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Biomedical subjects

Zbigniew Gasior

Publications and source records attributed to Zbigniew Gasior.

At least 19 recordsLinked to original sources
PubMed2006

Inflammatory markers in a 2-year follow-up of coronary artery disease.

Our study was designed in an attempt to determine the dynamics of changes in serum tumor necrosis factor (TNF)-alpha, soluble forms of its receptors (sTNFR 1, sTNFR 2), and adhesion molecules (sE-selectin, sP-selectin, sVCAM-1, sICAM-1) over a 2-year follow-up of patients with coronary artery disease (CAD). The study involved 70 patients with stable CAD (stable angina class II/III according to the Canadian Cardiovascular Society) and 20 apparently healthy subjects. Over the follow-up period a marked attenuation of angina (P<0.001) was observed. Interventional treatment (percutaneous coronary intervention, coronary artery bypass grafting) was used in 53 CAD patients. Laboratory analysis revealed a significant decrease of serum TNF-alpha and sTNFR1 at 2 years (TNF-alpha: 12.1+/-0.7 pg/ml; sTNFR 1: 1306+/-46 pg/ml) as compared to baseline levels (16.5+/-0.7 pg/ml, P=0.030; 1551+/-82 pg/ml, P=0.048, respectively). The levels of sP-selectin (159+/-7 vs 201+/-14 ng/ml, P<0.01) and sICAM-1 (133+/-4 vs 153+/-6 ng/ml, P<0.05) were found to be significantly increased as compared to the baseline. Interventional procedures resulted in suppression of both cytokine (TNF-alpha, sTNFR 2) and adhesion molecule (sE-selectin, sP-selectin) activation in the CAD group. The baseline and post-follow-up TNF-alpha and sTNFR 1 levels showed persistent elevation in CAD patients as compared to the controls (9.0, 956.3 pg/ml, respectively; P<0.01). There were no differences between baseline and final cytokines and adhesion molecules in healthy subjects. The course of CAD as modified by a clinically effective therapy is characterized by changes of immune markers activation. Revascularization seems to be an important factor suppressing both cytokine and adhesion molecule activation in CAD patients.

Analysis of Variance↗
PubMed2006

Churg-Strauss syndrome and congenital factor Leiden thrombophilia as nontypical causes of intracardiac thrombosis.

We present and discuss the case of a 26-year-old man suffering from Churg-Strauss syndrome (CSS). In our patient the disease severely affected both the heart and the lungs. Left ventricular dysfunction and intracardiac thrombosis, probably secondary to the cardiotoxic effect of eosinophils, were revealed by echocardiography. The risk of thrombosis was additionally increased by the coexistence of the factor V Leiden gene mutation. An opportunely established diagnosis allowed institution of an appropriate pharmacotherapy and subsequently to obtain a significant abatement of the clinical symptoms as well as the laboratory manifestations of the disease.

Adult↗
PubMed2006

Genetic background of acute coronary syndromes.

Acute coronary syndromes (ACS) are one of the major causes of mortality nowadays. Although much is known about factors involved in atherogenesis and acute coronary events, there are still many cases in which a lack of classical risk factors, together with family history, suggests the presence of an unrevealed genetic predisposition and molecular mechanisms. This paper reviews genetic predisposition to ACS. It also indicates which genes are linked to the processes of destabilization and rupture of atherosclerotic plaque and thus may be potential targets for more effective prophylaxis and treatment.

Journal Article↗
PubMed2006

[Ruptured aneurysm of the sinus of Valsalva].

Aneurysm of the sinus of Valsalva is a rare cardiac disease. It is usually an asymptomatic anomaly, however when it ruptures, symptoms appear and patient's condition deteriorates rapidly. We describe a case of a 24-year female with a ruptured aneurysm of the non-coronary sinus of Valsalva. The aneurysm ruptured in the right atrium causing severe hemodynamic complications. The diagnosis was made by transthoracic and transesophageal echocardiography.

Adult↗
PubMed2006

[Cachexia in chronic cardiac disease. Ancient syndrome new idea?].

Cachexia has long been recognized as serious complication of chronic illness. Cardiac cachexia is a syndrome of generalised wasting which carries a poor prognosis of the chronic heart disease. Characteristic features of cachexia include the activation of the immune system associated with raised plasma concentriations of tumor necrosis factor alpha (TNF(alpha) and other plasma cytokines. Another crucial issue is muscle wasting through the ubiquitin proteasome pathway. The prevention or attenuation of disease related skeletal muscle degeneration has been a common goal in the treatment of cardiac cachexia.

