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Piotr Hoffman

Publications and source records attributed to Piotr Hoffman.

11 recordsLinked to original sources
PubMed2003

Prediction of paroxysmal atrial fibrillation after aortic valve replacement in patients with aortic stenosis: identification of potential risk factors.

BACKGROUND AND AIM OF THE STUDY: Paroxysmal atrial fibrillation (AF) is a frequent complication after cardiac surgery. The study aim was to identify preoperative predictors of risk for this condition in patients with aortic stenosis after aortic valve replacement. METHODS: The influence of clinical, echocardiographic and 24 h electrocardiogram (ECG) parameters on episodes of paroxysmal AF after aortic valve replacement (AVR) in 423 patients (156 women, 267 men; mean age 58 +/- 10 years) with aortic stenosis was analyzed. Episodes of postoperative paroxysmal AF were noted in 120 patients (28%). RESULTS: Univariate analyses identified the following variables as risk factors for arrhythmia: age, NYHA functional class, history of preoperative paroxysmal AF, left ventricular mass index, >300 supraventricular beats on 24h ECG before surgery, presence of supraventricular tachycardia (SVT), SVT of >5 beats or with a rate >120 beats/min. Concomitant coronary artery bypass (CABG) grafting and presence of enlarged left atrium had no impact. By multivariate analysis, four variables were identified as independent predictors: age (odds ratio 1.7; 95% CI 1.2-2.1); history of paroxysmal AF (OR 3.2; CI 1.4-7.3); presence of >300 supraventricular beats/24 h (OR 1.9; CI 1.1-3.4); and presence of SVT (OR 2.1; CI 1.3-3.4). Discriminatory analysis revealed that a model comprising these four parameters enabled risk prediction in 68% of patients. CONCLUSION: In patients with isolated aortic stenosis, age, past history of paroxysmal AF episodes, >300 supraventricular beats/24 h and presence of SVT during 24 h before AVR were predictors of postoperative paroxysmal AF episodes. Left atrial diameter and simultaneous CABG during AVR did not influence the likelihood of postoperative paroxysmal AF.

Adult↗
PubMed2002

[The evaluation of the left ventricle function in patients with aortic stenosis and severe heart failure after surgical treatment of valvular heart disease].

Surgical treatment of aortic stenosis in patients (pts) with severe heart failure represents high-risk procedure. The aim of this study was to identify prognostic factors and assess the late outcome after aortic valve replacement (AVR) in patients with isolated aortic stenosis and left ventricle ejection fraction (EF) < or = 40%. The study group consisted of 37 pts 25 (67%) men and 12 (33%) women, aged 57 +/- 12 yrs. Mean follow-up period was 18 +/- 17 months (range 6 to 72 months). Before AVR and within follow-up period clinical assessment was based on NYHA classes and echocardiographic study to evaluate left ventricle function. Early mortality rate was 8.3%, late mortality was 5.8%. EF significantly improved from 27 +/- 7% to 59 +/- 15% (p < 0.001) after AVR. It was accompanied by clinical improvement. Left ventricle function improvement did not depend on age, sex of patients, concomitant revascularization and preoperative maximum transaortic gradient. Significant correlation (r = -0.4, p = 0.02) between preoperative left ventricle end-diastolic diameter and postoperative EF improvement was noted.

Aortic Valve Stenosis↗
PubMed2002

[Influence of insertion-deletion polymorphism of the angiotensin converting enzyme gene on left ventricular hypertrophy in patients with aortic stenosis--differences in men and women].

UNLABELLED: The role of different parameters (including genetic factors) on the timing and extend of left ventricle hypertrophy in patients with aortic stenosis is not defined. In our study we analyze the influence of clinical, echocardiographic parameters and I/D polymorphism of the angiotensin converting enzyme gene on the left ventricle hypertrophy (left ventricle mass index) in this group of patients. The study was done with the group of 302 pts with aortic stenosis--120 women and 182 men; mean age 58 +/- 11 yrs. Stepwise (backward) regression was used to assess the influence of the analyzed parameters (age, gender, history of hypertension, EF, MGA, presence of significant coronary artery disease and I/D ACE polymorphism) on the LVH in the all pts and in the women and the men separately. In the whole group the LVMI depends on EF (t = -6.5; p = 0.0001--higher LVMI in lower EF), MGA (t = 3.9; p = 0.0001--higher LVMI in higher MGA) and gender (t = 2.8; p = 0.005--higher LVMI in men). In women LVMI was related with EF (t = -3.6; p = 0.001--higher LVMI in lower EF), age (t = 2.9; p = 0.004--higher LVMI in older pts) and MGA (t = 2.5; p = 0.013--higher LVMI in higher MGA). In men the LVMI depends on EF (t = -4.8; p = 0.0001--higher LVMI in lower EF) and MGA (t = 1.98; p = 0.049--higher LVMI in higher MGA). Significant relationship between LVMI and results of I/D ACE polymorphism was observed both in women and men. I/D polymorphism relationship with LVMI was divergent in these 2 groups--association of higher LVMI with lack of DD type of polymorphism in women and presence of DD polymorphism in men. CONCLUSIONS: 1. Left ventricle hypertrophy in pts aortic stenosis is higher in men than in women. 2. In women left ventricle hypertrophy is related with ejection fraction, maximal aortic gradient, age and I/D ACE polymorphism; in men it is related to EF, MGA and I/D ACE polymorphism. 3. The influence of I/D ACE polymorphism on the left ventricle hypertrophy is divergent in women and men--in women related to the lack of DD polymorphism, in men related to the presence of DD polymorphism.

