Biomedical subjects

Z Sadowski

Publications and source records attributed to Z Sadowski.

At least 55 records · Page 3Linked to original sources

PubMed1992

[Evaluation of clinical effectiveness and adverse effects of Polnitrin].

In a double-blind, randomized, placebo cross-controlled trial the effectiveness and the adverse effects of two types of buccal tablets containing 5 mg nitroglycerin: Polnitrin produced by Warsaw Pharmaceutical Works POLFA and its analogue of foreign origin, were assessed. The third compared preparation was sublingual nitroglycerin in 0.5 mg tablets. The longest dissolution in the buccal cavity showed Polnitrin (mean 6.6 hours). Polnitrin significantly increased the resting heart rate during 3 hours, and during 6 hours at maximal effort. The foreign analogue decreased significantly the systolic pressure during 3 hours after application. No significant differences were noted in the effects on the basic haemodynamic parameters between the compared buccal tablets. Exercise tolerance and coronary reserve were assessed with repeated exercise tests on moving track (Marquette Case-12). Immediately after being stuck to the gum Polnitrin, its analogue and sublingual nitroglycerin significantly prolonged the marching time: total, till pain, and till ischaemia. After 6 hours the marching time till pain appearance was significantly longer after Polnitrin than after placebo or its analogue. Local adverse effects connected with the presence of the tablet in the oral vestibule may hamper the treatment with Polnitrin in some cases. The most frequent side effect were headaches which are known to occur usually after all nitrates.

Administration, Buccal↗

PubMed1992

[Thrombolytic therapy of myocardial infarction. Prognostic value of early reduction of elevation of ST segment].

In-hospital mortality, infarction mass (estimated enzymatically) and electrocardiographic indexes (total ST-segments elevation, number of leads with R-wave presence and total R-waves amplitude) were assessed in 532 patients with acute myocardial infarction, randomized to two treatment groups: 272 treated with streptokinase (SK) and 260 with heparin (H). Echocardiographic contractility indexes (contractility disturbances area index, contractility disturbances index, left ventricle diastolic diameter) and heart volume estimated from X-ray film were also assessed. There were no significant differences in mortality and infarction area between the two groups. In 175 patients total ST-segments elevation was reduced by at least 50%, in the rest 340 patients this reduction was less significant. In the group with early elevated ST-segment reduction there were less in-hospital deaths (p less than 0.01), smaller infarction mass (p less than 0.0001) and significantly less disturbed electrocardiographic contractility indexes. Results suggest that simple electrocardiographic index, namely reduction of ST-segment elevation by 50% after 2 hours of treatment may be a useful prognostic tool, independent on treatment options, as far as in-hospital mortality, necrosis mass and left ventricle contractility disturbances are concerned.

Adult↗

PubMed1992

[Does the appearance of pro-arrhythmic response to anti-arrhythmic drugs have prognostic significance?].

Study was undertaken to assess whether proarrhythmic response to antiarrhythmic drug is a risk factor for cardiac death in patients (pts) with ischaemic heart disease (IHD). In 782 pts with IHD and frequent and/or complex ventricular ectopic beats (VEB) 1041 drug tests guided by 24 hour Holter monitoring were conducted. The following drugs were assessed: propranolol, disopyramide, mexiletine, amiodarone. Pro-arrhythmia was defined according to Velebit: 1/greater than or equal to 4-fold increase in VEBs, 2/greater than or equal to 10-fold increase in repetitive forms of 3/new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). Proarrhythmic effect was observed in 8.4% of pts and in 7.9% of drug tests. The frequency with individual drugs ranged from 5.7% to 9%. No drug was completely free of this type of reaction. Antiarrhythmic drugs inducing arrhythmogenic response were eliminated. Pts were followed-up for a mean of 22 months (range 1-49). Chronic antiarrhythmic treatment was conducted. Pts were discharged taking the agent deemed most effective for suppression of arrhythmia. Follow-up visits were made every 6-12 months. All cases of death were verified. In long-term observation cardiac death and sudden death occurred in 53 and 32 pts. With actuarial analysis (Kaplan-Meler method, log rank test) there was significant difference in cardiac death (p less than 0.05) of pro-arrhythmia (+) compared with ++pro-arrhythmia (-) pts at yr (11% v 4%, 7% v 3%) and 3 yr (24% x 11%, 16% v 7%). The relative importance of baseline clinical variables in predicting survival was assessed with a stepwise Cox regression.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗

PubMed1991

Proarrhythmic response to antiarrhythmic drug as a risk factor for sudden cardiac death in patients with ischemic heart disease.