Animals↗
PubMed2005

Transcriptional activity of genes encoding Transforming Growth Factor beta and its receptors in peripheral blood mononuclear cells from patients with acute coronary syndromes.

BACKGROUND: Recent data report altered gene expression of numerous pro- and anti-inflammatory factors involved in pathology of acute coronary syndromes (ACS). Transforming growth factor beta (TGFbeta) signaling is engaged in a wide range of processes. Its effect on vessels seems to be protective due to its anti-inflammatory and anti-atherogenic action. However, it also seems to be engaged in such negative effects as neointima formation and fibrosis. The aim of the study was to assess the expression of the genes encoding TGFbeta and its receptors (type I, II, and III) in patients with ACS. METHODS: The study was carried out on 24 patients with acute coronary syndrome (7 with unstable angina [UA] and 17 with myocardial infarction [MI]) and 10 age-matched healthy subjects (control). To evaluate gene expression of TGFbeta and its receptors total mRNA was extracted from peripheral blood mononuclear cells (PBMC) and the number of mRNA copies were assessed by quantitative reverse transcriptase polymerase chain reaction (QRT-PCR). RESULTS: MI and UA patients demonstrated significantly lower TGFbeta gene expression compared to control (2789+/-418 c/microg vs. 20262+/-2548 c/microg; p<0.001, and 3390+/-518 c/microg vs. 20262+/-2548 c/microg; p<0.001, respectively), as well as noticeably lower transcriptional activity of genes encoding its type I (3295+/-447 c/microg vs. 12859+/-1929 c/microg; p<0.001, and 3258+/-721 c/microg vs. 12859+/-1929 c/microg; p<0.01, respectively) and type II receptors (2364+/-346 c/microg vs. 19003+/-2357 c/microg; p<0.001, and 2680+/-522 c/microg vs. 19003+/-2357 c/microg; p<0.01, respectively). Also, gene expression of the type III receptor was inferior in the studied group compared to the control, although the difference was significant only for the UA group vs. control. Expressions of the studied genes did not differ between patients with MI and those with UA. CONCLUSION: Our report shows that the decreased activity of TGFbeta in patients with ACS is at least partly due altered transcriptional activity of genes encoding both TGFbeta and its receptors, what may be responsible for the evolution of atherosclerotic lesions.

Adult↗
PubMed2005

Effects of nebivolol on left ventricular function in elderly patients with chronic heart failure: results of the ENECA study.

AIM: To examine the effect of the beta(1)-selective beta-blocker nebivolol, administered as add-on therapy, on left ventricular function in 260 elderly patients (>65 years) with chronic heart failure (CHF). METHODS: The principal inclusion criteria were (1) NYHA class II-IV CHF and (2) a left ventricular ejection fraction (LVEF) <= 35%. The primary end-point was the change in LVEF in response to nebivolol treatment for 8 months. RESULTS: Baseline LVEF values in the two groups were as follows: nebivolol 25.41+/-7.09% and control 26.41+/-5.55%. LVEF improved significantly (p=0.027) more in the nebivolol group (6.51+/-9.15%) than in the control group (3.97+/-9.20%), the relative improvement (percentage increase in the initial value) being 35.70+/-57.62% in the nebivolol group and 19.19+/-40.96% (p=0.008) in the placebo group. Examination of different subgroups did not reveal any heterogeneity in the effects of nebivolol treatment vs. placebo treatment. There were no significant differences between the nebivolol and placebo groups as concerns the changes in clinical status, quality of life, or safety parameters. CONCLUSION: The findings of the ENECA study confirmed that nebivolol significantly improved cardiac function and proved to be safe and well tolerated in elderly patients with signs of CHF and an impaired LVEF.

Adrenergic beta-Antagonists↗
PubMed2005

[Combinated clinical picture of hypertrophic cardiomyopathy in 53-year-old male].

We present and discuss a case of hypertrophic obstructive cardiomyopathy (HOCM), which until the proper interpretation of echocardiography image had been diagnosed and treated as a combinated mitro-aortic valve disease. Due to years of maltreatment the disease has reached an advanced stage. Available healing procedures, with thoroughly proved efficacy in reducing the sub-valvular pressure gradient, include: implantation of cardio-stimulator, alcohol ablation and surgical treatment. In the presented case the co-existing diseases have made the choice of optimal treatment difficult.

Aortic Valve Insufficiency↗
PubMed2004

Cigarette smoking and inflammatory indices in coronary artery disease.

