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Biomedical subjects

T Petelenz

Publications and source records attributed to T Petelenz.

At least 19 recordsLinked to original sources
PubMed2001

[The physical capacity of men with ischaemic heart disease after cardiac rehabilitation].

The aim of the study was the evaluation of physical capacity of cardiovascular system and the ability to perform permitted exercises in a group of 114 patients who underwent pharmacological or surgical treatment of ischaemic heart disease and subsequently were submitted to 12 month lasting cardiac rehabilitation. Rehabilitation programme comprised hospital, sanatorium and ambulatory periods. The control group comprised 29 patients without changes in coronary arteries. All patients underwent treadmill test, according to Bruce protocol. The efficacy of rehabilitation was estimated in the particular groups regarding to the method of treatment. 143 men, were enrolled in the study in following groups: A--patients with the history of myocardial infarction (MI) treated pharmacologically (n = 29) B--patients with the history of MI after surgical treatment (n = 29) C--patients without MI after surgical treatment (n = 28) D--patients without MI treated pharmacologically (n = 28) K--control group (n = 29). All men in groups A, B, C completed cardiac rehabilitation programme. The highest level of physical capacity was observed in group of operated (CABG) patients. Patients treated pharmacologically reached significantly lower level of physical capacity.

Adult↗
PubMed2000

Cardiac sympathovagal balance during endoscopic retrograde cholangiopancreatography.

BACKGROUND AND STUDY AIMS: Cardiopulmonary complications have been reported during upper gastrointestinal endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to evaluate the sympathovagal response to the stretching of the common bile duct caused by contrast medium injection during ERCP. PATIENTS AND METHODS: The 16 patients included in the study were assigned to two groups according to the size of common bile duct. Group A consisted of patients with normal-sized bile ducts, while Group B patients had dilated common bile ducts. The heart rate variability (HRV) technique was used to assess the sympathovagal balance. The HRV data were gathered using the Holter technique, and frequency domain analysis revealed two main spectral components of HRV: low frequency (LF) and high frequency (HF). RESULTS: In patients with normal-sized bile ducts, contrast injection initiated a rapid increase in the power spectra (ms2) of both the HF and LF components. In patients with dilated common bile ducts, this phenomenon was not observed. CONCLUSIONS: During ERCP, contrast injection into a dilated common bile duct does not stimulate the autonomic nervous system in the same way as it does when the common bile duct is of normal size.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1999

[The evaluation of the coronary artery sufficiency in myocardial infarction patients after cardiac surgery and preventive therapy].

During 5 years period (1989-1993) the authors investigated a group of 40 patients with coronary artery disease after myocardial infarction treated in the Silesian Center of Cardiology in Katowice. 20 patients were operated on (CABG), 20 were medically-treated. It was evaluated the history, physical status, stress-test, echocardiography and 24-hours ECG. Stress test was estimated according to Mark's test. In the echocardiographic examination it was observed wall motion score index (WMSI) and the left ventricular abnormal contraction area (AA). In the operated group it was noticed higher physical ability and no influence of CABG on left ventricular contractability.

Adult↗
PubMed1999

[Importance of respiration for non-invasive assessment of cardiac autonomic control in patients with ischemic left ventricular dysfunction].

UNLABELLED: Respiratory rate is an important factor influencing heart rate variability (HRV), but is usually ignored in the studies in patients with ischaemic heart disease (IHD). This factor may significantly contribute to the changes in HRV in ischaemic left ventricular impairment. We examined 186 patients with IHD (46 females, 140 males), including 54 pts with left ventricular ejection fraction < 40% and 132 pts with preserved LVEF (> or = 40%). HRV was evaluated in supine and standing position from short-term ECG (512 beats, 1 kHz, 12 bit) in time- (mean RR interval--RRI, and standard deviation of RRI-SD-RR) and frequency-domain (FFT). Power spectral density of high and low frequency (HF 0.14-0.5 and LF 0.04-0.15 Hz) was estimated and expressed as log-values. The frequency of respiration (fResp, Hz) was defined as the frequency of maximum HF power. RESULTS: Patients with LVEF < 40% had shorter RRI in supine (879 + 157 vs 942 +/- 147 ms, p < 0.05), but similar in standing. FResp was greater both in supine (0.308 +/- 0.05 vs 0.274 +/- 0.047 Hz) and in standing (0.329 +/- 0.055 vs 0.274 +/- 0.047, all p < 0.001) in low, as compared to preserved LVEF. As expected, HRV parameters were more reduced in LVEF < 40%. The differences of raw values were as follows: SD-RR 29 +/- 16 vs 34 +/- 15 i 27 +/- 13 vs 31 +/- 12 ms, both p < 0.05, HF 3.21 +/- 0.36 vs 3.33 +/- 0.32, p < 0.05 and 3.19 +/- 0.32 vs 3.21 +/- 0.29 p > 0.1, LF 3.41 +/- 0.33 vs 31.49 +/- 0.30 and 3.52 +/- 0.30 vs 3.61 +/- 0.32, p < 0.05, ANOVA). The differences were observed despite adjustment for age, sex and RRI. When fResp was added as covariate they became not significant. CONCLUSION: Patients with left ventricular dysfunction had faster rate of respiration. This finding may explain, in part, reduced HRV in these patients. The rate of respiration should be taken into account for correct interpretation of HRV analysis.