The prognostic significance of arrhythmogenic response to an antiarrhythmic drug was studied. In 782 patients with ischemic heart disease (IHD) and frequent and/or complex ventricular premature beats (VPBs), 1,041 drug tests guided by 24-hour Holter monitoring were conducted. The following drugs were assessed: beta blockers, disopyramide, mexiletine, amiodarone. Proarrhythmia was defined as: (1) greater than 4-fold increase in VPBs, (2) greater than 10-fold increase in repetitive forms, or (3) new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). During a follow-up of 1-49 months (mean 22) patients were treated with antiarrhythmic drugs found to be safe in control Holter monitoring. Proarrhythmic effects were observed in 8.4% of patients. No drug was completely free of this type of reaction. In long-term observation, cardiac death and sudden death occurred in 53 and 32 patients, respectively. With actuarial analysis (Kaplan-Meier method, log-rank test) there was a significant difference in cardiac death (P less than 0.01) and sudden death rate (P less than 0.05) of proarrhythmia (+) compared with proarrhythmia (-) patients at 1 year (11% vs 4%, 7% vs 3%) and 3 years (24% vs 11%, 16% vs 7%). Proarrhythmic response was an independent risk factor apart from myocardial infarction, VT/VF, ejection fraction less than 40% and QTc greater than 440 msec. Arrhythmogenic response to antiarrhythmic drugs seems to be an additional predictor of sudden death in IHD.

Anti-Arrhythmia Agents↗

PubMed1990

[Natural and postoperative course of coronary disease in late observations: prognostic value of clinical indicators and invasive and non-invasive studies].

The results of a prospective study in 301 patients (pts) with angiographically documented coronary artery disease are presented. The mean follow-up period was 30 +/- 14 months, the mean age of pts was 48 +/- 9 years. A prognostic significance of 37 indicators obtained from clinical, hemodynamical, angiographical and noninvasive studies was investigated. In the group of pts treated medically (n = 202) the natural history of disease was defined by the following indicators: history of myocardial infarction, congestive heart failure, NYHA functional class III and IV, frequent ventricular premature depolarizations (VPD), abnormal ecg at rest, QT greater than QS2 index, left ventricular (LV) ejection fraction less than 50%, elevation of LV end-diastolic pressure and LV end-diastolic volume index LV wall motion abnormalities in particular dyskinesia, left main coronary artery disease and three vessel coronary artery disease. In a multivariate Cox model analysis, the independent correlates of long-term survival were frequency of VPD (p less than 0.001), NYHA functional class III-IV (p less than 0.003), QT greater than QS2 index (p less than 0.01), LV ejection fraction (LVEF) less than 50% (p less than 0.02). The combination of two indicators: LVEF less than 50% and QT greater than QS2 identify pts with high mortality rate (31%) during a two year follow-up period as compared with only 1% in the group with LVEF greater than or equal to 50% and QT less than or equal to QS2. The different clinical and hemodynamical characteristics of both the groups of pts treated medically or surgically made a reliable comparison of those two methods of treatment impossible.

Adult↗

PubMed1990

[Effect of coronary disease risk factors on the progression of coronary arteriosclerosis].

UNLABELLED: A group of 43 patients (pts) from a larger group 451 pts with coronary artery disease (CAD) confirmed by coronary angiography were recatheterized because of deterioration of symptoms. After the first angiography patients had no indications to coronary artery bypass grafting (CABG) or gave no consent to surgery. The group comprised 3 women and 40 men aged 27 to 62 years (mean age 45 +/- 8 years). The mean interval between coronarography was 35 +/- 22 months. Four independent reviewers evaluated 15 segments of coronary arteries according to American Heart Association. The coronary lesions were scored on the basis of reduction in luminal diameter as follows: 0 point = 0-29%, 1 = 30-49%, 2 = 50-69%, 3 = 70-98%, 4 = 90-99%, 5 = 100% occlusion. The influence of the following risk factors on the progression was evaluated: age, sex, hypertension, diabetes, lipid disturbances, smoking, hyperuricaemia, family history. The patients were divided into 3 groups: group I--no or slight progression (0 to 4 points) in two successive coronary angiographies, group II--moderate progression (5 to 9 points) and group II--significant progression (10 points or more). The number of patients in these groups was 14, 12 and 17 respectively. In such isolated groups, the clinical events were compared: unstable angina, myocardial infarctions, need for CABG, cardiac deaths within follow-up period. The ejection fraction of the left ventricle was also evaluated. STATISTICAL ANALYSIS: was conducted by multiple regression model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

[Prognostic value of QT-QS2 index in the assessment of sudden coronary death].

200 patients aged 49 +/- 8 with coronary artery disease underwent selective coronarography, left ventriculography as well as performed every year laboratory, polycardiography, ECG exercise test, 24-hour ECG Holter monitoring and X-ray chest examinations. Mean follow-up period was 34 +/- 10 months. For QT-QS2 index monitoring patients were divided into two groups: I--with abnormal index QT greater than QS2 (61-30%) and II--with the normal one QT less than QS2 (139-70%). Lown's classification was applied for ventricular premature beats assessment. Left ventricular contractility was estimated in hemodynamic examination. 28 patients died due to cardiac reasons during follow-up (14%). Among 19 suddenly died patients (9.5%) 7 had a normal and 12 an abnormal QT-QS2 index. Sudden mortality rate was 5% in the normal QT less than or equal to QS2 subgroup, and 20% in the abnormal QT greater than QS2 one. These differences are statistically significant.

