium and is equipped with efficient image analysis software. Cardiac MRI has higher spatial resolution than SPECT and excellent sequences for myocardial function and viability detection but the lack of easy-to-use methods of acquisition and post-processing of perfusion images prevents this method from being used for perfusion evaluation in clinical practice. The aim of the study was to explore whether the 3-D co-registration of "cine" MRI (cine MRI), delayed enhancement MRI (DE MRI) and gated SPECT (GSPECT) images might be used for differentiating all reversible and irreversible effects of ischemia in anatomically matched myocardial regions. METHODS: We analyzed 685 segments of the heart (6 segments in each short axis slice)-obtained as a result of MRI and GSPECT studies performed in 18 patients. In each segment, myocardial function, perfusion and viability were analyzed. Myocardial wall function was evaluated using the matched images of diastolic and systolic phases of cine MRI. Perfusion as MIBI uptake per volume (MIV) (counts/mm3) in each myocardial segment was evaluated by co-registration of diastolic phases of cine MRI and GSPECT. Transmural extent of infarction was determined by co-registration of DE MRI and diastolic phase of cine MRI. RESULTS: We have found a close correlation between regional perfusion and function at rest in matched MRI and SPECT images: dysfunctional segments had significantly less MIV (MIV = 4.63 SD 1.58) than normal segments (MIV = 8.86 SD 2.77) (p < .05). There was no significant difference in MIV between viable and non-viable dysfunctional segments defined by DE MR due to a small number of nonviable segments in our study (18/685). CONCLUSION: Matching rest perfusion and function in anatomically co-registered myocardial segments in our study confirms that 3-D image co-registration of cine MRI, DE MRI and gated SPECT could be a precise method of integrated visualization of perfusion, function and viability helping in differentiating all forms of reversible and irreversible effects of myocardial ischemia.

Aged↗
PubMed2006

[Detection of patients at risk for paroxysmal atrial fibrillation (PAF) by signal averaged P wave, standard ECG and echocardiography].

UNLABELLED: The aim of this study was to evaluate whether analysis of signal averaged P wave, together with left atrial diameter (LA) and P wave duration in surface ECG lead II (PII) allow to predict the risk of PAF. MATERIAL AND METHODS: Patients with coronary heart disease and/or hypertension were examined (n=145). They were divided into two groups 110 patients with PAF were compared with 35 patients without PAF Age (60,5 vs. 57,4 years) and LA size (39,8 vs. 3,7 mm) were similar in two groups. RESULTS: The root mean square voltage (RMS) for the last 10,20, 30 ms were calculated and for all of the filtered P wave (RMSW) were measured RMS ratio (RMSR) were calculated according to RMSW/ RMS20. Filtered P wave duration (PWD) and difference befteen PWD and P II (PWD-PII) were established. Most of the analyzed parameters were statistically significant (p<0,05). The statistical analyses made it possible to outline the score index evaluating how PAF reacts parameters. CONCLUSIONS: Score index evaluating of the PAF occurrence and its influence is statistically significant with sensitivity 86%, specificity 83,5% and index positive predictor 82,7% and index negative predictor 83,7%. The most significant parameters which detect the patients with the occurrence of PAF are PWD > or =130ms, RMS20<3, microV, RMS10<2,2 microV and PWD-PII > or =40 ms.

Amiodarone↗
PubMed2006

[The influence of weather conditions on the occurrence of paroxysmal atrial fibrillation].

UNLABELLED: The effect of the changing weather conditions on the incidence of the paroxysmal atrial fibrillation (PAF) has not been documented before. MATERIAL AND METHODS: This analysis retrospectively assessed the influence of the weather conditions on 1153 PAF cases over the period of 10 years. The average age of the studied population was 64.9 +/- 9.2 years. There was 60% males in the group. The majority (84%) had an existing heart disease, the remaining part was diagnosed as the lone PAF. RESULTS: The following factors favoured the FAP occurrence: high air temperature (> 25 Centigrade) for more than 3 days, low temperature (< 8 Centigrade), water vapor pressure > 16.5 kPa, accelerated increase of the air pressure > 8hPa over 2 days. CONCLUSIONS: The following weather conditions such as: temperature, air humidity and pressure have a definite impact on the occurrence of the paroxysmal atrial fibrillation episodes in 87% of patients especially those with co-existing coronary heart disease, hypertension or older age.

Aged↗
PubMed2005

[Cardiac tomographic studies for the risk assessment in coronary artery disease].

