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Biomedical subjects

T Dryjański

Publications and source records attributed to T Dryjański.

16 recordsLinked to original sources
PubMed1999

Right ventricular morphology and function after pulmonary resection.

OBJECTIVE: To identify the effect of pulmonary resection on right ventricular performance and its possible contribution to mortality and morbidity. METHODS: Before and 2 days after pulmonary resection for primary lung cancer in 31 patients (21 males; ages 32-69 years), echocardiographic examinations of the right ventricle were performed. Systolic, diastolic and stroke volumes as well as right ventricular ejection fraction were estimated. Right ventricular volumes were calculated using the subtracting method. RESULTS: Right ventricular end-diastolic volume index increased significantly in patients after pneumonectomy: 80.4+/-7.2 ml/m2 versus preoperative evaluation: 66.1+/-5.2 ml/m2 (P = 0.031). In patients who underwent pneumonectomy right ventricular ejection fraction significantly decreased from 48+/-5.0% preoperatively to 39%+/-4.1% after surgery (P = 0.027). Fourteen patients after pneumonectomy had development of supraventricular arrhythmias postoperatively. These patients had much higher right ventricular end-diastolic volume index (76.3+/-6.4/82.1+/-7.4; P = 0.032) and lower right ventricular ejection fraction (42+/-4.3/37+/-3.9; P = 0.021) after surgery in comparison with patients who had normal sinus rhythm postoperatively. CONCLUSION: Pulmonary resection caused a significant dilatation and dysfunction of right ventricle in the early postoperative period. Early detection of deterioration in right ventricular function after pneumonectomy may provide the opportunity for interventional therapy.

Diastole↗
PubMed1997

Evaluation of myocardial muscle functional parameters in patients with multiple sclerosis.

Structural and functional parameters of myocardium were evaluated with 2D+ Doppler echocardiography in two similar age groups of MS patients: S1: 12 subjects in 3-4 Degrees EDSS (Expanded Disability Status Scale), S2: 12 subjects in 5-7 degrees EDSS. The control group comprised 12 healthy subjects temporarily (at least 1 month) immobilized due to lower limb fractures. Investigations were performed in the supine position and 3 min after tilting to the erect position. Symptoms of organic myocardial injury which might have caused its insufficiency were not observed in any subjects. All structural parameters evaluated by this method did not differ significantly in the examined groups. Symptoms suggesting myocardial insufficiency were found in patients from group S2. Statistically significant decrease of ejection fraction (EF) and cardiac output (CO) was observed in the supine position of S2 patients as compared to S1 and the controls. These symptoms intensified in the erect position in S2 patients and they were accompanied by the decreased values of stroke volume (SV). The fact that in the majority of patients orthostatic hypotonia was not observed and that those disorders were not compensated by significant intensification of heart rate suggest to us that besides disorders resulting from autonomic nervous system dysfunction they may have been caused by secondary myocardial injury in the course of MS.

Adult↗
PubMed1993

[Clinical analysis of cardiac arrhythmias in patients with chronic renal failure treated conservatively. II. Evaluation of the relationship between cardiac arrhythmias and some echocardiographic indices--preliminary investigations].

Cardiac arrhythmias detected during 24-hr electrocardiographic Holter monitoring were correlated with some echocardiographic indices in 20 patients chronic renal failure (c.r.f.) on conservative treatment (10 women and 10 men, aged 43.6 +/- 9.8 years). Comparative groups consisted of 10 patients with chronic primary glomerulonephritis without arterial hypertension and renal failure (2 women and 8 men, aged 34.2 +/- 10.5 years), and 10 patients with primary arterial hypertension without clinical symptoms of renal disease (1 woman and 9 men, aged 36.6 +/- 9.5 years). In c.r.f. patients echocardiographic investigations disclosed that the left atrial diastolic dimension was within a normal range. The right ventricular diastolic dimension (RVDD) was, left ventricular systolic (LVDS) and diastolic (LVDD) dimensions and left ventricular end-diastolic volume (LVEDV) were slightly increased. The left ventricular ejection fraction (EF) was significantly lowered. In c.r.f. patients the left ventricular mass (LVM) was increased to approximately 300 g. In c.r.f. patients a significant positive correlation was found between number of ventricular extrasystoles registered within 24 hrs and RVDD. The investigation disclosed that: 1) in c.r.f. patients with arterial hypertension showed ultrasonographic signs of hypertrophic-dilated cardiomyopathy with impaired left ventricular ejection fraction; 2) in c.r.f. patients incidence and nature of cardiac arrhythmias were independent of LVM, LVDD and LVDS; 3) numbers of ventricular extrasystoles registered within 24 hrs can increase with the increase in RVDD and the decrease in EF.

