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32 results on '"R. Grzywna"'

1. P4686Multimodal assessment of right ventricular-arterial coupling allows better prognostication in pulmonary arterial hypertension patients

Author

P Blaszczak, Dorota Jurgilewicz, Piotr Szumowski, Karol Kamiński, Lukasz A. Malek, Remigiusz Kazimierczyk, Marcin Hładuński, Janusz Mysliwiec, Bożena Sobkowicz, Włodzimierz J. Musiał, and R Grzywna

Subjects
medicine.medical_specialty, business.industry, Internal medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Ventricular arterial coupling
Abstract

Background The concept of coupling mainly refers to the relationship between ventricular contractility and afterload. Together, strictly related parameters may provide a more accurate estimation of the RV performance status. Indexing RV function, assessed by CMR feature tracking analysis, with a pulmonary artery systolic pressure (PASP) obtained from right heart catheterization (RHC) allows estimation of ventricular-arterial coupling and could help in prognostic stratification of pulmonary arterial hypertension (PAH) patients. Aim To verify the prognostic value of multimodal approach to estimate RV ventricular-arterial coupling in PAH patients. Methods Twenty-six stable PAH patients (mean age 49.92±15.94 years) and twelve healthy subjects (control group, 44.75±13.51 years) were enrolled into the study. CMR feature tracking analysis of the RV was performed for generation of RV global longitudinal strain (RV GLS); RV ejection fraction was also obtained by CMR. Right heart catheterization was carried out only in the PAH group with a standard technique.RV- arterial coupling was evaluated by the ratio of RV GLS/PASP. Mean follow-up time of this study was 16.6±7.5 months and the clinical end-point (CEP) was defined as death or clinical deterioration. Results In study group, RV GLS significantly correlated with hemodynamic parameters from RHC – mean pulmonary artery pressure, mPAP (r=0.53, p=0.04) and pulmonary vascular resistance, PVR (r=0.57, p=0.002). Mean RV GLS/PASP ratio in PAH group was (−)0.24±0.15%/mmHg. Patients who reached CEP (n=15) had a significantly higher RV GLS and RV GLS/PASP ratio (−13.3±7.9% vs −20.4±6.2%, p=0.01 and −0.15±0.09%/mmHg vs −0.36±0.19%/mmHg, p=0.005, respectively). However, ROC analysis revealed higher area under curve (AUC) of RV GLS/PASP in predicting CEP than of RV GLS alone (0.82 (95% CI 0.64–1) vs 0.77 (95% CI 0.58–0.96), p Figure 1 Conclusions Combining CMR and hemodynamic measurements via catheterization offers the potential for more comprehensive assessment of pulmonary vascular load and right heart function, as required for evaluation of the hemodynamic state in patients with PAH. Acknowledgement/Funding This work was supported by National Center for Science in Poland [“Preludium” grant 2017/25/N/NZ5/02689 to R.K.]

Published
2019

2. P1630Myocardial late gadolinium enhancement mass and FDG uptake assessments using a hybrid PET/MRI system in patients with pulmonary arterial hypertension

Author

R Grzywna, B. Milosz-Wieczorek, Włodzimierz J. Musiał, B Misko, Remigiusz Kazimierczyk, Janusz Mysliwiec, Karol Kamiński, Marcin Hładuński, Lukasz A. Malek, Bożena Sobkowicz, Dorota Jurgilewicz, Małgorzata Knapp, Piotr Szumowski, and P Blaszczak

Subjects
03 medical and health sciences, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, Fdg uptake, Late gadolinium enhancement, Medicine, In patient, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Nuclear medicine, business
Published
2018

3. P6335An association between myocardial 18-F glucose uptake obtained by PET/MRI hybrid and sTWEAK platelet content in patients with pulmonary arterial hypertension

Author

Karol Kamiński, Krzysztof Kowal, Remigiusz Kazimierczyk, R Grzywna, P Blaszczak, Włodzimierz J. Musiał, Małgorzata Jasiewicz, Bożena Sobkowicz, Ewa Waszkiewicz, Piotr Szumowski, and Lukasz A. Malek

Subjects
medicine.medical_specialty, business.industry, Glucose uptake, Internal medicine, Cardiology, Medicine, Platelet, In patient, Cardiology and Cardiovascular Medicine, business
Published
2018

4. P6337IL-6 plasma concentration is associated with right ventricular myocardial 18-F glucose uptake, but not functional RV parameters obtained by MRI in patients with pulmonary arterial hypertension

Author

P Blaszczak, Lukasz A. Malek, R Grzywna, Remigiusz Kazimierczyk, Janusz Mysliwiec, D Jurgielewicz, Piotr Szumowski, Bożena Sobkowicz, Włodzimierz J. Musiał, Ewa Tarasiuk, Małgorzata Jasiewicz, Karol Kamiński, and Marcin Hładuński

Subjects
medicine.medical_specialty, business.industry, Glucose uptake, Internal medicine, Plasma concentration, Cardiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business
Published
2018

5. P2610The relationship between myocardial 18F-FDG uptake and novel hemodynamic parameters of right ventricle obtained by PET/MRI hybrid in patients with pulmonary arterial hypertension

Author

Lukasz A. Malek, Remigiusz Kazimierczyk, P Blaszczak, R Grzywna, Dorota Jurgilewicz, Janusz Mysliwiec, Karol Kamiński, Włodzimierz J. Musiał, Jolanta Misko, B. Milosz-Wieczorek, Marcin Hładuński, Bożena Sobkowicz, and Piotr Szumowski

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Hemodynamic measurements, business.industry, Hemodynamics, Magnetic resonance imaging, 18f fdg uptake, medicine.anatomical_structure, Ventricle, Internal medicine, medicine, Cardiology, In patient, Radiology, Cardiology and Cardiovascular Medicine, business
Published
2017

