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Biomedical subjects

Z Kornacewicz-Jach

Publications and source records attributed to Z Kornacewicz-Jach.

At least 19 recordsLinked to original sources
PubMed2005

Human hematopoietic stem/progenitor-enriched CD34(+) cells are mobilized into peripheral blood during stress related to ischemic stroke or acute myocardial infarction.

The hematopoietic and non-hematopoietic stem/progenitor cells harvested directly from the bone marrow (BM) or G-CSF mobilized peripheral blood were demonstrated to play an important role in regeneration of damaged organs (1, 2). Here, we asked if the stroke- or acute heart infarct-related stress triggers mobilization of stem/progenitor-enriched CD34(+)cells from the BM into the peripheral blood, which subsequently could contribute to regeneration of damaged tissues. To address this question the peripheral blood samples were harvested from patients with ischemic stroke during the first 24 h of manifestation of symptoms and on the second and sixth day afterwards or during the first 24 h of acute cardiac pain as well as on the second and sixth day of infarct. We measured in these patients (i) percentage of circulating hematopoietic stem/progenitor-enriched CD34(+) cells in peripheral blood by employing fluorescence activated cell sorter (FACS) and (ii) number of hematopoietic progenitor cells for the granulocyte-monocytic colony-forming unit (CFU-GM) and erythoid burst-forming unit (BFU-E) lineages circulating in peripheral blood. We concluded that stress related to ischemic stroke or acute myocardial infarction triggers the mobilization of hematopoietic stem/progenitor-enriched CD34(+) cells from the BM into peripheral blood. These circulating stem/progenitor-enriched CD34(+) cells may contribute to the regeneration of ischemic tissues, however, this possibility requires further studies.

Acute Disease↗
PubMed2000

Is abnormal postprandial lipemia a familial risk factor for coronary artery disease in individuals with normal fasting concentrations of triglycerides and cholesterol?

OBJECTIVE: To assess the postprandial response to a fat load in patients with coronary artery disease (CAD) and age-matched controls. METHODS: Postprandial lipemia was assessed in patients with CAD confirmed by angiography (study group, n = 44) and in patients without coronary lesions (control group, n = 20). Family members of patients with CAD were also included (spouses group, n = 22; progeny group, n = 33). Fasting triglyceride and cholesterol concentrations in the control and study groups were less than 2.3 and 6.47 mmol/l, respectively. After initial blood sampling, the patients consumed 30% cream (200 ml/m2 body area). Repeat measurements of triglycerides, total cholesterol and high-density lipoprotein were made after 2, 4, 6, and 8 h. RESULTS: Changes were most marked in triglyceride concentrations. Peak values were observed after 4 h in the spouses, progeny, and control groups, and after 6 h in the study group. To compensate for the large age span (8-40 years) of the progeny, two subgroups were formed, taking 25 years as the cut-off value. Triglycerides continued to increase until the 4th hour in both subgroups, but the subgroups differed as to the absolute concentration of triglycerides. During the first 6 h of the test, the concentrations were significantly greater in the subgroup of older progeny than in their fathers with CAD. CONCLUSIONS: These findings indicate that triglycerides are metabolized at a slower rate and remain longer in the circulation of patients with CAD, as compared with patients without CAD. A significantly greater level of postprandial lipemia has been observed in adult progeny of patients with CAD, suggesting a genetic disorder of triglyceride metabolism in these individuals.

Adult↗
PubMed2000

The terminal portion of the T wave: a new electrocardiographic marker of risk of ventricular arrhythmias.

Experimental studies have shown that transmural dispersion of repolarization (DoR), defined as the difference in action potential duration between mid-myocardial M-cells, epicardial, and endocardial cells is reflected in the duration of the terminal portion of the T wave (TpTe) on the surface ECG. Since DoR is an important factor associated with the propensity for reentrant arrhythmias, this study examined if TpTe may serve as a marker of risk of ventricular arrhythmias. Data from 18 patients with coronary artery disease and inducible sustained ventricular tachycardia (VT group) were compared with those of 16 survivors of myocardial infarction without inducible VT (control group). TpTe was automatically measured in each beat of 24-hour ECG recordings, and programmed ventricular stimulation was performed in the antiarrhythmic drug-free state. TpTe was expressed as the absolute interval in milliseconds, and relative to the duration of QTe (TpTe/QTe x 100%). TpTe duration was 74 +/- 14 ms in the VT group versus 63 +/- 16 ms in the control group (P < 0.004). The TpTe interval expressed as a percent of the QT interval was 21 +/- 4% in the VT group versus 17 +/- 3% in the control group (P = 0.02). In patients with coronary artery disease. TpTe was longer in patients with, versus without, inducible VT. The results of this study support the hypothesis that TpTe reflects transmural dispersion of repolarization.

