The authors described the usefulness of magnetic resonance imaging in the evaluation of the viability of the left ventricular myocardium in a patient with a history of cardiac infarction treated with primary coronary angioplasty (primary... more
The authors described the usefulness of magnetic resonance imaging in the evaluation of the viability of the left ventricular myocardium in a patient with a history of cardiac infarction treated with primary coronary angioplasty (primary PCI) and with symptoms of postreperfusion injury of the left ventricular muscle (no-reflow phenomenon). The perfusion of the left ventricular myocardium was evaluated with the use of paramagnetic contrast. The heart movement was evaluated at rest and after the administration of a small dose of dobutamine. The use of magnetic resonance tomography made it possible to pinpoint the area of stunned and necrotic myocardium.
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The goal of this study was to develop an optimal procedure to determine age-related changes in trabecular bone. The investigations were based on two-dimensional images of the human vertebral trabecular bone specimens. The following... more
The goal of this study was to develop an optimal procedure to determine age-related changes in trabecular bone. The investigations were based on two-dimensional images of the human vertebral trabecular bone specimens. The following indices of trabecular structure were considered: bone volume/total volume, star volume of the marrow cavity, Euler number and the probability of disconnection (straightforwardly connected with the number of separated parts of the network). To follow precisely the changes in the trabecular structure with age, a computer simulation model was used. Up to 35 years of physiological remodelling were simulated. The validation of the model calculations was based on a quantitative comparison with the data measured for older individuals. The simulations confirmed that the description of the age-related changes in the trabecular bone by means of the architectural parameter (star volume) constitutes a promising tool for subjects older than approximately 50 years. For...
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Impaired left ventricular (LV) function with decreased ejection fraction (EF) is a frequent finding in patients with ischaemic heart disease. As a non-invasive method, cardiovascular magnetic resonance (CMR) has become an important... more
Impaired left ventricular (LV) function with decreased ejection fraction (EF) is a frequent finding in patients with ischaemic heart disease. As a non-invasive method, cardiovascular magnetic resonance (CMR) has become an important diagnostic method in cardiology within the past decade, especially for assessing myocardial function. The purpose of this study is to compare EF estimated with 99mTc gated SPECT (GSPECT) and with CMR. The study was performed in a group of 35 patients (11 F, 24 M; mean age 57 SD 10) after myocardial infarction. EF in CMR procedure was calculated using cine gradient echo sequences. GSPECT measured EF was estimated by Tc 99. The mean value of EF measured with scintigraphy was 50.5 +/- 17%, and measured with CMR 48.3 +/- 15%. The difference in mean values of EF was not statistically significant. 1. EF in CMR was highly concordant with GSPECT. 2. The mean value of EF measured with CMR in 75% of study patients was smaller than in the scintigraphy group, but the...
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Conventional coronary angiography is the undisputed gold standard for the detection of coronary artery disease. A small but not negligible risk related to the procedure, cost, and radiation exposure have given rise to the development of... more
Conventional coronary angiography is the undisputed gold standard for the detection of coronary artery disease. A small but not negligible risk related to the procedure, cost, and radiation exposure have given rise to the development of noninvasive alternatives such as multi-slice computed tomography, and magnetic resonance coronary angiography. In some patients classic X-ray coronary angiography involves high risk and technical difficulties. Fast, non-complicated and easy to use non-invasive imaging procedures should be developed to avoid unnecessary or technically difficult, uncomfortable situations for patients with documented myocardial ischemia. We present three cases of patients who underwent coronary artery bypass graft surgery or were disqualified from it on the basis of MSCT imaging.
