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P Podolec

Publications and source records attributed to P Podolec.

27 records · Page 2Linked to original sources

Thallium-201 myocardial perfusion imaging in patients before and after successful percutaneous transluminal coronary angioplasty.

We studied the value of exercise thallium-201 (Tl-201) scintigraphy for evaluation of myocardial perfusion improvement and the detection of restenosis in patients after successful percutaneous transluminal coronary angioplasty (PTCA). Fifty-three patients (43 male and 10 female) ages 38-71 years (mean 55.3) were analysed. Exercise Tl-201 scintigraphy was performed before PTCA, and 6-10 days and then 3-6 months after the procedure. In all patients repeated coronary angiography was done 3-6 months after PTCA. Before PTCA myocardial perfusion defects were observed in all patients. Immediately after PTCA, an improvement in myocardial perfusion was noted in 36 patients (61%). Total normalisation of the scintigraphic picture was observed in only 12 patients. Coronary angiography after 3-6 months showed patency of dilated vessels in 11 out of those 12 patients (91.3%). In scintigraphy, performed 3-6 months after PTCA, a normal scan was present in 20 patients and recurrence of stenosis was found in only 2 of those 20. Stenosis was found in 22 (60%) of 33 patients with perfusion defects. For the purpose of describing the character of the myocardial perfusion changes, statistical analysis of a number of segments was performed. The predictive value of Tl-201 scintigraphy for detection of restenosis was established. The positive value for the procedure performed 6-10 days after PTCA was 56%, and the negative value of prediction of restenosis was 91%. Three to 6 months after PTCA, a high negative value of scintigraphy was observed (-90%) and a low positive predictive value was still present (63%).

Adult↗

[Scintigraphic evaluation of myocardial perfusion after using TI-201 in patients before and after successful percutaneous transluminal coronary angioplasty].

We analysed 53 patients (43 men and 19 women) age 38-71. Exercise TI-201 scintigraphy was performed before PTCA, 6 to 10 days and 3 to 6 months after PTCA. Before PTCA in all the patients myocardial perfusion detects on scintigraphy were observed. The imaging performed 6 to 10 days after PTCA showed an improvement seen as a decrease in the number of ischaemic segment in 36 patients (67.9%) and total normalisation of scintigraphic picture in 12 patients. Coronary angiography performed 6 months after PTCA showed patency of the dilated vessel in 11 (91.3%) among these patients. In exercise TI-201 scintigraphy performed 3 to 6 months after PTCA normalised scan was observed in 20 patients, recurrence of stenosis was found only in 2 (10%) of those patients. In 33 patients with transient perfusion defects, angiographic restenosis was found in 22 (60%) patients. Predictive value of exercise TI-201 scintigraphy for occurrence of restenosis was established. Positive predictive value of the study performed 6 to 10 days after PTCA was 56%. Negative predictive values of such a study was 91%. Similarly, for detection of restenosis in scan performed 3 to 6 months after PTCA there was found a strong negative predictive value-90% and a weak positive predictive value-63%.

Adult↗

[Long-term observation of patients with biopsy proven myocarditis or dilated cardiomyopathy].

Dilated cardiomyopathy (DC) and myocarditis (MCD) are still cardiac diseases of unknown etiology and pathogenesis. Due to uncertain natural history of MCD also treatment remains controversial. We observe long-term outcome of 30 pts with biopsy-proved MCD (group I) and 25 pts with DC (group II). The diagnosis of MCD was established on Dallas criteria of MCD. Almost all pts presented symptoms of congestive heart failure. All group I pts were treated with immunosuppressive agents: azathioprine 1.5 mg/kg/d and prednisone with initial dose of 1.5 mg/kg/d. After tapering off 0.75 mg/kg/d of prednisone and initial dose of azathioprine were given up to 6 months. All pts obtained digitalis, diuretics, ACEI, antiarrhythmic drugs if necessary. We studied the survival and clinical status (NYHA class) of treated pts. Clinical improvement was observed in 93% of pts with MCD within 6 months, but 20% of pts deteriorated within the next 6 months. Almost all pts survived 1 year. Out of 30 pts with MCD, 16 pts remain in lower NYHA class (NYHA I-II) between 26 and 69 months of follow-up. Within the group II (DC) 28% of pts died in the first year of observation. Out of 15 pts in 14 pts advanced chronic heart failure (NYHA III-IV) is presented in the end of observation. Echocardiographic parameters of pts with congestive heart failure and biopsy-proved MCD or DC did not differ significantly. We observed correlation between improvement of the LV echocardiographic parameters and improvement of clinical status of treated pts.

Adolescent↗

[Usefulness of imaging methods in the diagnosis of aortic dissecting aneurysms].

Based upon personal experience and literature the authors briefly discuss the usefulness of arteriography, ultrasonography, CT and MR in the diagnosis of aortic dissecting aneurysms. In the diagnostic algorithm concerning aortic dissection type I and II acc. DeBakey, the initial diagnostic method should be echocardiography, followed by CT or MR or eventually aortography. In the case of type III aortic dissection the authors recommend transesophageal echocardiography and CT or MR or eventually aortography as the last examination.

Aortic Dissection↗

[Infectious aortic valve endocarditis. Echocardiographic evaluation].

In the group of 37 patients (pts) with infective endocarditis of aortic valve comparative analysis of echocardiograms with intraoperative or pathomorphological findings was performed. Infection caused development of vegetations in 17 pts, cusp rupture in 7 and perivalvular abscess in 4 pts. Echocardiographic examination enabled diagnosis of vegetations in 16 pts. In 2 pts abscess cavity was shown between mitral and aortic annulus. Two-dimensional echocardiography provided more detailed data concerning number and localization of vegetation, and development of perivalvular abscess cavity. However cusps rupture was shown by M-mode echograms in 4 from 7 pts. In the course of antibiotic therapy 7 pts died: from 30 pts treated surgically the result of treatment was beneficial in 27. The examinations confirmed poor clinical prognosis of premature mitral valve closure for the patients with aortic insufficiency.

Abscess↗