Aged↗
PubMed1999

Atrial epicardial pacing with long stimulus to P wave interval in a patient with arrhythmogenic right ventricular dysplasia complicated by right atrial thrombosis.

Atrial epicardial pacing with a long stimulus to P wave interval in a patient with arrhythmogenic right ventricular dysplasia complicated by right atrial thrombosis is discussed. Arrhythmogenic right ventricular dysplasia (ARVD) is associated with a high incidence of malignant ventricular arrhythmias. Most patients with ARVD need antiarrhythmic drugs, catheter ablation, or an implantable cardioverter defibrillator. We report a patient with ARVD in whom effective treatment with sotalol caused severe, symptomatic sinus bradycardia requiring permanent pacing. Due to leftward displacement of the right ventricle and the presence of two thrombi in the right atrium, an epicardial atrial lead and AAI pacemaker were implanted. A long stimulus to P wave interval caused by severe dilatation of the right atrium was recorded. During a 6 months of follow-up on sotalol treatment there were neither ventricular tachycardia (VT) attacks nor pacing problems.

Arrhythmogenic Right Ventricular Dysplasia↗
PubMed1999

Increased levels of factor VII, fibrinogen and activity of plasminogen activator inhibitor during postprandial triglyceridemia in patients with ischemic heart disease confirmed by angiography.

BACKGROUND AND AIM: Impaired elimination of triglycerides (TG) after postprandial lipemia is often observed in patients with ischemic heart disease (IHD). Longer retention of TG-rich lipoproteins in the circulation may in turn be the cause of hemostatic disturbances in the form of hypercoagulation. The aim of this study was to evaluate the influence of postprandial lipemia on the hemostatic system in normolipemic patients with angiographically documented atherosclerotic changes of coronary arteries. METHODS AND RESULTS: 20 males under 60 years of age with IHD and 10 healthy males matched for age were studied. Hemostatic and lipid parameters were determined in blood collected before (fasting) and after (2, 4, 6 and 8 hours) an oral fat load (200 ml of 30% cream). A statistically significant increase in factor VII (FVIIc-%) was found during postprandial lipemia in comparison with fasting. Although in patients with IHD the area under the curve for FVIIc was not significantly different than in the control group, it was observed that FVIIc in the IHD group exceeded the fasting level earlier (4, 6 and 8 h) than in controls (8 h). Levels of FVIIc reached for the IHD group: fasting value = 96.3 +/- 16.3; postprandial 4 h = 103.2 +/- 21.3, 6 h = 105.2 +/- 21.8, 8 h = 106.0 +/- 21.4; for the controls: fasting value = 96.8 +/- 17.2; postprandial 8 h = 107.7 +/- 22.0. In the IHD group, unlike in controls, postprandial lipemia was accompanied by a statistically significant rise in fibrinogen levels (Fb-g/l) as compared with fasting (fasting value = 3.69 +/- 0.59; postprandial 2 h = 3.89 +/- 0.65, 4 h = 3.93 +/- 0.63). Mean values for PAI-1 were lower in the IHD than in the control group, but PAI-1 activity during postprandial lipemia rose earlier in the IHD group (4 and 6 h) than in the controls (6 h). PAI-1 levels were in the IHD: fasting values = 1.4 +/- 1.2; postprandial 4 h = 2.3 +/- 1.6, 6 h = 2.5 +/- 1.7; in the control: fasting value 2.9 +/- 1.7; postprandial 6 h = 3.9 +/- 2.0. The level of fragment 1 + 2 (F1 + 2) during postprandial lipemia decreased in both groups. CONCLUSIONS: The lipemic stimulus in fasting normolipemics induces a hypercoagulant effect with greater changes in patients with ischemic heart disease than in healthy subjects. Longer periods of postprandial lipemia might constitute an additional factor promoting thrombus formation in patients with dysfunction of the vascular endothelium.

Adult↗
PubMed1999

[Common double inlet ventricle (univentricular heart) in 27 year old man: a case report].

We present 27-years old man with common double inlet ventricle (CV), hypoplastic pulmonary artery and transposition of the great arteries which was diagnosed in childhood. Based on echocardiographic examination we found unidentify type of CV. Patient did not have surgery and was in good condition. He has been working. We believe that main reason of his good condition is hemodynamically optimal width of the hypoplastic pulmonary artery.

