Showing papers by "Adam Torbicki published in 2011"

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Results From an International Prospective Registry

Abstract: Background—Chronic thromboembolic pulmonary hypertension (CTEPH) is often a sequel of venous thromboembolism with fatal natural history; however, many cases can be cured by pulmonary endarterectomy. The clinical characteristics and current management of patients enrolled in an international CTEPH registry was investigated. Methods and Results—The international registry included 679 newly diagnosed (≤6 months) consecutive patients with CTEPH, from February 2007 until January 2009. Diagnosis was confirmed by right heart catheterization, ventilation-perfusion lung scintigraphy, computerized tomography, and/or pulmonary angiography. At diagnosis, a median of 14.1 months had passed since first symptoms; 427 patients (62.9%) were considered operable, 247 (36.4%) nonoperable, and 5 (0.7%) had no operability data; 386 patients (56.8%, ranging from 12.0%– 60.9% across countries) underwent surgery. Operable patients did not differ from nonoperable patients relative to symptoms, New York Heart Association class, and...

Corrigendum to: ‘Guidelines for the diagnosis and treatment of pulmonary hypertension’ [European Heart Journal (2009) 30, 2493–2537]. The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)

Abstract: The 2009 ESC Practice Clinical Guidelines for the diagnosis and treatment of pulmonary hypertension included the endothelin receptor antagonist sitaxentan in an algorithm of evidence-based treatment for pulmonary arterial hypertension. Sitaxentan was recommended with a Class I/Level A grade of evidence in WHO functional class III patients and Class IIa/Level C grade of evidence in WHO functional clsses II and IV. Sitaxentan was initially authorized by …

[Recurrent effusive pericarditis in the course of adult-onset Still's disease--case reports of two patients].

Abstract: Pericardial effusion is caused by various pathological agents. In differential diagnosis infectious as well as non-infectious factors have to be considered. Adult-onset Still disease (AOSD)--relatively uncommon systemic inflammatory disorder of unknown etiology--is among possible diagnosis. The disease typically affects patients in the age between 16-35 years and is characterized by spiking fever, arthralgia, evanescent salmon rash with other abnormalities including pharingitis, serositis (especially pleuritis and pericarditis) and leucocytosis as well as increased serum levels of inflammatory indicators. We present two patients with recurrent pericardial effusion in the course of AOSD.

[Thrombo-embolic pulmonary hypertension--do not spoil a chance for effective surgery!].

Abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension with persistent pulmonary perfusion defects causes by unresolved thrombi. All symptomatic CTEPH patients with documented pulmonary vascular resistance > 300 dyn * sec * cm –5 and proximal lesions should be considered for surgical treatment — pulmonary endarterectomy. The role of pharmacological treatment remains controversial and should be restricted to inoperable cases and persistent pulmonary hypertension after pulmonary endarterectomy. Every year about 30 procedures is performed in two specialised centers in Poland with 1 year mortality at 8–9 %. Number of procedures done gives the frequency of pulmonary endarterectomy at 0.7/million of population/year. Current data from UK indicate the actual ratio of surgical treatment of CTPH at 2/million/year. The article discusses reasons for CTEPH is underdiagnosed and why rate of surgical therapy in Poland is too low. Kardiol Pol 2011; 69, 8: 875–878

Statement on the diagnosis and treatment of tobacco dependence in patients with cardiovascular diseases

Abstract: 1Centrum Onkologii, Instytut im. Marii Skłodowskiej-Curie, Warszawa 2Przewodniczący Zarządu Sekcji Epidemiologii i Prewencji Polskiego Towarzystwa Kardiologicznego 3Prezes Polskiego Towarzystwa Kardiologicznego 4Polskie Towarzystwo Nadciśnienia Tętniczego 5Prezes Towarzystwa Internistów Polskich 6Konsultant Krajowy w Dziedzinie Hipertensjologii 7Konsultant Krajowy w Dziedzinie Kardiologii 8Przewodniczący Rady Redakcyjnej Polskiego Forum Profilaktyki Chorób Układu Krążenia 9Zastępca Prezesa Europejskiego Towarzystwa Kardiologicznego* 10Prezydent Europejskiego Towarzystwa Chirurgii Serca i Naczyń (2010–2012)**

Zakrzepowo−zatorowe nadciśnienie płucne — nie marnujmy szansy na skuteczne leczenie operacyjne!

Abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension with persistent pulmonary perfusion defects causes by unresolved thrombi. All symptomatic CTEPH patients with documented pulmonary vascular resistance > 300 dyn*sec*cm –5 and proximal lesions should be considered for surgical treatment — pulmonary endarterectomy. The role of pharmacological treatment remains controversial and should be restricted to inoperable cases and persistent pulmonary hypertension after pulmonary endarterectomy. Every year about 30 procedures is performed in two specialised centers in Poland with 1 year mortality at 8–9%. Number of procedures done gives the frequency of pulmonary endarterectomy at 0.7/million of population/year. Current data from UK indicate the actual ratio of surgical treatment of CTPH at 2/million/year. The article discusses reasons for CTEPH is underdiagnosed and why rate of surgical therapy in Poland is too low.

