Showing papers by "Andrzej Rynkiewicz published in 2007"

2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

Abstract: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension.

Abstract: Authors/Task Force Members: Giuseppe Mancia, Co-Chairperson (Italy), Guy De Backer, Co-Chairperson (Belgium), Anna Dominiczak (UK), Renata Cifkova (Czech Republic), Robert Fagard (Belgium), Giuseppe Germano (Italy), Guido Grassi (Italy), Anthony M. Heagerty (UK), Sverre E. Kjeldsen (Norway), Stephane Laurent (France), Krzysztof Narkiewicz (Poland), Luis Ruilope (Spain), Andrzej Rynkiewicz (Poland), Roland E. Schmieder (Germany), Harry A.J. Struijker Boudier (Netherlands), Alberto Zanchetti (Italy)

2007 Guidelines for the management of arterial hypertension

Abstract: For several years the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) decided not to produce their own guidelines on the diagnosis and treatment of hypertension but to endorse the guidelines on hypertension issued by the World Health Organization (WHO) and International Society of Hypertension (ISH)1,2 with some adaptation to reflect the situation in Europe. However, in 2003 the decision was taken to publish ESH/ESC specific guidelines3 based on the fact that, because the WHO/ISH Guidelines address countries widely varying in the extent of their health care and availability of economic resource, they contain diagnostic and therapeutic recommendations that may be not totally appropriate for European countries. In Europe care provisions may often allow a more in-depth diagnostic assessment of cardiovascular risk and organ damage of hypertensive individuals as well as a wider choice of antihypertensive treatment. The 2003 ESH/ESC Guidelines3 were well received by the clinical world and have been the most widely quoted paper in the medical literature in the last two years.4 However, since 2003 considerable additional evidence on important issues related to diagnostic and treatment approaches to hypertension has become available and therefore updating of the previous guidelines has been found advisable. In preparing the new guidelines the Committee established by the ESH and ESC has agreed to adhere to the principles informing the 2003 Guidelines, namely 1) to try to offer the best available and most balanced recommendation to all health care providers involved in the management of hypertension, 2) to address this aim again by an extensive and critical review of the data accompanied by a series of boxes where specific recommendations are given, as well as by a concise set of practice recommendations to be published soon thereafter as already done in 2003; …

2007 ESH-ESC guidelines for the management of arterial hypertension - The task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC)

Abstract: Authors/Task Force Members: Giuseppe Mancia, Co-Chairperson (Italy), Guy De Backer, Co-Chairperson (Belgium), Anna Dominiczak (UK), Renata Cifkova (Czech Republic) Robert Fagard (Belgium), Giuseppe Germano (Italy), Guido Grassi (Italy), Anthony M. Heagerty (UK), Sverre E. Kjeldsen (Norway), Stephane Laurent (France), Krzysztof Narkiewicz (Poland), Luis Ruilope (Spain), Andrzej Rynkiewicz (Poland), Roland E. Schmieder (Germany), Harry A.J. Struijker Boudier (Netherlands), Alberto Zanchetti (Italy)

Exercise stress test and comparison of ST change with cardiac nucleotide catabolite production in patients with coronary artery disease.

Abstract: Background: Uridine (Ur) and hypoxanthine (Hx) are the major end products of ischemic nucleotide breakdown in the human heart. Hypoxanthine is further metabolized to uric acid (UA). The aim of the study was the evaluation of whether changes in nucleotide concentrations during exercise correlate with electrocardiography (ECG) changes, and the severity of coronary artery disease (CAD). Methods: Twenty-nine males with CAD and 11 controls without CAD (mean age 56.1 vs. 51.45) were subjected to treadmill exercise. The test was considered positive if ECG showed more then 1 mm ST segment depression. Venous blood samples taken before and 10 minut after the exercise were analysed by high performance liquid chromatography. Results: Twenty-two out of 29 patients with CAD and 6 of 11 in the control group had abnormal exercise stress tests according to ECG criteria only. Mean ∆Ur was positive in the CAD group and negative in the control group (0.45 SEM ± 0.09 µM/L vs. -0.43 SEM ± 0.21 µM/L, p vs. -48.18 SEM ± 13,8 µM/L, p < 0.00001); Hx increased in both groups, and the change was not significantly different. Correlations of CAD-index with ST depression, ∆Ur and ∆UA, were: r = 0.43 (p < 0.005), r = 0.62 (p < 0.001), and r = 0.39 (p < 0.01), respectively. Sensitivity of any increase of uridine was superior to 1.5 mm ST depression during exercise. Conclusions: Blood Ur and UA concentration changes during exercise correlate with severity of CAD. We observed slightly greater accuracy of uridine change in comparison to ST changes, thus being a possible new tool in diagnosis of CAD. (Cardiol J 2007; 14: 573-579).