Adult↗
PubMed1998

Electrocardiographic changes after alcohol septal ablation in hypertrophic obstructive cardiomyopathy.

OBJECTIVE: To report acute and mid-term electrocardiographic changes in patients with hypertrophic obstructive cardiomyopathy (HOCM) after alcohol ablation of the first large septal branch of the left anterior descending coronary artery; and to relate electrocardiographic data with the left ventricular outflow tract pressure gradients. PATIENTS: Nine consecutive symptomatic patients with HOCM (mean (SD) age 45 (12) years). METHODS: Analysis of baseline and post-procedure ECGs and 24 hour ambulatory monitoring (up to six months). ECG data were related to left ventricular outflow tract pressure gradients. RESULTS: One patient developed complete atrioventricular block requiring permanent pacing. The PR interval was significantly prolonged up to third month after ablation. Immediately after the procedure all patients developed right bundle branch block. At the sixth month of follow up, right bundle branch block was present in four patients. New anterior ST elevation developed immediately after ablation in five of the nine patients, and new Q waves in four. The QRS duration was significantly prolonged immediately after ablation and during follow up. There was significant but transient prolongation of QT-mean and QTc-mean intervals. QT dispersion, QTc dispersion, and JTc-mean interval were not affected. JT and JTc dispersions were transiently prolonged. No serious ventricular arrhythmias were recorded during Holter monitoring, either before or after the procedure. There were no significant correlations between the left ventricular outflow tract pressure gradient and QTc, QT-d, QTc-d, JTc, JT-d, JTc-d, or QRS duration before and after ablation. CONCLUSIONS: Alcohol septal ablation for HOCM induces significant changes in the resting ECG in most patients, despite the occlusion of a relatively small artery. The changes include new Q waves, new bundle branch block, transient anterior ST segment elevation, atrioventricular block, and transient prolongation of QT interval.

Adult↗
PubMed1998

[The evaluation of surgical revascularization of the left ventricular systolic function after surgery].

To determine the effects of coronary artery bypass grafting (CABG) on the left ventricular function the 83 patients aged 52 +/- 6 years with ischaemic heart disease were examined by a standard two dimensional echocardiography (ECHO) and exercise test (EXT) before CABG and 1, 3, 6, 12 month after CABG. The following parameters were measured: LV ejection fraction (LVEF) and wall motion score index (WMSI) according to 14-segmental model and the duration of exercise test with work load. In conclusion, in patients surgical revascularization can significantly improve left ventricular function 6 and 12 month after CABG. We didn't observe connection between left ventricular function and result of exercise-test.

Adult↗
PubMed1997

[Labor in women with heart and great vessel diseases].

The way of termination of pregnancy was retrospectively analysed in 95 pregnant women with heart and/or great vessels diseases, hospitalised in years 1989-1991 and 1995-1996 in the Department of Obstetrics and Perinatology of Pomeranian Medical Academy. The condition of cardiovascular system was assessed according to NYHA classification on admission and just before delivery with participation of an experienced cardiologist. Kind of heart disease, mode and period of delivery, perinatal cardiovascular symptoms, duration of delivery and duration of hospitalisation, weight and clinical condition of the newborns were taken under consideration. In more than half of cases (60%) cesarean sections were performed. Among the indications for elective cesarean section cardiological indications formed the dominant group (29.5%). During perinatal period deterioration of circulatory system sufficiency associated with increase of number of cesarean sections were observed.

Adolescent↗
PubMed1996

[Exercise echocardiography with left atrial stimulation: advantages and limitations of the method].

Exercise echocardiography seems a relatively reliable diagnostic technique for evaluation of patients with coronary artery disease. The prognostic aspects of the stress echo have widely been documented with the use of various stressors (exercise, dipyridamole, dobutamine, pacing). Rapid atrial pacing echocardiography is highly specific and sensitive technique for the detection of the coronary disease, especially in patients who are unable to perform an active stress test. This technique minimizes the factors decreasing image quality during exercise (chest wall movements and hyperventilation). Exercise echocardiography is safe, relatively cheap, and can be done in every hospital.

Cardiac Pacing, Artificial↗
PubMed1993

[Head-up tilt table test in patients with syncope of unexplained origin].