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Magnetic resonance imaging (MRI) is a non-invasive method characterised by high temporal and spacial resolution that makes it possible to obtain very high-quality pictures. It is a less invasive method than TEE and is very significant in... more
Magnetic resonance imaging (MRI) is a non-invasive method characterised by high temporal and spacial resolution that makes it possible to obtain very high-quality pictures. It is a less invasive method than TEE and is very significant in the diagnosis of heart tumours. MRI makes it possible to assess the parameters influencing hemodynamic as well as morphological qualities of the tumour such a its size, its movement, its relation to the surrounding structures and the presence of a capsule. With the use of additional programming, it is possible to evaluate, indirectly, the metabolism of the diagnosed lesion as well as the degree of blood perfusion. Thus, MRI diagnosis of the heart is a valuable complementary technique in the verification of the diagnosis and in the referral to cardiosurgical treatment. The aim of this paper is to present the use of MRI in the diagnosis of an abscess of the mitral valve anulus in a female patient who did not agree to the transoesophageal echocardiogra...
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The aim of the study was to assess usefulness of multislice spiral computed tomography--MSCT (Somatom Plus 4 Volume Zoom, Siemens) in non-invasive assessment of the potency of coronary artery bypass grafts both venous and arterial grafts... more
The aim of the study was to assess usefulness of multislice spiral computed tomography--MSCT (Somatom Plus 4 Volume Zoom, Siemens) in non-invasive assessment of the potency of coronary artery bypass grafts both venous and arterial grafts as well as stents. The study was performed using the MSCT method with Heart View Software with retrospective electrocardiographic gating. Nonionic, hypo-osmolar contract media was infused into a peripheral vein to highlight the coronary arteries and bypasses. All patients, due to clinical indications, underwent coronary and bypass angiography. Two group of patients (82 persons) in total were evaluated: after aorto-coronary bypassing (Group I--57 persons, incl. 40 males and 17 females) and after stent implantation (Group II--25 persons, incl. 19 males and 6 females). The patients were referred to invasive diagnostics for recurrence and aggravation of clinical symptoms. In group I, the patency of 187 bypasses was evaluated (21 arterial and 166 venous)...
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1. Acta Cardiol. 2004 Apr;59(2):219-21. Evaluation of the relationship between selected markers of the inflammatory process and aortic valve calcifications. Pasowicz M, Konieczyńska M, Podolec P, Starzyk K, Mura A, Stepień E, Przewłocki... more
1. Acta Cardiol. 2004 Apr;59(2):219-21. Evaluation of the relationship between selected markers of the inflammatory process and aortic valve calcifications. Pasowicz M, Konieczyńska M, Podolec P, Starzyk K, Mura A, Stepień E, Przewłocki T, Tracz W. ...
Research Interests: Cytokines, Humans, Female, Male, Aged, and 5 moreMiddle Aged, C reactive protein, Calcinosis, ACTA, and Biological markers
The role of magnetic resonance imaging (MRI) as a diagnostic tool of coronary arteries disease has increased over the last years. Cardiac magnetic resonance (CMR) is a preferable tool in assessment of ventricular mass and function,... more
The role of magnetic resonance imaging (MRI) as a diagnostic tool of coronary arteries disease has increased over the last years. Cardiac magnetic resonance (CMR) is a preferable tool in assessment of ventricular mass and function, presence and size of post infarct scaring and anomalies of coronary arteries. CMR becomes also a useful method in evaluation of myocardial viability. Examination with gadolinium dye allows for evaluation of myocardial perfusion and viability. The extent of the post infarct late enhancement zone has an important prognostic value in the recovery of the left ventricle function. Dobutamine, adenosine or dypirydamol stress CMR becomes a promising noninvasive diagnostic modality in detection of coronary artery disease. At present coronary arteries magnetic resonance angiography is being developed as well as CMR spectroscopy.
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Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) has been shown to be associated with ventricular arrhythmias, however, its prognostic role in predicting sudden cardiac death has not yet been established. To... more
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) has been shown to be associated with ventricular arrhythmias, however, its prognostic role in predicting sudden cardiac death has not yet been established. To explore a potential relationship between LGE visualised by CMR and life-threatening ventricular tachyarrhythmia in hypertrophic cardiomyopathy (HCM). The LGE in CMR was assessed in 55 HCM patients. We compared the frequency and extent of LGE in HCM patients with sustained ventricular tachycardia (VT) or who survived ventricular fibrillation (VF) or sudden death [group VF (+)] versus HCM patients without these tachyarrhythmias [group VF (-)]. There were 14 patients in the VF (+) group and 41 patients in the VF (-) group, and they were followed for a mean period of 37 months. In group VF (+), adequate ICD intervention occurred in 9 patients (8 patients with VF and one patient with sustained VT), and VF arrest occurred in 5 patients (4 patients were res...