6. Prasugrel versus clopidogrel for acute coronary syndromes without revascularization

Author

L. Wang, T. Stys, William E. Boden, R. H. Urbano, D. M. Olinic, Karen S. Pieper, A. Kuijper, E. Soh, J. Nicolau, Jadwiga Nessler, William J. Rogers, Ernesto Rivera, R. Braam, H. Kadr, J. Csikasz, B. Boichev, Prafulla Kerkar, I. Kraiz, R. Babu, Ali Aydinlar, D. Safley, O. Nguyen-Khac, P. Chua, W. Buchanan, C. A. Morales, A. Abyankar, A. Srinivas, S. Genth-Zotz, J. Rocha Faria Neto, D. Drenning, L. Moretti, S. Varma, D. Roth, C. Matei, Jane E. Onken, H. Tumbev, P. Keeling, Xian Li, N. Ciglenecki, Shahyar M. Gharacholou, P. P. Goh, D. Sporn, M. Chang, Marcin Gruchała, R. Foreman, Bogdan Minescu, S. Nawaz, N. Alexeeva, Y. Shalev, C. Fastabend, L. van Zyl, J. F. Certic, J. Longo, J. Wang, K. Dave, Olivier Morel, F. Maatouk, Y. El Rakshy, J. Giacomini, P. Lazov, R. Marino, Dimitar Raev, M. Y. Chan, L. Z. Dextre, Y. Hao, P. Sepulveda, K. Ramshev, C. Bayron, Ameer Kabour, Alon Marmor, Luciano Moreira Baracioli, H. Marais, Rajendra H. Mehta, R. Breedveld, A. Ben Khalfallah, Kurtulus Ozdemir, I. Westendorp, J. A. Quion, Daniel J. George, D. F. Garcia, J.-P Bassand, G. Szalai, Huw Griffiths, O. Ushakov, M. Tzekova, E. Suprun, A. Mowafy, N. El Mansour, Gail V.W. Johnson, Tereshchenko Sn, W. T. Lai, Petr Widimsky, Hany Ragy, V. R. Castillo, M. Padour, Gilles Montalescot, Louie Tirador, Deepak L. Bhatt, M. Marrinan, S. Promisloff, A. Nambiar, Reginald G.E.J. Groutars, S. R. Lee, J. Cabrera, S. Zhang, András Jánosi, K. Wita, R. Sciborski, Annabelle Rodriguez, P. Sedlon, Jaroslaw D. Kasprzak, A. Faynyk, A. Romero Acuña, M. C. Ramirez, Rakesh Gupta, R. Saligrama, Jacek Gniot, Y. Ke, John H. Alexander, X. Liu, E. Baranov, R. Grzywna, Mukul Sharma, A. Linka, Jarosław Wójcik, Haroon Rashid, M. S. Sanchez, M. Gadkari, B. Rao, James S. Zebrack, Paul W. Armstrong, Francois Schiele, Gracita O. Topacio, Peter J. Casterella, A. Belhassane, P. Golino, F. Plat, P. Roberts-Thomson, K. S. Kim, Stephen D. Wiviott, Mathew T. Roe, Y. D. Chen, I. A. Khan, S. Thanvi, S. Isserman, G. Falck, R. M. Coching, S. C. Stamate, M. Ogorek, K. Danisa, Poul Anders Hansen, M. Medvegy, Amos Katz, R. K. Seerangachar, B. Farah, V. Kale, B. Kusnick, Maurice Pye, M. Mosseri, M. Vatutin, D. Weinstein, Norma Keller, A. Mihov, Ewa Mirek-Bryniarska, N. Adjei, S. Sethi, A. Irimpen, M. Broeders, T. Huynh, K. Niezgoda, P. Samardzic, D. Ziperman, Stuart J. Pocock, T. Arad, J. Lewczuk, M. Amuchastegui, R. Moscoso, B. Dimov, W. A. Ahmad, E. Dalli, P. Laothavorn, S. Shaikh, Helmut U. Klein, J. Menon, H. Colombo, L. Fattore, G. Zarrella, Dorairaj Prabhakaran, N. Viboolkitvarakul, Judith D. Goldberg, Neetika Garg, Y. Hasin, F. Rossi Dos Santos, S. J. Vigo, L. Horbach, O. Prokhorov, H. Moellmann, T. R. Vera, C. E. Botta, Domitilla Russo, M. Rossovskaya, David C. Henderson, Rebecca B. Costello, V. Shcherbak, C. J.P.J. Werter, W. Kus, I. Dobre, P. Marechal, T. Nair, H. Nielsen, J. Waites, J. B. Moraes Junior, T. Römer, J. Senior, P. Ionescu, S. Kalashetti, R. N. Ortega, Gail E. Hafley, G. A. Dan, Apur R. Kamdar, Ruth Ann Greenfield, David F. Kong, J. Bergallo, O. Barnum, Antonis S. Manolis, Sumeet Subherwal, S. Schaefer, A. Figueredo, Habib Gamra, S. Bandyopadhyay, V. Miloradovic, Imran Arif, Peter R. Carroll, M. Demirtas, S. Guidera, G. Rogelio, Naseem Jaffrani, N. Mulvihill, Marvin J. Slepian, Darren K. McGuire, Rohit Kalra, Luís A. Providência, F. Van de Werf, Andras Vertes, J. Xu, C. F. Gamio, R. G. Xuereb, R. F. Ramos, E. Kis, N. Bustros, M. De Luca, S. Zhurba, T. Connelly, S. Singhi, F. Gredler, Serdar Kucukoglu, Francesco Fedele, C. Chavez, Christoph Kadel, Antônio Carlos Sobral Sousa, S. Srimahachota, Igor Kaidashev, J. H. Garcia, I. Teodorescu, Birute Petrauskiene, O. Kracoff, Liwa T. Younis, Alain Bouchard, P. Osmancik, Y. Sun, C. Hammett, S. Sabri, William Wallace, Mehmet Yazici, L. Ermoshkina, Harish Chandna, G. Ramos-Lopez, M. Bronisz, Sergio Luiz Zimmermann, Giuseppe Ambrosio, V. Hergeldjieva, César A. Jardim, A. Rifai, H. Lui, A. Lee, J. Scholz Issa, A. Blenkhorn, P. Micale, V. Barbarich, C. Maccallum, Peter J. Grant, G. Topacio, N. Budassi, J. Yan, Keith A.A. Fox, Y. Xia, Jan H. Cornel, A. Rafael, Paul Hermany, S. Potthoff, Mohsin A.F. Khan, Pierre Coste, Neal Ready, N. T. Duda, M. Reyes, A. Chandran, I. G. Gordeev, Anne W. Beaven, B. J.B. Hamer, C. Treasure, Pravin Manga, M. R. Babarskiene, T. Devedzhiev, Alberto Menozzi, L. Lenarz, N. Llerena, Thomas F. Lüscher, Giovânio Vieira da Silva, Y. Malynovsky, L. Ramanathan, M. Belicova, M. O. Ibarra, D. Chew, R. Castillo, M. Kesselbrenner, A. H. Li, E. Baldjiev, M. El-Harari, S. H. Hur, S. Chiaramida, C. E. Chiang, Viliam Fridrich, L. R. Cartasegna, A. Yagensky, Steven E. Hearne, Gregory Pavlides, Witold Rużyłło, Y. Chandrashekhar, S. Welka, H. Petijean, Jose L. Leiva-Pons, Shaul Atar, Andrzej Lubiński, S. Zhao, János Tomcsányi, Narinder Singh, D. Banker, T. Boyek, H. Ebinc, N. Calambur, A. Mouhaffel, M. Creteanu, H. Huang, J. O. Jeong, E. Goudreau, D. Alexopoulos, E. Duronto, S. Car, O. Bashkirtsev, J. Mandak, V. Papademetriou, David O. Williams, Oscar Pereira Dutra, R. Baman, T. J. Hong, J. O. Ibañez, D. L. Gomez, R. K. Jain, R. Jozwa, L. Di Lorenzo, Matthew Wilson, Christian W. Hamm, A. Buakhamsri, Nikitas Moschos, Ashok Kumar, A. Kadiiski, C. Y. Lee, M. Opazo, J. Tang, E. Ferrari, P. Colon-Hernandez, Jean-Pierre Déry, B. Goloborodko, L. Gimple, Diego Ardissino, M. Bergovec, S. Thew, Dariusz Dudek, K. Tang, P. A.G. Zwart, A. Deshpande, S. Sathe, Yves Cottin, V. Pai, O. Koval, J. Lesnik, Pavan S. Reddy, A. Espinoza, Rungroj Krittayaphong, Carisi Anne Polanczyk, E. Kukuy, L. Tejada, J. Nobel, Renato D. Lopes, J. Bagatin, A. Manolova, E. Boudriot, A. Godoy, N. Perepech, Christopher D. Olympios, A. E. Guimarães, James Harris, Aref Rahman, D. Foley, H. J. Kruik, J. Bruguera I Cortada, I. Fotiadis, A. Bharani, Petar Otasevic, Eileen Brown, N. Gratsiansky, J. E. Poulard, Vladimir Gašparović, Habib Haouala, A. de Belder, J. Schmedtje, Lilia Nigro Maia, J. Cobos, Werner Benzer, E. Korban, A. U. Quraishi, X. Hong, A. Bazzi, P. Kotha, L. Gubolino, H. Ingersoll, Debra Marshall, Udo Sechtem, Sandipan Dutta, G. Frago, Anthony Mathur, Shaun G. Goodman, William Bachinsky, A. Hamer, Jaime Gomez, Patrizio Lancellotti, Vance Wilson, L. White, P.P. Mohanan, Aleksandar Knezevic, Sorin J. Brener, Susanna R. Stevens, H. Luquez, S. K. Lee, P. E. Leaes, P. Benjarge, T. Tu, Z. Coufal, N. Koliopoulos, Mahmut Şahin, X. Huang, S. Boldueva, J. De Souza, N. Chidambaram, S. Zolyomi, K. G. Shyu, H. Montecinos, A. Piombo, Wladmir Faustino Saporito, R. L. Kulkarni, I. Szakal, G. Arminio, M. Elbaz, Samir Pancholy, Jang Ho Bae, Giuseppe Musumeci, S. B. Zouari, A. Chois, D. Wojciechowski, A. Bakbak, E. Bozkurt, Kenneth J. Winters, R. Raugaliene, D. Sarkar, J. M. Alegret, Hubertus Heuer, E. Bobescu, E. Roncallo, R. Carlsson, R. Craig McLendon, L K Newby, K. Zrazhevskiy, João Pedro Ferreira, A. Haidar, D. Tellez, Robert Olszewski, Shmuel Gottlieb, H. Jure, A. Garcia Escudero, S. Sengupta, V. Ochean, W. Kostuk, G. Range, F. Leroy, G. Parale, R. Fernandez, M. Fulwani, M. Padovan, Y. Dovgalevskiy, Kreton Mavromatis, H. Hart, Y. G. Ko, F. Seixo, V. Bisne, J. McGarvey, Kimberly L. Blackwell, John H. Strickler, Sanjay Kumar, A. Bordonava, L. Egorova, C. Patocchi, A. Karczmarczyk, Chiara Melloni, Piyamitr Sritara, M. Anastasiou-Nana, Roman Szełemej, K. Penchev, D. Morales, M. Tokmakova, Krzysztof Zmudka, Rakesh Yadav, E. Bressollette, D. Nul, A. L. Astesiano, M. Urban, Abdulhay Albirini, C. T. Chin, F. Moulin, I. M. Coman, R. Watkin, J. Abanilla, J. Brønnum-Schou, J. Anusauskiene, P. Andrade