Papers by Małgorzata Kobylecka
In Press, DOI: 10.5114/aoms.2014.43893
Introduction: Recent studies point to analysis of T-wave alternans as aprom-ising indicator of an... more Introduction: Recent studies point to analysis of T-wave alternans as aprom-ising indicator of an increased risk of life-threatening ventricular arrhyth-mias. In this study the occurrence of T-wave alternans in the high-resolution ECGs recorded during the exercise stress test and scintigraphic tests (SPECT) in patients with ischemic heart disease was examined. Material and methods: The study group consisted of 33 patients after myo-cardial infarction. In the group of patients after myocardial infarction and with low left ventricular ejection fraction correlations of 70% between the test results of T-wave alternans and SPECT and 60% between the test results of T-wave alternans and stress test were found. Results: In the group of patients after myocardial infarction but with high left ventricular ejection fraction correlations were respectively 39% and 48%. The analysis of the electrocardiographic maps showed astrong depen-dence of this correlation on the T-wave alternans amplitude an...
Nuclear Medicine Review, 2016
There is no controversy in the published literature that sensitivity and specificity of parathyro... more There is no controversy in the published literature that sensitivity and specificity of parathyroid scintigraphy is superior to other imaging techniques. However no uniform protocol has been established for scintigraphy. In order to analyze parathyroid scintigraphic images in the Department of Nuclear Medicine at the Medical University of Warsaw we have developed a program that allows qualitative and quantitative evaluation of recorded images and motion artifacts correction. This program offers a uniform procedure of analysis of parathyroid imaging results in diagnostic centers, accelerates the analysis of parathyroid tests performed with use of single radioactive tracer, that require the acquisition of consecutive images of the patient, without altering his body position between successive stages of registration. This program allows for automation of previously time consuming procedures and thus saves time and decreases a risk of operator's errors.
Endokrynologia Polska, 2005
Acta Cardiologica, Mar 1, 2002
Journal of Nuclear Cardiology, 2016
Inflammatory infiltrations in EAT which releases inflammatory cytokines correspond anatomically t... more Inflammatory infiltrations in EAT which releases inflammatory cytokines correspond anatomically to the atheromatous plaques in underlying coronary vessels. However, it is unknown whether inflammatory activity of pericoronary adipose tissue (PCAT) promotes coronary atherosclerosis. 35 non-diabetic patients with confirmed CAD and 35 non-CAD controls matched for age and BMI underwent 18F-FDG-PET/CT. Maximal SUV normalized by LA blood activity was measured on the sections corresponding to the respective coronaries (RCA, LCX, LAD), as well, as in subcutaneous fat, visceral fat, and epicardial fat. Extent of CAD was determined by % stenosis in segments corresponding to 18F-FDG-PET/CT sections in coronarography using quantitative coronary analysis. PCAT SUV was significantly greater than SUV in other fat locations, as well as PCAT SUV in the controls. In CAD patients with BMI >25, PCAT SUV was positively related to % stenosis of a respective coronary artery (RCA: 0.43; P < .05; LCX 0.58; P < .05; LAD 0.65; P < .05). PCAT SUV was the only independent predictor of coronary stenosis of LAD and RCA. Inflammatory activity of PCAT is greater than in other fat locations, in CAD is greater than in non-CAD controls, and is independently associated with coronary stenosis. In overweight patients, PCAT SUV correlates with the extent of CAD.
Endokrynologia Polska, 2005
Restricted number of neuroendocrine tumors (NET) shows overexpression of somatostatin receptors. ... more Restricted number of neuroendocrine tumors (NET) shows overexpression of somatostatin receptors. Therefore, long-acting somatostatin analogues are used in diagnosis and treatment of those tumors. Here we present our first case of NET, localized in pancreas treated with DOTA-D-Phe 1-Tyr 3-octreotide (DOTATATE), for receptor-mediated radioisotope therapy. DOTATATE is a newly developed somatostatin analogue labeled with beta-emitter yttrium 90 (90Y) and beta, gamma-emitter lutetium 177 (177Lu). A 34-year old woman was suffering from several years gastrointestinal symptoms. NET of the pancreas with multiple metastases into the liver was diagnosed based on histopatological, biochemical and radiological tests. First, she had chemiotherapy (leucovorin, 5-FU, cisplatin), however there was any positive effects of this therapy. Next, she received four single doses of 90Y DOTATATE at 4-6- week intervals, yielding a cumulative dose of 7.4 GBq/m2. During the 4th cycle the Lu-177 DOTATATE was additionally administered. As a renal protection i.v. infusion of amino acid solution were used during the treatment sessions. To date, patient has shown partial remission with reduction of tumor masses. We observed spectacular clinical, biochemical and radiological improvement. Radioisotope therapy could be a powerful and promising method of treatment at least in patients who had no other treatment option.