Autonomic Nervous System↗
PubMed1998

[The dipyridamole test in coronary disease diagnosis].

One of the coronary disease diagnostic methods of big sensitivity and specificity is perfusive effort scintrigraphy of myocardium by means of thallium-201. For few years the dipyridamole test has been applied instead of the effort test. Perfusive scintigraphy of myocardium after provocative treatment by means of dipyridamole and then selective coronary arteriography of coronary vessels, have been carried out at 25 patients with ischemia. These studies showed almost 100% of conformability with exposing the ischemia zones in scintigraphy and coronary arteriography in cases of coronary vessels contraction over 50%. The dipyridamole test also revealed the ischemzones in myocardium that are in agreement with coronary vascularization deficiency. That test can be utilized in revealing the coronary disease and is helpful in qualifying patients for coronary arteriography. At the same time studies that have been carried out prove that applying dipyridamole is absolutely contraindicated in treating of coronary disease of the organic background.

Adult↗
PubMed1998

Self--administered cough cardiopulmonary resuscitation (c-CPR) in patients threatened by MAS events of cardiovascular origin.

Sudden cardiac death caused by cardiac arrhythmia's or asystolies in patients with coronary heart disease can often be avoided if resuscitation is administered immediately, preferably before the patient loses consciousness. In cases when rapid help is not available usually death occurs. We have studied a method of cardiopulmonary resuscitation (CPR) which can be self--administered by patients trained in recognizing imminent arrival of life-threatening Morgani Adams Stokes (MAS) events. The recent study comprised the three methods of investigation in three separate groups of patients: the first group underwent invasive procedures (20 pts), the second non invasive Doppler studies (31 pts) and the third in-and outhospital clinical observations (115 pts). The results indicate that evoked coughing can effectively prevent fainting and maintaining consciousness until conventional CPR help becomes available.

Adult↗
PubMed1997

[Transient ST segment elevation after electrical cardioversion of atrial fibrillation].

In 50 patients (30F, 20M), aged 47 +/- 8 who underwent artificial heart valve implantation, the transient ST segment elevation (uST) of at least 0.1 mV on ECG immediately after electrical cardioversion (KE) of atrial fibrillation (MP) was evaluated. uST of 2 +/- 0.7 mV, lasting for 1.5 +/- 0.8 minutes was observed in 52% of cases (15F, 9M). Occurrence of uST correlated significantly with the following parameters: enlarged left atrium, high values of energy delivered during KE, history of more than cardiosurgical operation. Inversely, uST did not depend on duration of MP, efficacy of KE, BMI and the time span between the operation and KE.

Adult↗
PubMed1997

Pregnancy and delivery prognostic risk score for women with congenital heart disease and acquired valvular heart disease.

Hemodynamic changes related to pregnancy in women with Congenital Heart Disease (ConHD) or Acquired Valvular Heart Disease (AVHD) require special medical care during pregnancy and especially immediately prior to, and after delivery. Following a five year retrospective study (1978-1982), the authors monitored prospectively over a period of 12 years (1983-1994), 378 pregnancies in 252 women with ConHD and AVHD. Based on the results of the initial clinical examination and monthly follow-up visits, a numerical risk score was assigned for each patient. The study showed good conformity between the predictive risk score values and the patient's condition in the course of pregnancy and delivery. Thus, this method represents a novel and potentially very useful clinical tool for management of pregnancy in patients with ConHD and AVHD.

Abortion, Spontaneous↗
PubMed1996

[Silent myocardial ischemia before and after revascularization].

