41 results on '"Radosław Targoński"'
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2. Long-Term Mortality After TAVI for Bicuspid vs. Tricuspid Aortic Stenosis: A Propensity-Matched Multicentre Cohort Study
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Aleksandra Gasecka, Michał Walczewski, Adam Witkowski, Maciej Dabrowski, Zenon Huczek, Radosław Wilimski, Andrzej Ochała, Radosław Parma, Piotr Scisło, Bartosz Rymuza, Karol Zbroński, Piotr Szwed, Marek Grygier, Anna Olasińska-Wiśniewska, Dariusz Jagielak, Radosław Targoński, Grzegorz Opolski, and Janusz Kochman
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aortic stenosis (AS) ,bicuspid aortic valve (BAV) ,transcatheter aortic valve implantation (TAVI) ,mortality ,outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
ObjectivesPatients with bicuspid aortic valve (BAV) stenosis were excluded from the pivotal trials of transcatheter aortic valve implantation (TAVI). We compared the in-hospital and long-term outcomes between patients undergoing TAVI for bicuspid and tricuspid aortic valve (TAV) stenosis.MethodsWe performed a retrospective registry-based analysis on patients who underwent TAVI for BAV and TAV at five different centers between January 2009 and August 2017. The primary outcome was long-term all-cause mortality. Secondary outcomes were in-hospital mortality, procedural complications, and valve performance.ResultsOf 1,451 consecutive patients who underwent TAVI, two propensity-matched cohorts consisting of 130 patients with BAV and 390 patients with TAV were analyzed. All-cause mortality was comparable in both groups up to 10 years following TAVI (HR 1.09, 95% CI: 0.77–1.51). Device success and in-hospital mortality were comparable between the groups (96 vs. 95%, p = 0.554 and 2.3 vs. 2.1%, p = 0.863, respectively). Incidence of procedural complications was similar in both groups, with a trend toward a higher rate of stroke in patients with BAV (5 vs. 2%, p = 0.078). Incidence of moderate or severe paravalvular leak (PVL) at discharge was comparable in both groups (2 vs. 2%, p = 0.846). Among patients with BAV, all-cause mortality was similar in self-expanding and balloon-expandable prostheses (HR 1.02, 95% CI: 0.52–1.99) and lower in new-generation devices compared to old-generation valves (HR 0.27, 95% CI 0.12–0.62).ConclusionPatients who had undergone TAVI for BAV had comparable mortality to patients with TAV up to 10 years after the procedure. The device success, in-hospital mortality, procedural complications, and PVL rate were comparable between the groups. The high rate of neurological complications (5%) in patients with BAV warrants further investigation.
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- 2022
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3. Correction: Pluta et al. Platelet–Leucocyte Aggregates as Novel Biomarkers in Cardiovascular Diseases. Biology 2022, 11, 224
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Kinga Pluta, Kinga Porębska, Tomasz Urbanowicz, Aleksandra Gąsecka, Anna Olasińska-Wiśniewska, Radosław Targoński, Aleksandra Krasińska, Krzysztof J. Filipiak, Marek Jemielity, and Zbigniew Krasiński
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n/a ,Biology (General) ,QH301-705.5 - Abstract
The authors would like to make the following correction to the published paper [...]
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- 2022
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4. Platelet–Leucocyte Aggregates as Novel Biomarkers in Cardiovascular Diseases
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Kinga Pluta, Kinga Porębska, Tomasz Urbanowicz, Aleksandra Gąsecka, Anna Olasińska-Wiśniewska, Radosław Targoński, Aleksandra Krasińska, Krzysztof J. Filipiak, Marek Jemielity, and Zbigniew Krasiński
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aggregates ,biomarker ,cardiovascular disease ,flow cytometry ,leucocyte ,platelets ,Biology (General) ,QH301-705.5 - Abstract
Platelet–leucocyte aggregates (PLA) are a formation of leucocytes and platelets bound by specific receptors. They arise in the condition of sheer stress, thrombosis, immune reaction, vessel injury, and the activation of leukocytes or platelets. PLA participate in cardiovascular diseases (CVD). Increased levels of PLA were revealed in acute and chronic coronary syndromes, carotid stenosis cardiovascular risk factors. Due to accessible, available, replicable, quick, and low-cost quantifying using flow cytometry, PLA constitute an ideal biomarker for clinical practice. PLA are promising in early diagnosing and estimating prognosis in patients with acute or chronic coronary syndromes treated by percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). PLA were also a reliable marker of platelet activity for monitoring antiplatelet therapy. PLA consist also targets potential therapies in CVD. All of the above potential clinical applications require further studies to validate methods of assay and proof clinical benefits.
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- 2022
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5. Diagnostic and Prognostic Value of miRNAs after Coronary Artery Bypass Grafting: A Review
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Ewelina Błażejowska, Tomasz Urbanowicz, Aleksandra Gąsecka, Anna Olasińska-Wiśniewska, Miłosz J. Jaguszewski, Radosław Targoński, Łukasz Szarpak, Krzysztof J. Filipiak, Bartłomiej Perek, and Marek Jemielity
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miRNA ,coronary artery bypass grafting ,coronary artery disease ,diagnosis ,prognosis ,biomarkers ,Biology (General) ,QH301-705.5 - Abstract
MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3’-untranslated region of messenger RNA (mRNA), thus inhibiting mRNA translation or inducing mRNA degradation. MiRNAs have been associated with various cardiovascular diseases, including heart failure, hypertension, left ventricular hypertrophy, or ischemic heart disease. In addition, miRNA expression alters during coronary artery bypass grafting (CABG) surgery, which could be used to predict perioperative outcomes. CABG is an operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. Despite a very low perioperative mortality rate and excellent long-term survival, CABG is associated with postoperative complications, including reperfusion injury, graft failure, atrial fibrillation and perioperative myocardial infarction. So far, no reliable diagnostic and prognostic tools to predict prognosis after CABG have been developed. Changes in the perioperative miRNA expression levels could improve the diagnosis of post-CABG myocardial infarction and atrial fibrillation and could be used to stratify risk after CABG. Herein, we describe the expression changes of different subtypes of miRNAs during CABG and review the diagnostic and prognostic utility of miRNAs in patients undergoing CABG.
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- 2021
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6. Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
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Radosław Targoński, Marek A. Deja, Radosław Parma, Wojciech Wańha, Tomasz Darocha, Dariusz Jagielak, Damian Hudziak, Radosław Gocoł, Wojciech Wojakowski, Tomasz Figatowski, and Adrianna Hajder
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Coronary angiography ,medicine.medical_specialty ,Aorta ,New York Heart Association Class ,Transcatheter aortic ,Clinical events ,business.industry ,General Medicine ,medicine.disease ,Stenosis ,Internal medicine ,medicine.artery ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,Symptomatic aortic stenosis ,business - Abstract
Background: The purpose of this study was to compare the safety and clinical outcomes of transcarotid (TC) and transapical access (TA) transcatheter aortic valve implantation (TAVI) patients whom the transfemoral approach (TF) was not feasible. Methods: The analysis included consecutive patients with severe symptomatic aortic stenosis treated from 2017 to 2020 with TC-TAVI or TA-TAVI in two high-volume TAVI centers. The approach was selected by multidisciplinary heart teams after analyzing multislice computed tomography of the heart, aorta and peripheral arteries, transthoracic echocardiography and coronary angiography. Results: One hundred and two patients were treated with alternative TAVI accesses (TC; n = 49 and TA; n = 53) in our centers. The groups were similar regarding age, gender, New York Heart Association class, and echocardiography parameters. Patients treated with TC-TAVI had significantly higher surgical risk. The procedural success rate was similar in both groups (TC-TAVI 98%; TA-TAVI 98.1%; p = 0.95). The rate of Valve Academic Research Consortium-2 defined clinical events was low in both groups. The percentage of new-onset rhythm disturbances and permanent pacemaker implantation was similar in TC and TA TAVI (4.1% vs. 11.3%; p = 0.17 and 10.2% vs. 5.7%; p = 0.39, respectively). In the TA-TAVI group, significantly more cases of pneumonia and blood transfusions were observed (11% vs. 0%; p = 0.01 and 30.2% vs. 12.2%; p = 0.03). The 30-day mortality was similar in TC and TA groups (4.1% vs. 5.7%; p = 0.71, respectively). Conclusion: Both TC and TA TAVI are safe procedures in appropriately selected patients and are associated with a low risk of complications.
