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Biomedical subjects

S Pasyk

Publications and source records attributed to S Pasyk.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Effect of water immersion on the cortisol, glucose, growth hormone and prolactin levels in patients with transplanted heart].

In 6 heart transplant patients (HTP) and in ten healthy subjects the influence of head out water immersion (WI) on blood levels of glucose, cortisol, somatotropic hormone (HGH) and prolactin was examined. Under baseline conditions. HTP showed similar blood levels of the above mentioned parameters as normals. After WI a significant increase of blood HGH but decrease of blood cortisol and prolactin were found in both examined groups. HTP differed from healthy subjects only by a less marked decline of blood cortisol induced by WI. Data obtained in this study suggest presence of a preserved physiological endocrine response of HTP to WI.

Adult↗
PubMed1990

Predictors of ventricular tachycardia inducibility in programmed electrical stimulation and the effectiveness of serial drug testing: Polish multicenter study.

In 100 patients with IHD and complex ventricular arrhythmias, programmed electrical stimulation was performed using up to three extrastimuli at sinus rhythm, and paced 100, 120 and 140 beats/min delivered from the RV apex, outflow tract or the LV with ventricular mapping to evaluate late potentials (LP) in 41 patients. Sustained monomorphic VT (SMVT) was provoked in 91% of 42 patients with a history of VT/VF, P less than 0.001, all five patients had SMVT in 24-hour ECG, P less than 0.005, and 91% of 21 patients with LV dyskinesis, P less than 0.01. After depolarizations were found in 62% of 21 patients with a history of VT, in 58% of 31 patients with inducible VT, P less than 0.01 and in five of six patients with LV dyskinesis. In patients with inducible VT, LP had a higher amplitude (105 +/- 35 vs 60 +/- 47 microV) and were more delayed (202 +/- 96 vs 133 +/- 75 msec) than in noninducible patients. In 17 patients, serial drug testing was performed after oral administration using mexilitene, disopyramide, chinidine, propafenone, sotalol, and amiodarone. If one drug was tested, the therapy efficacy was 25%, if two drugs-60%, and if three drugs-75%. In eight patients, VT was inducible in all tests, but in only one of these patients chronic antiarrhythmic therapy was not effective. We conclude that the most important predictors of VT inducibility are a history of VT or 24-hour ECG, and LV dyskinesis. Serial drug testing is efficient only when many drugs are tested, but even if VT is inducible, it does not exclude the possibility of a good clinical outcome in chronic therapy.

Adult↗
PubMed1990

[Surgical treatment of paroxysmal ventricular tachycardia (personal observations)].

Five patients with recurrent VT/VF resistant to medical treatment were successfully treated surgically. In 3 patients excision of the altered endocardium by Harken's method (endocardial peeling) was done; in 2 of the patients it was preceded by intraoperative electrophysiological study. Two other patients were treated alternatively: a 45-year old patients with post-MI cardiomyopathy had a cardiac transplantation and a 57-year old patient with good left ventricular function an implantation of a automatic cardioverter-defibrillator (AICD). No patient had VT and/or VF during the 14-35 month follow-up. Exercise tolerance improved in all patients. Good short- and longterm results of surgical treatment show that these methods can be effective in treating patients with life-threatening arrhythmias resistant to pharmacological therapy.

Aged↗
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

[Late right and left ventricular potentials using inter-cardiac recording in patients with ischemic heart disease--methodologic and clinical problems].

The aim of the study was to compare detection frequency of late inter-cardiac potentials recorded from the right and left ventricle. There was also estimated relationship between their incidence and ventricular tachycardia or fibrillation occurrence. 41 patients with ischemic heart disease underwent the study. Electrophysiologic examination were performed because of ventricular tachycardia and/or fibrillation attacks or complex ventricular arrhythmias recorded in ECG Holter monitoring. In 11 patients intracardiac electrocardiograms were recorded from both ventricles, in 29 only from the right and in 1 from the left one. All patients underwent programmed right and/or left ventricular stimulation. Left ventricular end-diastolic diameter, segmental contractility and ejection fraction were echocardiographically estimated. Study results were statistically analyzed by means of CHI2 and t-Student tests for unpaired variables. Late potentials were more frequently observed in patients with left ventricular dyskinesis (p less than 0.01) and decreased ejection fraction. Late potentials recorded in patients with a history of ventricular tachycardia or fibrillation were more delayed to proceeded QRS complex and had a greater amplitude. This prolongation of ventricular activation can make an anatomic substrate for dangerous ventricular arrhythmias occurrence. Since the presence of late potentials in patients with contractility disorders is connected with more frequent incidence of spontaneous and provoked ventricular arrhythmias, endocardial late potentials recording may be of a prognostic value, if it is performed from both ventricles.

Coronary Disease↗
PubMed1990

[A case of paroxysmal ventricular tachycardia surgically treated based on electrophysiological diagnosis].

There was presented a case of recurrent ventricular tachycardia in the patient after myocardial infarction. Considering uneffective pharmacotherapy and several cardiac arrests, the patient underwent guided endo-cardiotomy based on complex electrophysiological diagnostics (including intraoperative examination). Postoperative period was uncomplicated. There were no recurrences of ventricular tachycardia during 18-month follow-up.

