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Biomedical subjects

A Dabrowski

Publications and source records attributed to A Dabrowski.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Pro-arrhythmic effects of antiarrhythmic drugs in patients with ischemic heart disease].

The incidence of proarrhythmic effect of antiarrhythmic drugs (AADs) in not well documented. The aim of the study was to assess the frequency od proarrhythmia in patients with ischemic heart disease (IHD) and ventricular premature beats (VPBs) in whom various class I, II and III AADs were tested by 24-h Holter ecg. All data were collected in a prospective manner. Our material consisted of 639 patients with IHD and VPBs (Lown's grade 2-5). The mean age was 53 years. 63% of patients had previously myocardial infarction. 15% and 3% had documented ventricular tachycardia (VT) or ventricular fibrillation (VF), (VF), respectively. Baseline Holter monitoring revealed repetitive VPBs or R on T phenomenon in 64% of cases. Plasma electrolytes level, renal and hepatic function were normal. Antiarrhythmic therapy was guided by repeated 24-h Holter ecg on a maintenance dosage of the drug. Propranolol was a drug of first choice. Disopyramide or mexiletine was added if propranolol alone was found to be ineffective in control Holter ecg. Amiodarone was a drug of a next choice. It was allowed modify the treatment in patients with contraindication to propranolol, clinical VT/VF or high grade VPBs. 794 drug tests were conducted. Number of tests/patient ranged 1-4. The following AADs were assessed: propranolol (352 tests), disopyramide (280 tests), mexiletine (73 tests), amiodarone (89 tests). Aggravation of arrhythmia was defined by modified criteria proposed by Velebit: 1) greater than or equal to 4-fold increase in VPBs, 2) greater than or equal to 10-fold increase in couplets or salvoes, 3) occurrence of VT. Proarrhythmia was recognized when at least one criterion was present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Programmed electrical stimulation of the heart in relation to left ventricular contractility in ischemic heart disease].

To determine the relation between left ventricular contractility disorders and the inducibility of serious ventricular arrhythmias, 83 patients (pts) with ischaemic heart disease and ventricular tachycardia (VT) or fibrillation (VF) in history and/or Lown's class IVb arrhythmia in 24-hour Holter ECG monitoring were evaluated by means of echocardiography and programmed electrical stimulation (PES) of the heart. Inducible VT or VF were observed in 66% of pts: sustained monomorphic VT (SMVT) in 33%, nonsustained VT (NSVT) in 28% and VF in 6%. VT or VF were significantly more frequent in patients with VT/VF in history (91% vs 42%, p less than 0.001), SMVT (48% vs 17%, p less than 0.01) as well as NSVT (38% vs 17%, p less than 0.01). Low ejection fraction (EF less than 40%) was observed in 18 pts (22%), VT/VF was inducible in 94% of them, while only in 57% with EF greater than or equal to 40%, p less than 0.01, SMVT in 39% vs 30%, NSVT in 33% vs 25%. Among 21 pts (21%) with left ventricular (LV) dyskinesis in 91% of pts while only in 55% without it, p less than 0.01, SMVT in 53% vs 26%, p less than 0.05. We concluded that in patients with previous myocardial infarction, VT/VF in history and abnormal LV contractility full haemodynamic, angiographic and electrophysiologic examination should be performed to determine their risk of sudden death due to serious ventricular arrhythmia before final decision about the mode of treatment.

Adult↗
PubMed1990

[Complex ventricular arrhythmias in ischemic heart disease].

