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Walerian Piotrowski

Publications and source records attributed to Walerian Piotrowski.

10 recordsLinked to original sources
PubMed2006

Characterization of insomnia in patients with essential hypertension.

INTRODUCTION: Insomnia may increase risk of cardiovascular events. There is little data available reporting the prevalence and clinical relevance of insomnia in patients with essential hypertension. Therefore, the aim of the study was to investigate the relationship between insomnia and different clinical and biochemical parameters in essential hypertension patients. METHODS: Four hundred and thirty-two patients (mean age 47+/-13 years; 253 male, 179 female) with essential hypertension were screened for insomnia using the athens Insomnia Scale (AIS). Several variables including age, sex, known duration of hypertension, body mass index, creatinine, left ventricular mass index, coexisting disorders, smoking status and alcohol use were analysed. Twenty-four-hour ambulatory blood pressure measurements (ABPM) were performed. RESULTS: Among patients included in the study, 207 subjects (mean age: 49+/-13 years; 47.9%) had an AIS score of 15 or higher and were identified as insomniacs. Insomnia was more frequent in women than in men (60.9% vs 38.7%, p<0.001) and was reported more frequently in patients with coronary artery disease. Subjects with insomnia were older and had longer duration of hypertension. There were no differences between insomniacs and non-insomniacs in ABPM parameters. A relationship was found between the number of antihypertensive drugs and insomnia frequency. There were correlation between AIS score and age (r=0.21; p<0.001) and duration of hypertension (r=0.22; p<0.001). In the sub-group of untreated essential hypertension patients, there were negative correlations between AIS score and night fall in systolic and diastolic blood pressure. CONCLUSION: Our results showed that insomnia is common in patients with essential hypertension and indicate an association between insomnia and gender, known duration of hypertension and number of hypertensive drugs taken. Untreated essential hypertension insomniacs were characterized by less pronounced nocturnal fall in both systolic and diastolic blood pressure compared with non-insomniacs.

Adult↗
PubMed2006

Did favourable trends in food consumption observed in the 1984-2001 period contribute to the decrease in cardiovascular mortality? - Pol-MONICA Warsaw Project.

AIM: To compare food consumption trends (1984-2001) with cardiovascular mortality trends (1984-2002) in an adult population of right-bank Warsaw residents and establish the delay between dietary changes and mortality reduction. METHODS: Cardiovascular mortality rates for the 1984-2002 period, calculated based on the Central Statistical Office data and the results of individual evaluation of nutrition patterns in 4 independent Pol-MONICA cross-sectional studies (1984, 1988, 1993 and 2001) were analysed. RESULTS: The cardiovascular mortality rate in right-bank Warsaw inhabitants tended to increase until 1991, and then a decline was observed -- in 2002 in comparison to 1991 the mortality rate in both genders decreased by over 50%. From 1984 to 2001 a significant decrease in the following dietary factors was found: total energy intake, dietary cholesterol, and Keys score reflecting atherogenicity of the diet and animal fats. In contrast trends of vegetable fats intake increased. The favourable changes in the dietary habits of Warsaw inhabitants were correlated with the reduction of cardiovascular mortality (R2 within the range of 0.35-0.95), and the strongest relationship between these facts occurred after 7 years. CONCLUSIONS: A positive tendency observed with respect to nutrition patterns of right-bank Warsaw inhabitants contributed to the reduction of cardiovascular mortality.

Adult↗
PubMed2006

Endothelium-dependent acetylcholine-induced vasodilatory response of saphenous vein grafts.