Stanowisko zespołu ekspertów Polskiego Towarzystwa Ginekologicznego, Polskiego Towarzystwa Kardiologicznego oraz Polskiego Towarzystwa Menopauzy i Andropauzy na temat wpływu terapii hormonalnej okresu menopauzalnego na układ sercowo-naczyniowy

Abstract: 1 Przewodnicząca Sekcji Chorób Serca u Kobiet, Klinika Kardiologii, Pomorska Akademia Medyczna, Szczecin 2 Sekretarz Sekcji Chorób Serca u Kobiet, I Klinika Kardiologii i Nadciśnienia Tętniczego, Uniwersytet Jagielloński Collegium Medicum, Kraków 3 Prezes Polskiego Towarzystwa Kardiologicznego, I Katedra i Klinika Kardiologii, Akademia Medyczna, Gdańsk 4 Prezes Polskiego Towarzystwa Ginekologicznego, I Katedra i Klinika Ginekologii Onkologicznej i Ginekologii, Uniwersytet Medyczny, Lublin 5 Prezes Polskiego Towarzystwa Menopauzy i Andropauzy, III Katedra i Klinika Ginekologii, Uniwersytet Medyczny, Lublin 6 Klinika Menopauzy i Chorób Kobiecych, Instytut Centrum Zdrowia Matki Polki, Łódź 7 Klinika Położnictwa i Ginekologii, Centrum Medyczne Kształcenia Podyplomowego, Warszawa 8 I Katedra i Klinika Położnictwa i Ginekologii, Warszawski Uniwersytet Medyczny

Sympathetic neural responses to coronary occlusion during balloon angioplasty

Abstract: OBJECTIVE The sympathetic nervous system is a key modulator of prognosis and outcome in cardiac ischaemia and infarction. The effects of acute cardiac ischaemia on sympathetic neural traffic in humans are unknown. We tested the hypothesis that angioplasty, and associated transient myocardial ischaemia, elicits changes in neural circulatory control, including direct intraneural measures of sympathetic traffic. METHODS We measured muscle sympathetic nerve activity (MSNA), blood pressure and heart rate in 12 patients (11 men, one woman) undergoing clinically indicated elective coronary angioplasty of the left anterior descending (n = 7) or circumflex (n = 5) coronary artery. Baseline data were obtained for 2 min before occlusion. Each balloon inflation was designed to last up to 120 s. RESULTS Coronary occlusion had no significant effect on blood pressure or heart rate. In contrast, occlusion resulted in a significant increase in MSNA, in 10 of the 12 patients, and in all seven of those patients undergoing angioplasty of the left anterior descending artery. The group mean increase in MSNA during occlusion was 36 +/- 11% (P = 0.008 versus preocclusion). MSNA increased within 60 s of occlusion (129 +/- 12% of baseline; n = 12; P = 0.04), and increased further during the next 60 s to 141 +/- 12% of baseline levels (n = 10; P < 0.001). Increases in MSNA were similar in patients with and without significant chest pain (39 +/- 9% versus 34 +/- 13%, respectively; P = 0.84). CONCLUSION Acute coronary occlusion during angioplasty increases central sympathetic outflow, but there is no systematic change in heart rate. The increase in sympathetic nerve traffic cannot be explained by blood pressure changes or occlusion-related chest pain.

Diurnal blood pressure profile in patients with hypertension and coronary artery disease confirmed by angiography

Abstract: Wstep Nadciśnienie tetnicze jest uznanym, klasycznym czynnikiem ryzyka choroby wiencowej. Ambulatoryjny pomiar ciśnienia tetniczego krwi (ABPM, ambulatory blood pressure monitoring ) ma udowodnione znaczenie w oszacowaniu ryzyka zdarzen sercowo-naczyniowych u pacjentow z rozpoznanym nadciśnieniem tetniczym. Celem pracy byla analiza dobowego profilu ciśnienia tetniczego krwi (BP, blood pressure ) w grupie pacjentow ze stabilną, potwierdzoną koronarograficznie chorobą wiencową. Material i metody Badaniem objeto grupe 279 pacjentow przyjetych do kliniki w celu wykonania planowej koronarografii. Badaną grupe podzielono na dwie podgrupy: A - z istotnymi hemodynamicznie zmianami tetnic wiencowych i B - bez istotnych zwezen tetnic wiencowych. Dwa tygodnie po wykonanej koronarografii przeprowadzano pomiar BP metodą tradycyjną oraz ABPM. Dzienne wartości BP byly rejestrowane co 20 minut w godzinach 6.00-22.00, nocne natomiast co 30 minut w godzinach 22.00-6.00. Jako non-dippers określono pacjentow, u ktorych spadek średniej wartości BP w nocy nie przekraczal 10% w stosunku do średniej wartości dziennej. Wyniki Statystycznie istotne roznice średnich wartości BP miedzy grupami A i B zaobserwowano jedynie w nocy w zakresie średniego ciśnienia skurczowego (124 ± 14 vs. 117 ± 14 mm Hg, p vs. 65 ± 8 mm Hg, p vs. 54%, p vs. 51, p dystolic blood pressure ) zmierzonego metodą tradycyjną, byla statystycznie nizsza w podgrupie A niz w podgrupie B (78 ± 13 mm Hg vs. 81 ± 11 mm Hg, p Wnioski Wystepowanie istotnych hemodynamicznie zmian w tetnicach wiencowych ma związek z nieprawidlowym profilem ciśnienia tetniczego. Pomiary w warunkach gabinetu lekarskiego mogą byc niewystarczające w podejmowaniu decyzji o terapii hipotensyjnej u chorych z nadciśnieniem tetniczym i wspolistniejącą chorobą wiencową.