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- 2023
7. Harnessing the parallax for better spatial awareness
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Radosław Targoński, Aleksandra Gąsecka, Marlon S. Luis, Dariusz Jagielak, Miłosz Jaguszewski, and Nicolo Piazza
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Cardiac Catheterization ,Treatment Outcome ,Catheters ,Percutaneous Coronary Intervention ,Fluoroscopy ,Humans ,Radiology, Nuclear Medicine and imaging ,Equipment Design ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Despite easy access to imaging diagnostic procedures and an abundance of spatial data, most cardiac interventions are still performed under two-dimensional fluoroscopy. Incorporating anatomical data from scans into procedures plans has the potential to improve the swiftness and outcomes of percutaneous cardiac interventions. Therefore, procedure planning based on the specific anatomy is becoming a new standard of excellence in interventional cardiology. Still, we often tend to disregard specific spatial relations and the actual direction of catheter tip movement inside the body, relying on a try and error approach. The precise spatial orientation of instruments and prosthetic devices is crucial, especially during structural heart interventions. Here, we present how deliberate movements of objects under fluoroscopy can reveal the spatial orientation of catheters and other devices. We also propose a novel "two-point rule" for identifying three-dimensional relations between points in space. Understanding and applying this rule might substantially increase the spatial awareness of operators performing cardiovascular interventions. Although the concept is pretty simple, using it "live" during interventional cardiology procedures requires thorough understanding and practice. We propose the "two-point rule" as a crucial rule to develop expertise in spatial orientation under fluoroscopy and ensure high-quality outcomes.
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- 2022
8. Transfermoral transcatheter aortic valve implantation using self-expanding Allegra bioprosthesis: One-year single-center outcomes
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Radosław Targoński, Romuald Lango, Aleksandra Stańska, Joanna Milan, Marcin Fijałkowski, Miłosz Jaguszewski, Dariusz Jagielak, Mirosław Gozdek, and Mariusz Kowalewski
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medicine.medical_specialty ,New York Heart Association Class ,Transcatheter aortic ,Hemodynamics ,Prosthesis Design ,Single Center ,Transcatheter Aortic Valve Replacement ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Allegra ,Stroke ,transcatheter aortic valve implantation ,Aged ,Bioprosthesis ,business.industry ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Interventional Cardiology ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Aortic valve stenosis ,Cardiology ,Original Article ,Female ,NAUTILUS clinical study ,Terfenadine ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block - Abstract
Background The NAUTILUS study aimed to evaluate the safety and performance of the Allegra bioprosthesis in high-risk recipients undergoing transcatheter aortic valve implantation and previously reported 30-day outcomes. In the current investigation 1-year results of the trial are presented. Methods Twenty-seven recipients with severe, symptomatic aortic valve stenosis at high surgical risk, who underwent treatment using the next-generation self-expanding Allegra via transfemoral approach were prospectively enrolled. Clinical endpoints assessed were: mortality, stroke, permanent pacemaker implantation, New York Heart Association class and re-hospitalizations. Prosthetic valve performance evaluation comprised of: mean gradient, effective orifice area and paravalvular leak. Results Patients were elderly (82.8 ± 4.2 years) and predominantly female (n = 19, 70.4%). All of them were deemed to be at high surgical risk with a mean logistic EuroSCORE of 12.5 ± 6.7. The bioprosthesis was successfully implanted in 92.6% of the cases (n = 25). At 1-year, all-cause mortality was 12.0% (n = 3) and stroke was 4.0% (n = 1). Three (12%) of patients developed complete atrioventricular block and received permanent pacemakers. 84% of patients were in New York Heart Association class II or lower. Need for subsequent hospitalization arose in 48% patients. The echocardiographic assessment confirmed an acceptable hemodynamic profile of the Allegra with low mean transprosthetic gradient (9.5 ± 3.4 mmHg), absence of severe paravalvular leak and a 20%-presence of moderate paravalvular leak. Conclusions The current follow-up observation study shows that the Allegra was associated with a satisfactory safety profile and hemodynamic performance at 1-year after implantation.
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- 2021
9. Optimal fluoroscopic viewing angles for stenting of the coronary aorto-ostial lesions
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Jarosław Meyer-Szary, Aleksandra Gasecka, Miłosz Jaguszewski, Edyta Szurowska, Radosław Targoński, Bartosz Baścik, Dariusz Jagielak, and Laboratory for Experimental Clinical Chemistry
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medicine.medical_specialty ,Percutaneous ,Aortic root ,multislice computed tomography ,Coronary Angiography ,Coronary artery disease ,Internal medicine ,medicine.artery ,Multidetector Computed Tomography ,medicine ,Humans ,Dicom viewer ,cardiovascular imaging ,Aorta ,business.industry ,Heart ,General Medicine ,Multislice computed tomography ,medicine.disease ,Viewing angle ,Coronary Vessels ,Interventional Cardiology ,Coronary arteries ,medicine.anatomical_structure ,Treatment Outcome ,Fluoroscopy ,Cardiology ,cardiovascular system ,Original Article ,coronary intervention ,Stents ,Radiology ,aorto-ostial lesions ,Cardiology and Cardiovascular Medicine ,business ,optimal projection curves - Abstract
Background: Long-term results after stenting aorto-coronary ostial lesions (AOL) are worse than those achieved in non-ostial locations. AOL interventions still pose a substantial challenge for interventional cardiologists. The aim of the study was to determine the optimal fluoroscopic viewing angles of the left and right coronary ostia, based on multislice computed tomography (MSCT) data. Methods: Cardiac MSCT exams of 30 patients with clinical suspicion of coronary artery disease were analyzed. En face angles of both coronary ostia, as well as their optimal projection curves, were determined by 2 independent observers in a standard Dicom viewer, without any additional, specialized software add-ons, using a systematic, step-by-step approach. Spatial relations between the ostial plane and the aorta were also assessed. Results: The average en face angle of the left coronary ostium was RAO 23°, CAU 45°; for the right coronary ostium RAO 18°, CRA 5°. The mean inter-observer differences for the en face angles of the left and right coronary arteries were 5° and 7°, respectively. Conclusion: Multislice computed tomography data provide precise spatial information on the orientation of the coronary ostia and their relation to the aortic root. Their utilization for determining the patient-specific viewing angle may substantially facilitate percutaneous coronary interventions in AOL.
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- 2021
10. Three-dimensional echo-guided transcatheter mitral valve-in-valve implantation in prosthesis with no radiopaque marker
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Izabela K Pisowodzka, Dariusz Jagielak, Radosław Targoński, Jadwiga Fijałkowska, and Marcin M Fijałkowski
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Heart Valve Prosthesis Implantation ,Cardiac Catheterization ,Treatment Outcome ,Heart Valve Prosthesis ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Cardiology and Cardiovascular Medicine ,Prosthesis Design ,Echocardiography, Transesophageal ,Prosthesis Failure - Published
- 2022
11. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review
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Jarosław Meyer-Szary, Marlon Souza Luis, Szymon Mikulski, Agastya Patel, Finn Schulz, Dmitry Tretiakow, Justyna Fercho, Kinga Jaguszewska, Mikołaj Frankiewicz, Ewa Pawłowska, Radosław Targoński, Łukasz Szarpak, Katarzyna Dądela, Robert Sabiniewicz, and Joanna Kwiatkowska
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Models, Anatomic ,Cross-Sectional Studies ,Health, Toxicology and Mutagenesis ,Printing, Three-Dimensional ,Public Health, Environmental and Occupational Health ,Humans ,Prostheses and Implants - Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
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- 2022
12. Sodium-induced inflammation—an invisible player in resistant hypertension
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Szymon Price, Janusz Sadowski, Radosław Targoński, and Ryszard Targoński
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Physiology ,Sodium ,chemistry.chemical_element ,Inflammation ,030204 cardiovascular system & hematology ,Pharmacology ,Glycocalyx ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal Medicine ,medicine ,Doxazosin ,030212 general & internal medicine ,Aldosterone ,business.industry ,Neutrophil extracellular traps ,medicine.disease ,medicine.anatomical_structure ,chemistry ,Pathophysiology of hypertension ,Vascular resistance ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
The purpose of this review was to discuss the role of sodium and inflammation in the pathophysiology of hypertension and the observed different hemodynamic effects of drugs. The Pathway-2 study revealed that similar reductions in vascular resistance after spironolactone and doxazosin resulted in opposite effects on sodium balance, water retention, and hemodynamic parameters. These and other clinical findings were bridged to recent experimental and physiological data. Tissue sodium accumulation in salt-sensitive individuals due to endothelial glycocalyx dysfunction causes macrophage infiltration, vascular inflammation, and local changes in angiotensin-2 and aldosterone concentrations. This inflammatory cascade leads to factor XII-related coagulation disorders with neutrophil extracellular trap formation (NETosis). This model of sodium-induced microcirculation impairment was used to explain the differences in central hemodynamic parameters after spironolactone or doxazosin treatment in resistant hypertension. Hypertension treatment by induced sodium removal or reduced sodium intake should reduce endothelial glycocalyx dysfunction, inflammation, NETosis, and coagulation disorders, leading to improved vascular health and cardiac diastolic function.
