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Smolarek D, Jankowska H, Dorniak K, Hellmann M. A rare case of isolated persistent left superior vena cava diagnosed by echocardiography. J Cardiothorac Surg 2024; 19:175. [PMID: 38575998 PMCID: PMC10996098 DOI: 10.1186/s13019-024-02709-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The persistent left superior vena cava (PLSVC) is an infrequent vascular variant. PLSVC with absent right superior vena cava, also known as isolated PLSVC, is an exceptionally rare entity. In this case we present a patient with isolated PLSVC draining to coronary sinus, diagnosed incidentally during echocardiography. CASE PRESENTATION A 35-year-old man underwent a transthoracic echocardiography which showed an enormously dilated coronary sinus. Hand-agitated saline was injected via peripheral intravenous cannulas. The contrast appeared firstly in the coronary sinus before it opacified the right atrium. Since this was also visible by the right antecubital saline injection, it indicated an extremely rare case of PLSVC with the absence of right superior vena cava which was confirmed by cardiac magnetic resonance. CONCLUSIONS The finding of a distinctively dilated coronary sinus in echocardiography led us to further investigation using agitated saline that revealed an infrequent anomaly termed isolated PLSVC. The in-depth diagnosis of this vascular variant is crucial considering that it may lead to important clinical implications, such as difficulties with central venous access, especially in the current era of a rapid development of cardiac device therapies.
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Affiliation(s)
- Dorota Smolarek
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland.
| | - Hanna Jankowska
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
| | - Karolina Dorniak
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
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Jankowska H, Dorniak K, Dudziak M, Glińska A, Sienkiewicz K, Kulawiak-Gałąska D, Fijałkowska J, Dubaniewicz A, Hellmann M. The usefulness of speckle tracking echocardiography for the prediction of cardiac involvement in patients with biopsy-proven sarcoidosis. Echocardiography 2024; 41:e15777. [PMID: 38526991 DOI: 10.1111/echo.15777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Cardiac sarcoidosis (CS) is commonly diagnosed based on clinical criteria and abnormalities in noninvasive imaging reported in patients with biopsy-proven extracardiac sarcoidosis. Electrocardiogram and two-dimensional echocardiography have a low sensitivity for CS detection. Cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) have limitations in terms of cost and availability. OBJECTIVES This study aimed to assess the usefulness of left ventricular longitudinal strain, measured using two-dimensional speckle tracking echocardiography (STE), for the prediction of late gadolinium enhancement (LGE) presence in CMR in patients with biopsy-proven sarcoidosis. PATIENTS AND METHODS A total of 119 patients with biopsy-proven extracardiac sarcoidosis were divided, according to the clinical criteria proposed by the 2014 Heart Rhythm Society expert consensus statement (HRS 2014), into two groups: 43 individuals with "probable cardiac sarcoidosis", CS(+) and 76 individuals without cardiac sarcoidosis, CS (-). Data from echocardiography, CMR, 12-lead ECG and 24 h Holter monitoring were analyzed. RESULTS Left ventricular global longitudinal strain (LV-GLS) was slightly reduced in the entire sarcoidosis group (-18.61± 2.96), no difference between the CS (+) and CS (-) subgroups was found (-18.0% ± 3.2% and -18.9% ± 2.8%, respectively; p = .223). No cut-off value for LV-GLS was identified that could predict the presence of LGE. Segmental longitudinal strain impairment partially correlated with the presence of LGE on CMR. CONCLUSIONS In our cohort of sarcoidosis patients, segmental longitudinal strain proved more helpful in the diagnostic process than LV-GLS. The ultimate role of STE in the diagnosis of CS remains to be established.