Adult↗
PubMed1993

[Echocardiographic evaluation of funnel chest after surgical intervention].

An analysis of echocardiographic examination in 22 patients operated for funnel chest is presented. Patients were divided into two groups: group I--isolated anomaly, and group II--patients with coexistent other postural deformations. During the operation, rib's cartilages in the parasternal region were excised, sternum was cut transversally above the deformation and longitudinally across it, and than anterior thoracic wall was stabilized in the proper position with Kirschner's wires. Before and 6 months after surgery echocardiographic examinations were performed with systolic, diastolic and ejection volume indices calculation. marked haemodynamic improvement was noted with the increase of diastolic and ejection volume of both heart ventricles. Improvement was more evident in patients with severe deformations and with coexistent other postural anomalies.

Adolescent↗
PubMed1992

[Results of conventional treatment of severe congestive heart failure with vasodilators].

In 61 patients with NYHA IV class chronic congestive heart failure, treated in succession with digoxin (D) and furosemide (F) for two weeks, with D+F and isosorbide dinitrate (S) or nifedipine (N) for two weeks, with D+F+S or N without C for two weeks, clinical status, chest X-ray picture and two dimensional echocardiography were evaluated at the end of each stage of the treatment. There were analyzed heart rate (HR), arterial systolic (Ps) and diastolic (Pd) blood pressure, body weight (Mc), 24-hour urinary output (Dd), cardio-thoracic index (CTI), cardiac volume index (CVI) and dimensions of the left ventricle: systolic (LVIDs), and diastolic (LVIDd). The mean daily doses of the drugs were as follows: D-0.290 +/- 0.108 mg, F-13.0 +/- 4.1 mg, S-44.5 +/- 9.8 mg, N-42.0 +/- 12.2 mg, and C-75.1 +/- 24.4 mg. The treatment with vasodilators (Vd) induced decreases in Mc, CVI, LVIIDs and LVIDd in comparison with the treatment with D and F. The largest lowerings in HR, Ps, Pd and Mc were observed during the treatment with D and F. The most beneficial effects with regard to CVI, LVIDs and LVIDd were obtained during four-week treatment with captopril.

Adult↗
PubMed1990

[Effect of nitrates on left ventricular function and exercise tolerance in patients with mild circulatory failure caused by ischemic heart disease].

In 26 patients with ischaemic heart disease with symptoms of mild chronic circulatory failure (NYHA grade II) aged 56.2 +/- 14.4 years the left ventricular function was tested by two-dimensional echocardiography, the exercise tolerance was determined on cycle ergometer at submaximal workloads, the cardiothoracic index (CTI) and cardiac volume index (CVI) were calculated from chest radiograms. The tests were done before and after 2 and 6 weeks of treatment with isosorbide dinitrate in doses of 49.6 +/- 15.2 mg/day. Isosorbide was found to increase somewhat the ejection fraction (EF), and to raise statistically significantly (p less than 0.05) the velocity of shortening of the circumferential fibres in left ventricular myocardium (mVCF), and to reduce the internal dimensions of the left ventricle (LVIDd and LVIDs), without changing the values of the ejection index (SVI) and cardiac index (CI). Decreased transverse dimensions of the left ventricle was correlated with a significant decrease of the CVI index. No statistically significant effect of isosorbide was noted on the parameters characterizing exercise tolerance but the quotient of the exercise-induced heart rate by the workload (HR/Wat) and the index of myocardial oxygen requirement (HRx Ps) were decreased in a demonstrable way.

Adult↗
PubMed1990

[Changes in left-ventricular function in chronic congestive heart failure treated with digoxin, furosemide and vasodilators].

