Showing papers by "Jerzy Sadowski published in 2002"

Mechanisms of Increased Vascular Superoxide Production in Human Diabetes Mellitus Role of NAD(P)H Oxidase and Endothelial Nitric Oxide Synthase

Abstract: Background— Increased superoxide production contributes to reduced vascular nitric oxide (NO) bioactivity and endothelial dysfunction in experimental models of diabetes. We characterized the sources and mechanisms underlying vascular superoxide production in human blood vessels from diabetic patients with coronary artery disease compared with nondiabetic patients. Methods and Results— Vascular superoxide production was quantified in both saphenous veins and internal mammary arteries from 45 diabetic and 45 matched nondiabetic patients undergoing coronary artery bypass surgery. NAD(P)H-dependent oxidases were important sources of vascular superoxide in both diabetic and nondiabetic patients, but both the activity of this enzyme system and the levels of NAD(P)H oxidase protein subunits (p22phox, p67phox, and p47phox) were significantly increased in diabetic veins and arteries. In nondiabetic vessels, endothelial NO synthase produced NO that scavenged superoxide. However, in diabetic vessels, the endothelium...

Evaluation of patency of coronary artery bypass grafts and stents using multislice spiral computed tomography in comparison with angiography

Abstract: UNLABELLED The aim of the study was to assess usefulness of multislice spiral computed tomography--MSCT (Somatom Plus 4 Volume Zoom, Siemens) in non-invasive assessment of the potency of coronary artery bypass grafts both venous and arterial grafts as well as stents. METHODS The study was performed using the MSCT method with Heart View Software with retrospective electrocardiographic gating. Nonionic, hypo-osmolar contract media was infused into a peripheral vein to highlight the coronary arteries and bypasses. All patients, due to clinical indications, underwent coronary and bypass angiography. MATERIAL Two group of patients (82 persons) in total were evaluated: after aorto-coronary bypassing (Group I--57 persons, incl. 40 males and 17 females) and after stent implantation (Group II--25 persons, incl. 19 males and 6 females). The patients were referred to invasive diagnostics for recurrence and aggravation of clinical symptoms. RESULTS In group I, the patency of 187 bypasses was evaluated (21 arterial and 166 venous). In MSCT, was found in 131 of the bypasses patency (114 venous and 4 arterial). 56 bypasses, (52 venous and 4 arterial) were obstructed. In the bypassography performed were obstructed 53 (5 venous and 3 arterial), 134 bypasses were patent (116 venous and 18 arterial). In the bypass patency assessment using MSCT compared to coronarography, specificity of 94.7% and sensitivity of 92.4% were achieved. In group II, patency was evaluated in 26 stents: 21 implanted to native vessels and 5 in venous bypasses. 19 stents in native vessels were found patent, whereas 2 were obstructed. In the coronary bypasses performed, patency was confirmed in 19 stents and 2 were obstructed. In MST obstruction was demonstrated in 4 stents in coronary bypasses, which was confirmed in bypassography. One stent was assessed patient in both methods. CONCLUSION The MSCT method is useful for assessment of patency of venous and arterial bypasses as well as stents.

[Usefulness of magnetic resonance imaging in diagnosis of mitral valve anulus abscess--case report].

Abstract: Magnetic resonance imaging (MRI) is a non-invasive method characterised by high temporal and spacial resolution that makes it possible to obtain very high-quality pictures. It is a less invasive method than TEE and is very significant in the diagnosis of heart tumours. MRI makes it possible to assess the parameters influencing hemodynamic as well as morphological qualities of the tumour such a its size, its movement, its relation to the surrounding structures and the presence of a capsule. With the use of additional programming, it is possible to evaluate, indirectly, the metabolism of the diagnosed lesion as well as the degree of blood perfusion. Thus, MRI diagnosis of the heart is a valuable complementary technique in the verification of the diagnosis and in the referral to cardiosurgical treatment. The aim of this paper is to present the use of MRI in the diagnosis of an abscess of the mitral valve anulus in a female patient who did not agree to the transoesophageal echocardiography (TEE). In this case, the usefulness of MRI to establish the diagnosis of the anular abscess of the mitral valve was proved. The final diagnosis was confirmed during the operation.

Management of coexistent advanced coronary artery disease and internal carotid artery stenosis

Abstract: We discuss a case of a 60-year old man admitted to our Department with symptoms of unstable angina and stenosis of carotid artery. Coronary angiography revealed three-vessel coronary artery disease. Doppler ultrasound (USG) and multislice spiral computed tomography (MSCT) of carotid and vertebral arteries showed a high-grade stenosis of the left internal carotid artery with a poststenotic aneurysm containing thrombi. Since the risk of a simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) was assessed as high, a two-staged procedure was performed. The CEA was performed first and one month later patient underwent CABG with a good result.

Left ventricular true aneurysm without coronary artery occlusion--a case study.

Abstract: BACKGROUND Left ventricular true aneurysm is described as distinct area of the left ventricular wall with systolic dyskinesia where typical myocardial structure is replaced with fibrous tissue. Transmural infarction following occlusion of left anterior descending coronary artery is the most common cause of formation of the left ventricular aneurysm. CASE REPORT A 51-year old white male, with the history of inferolateral wall myocardial infarction 6 years ago was admitted to the emergency department at the local hospital last year because of sudden cardiac arrest due to ventricular fibrillation in the course of inferolateral myocardial infarction. Later on the patient did not come back to work, felt very weak and had dyspnea on mild exertion. Coronary angiogram performed one year later (the patient refused coronary angiography examination at the time of myocardial infarction) showed normal coronary arteries with a recessive right coronary artery. The left coronary artery was wide with normal contrast flow. Ventriculography showed large, true dyskinetic aneurysm with mural thrombus in the apical segment of the left ventricular wall. Left ventricular ejection fraction was 30%. Patient was qualified for the aneurysmectomy. A large dyskinetic aneurysm (8 cm) of the apical and anterolateral segment of the left ventricular wall was detected intraoperatively. A fresh thrombus weighing 9 g was evacuated from the inside of the aneurysm. Stoney's aneurysmectomy was performed. Histopathology showed a typical picture of scar tissue without signs of active inflammation. CONCLUSION Normal coronary angiogram does not exclude development of large true aneurysm of left ventricular wall of typical localization for acute occlusion of left anterior descendent artery.