BACKGROUND: Smoking-induced endothelial dysfunction may lead to inflammatory activation within a vascular wall mediated by cytokines and adhesion molecules. The aim of the study was to assess the relationship between the smoking status and serum levels of tumor necrosis factor (TNF) alpha, sTNFR 1 and 2 (soluble forms of TNF receptor), Interleukin (IL)-2, IL-10 and some selected adhesion molecules (AM): sE-selectin, sP-selectin, Vascular Cell AM-1 (sVCAM-1) and Intercellular AM-1 (sICAM-1) in patients with coronary artery disease (CAD). METHODS AND RESULTS: The study group consisted of 122 consecutive admissions with stable CAD (class II/III CCS): 31 current smokers (group I; mean age+/-S.E.M.: 53.8+/-1.6 years), 38 ex-smokers (group II; mean age+/-S.E.M.: 57.8+/-1.4 years) and 53 patients who have never smoked (group III; mean age+/-S.E.M.: 62.4+/-1.1 years). Serum concentration of IL-2 was higher in the group of active smokers (77.5+/-12.7 pg/ml) than in ex-smokers (40.0+/-10.6 pg/ml; P=0.017). AM determination also revealed differences between groups I and II-elevated serum sP-selectin levels in active smokers (174.7+/-17.1 ng/ml) than in ex-smokers (123.5+/-10.3 ng/ml; P=0.024). Serum sTNFR 2 level was higher in group III (2457.3+/-120.5 pg/ml) in comparison to group II (2018.4+/-121.5 pg/ml; P=0.006). There were no differences between TNF alpha, sTNFR 1, IL-10, sE-selectin, sICAM-1, sVCAM-1 levels in the groups examined. CONCLUSIONS: Cigarette smoking is associated with the elevation of IL-2 and sP-selectin serum levels in patients with stable CAD. CAD patients who have never smoked are characterized by delayed onset of angina and increased sTNFR 2 concentrations.

Age Factors↗
PubMed2004

[Value of dobutamine stress echocardiography for the diagnosis of coronary artery disease in women with aortic valve stenosis].

UNLABELLED: Dobutamine stress echocardiography (DSE) is widely used for diagnosis of coronary artery disease (CAD). However, data regarding the diagnosis of coronary artery disease in patients with moderately elevated maximal gradient across the stenosed aortic valve (AS) are limited. This study was designed to the value of DSE in the diagnosis of CAD in women with moderately elevated maximal gradient across the AS. PATIENTS AND METHODS: DSE was performed in 162 patients within the multicentre study. The group included 58 (mean age 61 +/- 13 years) females and 104 (mean age 58 +/- 13 years) males. DSE was performed with step-wise infusion every three minutes (5, 10, 20, 30 and 40 microg/kg/min). If the target heart rate was not reached, a further dose of 40 mcg/kg/min. together with atropine 0.25-1 mg was administered, in the absence of signs and symptoms of ischemia. Ischaemia was defined as new or worsened wall motion abnormalities at echocardiography. Coronarography was performed according to generally accepted indications. The significant coronary artery disease (>1 = 50% luminal diameter stenosis) of one of the major epicardial vessel was accepted as positive result for making the diagnosis of CAD. RESULTS: There was significant difference at rest between women and men with regard to left ventricular diastolic diameter (47.7 +/- 6.5 vs 55.6 +/- 8.8 mm), systolic diameter (30.1 +/- 7.9 vs 38.1 +/- 11.5 mm), ejection fraction (67 +/- 12 vs 55 +/- 17%), wall motion score index (1.05 +/- 0.17 vs 1.22 +/- 0.36) p<0.001. There were also a significant difference in left ventricular mass index and diastolic septum diameter (131 +/- 48 vs 152 +/- 46) and (12.5 + 2.7 vs 13.5 +/- 2.6 mm). Dobutamine peak dose was 31 +/- 11 microg/kg/min. The mean heart rate, mean systolic pressure and diastolic pressure were 114 +/- 26/min, 143 +/- 26 and 81 +/- 15 mmHg respectively. Sensitivity, specificity, and accuracy of DSE for the diagnosis of CAD in women were 77.8%, 95.8% and 90.9%. Those in men were 72.7%, 78.8% and 75.6%, respectively (NS). CONCLUSION: The diagnostic value of dobutamine stress echocardiography for the diagnosis of coronary artery disease in women with stenosed aortic valve is high. DSE is good method for the diagnosis.

Adolescent↗
PubMed2004

[Immunologic activity in coronary heart disease and atherosclerosis of the lower extremities].