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Research Interests: Risk assessment, Sudden Death, Humans, Female, Male, and 14 moreHeart rate, Fibrosis, Risk factors, Middle Aged, Adult, Cardiovascular Imaging, Sudden Cardiac Death, Risk Factors, Risk Assessment, Hypertrophic Cardiomyopathy, Ventricular Tachycardia, Positive predictive value, Contrast Media, and Case Control Studies
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We report a case of acute coronary syndrome in a 58 year-old man with a history of double Bentall De Bono procedure (redo due to endocarditis). During the second operation, both main native coronary arteries were anastomosed end-to-end to... more
We report a case of acute coronary syndrome in a 58 year-old man with a history of double Bentall De Bono procedure (redo due to endocarditis). During the second operation, both main native coronary arteries were anastomosed end-to-end to aortic prosthesis using short vein graft insertions. Four months later the patient presented to the CCU with unstable angina. Computed tomography-scan suggested bilateral ostial stenoses. Percutaneous coronary intervention of the left proximal anastomosis was performed with DES. 14 months later the patient was treated with in-(DES) DES implantation.
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Magnetic resonance imaging of tissues and organs, specifically the use of magnetic resonance specroscopy (MRS) for examination of metabolism in vivo, is a relatively new modality with a very dynamic development and a promising future. In... more
Magnetic resonance imaging of tissues and organs, specifically the use of magnetic resonance specroscopy (MRS) for examination of metabolism in vivo, is a relatively new modality with a very dynamic development and a promising future. In the past few years, magnetic resonance imaging (MRI) has been used more widely in cardiology. A certain stereotype has been broken that this modality is dedicated strictly for neuroradiology. The technological advances in MRI include introduction of new systems with short acquisition times and software for imaging of the heart and large vessels (cardiac package). Potent and fast gradients in new MR systems make it possible to use cardiac MRS in clinical practice. The introduction of in vitro spectroscopy is an important step in the identification of the metabolic components of the myocardium, just as the in vivo spectroscopy was important in neuroradiology. This method has been used over many years for basic science, and only now is it being used wi...
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Research Interests: Animal Studies, Magnetic Resonance Imaging, Quality of life, Treatment Outcome, Oxidative Stress, and 34 moreExercise therapy, Heart Failure, Peroxidase, Humans, Copper, Left Ventricular Assist Device, Chronic Disease, Female, Male, Cortex, Polymerase Chain Reaction, Oxygen Uptake, Vascular endothelium, Glutathione Peroxidase, Zinc, Shear Stress, Superoxide Dismutase, Enzyme, Steady state, Aged, Middle Aged, Antioxidant enzyme, Skeletal Muscle, Nitric Oxide Synthase, Public health systems and services research, Chronic Heart Failure, Angiotensin Converting Enzyme, Ventricular Remodeling, Physical Training, Vasodilation, Exercise Test, Exercise Tolerance, Left Ventricle, and The American
Percutaneous coronary interventions (PCI) with stent implantation play an important role in the revascularization therapy of coronary artery disease. Introduction of drug eluting stents (DES) diminished problem of restenosis but brought... more
Percutaneous coronary interventions (PCI) with stent implantation play an important role in the revascularization therapy of coronary artery disease. Introduction of drug eluting stents (DES) diminished problem of restenosis but brought several new major problems like i.e. late stent thrombosis. This makes bare metal stents (BMS) still popular choice for some patients. Coronary-artery-computed-tomography becomes useful device in the noninvasive diagnostics measure of restenosis after PCI. Development of 64-slice computed tomography (CT) enables the noninvasive imaging and evaluation of stents with diameter higher than 3,0 mm and detection of significant restenosis with a low number of false positive results. CT allows with high accuracy to exclude in-stent restenosis among patients with atypical angina, especially those localized in proximal segments of coronary arteries. Future development of CT is needful since evaluation of significant number of examinations remains difficult or ...