UNLABELLED: We studied 41 patients (21 m, 20 f) aged 22-70 years (mean 51) with syncope of unexplained origin using 60 degrees head-up tilt test (TT). Continuous ecg recording and direct arterial blood pressure were monitored. In case of positive response (e.g. syncope) in first examination next TT after administration of atropine (0.02 mg/kg) was performed. In first TT syncope was evoked in 19 patients (46%). Mean time from onset of tilt to syncope (TOS) was 15 +/- 13 min. Atropine administration protected against syncope during second TT in 7 patients, prolonged TOS in 4 (from 12 +/- 7 to 34 +/- 4 min) and shorted TOS (from 26 + 17 to 16 + 14 min) in the next 8 patients. We distinguished on that base: in 7 patients cardioinhibitory form, in 4 mixed form and in the next 8 patients vasodepressor form of vasovagal syndrome. We used in treatment: a) implantation of DDD or VVI pacemaker in 7 patients, b) clonidine in 8 patients, c) propranolol in 2 patients, d) derivates of atropine in 2 patients. During 1 year follow-up 14 patients are free of syncope and in the next 5 syncope occurred rarely. CONCLUSIONS: 1. Head up tilt test is very useful in diagnosis of syncope of unknown origin. 2. Second tilt after administration of atropine in patients with syncopal response in the first test helps to differ the type of vasovagal syndrome and to improve its treatment.

Adult↗
PubMed1993

[Carotid sinus massage in diagnosing syncope of unknown origin].

Carotid sinus massage (CSM) was performed in 44 patients (23 female, 21 male, mean age 52 years) with recurrent episodes of unexplained syncope and without any organic heart disease. The protocol of examination consisted of 5 s CSM performed unilaterally in supine, upright 60 degrees positions, after administration of propranolol (i.v. 0.1 mg/kg) and during autonomic inhibition (atropine i.v. 0.02 mg/kg after propranolol). The diagnosis of hypersensitive carotid sinus syndrome (HCSS) was established in case of pathologic response to CSM in supine and upright 60 degrees positions. Positive results of CSM was obtained in 15 (34%) examined patients. Cardioinhibitory form of HCSS was recognized in 9 and mixed form in 6 cases. Pathologically augmented carotid sinus reflex was provoked in 8 cases by massage of the right, in 4 cases of the left and in 3 both carotid sinuses. Maximal time of electrical asystole after CSM was 6300 ms while maximal decreased od systolic blood pressure was 70 mmHg. Intravenous administration of propranolol caused decrease of systolic blood pressure approximately 43 +/- 15 mmHg whereas the cardioinhibitory effect of CSM after this drug significantly was increased only in patients with a positive response to CSM in the supine or upright 60 degrees positions. Autonomic inhibition significantly decreased the cardioinhibitory effect of CSM without significant influence on its vasodepressive component.

Adult↗
PubMed1993

[Doppler microprobe allows evaluation of local coronary circulation].

The local coronary flow in 42 patients (mean age: 59 +/- 9 years) with ischemic heart disease was assessed by means of an 0.018" intracoronary Doppler guidewire. Study population was divided into two groups: group I--"normal vessels" (diameter stenosis < 30%) and group II--"stenosis vessels" (diameter stenosis > 60%). Measurements of: averaged peak velocity (APV), diastolic-systolic velocity ratio (DSVR) were performed in proximal segments of normal vessels and proximally to stenosis in group II. APV and DSVR were recorded at rest (bas) and during papaverine induced hyperemia. Coronary flow reserve (CFR) was calculated as ratio hyperemic and resting values of APV. Mean value of APV at rest was highest for left main stem, lowest for venous by-passes (SVBG) but did not differ among three coronary arteries (LAD, LCX, RCA). CFR value was significantly higher for group I then for group II (2.75-3.3 vs 1.8-2.0) but did not differ significantly among particular arteries in both groups. Mean value of DSVRbas in both examined groups was lowest for right coronary artery and for SVBG (ca. 1.0) and did not change significantly during hyperemia. This value was significantly higher (ca. 2.0) for left coronary arteries (LAD, LCX) then for RCA and SVBG and significantly decreased after administration of papaverine.

Aged↗
PubMed1993

[Doppler microprobe for evaluation of coronary circulation after successful coronary angioplasty].

