PubMed Health⌕ Search

Biomedical subjects

Piotr Lipiec

Publications and source records attributed to Piotr Lipiec.

10 recordsLinked to original sources
PubMed2005

Regional aortic function is correlated with intima-media thickness-insights from three-dimensional echocardiography.

BACKGROUND: Thickening of arterial intima and the presence of atherosclerotic plaques may influence vessel pulsation by increasing the wall stiffness. There are no data available concerning regional changes in aortic elasticity in relation with local wall thickness and the magnitude of atherosclerosis. METHODS: The study group comprised 48 patients (33 men, age 54 +/- 11 years) referred for transesophageal echocardiography. Reconstruction of 2-cm segments of aorta was divided by coaxial planes into 4 longitudinal sections. Thereafter, diastolic and systolic radius, thickness of atherosclerotic plaques, and intima-media thickness (IMT) in each section were measured. The relative change in regional aortic lumen (pulsation) was measured and regional beta-index was calculated. In total, 192 aortic sections were analyzed. RESULTS: The volume of the examined sections of the aortic segments ranged from 0.6 to 4.1 cm3 (mean 1.6 +/- 0.7 cm3) in systole and from 0.5 to 3.7 cm3 (mean 1.4 +/- 0.7 cm3) in diastole. The pulsation of the aortic sections varied from 0.04 to 0.78 cm3 (mean 0.21 +/- 0.13 cm3), which constituted 1% to 21% (mean 6 +/- 4%) of the section volume. The thickness of atherosclerotic plaques in the studied aortic sections ranged from 0.03 to 1.87 mm (mean 0.31 +/- 0.26 mm) and IMT was within the range 1.28 to 3.61 mm (mean 1.87 +/- 0.39 mm). The regional beta-index of the individual section ranged from 1.6 to 97.1 (mean 12.5 +/- 14.6). The regional beta-index was statistically significantly dependent on the IMT (r = 0.43, P < .001), but not on the thickness of atherosclerotic plaques (P = .96). The variability of regional beta-index, defined as the difference between the highest and the lowest beta-index in the sections of the same aortic segment, ranged from 1.7 to 83.1 (mean 20.0 +/- 20.7) and was borderline correlated with the IMT (r = 0.26, P = .07), but not with the thickness of atherosclerotic plaques (P = .87). CONCLUSIONS: Three-dimensional echocardiography facilitates quantitative analysis of aortic wall stiffness and regional beta-index measurements. The local aortic wall beta-index and its regional variability is dependent on IMT, but not on the thickness of atherosclerotic plaques.

Adult↗
PubMed2004

Right coronary artery-to-right ventricle fistula complicating percutaneous transluminal angioplasty: case report and review of the literature.

This case report describes an iatrogenic right coronary artery-to-right ventricle fistula resulting from percutaneous transluminal coronary angioplasty. In this patient transthoracic echocardiography with Doppler color flow mapping allowed direct visualization of the right coronary artery aneurysm and the coronary fistula, enabling us to identify the cardiac chamber into which the fistula drained. Transthoracic echocardiography was used for follow-up of this patient, demonstrating spontaneous closure of the fistula within 3 months of the procedure. In addition, this article provides a brief overview of reported cases of percutaneous transluminal coronary angioplasty-induced coronary fistulae. The clinical course of this complication and therapeutic approaches presented in the literature are also briefly discussed.

Angioplasty, Balloon, Coronary↗
PubMed2004

[Intravascular ultrasound imaging and histological evaluation of the aorta].