48 patients (62.8 +/- 9.1 yrs) with III or IV NYHa class congestive heart failure after 2-week therapy with digoxin (D) and furosemide (F) underwent two-dimensional echocardiographic examination to assess left ventricular function. Then in 25 patients (group I) DF and nifedipine (N) were given within 2 weeks, D, F, N and captopril (C) within 4 weeks and again D, F, N within 2 weeks. In 23 patients (group II) isosorbide dinitrate (S) was administered instead of nifedipine. 2-DE examination had been performed at the end of the each study stage. Optimal daily drug dose were: D-0.34 +/- 0.07 mg, F-40.7 +/- 12.5 mg, S-44.3 +/- 10.4 mg and 75.8 +/- 26.4 mg. Nifedipine and isosorbide dinitrate administrated with digoxin and furosemide did not improve left ventricular function in comparison with a standard therapy (DF). The best positive changes were observed in both groups during treatment with captopril. Ejection fraction by Teichholz increased from 42.9 +/- 15.0% during DF stage to 45.2 +/- 11.5% (DFNK stage) in group I (p less than 0.001) and from 35.3 +/- 10.5% to 36.4 +/- 10.4% in group II respectively (p greater than 0.01). Left ventricular systolic and diastolic internal diameters significantly decreased (p less than 0.05) whereas stroke volume and cardiac indices nonsignificantly increased (p greater than 0.05). Captopril with digoxine, furosemide and nifedipine caused significant hemodynamic improvement. Effect of captopril with nifedipine was greater that of captopril with isosorbide dinitrate.

Adult↗
PubMed1990

[Results of treatment for severe congestive heart failure with digoxin, furosemide and vasodilating agents].

In 61 patients with class IV (NYHA) of chronic congestive cardiac failure treated for 2 weeks with digoxin (0.290 +/- 0.108 mg/d) and furosemide (13.0 +/- 4.1 mg/d), for 2 weeks with digoxin, furosemide and isosorbide dinitrate (44.5 +/- 9.8 mg/d) or nifedipine (42.0 +/- 12.2 mg/d), for 4 weeks with digoxin, furosemide, isosorbide or nifedipine and captopril (angiotensin converting enzyme inhibitor) (75.1 +/- 24.4 mg/d), and for the last 2 weeks with digoxin, furosemide, isosorbide or nifedipine without captopril, after each stage the clinical state, exercise tolerance and haemodynamic parameters determined echocardiographically were assessed. Ten weeks of treatment by this method caused regression of pulmonary congestion in 80%, oedema in 63.3% and hepatomegaly in 33.3% of the patients. Moreover, 60.7% of the patients returned to class III, 13.1% to class II, and 26.2% remained in class IV (NYHA). In the group treated with digoxin, furosemide, nifedipine with captopril (n = 30) a significant rise was observed of the value of the ejection fraction and cardiac index in relation to the treatment with digoxin and furosemide and the treatment with digoxin, furosemide, nifedipine (p less than 0.05). No drug improved significantly the tolerance of submaximal exercise. During the treatment with captopril no clinical improvement was achieved in 4 cases, and worsening occurred in 3 cases of severe cardiac failure (7 of 61 patients, 11.5%). The obtained results showed that vasodilating drugs are safe in congestive cardiac failure and in many cases of severe failure captopril contributed to rapid clinical and haemodynamic improvement.

Adult↗
PubMed1989

[Modified Ravitch operation in the treatment of patients with funnel chest].

The characteristic traits of funnel chest have been presented and the clinical results of surgical treatment in 13 patients by the modified Ravitch method have been discussed. Nine results were excellent and four results were good. A marked improvement of general physical function of the patients due to the increase of respiratory system efficiency and a good cosmetic effect were found. The modification of the operation consists in additional longitudinal osteotomy of the sternum, suturing of the manubrium to the sternum shaft, non-suturing of the rib cartilages after resection, filling of the through-like groove in the reposited sternum with the fragments of the resected rib cartilages, and immobilization of the fragments of the longitudinally osteotomized sternum that are inserted crosswise with several (usually three) Kirschner wires, based on the thorax.

