[Cardiac resynchronisation therapy with the use of epicardial lead placement--a case report].
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Cardiac Pacing, Artificial↗
Biomedical subjects
Wiktor Piechota
Publications and source records attributed to Wiktor Piechota.
[Correlation of high-sensitivity CRP concentration with the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease].
UNLABELLED: Atherogenesis is combined with inflammation of low intensity within endothelium. To-date studies have demonstrated that C-reactive protein is the best marker of this type of inflammation because its concentrations not only reflect the intensity of the process but they also carry prognostic information in apparently healthy general population as well as in patients with symptomatic atherosclerosis. The aim of this study was to evaluate the correlation between high-sensitivity CRP (hsCRP) and the extent of coronary atherosclerosis in men undergoing coronary angiography. The secondary aim was to assess the influence of statin treatment on hsCRP levels by comparing these levels in statin-treated and statin-naive patients. MATERIALS AND METHODS: 112 men with symptoms of ischemic heart disease were included in the study. In 98 cases coronary angiography was performed 52 patients were treated with statins. The extent of atherosclerosis in the coronary bed was evaluated according to four indexes: Gensini score (G), Friesinger score (F), Number of Vessels Diseased (NVD) and Arterial Segment Score (ASS). Concentrations of hsCRP concentrations were obtained with NB100 Dade-Behring kit. Pearson correlation coefficient was calculated for CRP concentrations following their logarithmic transformation. Correlation evaluation was confined to statin-naive patients due to convincing data about the influence of statins on CRP levels. RESULTS: A significant correlation between levels of hsCRP and extension of coronary atherosclerosis was found with all used indexes (G: R=0.335; p=0.0151, F: R=0.406; p=0.0028, NVD: R=0.0338; p=0.0142, ASS=0.368; p=0.071). The mean concentration of hsCRP was 27.7% lower in the patients on statins than in statin-naive patients within the low and moderate range of concentrations (up to 70th percentile, 2.4 mg/l) (p<0.02). In 25% of study subjects hsCRP exceeded the level of 3.0 mg/l which is the cut-off value for increased risk of atherothrombotic complications. CONCLUSIONS: The study showed a significant correlation between hsCRP and the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease. A significantly lower concentration of hsCRP was observed in the group of patients treated with statins compared to statin-naive patients, which may result from the proposed CRP reducing influence of these drugs. A quarter of study subjects had hsCRP levels exceeding the cut-off value for increased cardiovascular risk.
Biomarkers↗
[Troponin I levels after uncomplicated, elective percutaneous coronary intervention in patients with stable coronary heart disease].
UNLABELLED: Percutaneous coronary intervention is a proven method of treatment of significant number of patients with coronary artery disease. Sometimes it is accompanied by increases of troponin levels. Frequency and degree of these phenomena are not well known. THE AIM: of the present study was to establish frequency and a degree of the increase of cardiac troponin I (cTnI) in patients with stable coronary artery disease who underwent elective PTCA without complications during hospitalization. MATERIAL AND METHODS: Our study included 99 patients fulfilling the above mentioned criteria. Average patients' age was 58,7 years (range 37-82 years). In 67 patients PTCA was performed on one artery, in 27 on two and in five on 3 arteries. In 36 patients standard stents were implanted, in the remaining (63 patients) only PTCA was performed. In the group with stents 29 patients had 1 stent implanted, 6 patients had 2 stents and one had 3 stents implanted. In all the patients cTnI (Abbott AxSYM Immunoassay) were determined before PTCA, 12 and 24 hours after PTCA. RESULTS: After 12 hours percentage of cTnI results above 1.22 microg/L (cut-point for spontaneous infarction according to the new definition of heart infarction) amounted to 35% and above 2.0 microg/L (cut-off according WHO infarction definition) 28%. After 24 hours the percentages were similar. Typical cTnI results (90%) after PTCA were below 10 microg/L. cTnI levels were weakly but statistically significantly correlated with number of vessels, which underwent PTCA. CONCLUSION: Moderate increases in troponin I after PTCA seem to correspond to minimal, in general, cardiac injury.
Adult↗
[Clinical outcome of patients after transmyocardial laser revascularization alone and combined with coronary artery bypass grafting].
The aim of the study was to assess the effect of transmyocardial laser revascularization (TMLR) alone and in combination with coronary artery bypass grafting (CABG) on the angina score (CCS--Canadian Cardiovascular Society class), exercise tolerance and left ventricular function 6 months after the procedures. Sixty two patients were subjected to revascularization, 38 to sole TMLR procedure and 24 to combination CABG and TMLR (CABG/TMLR group). The angina score and exercise stress test together with radionuclide ventriculography were performed before and 6 months after the operation. The angina class and exercise tolerance were similar in both groups preoperatively. After the operation the improvement was seen in both groups with no statistical difference. The left ventricular ejection fraction were 61 +/- 8% and 54 +/- 8% (p < 0.05) before operation and after 6 months respectively. Transmyocardial laser revascularisation alone and in combination with coronary artery bypass grafting may relieve the angina and improve the exercise tolerance. However the left ventricular ejection fraction may drop significantly.
Coronary Artery Bypass↗
[C-reactive protein as a new risk factor of coronary heart disease in the population of young Polish males].
UNLABELLED: The aim of this study was to measure the levels of C-reactive protein (CRP) and examine their relationship with traditional risk factors of the coronary heart disease. Methods and participants. We examined a group of 150 males aged between 18 and 24. Each participant underwent physical examination and gave his previous medical history which included the place of residence, family background and current medication. In each case blood pressure was measured and body mass index (BMI) as well as waist/hip (W/H) ratio were established. The following biochemical parameters were measured in the serum of each participant: glucose, total cholesterol, HDL-cholesterol, triglycerides, apolipoproteins A-I and B (Apo A, Apo B), uric acid and C-reactive protein. LDL-cholesterol level was obtained from Friedewald's formula. High sensitivity C-reactive protein (hs-CRP) was measured by automatic DADE-Behring nefelometer. RESULTS: The results underwent variation, correlation and regression analyses. The mean age of participants was 20.5 +/- 1.2 years. The mean BMI, W/H ratio, systolic and diastolic blood pressure as well as traditional coronary heart disease risk factors (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, uric acid, Apo A, Apo B) were within reference range. The mean CRP level was 0.135 +/- 0.24 mg/dl. There was statistically significant positive correlation between CRP level and W/H ratio. There was statistically significant negative correlation between CRP level and HDL-cholesterol and Apo-A levels. There was no statistically significant correlation between CRP level and smoking. CONCLUSIONS: Our study confirmed findings by other authors that there is a relationship between CRP level and other coronary heart disease factors such as W/H ratio and HDL-cholesterol. The lack of relationship between CRP level and smoking remains consistent with previous findings of Onat and Mendall. The mean CRP level in our study group was similar to CRP levels observed in large European populations.
Adult↗
[Transmyocardial laser revascularization].
This review describes the transmyocardial laser revascularization (TMLR) which is a method used to treat patients with end-stage coronary heart disease who have been excluded from standard invasive treatments (coronary artery by-pass grafting, percutaneous transluminal coronary angioplasty) and no longer benefit from maximum medical therapy. TMLR consists in reestablishing blood flow to the ischaemic myocardium by creating a number of laser-drilled channels which are thought to allow a direct contact between the left ventricle and the myocardial plexus. This paper also presents a review of the available evidence of the efficacy of the procedure.
Angioplasty, Laser↗