UNLABELLED: It has been shown in several in-vitro studies that IVUS images correlate well with histology and angioscopy. The existing data on intravascular imaging of large-diameter elastic arteries are scant. The aim of this study was to compare the IVUS images of aorta with the reference method--histological section by evaluating the accuracy of measurements performed at corresponding aortic segments. MATERIALS AND METHODS: 15 human aortic specimens were derived from post-mortem examination and in-vitro IVUS imaging was performed, including measurements of vessel diameters and cross-sectional areas in three specified areas. Corresponding regions of interest obtained with histology were subsequently evaluated and parameters matched to those by IVUS were calculated. RESULTS: Total of 45 pairs of measurement were compared. Mean vessel internal diameter on IVUS was 14.4 mm (SD 2.7 mm) and intima thickness was 0.6 mm (SD 0.8 mm). The corresponding aortic internal diameter observed with histology was 13.2 (SD 2.6 mm) and intima thickness--0.3 mm (SD 0.03). An overall agreement between IVUS and histology specimens was high, yelling correlation ratio of 0.99. The highest level of agreement was observed for external vessel area validation--correlation ratio 0.98. The largest discrepancy was observed for intima and media thickness, with correlation ratios of 0.61 and 0.72, respectively. CONCLUSIONS: Our data suggest that examination of aorta with intravascular ultrasound is feasible and may provide additional information in assessment of cardiovascular pathology. More complete risk stratification, which includes IVUS examination of aorta, is an important factor to determine the necessity for early preventive treatment, especially in patients with normal coronary arteries.

Aorta↗
PubMed2004

[Regional aortic function studied by three-dimensional echocardiography].

UNLABELLED: Aortic pulsation is caused by the arterial blood pressure variation during the cardiac cycle. Thickening of arterial intima, as well as the presence of atherosclerotic plaques may influence vessel pulsation by increasing wall stiffness. There is no data available concerning regional changes in aortic elasticity in relation with local wall thickness and the magnitude of atherosclerosis. The study group comprised 36 patients (27 men, 9 women, mean age 53 +/- 10 years) referred to our echocardiographic laboratory for transesophageal echocardiography (TEE). TEE probe was placed at the depth of 35 cm. The spatial interval between acquired images was 3 degrees. The reconstructed data sets were reviewed and the border between the aortic wall, plaque and lumen was determined. The reconstruction of a two-centimeter-long segment of aorta was divided by coaxial planes into four longitudinal sections. Thereafter the diastolic and systolic radius of each section, thickness of atherosclerotic plaques and intima-media thickness in each section were measured. The regional beta-index was calculated as Ln (systolic pressure/diastolic pressure)/relative change in regional aortic lumen, where relative change in regional aortic lumen was calculated as the difference between aortic lumen volume in systole and diastole divided by aortic lumen volume in diastole. In total, 144 aortic sections were analyzed. The volume of two-centimeter-long segments of descending aorta ranged from 6.9 cm3 to 31.5 cm3 (mean 12.8 +/- 5.2 cm3) in systole and from 4.9 cm3 to 29.2 cm3 (mean 11.2 +/- 4.9 cm3) in diastole. The volume of the examined sections of the aortic segments ranged from 1.3 cm3 to 10.6 cm3 (mean 3.2 +/- 2.6 cm3) in systole and from 1.1 cm3 to 8.7 cm3 (mean 2.8 +/- 1.5 cm3) in diastole. The pulsation of the aortic sections varied from 0.01 cm3 to 2.7 cm3 (mean 0.4 +/- 0.3 cm3), which constituted 0 to 37% (mean 13 +/- 8%) of the section volume. The thickness of atherosclerotic plaques in the studied aortic sections ranged from 0.0 mm to 1.1 mm (mean 0.3 +/- 0.2 mm) and the intima-media thickness was within the range 1.3 mm to 2.5 mm (mean 1.9 +/- 0.3 mm). The regional beta-index of the individual section ranged from 1.1 to 253.9 (mean 9.3 +/- 24.3). The regional beta-index was statistically significantly dependent on the intima-media thickness (p=0.02). We found no significant correlation between beta-index and the thickness of atherosclerotic plaques in the studied segments (p=0.38). CONCLUSIONS: Transoesophageal three-dimensional echocardiography facilitates quantitative analysis of aortic wall stiffness and regional beta-index measurements. The local variability of beta-index is correlated with intima-media thickness, whereas the correlation with the thickness of atherosclerotic plaques is not statistically significant. These measurements may be of importance in the assessment of the degree of atherosclerosis advancement. It forms new perspectives in diagnostics with the ability to evaluate the influence of pharmacotherapy and life-style modifications.