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- 2020
13. Mast cell derived carboxypeptidase A3 is decreased among patients with advanced coronary artery disease
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Radosław Targoński, Tomasz Koliński, Piotr Trzonkowski, Janusz Siebert, Magdalena Reiwer-Gostomska, Łukasz Lewicki, Karolina Piekarska, and Natalia Marek-Trzonkowska
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Male ,medicine.medical_specialty ,Proteases ,Cathepsin G ,Carboxypeptidases A ,Down-Regulation ,Coronary Artery Disease ,Clinical Cardiology ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,Chymases ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Mast Cells ,Prospective Studies ,Myocardial infarction ,Non-ST Elevated Myocardial Infarction ,Taxonomy ,Aged ,biology ,business.industry ,Chymase ,Biodiversity ,General Medicine ,Middle Aged ,medicine.disease ,Mast cell ,Carboxypeptidase ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Case-Control Studies ,biology.protein ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Blood vessel - Abstract
Background: Coronary artery disease (CAD) affects milions of people and can result in myocardial infarction (MI). Previously, mast cells (MC) have been extensively investigated in the context of hypersensitivity, however as regulators of the local inflammatory response they can potentially contribute to CAD and/or its progression. The aim of the study was to assess if serum concentration of MC proteases: carboxypeptidase A3, cathepsin G and chymase 1 is associated with the extension of CAD and MI. Methods: The 44 patients with angiographically confirmed CAD (23 subjects with non-ST-segment elevation MI [NSTEMI] and 21 with stable CAD) were analyzed. Clinical data were obtained as well serum concentrations of carboxypeptidase A3, cathepsin G and chymase 1 were also measured. Results: Patients with single vessel CAD had higher serum concentration of carboxypeptidase than those with more advanced CAD (3838.6 ± 1083.1 pg/mL vs. 2715.6 ± 442.5 pg/mL; p = 0.02). There were no significant differences in levels of any protease between patients with stable CAD and those with NSTEMI. Patients with hypertension had ≈2-fold lower serum levels of cathepsin G than normotensive individuals (4.6 ± 0.9 pg/mL vs. 9.4 ± 5.8 pg/mL; p = 0.001). Cathepsin G levels were also decreased in sera of the current smokers as compared with non-smokers (3.1 ± 1.2 ng/mL vs. 5.8 ± 1.2 ng/mL, p = 0.02). Conclusions: Decreased serum level of carboxypeptidase is a hallmark of more advanced CAD. Lower serum levels of carboxypeptidase A3 and catepsin G are associated with risk factors of blood vessel damage suggesting a protective role of these enzymes in CAD.
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- 2020
14. An alternative to airborne droplet transmission route of SARS-CoV-2, the feco-oral route, as a factor shaping COVID-19 pandemic
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Ryszard, Targoński, Aleksandra, Gąsecka, Adrian, Prowancki, and Radosław, Targoński
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General Medicine - Abstract
The Chinese scenario, a rapid increase in the frequency of SARS-CoV-2 infections and sudden decline, is uncommon worldwide. Enormous differences in COVID-19 severity among individual countries are the striking findings of the pandemics. It has been demonstrated that a mild course of COVID-19 is associated with gastrointestinal symptoms, less inflammatory response, and better prognosis. The presence of SARS-CoV-2 was observed longer in the gastrointestinal tract than in respiratory swabs, promoting feco-oral transmissions and mild virus attenuation. The spread of the pandemic and its severity might, consequently, depends on the dominant environmental route of infection and emerging immunity. We hypothesize that the feco-oral SARS-CoV-2 transmission may help to achieve the long-term immunity against COVID-19, since it enables the continuous contact with viral antigens in the gastrointestinal tract, resulting in lower mortality rate. To conclude, countries producing rice through traditional methods developed rapidly emerging long-lasting population immunity, possibly through increased SARS-CoV-2 antigen exposure in the gastrointestinal tract. Our hypothesis brings attention to this potential route of herd immunity against SARS-CoV-2 which warrants further investigation in the future.
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- 2022
15. TCT-51 Complete Cerebral Protection via Left Radial Approach During Transcatheter Aortic Valve Replacement: Results From the PROTEMBO C Trial
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Marek Grygier, Marcin Misterski, Juergen Leick, Adam Witkowski, Tobias Schmidt, Mohamed Abdel-Wahab, Inga Narbute, Derk Frank, Michael Lauterbach, Radosław Targoński, Andrejs Erglis, Matti Adam, Johannes Wilde, Nikos Werner, Christian Frerker, Dariusz Jagielak, and Fernando Gatto
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medicine.medical_specialty ,Transcatheter aortic ,Valve replacement ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
16. To Curb the Progression of Fatal COVID-19 Course-Dream or Reality
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Janusz Sadowski, Ryszard Targoński, Radosław Targoński, and Szymon Price
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Sodium ,chemistry.chemical_element ,Inflammation ,Angiotensin-Converting Enzyme Inhibitors ,ACEI/ARB ,030204 cardiovascular system & hematology ,Spironolactone ,Bioinformatics ,Glycocalyx ,Inflammation and Cardiovascular Diseases (A Kirabo, Section Editor) ,03 medical and health sciences ,chemistry.chemical_compound ,Angiotensin Receptor Antagonists ,0302 clinical medicine ,Renin–angiotensin system ,Antithrombotic ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,SARS-CoV-2 ,Heparin ,COVID-19 ,chemistry ,Hypertension ,Disease Progression ,medicine.symptom ,business ,medicine.drug - Abstract
Purpose of Review To analyze the impact of sodium retention states on the course of COVID-19 and propose possible interventions to curb disease progression. Recent Findings Numerous data confirm a positive association of non-communicable diseases, aging, and other sodium-retaining states, including iatrogenic ones, with more severe sometimes fatal clinical course of COVID-19. Reasons for this effect could include increased angiotensin signaling via the AT1R receptor. The endothelial glycocalyx also plays an important role in infection, leading to a vicious cycle of inflammation and tissue sodium retention when damaged. RAS inhibitors may help restore glycocalyx function and prevent severe organ damage. Anticoagulants, especially heparin, may also have therapeutic applications due to antithrombotic, anti-inflammatory, glycocalyx-repairing, and antialdosteronic properties. The ambiguous influence of some diuretics on sodium balance was also discussed. Summary Abnormal sodium storage and increased angiotensin-converting enzyme activity are related to the severity of COVID-19. Inducing sodium removal and reducing intake might improve outcomes.
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- 2021
17. Successful transcatheter treatment of late complications after the Bentall procedure
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Radosław Targoński, Marcin Fijałkowski, Jarosław Meyer-Szary, Dariusz Jagielak, and Robert Sabiniewicz
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Heart Valve Prosthesis Implantation ,medicine.medical_specialty ,Postoperative Complications ,business.industry ,Aortic Valve ,Bentall procedure ,medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Surgery - Published
- 2021
18. Transcatheter aortic valve implantation through a transcarotid approach and cerebral injury
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Jadwiga Fijałkowska, Radosław Targoński, Jan Rogowski, Aleksandra Stańska, Marcin Fijałkowski, Edyta Szurowska, Miłosz Jaguszewski, and Dariusz Jagielak
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Cerebral injury ,medicine.medical_specialty ,Transcatheter aortic ,business.industry ,MEDLINE ,Aortic Valve Stenosis ,Transcatheter Aortic Valve Replacement ,Treatment Outcome ,Internal medicine ,Aortic Valve ,Heart Valve Prosthesis ,Cardiology ,medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business - Published
- 2020
19. Sodium-induced inflammation-an invisible player in resistant hypertension
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Ryszard, Targoński, Janusz, Sadowski, Szymon, Price, and Radosław, Targoński
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Heart Failure ,Inflammation ,Hypertension ,Animals ,Humans ,Sodium Chloride, Dietary - Abstract
The purpose of this review was to discuss the role of sodium and inflammation in the pathophysiology of hypertension and the observed different hemodynamic effects of drugs. The Pathway-2 study revealed that similar reductions in vascular resistance after spironolactone and doxazosin resulted in opposite effects on sodium balance, water retention, and hemodynamic parameters. These and other clinical findings were bridged to recent experimental and physiological data. Tissue sodium accumulation in salt-sensitive individuals due to endothelial glycocalyx dysfunction causes macrophage infiltration, vascular inflammation, and local changes in angiotensin-2 and aldosterone concentrations. This inflammatory cascade leads to factor XII-related coagulation disorders with neutrophil extracellular trap formation (NETosis). This model of sodium-induced microcirculation impairment was used to explain the differences in central hemodynamic parameters after spironolactone or doxazosin treatment in resistant hypertension. Hypertension treatment by induced sodium removal or reduced sodium intake should reduce endothelial glycocalyx dysfunction, inflammation, NETosis, and coagulation disorders, leading to improved vascular health and cardiac diastolic function.