The purpose of the study was to describe the clinical picture in patients with ischemic heart disease (IHD) and verifying severity of ventricular arrhythmias. The study included 856 patients with IHD aged 23-88 years (mean = 55.3), including 659 men and 197 women. Holter monitoring was performed in all patients. Ventricular arrhythmias were graded according to Lown. The patients were divided into five groups: group 1-349 patients with Lown's grade 1 and 2; group 2-95 patients with grade 3; group 3-152 patients with grade 4a and 4b; group 4-11 patients with grade 5; group 5-507 patients (selected from groups 2, 3 and 4) with Lown's grade 3 and 4 or 5. Arterial hypertension was found in 17.1%, myocardial infraction in 66%, and syncope in 12.3% of the patients. The patients with complex ventricular arrhythmias versus Lown's grade 1 and 2 show significant differences especially in respect to: the frequency of previous anterior myocardial infraction, the incidence of pain at rest, loss consciousness, the frequency of ventricular tachycardia and fibrillation, anginal pain and exercise-related arrhythmias. The patients with Lown's ventricular arrhythmia grade 3-5 do not differ significantly in their clinical manifestations of IHD from the patients with ventricular arrhythmias grade from 3 to 5. The development of silent myocardial ischemia during exercise stress testing is typical also for the patients with complex ventricular arrhythmias. A decreased contractility index, ejection fraction and dyskinesis are significantly more frequent in the patients with complex ventricular arrhythmias.

Adult↗
PubMed1990

[Effect of amiodarone and disopyramide on the results of electrocardiographic exercise stress testing in patients with coronary disease].

The study was designed to assess the influences of antiarrhythmic therapy on exercise tolerance in patients with coronary artery disease and ventricular arrhythmias. Subjects for this study were subdivided into 3 groups: group I - 46 patients treated with amiodarone 1,200 mg daily during 10 days and 200-600 mg daily within next days, group II - 79 patients receiving disopyramide 300-600 mg daily, group III - 129 patients with combined administration of disopyramide 300-600 mg daily and propranolol 30-240 mg daily. propranolol 30-240 mg daily. Submaximal exercise stress testing was performed in each patient before treatment and after the medication for 4 weeks (group I) and for 2 weeks (groups II, III). The following parameters have been evaluated: maximal archived workload, maximal heart rate blood pressure response, double product (maximal heart rate x maximal systolic blood pressure), reasons for ending the test (target heart rate, typical angina, exhaustion, ST-segment depression greater than or equal to 2 mm, occurrence of ventricular arrhythmia, blood pressure greater than 250/120 mm Hg, significant drop in systolic pressure). Positive result of exercise ECG was defined: horizontal or down-sloping ST-segment depression greater than or equal to 1 mm and/or typical chest pain. The data from the first and second tests were estimated for significance of differences between the mean values with following results: 1) maximal achieved workload, 86 +/- 46 and 103 +/- 49 W (p less than 0.02) in group I; 101 +/- 64 and 106 +/- 50 W (NS) in group II; 107 +/- 55 and 119 +/- 54 W, W (p less than 0.01) in group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Amiodarone↗
PubMed1990

[Late ventricular potentials and spontaneous and electric stimulation-induced ventricular tachycardia].

The purpose of this study was to compare the relation of signal averaged variables of the QRS complex to spontaneous and to inducible sustained ventricular tachycardia. Signal averaging of the surface QRS complex was performed in 96 patients with coronary artery disease and ventricular arrhythmias. Twenty eight of them were evaluated by programmed electrical stimulation. Signal average variables were considered abnormal as: 1) the QRS duration as the time from the onset to end point of the QRS vector complex greater than 120 ms, 2) the maximal amplitude of the terminal 40 ms of the QRS vector complex less than 25 microV, 3) the duration of low (less than 40 microV) amplitude signal of QRS vector complex less than or equal to 40 ms. The ventricular late potentials were defined as the pressure of 2 or 3 abnormal averaged variables. Programmed electrical stimulation was performed using single and double extrastimuli at sinus rhythm and at ventricular pacing rates 100, 120, 140 bpm, followed by ventricular burst pacing (3 and 10 consecutive beats) at sinus rhythm. If stimulation of the right ventricular apex did not initiate ventricular arrhythmias (sustained ventricular tachycardia, ventricular fibrillation or two repetitive nonsustained ventricular tachycardias) right ventricular outflow tract stimulation was performed. Sustained ventricular tachycardia was defined as ventricular tachycardia lasting 30 s or requiring termination because hemodynamic compromise. Quantitative comparison of signal averaged variables was performed in patients with inducible versus noninducible ventricular tachycardia and in patients with spontaneous versus non-spontaneous ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1990

[Late ventricular potentials and ventricular arrhythmia in patients with stable ischemic heart disease].

