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Biomedical subjects

Tadeusz Mandecki

Publications and source records attributed to Tadeusz Mandecki.

8 recordsLinked to original sources

Tilt table testing in obesity.

INTRODUCTION: An imbalance between the sympathetic and parasympathetic nervous systems has been indicated in obesity. The aim of the present study was to evaluate the results of tilt table testing (TT) in obese patients. METHODS: 59 patients with simple obesity (F/M: 50/9; BMI: 36.9+/-3.9 kg/m(2)), and 19 healthy subjects of the control group (F/M: 16/3; BMI: 24.7+/-4.3 kg/m(2)) were examined. Additionally, TT was carried out in 11 patients from the obese group after a 3-month weight reduction treatment. We evaluated HR (heart rate), SBP (systolic blood pressure), DBP (diastolic blood pressure): values at rest, post-inclination values (HRt-1, SBPt-1, DBPt-1), differences between the maximum and minimum values as obtained on TT (HRt-range, SBPt-range, DBPt-range), and % differences of HR (%HRt-increase, %HRt-decrease, %HRt-range). RESULTS: A positive TT response was observed in 10 obese patients, and in none of the controls. Higher differences of HR values were observed in the obese (P<0.05) in comparison to control group. Patients with a positive TT response presented a significant increase in HRt-1, HRt-range, and %HRt-range when compared to negative TT and controls (P<0.02). A 3-month weight reduction treatment resulted in a decrease in HR at rest, and decrease in SBP and DBP-both rest values and values after table-inclination. CONCLUSIONS: A positive TT response is observed more often in patients with simple obesity. HR reaction to tilting varies between the patients and controls. A 3-month weight reduction treatment influences the cardiovascular response to tilting. Our results seem to support the hypothesis of autonomic imbalance in obesity.

Adult↗

Hyperlipidaemias and serum cytokines in patients with coronary artery disease.

OBJECTIVE: The inflammatory processes as well as the lipid disturbances play an important role in the pathogenesis of atherosclerosis. The aim of the study was to evaluate the influence of the hyperlipidaemias on serum levels of tumour necrosis factor (TNF) alpha, the soluble form of TNF receptor (sTNFR) 1 and 2, Interleukin (IL)-10 in patients with stable coronary artery disease (CAD). METHODS AND RESULTS: The study group comprised 94 consecutive admissions with stable CAD: 39 patients with hypercholesterolaemia (group HC), 22 patients with mixed hyperlipidaemia (group HL) and 33 patients with normal lipids (group NL). Twenty healthy volunteers were the controls (group C). Serum TNFalpha levels were higher in all CAD groups (p < 0.001) than in healthy subjects. Mean serum concentrations of sTNFR 1 were significantly higher in group NL (p < 0.05) in comparison both to group HC and controls. IL-10 levels were higher in group HC than in controls (p < 0.5). In all CAD patients TNFalpha showed a negative correlation with HDL-cholesterol (p < 0.001) and a positive correlation with triglycerides (p < 0.00 1). Moreover, sTNFR 1 and IL-10 showed a negative (p < 0.05) and sTNFR 2 a positive correlation with LDL-cholesterol (p < 0.001). CONCLUSIONS: CAD patients are characterized by increased serum concentrations of TNFalpha. It seems likely that immune activation (TNFalpha, sTNFR 1, sTNFR 2, and IL- 10) in CAD patients is related to serum lipids levels.

Body Mass Index↗

Serum levels of selected adhesion molecules in patients with coronary artery disease.

BACKGROUND: Adhesion molecules have been suggested as mediators of atherosclerotic inflammatory process. They may contribute to the pathogenesis of stable and unstable angina. METHODS: The study group consisted of 59 patients with coronary artery disease: 27 patients with stable exertional angina (group A), 32 patients with unstable angina (group B). 20 healthy persons acted as controls (group C). Serum levels of soluble Intercellular Adhesion Molecule 1 (sICAM-1), Vascular Cell Adhesion Molecule 1 (sVCAM-1), sE-selectin, sP-selectin were measured both before and after the treadmill ECG stress test in groups A and C. In group B the measurements were carried out at 6, 24, and 48 hours following an episode of chest pain. RESULTS: There were no differences between the baseline serum levels of adhesion molecules as determined in groups A and C. In patients with stable angina, the post-exercise concentrations of sE-selectin were significantly higher (68.8+/-29 ng/ml) in comparison to both baseline- (38.7+/-15 ng/ml), and group C-values (pre-exercise: 35.1+/-16; post-exercise: 49.9+/-15 ng/ml). In unstable patients, serum sP-selectin (190.1+/-99 ng/ml) and sVCAM-1 levels (1359+/-299 ng/ml) were higher when compared to those found in groups A (142.3+/-24; 962+/-352 ng/ml, respectively) and C (136.4+/-33; 851+/-168 ng/ml, respectively). CONCLUSIONS: Serum levels of soluble adhesion molecules in patients with stable angina are comparable to those of healthy persons. Stress test-induced increase of sE-selectin concentration may reflect endothelial response to exercise. Unstable angina is characterized by significant elevation of sP-selectin and sVCAM-1 serum levels which seems to be related to enhanced platelets and leukocytes activation.

Aged↗

Selected cytokines and soluble forms of cytokine receptors in coronary artery disease.