- Published
- 2019
20. Efficacy and safety of levosimendan and dobutamine in heart failure: A systematic review and meta-analysis
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Aleksandra Gasecka, Miłosz Jaguszewski, Radosław Targoński, Krzysztof J. Filipiak, Lukasz Szarpak, Laboratory for Experimental Clinical Chemistry, and Laboratory for General Clinical Chemistry
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medicine.medical_specialty ,Cardiotonic Agents ,MEDLINE ,Text mining ,Dobutamine ,Internal medicine ,Intensive care ,medicine ,Humans ,Intensive care medicine ,Simendan ,Heart Failure ,business.industry ,Hydrazones ,General Medicine ,Levosimendan ,medicine.disease ,Pyridazines ,Treatment Outcome ,Meta-analysis ,Heart failure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Published
- 2021
21. Polyhedral erythrocytes in intracoronary thrombus and their association with reperfusion in myocardial infarction
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Lukasz Lewicki, Radosław Targoński, Patrycja Mołek, Jadwiga Nessler, Jarosław Zalewski, Michal Zabczyk, Anetta Undas, and Krzysztof Krawczyk
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Male ,medicine.medical_specialty ,Erythrocytes ,Ischemia ,030204 cardiovascular system & hematology ,Coronary Angiography ,Fibrin ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Internal medicine ,parasitic diseases ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Thrombus ,Retrospective Studies ,Thrombectomy ,Aspirin ,biology ,business.industry ,Coronary Thrombosis ,General Medicine ,Middle Aged ,medicine.disease ,Clopidogrel ,medicine.anatomical_structure ,Cardiology ,biology.protein ,Microscopy, Electron, Scanning ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,Perfusion ,Artery ,medicine.drug ,Follow-Up Studies - Abstract
The tightly packed arrays of polyhedral erythrocytes, polyhedrocytes, formed during thrombus contraction, have been detected in some intracoronary thrombi (ICT) obtained from patients with ST-segment elevation myocardial infarction (STEMI). We sought to investigate determinants of polyhedrocyte content in ICT and its association with reperfusion in STEMI.We assessed the composition of ICT obtained during thrombectomy within 12 h since the symptom onset in 110 STEMI patients, following 300 mg of aspirin (n = 110) and 600 mg of clopidogrel (n = 75). The predominance of fibrin, erythrocytes, polyhedrocytes or platelets was evaluated using scanning electron microscopy.Polyhedrocytes were found in 34 (30.9%) ICT, in which they covered 20-50% (median 38.8%) fields of view. Patients with polyhedrocytes in ICT had lower median minimal reference infarct-related artery (IRA) diameter by 20% (p 0.0001) and area by 31% (p 0.0001) versus those without polyhedrocytes. Time of ischemia showed association with the polyhedrocyte content (r = 0.26, p = 0.007). By multivariate analysis, minimal IRA diameter (β = - 0.50, p 0.0001) and ischemia time (β = 0.20, p = 0.035) independently affected polyhedrocyte content in ICT (ROur findings indicate that the presence of polyhedrocytes in ICT, observed in one-third of STEMI patients, is associated with smaller minimal IRA diameter, prolonged ischemia and their formation in late presenters is associated with more effective thrombus aspiration and better myocardial reperfusion.
- Published
- 2019
22. Prognostic significance of red cell distribution width and its relation to increased pulmonary pressure and inflammation in acute heart failure
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Andrzej Rynkiewicz, Radosław Targoński, Janusz Sadowski, Magdalena Starek-Stelmaszczyk, and Ryszard Targoński
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Erythrocyte Indices ,medicine.medical_specialty ,Anemia ,030204 cardiovascular system & hematology ,Clinical Cardiology ,Systemic inflammation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Retrospective Studies ,Heart Failure ,Inflammation ,Mean corpuscular hemoglobin concentration ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,Atrial fibrillation ,Red blood cell distribution width ,General Medicine ,medicine.disease ,Prognosis ,Heart failure ,Cardiology ,Hemoglobin ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Red cell distribution width (RDW) in acute heart failure (AHF) is accepted as a prognostic indicator with unclear pathophysiological ties. The aim of this study was to evaluate the prognostic value of RDW in AHF patients in relation to clinical and echocardiographic data. Methods: 170 patients with AHF were retrospectively studied. All patients had laboratory testing and an echocardiogram performed within 24 h of admission to the Cardiology Department. Results: During the mean 193 ± 111 days of follow-up, 33 patients died. More advanced age, high RDW and low peak early diastolic velocity of the lateral mitral annulus (MVe’) were independent predictors of all-cause mortality with hazard ratios of: 1.05 (95% CI 1.02–1.09), p < 0.005, 1.40 (95% CI 1.22–1.60), p < 0.001, and 0.77 (95% CI 0.63–0.93), p < 0.007, respectively. In a stepwise multiple linear regression model, RDW was correlated with hemoglobin concentration (standardized b = –0.233, p < 0.001), mean corpuscular volum (standardized b = –0.230, p < 0.001), mean corpuscular hemoglobin concentration (standardized b = –0.207, p < 0.007), the natural logarithm of C-reactive protein (CRP) (standardized b = 0.184, p < 0.004) and tricuspid regurgitation peak gradient (TRPG) values (standardized b = 0.179, p < 0.006), whereas MVe’ was correlated with atrial fibrillation (standardized b = 0.269, p < 0.001). Conclusions: The present data demonstrates a novel relation between higher levels of RDW and elevated TRPG and high sensitivity CRP values in patients with AHF. These findings suggest that RDW, the most important mortality predictor, is independently associated with elevated pulmonary pressure and systemic inflammation in patients with AHF. Moreover, in AHF patients, more advanced age and decreased MVe’ are also independently associated with total mortality risk.
- Published
- 2018
23. Successful versus unsuccessful antegrade recanalization of single chronic coronary occlusion: Eight-year experience and outcomes by a propensity score ascertainment
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Ulf Landmesser, Marcin Gruchała, Emilia Masiewicz, Jasmina Alibegovic, Maciej Duda, Michal Chmielecki, Piotr Drewla, Radosław Targoński, Milosz Jaguszewski, Lukasz Lewicki, Marcin Fijałkowski, Paweł Skarżyński, Dariusz Ciećwierz, Andrzej Rynkiewicz, Natasza Gilis-Malinowska, Slawomir Burakowski, Aneta Strozyk, and Witold Dubaniewicz
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Selection bias ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Percutaneous coronary intervention ,General Medicine ,Revascularization ,medicine.disease ,Surgery ,Coronary occlusion ,Propensity score matching ,Conventional PCI ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,Mace ,media_common - Abstract
Aims The effectiveness of revascularization of chronic total occlusion (CTO) remains intriguing. Thus, we sought to investigate whether a successful PCI for single CTO improves outcomes in a setting of stable angina and chronic occlusion of single coronary artery. Methods and Results Of 11 957 consecutive patients referred for nonurgent PCI between 2003 and 2010, 1110 displayed single CTO and were enrolled to the central CTO-registry database. The primary end-point included all-cause mortality, the secondary end-point a composite of safety outcome measure of all-cause death, nonfatal-MI, the need for urgent revascularization and stroke. The major adverse cardiovascular event (MACE) records were extracted from the national administrative database and all patients were linked to the long-term follow-up. Since the patient assignment was not random, we performed the propensity scoring to minimize selection bias; 734 patients (66%) had a successful PCI-CTO. Compared with successful procedures, unsuccessful procedures had similar rates of all-cause death both in crude (HR, 0.78; 95%CI, 0.49–1.25; P = 0.30) and adjusted analysis (HR, 0.80; 95%CI, 0.50-1.28; P = 0.34). A similar, significant reduction in overall MACE was noted with successful PCI-CTO compared with unsuccessful procedure in unadjusted (HR, 0.74; 95%CI, 0.56–0.96; P = 0.020) and adjusted calculation (HR, 0.73; 95%CI, 0.56–0.96; P = 0.019). Patients after successful PCI-CTO as compared with failed recanalization less frequently underwent surgical revascularization. The benefit was sustained at 3 years follow-up. Conclusions Successful PCI for single CTO does not improve long-term survival, nonetheless, is associated with reduced overall MACE and the need for surgical revascularization. © 2015 Wiley Periodicals, Inc.