Ischaemic heart disease especially after previous myocardial infarction can predispose to the life-threatening ventricular arrhythmias. Late potentials (LP) are confirmed parameters predicting patients prone to sudden cardiac death in ventricular arrhythmias mechanism. Late potentials registered noninvasively from the body surface were analysed in 86 patients with stable ischaemic heart disease (67 males and 19 females aged 35-67, mean 53 years). Registration of signal average electrocardiograms (SA-ECG) were performed by Simson technic (X, Y, Z orthogonal leads) using identical analysing systems and quantitative SA-ECG criteria in all three participating centers. In all patients ventricular arrhythmias detected on 24-hour ecg Holter monitoring were assessed. The localisation of previous myocardial infarction and echocardiographic assessment of left ventricular function were also analysed in each case. The results of SA-ECG were correlated with these clinical findings. Late potentials were detected (according to two or three accepted criteria) in 16 pts (19%), in 53 pts (61%) SA-ECG were normal but in other 17 pts (20%) abnormal SA-ECG (according to only one criterium) were registered. Out of these 17 pts with abnormal SA-ECG, 14 pts had prolonged filtered QRS duration as the only incorrect SA-ECG parameter. Comparative analysis between studied groups shows higher incidence of previous Q-wave myocardial infarctions in patients with LP and with abnormal SA-ECG than in patients with normal SA-ECG (63% and 71% vs 43% respectively; p less than 0.01). Ventricular arrhythmias observed in studied patients occurred with similar frequency in all groups however in patients with LP and with abnormal SA-ECG complex ventricular arrhythmias were more common than in group with normal SA-ECG (56% and 53% vs 49% respectively: NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1990

[Comparative evaluation of the results of Holter monitoring and programmed ventricular stimulation in patients with ischemic heart disease].

24-hour ECG Holter monitoring and programmed ventricular stimulation were performed in 81 patients (64 males and 17 females aged 35-65). No ++anti-arrhythythmic agents nor beta-blockers were administrated. 58 patients suffered from myocardial infarction in the past, and 38 had a history of ventricular tachycardia. Right atrial and ventricular stimulation (in 7 patients also left ventricular stimulation) was performed using stimuli of a 2 ms pulse width. 24-hour ECG Holter monitoring was recorded on a magnetic tape from two bipolar precordial leads. Both examinations results were compared to assess correlation between ECG Holter monitoring parameters and inducibility of VT or VF by programmed stimulation. Significant correlation was stated among occurrence of: 1) spontaneous sustained ventricular tachycardia and induced by stimulation monomorphic sustained VT (p less than 0.005) as well as estimated both sustained and nonsustained VT (p less than 0.010) 2) spontaneous nonsustained VT and induced by stimulation sustained or nonsustained monomorphic VT (p less than 0.025). There was no correlation between spontaneous ventricular arrhythmias estimated by Lown and Wolf's classification and possibility to induce monomorphic VT as well as between any of ECG Holter monitoring parameters and polymorphic VT or ventricular fibrillation induced by stimulation. Aggressiveness extent of stimulation protocol necessary to induce monomorphic VT was similar in patients with or without VT recorded by Holter method.

Adult↗
PubMed1989

Retroperitoneal tumors.