Lotufo, Joseph G. Rogers, M. Bessen, P. C. Sartori, Paulo Roberto Ferreira Rossi, K. Atassi, H. V. Anderson, B. Klugherz, Bateshwar Prasad Singh, Mirza S. Baig, Z. Yusof, J. H. Geertman, A. Labroo, P. Nash, Freek W.A. Verheugt, Nancy J. Brown, M. A. Alcocer, A. Neskovic, L. Francek, Judith S. Hochman, A. Hoffmann, R. Dran, A. Podczeck-Schweighofer, Jeffry Katz, Josh Roberts, Roger E. McLendon, Ronald Rodriguez, T. Downes, A. Roth, L. E. Mayorga, Armagan Altun, José-Luis López-Sendón, M. Krotin, N. van der Merwe, O. Gigliotti, C. Park, G. Brigden, M. Kumbla, D. C G Basart, D. Erdogan, R. van Kranen, J. Beloscar, Johny Joseph, Pierluigi Tricoci, J. Marino, N. Mahon, S. Dani, I. Kovalskyy, Ioannis Nanas, V. Volkov, M. I. Edmilao, J. Kruells-Muench, F. Alamgir, R. Rinaldi, W. E. Mogrovejo, J. Mirat, C. Staniloae, S. Borromeo, H. Kozman, H. Zhang, Y. Zhou, S. Shurmur, A. Manari, M. A. Barrera, A. Vasylenko, D. Keedy, Paul A. Gurbel, Ali Oto, Charles R. Lambert, V. G. Ribeiro, A. Quintero, H. Joshi, L. Tang, J. Allan, C. S. Díaz, F. Carvalho Neuenschwander, Mircea Cintezǎ, M. Kokles, G. Piovaccari, Z. Kovacs, W. Li, C. Beauloye, E. J. Ramos, D. Bertolim Precoma, J. Burstein, G. Covelli, E. C. Zambrano, Assen Goudev, A. Tang, F. Henriquez, S. Tangsuntornwiwat, C. Kirma, GR Aycock, Kenneth W. Mahaffey, M. Ardnt, Jose C. Nicolau, O. Barbarash, E. K. Shin, P. Potapenko, T. Supryadkina, Asok Venkataraman, W. Mogrovejo, M. Acikel, R. Bohorquez, M. Syvänne, M. Chan, H. Mardikar, H. Berlin, O. Quintana, K. Heintz, J. M. Bastos, Guillermo Llamas Esperon, G. Aroney, J. Chen, Nancy H. Collins, C. Ahsan, G. Heins, F. Baer, V. Kondle, Nicholas Danchin, G. Shetty, Sergio Berti, Philip E. Aylward, James Cotton, G. S. Vallejo, Massimo Volpe, Z. Vasiljevic-Pokrajcic, C. Bugueño, Seung Woon Rha, S. Ilic, G. E. Stanciulescu, Z. Li, D. Nassiacos, R. Sciberras, S. Kuanprasert, Denilson Campos de Albuquerque, M. Pavlovic, Craig S. Barr, Mohammed R. Essop, John G. Canto, David T. Roberts, M. Ozdemir, Jacquelyn Miller, T. K. Ong, Sian E. Harding, V. Bose, J. Yoon, R. Syan, M. A. Paz, O. Maskon, Dennis V. Cokkinos, L. Kraus, Z. Masud, K. Amosova, M. Boyarkin, L. Mos, Dmitry Zamoryakhin, Arif Anis Khan, Jeffrey A. Breall, A. Gallino, Ivo Petrov, F. A. Alves da Cost, Saul Vizel, Hugo Vargas Filho, P. Kaewsuwanna, G. Antonelli, Chuen Den Tseng, I. Vakaliuk, J. Miklin, A. El Hawary, Ashok Jacob, D. Gumm, Kurt Huber, G. Pajes, N. Jathappa, Stanislaw Bartus, P. V. Lavhe, C. Romero, J. Balkin, T. Gould, R. Durgaprasad, Felipe Martinez, Henning Ebelt, A. Puri, D. K. Agarwal, E. E. Buyukoner, R. Mora Junior, P. Poliacik, A. Dande, X. Zhao, J. Floro, A. Bagriy, Yuliya Lokhnygina, M. Atieh, V. Batushkin, Valentin Markov, O. Karpenko, Peter Clemmensen, P. Castro, L. Paloscia, F. Florenzano, J. L. Accini, Tony Schibler, J. Arneja, W. Wu, B. Andruszkiewicz, Michael A. Morse, P. Vojtisek, D. Sadler, S. Frischwasser, M. Cayli, W N Leimbach, E. Flores, B. Wang, A Sosa Liprandi, Y. Michalaros, H. C. Finimundi, Raul D. Santos, N. Vijay, E. Magnus Ohman, Y. Karpenko, J. Sirotiakova, Z. Shogenov, D A Zateyshchikov, Eric P. Viergever, R. Bach, Gary S. Niess, D. C. Acosta, G. Piegari, J. B. Gupta, J. Shanes, E. Ronner, J. Arter, Claudio Cavallini, M. A. Hominal, V. Bugan, S. D. Varini, K. Nyman, B. G. Castillo, Sinan Aydoğdu, N. Novikova, D. Wang, P. Simpson, Y. Huang, Taral Patel, Gabriel Tatu-Chitoiu, D. Silva Junior, H. Theron, C. Alvarez, Anikó Ilona Nagy, T. Chua, P. Georgiev, D. Rittoo, G. De Luca, R. Blonder, Alberto Caccavo, D. Koganti, E. Manenti, N. Ghaisas, G. Letcher, D. Platogiannis, Arshed A. Quyyumi, J. Dy, Z. Ples, W. Kunz Sebba Barroso de Souza, Hamid Taheri, S. Kammoun, A. Salvioni, B. Stockins, K. Sutalo, J. C. Post, Merih Kutlu, Vijay K. Chopra, C. Mathis, Stephen M. Schwartz, Manish Jain, D. Coisne, A. Goudev, A. Dalby, João Morais, P. van Kalmthout, Andrzej Budaj, I. Dotani, L. Mircoli, R. Vicari, J. P. Herrman, M. Moran, G. Lupkovics, Alexander Parkhomenko, J. Heath, Andrew Moriarty, C. Pop, J. Y. Hwang, S. Kassam, R. Martingano, I. Nikolskaya, Z. Zheng, Johann S. de Bono, M. Izzo, R. Labonte, E. H. Forte, W. Moleerergpoom, Piera Angelica Merlini, D. Lee, W. Macias, G. Syan, S. Zhou, S. W. Kim, T. Duris, E. Shaoulian, Andreas U. Wali, Marco Antonio Mota Gomes, Pritibha Singh, M. Ovize, M. Del Core, W. Bowden, B. Xu, Ravi Bhagwat, C. Wongvipaporn, J. Vojacek, Steven Lindsay, F. McGrew, J. Gorny, J. D. Pappas, R. Vuyyuru, J. Chahin, Ashraf Reda, T. Lau, E. Conn, J. Meisner, S. Meymandi, A. D. Hrabar, M. Slanina, D. Jarasuniene, C. Lang, A. Vo, Christian Hamm, H. Gogia, Z. Yuan, T. Mathew, A. Van Dorpe, J. Kettner, M. Barbiero, Harvey D. White, L. Rudenko, V. Jain, M. Carter, David Erlinge, G. Ma, V. Sierkova, D. K. Kim, Steven O. Smith, R. K. Premchand, P. Jetty, J. Y. Hou, V. Simanenkov, T. Kaelsch, David P. Foley, A. Francis, Piotr Ponikowski, Ramón Corbalán, D. Connolly, J. Tuma, R. Zambahari, Miodrag Ostojic, R. Lamich, A. Rabelo Alves, V. Tseluyko, G. Moises Azize, L. Khaisheva, G. Pencheva, C. Ingram, J. Cooke, A. Prado, M. De Tollenaere, M. Kim, Alan Rees, Melanie B. Turner, Mark B. Abelson, H. L. Luciardi, L. Illyes, R. Sarma, L. Manriquez, J. A. Marin Neto, D. Iordachescu-Petica, G. Hoedemaker, Victor S. Gurevich, F. Ridocci, J. Grman, F. Waxman, Jorge F. Saucedo, E. Boughzala, B. S. Jagadesa, Heba Abdullah, A. Weiss, N. Bichan, L. Tami, Y. Bouzid, N. I. Gomez, Zafar Sy, Béla Merkely, J. P. Albisu, L. Rodriguez-Ospina, John C. Chambers, L. L. Lobo Marquez, R. Guan, Steven Georgeson, M. K. Sarna, L. Nogueira Liberato de Sousa, Mika Laine, P. Pimentel Filho, Teresa Kawka-Urbanek, G P Arutyunov, S. Elhadad, A. Dambrauskaite, R. Leon de la Fuente, Audes D. M. Feitosa, P. Baetslé, Abraham Al Ahmad, José Francisco Kerr Saraiva, Roland P.T. Troquay, J. Berlingieri, Margaret Arstall, J. L. Coronado, K. Yang, S. V. Shalaev, Bernard J. Gersh, A. El-Etreby, Elżbieta Zinka, F. De Valais, John E.A. Blair, P. Fajardo, M. Rodriguez, R. Boujnah, H. Hammerman, Y. S. Chong, Stigi Joseph, M. H. Jeong, J. Ge, Q. He, Robert S Iwaoka, Bimal R. Shah, J. Sawhney, T. Sakulsaengprapha, G. Werner, Jill Anderson, M. Hondl, Meinrad Gawaz, Gilmar Reis, M. Dalkowski, Tomáš Janota, M. Damiao Gomes Seabra, A. Dharmadhikari, Aleš Linhart, John Elliott, Kodangudi B. Ramanathan, Doron Zahger, Dilek Ural, L. Regos, F. R. Bolohan, Marcello Galvani, B. Zakhary, N. Qureshi, D. Deac, Maria Emília Figueiredo Teixeira, T. Venter, Santosh Gupta, W. Wright, P. Telekes, A. Furber, V. Nykonov, Zhu Junren, M. Cinteza, I. Lang, S. Junejo, D. Martins, Mauro Esteves Hernandes, G. Ishmurzin, Anthony J. Dalby, R. Scioli, P. Babu, R. Habaluyas, V. Mendoza, G. B. Scaro, Matthew T. Roe, M. Senaratne, D. J. van der Heijden, T. Pillay, Yoav Turgeman, J. Moreira, C. Cuccia, C. Astarita, S. De Servi, Robert G. Wilcox, M. C. Constantinescu, Kardiyoloji, Roe Matthew, T., Armstrong Paul, W., Fox Keith, A. A., White Harvey, D., Prabhakaran, Dorairaj, Goodman Shaun, G., Cornel Jan, H., Bhatt Deepak, L., Clemmensen, Peter, Martinez, Felipe, Ardissino, Diego, Nicolau Jose, C., Boden William, E., Gurbel Paul, A., Ruzyllo, Witold, Dalby Anthony, J., McGuire Darren, K., Leiva Pons Jose, L., Parkhomenko, Alexander, Gottlieb, Shmuel, Topacio Gracita, O., Hamm, Christian, Pavlides, Gregory, Goudev Assen, R., Oto, Ali, Tseng Chuen, Den, Merkely, Bela, Gasparovic, Vladimir, Corbalan, Ramon, Cinteza, Mircea, McLendon R., Craig, Winters Kenneth, J., Brown Eileen, B., Lokhnygina, Yuliya, Aylward Philip, E., Huber, Kurt, Hochman Judith, S., Ohman E., Magnu, and Golino, Paolo