- Published
- 2015
24. Successful recanalisation of isolated chronic total occlusions improves outcomes in long-term observation: a case-control study
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Radosław Targoński, Natasza Gilis-Siek, Aneta Strozyk, Miłosz Jaguszewski, Emilia Masiewicz, Andrzej Rynkiewicz, Łukasz Lewicki, Dariusz Ciećwierz, Marcin Fijałkowski, Michal Chmielecki, Marcin Gruchała, Witold Dubaniewicz, and Maciej Duda
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,Comorbidity ,Coronary Angiography ,Cohort Studies ,Angina ,Percutaneous Coronary Intervention ,medicine ,Humans ,Angina, Stable ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Interventional cardiology ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Causality ,Survival Rate ,Treatment Outcome ,Coronary Occlusion ,Case-Control Studies ,Cohort ,Conventional PCI ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background and aim: The long-term benefit of percutaneous recanalisation of chronic total occlusion (CTO) is still unclear. Given advances in interventional cardiology over the last two decades, we sought to investigate whether a successful percutaneous coronary intervention for CTO (PCI-CTO) improves outcomes in an age- and gender-matched single-centre cohort of stable angina patients. Methods: Out of 401 consecutive patients enrolled to the CTO-Registry database, 276 patients were included in the final analysis. Patients with unsuccessful PCI-CTO (n = 138) were age- and gender-matched in a 1:1 ratio with patients who underwent a successful procedure. The primary end-points included hard end-points comprising death and nonfatal myocardial infarction (MI) and a composite safety outcome measure of death, nonfatal MI and ischaemia-driven revascularisation. The secondary end-point was improvement in angina status or complete resolution of angina symptoms. Patients were followed up for six months and at two years. Results: Patients who underwent a successful recanalisation of CTO, compared to those who underwent an unsuccessful procedure, revealed similar rates of composite death and MI at six months (0.7% vs. 1.4%; hazard ratio [HR], 0.50; 95% confidence interval ratio [CI], 0.05–4.80; p = 0.56) and two years (1.4% vs. 5.8%; HR 0.24; 95% CI 0.07–0.85; p = 0.053). A significant difference in composite safety end-points between subsets, although not recorded after six months of observation (8.7% vs. 15.2%; HR 0.54; 95% CI 0.27–1.07; p = 0.095), was noted at two years follow-up (15.2% vs. 29.7%; HR 0.47; 95% CI 0.29–0.77; p = 0.004). A greater improvement in symptom burden or resolution of angina symptoms was documented after a successful PCI at both six months (68.1% vs. 23.2%, p < 0.001; 80.4% vs. 34.8%, p < 0.001, respectively) and two years (52.2% and 8.0%, p < 0.001; 68.1% vs. 22.5%, p < 0.001, respectively). Conclusions: Successful recanalisation of CTO improves outcomes in long-term observation.
- Published
- 2013
25. Elevated Serum Tryptase and Endothelin in Patients with ST Segment Elevation Myocardial Infarction: Preliminary Report
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Emilia Masiewicz, Radosław Targoński, Natalia Marek-Trzonkowska, Piotr Trzonkowski, Tomasz Koliński, Lukasz Lewicki, Magdalena Reiwer-Gostomska, and Janusz Siebert
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medicine.hormone ,Male ,medicine.medical_specialty ,Article Subject ,Immunology ,Myocardial Infarction ,Tryptase ,Coronary artery disease ,Endothelins ,Lesion ,Internal medicine ,medicine ,lcsh:Pathology ,ST segment ,Humans ,Myocardial infarction ,cardiovascular diseases ,Prospective Studies ,Aged ,Platelet-Derived Growth Factor ,biology ,business.industry ,Cell Biology ,Ribonuclease, Pancreatic ,Middle Aged ,medicine.disease ,Proto-Oncogene Proteins c-kit ,medicine.anatomical_structure ,Endocrinology ,Cardiology ,biology.protein ,Female ,Tryptases ,medicine.symptom ,business ,Endothelin receptor ,Artery ,lcsh:RB1-214 ,Research Article - Abstract
An inflammatory response plays a crucial role in myocardial damage after an acute myocardial infarction.Objectives. To measure serum concentrations of several mediators in patients with an acute myocardial infarction (STEMI) and to assess their potential relationship with a risk of coronary instability.Patients and Methods. The 33 patients with STEMI and 19 healthy volunteers were analyzed. The clinical data were obtained; as well serum concentrations of tryptase, endothelin (ET-1), angiogenin, soluble c-kit, and PDGF were measured.Results. Patients with STEMI had higher serum tryptase and ET-1 than healthy volunteers (2,5 ± 0,4 ng/mL versus 1,1 ± 0,4 ng/mL and 0,7 ± 0,1 ng/mL versus 0,3 ± 0,1 ng/mL, resp.). Subjects with significant lesion in left anterior descending artery (LAD) had lower serum ET-1 compared to those with normal LAD (0,6 ± 0,2 pg/mL versus 0,9 ± 0,4 pg/mL). Patients with three-vessel coronary artery disease (CAD) had higher level of soluble c-kit compared to those with one- or two-vessel CAD: 19,9 ± 24,1 ng/mL versus 5,6 ± 1,9 ng/mL.Conclusions. Elevated serum tryptase and ET-1 may be markers of increased coronary instability; some cytokines may be related to the extension of CAD.