Cardiac imaging studies provide clinically important prognostic information for cardiovascular events risk stratification. Starting with diagnostics they are most valuable in patients with intermediate clinical risk. Myocardial perfusion scintigraphy (SPECT) may serve to assess the cardiovascular risk, documents the size and severity of ischaemia. Additionally gated SPECT gives substantial information about the left ventricular function. Combining the clinical scintigraphic and functional analysis seems to determine the cardiovascular risk in the most impartial way. The calcium score in multislice spiral computed tomography detecting the early stages of the coronary artery disease may provide incremental prognostic information in the specific subgroups of patients. The magnetic resonance tomography seems to be the most accurate method for diagnosing the myocardial viability.

Coronary Artery Disease↗
PubMed2005

[Clinical and angiographic correlates of coronary calcium scoring in multislice computed tomography (MSCT)].

BACKGROUND: The MSCT calcium scoring allows to identify patients with increased coronary event risk or at early stages of coronary artery disease (CAD). AIM: The aim of the study was to find the correlation of calcium score with various clinical features and degree of coronary stenosis. METHODS: 40 consecutive patients (10 women) with angiographically proven coronary artery disease were assessed for coronary calcium score by means of MSCT not later than 48 hours after the angiography. The acquisition parameters were as follows: 3.2 mm slice thickness, 1.6 mm increment, pitch 1.25, 120 kV, 200 mAs, rotation time of 500 ms, supine patients during single breath-hold. The calcium score was semiautomatically calculated taking into account the size and density higher than 130 Hounsfield units. The clinical features such as the presence of hypertension, diabetes, dyslipidaemia, obesity (body mass index), smoking, CCS angina score, previous myocardial infarction, CAD duration, degree of stenosis and diffused disease were also analysed by means of Spearman's test. RESULTS: The calcium score in the left anterior descending artery (LAD) 271 + 598 showed good correlation with the degree of stenosis in the LAD 69 +/- 37 (r = 0.591, p<0.0001) and angina score (median 2, p<0.001). It was also correlated as well as calcium score in the LMA 55 +/- 147 with the CAD duration of 9 +/- 9 years and diabetes (p<0.01). The CS in the RCA 102 +/- 362 was associated with the diabetes, dyslipidaemia and obesity with the p<0.03. The score in the LCX 282 +/- 797 was correlated with the degree of stenosis in every artery (p<0.001 for the LCX = 56 +/- 39). The total calcium score 675 +/- 1462 was associated with the angina score, CAD duration (p<0.001), diffused disease and the stenosis in the LAD and LCX (p<0.0001). CONCLUSION: The total and the LAD coronary calcium score may be associated with the severity of symptoms, degree of stenosis in the LAD and disease extent. The calcium deposits in the RCA may be more frequent in patients with metabolic disorders.

Adult↗
PubMed2005

[Left ventricular function in gated single photon emission computed tomography (GSPET) in patients with myocardial infarction subjected to thrombolysis or primary PTCA].

Primary Percutaneous Transluminal Coronary Angioplasty (PTCA) is increasingly common method of treatment patients with acute myocardial infarction. The aim of the study was to assess the left ventricular function in patients with myocardial infarction subjected to thrombolysis or primary PTCA. Gated Single Photon Emission Computed Tomography was performed in 40 patients 6 months after myocardial infarction treated either with thrombolysis or primary PTCA. Left ventricular ejection fraction (LVEF), left ventricular enddiastolic (LVED) and systolic (LVES) volumes were analysed both at rest and after stress. Six months after myocardial infarction LVEF was significantly greater and LVED, LVES volumes smaller in patients treated with primary PTCA in comparison to patients treated with thrombolysis. The above observation suggests that patients subjected to primary PTCA might have better functional outcome in comparison to matched patients treated with thrombolysis after 6 months post myocardial infarction.

Adult↗
PubMed2005

[Degenerative valvular and left ventricle structural changes in echocardiography in patients with rheumatoid arthritis].

UNLABELLED: The disproportion between absence of clinical manifestations of circulatory system involvement and serious lesions in the heart found on post mortem examinations, more frequently diagnosed congestive circulatory failure and also higher mortality rate of patients with rheumatoid arthritis (RA), encouraged the authors to study the subject. THE AIM OF THE STUDY: Echocardiographic assessment of the effect of rheumatoid process on the heart in patients with RA without clinically overt features of heart disease. MATERIAL AND METHODS: The study was conducted in 50 patients with RA diagnosed on the basis of the American College of Rheumatology (ACR) criteria and in 50 persons matched with the patients with respect to age, gender, body area and body mass index, heart rate and arterial pressure. Persons with manifestations and/or history of cardiovascular diseases were excluded from the study. RESULTS AND CONCLUSION: The authors found that: in rheumatoid arthritis, the involvement of the heart by the pathological process is manifested as degenerative changes of valve leaflets, and these lesions correlate with interventricular septum thickness and the mass and mass index of the left ventricle.