Subjects
Male, Prasugrel, Myocardial Infarction, Kaplan-Meier Estimate, Piperazines, Purinergic P2 Receptor Antagonists, Myocardial infarction, education.field_of_study, Cardiovascular diseases [NCEBP 14], Acute Coronary Syndrome, Aged, Angina, Unstable, Aspirin, Cardiovascular Diseases, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Middle Aged, Platelet Aggregation Inhibitors, Prasugrel Hydrochloride, Stroke, Thiophenes, Ticlopidine, Medicine (all), Hazard ratio, Clopidogrel, Acute Coronary Syndromes, General Medicine, Angina, Combination, Cardiology, medicine.drug, medicine.medical_specialty, Acute coronary syndrome, Population, Unstable, Drug Therapy, General & Internal Medicine, Internal medicine, medicine, cardiovascular diseases, education, Acute coronary syndromes, Revascularisation, Unstable angina, business.industry, medicine.disease, REVASCULARIZAÇÃO MIOCÁRDICA, business
Abstract

Item does not contain fulltext BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel. RESULTS: At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval [CI], 0.79 to 1.05; P=0.21). Similar results were observed in the overall population. The prespecified analysis of multiple recurrent ischemic events (all components of the primary end point) suggested a lower risk for prasugrel among patients under the age of 75 years (hazard ratio, 0.85; 95% CI, 0.72 to 1.00; P=0.04). Rates of severe and intracranial bleeding were similar in the two groups in all age groups. There was no significant between-group difference in the frequency of nonhemorrhagic serious adverse events, except for a higher frequency of heart failure in the clopidogrel group. CONCLUSIONS: Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

Published
2012

7. Day/night ratio of microproteinuria and blood pressure rhythm in type II diabetes

Author

Raszewski G, Krawczyk W, R. Grzywna, Klimek K, K. Marczewski, and P. Różyc

Subjects
Adult, Male, medicine.medical_specialty, Ambulatory blood pressure, Endocrinology, Diabetes and Metabolism, Gastroenterology, Nephropathy, Diabetic nephropathy, Endocrinology, Internal medicine, Diabetes mellitus, Alpha-Globulins, Internal Medicine, medicine, Humans, Proteinuria, business.industry, Albumin, General Medicine, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, Circadian Rhythm, Blood pressure, Diabetes Mellitus, Type 2, Immunoglobulin G, Electrocardiography, Ambulatory, Microalbuminuria, Colorimetry, Female, medicine.symptom, business
Abstract

The paper discusses the results of the studies conducted with a group of patients with type II diabetes without clinical nephropathy. The aim of the study was to attempt to determine the markers for early stages of diabetic nephropaty in NIDDM patients. The following examinations were carried out: the level of selected microproteinuric components, 24 h monitoring of arterial blood pressure, and electrocardiogram (ECG). Among the patients examined, the level of alfa-1-microglobulin, albumin and immunoglobulin G (IgG) in diabetic patients was higher than in the control group, and the increased activity of βNAG was observed. The 24 h profile of blood pressure and the ratio afternoon/night of albumin excretion flattened in the majority of diabetic patients. The results of the study suggest that the proximal tubules and the membranes of renal glomeruli are damaged as early as during the period of subclinical diabetic nephropathy.