- Published
- 2015
26. Emergency echocardiography to guide therapy in a patient with Takotsubo cardiomyopathy complicated with dynamic left ventricular outflow tract obstruction
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Radosław Nowak, Radosław Targoński, Milosz Jaguszewski, Witold Dubaniewicz, and Aleksander Włodarczyk
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medicine.medical_specialty ,Acute coronary syndrome ,Ejection fraction ,business.industry ,Heart Ventricles ,Cardiomyopathy ,Ventricular outflow tract obstruction ,Ventricular Outflow Obstruction ,medicine.disease ,Coronary artery disease ,Echocardiography ,Takotsubo Cardiomyopathy ,Internal medicine ,medicine ,Cardiology ,Humans ,Female ,cardiovascular diseases ,Myocardial infarction ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,TIMI ,Aged - Abstract
A 76-year-old woman with no previous cardiovascular history was admitted to an emergency setting with suspicion of ST-segment elevation acute myocardial infarction. She was suffering from retrosternal chest pain and dyspnoea just after a family quarrel. Clinical examination revealed a heart rate of 80 bpm, blood pressure of 110/50 mm Hg, and systolic murmur grade 4 in the Levine grading scale, with no signs of pulmonary congestion, peripheral oedema, or hepatomegaly. Electrocardiogram documented ST-segment elevation in precordial leads V2–V6 and lead I (Fig. 1A), and highly sensitive troponin T level was significantly elevated (1.3 ng/mL). Urgent coronary angiography was performed and demonstrated TIMI II grade flow in the left anterior descending artery, with no obstructive coronary artery disease or angiographic evidence of acute plaque rupture (Fig. 1B, C). An echocardiogram performed immediately after heart catheterisation revealed ellipsoidal asymmetric hypertrophy of the basal septum, apical ballooning, hyperkinesia of basal segments with left ventricular ejection fraction of 37%, and pronounced systolic anterior motion (SAM) (Fig. 1D, arrow) of both mitral leaflets causing mild mitral regurgitation (MR) and dynamic left ventricular outflow tract obstruction (LVOTO). The maximal velocity was 5.6 m/s and maximal peak gradient was 126 mm Hg (Fig. 1E). Based on the clinical and echocardiographic findings, therapy with bisoprolol 2.5 mg and intravenous fluid infusion was carefully initiated. Control echocardiography five days later showed hypokinesis of previously akinetic segments, normokinesis of basal segments, and no signs of SAM and dynamic LVOTO. The patient was discharged home with no cardiac symptoms, with the diagnosis of typical variant of Takotsubo cardiomyopathy (TTC). TTC is a reversible cardiomyopathy, usually affecting postmenopausal women with clinical presentation mimicking acute coronary syndrome. Since up to 10% of patients develop severe compl ications, despite the favourable long-term prognosis, TTC remains a life-threatening disease in the acute phase. We present a case of a woman with TTC complicated by acute SAM with mild MR and dynamic, severe LVOTO. Elderly women, with relatively small left ventricle cavity and septal bulge, are more likely to develop such complications. In patients with LVOTO continuous infusion of catecholamines or excessive diuretic therapy can increase the intraventricular pressure gradient that leads to further haemodynamic compromise and is thus not recommended. In such a clinical scenario careful intravenous fluid therapy, as well as use of intra-aortic balloon pump, should be considered. In patients without circulatory compromise with concomitant LVOTO, beta-blocker therapy is strongly recommended. However, the efficacy and safety of such treatment should be evaluated in further studies. This case highlights the role of immediate bedside echocardiography in a patient with TTC and systolic murmur, to guide immediate treatment strategy. Figure 1. A. ST-segment elevation in precordial leads V2– –V6 and lead I. B, C. Coronary angiography with no obstructive coronary artery disease. D, E. Asymmetric hypertrophy of the basal septum, apical ballooning, pronounced SAM (D, arrow) and dynamic LVOTO (E) A
- Published
- 2015
27. Association between the PlA platelet glycoprotein GPIIIa polymorphism and extent of coronary artery disease
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Janusz Limon, Witold Dubaniewicz, Wojciech Sobiczewski, Andrzej Rynkiewicz, Piotr Drewla, Bartosz Wasag, Radosław Targoński, Dariusz Ciećwierz, Karolina Ochman, Marcin Gruchała, Piotr Romanowski, and Paweł Skarżyński
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Adult ,Male ,medicine.medical_specialty ,Genotype ,Coronary Artery Disease ,Coronary Angiography ,Polymerase Chain Reaction ,Severity of Illness Index ,Gastroenterology ,White People ,Pathogenesis ,Coronary artery disease ,Plasminogen Activators ,Internal medicine ,medicine ,Humans ,Platelet ,Allele ,Allele frequency ,Aged ,Membrane Glycoproteins ,Polymorphism, Genetic ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,Surgery ,Poland ,Gene polymorphism ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: The Pl A2 allele of the gene encoding for GPIIIa subunit of the platelet membrane receptor glycoprotein (GP) IIb/IIIa has been suggested as a significant risk factor for thrombotic complications of coronary artery disease (CAD). The aim of the current investigation was to investigate the association between Pl A GPIIIa polymorphism and the extent of angiographically confirmed CAD in patients from the north region of Poland. Methods: The study was performed in 397 male Caucasian patients. All subjects had significant coronary artery stenosis confirmed by elective coronary angiography. Screening for the Pl A GPIIIa genotypes was performed by polymerase chain reaction of genomic DNA, followed by Nci I digestion and agarose gel electrophoresis. Results: The genotype distribution of the Pl A GPIIIa polymorphism in our study group was Pl A1/A1 —75%, Pl A1/A2 —24% and Pl A2/A2 —1% with Pl A1 and Pl A2 allele frequencies of 0.87 and 0.13, respectively. The prevalence of the homozygous Pl A1/A1 genotype among subjects with multiple-vessel CAD (two or three vessels with at least 50% stenosis) was significantly higher than in patients with single-vessel disease; the odds ratio of Pl A2/A2 or Pl A1/A2 patients for having multiple-vessel CAD was 0.46 (95% CI 0.27–0.77, P Pl A1/A1 patients was significantly higher in comparison to Pl A2/A2 and Pl A1/A2 patients (7.58±2.20 and 6.98±2.37, respectively, P Conclusions: Our results suggest, that the Pl A1/A1 genotype of Pl A GPIIIa polymorphism is associated with more severe CAD in male Caucasian patients from the north region of Poland.
- Published
- 2003
28. The successful treatment of cardiogenic shock with primary percutaneous coronary intervention (T-stenting) of total occluded unprotected left main performed during cardiopulmonary resuscitation
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Emilia Masiewicz, Łukasz Lewicki, Radosław Targoński, Andrzej Rynkiewicz, and Miłosz Jaguszewski
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medicine.medical_specialty ,medicine.medical_treatment ,Shock, Cardiogenic ,Angina ,Left coronary artery ,Percutaneous Coronary Intervention ,Restenosis ,medicine.artery ,Internal medicine ,medicine ,Humans ,business.industry ,Cardiogenic shock ,Percutaneous coronary intervention ,Sudden cardiac arrest ,Middle Aged ,medicine.disease ,Cardiopulmonary Resuscitation ,Drug-eluting stent ,Right coronary artery ,Cardiology ,Female ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
A 61-year-old male with no previous cardiovascular history was admitted to the coronary care unit suffering from acute angina. On presentation the patient was conscious, the heart rate was 100 bpm, and the blood pressure was 80/60 mm Hg. Standard electrocardiogram displayed prominent ST-segment elevation in the anterolateral leads. The initial treatment was 300 mg of aspirin, 600 mg of clopidogrel, and intravenous bolus of unfractioned heparin, all given in the ambulance. In the catheterisation laboratory, sudden cardiac arrest occurred and the patient was subsequently defibrillated. The patient needed defibrillation because of ventricular fibrillation followed by pulseless electrical activity. A cardiopulmonary resuscitation (CPR) was started. Through the left femoral artery a balloon for intra-aortic balloon counterpulsation (IABP) was introduced. The coronary angiogram of the left coronary artery (LCA) selectively engaged with a 6 French EBU-4 guiding catheter revealed an acute total occlusion of the left main stem (LMS) (Fig. 1A). During the CPR, a manual thrombectomy was performed and the blood flow in left anterior descending artery was restored (Fig. 1B). The left circumflex artery (LCX) was opened after a second thrombectomy (Fig. 1C). The patient received a subsequent intracoronary bolus of abciximab. Finally, the culprit lesion localised in the distal portion of the LMS was treated with a second-generation everolimus eluting stent 3.5/18 mm deployed at 20 atmospheres (Fig. 1D), and post dilated with a 4.0/15 mm non-compliant balloon. The final kissing-balloon inflation was complicated with a dissection of the ostial portion of the LCX (Fig. 1E). It was subsequently covered with a 3.0/18 mm drug eluting stent using a “T and protrusion” technique (Fig. 1E, inset). As percutaneous coronary intervention of the LCA was accomplished, the angiography of the right coronary artery showed no significant disease. After the procedure, the patient was transferred to the coronary care with catecholamine infusion and IABP 1:1 support. On the third day of hospitalisation, the patient received a red blood cell transfusion due to the large local haematoma and severe anaemia. IABP was removed 6 days after baseline; the patient was weaned from the respirator and extubated. In 4-month follow-up the patient remained asymptomatic with New York Heart Association class II. The control angiography revealed a good result in both left main and left circumflex arteries with no signs of in-stent restenosis (Fig. 1F). Figure 1. A. Acute occlusion of the left main coronary artery; B. The angiographic result after manual thrombectomy in left anterior descending artery; C. The angiographic result after manual thrombectomy in left circumflex artery (LCX); D. The angiographic result after implantation of drug eluting stent to the left main; E. Ostial dissection in LCX after kissing balloons and the final angiographic result; F. The angiographic follow-up after 4 months A C
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- 2014
29. Acute coronary artery thrombosis during the postpartum period complicated by cardiogenic shock and AH1N1 infection
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Lukasz, Łewicki, Aneta, Stróżyk, Miłosz, Jaguszewski, Wiesław, Puchalski, Andrzej, Rynkiewicz, and Radosław, Targoński
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Adult ,Polymorphism, Genetic ,Coronary Thrombosis ,Shock, Cardiogenic ,Puerperal Disorders ,Coronary Angiography ,Electrocardiography ,Ventricular Dysfunction, Left ,Influenza A Virus, H1N1 Subtype ,Influenza, Human ,Mutation ,Humans ,Female ,Methylenetetrahydrofolate Reductase (NADPH2) - Published
- 2012
30. Recanalization of isolated chronic total occlusions in patients with stable angina
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Brahmajee K. Nallamothu, Marcin Fijałkowski, Miłosz Jaguszewski, Dariusz Ciećwierz, Emilia Masiewicz, Andrzej Koprowski, Witold Dubaniewicz, Radosław Targoński, Andrzej Rynkiewicz, and Christian Templin
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Disease ,Angina ,Cohort Studies ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Humans ,In patient ,cardiovascular diseases ,Myocardial infarction ,Angina, Stable ,Aged ,Retrospective Studies ,business.industry ,Percutaneous coronary intervention ,Retrospective cohort study ,Canadian Cardiovascular Society ,Middle Aged ,medicine.disease ,surgical procedures, operative ,Coronary Occlusion ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Despite procedural advances, recanalization of chronic total occlusions (CTOs) with percutaneous coronary intervention (PCI) remains controversial, particularly given that its long-term benefits are unclear. We assessed the association between successful PCI and symptom improvement as well as outcomes in patients with CTO and stable angina.We performed a retrospective study of 386 consecutive patients undergoing attempted PCI of an isolated CTO (i.e., no other angiographically-significant disease was present). We analyzed prospectively the change in Canadian Cardiovascular Society (CCS) classification system and occurrence of major adverse cardiovascular events (death, myocardial infarction or target vessel revascularization), after stratifying patients by procedural success. To understand which patients might benefit most from attempted PCI, multivariable models were constructed to predict: likelihood of successful PCI and symptom improvement, defined as resolution of angina or improvement of ≥ 2 CCS classes.A total of 247 (64%) patients had successful PCI. Greater symptom improvement was noted after successful PCI at both 6 months (79.8% versus 34.5% with resolution of angina or improvement of ≥ 2 CCS classes, p0.01) and 24 months (71.7% and 20.9%, respectively, p0.01). No differences were noted in MACE (11.3% vs. 10.0% at 6 months, p=0.70; and 18.6% vs. 19.4% at 24 months, p=0.84). Multivariable analysis identified several factors associated with successful PCI, but not predictive of symptom improvement. In conclusion, successful PCI of an isolated CTO improves symptom burden, but is not associated with MACE at 6 or 24 months.Several factors are associated with successful PCI, but identifying those most likely to have symptom improvement remains challenging.