INTRODUCTION: It has been suggested that endothelial dysfunction is critical to saphenous vein graft (SVG) occlusion. AIM: To evaluate in vivo endothelium-mediated vasoreactivity in angiographically non-stenotic SVG. METHODS: The group consisted of 31 patients (pts), aged 58.7+/-8.7 years, 54+/-38 months after coronary bypass surgery. In each patient one angiographically normal SVG was selected for the study. Endothelium-dependent vasoreactivity was investigated with acetylcholine (Ach) 50 microg intragraft infusion. Graft diameter changes were measured by quantitative computer angiography (QCA). RESULTS: In 17 (54.8%) pts there was a significant reduction in graft diameter following Ach infusion, from 3.8+/-0.7 to 3.2+/-0.7 mm (p=0.0001), whereas in 4 (12.9%) pts there were no diameter changes (3.2+/-0.7 mm). In the 10 remaining pts (32.3%) we found graft dilatation from 3.5+/-0.5 mm to 3.9+/-0.5 mm (p=0.0002). In multivariate linear regression analysis, SVG dilatation positively correlated with a low ratio of graft/artery diameter (p <0.002), high HDL-cholesterol level (p <0.001) and absence of hypertension (p <0.03), and negatively correlated with postoperative myocardial infarction (p <0.01). CONCLUSIONS: Endothelium-dependent vasodilatory response to Ach is present in one third of old SVG. Dilative response to Ach 50 is better preserved in SVG with smaller difference between graft/grafted artery diameters. Adequate matching of the graft/grafted artery diameters probably preserves the endothelium-dependent dilative response of the graft.

Acetylcholine↗
PubMed2004

Is the assessment of lipid profile performed up to seventy two hours from hospital admission due to acute coronary syndrome still valid?

BACKGROUND: Serum concentration of lipids and lipoproteins changes during the course of acute coronary syndrome (ACS). Total cholesterol and LDL-cholesterol levels decrease. Also HDL-cholesterol and triglyceride levels are not stable. Therefore, it has been suggested that reliable assessment of lipid profile can be performed either during the first 24 hours or after 6 weeks or even 3 months from the onset of ACS. AIM: To examine whether lipid parameters remain stable during the first 72 hours of hospitalisation due to ACS. METHODS: The study group consisted of 84 patients, aged 30-88 years, hospitalised due to ACS, of whom 90% underwent primary percutaneous coronary intervention (PCI). In all patients lipid profile was assessed twice. The first measurement was performed as soon as possible, within 24 hours from hospital admission. The second measurement was obtained within 24 hours from the first sample (group I, n=42), between 24 and 48 hours (group II, n=28), or between 48 and 72 hours (group III, n=15) from the first measurement. Lipid parameters obtained from the first measurement were compared with those obtained during the second assessment. RESULTS: There were no significant differences between lipid parameters measured during the first and second measurement within all three investigated groups nor were there any significant inter-group differences. CONCLUSIONS: Lipid profile assessed within 72 hours from the hospital admission due to ACS is as valid as the measurement performed within the first 24 hours.

Acute Disease↗
PubMed2003

Familial dilated cardiomyopathy: evidence for clinical and immunogenetic heterogeneity.

BACKGROUND: There is increasing awareness of the familial nature of dilated cardiomyopathy (DCM). Mutations in the genes coding for cytoskeletal and sarcomere proteins have been identified. Phenotyping of familial DCM (FDCM) may help to improve genetic diagnosis. The aim of our study was to evaluate the clinical features, pattern of transmission, and immunogenetic data of FDCM. MATERIAL/METHODS: We obtained family histories in order to construct pedigrees and prospectively evaluated 204 family members of 27 patients with angiographically proven DCM. FDCM was defined as more than 1 person with DCM in a family. The study protocol included repeated clinical examination, electrocardiography, echocardiography and blood sampling. RESULTS: Among the families, we identified the following phenotypes: DCM with conduction defects (n=2), early onset DCM with a rapid course in male relatives (n=2), and DCM preceded by ventricular arrhythmia (n=1). The remaining families presented with a heterogeneous course of the disease. The disease was transmitted in an autosomal dominant fashion in 14 of our pedigrees, possibly X-linked in three and indeterminate in 10 sib-pairs. The frequency of the DRB1*04 allele was low in probands with the disease (3/20, 15%); heterozygozity for DRB1*03/DRB1*04, known to increase susceptibility to IDDM1, was identified in 2 of 20 DCM probands (10%). CONCLUSIONS: Familial dilated cardiomyopathy is a heterogeneous disorder; autosomal dominant transmission is most common. The distinct clinical phenotypes and specific immunogenetic features found in some families indicate that different pathogenetic mechanisms can lead to the

Adolescent↗
PubMed2003

[Are fluctuations in health status related to socioeconomic factors among the Polish population?].