Adolescent↗
PubMed1989

[Effect of a single dose of captopril on left-ventricular function in patients with chronic congestive cardiomyopathy].

In 15 patients with mild, chronic congestive heart failure the effect of a single dose of captopril (25 mg/m2 b.s.) on heart rate, systolic and diastolic blood pressure as well as on left ventricular function was studied at rest and after a submaximal physical effort. Preejection period (PEP), left ventricular ejection time (LVET) and the contractility index PEP/LVET were polycardiographically determined++. Left ventricular end diastolic volume (DVol), and systolic volume (SVol), ejection fraction (EF), stroke volume index (SVI) and cardiac index (CI) were estimated using two-dimensional echocardiography. Obtained data indicate, that in patients with chronic, congestive heart failure, a single dose of captopril lowers blood pressure at rest without significant changes of hemodynamic parameters, but improves left ventricular function during physical effort.

Adult↗
PubMed1989

[Evaluation of the effect of nifedipine in patients with chronic congestive heart failure].

18 patients with II NYHA class chronic congestive heart failure (CCHF) had been given nifedipine (Cordipin) 54.4 +/- 12.0 mg (day) for 6 weeks (group I). In 25 patients with III--IV NYHA class CCHF after 2-week optimal improvement of a clinical state with digoxine (D) and furosemide (F), nifedipine (N) had been added for 2 weeks/mean daily dose -- 40.8 +/- 12.8 mg (group II). Estimation of a left ventricular function using 2-DE and a submaximal effort tolerance as well as clinical examinations were carried out initially, after 2 and 6 weeks in group I, whereas in group II post D, F 2-week therapy and after next 2 weeks of combined D, F, N treatment. Nifedipine significantly increased ejection fraction from 44.2 +/- 13.0% to 49.0 +/- +/- 12.6% and decreased myocardial oxygen demand factor from 23.36 +/- 9.81 to 21.08 +/- 7.55 X 10(3) (p less than 0.05). Nonsignificant but marked increase of diuresis, cardiac and stroke indices as well as body weight loss were observed. Nifedipine addition to D and F neither improved nor deteriorated examined parameters in patients with III-IV NYHA class CCHF. Nifedipine did not also improve the submaximal exercise tolerance in both groups.

Adult↗
PubMed1983

Effect of blood withdrawal on the left ventricular systolic time intervals at rest and during prolonged recovery following submaximal exercise.

0.40 1 of full blood were withdrawn from 18 males aged 19-23. One day before withdrawal, one hour and 24 h after withdrawal the subjects performed a 10-min exercise on a Monark bicycle ergometer with a load producing heart rate acceleration up to 170/min. At rest and in the course of 120-min post-exercise recovery ventricular systolic time intervals were investigated using the method of Weissler. Immediately after blood withdrawal and one hour later the authors observed a decreased left ventricular ejection time index (LVETI), increased pre-ejection period (PEP), and increased isovolumetric contraction time (ICT), as well as increased PEP/LVET ratio. In the course of recovery following exercise performed one hour after withdrawal the LVET value was lower, and the values of PEP, ICT and PEP/LVET ratio higher than those obtained after identical exercise performed before withdrawal.

Adult↗
PubMedDate not supplied

[Effect of using nifedipine by patients with chronic congestive heart failure treated with digoxin and furosemide].

Nifedipine was administrated to 25 patients with chronic congestive heart failure treated with digoxin and furosemide++, nifedipine (NF) in a daily dose of 30-80 mg for 14 days. Before and after the treatment with nifedipine chest X-ray, blood biochemical investigations, echocardiographic evaluation of the left ventricular function and submaximal exercise test were performed. Nifedipine induced significant decreases in the left ventricular systolic dimension, heart volume, blood serum potassium and uric acid concentrations and hematocrit . Resting and exertional heart rate, blood pressure, exercise power and duration, watt-pulse, myocardial oxygen demand index, ejection fraction, cardiac output, body weight, 24-hour urinary output, blood serum concentrations of urea, creatinine, sodium and chloride changed insignificantly following nifedipine administration. The obtained results suggest that long-term nifedipine treatment of patients who were already given digoxin and furosemide neither improve nor worsen their clinical status.

Adult↗