Aged↗
PubMed2003

[Left ventricular function in rheumatoid arthritis patients].

BACKGROUND: The disproportion between the absence of clinical manifestations of circulatory system involvement and serious lesions in the heart found on post mortem examinations, more frequently diagnosed congestive circulatory failure and also higher mortality rate of patients with rheumatoid arthritis (RA), encouraged the authors to study the subject. THE AIM OF THE STUDY WAS: Echocardiographic assessment of the effect of rheumatoid process on left ventricular structure, and systolic and diastolic function in patients with RA without clinically overt features of heart disease. METHODS: The study was conducted in 50 patients with RA diagnosed on the basis of the ACR criteria and in 50 persons matched with the patients with respect to age, gender, body area and body mass index, heart rate and arterial pressure. Persons with manifestations and/or history of cardiovascular diseases were excluded from the study. RESULTS: The authors found that: in RA, the involvement of the myocardium by the pathological process was manifested as increased wall thickness, increased mass and mass index of the left ventricle with impairment of its diastolic function and normal systolic function. With progressing rheumatoid process, left ventricular systolic function impairment was observed. Left ventricular diastolic dysfunction in the course of rheumatoid arthritis usually was not manifested clinically.

Arthritis, Rheumatoid↗
PubMed2003

Left ventricular function assessed by gated spet after an exercise-augmented adenosine infusion. Correlation with myocardial ischaemia.

BACKGROUND: Gated single photon emission tomography (SPET) may simultaneously assess perfusion and function of the myocardium. AIM: To evaluate the relationship between the presence of ischaemia during an adenosine stress test and the changes in left ventricular (LV) function obtained after stress and at rest with gated SPET by using adenosine same-day stress and rest protocol. METHODS: The study population consisted of twenty eight patients. The gated SPET acquisition was performed both after adenosine vasodilatation and at rest with a protocol as follows: 300 MBq of Tc-99m Myoview at stress, 700 MBq reinjection at rest and double head gamma camera. Global left ventricular ejection fraction (LVEF) and end-diastolic and end-systolic volumes (EDV, ESV) as well as the regional wall motion reversibility from post-stress and resting scan were analysed. RESULTS: Wall motion disturbances were present in the stress study in 15 patients with subsequent improvement in 14 cases on the rest scans. An independent evaluation of the perfusion data revealed significant reversible myocardial ischaemia in 18 patients and negative result in 10. There was a significant difference between EDV change in patients with or without ischaemia (p<0.02). The post-stress LVEF and ESV were significantly different from those measured at rest. Reversible regional wall motion impairment indicated the presence of significant reversible myocardial ischaemia with an 88% positive predictive value (70% and 75% for sensitivity and specificity, respectively). CONCLUSIONS: The post-stress LVEF with gated SPET may not reflect true resting measurements. The qualitative assessment of regional wall motion reversibility shows better correlation with the ischaemic scan pattern than the difference in the LVEF and may be helpful in assessing the significance of reversible myocardial ischaemia.

Adenosine↗
PubMed2003

[Clinical outcome of patients after transmyocardial laser revascularization alone and combined with coronary artery bypass grafting].

The aim of the study was to assess the effect of transmyocardial laser revascularization (TMLR) alone and in combination with coronary artery bypass grafting (CABG) on the angina score (CCS--Canadian Cardiovascular Society class), exercise tolerance and left ventricular function 6 months after the procedures. Sixty two patients were subjected to revascularization, 38 to sole TMLR procedure and 24 to combination CABG and TMLR (CABG/TMLR group). The angina score and exercise stress test together with radionuclide ventriculography were performed before and 6 months after the operation. The angina class and exercise tolerance were similar in both groups preoperatively. After the operation the improvement was seen in both groups with no statistical difference. The left ventricular ejection fraction were 61 +/- 8% and 54 +/- 8% (p < 0.05) before operation and after 6 months respectively. Transmyocardial laser revascularisation alone and in combination with coronary artery bypass grafting may relieve the angina and improve the exercise tolerance. However the left ventricular ejection fraction may drop significantly.

Coronary Artery Bypass↗
PubMed2002

[Transmyocardial laser revascularization].

This review describes the transmyocardial laser revascularization (TMLR) which is a method used to treat patients with end-stage coronary heart disease who have been excluded from standard invasive treatments (coronary artery by-pass grafting, percutaneous transluminal coronary angioplasty) and no longer benefit from maximum medical therapy. TMLR consists in reestablishing blood flow to the ischaemic myocardium by creating a number of laser-drilled channels which are thought to allow a direct contact between the left ventricle and the myocardial plexus. This paper also presents a review of the available evidence of the efficacy of the procedure.

Angioplasty, Laser↗