In 82 patients with unstable ischemic heart disease (IHD) before and after revascularisation (percutaneous transluminal coronary angioplasty-PTCA-in 11 patients and coronary artery bypass graft-CABG-in 71 patients) silent ischemia incidence was observed. In these patients before and after operation election fraction (EF) and wall motion score index (IK) were compared echocardiographically as well as physical ability according to Bruce protocol in treadmill exercise test. Data (EF and IK and exercise test) before and after operation didn't change significantly. Silent ischemia was directed before operation in 17 patients (21.8%) and in 15 patients (19.4%) one month after those procedures.

Adult↗
PubMed1996

[Qualifying patients with unstable angina for invasive tests based on electrocardiographic examinations].

In 40 patients with unstable angina pectoris a variety of electrocardiographic parameters were analysed. In all patients routine ECG, signal averaged high resolution ECG. 24 hour ECG recordings and heart rate variability analysis were performed at admission and repeated at 7 day of hospitalization. During second week patients underwent also exercise treadmill test. On basis of clinical presentation each patient was qualified to invasive investigation, 31 patients had need for urgent cardiac catherization (group I-urgent indications) and in the remaining 9 patients cardiac catherization was performed 3 months after the relief of acute symptoms (group II-non-urgent indications). The most impressive implications were draw from repeated 24 hour Holter ECG monitoring. In patients with urgent indications (gr. I) more frequent and severe ischemic episodes, as well as more frequent ventricular arrhythmias were observed. Patients from group I were unable to achieve higher grades on exercise treadmill test, while ST segment depression was comparable in both groups. Heart rate variability analysis showed greater disturbances of cardiac vagal control in group I. The number of critically stenosed vessels was similar in both groups, however left ventricular systolic dysfunction was observed mainly in patients with urgent indications for cardiac catherization.

Adult↗
PubMed1995

Heart rate variability. Is it influenced by disturbed sinoatrial node function?

Analysis of heart rate variability (HRV) is commonly used to assess the influences of the autonomic nervous system on the heart; however, its relation to the sinoatrial node function has not been clearly defined. In this study, the authors performed HRV investigations in 150 patients (51 women and 99 men; mean age, 49 years; range, 17-80 years) in whom clinical observation and electrophysiologic transesophageal studies proved sinoatrial node dysfunction (SAND) and in 50 healthy control subjects (19 women and 31 men; mean age, 37 years; range, 15-60 years). All examined subjects underwent transesophageal left atrial overdrive pacing for the evaluation of sinus node recovery. The HRV analysis was based on 1-minute esophageal electrocardiographic recordings. Two time-domain HRV variables were measured: variability range ([VR]) the difference between the longest and the shortest sinus cycle length, divided by basic sinus cycle length) and beat-to-beat variability ([DSCL]--the maximum difference between any two consecutive sinus cycle lengths) during a 1-minute recording. Because of the known effects of age and basic sinus cycle, statistically adjusted means of VR and DSCL were compared. In patients suffering from SAND, DSCL was significantly higher than in the control subjects (198 +/- 206 vs 98 +/- 89 ms, respectively), as was VR (30.3 +/- 23.3% vs 20.9 +/- 121.1%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Analysis of heart rhythm variability in evaluation of treatment for unstable angina pectoris].

Unstable angina pectoris is accompanied by several unfavourable autonomic disturbances. A noninvasive assessment of the autonomic cardiac control is possible by means of heart rate variability analysis (HRV). 26 patients with unstable angina pectoris were enrolled in the study. All patients received obligatory nitroglycerin and heparin intravenously within two days, and gallopamil (G) or metoprolol (M) together with aspirin or ticlopidine orally randomly, which were continued for 3 month or shorter if coronary revascularization was earlier performed. 512 R-R intervals was registered in each patient at 7th day of hospitalization and in 14th at the time of admission. Kardioassist v.1.0 system was used for heart rate variability analysis. After analog to digital conversion, with 12 bit resolution and 1000 Hz of sampling rate, seriogram of R-R intervals was obtained, and then power spectrum density was computed with the Fast Fourier Transform. Time-domain analysis provided mean (basic) R-R interval (BCL) and its standard deviation (SD-RR). In frequency-domain the following spectral variables were analysed: power spectral density (s2/Hz) of the high frequency component (aHF, 0.15-035 Hz), low frequency component (aLF, 0.05-0.15 Hz) and very low frequency component (aVLF, 0.004-0.05 Hz), percentage power of respective components (%HF, %LF and %VLF) and autonomic balance indices: aLF:aHF and %LF:%HF. These variables were compared in patients treated with G (13 patients) against those with M (13 patients). Additionally, the effects of treatment regimen was evaluated also in 14 patients, in whom HRV analysis was performed at admission and 7 days later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Gutron treatment of patients suffering from essential orthostatic hypotony. Part One--Hemodynamic non-invasive investigation.

