The relationship between left ventricle (LV), extracellular matrix remodeling and fibrosis-linked amphiregulin (ARG) in cirrhotic cardiomyopathy (CCM) is unknown. The aim of the study was to investigate the associations between markers of extracellular matrix remodeling and ARG in cirrhosis and their association with indicators of ventricular remodeling and LV functional parameters. In hepatitis C virus (HCV) patients with cirrhosis, who underwent echocardiography, the presence of left ventricular diastolic dysfunction (LVDD) was determined by having gradable diastolic dysfunction in accordance with modified 2020 Cirrhotic Cardiomyopathy Consortium criteria.
View Article and Find Full Text PDFProteins are dynamic entities and populate ensembles of conformations. Transitions between states within a conformational ensemble occur over a broad spectrum of amplitude and time scales, and are often related to biological function. Whereas solid-state NMR (SSNMR) spectroscopy has recently been used to characterize conformational ensembles of proteins in the microcrystalline states, its applications to membrane proteins remain limited.
View Article and Find Full Text PDFConventional angiography of the coronary arteries is a standard in heart and coronary arteries diagnosis, sufficient to choose a treatment method. The introduction of 64-row multidetector computed tomography improved the imaging of coronary arteries by increasing its spatial and temporal resolution. It has been shown that the potential clinical value of CT angiography, including dual source computed tomography (DSCT), is based particularly on the exclusion of coronary artery disease and is now a recognized clinical indication in patients with equivocal stress test results.
View Article and Find Full Text PDFBackground: Pulmonary endarterectomy is the treatment of choice for a majority of patients with chronic thromboembolic pulmonary hypertension (CTEPH), however, haemodynamic criteria for the surgery have not been established. It is still unknown whether patients with mild CTEPH should be operated on and what is the clinical course of unoperated, anticoagulated mild CTEPH.
Aim: To determine the clinical course in chronically anticoagulated, unoperated patients with mild CTEPH.
Chronic thromboembolic pulmonary embolism not preceded by clinical thromboembolic event(s) in a 50 year-old male with a history of three-year dyspnea on exertion was detected. Proximal chronic pulmonary embolism, mean pulmonary artery pressure 32 mm Hg, and pulmonary vascular resistance of 444 dyn x s(-1) x cm(-5) were found. We describe a 11-year clinical course of anticoagulated patient with monitoring of functional status and echocardiography and with control of pulmonary haemodynamics at the end of follow-up.
View Article and Find Full Text PDFUnlabelled: It is little known on oxygen saturation in patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Aim Of The Study: To assess the occurrence, evolution and clinical significance of oxygen desaturations (D) during 1-year observation in CTEPH patients.
Material And Method: The study involved 24 consecutive patients with CTEPH (6 males, 18 females, mean age 63, range 22-75 years).
Unlabelled: Little is known on oxygen saturation in patients with chronic pulmonary embolism. AIM OF THE STUDY WAS: Tto assess the occurrence and importance of oxygen desaturations (D) in these patients.
Material And Methods: The study involved 58 normotensive patients with chronic pulmonary embolism (18 males, 40 females, mean age 60 years, range 22-87 years) and was carried out 6 weeks to 2 years after an acute pulmonary embolic event.
Background: Little is known about the incidence and diagnosis of pulmonary thromboembolism (PE) in patients with chronic permanent atrial fibrillation (CAF). Also it has not been established if echocardiography, a diagnostic tool useful in clinical evaluation of both diseases, is of value in diagnosis of PE in CAF patients.
Aim: To establish the prevalence of PE among patients suffering from CAF without or with poorly controlled anticoagulation as well as to evaluate the possibility to detect PE and to assess the diagnostic role of echocardiography.
Introduction: Currently pulmonary endarterectomy is considered the method of choice in patients with chronic thromboembolic pulmonary hypertension (CTEPH). It is not known if this option should be recommended in all suitable patients as it is highly variable with respect to prognosis. There is also doubt about selection of adequate time to refer patients with CTEPH for surgery.
View Article and Find Full Text PDFTo prove alpha1-adrenergic hypothesis for pulmonary hypertension we studied 6 patients aged 63.3 +/- 8 (range 50-75) years with stable, advanced chronic obstructive pulmonary disease (COPD), FEV=1.51 +/- 0.
View Article and Find Full Text PDFDiagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) remains a major clinical problem. An attempt was made to learn whether electrocardiography has the potential to alleviate that problem. Sensitivity, specificity, negative and positive predictive value as well as a likelihood ratio of electrocardiogram (ECG) signs of right ventricular overload (RVO) were determined in 56 patients with chronic pulmonary embolism and a mean pulmonary artery pressure (mPAP) ranging from 15 to 80 mm Hg.
