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Unlabelled: The aim of the study is the analysis of own results of myocardial infarction treatment using percutaneous coronary intervention (PCI) in the setting of twenty-four hour long hemodynamic service. Between 01.12.1998 and 31.12.2001 249 patients with diagnosis of acute myocardial infarction were admitted to our Department. Their mean age was 58 years, men -73.5%, median of pain duration was 4 hours, diabetes occurred in 11.6%, hypertension in 37.3%, dyslipidemia occurred in 14%, smokers constituted 59% of patients. 60.2% of patients were in Killip class I, 18.5% in class II, 8.0% in class III and 13.3% in class IV. Anterior and/or lateral myocardial infarction was diagnosed in 105 patients, inferior and/or posterior in 144 patients. Angiography was performed in 225 patients, PCI was performed in 178. TIMI 3 flow was achieved in 76% of patients with shock and 90% of patients without shock. Multivessel coronary artery disease was present in 71% of patients. 30-day mortality in patients treated with PCI was 11.8%, after exclusion of III and IV Killip class patients mortality was 4.3%. 30-day mortality in group of patients with cardiogenic shock was 38.0%. Relative risk of death in patients in III and IV Killip class was higher for these treated conservatively: IV class -1.51 (p = 0.075), III and IV class (common group) -1.38 (p = 0.064). In the year of 2001 30-day mortality among the patients in I and II Killip class treated with PCI was 2.43%., Conclusions: 1. Primary percutaneous coronary intervention in the treatment of myocardial infarction improves prognosis in group of patients with cardiogenic shock in 30-day observation. 2. 11.8% mortality observed in our PCI treated group is associated in our opinion with occurrence of multivessel coronary disease in 71% of patients.

The whole blood and plasma viscosity changes in course of acute myocardial infarction were examined. The examination were performed at the beginning of acute phase of myocardial infarction (period 1), at second to third day (period 2) and after about 10 days of infarction episode (period 3). 77 patients (mean age 56.8 +/- 9.8 years) suffered from myocardial infarction were examined. The whole blood viscosity at following shear rates [s-1]: 0.116; 1.0; 4.59; 150 and plasma viscosity were performed. Besides the viscometric examinations the total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose and fibrinogen as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. The control group consisted of 110 healthy persons (aged 56.6 +/- 10 years). Some persons of control group have got risk factors of atherosclerosis as: obesity, artery hypertension and cigarette smoking. The following additional parameters were investigated: hematocrit, the artery pressure, the body mass index, total cholesterol concentration, serum LDL-cholesterol, HDL-cholesterol, fibrinogen and blood morphology. The corrected whole blood viscosity was adjusted to 45% of hematocrit. It was stated that the native whole blood viscosity was disturbed at all periods of disease. The corrected whole-blood viscosity in all periods of acute myocardial infarction comparing with controls increased. The greatest rise of corrected whole blood viscosity was especially observed in second period of acute myocardial infarction. Plasma viscosity in patients with acute myocardial infarction is increased in all periods. The greatest rise of plasma viscosity was in second period of disease. The rheological blood and plasma disturbances were connected with increase of total cholesterol, LDL-cholesterol, triglycerides and fibrinogen. These disturbances of blood and plasma viscosity may play a role in promoting myocardial infarction factors.