Adult↗

PubMed1989

Decreased plasma dehydroepiandrosterone sulfate and dihydrotestosterone concentrations in young men after myocardial infarction.

Plasma levels of dehydroepiandrosterone sulfate (DHEA-S), testosterone, dihydrotestosterone (DHT) androstenedione, sex hormone-binding globulin (SHBG), lipoproteins, apolipoproteins and high density lipoprotein (HDL) subfraction were measured in 32 men aged 26-40 years after myocardial infarction (MI) suffered at least 3-4 months prior to the study, who were normocholesterolemic and had angiographically demonstrated coronary occlusion. The control group consisted of 76 healthy men aged 25-40 years. Blood samples were obtained in the morning from fasting subjects. A significant decrease in plasma DHEA-S and DHT levels were found in MI patients. Also, a significant decrease in HDL-cholesterol, HDL2-cholesterol (HDL2-C) and apolipoprotein A-I, an increase in apolipoprotein B and LDL-cholesterol (LDL-C) levels were observed in those patients as compared with healthy men. However, there were no differences in testosterone, androstenedione and SHBG concentrations between the groups. Significant correlations between testosterone and HDL2-C (r = 0.46, P less than 0.01), as well as between DHEA-S and HDL3-C (r = 0.39, P less than 0.05) levels in MI patients were observed. These results suggest that decreased levels of plasma DHEA-S and DHT may promote the development of coronary atherosclerosis in men.

Adult↗

PubMed1989

[Comparative evaluation of biological availability and anti-arrhythmia effectiveness of Mexicard (mexiletine Polfa)].

In 16 healthy males bioavailability of Mexicord (Polfa) was studied, in comparison with mexiletine of foreign made. Bioavailability extent (EBA) of Mexicord was over 99% in comparison with a standard drug. Comparative study of antiarrhythmic activity and side effects was performed in 32 patients with frequent ventricular premalure beats and nearly in a half of them resistant to antiarrhythmic agents. Mexicord was effective in 47% of treated patients, and side effects (most often nausea) were observed in 28% of patients, but only in 1 case therapy withdrawal was necessary. Statistical study proved a lack of significant differences in antiarrhythmic effectiveness and side effects between Mexicord (Polfa) and a drug of foreign made.

Adult↗

PubMed1989

[Evaluation of biological equivalency of Sustonit (Polfa) and Sustac by plethysmography].

Bioequivalence of Sustonit tablets (2.6 and 6.5 mg) produced at WZF Polfa and Sustac tablets (2.6 and 6.5 mg) made by Krka (Yugoslavia) and WZF Polfa (Poland) was studied by means of the digital plethysmography. All the three drugs with the nitroglycerin content of 2.6 mg were found to be biologically equivalent. On the other hand, Sustonit (WZF Polfa) and Sustac (Krka) tablets with 6.5 mg nitroglycerin proved to possess better bioavailability than Sustac (6.5 mg) tablets produced previously at WZF Polfa.

Adult↗

PubMed1989

[Evaluation of the relative biological availability of amiodarone Polfa preparation after extravascular administration of a single dose].

Relative bioavailability of amiodarone was studied in 10 healthy volunteers after its 600 mg single dose administration. Mean values of individual maximal concentrations and time for reaching them did not significantly differ and were respectively 0.828 +/- 0.401 microgram/ml and 4.4 +/- 1.5 h for Amiodarone preparation Polfa and 0.541 +/- 0.207 microgram/ml and 5.2 +/- 1.6 h for Cordarone preparation. Bioavailability extent (EBA) of examined preparation was 120 per cent in comparison with the standard one. Amiodarone absorption from both preparations was slow and individually diversified. Absorption rate constant Ka did not statistically significant differ and was respectively 0.35 +/- 0.10 1/h and 0.49 +/- 0.35 1/h. Obtained data indicated that both preparations were biologically equivalent.

Administration, Oral↗

PubMed1989

[Value of two-dimensional and Doppler echocardiography in the diagnosis of rupture of the interventricular septum in myocardial infarction].

Usefulness of two-dimensional and Doppler echocardiography in diagnosis of the ruptured interventricular septum in a course of myocardial infarction was evaluated basing on own material consisted of 6 cases. Ventricular septal defect was visualized in 5 patients. The blood flow through the ventricular septum was detected in all of 6 patients. Obtained results were concordant with intraoperative and anatomicopathologic findings as for as the localization of the rupture is concerned.

Aged↗

PubMed1989

[Activitrax--a pacemaker with a regulated rhythm rate].

In 10 patients: 7--with the complete atrioventricular block and 3 with the sick sinus syndrome the rate responsive activity sensing pacemaker--Activitrax was implanted. Significant increase of rheographically measured cardiac output in a course of rate responsive pacing in comparison with on demand constant frequency rate stimulation was stated during treadmill exercise tests performed 6 and 12 weeks after a pulse generator implantation.

Adult↗

PubMed1988