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Research Interests: Software Development, Image Analysis, Digital imaging, Cardiovascular disease, Poland, and 23 moreImage Quality, Echocardiography, Digital, Humans, Ultrasonography, Female, Male, Real Time, Clinical Sciences, Medical Diagnosis, Aged, Middle Aged, Medical Image, Teleradiology, Coronary Angiography, Adult, Cardiac Imaging, Reproducibility of Results, Radiology Information Systems, Remote Consultation, Clinical Application, Data Transmission, and Data Format
Pressure-induced left ventricular hypertrophy is one of the mechanisms responsible for an impaired coronary vasodilating capacity leading to myocardial ischemia and angina. The aim of the study was to investigate myocardial perfusion... more
Pressure-induced left ventricular hypertrophy is one of the mechanisms responsible for an impaired coronary vasodilating capacity leading to myocardial ischemia and angina. The aim of the study was to investigate myocardial perfusion using cardiovascular magnetic resonance in patients with arterial hypertension and a history of chest pain and normal coronary angiography, and to estimate the influence of left ventricular hypertrophy on the parameters of myocardial perfusion. The study included 102 patients (mean age 55.4 +/- 7.7 years) with well controlled hypertension and 12 healthy volunteers. In 96 patients, myocardial first-pass perfusion cardiovascular magnetic resonance both at rest and during an infusion of adenosine 140 microg/kg/min was performed. Semiquantitative perfusion analysis was performed by using the upslope of myocardial signal enhancement to derive the myocardial perfusion index and the myocardial perfusion reserve index. The study group was divided according to the presence of left ventricular hypertrophy in the cardiovascular magnetic resonance examination: group with left ventricular hypertrophy (n = 40) and without left ventricular hypertrophy (n = 56). Independent of the presence of left ventricular hypertrophy, there were significant differences in baseline myocardial perfusion index between hypertensive patients and controls (0.13 +/- 0.07 vs. 0.04 +/- 0.01; P < 0.001), and in stress myocardial perfusion index (hypertensive patients 0.21 +/- 0.10 vs. controls 0.09 +/- 0.03; P < 0.001). In hypertensive patients, the myocardial perfusion reserve index was reduced in the mid and apical portions of the left ventricle (1.71 +/- 1.1 vs. 2.52 +/- 0.83; P < 0.02). There was no significant correlation of myocardial perfusion reserve index with left ventricular mass or hypertrophy. In patients with mild or moderate hypertension and a history of chest pain with normal coronary angiography, there is regional myocardial perfusion reserve impairment that is independent of the presence of left ventricular hypertrophy and may be a reason for angina.
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Research Interests: Treatment Outcome, Risk assessment, Stents, Heart Failure, Prospective studies, and 21 moreHumans, Hospitalization, Female, Male, Magnetic Resonance, Follow-up studies, Risk factors, Recurrence, Clinical Sciences, Aged, Middle Aged, Myocardial Infarction, Myocardium, Time Factors, Chi Square Distribution, Risk Factors, Risk Assessment, Ejection Fraction, Proportional Hazards Models, Predictive value of tests, and Contrast Media
Research Interests: Cardiology, Research Design, Treatment Outcome, Humans, Heparin, and 19 moreFemale, Male, Follow-up studies, Monoclonal Antibodies, Creatine Kinase, Aged, Middle Aged, Percutaneous Coronary Intervention, Coronary Angiography, Myocardial Infarction, Time Factors, Biological markers, Combination drug therapy, Streptokinase, Tissue Plasminogen Activator, Recombinant Proteins, Logistic Models, Thrombolytic Therapy, and Tyrosine
Research Interests: Electrical Engineering, Gastroenterology, Cancer, Infectious Diseases, Helicobacter pylori, and 29 moreCausality, Social Class, Stroke, Humans, Clinical Medicine, Female, Male, Statistical Significance, Brain Ischemia, Nutritional Status, Heart Disease, Epidemiology of Helicobacter pylori infection, Clinical Sciences, Aged, Prevalence, Middle Aged, Anti-Bacterial Agents, Body mass index (BMI), Coronary heart disease, Public health systems and services research, Coronary Artery Disease, Neurosciences, Health Survey, Enzyme Linked Immunosorbent Assay, Total Cholesterol, H Pylori, Renal Dialysis, Case Control Studies, and Serum lipids