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Affiliation(s)
- Hanna Jankowska
- Department of Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
| | - Karolina Dorniak
- Department of Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
| | - Maria Dudziak
- Department of Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Glińska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Jadwiga Fijałkowska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Dubaniewicz
- Department of Pulmonology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
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Puch-Walczak A, Kunicka K, Jagiełło K, Puzio E, Jankowska H, Hoffman P, Dudziak M, Kuziemski K, Drygas W, Zdrojewski T. Is the 2016 ESC diagnostic algorithm useful for assessing the prevalence of chronic heart failure in population-based studies? Kardiol Pol 2024; 82:175-182. [PMID: 38374779 DOI: 10.33963/v.phj.98958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Chronic heart failure (CHF) is a major healthcare problem. However, there are no epidemiological studies assessing the prevalence of CHF in the general population with diagnosis based on algorithms recommended for clinical practice. AIM The aim of the HF-Pomorskie survey was to assess the prevalence of three basic components of the 2016 ESC diagnostic algorithm for CHF (symptoms, N-terminal pro B-type natriuretic peptide [NT-proBNP], and abnormalities on echocardiography) and to determine whether this algorithm may be applicable to studies in general population samples. METHODS The study was performed in a representative sample of 313 adults (170 women and 143 men) aged between 20 and 90 years (mean 55.2 years [15.3]) in Northern Poland. A questionnaire to determine New York Heart Association [NYHA] class, laboratory tests including NT-proBNP, as well as transthoracic echocardiography and spirometry examinations were performed in all subjects. RESULTS Dyspnea (NYHA class II-IV) was reported by 13.7% of recruited participants. Dyspnea and elevated levels of NT-proBNP (>125 pg/ml) were found in 7.7% of all examined subjects, while dyspnea, elevated NT-proBNP levels accompanied by systolic or diastolic abnormalities on echocardiography occurred in 4.8%. In the group without dyspnea (86.3% of all examined subjects), every sixth subject had an elevated level of NT-proBNP. On the other hand, 5.8% of studied subjects reported a previous diagnosis of CHF, which was confirmed using the current ESC algorithm in 78% of them. CONCLUSIONS The prevalence of CHF assessed by the 2016 ESC diagnostic algorithm in the representative sample of adults was equal to 4.8%. The clinical algorithm for the diagnosis of CHF is fully applicable to the representative surveys in the general population. However, due to logistic and economic factors, echocardiography examination and NT-proBNP determination can be limited to patients reporting dyspnea or previous diagnosis of CHF.
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Affiliation(s)
- Aleksandra Puch-Walczak
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland.
| | - Katarzyna Kunicka
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdańsk, Poland
| | - Kacper Jagiełło
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland
| | - Ewa Puzio
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | - Hanna Jankowska
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | - Piotr Hoffman
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warszawa, Poland
| | - Maria Dudziak
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | | | - Wojciech Drygas
- Department of Social and Preventive Medicine, Medical University of Lodz, Łódź, Poland
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warszawa, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdańsk, Poland
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Hawryszko M, Sławiński G, Jankowska H, Dorniak K, Kochańska A, Daniłowicz-Szymanowicz L, Lewicka E. Coexistence of Left Atrial Tumor and Lung Cancer-The Key Role of an Individualized Approach. Diagnostics (Basel) 2024; 14:133. [PMID: 38248011 PMCID: PMC10814791 DOI: 10.3390/diagnostics14020133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
During the diagnostic work-up in oncology, it is exceedingly rare to assume a concomitant presence of two cancers, a benign one and a malignant one, in a single patient. A 61-year-old man was admitted to the cardiology department for cardiac evaluation prior to planned radical treatment of non-small cell (NSCLC) left lung cancer (cT3N1M0). Echocardiography revealed a prominent, unpedunculated structure, measuring 17 × 14 mm, located in the left atrium (LA) near the fossa ovalis. The tumor was confirmed via cardiac magnetic resonance (CMR) imaging, which showed the radiological features of an atrial myxoma. The patient consulted with the Cardiac Surgery Department and was deemed ineligible for surgical treatment of a lesion with mucinous features; thus, no definitive histopathologic confirmation of the tumor present was possible. He was then successfully treated with radical radiochemotherapy and immunotherapy. During the 2-year follow-up, regular echocardiography and CMR were performed, which documented a stable LA tumor size.
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Affiliation(s)
- Maja Hawryszko
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Hanna Jankowska
- Division of Cardiac Diagnostics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (H.J.); (K.D.)
| | - Karolina Dorniak
- Division of Cardiac Diagnostics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (H.J.); (K.D.)
| | - Anna Kochańska
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Ludmiła Daniłowicz-Szymanowicz
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.H.); (A.K.); (L.D.-S.); (E.L.)
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Jankowska H, Dorniak K, Ciarka A, Dudziak M, Hellmann M. Myxoma and lymphoma coexistence in a middle-aged woman with sarcoidosis. Pol Arch Intern Med 2023; 133:16440. [PMID: 36820530 DOI: 10.20452/pamw.16440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Hanna Jankowska
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | - Karolina Dorniak
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | - Aleksandra Ciarka
- Department of Pathomorphology, Medical University of Gdansk, Gdańsk, Poland
| | - Maria Dudziak
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland.