The objective of this paper was to analyze the choice of treatment in two-vessel coronary artery disease and to evaluate the effectiveness of the chosen treatment. The data of sixty-five patients with two-vessel coronary artery disease was analyzed. Two-vessel coronary artery disease was recognized when critical stenoses were present in two arteries with a diameter no less than 2 mm across. Patients who had a CABG were excluded. Patients were divided into three groups according to their treatment: those treated with CABG (29 patients), those treated with coronary angioplasty (20 patients), and those treated conservatively (16 patients). The mean follow-up was 29.3 months (12-48 mo). There were two groups of data collected. The first group consisted of data which might have influenced the decision-making and state of the patients after they had been introduced to the selected treatment. The second group consisted of data necessary to evaluate the state of the patients during the follow-up period. The statistical analysis was divided into three stages. In the first stage, clinical data connected to the selected treatments was studied. In the second, the effects of the chosen treatment were examined. During the third stage of analysis, variables which influenced the effectiveness of the specific treatment were evaluated. Decision-making in patients with two-vessel coronary artery disease depended on the co-existence of hypertension, diabetes, lower-limb ischemia and earlier-performed coronary angioplasty. The only statistically important angiographic feature was the condition of the proximal LAD. Objective improvements in the states of patients (evaluated by exercise tests) were frequently connected to CABG treatment. Subjective improvements in the states of patients were more often connected to conservative treatment. Elevated cholesterol levels were connected to the progression of the disease both in those treated conservatively and interventionally.

The aim of this study was to establish a connection between rheological disturbances and extensiveness of atherosclerotic changes in coronary angiogram. Patients were classified into two groups: group I--with multivascular atherosclerotic lesions (45 subjects at age of 58 +/- 11 years), group II--with univascular atherosclerotic lesions (18 subjects at age of 55 +/- 9 years). Blood samples were drawn from the cubital vein prior to the angiogram. Blood viscosity measurements were performed using low-shear Contraves viscometer-100 at 0.116; 1.0; 4.59 s-1 shear rates and Brokfield Cone/Plate Viscometer at 150 s-1. The plasma viscosity was measured by means of Ubbelohde's capilary viscometer. Besides the viscometric examinations the total cholesterol. LDL-cholesterol, HDL-cholesterol, triglycerides, glucose and fibrinogen as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. The results of studies indicate that in patients with multivascular coronary disease whole blood viscosity at all examined shear rates was significantly greater then in univascular patients. It was found that the LDL-lipoproteins concentration was significantly elevated in the I group. Other examined parameters did not differ significantly. The examinations indicate that there exists the connection between hemorheological disturbances and the extensiveness of coronary heart disease.

Unlabelled: The aim of this study was to explore if are there blood rheological disturbances in cardiac syndrome X. Two groups were examined: 23 patients (aged 41 divided by 72 years) suffering from cardiac syndrome X (typical anginal pain positive stress test and no lesion in coronary angiograms) and 20 healthy (aged 32 divided by 57 years). Blood samples were drawn from the cubital vein prior to the angiogram. Blood viscosity measurements were performed using the Brookfield Cone/Plate Viscosimeter at 150 s-1 shear rate, and by means of low-shear Contraves viscometer at 1 s-1 (a)nd 4.59 s-1 shear rates. The plasma viscosity was measured by means of Ubbelohde's capillary viscometer. Besides the viscometric examinations the total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and glucose plasma concentration as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. It was stated that blood and plasma viscosity were significantly elevated in syndrome X compared with the control group (p < 0.001)., Conclusion: The examinations indicate that in patients suffering from Cardiological Syndrome X the whole blood and plasma viscosity are increased.

The action promoting fibrinolytic treatment of myocardial infarction and questionnaire-based follow up of the results was carried out over a four million people area. 5262 questionnaires, in which physicians answered a number of questions, were received. The poll revealed that 79% of patients received fibrinolytic treatment. The authors estimate the overall percent of patients, treated in hospital wards, at about 27.7%. The mortality rate in the group of patients, who received streptokinase, was 8.61% and in the group of patients, who did not receive the treatment, was 16.28%. The signs of reperfusion were present in 60.38% of patients. The authors conclude that the increase in the number of patients administered fibrinolytic treatment should be aimed, and the results obtained in this group of patients come close to published data. Exercise tests are performed in too small number of myocardial infarction patients and only little proportion of them undergoes further coronary angiography.

