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Biomedical subjects

Jarosław Rzezak

Publications and source records attributed to Jarosław Rzezak.

At least 19 recordsLinked to original sources
PubMed2005

Is diagnostic myocardial biopsy useful in the XXI century?

BACKGROUND: Progress in non-invasive diagnostic techniques such as ultrasonography, computerised tomography or magnetic resonance caused a significant decrease in the use of diagnostic myocardial biopsy (DMB). However, recent advances in molecular biology and widening knowledge about the role of new biochemical markers gives hope for more detailed assessment of cardiomyocyte pathophysiology, based on the proper examination of myocardial biopsy specimen. AIM: To assess current usefulness of DMB in the diagnosis of various myocardial disorders and monitoring after heart transplantation. METHODS: DMB was performed in 104 patients (84.6% males) with a clinical diagnosis of idiopathicdilated cardiomyopathy (35.6%), post-inflammatory dilated cardiomyopathy (22.1%), restrictive cardiomyopathy (2.9%), post-infarction myocardial injury (17.3%), ventricular arrhythmias resistant to treatment (2.9%), cardiac tumour (0.96%), suspected arrhythmogenic right ventricular dysplasia (0.96%) and with transplanted heart (17.3%). In each patient 3-4 specimens of the right ventricular cardiac muscle were taken. Immunohistochemical reactions were used to assess the presence of desmin. Myocarditis was diagnosed on the basis of morphological assessment of specimens stained with HE, Mallory trichome and immunohistochemical methods which identified lymphocytes T (CD3, OPD 4, UCHL1), endothelium (CD34) and antigen MHC II (DP, QR). In addition, specimens suggesting laminopathy or amyloidosis were examined under electron microscope. RESULTS: DMB revealed the absence of desmin (19.2%), abnormal concentration of desmin (21.1%), myocarditis (19.2%), so-called vascular myocardial injury (16.3%), other proteinopathies (2.3%), amyloidosis (1.9%), connective tissue diseases (0.96%), arrhythmogenic right ventricular dysplasia (0.96%), toxic injury (0.96%) and normal myocytes (0.96%). CONCLUSIONS: Our results suggest that complex analysis of myocardial biopsy specimen provides detailed information of the pathogenesis of cardiac disorders. However, further progress in molecular biology is needed to achieve more complete diagnosis.

Adult↗
PubMed2005

One-year clinical outcome after emergency hospitalisation for suspected acute coronary syndrome -- a comparative analysis with respect to angiographic findings.

INTRODUCTION: Among patients with suspected acute coronary syndromes (ACS) referred for urgent coronary angiography there are some with normal angiograms. AIM: To compare, with respect to angiographic findings, one-year clinical outcomes in patients hospitalised for suspected ACS. METHOD: Between January 2001 and December 2003 emergency angiography was performed in 1169 patients. It revealed no significant coronary lesions in 97 (8.3%) cases, of these 40 being women and 57 men with a mean age of 55+/-15 yrs (Group 1). Sixty consecutive patients with ACS (20 women and 40 men with a mean age of 54+/-9 yrs) and significant coronary artery disease (CAD) confirmed by angiography were the study controls (Group 2). Demographic data, CAD risk factors, angiographic findings, ECG and echocardiographic data as well as laboratory test results were analysed. In a long-term follow-up, the prevalence of recurrent angina and all-cause mortality were assessed. RESULTS: There were no significant differences in patients' demographics between the two groups with the exception of arterial hypertension, which was more frequent in group 1. In group 1 the diagnosis of ACS was established in 14.5% cases, X syndrome in 14.4%, Prinzmetal angina in 4.1%, myocarditis in 6.1% and pulmonary thromboembolization in 5.1%. A definite diagnosis was not related to the cardiovascular disease in 36%. No complications were observed in the late follow-up of group 1 patients. CONCLUSIONS: Apparently normal angiograms are relatively common in patients referred for emergency coronary angiography. In patients without significant CAD on their angiograms the clinical outcome is favourable, without major adverse cardiovascular events in the long-term follow-up.

Acute Disease↗