Adult↗
PubMed2002

[Clinical implications of different locations of atrial septal defects].

A frequent congenital heart disease in adults is the atrial septal defects (ASD). The pathology represents substantial variability due to the different mechanisms of developmental failure that may occur during embryogenesis. Subsequently, the clinical manifestation of the defect varies despite some similarities. This article presents classification, prevalence, clinical manifestation of various forms of atrial septal defects and scope of available treatment.

Adult↗
PubMed2002

[Echocardiographic evaluation of left atrial function in dilated cardiomyopathy with restricted and non-restricted Doppler transmitral flow].

UNLABELLED: Left atrial (LA) function is of great importance in left ventricular (LV) filling. There is evidence that echocardiographic Doppler evaluation of transmitral flow, routinely used for LV filling estimation, is dependent on LA function. Information regarding the relation of LA size and function to transmitral flow in heart failure is limited. We used 2D echocardiographic acoustic quantification methods to assess LA function in patients with dilated, (non-ischemic) cardiomyopathy (DCM) and a control group. The DCM group was divided into 2 subgroups: Group 1-with restrictive LV Doppler filling pattern-18 patients (DCM-R) and Group 2-with non-restrictive LV Doppler filling pattern-11 patients (DCM-NR) with similar heart rate, age and degree of mitral regurgitation. LA maximal area, total emptying fraction and absolute and fractional area change during rapid emptying and atrial contraction were calculated. The LA was enlarged only in DCM-R. Both DCM groups had decreased total emptying fractions and rapid emptying area changes compared to controls. An enlarged LA area and more decreased total emptying were found in DCM-R with high LV filling pressures compared to DCM-NR. The restrictive group had a significantly smaller LA rapid emptying area change, as well as a smaller LA area change and emptying fraction during atrial contraction compared to DCM-NR. Within < or = 2 hrs after the echocardiography study, cardiac catheterization was performed in the DCM group. We found significantly higher LV filling pressures and lower LV ejection fractions in DCM-R compared to DCM-NR. Significant correlations were found between LA function and invasive parameters like capillary wedge and LV enddiastolic pressures and LV EF. CONCLUSION: Patients with DCM-R had significantly enlarged LA areas with more depressed total emptying fractions and smaller LA area changes during contraction compared to DCM-NR. Thus, left atrial function plays an important role in LV filling and its dysfunction can be a marker of poor prognosis.

Adult↗
PubMed2002

[Evaluation of left ventricular diastolic function with tissue doppler echocardiography (TDI) in patients after angioplasty of the artery responsible for infarction].

UNLABELLED: To assess the ability of left ventricular (LV) diastolic function to improve following angioplasty of an infarct related artery (IRA), 39 patients were evaluated with the Tissue Doppler Imaging (TDI). Studied group comprised of 30 males and 9 females (age 53.3 +/- 8.3 yrs), who were 1 to 6 months after myocardial infarction (MI). They qualified for angioplasty of IRA if dobutamine stress echocardiography proved viability of the affected myocardium. Regional wall diastolic function was assessed by TDI 1 day before (exam 1), 1-3 days (exam 2) and 30 days (exam 3) after successful angioplasty. TDI myocardial diastolic velocities (Em and Am wave, Em/Am ratio) and time intervals (isovolumic relaxation time IVRT, rapid filling time RFT, atrial filling time AFT) were measured in the long axis of posterior (20 pts), anterior (17 pts) and lateral (2 pts) walls. Regional E wave velocity was increased between exam 1 and 3 (6.0 +/- 1.5 cm/s vs 6.7 +/- 1.7 cm/s, p < 0.05), the same as Em/Am ratio (1.0 +/- 0.4 vs 1.3 +/- 0.9, p < 0.05). There was no significant change in Am wave velocity. The regional RFT was prolonged between exam 1 and 2 (151 +/- 39 ms vs 170 +/- 30 ms, p < 0.01), whereas IVRT was shortened (103 +/- 21 ms vs 87 +/- 20 ms, p < 0.001). CONCLUSIONS: Regional diastolic function showed improvement as assessed by TDI after successful angioplasty of IRA. TDI allows the assessment of regional diastolic performance and its dynamics.

Angioplasty, Balloon, Coronary↗
PubMed2002

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Journal Article↗