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Nabiałek-Trojanowska I, Jankowska H, Sławiński G, Dąbrowska-Kugacka A, Lewicka E. Echocardiographic Findings in Asymptomatic Mediastinal Lymphoma Survivors Years after Treatment Termination. J Clin Med 2023; 12:jcm12103427. [PMID: 37240533 DOI: 10.3390/jcm12103427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Patients treated due to mediastinal lymphomas are at risk of cardiovascular complications, as they receive chemotherapy, usually containing anthracyclines, often combined with thoracic radiotherapy. The aim of this prospective study was to assess early asymptomatic cardiac dysfunction using resting and dobutamine stress echocardiography (DSE) at least 3 years after the end of mediastinal lymphoma treatment. Two groups of patients were compared: those treated with chemoradiotherapy and those exclusively treated with chemotherapy. Left ventricular contractile reserve (LVCR) during DSE was assessed using changes in LV ejection fraction (LVEF), LV global longitudinal strain (LV GLS), and a novel parameter-Force, which is the ratio of the systolic blood pressure to the LV end-systolic volume. The study included 60 patients examined at a median of 89 months after the end of treatment. Resting echocardiography showed normal LVEF of 58.9 ± 9.6%, borderline LV GLS of -17.7 ± 3%, decreased mean stroke volume (SV) of 51.4 ± 17 mL, and indexed SV of 27.3 ± 8 mL/m2, and the right ventricular free wall longitudinal strain (LS) was impaired in some patients but not in all. There were no significant differences between the groups, with the exception of arterial hypertension, which was more common in the chemotherapy group (32% vs. 62.5%, p = 0.04). In resting echocardiography, only LV posterior wall LS differed significantly and was impaired in patients treated with chemotherapy (-19.1 ± 3.1% vs. -16.5 ± 5.1%, p = 0.04). DSE, performed in 21 patients after a median of 166 months from the end of cancer treatment, detected new contractility disorders in 1 patient (4.8%) and decreased LVCR in the majority of patients when determined using changes in LVEF or LV GLS, and in all patients when assessed with changes in Force. Conclusions: Most asymptomatic mediastinal lymphoma survivors showed preserved ventricular function on resting echocardiography. However, all of them showed impaired LV contractile reserve on DSE, as assessed with a simple parameter-Force. This may indicate subtle LV dysfunction and confirms the need for long-term monitoring of patients with potentially cardiotoxic cancer treatment.
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Affiliation(s)
- Izabela Nabiałek-Trojanowska
- First Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Hanna Jankowska
- Division of Cardiac Diagnostics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Alicja Dąbrowska-Kugacka
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Sławiński G, Jankowska H, Liżewska-Springer A, Lewicka E. Effective cardioprotection with early initiation of sacubitrilvalsartan in a patient with breast cancer and cancer treatment-induced heart failure. Kardiol Pol 2022; 80:869-870. [PMID: 35703431 DOI: 10.33963/kp.a2022.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdańsk, Poland
| | | | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland.
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Dorniak K, Di Sopra L, Sabisz A, Glinska A, Roy CW, Gorczewski K, Piccini D, Yerly J, Jankowska H, Fijałkowska J, Szurowska E, Stuber M, van Heeswijk RB. Respiratory Motion-Registered Isotropic Whole-Heart T 2 Mapping in Patients With Acute Non-ischemic Myocardial Injury. Front Cardiovasc Med 2021; 8:712383. [PMID: 34660714 PMCID: PMC8511642 DOI: 10.3389/fcvm.2021.712383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: T2 mapping is a magnetic resonance imaging technique that can be used to detect myocardial edema and inflammation. However, the focal nature of myocardial inflammation may render conventional 2D approaches suboptimal and make whole-heart isotropic 3D mapping desirable. While self-navigated 3D radial T2 mapping has been demonstrated to work well at a magnetic field strength of 3T, it results in too noisy maps at 1.5T. We therefore implemented a novel respiratory motion-resolved compressed-sensing reconstruction in order to improve the 3D T2 mapping precision and accuracy at 1.5T, and tested this in a heterogeneous patient cohort. Materials and Methods: Nine healthy volunteers and 25 consecutive patients with suspected acute non-ischemic myocardial injury (sarcoidosis, n = 19; systemic sclerosis, n = 2; acute graft rejection, n = 2, and myocarditis, n = 2) were included. The free-breathing T2 maps were acquired as three ECG-triggered T2-prepared 3D radial volumes. A respiratory motion-resolved reconstruction was followed by image registration of the respiratory states and pixel-wise T2 mapping. The resulting 3D maps were compared to routine 2D T2 maps. The T2 values of segments with and without late gadolinium enhancement (LGE) were compared in patients. Results: In the healthy volunteers, the myocardial T2 values obtained with the 2D and 3D techniques were similar (45.8 ± 1.8 vs. 46.8 ± 2.9 ms, respectively; P = 0.33). Conversely, in patients, T2 values did differ between 2D (46.7 ± 3.6 ms) and 3D