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Biomedical subjects

R Piotrowicz

Publications and source records attributed to R Piotrowicz.

At least 19 recordsLinked to original sources
PubMed1995

24-h ECG monitoring in patients with rheumatoid arthritis.

Although the main cardiac complication in patients with rheumatoid arthritis is subclinical pericarditis, mononuclear cell infiltrations into myocardium may cause cardiac arrhythmias and conduction defects. In order to examine these problems we evaluated 70 patients (53 women and 17 men) aged 18-83 years (average 56.7 +/- 11.2) with classic or definite rheumatoid arthritis, according to diagnostic criteria. Duration of the disease was 1-35 years (average 8.7 +/- 8.4). The control group comprised 70 patients admitted to hospital with degenerative joint disease, a duodenal ulcer, or who required treatment for ophthalmological or laryngeal reasons; these patients were matched for sex and age. In all patients standard 12-lead ECG investigations were performed, as well as 24-h ECG monitoring, using an Oxford Medical System device with two precordial leads CM5 and CS2, according to the Holter method. We analysed heart rate, conduction disturbances, and occurrence of arrhythmias, on the basis of generally assumed ECG criteria. Cardiac arrhythmias were found in 50% of patients with rheumatoid arthritis, and their occurrence was similar to that in the control group. Observed arrhythmias were independent of the progression of arthritis, the type of treatment administered, the familial occurrence of arthritis, the presence of manifestations pertaining to organs, the presence of rheumatoid factor, the stage of the disease according to Steinbrocker, or the presence of immune complexes in serum and HLA Dr antigens, which are regarded as fundamental in the pathogenesis of rheumatoid arthritis.

Adolescent↗
PubMed1992

[Diurnal variability of heart rate during paroxysmal ventricular tachycardia].

The aim of this study was to assess the diurnal variability of heart rate during VT. For the purpose of this investigation VT was considered to be a minimum of 3 consecutive ventricular beats in duration at a rate more than 100 bpm. From the group of 287 patients with VT during 24-hour ECG monitoring, a selection was made of 52 patients in whom episodes of monomorphic VT occurred in the day-time and night-time without any changes of the QRS morphology. Thirty one patients had ischemic heart disease, 10--dilated cardiomyopathy, 2--mitral valve prolapse and 10 patients had no evidence of heart disease. In these patients the rate of VT (HR-V), basic heart rate (HR-S) before VT, and coupling interval (CI) of VT initiating beat were measured during day-time and night-time. The mean VT rate was 170 +/- 34 bpm during day-time and 149 +/- 36 bpm during night-time (p < 0.001). The mean sinus rhythm rate was significantly (p < 0.001) greater during day-time (88 +/- 16 bpm) than at night (78 +/- 19 bpm). There was significant difference in the mean values of the CI between day-time and night-time (504 +/- 122 vs 589 +/- 181 ms). A significant correlation was noted between HR-V and HR-S at night (r = 0.73; p < 0.001) but not during day-time (r = 0.38). Thus, HR-V similarly as HR-S is greater during day-time than during night-time. Diurnal variability of HR-V may be related to changes in autonomic nervous system tone.

Activities of Daily Living↗
PubMed1992

[Effect of beta adrenergic blocking drugs on the prognostic value of ST-segment depression during exercise electrocardiogram testing].

Exercise testing has been shown to be predictive for future cardiac events in patients with established diagnosis of coronary heart disease. Exercise test parameters associated with poor prognosis may be unreliable if patient is receiving beta adrenergic agents. The purpose of this study was: 1) to compare the results of exercise testing performed before and during beta blocking therapy, and 2) to determine the role of beta blockers in the prognostic significance of the ST-segment response recorded during exercise testing. The study population consisted of 518 patients (mean age 52 +/- 7 years) with coronary heart disease. The diagnosis was based on the presence of one of the following three criteria: 1) typical history and significant ST-segment depression on resting or exercise electrocardiogram, 2) history of myocardial infarction, 3) significant coronary angiographic abnormalities. In all patients symptom-limited exercise test was performed before and two weeks after the onset of beta blocker therapy. The data from the first and second tests were estimated for significance of differences between the mean values with following results: maximal heart rate--135 +/- 21 and 123 +/- 19 bpm (p less than 0.001), maximal work load achieved--98 +/- 43 and 109 +/- 44 W (p less than 0.001), maximal systolic blood pressure--171 +/- 28 and 163 +/- 26 mmHg (p less than 0.001). Occurrence of characteristic ST-segment depression was more frequent during the first than during the second test (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
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↗
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↗
PubMed1987

[Lactate threshold and the physiological cost of work].

Mean values for body size, fitness and endurance performance indices have been obtained from 20 industrial workers. Then the pulse rate from ECG using the Holter method during the worktime was registered and from the regression line PF on load energy expenditure was calculated. The "somatic" and "fitness" indices of subjects were not statistically significantly different from average workers population in Poland. The mean AT demonstrated that the subjects were able to perform hard work without metabolic acidosis developing, though those exhibiting lower AT worked with higher physiological cost of work. The study confirmed that the Holter method is extremely good for energy expenditure investigation during the worktime. Furthermore it was demonstrated that the physiological cost of moderate-heavy work was lower in subjects with higher AT. The authors suggested that the level of AT for medium-fit workers should come to about 2 dm3(02) X min.-1 (60%v02 max.

Adult↗
PubMed1985

Clinical significance of the pattern of incomplete left bundle branch block with bifascicular block.

A comparative analysis was carried out of 126 patients (group I) with chronic right bundle branch block (RBBB) and left anterior (LAFB) or left posterior fascicle block (LPFB), and of 44 patients (group II) with the same bifascicular block associated with an ECG pattern of incomplete left bundle branch block (ILBBB). The two groups were found to be clinically different. In group II, heart failure, arrhythmia and first-degree atrioventricular block occurred significantly more frequently. During a mean follow-up period of 1581 +/- 118 days (85-6260 days), complete heart block (CHB) developed in 3.2% of patients in group I and in 22.7% in group II (p less than 0.01). In the same period, sudden cardiac death (SCD) occurred in 3.9% in group I and in 15.9 in group II (p less than 0.01). These results were analysed assuming a quadrifascicular character of the intraventricular conduction system. This made it possible to isolate on the basis of standard ECG findings patients with trifascicular block (group II--RBBB and LAFB or LPFB and septal LBBB) in whom prophylactic pacemaker implantation should be considered in view of high risk of CHB and SCD.

Adult↗