The influence of angiographically successful coronary angioplasty (PTCA) in 27 patients (mean age 64 +/- 8 years) was assessed by means of 0.018" intracoronary Doppler guidewire. Averaged peak flow velocity (APV) and diastolic-systolic velocity ratio (DSVR) were recorded in resting conditions (bas) and during papaverine induced hyperemia before and after PTCA. Coronary flow reserve (CFR) was calculated as ratio of hyperemic and resting APV. The parameters mentioned above were estimated proximally and distally to coronary stenosis to be dilated. Mean value of APVbas for distal part of the vessels was significantly lower (about 46-57%) then for the two proximal segments. PTCA caused significant increase of APVbas as for proximal (about 21-69%) as for distal segments (about 62-77%). That procedure caused significant increase of CFR only for right coronary artery (RCA). Mean values of DSVRbas in proximal position for left descendens (LAD) and left circumflex (LCx) arteries before PTCA were significantly higher than DSVbas for distal position but did not differ for RCA. PTCA caused significant increase of DSVRbas in distal position only for LAD and LCx. Our results showed that angiographically successful PTCA causes significant increase of APVbas for right and left coronary arteries and normalization of DSVRbas in distal segments of LAD and LCx.

Adult↗
PubMed1993

[Retrograde conduction (ventriculo-atrial) in patients with AV or intraventricular block. Electrophysiologic evaluation].

The purpose of the study was to evaluate ventriculoatrial conduction in patients with chronic complete AV block (AVB) (35 pts--gr. A), who were qualified for pacemaker implantation and in patients with bifascicular block (BFB) (20 pts--gr. B), who had electrophysiological study performed to determine indications for permanent pacing. Anterograde and retrograde conduction by accessory pathways were excluded in all patients. Incremental ventricular pacing (60-80 bpm to 200-220 bpm) and programmed ventricular stimulation were performed. Ventriculoatrial (VA) conduction was present in 12 of 35 patients in gr. A (34%) and in 15/20 patients in gr. B (75%). Mean VA conduction time was 192 +/- 50 ms in gr. A and 200 +/- 54 ms in gr. B, effective refractory period of right ventricle (ERP-RV) was 270 +/- 30 ms and 250 +/- 29 ms respectively. Mean retrograde Wenckebach point was 128 +/- 41 bpm in gr. A and 132 +/- 30 bpm in gr. B. The level of VA Wenckebach block in gr. A was found at AVN in 4 of 12 patients and in remaining was not directly recognised. Levels in gr. B were: AVN--6, not recognised--9 patients. Ventriculoatrial conduction shows complex properties and dependence on the type of ventricular stimulation. Electrophysiological study enables to find a level of retrograde block in some patients.

Adult↗
PubMed1992

[Sinus node in patients with atrioventricular and interventricular blocks. Electrophysiologic evaluation].

To assess the function of the sino-atrial node, electrophysiological study with pharmacological autonomic blockade was performed in 3 groups of patients: group I with a-v III zero or II zero type 2 heart block, group II with bifascicular interventricular blocks and group III-controls. Sino-atrial node electrogram was recorded in 81% of patients. Obtained results show, that sino-atrial node dysfunction is uncommon in patients with atrioventricular or interventricular blocks (8.6% and 15% respectively). Electrophysiological assessment of sino-atrial node function seems to be important in the consideration of patients with a-v or interventricular blocks for appropriate type of permanent pacing.

Adolescent↗
PubMed1992

[Mitral valve prolapse. Atrial stimulation, ajmaline test and "pharmacological denervation" in the evaluation of ventricular repolarization].

In patients with mitral valve prolapse syndrome (MVP) various electrophysiological abnormalities occur. There are convergent opinions concerning QT distance variability and the influence of autonomic nervous system on ventricular repolarization in this syndrome. In 38 MVP patients (group I) and 24 subjects without this abnormality (group II) ecg was recorded during transvenous right atrial pacing at baseline, after ajmaline administration and after pharmacological autonomic blockade (atropine + propranolol). The following ventricular repolarization parameters were analysed: QTe (distance to the end of T wave), JTe (distance between J point and the end of T wave--so called "pure repolarization"), QTdys (repolarization dispersion) and the corrected QTc.QTe during 90/min right atrial pacing was significantly shorter than QTc in both groups. QTc was abnormally prolonged (above 440 msec) in MVP group. Ajmaline administration prolonged QTe in group II only, whereas autonomic blockade resulted in marked shortening of QTe in MVP group. QTdys was significantly prolonged only after ajmaline administration in group II. Based on above results, the following conclusions are made: 1) Right atrial pacing technique may be used for calculating standardized QT distance, an alternative to corrected QT. 2) Ajmaline test is useless in ventricular repolarization estimations in MVP patients. 3) In MVP patients the influence of adrenergic system on ventricular repolarization at rest appears to be greater than in non-MVP subjects.

Adolescent↗