Cytokine activation may be connected to increase of clinical symptoms both of coronary heart disease and lower limbs atherosclerosis. Our aim is to determine the influence of the atherosclerosis generalization upon immune activation in coronary heart disease, with regard to ECG stress test. 127 patients have been included in the study: 21 with stable angina and peripheral artery disease (PAD)--group A, and 106 with stable angina--group B. 20 healthy persons comprised the control group (group K). The serum concentration of TNF alpha, sTNFR 1, E-selectin and sVCAM-1 has been measured before and after the ECG stress test, using the ELISA method. Serum concentration levels of TNF alpha (A: 17.8 +/- 6.2 pg/ml, B: 17.4 +/- 3.8 pg/ml) and sTNFR 1 (A: 1678.5 +/- 600 pg/ml, B: 1376.4 +/- 558 pg/ml) have been significantly higher in both research groups than in the control group K (8.3 +/- 1.4 pg/ml, p < 0.001; 1093.9 +/- 457 pg/ml, p < 0.01). The sTNFR 1 concentration has been significantly higher in group A than in group B (p < 0.05). A significant post-exercise increase in E-selectin serum concentration has been observed, regardless to coincidence of lower limbs atherosclerosis. The atherosclerosis generalization level, e.g. the prevalence of PAD, in patients with coronary heart disease has an influence on immune activation--patients with lower limbs atherosclerosis are characterized by higher sTNFR 1 serum level. The ECG stress test induces the increase of E-selectin serum concentration in coronary patients, regardless of PAD.

Aged↗
PubMed2004

["Heart attack in humans"--the health belief model in comparison with the health reality of patients with myocardial infarction].

Myocardial infarction (MI) is the direct cause of 40% of all deaths, independently of the high standard of medical treatment. The main aim of the study was to define the relationship between the declarative health model (declarations) and the real health activity of the sufferers (realization). The research was performed on 107 patients after acute MI, hospitalized in the Cardiology Department Medical University of Silesia. They were questioned in direct interviews. In addition, the modified form of Shalit's circle was applied. The results indicated the coexistence of two health models of patients. In declarations, there is a model of person with interior attribution of MI (90.65%) that has a feeling of ability to influence his/her health (e.g. through the lifestyle: 63.55%; an individual's character: 41.12%). In realization, there is a model of sick patient with exterior attribution of heart attack (e.g. political and economic crisis, innate predisposition). A similar tendency in the perception of health factors and planning of changes after MI was observed. For instance, 50.47% patients talked about "the increase caution" or "slowing down" as a new planned form of activity. Moreover, of 92% patients who have the social support only 33.64% consider that as an important factor for health. The results suggest a divergence between declarations and real health activity. The launched health model of beliefs seems to be too costly and not attractive enough. Taking into consideration the complete risk factors in MI and making the proposed health belief system more accessible seem to be essential for creating an adequate prevention program.

Adult↗
PubMed2003

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↗
PubMed2003

Serum tumour necrosis factor-alpha, interleukin-2 and interleukin-10 activation in stable angina and acute coronary syndromes.

BACKGROUND: Dynamic instability of coronary atherosclerotic plaque results in the development of both unstable angina and myocardial infarction. The aim of the study was to investigate the dynamics of serum concentrations of tumour necrosis factor (TNF)alpha, interleukin (IL)-10, and IL-2 in patients with myocardial infarction (MI) and unstable angina (UA) as compared to stable angina (SA) patients and healthy volunteers. METHODS: A total of 189 patients with coronary artery disease (CAD) were studied: 100 patients with SA (class II/III according to CCS), 57 patients with UA (Braunwald class IIIB; determinations at 6, 24, and 48 h after chest pain), and 32 patients with MI (determinations at admission, on the 7th and 30th days after MI). Twenty healthy volunteers acted as controls. RESULTS: Serum TNFalpha levels were elevated in all CAD groups (SA: 17.3+/-4; UA: 18.7+/-4; MI: 22.0+/-3 pg/ml; p<0.001) in comparison to the controls (8.3+/-1.4 pg/ml). However, the highest values were characteristic of MI patients, especially values obtained at admission (p<0.01 versus SA and UA). Mean serum concentrations of IL-2 were significantly higher in patients with MI and UA (89.6+/-40; 87.0+/-24 pg/ml, respectively; p<0.01) when compared to SA and the control group (58.3+/-49; and 51.5+/-39, respectively). Serum IL-10 levels were also higher in MI and UA patients. Levels of IL-2 and IL-10 measured following chest pain in unstable patients, as well as their consecutive determinations in MI patients did not show any change dynamics, that is, they were persistently elevated. CONCLUSIONS: When compared to stable CAD and healthy subjects, acute coronary syndromes are associated with long-term increase of serum concentrations of pro- and anti-inflammatory cytokines. It seems likely that sudden CAD progression leading to acute coronary syndromes is triggered/accompanied by prolonged immune activation.

Acute Disease↗
PubMed2003

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↗