INTRODUCTION: Several studies indicated that prevalence of ischaemic heart disease (IHD) rose with increasing wealth of the population and previously higher IHD prevalence was observed in the higher social strata. Later, the IHD prevalence was higher in lower social class because the higher social class faster followed the recommendation connected with IHD prevention. Currently, in majority of wealthy countries the higher IHD prevalence is connected with lower social class. To assess the relationship between analyzed social factors (social background, education of father and subject himself and character of activity at work), marital status and self evaluation of the health status on the one hand and on the other hand classical IHD risk factors and death both total and cardiovascular. The basis of analyses constituted the results of examined in 1984, 1988 and 1993 independent 3 random samples of Warsaw population aged 35-64 years, the study conducted within the framework of the Pol-MONICA Warsaw Project. The screened population was followed up to 1998 from the death and its cause point of view. To the lower social class were included persons with peasant or blue collar worker social background, subjects, whose father's or himself had not finished the elementary education, and whose employment required very heavy physical work. Separately the analysis dealt with marital status and self assessment of health status. The lower social class was characterized by higher BMI and higher prevalence of obesity, higher heart frequency, higher level of systolic, diastolic and pulse pressure as well as prevalence of hypertension and higher HDL-C level. Higher social class was characterized by higher height and higher prevalence of cigarettes smoking. Married persons were characterized by higher weight and height as well as BMI. Persons who evaluated health status as bad or poor had lower height but higher systolic, diastolic and pulse pressure as well as prevalence of hypertension than the reference characteristics. Regardless that 18 characteristics (social factors and classical risk factors) were introduced previously into the regression model to evaluate the risk of death, in female population only lack of employment and poor assessments of health status out of social factors increased the overall risk of death; the risk of cardiovascular death increased with higher level of education, employment required heavy physical activity, not--maried status and poor or bad evaluation of health status, while compared with risk of reference characteristics. Among men the overall risk of death was connected with blue collar type of work, widow or divorced status, employment required heavy physical activity and poor or bad evaluation of health status. The risk of IHD death was connected with widow or not--married status, education at least college and poor or bad assessment of health status. One should conclude that currently in Poland the higher risk of death began to be transferred to lower social class.

Adult↗
PubMed2003

[The role of vitamins and minerals supplementation in nutrition of urban and rural population--Pol-MONICA Project].

The assessment of nutritional supplement usage was studied in randomly selected population samples-1329 men and women from Warsaw and 1398 from former Tarnobrzeg voivodeship respectively. The use of vitamins/minerals supplement was reported by 20% men and 28% women from Warsaw and 8% and 17% from former Tarnobrzeg voivodeship respectively. Use of supplements was more frequent among persons with university education, full-time employment and people taking other medicines. The role of supplement usage was different in cases of minerals and vitamins. Calcium and magnesium were used in the doses not sufficient (5-15% total intake) to eliminate the risk of deficiency. Vitamins were taken in amounts much higher (40-80% total intake) than Recommended Dietary Allowances (RDAs). Among 6-19% people, doses of vitamins A and E 10-times exceeded the RDAs.

Adult↗
PubMed2003

Is the decrease of cardiovascular mortality in Poland associated with the reduction of global cardiovascular risk related to changes in life style?