Aorta↗
PubMed2004

[Prognostic value of the parameters of left ventricular systolic function in patients with heart failure].

UNLABELLED: There are several parameters of left ventricular (LV) systolic function assessment. The calculation of the ejection fraction (EF) strongly relates to the preload and afterload conditions. Wall motion score index (WMSI) seems to be to impractical as the semi-quantitative method. Measurement of the LV pressure rise by Doppler evaluation of mitral regurgitation is a reproducible and an accurate method for dP/dt evaluation. As a method for LV systolic function estimation it does not depend on loading conditions. We have compared the prognostic value of these three methods in patients with a broad spectrum of systolic dysfunction. The study group consisted of 75 patients evaluated by all these methods in years 1995-1999 in our echocardiographic laboratory (73%--men, mean 54 +/- 12 years). In 13 patients the coronary artery disease was diagnosed but LV function was apparently normal, in 35--regional dysfunction after myocardial infarction was described, and in 27--global dysfunction due to idiopathic dilated cardiomyopathy. The EF ranged from 11% to 70% (mean 34 +/- 14%), WMSI--from 1 to 3.6 points (mean 2.2 +/- 0.7), and dP/dt from 235 to 4000 mmHg/s (mean 1108 +/- 698 mmHg/s). The closest relationship was noted between EF and dP/dt (R2=0.50). During 38 +/- 19 months of follow-up, 40 patients died (53%). In the multivariate logistic analysis the only significant parameter related to prognosis was EF (p=0.001). WMSI (p=0.12) and dP/dt (p=0.16) were not statistically significant correlated to death. CONCLUSION: The left ventricular ejection fraction still remains the most important parameter for the evaluation of prognosis in patients with depressed systolic function. Left ventricular pressure rise describes the systolic function but does not have impact on the prognostic evaluation.

Adult↗
PubMed2004

Real-time three-dimensional echocardiography: still a research tool or an imaging technique ready for daily routine practice? A pilot feasibility study in a tertiary cardiology centre.

BACKGROUND: The majority of studies demonstrating the diagnostic potential of three-dimensional (3D) echocardiography have been conducted on selected series of patients in research laboratories. AIM: To investigate the feasibility and usefulness of real-time 3D transthoracic echocardiography (RT 3D TTE) in daily routine practice. METHODS: The study group consisted of 35 consecutive patients referred to our echocardiographic laboratory. All subjects underwent standard 2D TTE and RT 3D TTE with the use of a commercially available ultrasound system (Sonos 7500, Philips Medical Systems). The quality of 3D acquisitions and post-processed images was graded as: insufficient, satisfactory, good or demo. RESULTS: 3D TTE of the study group yielded 298 acquisitions. 87,2% of acquisitions required post-processing. The quality of 3D datasets was graded as insufficient in 8,0%, satisfactory in 31,4%, good in 37,2% and demo in 23,4% of all acquisitions and reconstructions. Mean time required for 3D TTE, including post-processing, was 12 minutes. 3D reconstructions were particularly helpful in patients with valvular disease or prostheses (n=13), enabling detailed qualitative analysis of leaflets morphology and mobility. In cases of mitral valve prolapse (n=4) 3D TTE allowed identification of the prolapsing scallops. 3D color Doppler flow mapping enabled complete visualization of the regurgitant jets. "En face" reconstructions of atrial septal defects (n=2) facilitated assessment of the morphology of the defects and the tissue rims. In patients with cardiac pacemaker (n=4) 3D TTE allowed excellent visualization of the ventricular lead along with its tip. In patients with ischemic heart disease (n=14) 3D TTE failed to provide additional, clinically relevant information. CONCLUSIONS: RT 3D TTE may be used in clinical settings with high feasibility rate and provides additional, clinically relevant qualitative information. The lack of on-board quantitative analysis tools is the main limitation of the currently available system.

Academic Medical Centers↗