Published
1996

8. [Microproteinuria and circadian rhythm of blood pressure in patients with arterial hypertension]

Author

K, Marczewski, W, Krawczyk, R, Grzywna, P, Rózyc, M, Jarosz, G, Raszewski, and K, Klimek

Subjects
Adult, Male, Blood Pressure Monitoring, Ambulatory, Middle Aged, Circadian Rhythm, Electrocardiography, Proteinuria, Immunoglobulin G, Acetylglucosaminidase, Alpha-Globulins, Hypertension, Albuminuria, Humans, Female, Kidney Diseases, Protease Inhibitors
Abstract

Microproteinuria is a recognized sign of early nephropathy in the course of arterial hypertension. There is few data concerning the excretion of proteins other than albumin in this group of patients. The aim of the study was to examine circadian rhythm of alfa-l-microglobulin (AlMG), albumin (ALB), immunoglobulin G (IgG) excretion and N-acetyl-beta-glukosaminidase (beta NAG)-activity, then to compare the results with the results of 24 hour ambulatory monitoring of arterial blood pressure in patients with arterial hypertension. The study comprised 28 patients. The control group included 27 healthy volunteers. Albumin concentration was determined by Beckman ICS2 nephelometer, using Beckman and Dako reagents. Blood pressure and ECG were monitored by analysis with ABP-system (AMP-USA). In patients with arterial hypertension significantly higher levels of ALB, AlMG, IgG and increased beta NAG activity were observed in morning urine samples. Despite hypotensive treatment blood pressure values were slightly, though significantly higher than in the control group. Among patients in the study circadian BP rhythm was disturbed. The results obtained suggest that in this group of patients subclinical nephropathy develops involving renal glomeruli and proximal tubules--probably resulting from vascular and humoral disorders, with accompanied hypertension.

Published
1996

9. [Evaluation of the accuracy of arterial pressure measurements with different types of devices used for self-monitoring]

Author

J, Bołtuć, R, Grzywna, P, Paprzycki, and K, Marczewski

Subjects
Adult, Male, Self Care, Adolescent, Evaluation Studies as Topic, Hypertension, Humans, Female, Equipment Design, Blood Pressure Monitoring, Ambulatory, Middle Aged, Blood Pressure Monitors, Aged
Abstract

The self-control is the important item in hypertension treatment. The results of blood pressure measurements were received by using various types using different of oscillometric equipment (thumb, wrist and arm manket) and compared with the outcomes of mercury sphygmomanometer which was used in the same trial. The satisfactory correlation of results from different types of equipment was confirmed with the exception of the thumb oscillometric apparatus results.

Published
1996

10. [Treatment of cardiogenic shock in myocardial infarction with intraaortic counterpulsation]

Author

W, Rumiński, M, Markiewicz, D, Koziara, R, Grzywna, and B, Lakomski

Subjects
Adult, Aged, 80 and over, Male, Intra-Aortic Balloon Pumping, Counterpulsation, Myocardial Infarction, Shock, Cardiogenic, Humans, Female, Middle Aged, Aged
Abstract

The purpose of this study was to analyse the effects of intraaortic balloon counterpulsation (IABP) in treatment of patients with acute myocardial infarction (MI) complicated by cardiogenic shock. The study group consists of 20 consecutive patients (13 males and 7 females, aged 38-82 years) with cardiogenic shock developed in the course of MI. Catecholamines were administrated in all patients before intraaortic balloon pumping was instituted. IABP was performed using Datascope device. Efficacy of the procedure was determined with invasive measurements of arterial blood pressure and the level of diuresis. Of 20 patients with cardiogenic shock, 7 were successfully treated with IABP and they were discharged from the hospital.

Published
1993

11. [Value of Doppler echocardiography in evaluating pulmonary arterial pressure in patients with mitral valve defect]

Author

R, Trojnar, B, Rymar, A, Wysokiński, R, Grzywna, J, Wójcik, M, Markiewicz, W, Rumiński, and A, Kleinrok

Subjects
Adult, Male, Hypertension, Pulmonary, Humans, Mitral Valve Insufficiency, Blood Pressure, Female, Middle Aged, Pulmonary Artery, Echocardiography, Doppler
Abstract

In 40 patients aged 25-52 years (mean 36 years) with mitral valve disease but without overt circulatory failure haemodynamic studies and echocardiographic examinations were carried out recording the blood flow in the pulmonary artery and the blood flow through the tricuspid valve by pulsating and continuous-wave methods. From the obtained curves the time was calculated from the beginning of the flow to its maximum (TPV), the pre-ejection time (RPEP) and the right-ventricular ejection time (RVET), and the indices TPV/RVET and RPEP/RVET. Moreover, in 14 patients with coexistent insufficiency of the tricuspid valve the systolic pressure in the pulmonary artery was calculated by determining the systolic gradient across the tricuspid valve. On the basis of the results of haemodynamic examination the patients were divided into two groups: with normal (24 patients) and with raised (16 patients) pressure in the pulmonary artery. In the group of mitral valve disease and pulmonary hypertension a significantly shorter TPV, lower values of the TPV/RVET index and greater values of the RPEP/RVET index were found as compared with the patients with mitral disease and normal value of the systolic arterial pressure in the pulmonary artery. The systolic arterial pressure in the pulmonary artery determined on the basis of Doppler echocardiography with measurement of the regurgitation wave in tricuspid valve insufficiency showed a high agreement (r = 0.94) with the pressure recorded during cardiac catheterization.

Published
1989

14. [Comparative investigation of cardiac output using impedance rheography and invasive methods]

Author

A, Kleinrok, A, Sacharuk, W, Rumiński, J, Kosicki, R, Grzywna, M, Markiewicz, and T, Pałko

Subjects
Adult, Male, Heart Diseases, Reference Values, Humans, Female, Plethysmography, Impedance, Cardiac Output, Middle Aged, Exercise, Aged
Abstract

Authors performed comparative measurements of cardiac output using the impedance rheography and Fick's method in healthy men (6) reaching the value of correlation coefficient 0.88 and in patients with acquired cardiac defects (n = 21; r = 0.68). Authors also compared cardiac output values measured at rest and during exercise by means of thermodilution and rheographic methods in patients with heart failure (n = 9). Correlation coefficient was respectively 0.92 and 0.81.

Published
1989

15. Change of myocardial fluorodeoxyglucose uptake distribution after specific therapy of pulmonary arterial hypertension patients

Author

Remigiusz Kazimierczyk, Janusz Mysliwiec, Włodzimierz J. Musiał, Dorota Jurgilewicz, P Blaszczak, R Grzywna, Bożena Sobkowicz, Karol Kamiński, Marcin Hładuński, L.M Malek, and Piotr Szumowski

Subjects
Fluorodeoxyglucose, medicine.medical_specialty, business.industry, Internal medicine, medicine, Cardiology, Distribution (pharmacology), Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background Right ventricular (RV) function is a major determinant of survival in patients with pulmonary arterial hypertension (PAH). In our previous study, we confirmed that increased RV fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) (presented as higher ratio of FDG uptake of RV to LV) was associated with progressive RV dysfunction and preceded hemodynamic and clinical deterioration in PAH patients. Now, we obtained second PET/MRI assessments of the study group after 2-years of PAH-targeted treatment. Aim The aim of the study was to obtain change of cardiac FDG uptake in PAH patients after follow-up period and to indicate factors mainly affecting this change. Methods Twenty-eight PAH patients (51.32±15.91 years) had simultaneous PET/MRI scans performed during baseline visit. FDG was used and its uptake was quantified as mean standardized uptake value (SUV) for both left (LV) and RV. Second PET/MRI assessments were done after 2 years in the group of twenty patients (four deaths, four patients did not agree to perform additional scans). Results After follow-up period, we observed significant change of MRI-derived RV ejection fraction (45±10% to 51.2±12.7%, p=0.03), and improvement in hemodynamic parameters obtained from right heart catheterization (RHC) e.g. mean pulmonary artery pressure, mPAP (48.5±17.2 to 41.8±17.1 mmHg, p=0.01) and pulmonary vascular resistance, PVR (8.7±5.3 to 7.0±4.2 WU, p=0.04). Follow-up SUVRV/SUVLV ratio significantly correlated with follow-up RV hemodynamic parameters confirming relationship between RV function and cardiac metabolic alterations (Table 1). Interestingly, patients who had improvement in SUVRV/SUVLV (lower follow-up value than baseline, n=11) had significantly higher mPAP at baseline visit (58.9±18.7 vs 40.3±11.8 mmHg, p=0.02), suggesting that RV FDG accumulation in advanced PAH may decrease after the PAH-specific treatment in accordance with the degree of reduction in the pulmonary vascular resistance. Conclusion Impaired RV function is associated with increased glucose uptake of RV myocytes estimated by FDG PET in PAH patients. Targeted treatment may improve RV function and thus affect previously altered cardiac glucose uptake. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Polish National Science Centre

16. Echocardiographic Assessment of Right Ventricular-Arterial Coupling in Predicting Prognosis of Pulmonary Arterial Hypertension Patients.