Nuclear Medicine Review, 2016
There is no controversy in the published literature that sensitivity and specificity of parathyro... more There is no controversy in the published literature that sensitivity and specificity of parathyroid scintigraphy is superior to other imaging techniques. However no uniform protocol has been established for scintigraphy. In order to analyze parathyroid scintigraphic images in the Department of Nuclear Medicine at the Medical University of Warsaw we have developed a program that allows qualitative and quantitative evaluation of recorded images and motion artifacts correction. This program offers a uniform procedure of analysis of parathyroid imaging results in diagnostic centers, accelerates the analysis of parathyroid tests performed with use of single radioactive tracer, that require the acquisition of consecutive images of the patient, without altering his body position between successive stages of registration. This program allows for automation of previously time consuming procedures and thus saves time and decreases a risk of operator's errors.
Polish journal of radiology / Polish Medical Society of Radiology, 2015
Restoration of blood flow in epicardial coronary artery in patients with acute myocardial infarct... more Restoration of blood flow in epicardial coronary artery in patients with acute myocardial infarction can, but does not have to restore efficient blood flow in coronary circulation. The aim of the study was a direct comparison of microvascular obstruction (MVO) detected by rest and stress perfusion imaging and gadolinium enhancement obtained 2 min. (early MVO) and 15 min. (delayed MVO) post contrast. 106 patients with first anterior myocardial infarction were studied. Cardiovascular magnetic resonance (CMR) was performed 5±2 days after primary percutaneous coronary intervention (pPCI). Stress and rest perfusion imaging was performed as well as early and delayed gadolinium enhancement and systolic function assessment. Scoring of segmental function, perfusion defect, MVO and scar transmurality was performed in 16 segment left ventricular model. The prevalence of MVO varies significantly between imaging techniques ranging from 48.8% for delayed MVO to 94% with stress perfusion. Median s...
Circulation, Nov 23, 2010
Kardiologia Polska, 2012
Elevated levels of cardiac troponins are an established method of diagnosis of heart muscle necro... more Elevated levels of cardiac troponins are an established method of diagnosis of heart muscle necrosis. A case of a long distance amateur-marathon runner, who showed significant elevation of plasma troponin I after extreme physical effort is reported. The diagnostic examinations did not reveal atherosclerosis burden, but myocardial bridging of coronary artery. The authors describe the significance of the pathology in the view of extreme sport effort performed by the described patient.
Society of Nuclear Medicine Annual Meeting Abstracts, May 1, 2009
Polskie Archiwum Medycyny Wewnętrznej, 2014
The treatment of amiodarone-induced thyrotoxicosis (AIT) still remains a clinical challenge, requ... more The treatment of amiodarone-induced thyrotoxicosis (AIT) still remains a clinical challenge, requiring the cooperation of both endocrinologists and cardiologists. Unfortunately, even today AIT is related to significantly increased mortality. The aim of this study was to compare the efficacy of radioidine therapy for type II AIT in 2 groups of patients: with high or normal radioiodine uptake and treated by amiodarone (AM) in the past (AM- group) and with low radioiodine uptake and currently treated with AM (AM+ group). The AM- group included 57 patients and the AM+ group, 49. All patients received iodine-131 at a dose of 22mCi~800. Patient data were collected for over 2 years. After radioiodine administration, serum thyroid-stimulating hormone levels in the AM- group and AM+ group were 0.0 ±0.0 and 0.0 ±0.0, respectively, at 1 month; 1.2 ±3.3 and 0.6 ±1.2, respectively, at 12 months; and 4.2 ±3.6 and 1.9 ±0.8, respectively, at 2 years. All differences between the groups were statisti...
Endokrynologia Polska
Restricted number of neuroendocrine tumors (NET) shows overexpression of somatostatin receptors. ... more Restricted number of neuroendocrine tumors (NET) shows overexpression of somatostatin receptors. Therefore, long-acting somatostatin analogues are used in diagnosis and treatment of those tumors. Here we present our first case of NET, localized in pancreas treated with DOTA-D-Phe 1-Tyr 3-octreotide (DOTATATE), for receptor-mediated radioisotope therapy. DOTATATE is a newly developed somatostatin analogue labeled with beta-emitter yttrium 90 (90Y) and beta, gamma-emitter lutetium 177 (177Lu). A 34-year old woman was suffering from several years gastrointestinal symptoms. NET of the pancreas with multiple metastases into the liver was diagnosed based on histopatological, biochemical and radiological tests. First, she had chemiotherapy (leucovorin, 5-FU, cisplatin), however there was any positive effects of this therapy. Next, she received four single doses of 90Y DOTATATE at 4-6- week intervals, yielding a cumulative dose of 7.4 GBq/m2. During the 4th cycle the Lu-177 DOTATATE was add...