The risk of respiratory failure for chronic thromboembolic pulmonary hypertension patients after pulmonary endarterectomy

Abstract: Adres do korespondencji: lek. med. Piotr Szatkowski, Zakład Anestezjologii Instytutu Kardiologii, ul. Alpejska 42, 04-628 Warszawa, tel. +48 22 343 42 24, faks +48 22 343 45 07, e-mail: pszatkowski@ikard.pl Streszczenie Wstęp: Zakrzepowo-zatorowe nadciśnienie płucne (ZZNP) jest chorobą o niepomyślnym rokowaniu [1, 2]. Dla pacjentów z proksymalną lokalizacją zmian zakrzepowo-zatorowych w tętnicach płucnych endarterektomia tętnic płucnych (ang. pulmonary endarterectomy – PEA) jest leczeniem z wyboru [3]. Cel: Ocena powikłań pooperacyjnych u pacjentów z ZZNP poddanych PEA oraz czynników ryzyka ich występowania, ze szczególnym uwzględnieniem niewydolności oddechowej (NO). Materiał i metody: Retrospektywna analiza 115 pacjentów z ZZNP, w tym 80 mężczyzn, w średnim wieku 53 ±13 (25–77) lat, u których wykonano PEA od października 1995 r. do kwietnia 2010 r. Chorych podzielono na dwie grupy – I bez NO i II, u której wystąpiła pooperacyjna NO. Oceniono okołooperacyjne parametry hemodynamiczne, przebieg operacji i pobytu na oddziale intensywnej terapii. Wyniki: Niewydolność oddechowa wystąpiła u 32 (28%) operowanych. Przyczynami był reperfuzyjny obrzęk płuc (ROP) u 26 (22,6%) pacjentów, u 11 (9,6%) pacjentów – przetrwałe nadciśnienie płucne (PNP), u 3 (2,6%) pacjentów – krwawienie do oskrzeli. Zmarło 7 operowanych chorych (6,1%). Pacjenci, u których wystąpiła NO po operacji (grupa II), byli starsi (57 ±12 vs 52 ±14 lat; p = 0,0344), mieli istotnie wyższe przedoperacyjne wartości średniego ciśnienia w tętnicy płucnej (ang. pulmonary artery pressure – PAP; 54 ±10 vs 47 ±11 mm Hg; p = 0,0055) i przedoperacyjny naczyniowy opór płucny (ang. pulmonary vascular resistance – PVR; 1015 vs 584 dyn × s × cm–5; p = 0,0020), a także dłuższy czas krążenia pozaustrojowego (ang. extracorporeal circulation – ECC; 189 ±62 vs 161 ±34 min; p = 0,0187) i całkowity czas zatrzymania krążenia (ang. cardiac arrest – CA; 43 ±17 vs 32 ±16 min; p = 0,017). Abstract Background: Chronic thromboembolic pulmonary hypertension (CTEPH) has poor long term prognosis [1, 2]. Pulmonary endarterectomy (PEA) is a treatment of choice for patients with proximal location of thrombotic material [3]. Aim: Evaluation of post-PEA complication and its risk factors with special reference to development of respiratory failure (RF). Materials and methods: Records of 115 CTEPH patients, 80 males with a mean age of 53 ±13 (25-77) years, operated from October 1995 to April 2010 were reviewed. The patients were divided into two groups: group I without RF and group II with post-PEA RF. Hemodynamic data, procedural data and postoperative course were analysed. Results: Respiratory failure occurred in 32 (28%) of the operated patients. The causes of RF were reperfusion pulmonary oedema (RPO) 26 (22,6%), persistent pulmonary hypertension (PPH) 11 (9,6%), airways bleeding 3 (2,6%). Seven patients died (6,1%). The patients with post-PEA RF (group II) were older (57 ±12 vs. 52 ±14; p = 0,0344) and had significantly higher mean pulmonary arterial pressure (PAP; 54 ±10 vs. 47 ±11 mm Hg; p = 0.0055) and preoperative pulmonary vascular resistance (PVR; 1015 vs. 584 dyn × s × cm–5; p = 0.0020) and also longer extracorporeal circulation (ECC; 189 ±62 vs. 161 ±34 min, p = 0.0187) and cardiac arrest (CA; 43 ±17 vs. 32 ±16 min; p = 0.017). Conclusion: Respiratory failure is a frequent complication after PEA. High PVR and PAP before PEA are risk factors of RF and death. RF occurs more frequently after PEA in elderly patients and in those with longer ECC and CA.

cooperative pulmonary embolism registry Right heart thrombi in pulmonary embolism: Results from the international

Abstract: doi:10.1016/S0735-1097(03)00479-0 J. Am. Coll. Cardiol. 2003;41;2245-2251 Samuel Z. Goldhaber, and ICOPER Study Group Adam Torbicki, Nazzareno Galie, Anna Covezzoli, Elisa Rossi, Marisa De Rosa,cooperative pulmonary embolism registry Right heart thrombi in pulmonary embolism: Results from the internationalThis information is current as of May 24, 2011 http://content.onlinejacc.org/cgi/content/full/41/12/2245 located on the World Wide Web at: The online version of this article, along with updated information and services, isDownloaded from content.onlinejacc.org