Author

Kazimierczyk R, Kazimierczyk E, Knapp M, Sobkowicz B, Malek LA, Blaszczak P, Ptaszynska-Kopczynska K, Grzywna R, and Kaminski KA

Abstract

In response to an increased afterload in pulmonary arterial hypertension (PAH), the right ventricle (RV) adapts by remodeling and increasing contractility. The idea of coupling refers to maintaining a relatively constant relationship between ventricular contractility and afterload. Twenty-eight stable PAH patients (mean age 49.5 ± 15.5 years) were enrolled into the study. The follow-up time of this study was 58 months, and the combined endpoint (CEP) was defined as death or clinical deterioration. We used echo TAPSE as a surrogate of RV contractility and estimated systolic pulmonary artery pressure (sPAP) reflecting RV afterload. Ventricular-arterial coupling was evaluated by the ratio between these two parameters (TAPSE/sPAP). In the PAH group, the mean pulmonary artery pressure (mPAP) was 47.29 ± 15.3 mmHg. The mean echo-estimated TAPSE/sPAP was 0.34 ± 0.19 mm/mmHg and was comparable in value and prognostic usefulness to the parameter derived from magnetic resonance and catheterization (ROC analysis). Patients who had CEP ( n = 21) had a significantly higher mPAP (53.11 ± 17.11 mmHg vs. 34.86 ± 8.49 mmHg, p = 0.03) and lower TAPSE/sPAP (0.30 ± 0.21 vs. 0.43 ± 0.23, p = 0.04). Patients with a TAPSE/sPAP lower than 0.25 mm/mmHg had worse prognosis, with log-rank test p = 0.001. the echocardiographic estimation of TAPSE/sPAP offers an easy, reliable, non-invasive prognostic parameter for the comprehensive assessment of hemodynamic adaptation in PAH patients.

Published
2021
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17. Multimodal assessment of right ventricle overload-metabolic and clinical consequences in pulmonary arterial hypertension.

Author

Kazimierczyk R, Malek LA, Szumowski P, Nekolla SG, Blaszczak P, Jurgilewicz D, Hladunski M, Sobkowicz B, Mysliwiec J, Grzywna R, Musial WJ, and Kaminski KA

Subjects
Heart Ventricles diagnostic imaging, Humans, Predictive Value of Tests, Ventricular Function, Right, Hypertension, Pulmonary diagnostic imaging, Pulmonary Arterial Hypertension, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right etiology
Abstract

Background: In pulmonary arterial hypertension (PAH) increased afterload leads to adaptive processes of the right ventricle (RV) that help to maintain arterio-ventricular coupling of RV and preserve cardiac output, but with time the adaptive mechanisms fail. In this study, we propose a multimodal approach which allows to estimate prognostic value of RV coupling parameters in PAH patients., Methods: Twenty-seven stable PAH patients (49.5 ± 15.5 years) and 12 controls underwent cardiovascular magnetic resonance (CMR). CMR feature tracking analysis was performed for RV global longitudinal strain assessment (RV GLS). RV-arterial coupling was evaluated by combination of RV GLS and three proposed surrogates of RV afterload-pulmonary artery systolic pressure (PASP), pulmonary vascular resistance (PVR) and pulmonary artery compliance (PAC). 18-FDG positron emission tomography (PET) analysis was used to assess RV glucose uptake presented as SUV RV/LV . Follow-up time of this study was 25 months and the clinical end-point was defined as death or clinical deterioration., Results: Coupling parameters (RV GLS/PASP, RV GLS/PVR and RV GLS*PAC) significantly correlated with RV function and standardized uptake value (SUV RV/LV ). Patients who experienced a clinical end-point (n = 18) had a significantly worse coupling parameters at the baseline visit. RV GLS/PASP had the highest area under curve in predicting a clinical end-point and patients with a value higher than (-)0.29%/mmHg had significantly worse prognosis. It was also a statistically significant predictor of clinical end-point in multivariate analysis (adjusted R 2  = 0.68; p < 0.001)., Conclusions: Coupling parameters are linked with RV hemodynamics and glucose metabolism in PAH. Combining CMR and hemodynamic measurements offers more comprehensive assessment of RV function required for prognostication of PAH patients., Trial Registration: NCT03688698, 09/26/2018, retrospectively registered; Protocol ID: 2017/25/N/NZ5/02689.

Published
2021
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18. Prognostic value of late gadolinium enhancement mass index in patients with pulmonary arterial hypertension.

Author

Kazimierczyk R, Małek ŁA, Szumowski P, Błaszczak P, Jurgilewicz D, Hładuński M, Sobkowicz B, Myśliwiec J, Grzywna R, Musiał WJ, and Kamiński KA

Subjects
Case-Control Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Pulmonary Arterial Hypertension metabolism, Survival Rate, Ventricular Dysfunction, Right metabolism, Contrast Media metabolism, Gadolinium metabolism, Hemodynamics, Magnetic Resonance Imaging methods, Pulmonary Arterial Hypertension pathology, Ventricular Dysfunction, Right pathology
Abstract

Purpose: Dysfunction of the right ventricle (RV) is an important determinant of survival in patients with pulmonary arterial hypertension (PAH). The presence of late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) at RV insertion points (RVIPs) has been found in majority of PAH patients and was associated with parameters of RV dysfunction. We hypothesize, that more detailed quantification of LGE may provide additional prognostic information., Material and Methods: Twenty-eight stable PAH patients (mean age 49.9 ​± ​15.9 years) and 12 healthy subjects (control group, 44.8 ​± ​13.5 years) were enrolled into the study. Septal LGE mass was quantified at the RVIPs and subsequently indexed by subject's body surface area. Mean follow-up time of this study was 16.6 ​± ​7.5 months and the clinical end-point (CEP) was defined as death or clinical deterioration., Results: Median LGE mass index (LGEMI) at the RVIPs was 2.75 ​g/m2 [1.41-4.85]. We observed statistically significant correlations between LGEMI and hemodynamic parameters obtained from right heart catheterization - mPAP (r ​= ​0.61, p ​= ​0.001); PVR (r ​= ​0.52, p ​= ​0.007) and from CMR - RVEF (r ​= ​-0.54, p ​= ​0.005); RV global longitudinal strain (r ​= ​0.42, p ​= ​0.03). Patients who had CEP (n ​= ​16) had a significantly higher LGEMI (4.49 [2.75-6.17] vs 1.67 [0.74-2.7], p ​= ​0.01); univariate Cox analysis confirmed prognostic value of LGEMI. Furthermore, PAH patients with LGEMI higher than median had worse prognosis in Kaplan-Meier analysis (log-rank test, p ​= ​0.0006)., Conclusions: The body surface indexed mass of LGE at RV septal insertion points are suggestive of RV hemodynamic dysfunction and could be a useful non-invasive marker of PAH prognosis., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)

Published
2021
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19. Prognostic role of PET/MRI hybrid imaging in patients with pulmonary arterial hypertension.