techniques (50.1 ± 4.2 ms, P = 0.004). Moreover, with the 2D technique, T2 values of the LGE-positive segments were similar to those of the LGE-negative segments (T2LGE-= 46.2 ± 3.7 vs. T2LGE+ = 47.6 ± 4.1 ms; P = 0.49), whereas the 3D technique did show a significant difference (T2LGE- = 49.3 ± 6.7 vs. T2LGE+ = 52.6 ± 8.7 ms, P = 0.006). Conclusion: Respiratory motion-registered 3D radial imaging at 1.5T led to accurate isotropic 3D whole-heart T2 maps, both in the healthy volunteers and in a small patient cohort with suspected non-ischemic myocardial injury. Significantly higher T2 values were found in patients as compared to controls in 3D but not in 2D, suggestive of the technique's potential to increase the sensitivity of CMR at earlier stages of disease. Further study will be needed to demonstrate its accuracy.
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Affiliation(s)
- Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Lorenzo Di Sopra
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Agnieszka Sabisz
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Anna Glinska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Christopher W Roy
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - Davide Piccini
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Jadwiga Fijałkowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Matthias Stuber
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Romanowska A, Lewicka E, Sławiński G, Jankowska H, Zaucha R. Case Report: Adjuvant Radiotherapy Can Be an Effective Treatment for Intimal Sarcoma of the Heart. Front Oncol 2021; 11:621289. [PMID: 33718180 PMCID: PMC7953907 DOI: 10.3389/fonc.2021.621289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Intimal sarcoma of the heart is a sporadic disease, which involves symptoms of cardiac insufficiency due to a fast-growing intraluminal mass. Tumor resection is the first-line treatment, although its location precludes excision with wide uninvolved margins. Despite the aggressiveness of this neoplasm and a high risk of recurrence even after removal by microscopically radical surgery, no standard adjuvant therapy has been established. Chemotherapy is used either as an adjuvant treatment or in cases of advanced disease. In contrast, the use of radiotherapy is rare and usually considered in a palliative setting because the risk of radiation-induced heart disease after high-dose radiotherapy to the heart is significant. Herein, we present the cases of two patients, both diagnosed with cardiac intimal sarcoma, who received irradiation after tumor resection. In both cases, radiotherapy was effective, providing long-lasting local disease control. We regularly monitored cardiac function in both patients to assess the impact of radiotherapy on tumor-free heart structures. The excellent local control of the disease with only mild long-term cardiac dysfunction in both patients suggests that radiotherapy can be a useful treatment modality in this indication.
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Affiliation(s)
- Anna Romanowska
- Department of Oncology and Radiotherapy, University Clinical Centre, Gdańsk, Poland
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdańsk, Gdańsk, Poland
| | - Renata Zaucha
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
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Jankowska H, Dorniak K, Hellmann M, Dubaniewicz A, Dudziak M. Arguable ICD placement in a sarcoidosis patient with extensive cardiac involvement. Arch Med Sci 2020; 16:707-708. [PMID: 32399121 PMCID: PMC7212219 DOI: 10.5114/aoms.2019.86708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/15/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Hellmann
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
| | - Anna Dubaniewicz
- Department of Pulmonology, Medical University of Gdansk, Gdansk, Poland
| | - Maria Dudziak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland
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Dudziak M, Jankowska H, Dorniak K. [Cardiac sarcoidosis: diagnostics, treatment and follow-up]. Pol Merkur Lekarski 2018; 44:124-129. [PMID: 29601561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sarcoidosis is a generalised granulomatous disorder of unknown aetiology. Cardiac involvement may affect conduction system, myocardium, valvular apparatus and pericardium. Clinical spectrum ranges from asymptomatic involvement to sudden cardiac death. Patients with biopsy-proven extracardiac sarcoidosis should be screened for cardiac involvement (standard ECG, 24-hour Holter ECG, echocardiography) and in case of any abnormalities found on these tests, more advanced diagnostic methods should be used. Steroid treatment is still the mainstay of therapy in cardiac sarcoidosis. Several immunosuppresive agents are also effective and used in different combinations with steroids, as well as heart failure treatment (including ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics). Advanced heart block requires pacemaker implantation, and implantable cardioverterdefibrillator is an effective treatment in primary and secondary prophylaxis of sudden cardiac death. Heart transplantation is considered in advanced, drug-resistant heart failure or incessant ventricular arrhythmias unresponsive to other forms of therapy.