Electrocardiography↗
PubMed1990

[Effect of water immersion on glucose, insulin and atrial natriuretic factor levels in patients with transplanted heart].

In 6 heart transplant patients [HTP] and in 10 healthy subjects the influence of water immersion [WI] on blood levels of glucose, insulin and atrial natriuretic peptide [ANP] were studied. HTP showed significantly higher baseline ANP levels and a reduced response of ANP to water immersion as compared with normals. HTP did not differ from normals by baseline plasma levels of glucose and insulin. WI induced significant decline of blood glucose and increase of insulin in both examined groups. A significant correlation was found between WI induced increase of blood insulin and ANP and between the increase of ANP and decline of blood glucose both in HTP and in healthy subjects. Data presented in this paper suggest existence of a significant relationship between ANP and insulin secretion and participation of ANP in the carbohydrate metabolism both in normals and HTP.

Adult↗
PubMed1989

Estimation of the size of myocardial infarct and its clinical application.

CK-MB activity was estimated in 16 patients and infarct size was calculated on that basis using our own computer programme. The infarct size was confronted with ejection fraction calculated in haemodynamic studies (p = 0.01). In the next step the ejection fraction was determined basing exclusively on changes of CK-MB activity. Significant changes between the value of fractions defined in these ways appear in the case when myocardial necrosis simultaneously involves the right ventricle.

Adult↗
PubMed1989

Atrial natriuretic peptide secretion in heart transplant patients.

Plasma atrial natriuretic peptide (ANP), plasma renin activity (PRA), aldosterone (ALD) and vasopressin (VP) were assessed in six heart transplant patients (HTP) and ten healthy subjects under bed rest conditions and 60 and 120 minutes after head-out water immersion (WI). Bed rest had no significant influence on these parameters. WI raised plasma volume (PV) to the same extent in both groups. This increase of PV was accompanied by significant suppression of PRA, ALD and VP and an increase of plasma ANP. In HTP basal plasma ANP was significantly elevated and the ANP response to central hypervolemia reduced. Significantly elevated VP plasma levels were also found in HTP. These endocrine abnormalities in HTP seem to be caused by latent failure of the transplanted heart. No direct correlation was found between plasma ANP and PRA, ALD and VP under basal conditions and after WI in either HTP or normals.

Adult↗
PubMed1989

Renal response to central volume expansion induced by water immersion (WI) in heart transplant patients.

This work was aimed to assess the secretion of volume related hormones in heart transplant patients (HTP) and their relationship to excretory renal function studied under bed rest and water immersion conditions. Fractional sodium (FENa%) and potassium (FEK%) clearance, plasma renin activity (PRA), plasma aldosterone (Ald), vasopressin (AVP) and atrial natriuretic peptide (ANP) were estimated in six HTP with moderate renal failure (C creat = 69 +/- 6.9 ml/min) and in 10 healthy subjects (N) (C creat = 110 +/- 2.0 ml/min). All HTP were treated with cyclosporine A and azathioprine. In HTP basal AVP (6.18 +/- 0.92 pg/ml) and ANP (138.17 +/- 14.69 pg/ml) levels were significantly higher than in normals (2.07 +/- 0.11 pg/ml and 74.10 +/- 7.10 pg/ml, respectively). HTP were also characterized by increased FENa% and FEK% both under bed rest (DI) and water immersion (WI) conditions. As abnormalities of excretory renal function in HTP were not significantly related to the plasma endocrine profiles factors other than PRA, Ald, AVP and ANP seemed to be also involved in their pathogenesis.

Adult↗
PubMed1989

Coronary artery stenosis in patients with valvular heart disease.

144 patients with valvular heart disease (VHD) underwent selective coronary angiography. Significant coronary artery stenosis was found in 26% of the examined patients. Diagnostic accuracy of some clinical indexes was analysed in this group. Most useful in predicting the presence of significant coronary narrowing in patients with VHD were increased cholesterol level and the presence of arteriosclerosis in lower limbs. Patients over 40 years who have both these indicators should have coronary angiography performed prior to surgical treatment.

Adult↗
PubMed1983

Noninvasive quantification of jeopardized myocardial mass in dogs using 2-dimensional echocardiography and thallium-201 tomography.

The evaluation of jeopardized myocardial mass is important in defining the effect of interventions during myocardial infarction. To quantitate the in vivo mass at risk, 2-dimensional echocardiography (2-D echo) and thallium-201 single-photon emission computed tomography (SPECT) was performed in 10 closed-chest dogs after circumflex coronary artery occlusion. The 2-D images were manually digitized to compute left ventricular (LV) mass using a modified Simpson's rule algorithm. This measure of LV mass correlated well with the actual LV mass (r = 0.97). Perfused myocardial mass was estimated from thallium SPECT images 4 hours after occlusion using a region-growing algorithm. After the dogs were killed, the jeopardized mass was outlined using a dual perfusion staining technique using triphenyltetrazolium chloride and Evans blue dye. The actual perfused mass was well estimated by the thallium images (r = 0.96). The noninvasively determined mass at risk was calculated as: 2-D mass--thallium SPECT mass, and correlated well with the pathologically determined mass at risk (r = 0.91). Thus, the jeopardized mass may be determined noninvasively by using 2-D echo and thallium-201 tomography. This approach may provide further information regarding the effect of intervention therapy on jeopardized myocardium.

Animals↗