Author

Kazimierczyk R, Szumowski P, Nekolla SG, Blaszczak P, Malek LA, Milosz-Wieczorek B, Misko J, Jurgilewicz D, Hladunski M, Knapp M, Sobkowicz B, Mysliwiec J, Grzywna R, Musial WJ, and Kaminski KA

Subjects
Adult, Female, Fluorodeoxyglucose F18 pharmacokinetics, Heart Ventricles metabolism, Humans, Male, Middle Aged, Prognosis, Pulmonary Arterial Hypertension metabolism, Pulmonary Arterial Hypertension mortality, Radiopharmaceuticals pharmacokinetics, Survival Rate, Magnetic Resonance Imaging, Multimodal Imaging, Positron-Emission Tomography, Pulmonary Arterial Hypertension diagnostic imaging
Abstract

Objective: Right ventricular (RV) function is a major determinant of survival in patients with pulmonary arterial hypertension (PAH). Metabolic alterations may precede haemodynamic and clinical deterioration. Increased RV fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) was recently associated with progressive RV dysfunction in MRI, but the prognostic value of their combination has not been established., Methods: Twenty-six clinically stable patients with PAH (49.9±15.2 years) and 12 healthy subjects (control group, 44.7±13.5 years) had simultaneous PET/MRI scans. FDG uptake was quantified as mean standardised uptake value (SUV) for both left ventricle (LV) and RV. Mean follow-up time of this study was 14.2±7.3 months and the clinical end point was defined as death or clinical deterioration., Results: Median SUV RV /SUV LV ratio was 1.02 (IQR 0.42-1.21) in PAH group and 0.16 (0.13-0.25) in controls, p<0.001. In PAH group, SUV RV /SUV LV significantly correlated with RV haemodynamic deterioration. In comparison to the stable ones, 12 patients who experienced clinical end point had significantly higher baseline SUV RV /SUV LV ratio (1.21 (IQR 0.87-1.95) vs 0.53 (0.24-1.08), p=0.01) and lower RV ejection fraction (RVEF) (37.9±5.2 vs 46.8±5.7, p=0.03). Cox regression revealed that SUV RV /SUV LV ratio was significantly associated with the time to clinical end point. Kaplan-Meier analysis showed that combination of RVEF from MRI and SUV RV /SUV LV assessment may help to predict prognosis., Conclusions: Increased RV glucose uptake in PET and decreased RVEF identify patients with PAH with worse prognosis. Combining parameters from PET and MRI may help to identify patients at higher risk who potentially benefit from therapy escalation, but this hypothesis requires prospective validation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2021
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21. Increased platelet content of SDF-1alpha is associated with worse prognosis in patients with pulmonary prterial hypertension.

Author

Kazimierczyk R, Blaszczak P, Jasiewicz M, Knapp M, Ptaszynska-Kopczynska K, Sobkowicz B, Waszkiewicz E, Grzywna R, Musial WJ, and Kaminski KA

Subjects
Blood Platelets, Female, Humans, Hypertension, Pulmonary pathology, Middle Aged, Prognosis, Chemokine CXCL12 metabolism, Hypertension, Pulmonary genetics, Hypertension, Pulmonary metabolism
Abstract

Inflammatory processes and platelet activity play an important role in the pathophysiology of pulmonary arterial hypertension (PAH). Enhanced IL-6 signaling and higher concentration of stromal-derived factor alpha (SDF-1) have been previously shown to be linked with prognosis in PAH. We hypothesized that platelets of PAH patients have higher content of IL-6 and SDF-1 and thus are involved in disease progression. We enrolled into study 22 PAH patients and 18 healthy controls. Patients with PAH presented significantly higher plasma concentrations and platelet contents of IL-6, sIL-6R, and SDF-1 than healthy subjects (platelet content normalized to protein concentration: IL-6 (0.85*10 -10 [0.29 - 1.37] vs. 0.45*10 -10 [0.19-0.65], sIL-6R 1.54*10 -7 [1.32-2.21] vs. 1.14*10 -7 [1.01-1.28] and SDF-1 (2.72*10 -7 [1.85-3.23] vs. 1.70*10 -7 [1.43-2.60], all p < 0.05). Patients with disease progression (death, WHO class worsening, or therapy escalation, n = 10) had a significantly higher platelet SDF-1/total platelet protein ratio (3.68*10 -7 [2.45-4.62] vs. 1.69*10 -7 [1.04-2.28], p = 0.001), with no significant differences between plasma levels. Kaplan-Meier analysis revealed that patients with higher platelet SDF-1/total platelet protein ratio had more frequently deterioration of PAH in the follow-up (15.24 ± 4.26 months, log-rank test, p = 0.01). Concentrations of IL-6, sIL-6 receptor and SDF-1 in plasma and platelets are elevated in PAH patients. Higher content of SDF-1 in platelets is associated with poorer prognosis. Our study, despite of limitation due to small number of enrolled patients, suggests that activated platelets may be an important source of cytokines at the site of endothelial injury, but their exact role in the pathogenesis of PAH requires further investigation.

Published
2019
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22. The significance of diminished sTWEAK and P-selectin content in platelets of patients with pulmonary arterial hypertension.

Author

Kazimierczyk R, Błaszczak P, Kowal K, Jasiewicz M, Knapp M, Szpakowicz A, Ptaszyńska-Kopczyńska K, Sobkowicz B, Waszkiewicz E, Grzywna R, Musial WJ, and Kamiński KA

Subjects
Adult, Aged, Antihypertensive Agents therapeutic use, Blood Platelets drug effects, Epoprostenol therapeutic use, Female, Humans, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary physiopathology, Male, Middle Aged, Prognosis, Prospective Studies, Pulmonary Artery drug effects, Pulmonary Artery metabolism, Pulmonary Artery physiopathology, Solubility, Blood Platelets metabolism, Cytokine TWEAK blood, Hypertension, Pulmonary blood, P-Selectin blood
Abstract

Pulmonary arterial hypertension (PAH) is a progressive disease characterized by proliferative changes in pulmonary arteries. There is growing evidence suggesting that soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and P-selectin could be involved in PAH development and progression. Here we investigate whether circulating platelets may be a source of sTWEAK and contribute to diminished availability of sTWEAK and P-selectin in PAH patients. We have prospectively enrolled two independent study groups of stable patients with confirmed PAH and age matched controls: derivation (10 PAH; 15 controls) and validation (20 PAH; 12 controls). P-selectin and sTWEAK concentrations were measured in platelet-poor plasma and platelet lysate. To avoid procedural bias, in each group we employed different protocols for platelet isolation. Consistently, both in derivation and validation groups PAH patients presented significantly lower sTWEAK content in platelets than control group with no significant differences in plasma levels. Similarly, patients presented comparable to controls plasma P-selectin concentrations and lower concentration in platelet lysate. Kaplan-Meier analysis revealed that patients with low platelet sTWEAK/total protein concentration ratio had more frequently detoriation of PAH in the follow-up (16.51 ± 3.32 months), log-rank test, p = .03. Patients diagnosed with pulmonary arterial hypertension present diminished sTWEAK and P-selectin storage capacity in platelets. Thrombocytes appear to be a major source of sTWEAK that could be released upon local injury and its decreased availability could have an impact on pathophysiology and prognosis in PAH., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Published
2018
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23. [Successfully treated sudden cardiac arrest in a patient with single coronary artery originating from the right coronary sinus].

Author

Rumiński W, Błaszczak P, Jankowska A, Stazka J, Kicińska A, and Grzywna R

Subjects
Coronary Artery Bypass, Coronary Vessel Anomalies therapy, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Humans, Male, Middle Aged, Coronary Vessel Anomalies complications, Coronary Vessel Anomalies diagnosis, Death, Sudden, Cardiac etiology
Abstract

Congenital abnormalities of coronary arteries may predispose to life-threatening sudden cardiac events. We present a case of aborted sudden cardiac death in a patient who was diagnosed as having single coronary artery originating from right coronary sinus. The vessell divided into critically stenosed left main trunk and significantly narrowed right coronary artery. The patient was successfully treated with coronary artery bypass grafting preceded by implantation of ICD device.