Essential orthostatic hypotony (EOH) seems to present a rarely occurring and not well recognized syndrome. Group of 20 patients (pts) with EOH were treated with midodrine (Gutron, Gu) 5 mg i.v. Non-invasive hemodynamic variables, such as systolic time intervals and their derivates, based on polycardiographic recordings, were analysed. Heart rate and blood pressure measurements during orthostatic test were measured before and after Gu administration. The results of the orthostatic trial were compared to the control group of 20 volunteers. In healthy subjects, up-right position resulted in heart rate (HR) acceleration, diastolic blood pressure (DBP), total peripheral resistance (TPR), double and triple product (DP, TP), contraction coefficient (PEP/LVET) and dicrotic coefficient ('d') elevation, prejection period (PEP), electromechanical delay (QS1) and isovolumic contraction time (ICT) prolongation and lastly stroke volume (SV), cardiac output (CO) and middle rate of left ventricle ejection time (MRLVET) reduction. Patients with EOH showed a reduction of the degree of tilt-induced changes of the parameters. DBP fell down. After Gu these unfavourable changes were corrected to the values nearer the control group levels in three compensatory mechanisms. After Gu application in EOH-pts were seen: 1) favourable translocation of the resting (supine) values, but with the same reactivity to tilt, as before Gu (HR, TPR); 2) positive influences on orthostatic reaction, but inversely without any changes of resting values (PEPI, ICT, PEP/LVET, DP, DBP) and finally 3) favourable translocation of resting values together with inversed orthostatic reaction (SBP, QS2,TP). We stated clinical valuable efficacy of Gu. Gu influenced mainly the initial state of circulatory hemodynamics in resting and also in a lower degree in orthostatic reaction.

Adult↗
PubMed1993

Gutron treatment of patients suffering from essential orthostatic hypotony. Part Three--Hemodynamic-autonomic interactions.

In this communication neurovegetative investigation of circulatory system in essential orthostatic hypotony (EOH) is continued. Our previous polycardiographic and heart rate variability (HRV) studies showed, that hemodynamic alterations in EOH are concerned with impairment of both branches of autonomic system. But hemodynamic-autonomic interactions in EOH are till now not well recognized. Therefore, in group of 9 patients (pts) with EOH we performed a study before and after midodrine (Gutron, Gu) 5 mg i.v. treatment. Sympathovagal balance, based on heart rate variability (HRV), was analysed in orthostatic trial. Hemodynamic parameters such as: heart rate (HR), systolic and diastolic blood pressure (RRs and RRd), as well as double product (DP) were measured in resting and after tilt. Simultaneously, on basis of computer-assisted tachograms standard deviation of 512 sinus cycles lengths (SD-SCL) was calculated and on basis of power spectral analysis by means of fast Fourier transform, the following variables: amplitudes (absolute powers) of high (aHF, 0.15-0.35 Hz) and low frequencies (aLF, 0.05-0.15 Hz) spectra, percentage powers of HF and LF spectra (%HF, %LF) and their ratio, named vegetative control coefficient (VCC, %LF:%HF). The results were compared to the control group (18 healthy volunteers). We found in EOH-pts significant correlation between aLF and resting HR, whereas after Gu this correlation disappeared and made the reaction of these pts similar to the control subjects, in which these correlations didn't appear. Resting RRs and RRd negatively correlated with aLF in controls, while in EOH-pts this relations were inverse i.e. positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Metastatic neoplasms of the heart].

Two cases are presented of metastatic neoplasm of the heart easy for echocardiographic diagnosis. One infiltrated the pericardium with encapsulated fluid (visible also on X-ray), and the other was associated with filling of the right atrial lumen.

Adenocarcinoma↗
PubMed1993

[Leukemic changes in the myocardium of a patient with acquired valvular heart disease].

A rare case is described of extensive myocardial infiltrations during myeloid leukaemia in a patient with coexistent valvular heart disease, and active inflammatory process in the endocardium. The coexistence of these diseases caused even greater diagnostic difficulties. This case shows also that differential white blood cell sound should not be disregarded in cardiovascular diseases.

Adult↗