Background: Cytokines may play a role in the pathogenesis of atherosclerosis and coronary artery disease (CAD). Methods: We examined serum concentrations of selected pro- (TNFalpha, IL-2) and anti-inflammatory (IL-10) cytokines, and soluble forms of TNF receptors (sTNFR 1 and sTNFR 2) by ELISA in 45 patients with stable exertional angina (group 1), 32 patients with unstable angina (group 2), and 20 healthy subjects (group C). Results: Serum concentrations of both TNFalpha (group 1, 18.3; group 2, 17.2 pg/ml; P<0.001) and IL-10 (group 1, 46.1; group 2, 41.5 pg/ml; P<0.05) were significantly higher in patients with CAD than in group C (8.3 and 14.3 pg/ml, respectively). sTNFR 1 serum level was higher in group 1 (1399.6; P<0.05) than in healthy volunteers (1093.9 pg/ml). In turn, the serum level of IL-2 was significantly higher in unstable patients than it was in groups 1 and C (89.4, 59.8 and 52.8 pg/ml, respectively). In group 1, both TNFalpha and IL-2 correlated with serum lipids. Conclusions: Patients with CAD, irrespective of the form of the disease, have higher serum levels of pro- and anti-inflammatory cytokines than control subjects. Increased concentrations of IL-2 in unstable angina may suggest additional immunologic activation. The pro-inflammatory cytokine levels seem to be related to lipid disturbances.

Journal Article↗

Is there a relationship between left ventricular systolic function and serum cytokines level in patients with coronary artery disease?

BACKGROUND: There is growing evidence that cytokines play a pathogenic role in both heart failure and atherosclerosis. The aim of our study was to assess serum levels of selected cytokines and soluble forms of receptors in patients with coronary artery disease (CAD), and the relation between these concentrations and left ventricular (LV) systolic function. MATERIAL/METHODS: We measured serum levels of TNFalpha, sTNFR 1 and 2, IL-2, and IL-10 in 100 patients with CAD: 70 patients with LV regional wall motion disturbances (group A); and 30 patients with normal LV function (group B). The control group (group C) consisted of 20 healthy volunteers. RESULTS: Mean serum TNFalpha and IL-10 concentrations were significantly higher in groups A (18.3 +/- 3.5; 55.4 +/- 118.5 pg/ml) and B (17.9 +/- 4.9; 45.3 +/- 76.8 pg/ml) than in controls (8.3 +/- 1.4, p<0.001; 14.3 +/- 28.5, p<0.05; respectively). Moreover, in group A serum levels of sTNFR 1 were higher (1367.4 +/- 531.1 pg/ml) than in group C (1093.9 +/- 456.9 pg/ml; p<0.05). No differences were found in the study groups between serum sTNFR 2 and IL-2 levels. In group A, both the LV ejection fraction and motion score index correlated with TNFalpha (r=-0.277; r=0.282; p<0.05), and sTNFR 1 levels (r=-0.258; r=0.280; p < 0.05). CONCLUSIONS: The serum concentrations of TNFalpha and IL-10 are increased in patients with CAD. Additionally, patients with impaired LV contractility have higher sTNFR 1 concentrations. Serum cytokine activation may play a role in the development of heart failure in patients with CAD.

Case-Control Studies↗

[QT dispersion and characteristics of left ventricular hypertrophy in primary hypertension].

UNLABELLED: The aim of the study was to evaluate the QT dispersion and the severity of arrhythmias in hypertensive patients according to the asymmetry of the left ventricular hypertrophy. The study group consisted of 47 hypertensive patients. In 24 of them the left ventricular hypertrophy was symmetrical (group I) and in 23--asymmetrical (group II). For the evaluation of the left ventricular hypertrophy its thickness was analyzed in 13 segments. The ratio between the maximum and minimum thickness from any location was determined as the asymmetry index (AI). The value of this index 1,3 distinguished between patients with the symmetrical and asymmetrical left ventricular hypertrophy. 20 healthy subjects were examined as a control group (group III). All subjects underwent physical examination, the standard 12-lead electrocardiogram (ECG), twenty-four hour Holter recording and echocardiography. All the results for the QT dispersion (QTd, QTdc, QTdR) were highest in group II, lower in patients from group I and the lowest were observed in the control group. The differences in all parameters between group I and II were statistically significant: for QTd--V p < 0.01, QTdc--p < 0.05, QTdR--p < 0.05. The differences between groups II and III as well as I and III were statistically significant for all QT dispersion parameters: for QTd--p < 0.001 and p < 0.01 respectively, QTdc--p < 0.001, QTdR--p < 0.001 for both groups. We have observed a very distinct positive correlation between the asymmetry index and QTd, QTdc, QTdR (p < 0.001). These values correlated also, but less distinctly with the left ventricular mass index--LVMI (p < 0.05). The frequency and severity of ventricular ectopic beats did not differ significantly between group I and II. The results obtained indicate the lack of connection between the frequency of ventricular premature complexes and (1) all QT dispersion parameters, (2) LVMI, (3) AI. Supraventricular premature complexes occurred significantly more frequently in patients with the asymmetrical left ventricular hypertrophy compared to the group with the regular left ventricular hypertrophy (p < 0.05) and control group (p < 0.01). CONCLUSIONS: The left ventricular hypertrophy in primary hypertension may increase the QT dispersion. It seems that asymmetry of the left ventricular hypertrophy reinforces this increase. The increased QT dispersion in primary hypertension does not influence significantly the occurrence of ventricular arrhythmias.

Adult↗

[Atrial fibrillation in patients after coronary artery bypass grafting: the role of autonomic nervous system].

In 42 patients the 24-hour ECG was performed before and on the fifth day after the elective coronary artery bypass grafting. In general 34 bouts of atrial fibrillation occurred in 14 patients. According to frequency analysis of the HRV 23 (67.6%) of these paroxysms were found sympathetically driven, 6 (17.6%) vagally driven and 5 (14.7%) undefined. The predominating role of adrenergic activation in the initiation of the bouts of atrial fibrillation in this group of patients suggests the need to use adequate doses of beta-adrenolytic agents during the perioperative period of ischaemic heart disease treatment.

Adult↗