Journal of the American College of Cardiology, 2015
Background: paracrine activity of pericoronary adipose tissue (PCAT) may adversely affect coronar... more Background: paracrine activity of pericoronary adipose tissue (PCAT) may adversely affect coronary lesions formation and plaque stability. Maximal standardized uptake value (SUV) of 18-fluorodeoxyglucose (FDG) measurement by positron emission tomography has been proved to be an efficient tool to evaluate proinflammatory activity of different tissues. In patients with stable coronary artery disease it correlated with % of coronary stenosis. We sought to investigate, whether PCAT influenced plaque composition in Non-ST elevation Acute Coronary Syndromes (NSTE-ACS) patients. methods: 30 patients (98 coronary arteries: LM, RCA, LCX, LAD) have been investigated in non-diabetic subjects with moderate/low risk NSTE-ACS (GRACE <140). SUV was measured in PCAT surrounding arteries on the sections corresponding to coronary plaques detected by gray scale intravascular ultrasound and virtual histology (VH-IVUS) during routine coronarography. Additionally SUV was measured in subcutaneous fat (SC), visceral thoracic fat (VS), epicardial fat over right ventricle (EPI). Qualitative (calcified, fibrous, fibro-fatty, or necrotic core) and quantitative analyses of plaques were performed, and further correlated with PCAT SUV. In all patients Homeostasis Model of Assessment -Insulin Resistance (HOMA-IR) was calculated using the formula: fasting Glucose (mmol/L) x fasting Insulin (µU/L)/22.5. results: PVAT SUV in NSTE-ACS patients was significantly greater than in other fat locations (LM SUV: 1.60; RCA SUV: 1.47; LCX SUV: 1.89 LAD SUV: 2.30 vs SC SUV: 0.59; VS SUV: 0.78; EPI SUV: 0.99, p<0.001; ANOVA)
Background. Maximal standarized uptake value (SUVmax) of 18F-FDG is currently widely used for loc... more Background. Maximal standarized uptake value (SUVmax) of 18F-FDG is currently widely used for localization of sites with augmented inflammatory activity in different body locations. It has been previously shown that its value is proportional to macrophage density. Interestingly there is a growing number of publications looking for "outside-to-inside" signaling as a potential etiological mechanism of atherosclerotic plaque in coronary arteries. Accordingly we examined the adipose tissue inflammatory activity in visceral, periarterial and subcutaneous fat locations in patients with and without CAD. Methods. FDG-PET was performed in 22 consecutive patients. The presence of CAD was assessed according to Ca Score results measured during CT during the same study. The study population was divided in to 2 subgroups according to the presence or absence of significant calcifications in coronary arteries (Ca Scoring measured by CT >100 (Group1) or <10 (Group2). Both groups were matched for age and BMI. SUV max was measured in subcutaneous fat (SC), visceral thoracic fat (VS), epicardial fat over right ventricle (EPI), and periarterial fat (PAT) in proximal segments of coronary arteries (RCA, LCX, LAD, respectively). The circular ROI was used for each calculation. The ROI was placed in the areas confirmed by CT as a fat tissue (mean HU -100 +/-20). The associations of SUV values with gender, age, BMI, serum glucose were analyzed. SUVmax value in different adipose tissue locations was mean of three measurements taken by two researches blind to result. Results. SUV measurements in different adipose tissue locations were reproducible with interand intra-observer variability<10%. PAT SUV was not related to gender, age, BMI, or serum glucose. SUV max surrounding all three main coronary arteries was significantly greater than SUVmax in other fat locations, for both groups of patients (SC=0.21; VS= 0.4, EPI= 0.39; RCA=0.65, LCX=0.9, LAD=0.87; p<0.001). When compared Group1 and Group2, SUV surrounding all tree main coronary arteries was greater in patients with CAD (1.03 vs. 0.56; p<0.005). Conclusions. 1. maximal standardized uptake value of flurodeoxyglucose (FDG) detected by positron emission tomography could be a useful method for detection of inflammatory activity in different location of fat tissue. 2. Our results showed that metabolic (probably inflammatory) activity of the pericardial fat tissue correlates with calcium scoring and might play a role in pathogenesis of CAD.
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Papers by Małgorzata Kobylecka