BACKGROUND: After an ascending trend of cardiovascular mortality, which was observed up to the sixties, there was a declining tendency in western countries thereafter. The decrease in mortality rates in Poland has been noticed since 1991. There is an uncertainty whether this improvement in prognosis was only due to the improvement in health care level or was accomplished, to some extent, by population life style changes. AIM: To assess whether the decrease in cardiovascular mortality in Poland was accompanied by a simultaneous reduction in global cardiovascular risk profile. METHODS: The study was based on screened random samples from the Warsaw population aged 35-64 years, who were examined in the years 1984 (2646 subjects), 1988 (1433 subjects), 1993 (1539 subjects) and 2001 (853 subjects). The group evaluated in 1984 was followed up for 10 years with all fatal events recorded (364 deaths were registered including 166 cardiovascular deaths). The model of 10 years probability of total and cardiovascular death was developed, which was based on 11 risk factors (age, smoking cigarettes, systolic blood pressure, pulse pressure, ratio of total cholesterol/HDL-cholesterol, triglyceride, symptoms of coronary heart disease or heart failure, death of mother before 65 or death of father before 55 years due to myocardial infarction or stroke, energy in daily food intake and percentage of energy derived from saturated fatty acids). This model was applied to assess the probability of deaths between years 1984 and 2001, utilising data from screenings. RESULTS: The probability of death (in %) decreased from 1984 to 2001 by 11% in men. However, it remained stable for women. On the other hand the probability of cardiovascular death decreased by 25% and 33%, respectively. The main role in global risk decrease was played by beneficial trends in mean systolic blood pressure (in both genders) and percentage of smokers in men. CONCLUSIONS: Modification of life style influencing risk factors profile decreased the probability of death in the Warsaw population, correlating with changes in mortality rates.

Adult↗
PubMed2003

The C677T mutation in methylenetetrahydrofolate reductase gene, plasma homocysteine concentration and the risk of coronary artery disease.

BACKGROUND: The C677T mutation in methylenetetrahydrofolate reductase (MTHFR) gene is one of the causes of an elevated homocysteine plasma concentration and is probably one of the atherosclerotic risk factors. AIM: To assess the relationship between the presence of the MTHFR gene mutation, plasma homocysteine concentration and the risk of coronary artery disease (CAD). METHODS: The study group consisted of 120 consecutive patients (78% were male, mean age 59.2+/-9.6 years) with angiographically confirmed CAD and 106 healthy volunteers (76% were male, mean age 47.4+ or -6.0 years). The MTHFR gene mutation was detected based on the polymerase chain reaction and digestion with restrictive endonuclease HinfI. Total homocysteine plasma concentration was measured using HPLC. Folic acid and vitamin B12 plasma levels were assessed using the chemiluminescence method. Hyperhomocysteinemia was defined as homocysteine concentration > or =90 percentile of the control group which was > or =12.4 micro mol/L. RESULTS: The incidence of the mutation of allele T and the genotype TT was similar in patients and controls (51.7% vs 56.6%, and 9.2% vs 10.4%, NS, respectively). The folic acid and vitamin B12 levels were not related to the MTHFR genotype (folic acid: 8.1 ng/L in homozygotes TT vs 8.6 in heterozygotes CT and 8.3 in homozygotes CC; and vitamin B12: 273 pg/L vs 303.3 vs 314.3, respectively). Although homozygotes TT had significantly higher homocysteine concentration than heterozygotes and homozygotes CT or CC (15.4 vs 11.0 vs 11.2 micro mol/L, p<0.001), the odds ratio for CAD in genotype TT was 0.87 (95% CI 0.5-2.1, NS). The odds ratio in subjects with at least one mutated T allele was 0.82 (95%CI 0.5-1.4, NS). Homocysteine plasma concentration was significantly higher in patients with CAD than controls (12.8+/-5.1 vs 10.0+/-5.0 micro mol/L, p<0.001) and correlated significantly with folic acid (r= -0.28, p=0.0001), vitamin B12 (r= -0.19, p<0.005), age (r=0.35, p=0.0001) and creatinine (r=0.26, p=0.0001). The odds ratio for CAD in subjects with hyperhomocysteinemia was 7.1 (95%CI 3.4-14.9, p=0.001) and was 2.6 (95%CI 1.6-4.1, p=0.0001) with a homocysteine increase of 5 micro mol/L. Multivariate analysis showed that hyperhomocysteinemia was an independent risk factor of CAD (OR 2.7, 95%CI 1-7.2, p<0.05). Conclusions. Hyperhomocysteinemia rather than a mutation in the methylenetetrahydrofolate reductase gene, is an independent risk factor of coronary artery disease.

Adult↗