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Affiliation(s)
- Maria Dudziak
- Department of Noninvasive Cardiac Diagnostic, 2nd Chair of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
| | - Hanna Jankowska
- Department of Noninvasive Cardiac Diagnostic, 2nd Chair of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostic, 2nd Chair of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
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Kim DJ, Jankowska H, Dierke-Dzierzon C, Sturm M, Lindena G. [New morphine preparations with extended effect duration. 2 treatment observations]. MMW Fortschr Med 2000; 142:49. [PMID: 10851871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- D J Kim
- Mundipharma GmbH, Limburg, Lahn
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Grajek H, Witkiewicz Z, Jankowska H, Światkowski A. A New Method of Calculating Kováts Retention Indices for Substances Chromatographed on Carbon Adsorbents. ADSORPT SCI TECHNOL 1999. [DOI: 10.1177/026361749901700101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- H. Grajek
- Institute of Chemistry, Military Technical Academy, 00-908 Warsaw, Poland
| | - Z. Witkiewicz
- Institute of Chemistry, Military Technical Academy, 00-908 Warsaw, Poland
| | - H. Jankowska
- Institute of Chemistry, Military Technical Academy, 00-908 Warsaw, Poland
| | - A. Światkowski
- Institute of Chemistry, Military Technical Academy, 00-908 Warsaw, Poland
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Grajek H, Witkiewicz Z, Jankowska H. Application of Kováts retention indices for investigation of adsorption properties of activated carbons. J Chromatogr A 1997. [DOI: 10.1016/s0021-9673(97)00463-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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16
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Jankowska H. Abortion, church and politics in Poland. Newsl Womens Glob Netw Reprod Rights 1992:33-6. [PMID: 12285924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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17
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Jankowska H, Szczepańska-Putz M. [Clinical course of congenital toxoplasmosis in children]. Pol Tyg Lek 1992; 47:228-31. [PMID: 1437825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hundred eleven children with the congenital toxoplasmosis were treated at the Department of Infectious and Parasitic Diseases in Childhood in 1979-1988. Multi-symptomatic toxoplasmosis has been diagnosed in 35 cases, ocular form in 65, oligosymptomatic in 6, and asymptomatic in 5 cases. Clinical symptoms suggesting congenital toxoplasmosis was seen in the majority of children (63 cases) in the first year of life and the disease was diagnosed in 50% of cases (33 children) at this age. Congenital toxoplasmosis in the group of 78 children has been diagnosed later. The majority of cases was ocular form. Diagnosis of the oligo- and asymptomatic congenital toxoplasmosis is possible in the first year of life, only. A titre of antibodies is exclusively an indicator of the immunologic response, not a severity of infection and does not contribute to the prognosis. Antitoxoplasma drugs were administered to 102 children including 33 under the first year of life. Pyrimethamine, sulphonamides, and spiramycin were used in the treatment. Dosage, duration of therapy, and way of administration have been established individually in dependence of patients age and clinical form of the congenital toxoplasmosis. Two out of 35 children with multi-symptomatic congenital toxoplasmosis died whereas 13 demonstrate psychomotor retardation of significant degree despite the fact that 11 of them were treated in the first year of life.