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To develop and prospectively evaluate the safety and efficacy of an algorithm for tailoring neuroprotection devices (NPD) and stent types to the patient/lesion in carotid artery stenting (CAS). From November 2002 to October 2007, 499... more
To develop and prospectively evaluate the safety and efficacy of an algorithm for tailoring neuroprotection devices (NPD) and stent types to the patient/lesion in carotid artery stenting (CAS). From November 2002 to October 2007, 499 patients (360 men; mean age 65.2+/-8.4 years, range 36-88) were prospectively enrolled in a safety and efficacy study of tailored CAS using proximal (flow blockade or reversal) or distal (filters or occlusion) NPDs and closed- or open-cell self-expanding stents. Of the 535 lesions treated in the study, 175 (32.7%) were "high risk" by morphology. Half (50.1%) the patients were symptomatic. A quarter (137, 25.6%) of the procedures were performed under proximal protection and the remainder (398, 74.4%) with distal NPDs; the direct stenting rate was 66.9%. High-risk lesions were treated predominantly with a proximal NPD and closed-cell stent (77.1% and 82.9%, respectively) and less frequently by direct stenting (37.1%, p<0.0001 versus non-high-risk lesions). The in-hospital death/stroke rate was 2.0% (95% CI 0.85% to 3.23%), and the death/major stroke rate was 0.7% (95% CI 0.02% to 1.48%). There were no myocardial infarctions, but there was 1 (0.2%) further death within 30 days. With the tailored approach, symptom status and high-risk lesion morphology were not risk factors for an adverse outcome after CAS; only age >75 years (p<0.001) was a predictor of short-term death. Long-term survival (95.4% at 1 and 88.3% at 5 years) was similar for symptomatic versus asymptomatic patients, direct stenting versus predilation, and closed- vs. open-cell stent design; only coronary artery disease adversely impacted survival (p = 0.04). The rates of freedom from death/ipsilateral stroke were 94.9% at 1 year and 85.9% at 5 years. Tailored CAS is associated with a low complication rate and high long-term efficacy. CAS operators should have a practical knowledge of different NPDs, including at least one proximal type.
Research Interests: Algorithms, Filtration, Treatment Outcome, Risk assessment, Stents, and 20 moreEndovascular Therapy, Stroke, Prospective studies, Humans, Female, Male, Risk factors, Registries, Clinical Sciences, Aged, Middle Aged, Adult, Time Factors, Age Factors, Risk Factors, Risk Assessment, prosthesis Design, X ray Computed Tomography, Carotid Stenosis, and Carotid Artery Stenting
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To prospectively determine diagnostic performance and safety of contrast material-enhanced (CE) magnetic resonance (MR) angiography with 0.1 mmol per kilogram of body weight gadobenate dimeglumine for depiction of significant... more
To prospectively determine diagnostic performance and safety of contrast material-enhanced (CE) magnetic resonance (MR) angiography with 0.1 mmol per kilogram of body weight gadobenate dimeglumine for depiction of significant steno-occlusive disease (> or =51% stenosis) of renal arteries, with digital subtraction angiography (DSA) as reference standard.
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BACKGROUND: A 35-year-old man was referred to us in his third hour of severe retro-sternal pain, with ventricular fibrillation on paramedics' arrival. No contraindications to pPCl were revealed on telephone referral. Direct... more
BACKGROUND: A 35-year-old man was referred to us in his third hour of severe retro-sternal pain, with ventricular fibrillation on paramedics' arrival. No contraindications to pPCl were revealed on telephone referral. Direct questioning on cathlab admission, however, ...