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Introduction – Cardiac resynchronization therapy (CRT) is an additional therapeutic method in patients with advanced drug refractory heart failure (HF). In 10% of cases because of the unsuitable anatomy it is impossible to place the coronary sinus lead in the poster lateral vein. Objectives – To compare the effects of the bifocal right ventricular pacing (BFRVP) with those of the biventricular pacing (BVP) on the basis of clinical, ECG and echocardiographic parameters. Material and methods – 22 patients in NYHA class III or IV, large QRS, in sinus rhythm or in atrial fibrillation, with ejection fraction (EF) < 35%, drug refractory HF and CRT indication.17 patients (77, 27 %) with BVP and 5 patients (22,72 %) with BFRVP. The clinical (NYHA class, 6 min walk test), ECG (the BFRVP QRS duration/native duration) and echocardiographic (ejection fraction – EF, SPWMD) parameters were assessed and compared prior to implantation, at 3 and 6 month follow-up. Results – Compared with baseline the NYHA class (I and II post implantation vs. III and IV pre implantation) and the effort capacity (250, 72 ± 38,43m preprocedural vs. 319, 54 ± 54,27m postprocedural, p ≤ 0.0001) at 3 and 6 month respectively improved in all patients. The QRS bifocal paced was narrower than the native one, especially more narrow than the apical or RVOT exclusively paced complex. The BFRVP mildly improved the EF and the SPWMD. Conclusions – 1. The BFRVP determine a signifi cant reduction in ventricular dissynchronism and the improvement of contractility. 2. The BFRVP represents a therapeutic alternative in patients with CRT indication in which the attempt to place the coronary sinus lead fails. [ABSTRACT FROM AUTHOR]

Introduction - Myeloperoxidase (MPO) is an abundant hemoproteine released mainly by activated neutrophil and is present in some tissue macrophages such as those in vascular lesions. MPO-catalyzed reactions have been attributed to potentially proatherogenic biological activities throughout the evolution of cardiovascular disease, including during initiation, propagation and acute complication phases of the atherosclerotic process. Objective - We have examined the association between myeloperoxidase serum levels and the prognosis of pacients with unstable angina. Methods - We have evaluated 37 patients, age under 75, consequently hospitalized in the Cardiology Clinic of Emergency Clinic Hospital of Constanta, diagnosed with unstable angina and 18 healthy volunteers (without cardiovascular affections, hypercholesterolemia, diabetes and non-smokers). After discharge, the patients were monitored and the following data was recorded: death due cardiovascular cause and onset of major cardiovascular events or the need for coronary revascularization during 6 months of follow-up. The patients were divided in two groups: the first group - 10 patients with unstable angina with readmission in the following 6 months and the second group - 27 patients with unstable angina and good evolution. Myeloperoxidase activity was measured over a fixed time: T1 at hospital admission, T2 - at 48 hours and T3 - at discharge. Results - Serum MPO levels in patients with unstable angina and readmission in following months were significantly higher than in patients with good evolution (T1 - 2.4700 vs. 1.2259, pT = 0.0016; T2 - 2.9800 vs. 1.9667, pT = 0.0426; T3 - 3.2200 vs. 16259, pT = 0.0012) or in age-matched control patients (2.4700 vs 0.8444, pT=0.0002; 2.9800 vs 0.8444, pT<0.0001; 3.2200 vs 0.8444, pT<0.0001). Conclusion - Based on our study, we conclude that myeloperoxidase are elevated in serum after acute coronary event. In patients with unstable angina, increased MPO serum levels predicts an increased risk for subsequent cardiovascular events, so that MPO may serve both as a marker of diagnosis and as prognosis in patients who present chest pain. [ABSTRACT FROM AUTHOR]

The sinovial sarcoma is extremely rare; seven cases have been described in the literature of specialty. The majority of synovial sarcomas are localized in the right heart. Dispnoea, palpitations and syncopa are the major symptoms of the heart tumors. Th e echocardiography allows the detection of masses and of the pericardial liquid. The heart synovial sarcoma has a bad prognosis, in general, the medium survival being about 6 month. In this paper we will present a case of synovial heart sarcoma, localized in the left ventricle in which the echocardiography allowed the visualization of pericardial liquid and the cardiac masses. The pericardiocentesis shows the hemoragycal nature of pericardial liquid. Th e case presented, evolutes to death in 10 month from the surgery, the survival being above the medium survival described in literature, probably due to the low grade of the mitotic activity. [ABSTRACT FROM AUTHOR]

Background - Th e metabolic syndrome is a series of cardiovascular risk factors, with major implication in cardiovascular morbidity and mortality. Aims - The retrospective study which covered an 18 months period had the purpose to establish the prevalence of various risk factors within the metabolic syndrome, which can head both profilaxy and treatment for these patients. Material and method - 712 subjects were enroled in this study, who met diagnostic criteria for metabolic syndrome. They were divided by sex, age (20-39 years, 40-59 years, 60-79 years, 80-99 years), living environment (urban, rural) and number of met clinical criteria at the moment of diagnosis (3, 4, 5 criteria). Conclusions - Th e study reveals an increased prevalence of cardiometabolic syndrome among patients from Cardiovascular Recovery Clinic, especially for those who had major cardiac events. Th e identification of at least 3 criteria for metabolic syndrome enables early diagnosis, pursuit of markers for subclinical atherosclerosis and deployment of lifestyle changes, elements that can also be the key in improving clinical and paraclinical parameters. [ABSTRACT FROM AUTHOR]