Retroperitoneal tumors (RPTs) are most commonly found in anatomically confined spaces. Primary RPTs are to be distinguished from those arising from retroperitoneal organs or from the metastatic masses. They may originate either from anyone of the three embryonal leaves or may take on more complex composition, consequently accounting for their varied histological appearance (1, 10). Badowski et al. (1) gave the following occurrence ratio: mesenchymal tumors account for 61.5%, mixed tumors for 23% and nervous tissue tumors--15.5%. They possess either benign or malignant potentials, with invasion of the neighbouring tissues and organs by the growth. The mode of disease at early stage is rarely conspicuous. Patients usually present with vague abdominal pains and palpable resistance. The techniques that are employed consist in the CT, USG and the selective angiography accompanied by passage films and the urography.

Adult↗
PubMed1989

[Value of Holter monitoring and the electrocardiographic exercise test in the diagnosis of silent ischemia after myocardial infarction].

In 75 patients 24-hour ecg monitoring value was compared with exercise test in diagnostics of postinfarction silent ischemia. Results compatibility of both comparing examinations was 79% with regard to only painless ischemia (p less than 0.001) and 91% to both estimated painless or painful episodes (p less than 0.001). Painless ischemia was observed during ecg Holter monitoring and exercise test respectively in 39% and 35% of examined patients (NS) and/or with the angina respectively in 44% and 53% (p less than 0.01). 24-hour ecg monitoring and exercise test are of a comparable value in diagnosis of postinfarction silent ischemia, whereas in diagnostics of jointly estimated painless or painful ischemia the exercise test is a more sensitive examination than ecg Holter monitoring.

Adult↗
PubMed1988

Binding of dexamethasone and its effect on histamine release from rat mast cells.

Purified rat peritoneal mast cells were incubated for 20 h with or without dexamethasone (4 x 10(-6) M) and then passively sensitized with serum from Trichinella spiralis-infected rats. The release of histamine using various secretagogues (concanavalin A, crude antigen of T. spiralis and polymyxin B) was determined. Dexamethasone treatment markedly inhibited IgE-dependent release of histamine (from 33.9 +/- 5.0% to 12.4 +/- 5.1% and from 39.8 +/- 7.9% to 14.2 +/- 6.5% of total cellular histamine content, respectively) whereas histamine release stimulated by the nonimmunological stimulus, polymyxin B was unaffected by this steroid. This suggests that the effects of dexamethasone cannot be exclusively explained by inhibition of phospholipases. Specific binding of 3H-dexamethasone to purified mast cells displayed sigmoidal dependence on concentration which may be the result of either negative cooperativity or the presence of a different class of binding sites. Two saturation plateaux at 20-30 x 10(-9) M and 70-90 x 10(-9) M were observed. The equilibrium dissociation constant for the higher affinity binding sites was Kd1 = 1.9 x 10(-8) M and represented 25,290 sites/cell, whereas the apparent Kd2 for lower affinity sites amounted to 5.5 x 10(-8) M and represented about 120,000 sites/cell.

Animals↗
PubMed1988

Oxygen-derived free radicals in cerulein-induced acute pancreatitis.

Conscious rats were treated with a supramaximal dose of 5.10(-6)g.kg-1.h-1 of cerulein for periods of 3 and 12 h. In both groups of animals typical features of acute oedematous pancreatitis were proved by biochemical and histologic examinations. The most important finding of our study was the decrease of superoxide dismutase (SOD) activity in pancreatic tissue, accompanied by a slight increase of this scavenger enzyme in serum of rats stimulated with cerulein during 3 h. Parallelly, evident elevation of malondialdehyde (MDA) concentration in pancreatic tissue was noted. After the 12-h infusion of cerulein we were not able to detect any SOD activity in pancreatic tissue, whereas this activity appeared in ascitic fluid of tested animals. Further increase of MDA concentration in pancreatic tissue, in comparison with 3-h pancreatitis, was found. These data suggest that in 3-h and 12-h cerulein-induced pancreatitis the oxygen-derived free radicals mediate the increased lipid peroxidation in pancreatic tissue. We think that the depletion of the scavenger enzyme SOD may be responsible for such a disturbance of lipid metabolism.

Acute Disease↗