Published
2009

24. Day/night ratio of microproteinuria and blood pressure rhythm in type II diabetes.

Author

Marczewski K, Krawczyk W, Rózyc P, Raszewski G, Grzywna R, and Klimek K

Subjects
Adult, Alpha-Globulins urine, Blood Pressure Monitoring, Ambulatory, Colorimetry, Diabetes Mellitus, Type 2 urine, Electrocardiography, Ambulatory, Female, Humans, Immunoglobulin G urine, Male, Middle Aged, Proteinuria physiopathology, Circadian Rhythm, Diabetes Mellitus, Type 2 physiopathology, Proteinuria urine
Abstract

The paper discusses the results of the studies conducted with a group of patients with type II diabetes without clinical nephropathy. The aim of the study was to attempt to determine the markers for early stages of diabetic nephropathy in NIDDM patients. The following examinations were carried out: the level of selected microproteinuric components, 24 h monitoring of arterial blood pressure, and electrocardiogram (ECG). Among the patients examined, the level of alfa-1-microglobulin, albumin and immunoglobulin G (IgG) in diabetic patients was higher than in the control group, and the increased activity of beta NAG was observed. The 24 h profile of blood pressure and the ratio afternoon/night of albumin excretion flattened in the majority of diabetic patients. The results of the study suggest that the proximal tubules and the membranes of renal glomeruli are damaged as early as during the period of subclinical diabetic nephropathy.

Published
1996
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25. Microalbuminuria or micro-alpha-1-microglobulinuria: which one is better predictor of the development of the secondary nephropathy?

Author

Marczewski KT, Dziemidok P, Grzywna R, and Krawczyk W

Subjects
Adult, Case-Control Studies, Diabetic Nephropathies epidemiology, Diabetic Nephropathies urine, Female, Humans, Immunoglobulin G urine, Kidney Diseases epidemiology, Kidney Diseases urine, Male, Middle Aged, Predictive Value of Tests, Reference Values, Albuminuria diagnosis, Alpha-Globulins urine, Diabetic Nephropathies diagnosis, Kidney Diseases diagnosis, Protease Inhibitors urine
Published
1996

26. [Microproteinuria and circadian rhythm of blood pressure in patients with arterial hypertension].

Author

Marczewski K, Krawczyk W, Grzywna R, Rózyc P, Jarosz M, Raszewski G, and Klimek K

Subjects
Acetylglucosaminidase urine, Adult, Albuminuria physiopathology, Alpha-Globulins urine, Blood Pressure Monitoring, Ambulatory, Electrocardiography, Female, Humans, Hypertension complications, Immunoglobulin G urine, Kidney Diseases etiology, Kidney Diseases physiopathology, Male, Middle Aged, Protease Inhibitors urine, Proteinuria etiology, Circadian Rhythm physiology, Hypertension physiopathology, Proteinuria physiopathology
Abstract

Microproteinuria is a recognized sign of early nephropathy in the course of arterial hypertension. There is few data concerning the excretion of proteins other than albumin in this group of patients. The aim of the study was to examine circadian rhythm of alfa-l-microglobulin (AlMG), albumin (ALB), immunoglobulin G (IgG) excretion and N-acetyl-beta-glukosaminidase (beta NAG)-activity, then to compare the results with the results of 24 hour ambulatory monitoring of arterial blood pressure in patients with arterial hypertension. The study comprised 28 patients. The control group included 27 healthy volunteers. Albumin concentration was determined by Beckman ICS2 nephelometer, using Beckman and Dako reagents. Blood pressure and ECG were monitored by analysis with ABP-system (AMP-USA). In patients with arterial hypertension significantly higher levels of ALB, AlMG, IgG and increased beta NAG activity were observed in morning urine samples. Despite hypotensive treatment blood pressure values were slightly, though significantly higher than in the control group. Among patients in the study circadian BP rhythm was disturbed. The results obtained suggest that in this group of patients subclinical nephropathy develops involving renal glomeruli and proximal tubules--probably resulting from vascular and humoral disorders, with accompanied hypertension.

Published
1996

27. [Evaluation of the accuracy of arterial pressure measurements with different types of devices used for self-monitoring].

Author

Bołtuć J, Grzywna R, Paprzycki P, and Marczewski K

Subjects
Adolescent, Adult, Aged, Equipment Design, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Self Care instrumentation, Blood Pressure Monitoring, Ambulatory instrumentation, Blood Pressure Monitors, Hypertension prevention & control
Abstract

The self-control is the important item in hypertension treatment. The results of blood pressure measurements were received by using various types using different of oscillometric equipment (thumb, wrist and arm manket) and compared with the outcomes of mercury sphygmomanometer which was used in the same trial. The satisfactory correlation of results from different types of equipment was confirmed with the exception of the thumb oscillometric apparatus results.

Published
1996

28. [Treatment of cardiogenic shock in myocardial infarction with intraaortic counterpulsation].

Author

Rumiński W, Markiewicz M, Koziara D, Grzywna R, and Lakomski B

Subjects
Adult, Aged, Aged, 80 and over, Counterpulsation, Female, Humans, Male, Middle Aged, Shock, Cardiogenic etiology, Intra-Aortic Balloon Pumping, Myocardial Infarction complications, Shock, Cardiogenic therapy
Abstract

The purpose of this study was to analyse the effects of intraaortic balloon counterpulsation (IABP) in treatment of patients with acute myocardial infarction (MI) complicated by cardiogenic shock. The study group consists of 20 consecutive patients (13 males and 7 females, aged 38-82 years) with cardiogenic shock developed in the course of MI. Catecholamines were administrated in all patients before intraaortic balloon pumping was instituted. IABP was performed using Datascope device. Efficacy of the procedure was determined with invasive measurements of arterial blood pressure and the level of diuresis. Of 20 patients with cardiogenic shock, 7 were successfully treated with IABP and they were discharged from the hospital.

Published
1993

29. [Value of Doppler echocardiography in evaluating pulmonary arterial pressure in patients with mitral valve defect].

Author

Trojnar R, Rymar B, Wysokiński A, Grzywna R, Wójcik J, Markiewicz M, Rumiński W, and Kleinrok A

Subjects
Adult, Echocardiography, Doppler, Female, Humans, Hypertension, Pulmonary etiology, Male, Middle Aged, Mitral Valve Insufficiency complications, Blood Pressure physiology, Hypertension, Pulmonary diagnosis, Mitral Valve Insufficiency physiopathology, Pulmonary Artery physiopathology
Abstract

In 40 patients aged 25-52 years (mean 36 years) with mitral valve disease but without overt circulatory failure haemodynamic studies and echocardiographic examinations were carried out recording the blood flow in the pulmonary artery and the blood flow through the tricuspid valve by pulsating and continuous-wave methods. From the obtained curves the time was calculated from the beginning of the flow to its maximum (TPV), the pre-ejection time (RPEP) and the right-ventricular ejection time (RVET), and the indices TPV/RVET and RPEP/RVET. Moreover, in 14 patients with coexistent insufficiency of the tricuspid valve the systolic pressure in the pulmonary artery was calculated by determining the systolic gradient across the tricuspid valve. On the basis of the results of haemodynamic examination the patients were divided into two groups: with normal (24 patients) and with raised (16 patients) pressure in the pulmonary artery. In the group of mitral valve disease and pulmonary hypertension a significantly shorter TPV, lower values of the TPV/RVET index and greater values of the RPEP/RVET index were found as compared with the patients with mitral disease and normal value of the systolic arterial pressure in the pulmonary artery. The systolic arterial pressure in the pulmonary artery determined on the basis of Doppler echocardiography with measurement of the regurgitation wave in tricuspid valve insufficiency showed a high agreement (r = 0.94) with the pressure recorded during cardiac catheterization.

Published
1989

30. [Comparative investigation of cardiac output using impedance rheography and invasive methods].

Author

Kleinrok A, Sacharuk A, Rumiński W, Kosicki J, Grzywna R, Markiewicz M, and Pałko T

Subjects
Adult, Aged, Exercise, Female, Heart Diseases physiopathology, Humans, Male, Middle Aged, Reference Values, Cardiac Output, Plethysmography, Impedance
Abstract

Authors performed comparative measurements of cardiac output using the impedance rheography and Fick's method in healthy men (6) reaching the value of correlation coefficient 0.88 and in patients with acquired cardiac defects (n = 21; r = 0.68). Authors also compared cardiac output values measured at rest and during exercise by means of thermodilution and rheographic methods in patients with heart failure (n = 9). Correlation coefficient was respectively 0.92 and 0.81.

Published
1989

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