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MESH Headings
- Adolescent
- Age Factors
- Animals
- Antibodies, Protozoan/analysis
- Child
- Child, Preschool
- Chorioretinitis/congenital
- Chorioretinitis/diagnosis
- Chorioretinitis/drug therapy
- Chorioretinitis/immunology
- Coccidiostats/therapeutic use
- Diagnosis, Differential
- Female
- Humans
- Infant
- Male
- Toxoplasma/immunology
- Toxoplasmosis, Congenital/diagnosis
- Toxoplasmosis, Congenital/drug therapy
- Toxoplasmosis, Congenital/immunology
- Toxoplasmosis, Ocular/congenital
- Toxoplasmosis, Ocular/diagnosis
- Toxoplasmosis, Ocular/drug therapy
- Toxoplasmosis, Ocular/immunology
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Affiliation(s)
- H Jankowska
- Kliniki Chorób Zakaźnych i Pasozytniczych Wieku Dzieciecego AM, Warszawie
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Jankowska H, Szczepańska-Putz M. [Observations of children with chorioretinitis in congenital toxoplasmosis]. Pol Tyg Lek 1992; 47:232-3. [PMID: 1437826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hundred eleven children with congenital toxoplasmosis were followed up in the Department of Infectious and Parasitic Diseases in Childhood, Medical Academy in Warsaw, within 1979-1988. Ocular changes found in 91 children including chorioretinitis in 86 microphthalmia in 7, ophthalmic nerve atrophy in 15, vitreous body inflammation in 5, and cataract in 4. Only in 16 children the diagnosis was performed in the first year of life. In 15 children the recurrence of inflammatory process, most frequently in the time of puberty, was noted; twice in 5 of them. It was independent on the treatment which was previously administrated. Serological tests in ocular form of congenital toxoplasmosis do not indicate the dynamic changes in the inflammatory process. It is very important that small children are examined early and the treatment is started in the first year of life.
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Affiliation(s)
- H Jankowska
- Kliniki Chorób Zakaźnych i Pasozytniczych Wieku Dzieciecego AM, Warszawie
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Jankowska H, Szczepańska-Putz M, Wojnarowski M. [Results of acyclovir treatment of chickenpox and herpes zoster in children with immune tolerance]. Pol Tyg Lek 1989; 44:799-800. [PMID: 2485894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Acyclovir was used for the treatment of Varicella-zoster virus infections in 53 children (10 neonates and 43 children aged between 2 an 15 years) with immunological system deficiency hospitalized at the Department of the Infectious Diseases of Childhood in the Medical Academy in Warszawa. The obtained results of therapy were favourable except one fatal case of the child with visceral dissemination of the virus prior to acyclovir treatment. Compared with other antiviral agents used by the authors previously, acyclovir proved to be the most effective.
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Jankowska H, Rybacka-Atamaniuk J, Szczepańska-Putz M, Wojnarowski M. [Results of the antiviral treatment of chickenpox and herpes zoster in children with neoplasms]. Pediatr Pol 1988; 63:574-80. [PMID: 3075736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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22
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Choma J, Jankowska H, Piotrowska J, Jaroniec M. A simple isotherm equation for describing gas adsorption on heterogeneous microporous solids. Monatsh Chem 1987. [DOI: 10.1007/bf00809941] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lavrinenko-Ometsinskaya ED, Strelko VV, Jankowska H, Swiatkowski A. Quantum-chemical study of the sorption of halide ions by active carbons. THEOR EXP CHEM+ 1985. [DOI: 10.1007/bf00523999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Zakowska-Dabrowska T, Jankowska H. [Evaluation of the effectiveness of psychotherapy of psychoses]. Psychiatr Pol 1979; 13:357-63. [PMID: 390580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Cerański J, Jankowska H. [Ambulatory group psychotherapy in the treatment of psychoses]. Psychiatr Pol 1976; 10:661-5. [PMID: 1013246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Jaroszyński J, Jankowska H, Skowrońska J. [Subdepression: its course, treatment and prognosis]. Psychiatr Pol 1976; 10:643-5. [PMID: 1013244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Jankowska H. [Skin reactions in response to ampicillin treatment in children with infectious mononucleosis]. Pediatr Pol 1975; 50:1357-60. [PMID: 1187265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Leśkiewicz H, Bohdanowicz M, Jankowska H, Kurowicka A, Krajewski K, Maślińska J, Solik-Natkaniec K, Smreczyńska J, Warelis B. [Effect of INH administered prophylactically on tuberculin test in children and adolescents with exposure to superinfection]. Gruzlica 1973; 41:935-44. [PMID: 4755401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Tomassi W, Jankowska H, Pietrzyk S, Bryłka J. Application de l'electrode a poudre bipolaire au couplage de deux processus d'electrolyse. Electrochim Acta 1965. [DOI: 10.1016/0013-4686(65)87039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jankowska H, Tomassi W, Kocot-Bończakowa D. Über die erscheinung der verminderung des potentials der pulverelektrode im system Cl2-Cl−-H2O und die möglichkeit einer auswertung desselben. Electrochim Acta 1962. [DOI: 10.1016/0013-4686(62)87042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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