View Article and Find Full Text PDFPulmonary rehabilitation (PR) improve the quality of life in COPD patients, however, little has been known whether it may improve the survival. We assessed 7-year prognosis in 46 patients with advanced COPD, 27 of which completed successfully 2-year course of PR whereas 19 COPD patients made a control (C) group. At the end of 7-year observation 41.
View Article and Find Full Text PDFThe early recognition of chronic thromboembolic pulmonary hypertension (CTE-PH) is troublesome because of "honey moon" period with chronic dyspnea on exertion as the only one symptom. To find if routine electrocardiography may be useful in improving the diagnosis, value of right ventricular overload (RVO) signs in recognition echocardiographically determined chronic pulmonary hypertension (CPH) and angiographically confirmed CTE-PH in 90 consecutive patients hospitalized due to chronic exertional dyspnea was studied. CPE was found in 76.
View Article and Find Full Text PDFObjective: To evaluate risk factors in medically treated patients with chronic pulmonary embolism (CPE) who are not suitable candidates for definitive surgical therapy.
Study Design: A total of 53 consecutive patients with angiographically confirmed CPE were involved. Four patients underwent pulmonary endarterectomy, and 49 patients received continuous anticoagulation therapy and were followed up over an average period of 18.
The coexistence of chronic obstructive pulmonary disease (COPD) and chronic pulmonary embolism (PE) worsens prognosis and requires complex therapeutic procedures. However, the diagnosis COPD + PE is difficult because of similar clinical symptomatology. Pulmonary angiography was performed in 20 patients aged 60.
View Article and Find Full Text PDFWe compared results of symptom-limited exercise test (ET) and percutaneous oxygen saturation (SaO2) during ET in rehabilitated COPD patients (R) and in control COPD patients (C) before and after 2 years of study. Group of R consisted of 27 patients (FVC 2.15 l, FEV1 1.
View Article and Find Full Text PDFElectrocardiogram is commonly used in the diagnosis of cor pulmonale in patients with chronic obstructive pulmonary disease (COPD). Pulmonary hemodynamics being the definite method for diagnosis the disease can be used to vary the ecg criteria for diagnosis cor pulmonale. After excluding patients with old myocardial infarction and with pulmonary wedge pressure > 12 mm Hg in 66 patients aged 65.
View Article and Find Full Text PDFIt is suggested that ventricular arrhythmias may be the reason of sudden death in stable patients with COPD. Strenuous effort might provoke danger ventricular arrhythmias in those patients. The impact of maximal exercise test on cardiac ventricular arrhythmias was studied in 24 patients with advanced chronic obstructive pulmonary disease (COPD).
View Article and Find Full Text PDFThe clinical picture, differential diagnosis and prognosis in chronic thromboembolic pulmonary hypertension (CTEPH) is being discussed on the basis of a dozen of the authors' cases. The clinical course of CTEPH in 2 patients fulfilling the main criterium for pulmonary thromboendarterectomy and undergoing one year anticoagulation is examined. As a result patient with one large pulmonary vessel occlusion (a.
View Article and Find Full Text PDFWe compared 8 patients with COPD and fixed atrial fibrillation (group I) and 46 patients with COPD and sinus rhythm in ecg (group II). None of the patients had valvular heart disease, arterial hypertension or clinical signs of coronary artery disease. The studied groups did not differ while comparing their gas measurements, spirometry, pulmonary hypertension and right ventricular diameter (as measured in echo study).
View Article and Find Full Text PDFClinical significance of cardiac arrhythmias in patients with advanced and stable chronic obstructive pulmonary disease was assessed 22-24 hour Holter monitoring revealed supraventricular and ventricular arrhythmias in all 65 patients. There was a great variation of arrhythmia quality and quantity in the study group. Among others, 1808 complex ventricular extrasystoles in 33 patients and 302 episodes of nonsustained ventricular tachycardia in 19 patients were recorded.
View Article and Find Full Text PDFChronic enalapril therapy was assessed in 11 patients with cor pulmonale due to chronic obstructive pulmonary disease. Enalapril was added to the maintenance dose of diuretics and digitalis and when clinical stabilisation was achieved haemodynamics, spirometry, blood gases and maximal treadmill exercise test accompanied by +pulse oximetry were performed before and after 30 days, 10-20 mg a day, enalapril therapy. Haemodynamic study showed moderate but significant decrease in mean pulmonary artery pressure, from 24 +/- 3 to 21 +/- 5 mmHg (p = 0.
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