- Published
- 2012
31. First-in-Human Use of the Next-generation ProtEmbo Cerebral Embolic Protection System During Transcatheter Aortic Valve-in-valve Implantation
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Dariusz Jagielak, Radoslaw Targonski, and Dariusz Ciecwierz
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Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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32. Left Ventricular Size, Mass and Function in Relation to Angiotensin-Converting Enzyme Gene and Angiotensin-II Type 1 Receptor Gene Polymorphisms in Patients with Coronary Artery Disease
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Janusz Limon, Radosław Targoński, Karolina Ochman, Wojciech Sobiczewski, Bartosz Wasag, Andrzej Wojtowicz, Dariusz Ciećwierz, Andrzej Koprowski, Marcin Gruchała, Adam Grzybowski, Witold Dubaniewicz, Piotr Romanowski, and Andrzej Rynkiewicz
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Male ,medicine.medical_specialty ,Genotype ,Clinical Biochemistry ,Myocardial Infarction ,Coronary Artery Disease ,Peptidyl-Dipeptidase A ,Biology ,Polymerase Chain Reaction ,Receptor, Angiotensin, Type 1 ,Ventricular Function, Left ,White People ,Pathogenesis ,Coronary artery disease ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Coronary atherosclerosis ,DNA Primers ,Polymorphism, Genetic ,Receptors, Angiotensin ,Ejection fraction ,Angiotensin II ,Homozygote ,Biochemistry (medical) ,Angiotensin-converting enzyme ,DNA ,General Medicine ,Middle Aged ,medicine.disease ,Pathophysiology ,Endocrinology ,Echocardiography ,biology.protein ,Cardiology ,Female ,Gene Deletion - Abstract
The objective of the present study was to analyse the potential synergistic influence of the insertion/deletion polymorphism of the angiotensin-converting enzyme gene (I/D ACE) and the A1166C polymorphism of the angiotensin-II type 1 receptor gene polymorphisms (A1166C AT1R) on the left ventricular size and performance. Three hundred sixty and one consecutive, Caucasian patients with angiographically confirmed coronary artery disease (CAD) were enrolled into the study. Left ventricular diameter, mass and function were evaluated by echocardiography. Screening for the I/D ACE and A1166C AT1R genotypes was performed by polymerase chain reaction of genomic DNA, followed by restriction enzyme digestion and agarose gel electrophoresis. The I/D ACE and A1166C AT1R genotypes separately were not significantly associated with the left ventricular size and function parameters in CAD patients. However, trends towards decreased left ventricular ejection fraction (LVEF) as well as increased left ventricular end-diastolic diameter (LVEDD) and left ventricular mass index (LVMI) were observed when patients with genotype DD+CC/AC and DD+CC were compared to patients homozygous only in one locus (DD or CC). Significant increase in LVEDD and LVMI was observed only in patients with a history of anterior myocardial infarction with combined genotype DD+CC/AC or DD+CC. This study does not support the role of the ACE I/D and AT1R A1166C polymorphisms in the determination of the left ventricular size and performance in patients with significant coronary atherosclerosis. However, it indicates that the influence of polymorphisms may be present in specific patient populations.
- Published
- 2003
33. The Scalatrial natriuretic peptide gene wariants are associated with the extent of coronary artery disease
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Radosław Targoński, Adam Grzybowski, Jerzy Bellwon, Dariusz Ciećwierz, Marcin Gruchała, Karolina Ochman, Wojciech Sobiczewski, Witold Dubaniewicz, Bartosz Curyłło, Bartosz Wasag, and Andrzej Rynkiewicz
- Subjects
Coronary artery disease ,medicine.medical_specialty ,Atrial natriuretic peptide ,business.industry ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,medicine.disease ,business ,Cardiology and Cardiovascular Medicine ,Gene - Published
- 2002
- Full Text
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34. How to improve noninvasive coronary artery disease diagnostics in premenopausal women?
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Radosław Targoński, Wiesław Puchalski, Dariusz Ciećwierz, Marcin Fijałkowski, Adam Grzybowski, Andrzej Rynkiewicz, Wojciech Sobiczewski, Bożena Zięba, Marcin Gruchała, and Katarzyna Storoniak
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ST depression ,medicine.medical_specialty ,Supine position ,medicine.diagnostic_test ,business.industry ,media_common.quotation_subject ,Luteal phase ,Chest pain ,medicine.disease ,Angina ,Coronary artery disease ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography ,Menstrual cycle ,media_common - Abstract
Background The aim was to assess the influence of menstrual cycle on results of exercise echocardiography and electrocardiography. Methods Premenopausal women (n = 28) with regular monthly menses, presented typical angina, positive electrocardiogram (ECG) exercise stress test, and normal coronary angiogram were recruited. Exercise supine bicycle echocardiography with simultaneous recording of 12-lead ECG was performed once a week for 4 consecutive weeks. Occurrence of angina, time to angina, time to significant ST deviation, and segmental myocardial contractility were analyzed. Blood samples were drawn to estimate follicle-stimulating hormone, luteinizing hormone, β-estradiol, progesterone concentration and confirm the position in menstrual cycle. In correlation analysis, linear and logistic regression were used as appropriate. Qualitative variables were categorized into quartiles in logistic regression analysis. Results Exercise ST depression was more frequently observed in both luteal phases (early luteal 78%, late luteal 86%) compared to the late follicular phase (50%, P Conclusion In women with typical angina and normal coronary angiogram, the position in menstrual cycle influences the ST depression but not myocardial contractility during exercise echocardiography.