The circadian heart rate course was assessed in 3 groups of patients with left ventricular ejection fraction (LVEF) 10-15%, 20-25% and 30-35%. The study comprised 36 persons. In 9 patients heart failure was due to MI and in 17--to dilated cardiomyopathy. Those with atrial fibrillation, ventricular tachycardia, supraventricular tachycardia, diabetes, valvular heart diseases and with central system disorders were excluded from the study. Left ventricular ejection fraction was evaluated by echocardiography. Heart rate, calculated as a mean value every 5 minutes, was taken in patients during 24 hour recordings. For each patient separately, mean value of all measurement was calculated. Then a ratio of each actual value to the mean value was calculated. This ratio was defined as relative heart rate; [formula: see text] Circadian heart rate courses were approximated by Fourier row: [formula: see text]. The 24 harmonics were analyzed. Statistically significant differences in circadian courses were closed to amplitudes of 1st, 12th, 13th, 14th, 16th, 18th harmonics. Using test of variance homogeneity it has been demonstrated that variability of amplitudes of 12th and 17th harmonics as well as phase of 5th harmonic depend on left ventricular ejection fraction.

The aim of this study was to assess the effect of chronic home oxygen therapy on cardiac function in patients with idiopathic interstitial lung fibrosis. Ten patients (Group A) received standard pharmacological treatment (prednisone 10-15 mg/day) and supplementary home oxygen therapy (mean 16.4 h/day) for the period of 4 years. Eight patients (Group B) received pharmacological treatment alone for the same period of time. Left ventricular ejection fraction was measured with a scintillation probe. Right and left ventricular function was also assessed by means of echocardiography. All measurements were taken at the beginning of study and repeated at the end of the 4 year follow-up. Anatomical and functional deterioration was slower in group A than in group B. Statistically significant differences between the groups at follow-up were found with respect to the right ventricle-early inflow velocity and tricuspid E/A ratio. Changes in left ventricular function were also different between the groups. A significant decrease in ejection fraction and mitral E/A ratio was observed in group B, while the corresponding changes in group A were not significant. These results suggest that chronic home oxygen therapy attenuates cardiac dysfunction in patients with idiopathic interstitial lung fibrosis.

The study was performed in 18 patients (15 F and 3-M) aged 35-57 yers (mean 46 +/- 7) diagnosed as idiopathic lung fibrosis. Ten patients (group A) recived standard treatment (prednisone 10-15 mg/day) and supplementary home oxygen therapy (mean 16.4 h/day) for a period of 4 years. During exacerbations antibiotics, theophylline and expectorants were prescribed. Eight patients (group B) receiving the same treatment without home oxygen, served as controls. At study entry lung function test (TLC, VL, Dlco), blood gases, hematocrit, hemodynamic parameters of the pulmonary circulation and thermodilution cardiac output were measured in all patients. The measurements were repeated after 4 years of follow-up. At follow-up examination no differences in pulmonary function parameters were shown between the groups. Mean pulmonary artery pressure and pulmonary vascular resistance were significantly lower in patients receiving home oxygen therapy (group A) as compared with those treated pharmacologically only (group B). Best effects of oxygen therapy were observed in patient with lower pulmonary artery pressures at study entry.

Percutaneous transluminal coronary angioplasty was employed in a group of 178 patients (151 males and 27 females) aged 24 to 68 years (mean 42 +/- 12 years). Stable angina was diagnosed in 136 patients, unstable angina in 38, and an acute infarct in 4. In 150 patients there was one, in 25 two and in 5 patients 3 target stenoses. Lesions were localised in the left anterior descending artery in 130 cases, in the circumflex artery in 32 cases and in the right coronary artery in 49 cases. The attempts to dilate 78 stenoses with a fixed-wire, non-guided system was successful in 78% of cases. Success rate with the over-the-wire system was 85%. In total, we successfully dilated 173 patients, i.e. 82%. The highest success rate, 85%, was achieved in lesions localized in the left anterior descending artery and lowest in lesions localized in the left circumflex artery. Success rate in the groups with stable and unstable coronary artery disease was similar. Complications occurred in 6% of the cases. Experience of the operators involved in PTCA is an important factor influencing the success rate. In the first year of using this technique, good results were achieved in 48% of patients, in the second year in 63%. During the next two years 86% of the stenoses were successfully dilated.