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- 2008
35. Influence of menstrual cycle on myocardial contractility and chest pain during echocardiographic exercise stress test in premenopausal women with Angina and without stenosis in coronary arteries
- Author
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Andrzej Rynkiewicz, W Puchalski, A Butkiewicz, Marcin Gruchała, D Janczyk, K Storoniak, W. Sobiczewski, Radosław Targoński, B Zieba, and A. Grzybowski
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medicine.medical_specialty ,Epidemiology ,business.industry ,media_common.quotation_subject ,Exercise stress ,Chest pain ,medicine.disease ,Test (assessment) ,Coronary arteries ,Contractility ,Angina ,Stenosis ,medicine.anatomical_structure ,Internal medicine ,medicine ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Menstrual cycle ,media_common - Published
- 2006
36. LACK OF RELATIONSHIP BETWEEN ANGIOTENSIN CONVERTING ENZYME GENE POLYMORPHISM AND BLOOD PREASSURE AND ATHEROSCLEROSIS RISK FACTORS IN SUBJECTS WITHOUT CLINICAL MANIFESTATIONS OF ATHEROCSLEROTIC DISEASES
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Witold Dubaniewicz, J. Siebert, Wojciech Sobiczewski, Radosław Targoński, J. Bellwon, Dariusz Ciećwierz, Andrzej Rynkiewicz, B. Wasag, Marcin Gruchała, and K. Ochman
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medicine.medical_specialty ,Endocrinology ,biology ,Physiology ,business.industry ,Internal medicine ,Internal Medicine ,biology.protein ,Medicine ,Angiotensin-converting enzyme ,Gene polymorphism ,Cardiology and Cardiovascular Medicine ,business - Published
- 2000
37. LACK OF SIGNIFICANT RELATIONSHIP BETWEEN Seal POLYMORPHISM OF THE ATRIAL NATRIURETIC PEPTIDE GENE AND BLOOD PREASSURE AND ATHEROSCLEROSIS RISK FACTORS IN SUBJECTS WITHOUT CLINICAL MANIFESTATIONS OF ATHEROCSLEROTIC DISEASES
- Author
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Witold Dubaniewicz, Marcin Gruchała, Andrzej Rynkiewicz, J. Siebert, B. Wasag, Dariusz Ciećwierz, Wojciech Sobiczewski, J. Bellwon, K. Ochman, and Radosław Targoński
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medicine.medical_specialty ,Endocrinology ,Atrial natriuretic peptide ,Physiology ,business.industry ,Polymorphism (computer science) ,Internal medicine ,Internal Medicine ,medicine ,Cardiology and Cardiovascular Medicine ,business ,Seal (mechanical) ,Gene - Published
- 2000
38. SCAI polymorphism of the atrial natriuretic peptide gene in patients with coronary heart disease below 50 years of age with and without arterial hypertension
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Marcin Gruchała, Piotr Romanowski, Andrzej Rynkiewicz, Radosław Targoński, Witold Dubaniewicz, and Wojciech Sobiczewski
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medicine.medical_specialty ,Atrial natriuretic peptide ,Polymorphism (computer science) ,business.industry ,Internal medicine ,Internal Medicine ,medicine ,Cardiology ,In patient ,business ,Gene ,Coronary heart disease - Published
- 1999
39. Angiotensin converting enzyme gene polymorphism is associated with severity of coronary artery disease in men with high total cholesterol levels
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Radosław Targoński, Joanna Borzyszkowska, Janusz Limon, Wojciech Sobiczewski, Andrzej Rynkiewicz, Marcin Wirtwein, Marcin Gruchała, Dariusz Ciećwierz, and Anna Stanisławska-Sachadyn
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Aldosterone synthase ,Male ,Coronary Artery Disease ,Coronary Angiography ,Severity of Illness Index ,Coronary artery disease ,Renin-Angiotensin System ,chemistry.chemical_compound ,High-density lipoprotein ,Human Genetics • Original Paper ,Risk Factors ,Plant Genetics & Genomics ,CAD ,Life Sciences, general ,education.field_of_study ,biology ,Life Sciences ,General Medicine ,Middle Aged ,Cholesterol ,Female ,lipids (amino acids, peptides, and proteins) ,Microbial Genetics and Genomics ,Adult ,medicine.medical_specialty ,Genotype ,Population ,AGTR1 ,Gensini score ,Peptidyl-Dipeptidase A ,Receptor, Angiotensin, Type 1 ,Statistics, Nonparametric ,Sex Factors ,Internal medicine ,medicine ,Genetics ,Cytochrome P-450 CYP11B2 ,Humans ,education ,ACE ,Aged ,Polymorphism, Genetic ,Cholesterol, HDL ,Animal Genetics and Genomics ,Angiotensin-converting enzyme ,Human Genetics ,Cholesterol, LDL ,medicine.disease ,Atherosclerosis ,Angiotensin II ,CYP11B2 ,Endocrinology ,chemistry ,biology.protein ,Gene polymorphism - Abstract
This study examines whether renin-angiotensin-aldosterone system gene polymorphisms: ACE (encoding for angiotensin converting enzyme) c.2306-117_404 I/D, AGTR1 (encoding for angiotensin II type-1 receptor) c.1080*86AC and CYP11B2 (encoding for aldosterone synthase) c.-344CT are associated with the extension of coronary atherosclerosis in a group of 647 patients who underwent elective coronary angiography. The extension of CAD was evaluated using the Gensini score. The polymorphisms were determined by PCR and RFLP assays. The associations between genotypes and the extent of coronary atherosclerosis were tested by the Kruskal-Wallis test, followed by pairwise comparisons using Wilcoxon test. The population has been divided into groups defined by: sex, smoking habit, past myocardial infarction, BMI (, ≤ 25), age (, ≤ 55), diabetes mellitus, level of total cholesterol (, ≤ 200 mg/dl), LDL cholesterol (, ≤ 130 mg/dl), HDL cholesterol (, ≤ 40 mg/dl), triglycerides (, ≤ 150 mg/dl). Significant associations between the ACE c.2306-117_404 I/D polymorphism and the Gensini score in men with high total cholesterol levels (P(Kruskal-Wallis) = 0.008; P(adjusted) = 0.009), high level of LDL cholesterol (P(Kruskal-Wallis) = 0.016; P(adjusted) = 0.028) and low level of HDL cholesterol (P(Kruskal-Wallis) = 0.04; P(adjusted) = 0.055) have been found. No association between the AGTR1 c.1080*86AC and CYP11B2 c.-344CT and the Gensini score has been found. These results suggest that men who carry ACE c.2306-117_404 DD genotype and have high total cholesterol, high LDL cholesterol and low HDL cholesterol levels may be predisposed to the development of more severe CAD.
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40. Elevated Serum Tryptase and Endothelin in Patients with ST Segment Elevation Myocardial Infarction: Preliminary Report
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Lukasz Lewicki, Janusz Siebert, Natalia Marek-Trzonkowska, Emilia Masiewicz, Tomasz Kolinski, Magdalena Reiwer-Gostomska, Radoslaw Targonski, and Piotr Trzonkowski
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Pathology ,RB1-214 - Abstract
An inflammatory response plays a crucial role in myocardial damage after an acute myocardial infarction. Objectives. To measure serum concentrations of several mediators in patients with an acute myocardial infarction (STEMI) and to assess their potential relationship with a risk of coronary instability. Patients and Methods. The 33 patients with STEMI and 19 healthy volunteers were analyzed. The clinical data were obtained; as well serum concentrations of tryptase, endothelin (ET-1), angiogenin, soluble c-kit, and PDGF were measured. Results. Patients with STEMI had higher serum tryptase and ET-1 than healthy volunteers (2,5 ± 0,4 ng/mL versus 1,1 ± 0,4 ng/mL and 0,7 ± 0,1 ng/mL versus 0,3 ± 0,1 ng/mL, resp.). Subjects with significant lesion in left anterior descending artery (LAD) had lower serum ET-1 compared to those with normal LAD (0,6 ± 0,2 pg/mL versus 0,9 ± 0,4 pg/mL). Patients with three-vessel coronary artery disease (CAD) had higher level of soluble c-kit compared to those with one- or two-vessel CAD: 19,9 ± 24,1 ng/mL versus 5,6 ± 1,9 ng/mL. Conclusions. Elevated serum tryptase and ET-1 may be markers of increased coronary instability; some cytokines may be related to the extension of CAD.
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- 2015
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41. The Scalatrial natriuretic peptide gene polymorphism in relation to nonfatal myocardial infarction in patients with angiographically confirmed coronary heart disease
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Witold Dubaniewicz, Bartosz Curyłło, Dariusz Ciećwierz, Karolina Ochman, Marcin Gruchała, Rafal Dworakowski, Wojciech Sobiczewski, Andrzej Rynkiewicz, Bartosz Wasag, and Radosław Targoński
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medicine.medical_specialty ,business.industry ,medicine.drug_class ,medicine.disease ,Coronary heart disease ,Internal medicine ,medicine ,Natriuretic peptide ,Cardiology ,In patient ,Gene polymorphism ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Full Text
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