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The studies were carried out in 30 patients (24 men and six women) aged 40-56 years, mean age 51 years after myocardial infarction in whom enalapril in doses 5-10 mg daily, mean dose 8,5 mg daily was added to drugs used as yet. This drug was administered for six weeks. The patients had myocardial infarction 6-18 months before their inclusion to the studies. In all patients two-dimensional echocardiographic and Doppler examinations were performed twice: before and after the treatment with enalapril. Left ventricular contractility disturbances and the following parameters were analysed: maximal early diastolic filling rate (EDF), maximal late diastolic filling rate (LDF), EDF/LDF ratio and early diastolic deceleration time (dec. EDF) and early diastolic slope (EF sl.). Enalapril administered in patients after myocardial infarction caused an increase of ejection fraction and increase of the contractility of left ventricular muscle segments not involved by necrosis. It exerted, however, no effect on the changes of contractility index. After the treatment with enalapril the maximal late diastolic filling rate (LDF) was significantly decreased while early diastolic deceleration slope (EF sl.) was significantly increased. The observed influence of enalapril on the left ventricular filling profile may suggest an improvement of left ventricular diastolic function.

The dynamics was analysed of changes of arterial blood pressure, plasma kininogen and prekallikrein concentrations and plasma renin activity (PRA) in 50 patients with arterial hypertension, in relation to the type of blood pressure response to captopril. It was shown that after three weeks of treatment with captopril 150 mg daily, in 23 patients (46%) normalization of systolic and diastolic blood pressure occurred, and in 27 patients (54%), despite a significant reduction, blood pressure normalization was not achieved. In both groups of patients a significant decrease of plasma kininogen concentration and an increase of plasma prekallikrein level were found, indicating kininogenase activation and PRA increase. However, only in patients with arterial blood pressure normalization, a return of kininogen concentration to normal value was observed and a twofold increase of PRA in relation to the initial value was noted. Our studies indicate that in patients with arterial hypertension treated with captopril a correlation appears between the changes of plasma kinin system and PRA which determines the mode of blood pressure reaction to captopril.

The purpose of the work is detection and assessment of heart rhythm disturbances in elderly patients treated in the Department of Cardiology in Lublin for various circulatory system diseases. The study includes 66 patients aged 80-98 years, mean age 83.7 years (46 women and 23 men). During 24-hour ECG monitoring by Holter method the occurrence was evaluated of heart rhythm disturbances due to hyperexcitability and conduction disorders as well as the frequency of their treatment either pharmacological or by constant electrostimulation. Arrhythmias due to hyperexcitability were found in 96% of the patients and they were mostly supraventricular (89%). Atrioventricular conduction disturbances occurred in 35% of the patients. Ventricular arrhythmia requiring treatment (group 4 and 5 according to Lown) occurred in 19% of the patients. Electrostimulation therapy was used in 31.8% of the patients.

The purpose of the work was an assessment of the time and mechanism of the return of sinus rhythm in patients with paroxysmal supraventricular heart rhythm disturbances, treated pharmacologically. The Holter method enabled a precise determination of the mechanism of sinus rhythm return. A group of patients could be isolated with bradycardia-tachycardia syndrome, in whom attacks of MAS syndrome occurred only after regression of arrhythmia. At the time of the return of sinus rhythm and immediately after it transient conduction disturbances and hyperexcitability may occur.

A group was studied of 20 patients with diabetes mellitus treated in the Department of Cardiology for acute myocardial infarction. The duration of diabetes mellitus in these patients was from 5 months to 6 years, and in all patients this was the first myocardial infarction. For the study of personal features of the patients with diabetes mellitus and myocardial infarction R.B. Cattell's Self-Perception Sheet, H. Gough's ACL Adjective Test, and Multi-symptomatic Diagnostic Scale MMPI-WISKAD were used. The studied showed that the group of patients with diabetes mellitus and myocardial infarction was characterized by greater intensity of depression symptoms, excessive interest in own organism and its fitness with significant manifestation of hypochondriac-hysterical features and high level of restlessness and anxiety. The results of our study revealed many common features (great similarity) in the personality of patients with diabetes mellitus and myocardial infarction and patients with only diabetes but less common features with non-diabetic patients with myocardial infarction.

The concentration of magnesium and lipids was determined in the blood serum of 100 healthy medical students (57 women and 43 men) aged 22.3 on the average. Decreased values of magnesium concentration below 0.8 mmol/l were found in 28% of the studied subjects. In 14% of the persons magnesium concentration was below the lower range of own laboratory normal values which were 0.66 for men, and 0.70 mmol/l for women. Hypercholesterolaemia was found in 15% of the studied subjects. No relation was shown between magnesium concentration and the concentration of most blood lipids.

The purpose of the study was an evaluation of the effectiveness of the preparation ISO MACK RETARD in capsules of 60 mg and 120 mg in patients with advanced exacerbated ischaemic heart disease. The study included 72 patients, in 61 (84.7%) of them very good result treatment, estimated subjectively, was achieved. ISO MACK RETARD in capsules of 60 and 120 mg was well tolerated; in the studied group no side effects were observed.

By means of R. B. Cattell Self-Knowledge Sheet and Crumbough and Miholick Scale of the Awareness of the Meaning of Life, 25 patients were examined, prepared for surgical correction of valvular heart disease. By means of R.B. Cattell Self-Knowledge Sheet a group was isolated of patients showing high overt restlessness (OR) and high latent restlessness (LR). It was shown that the personalities of these two groups of patients demonstrated numerous common features, but very significant differences also existed. The patients with high latent restlessness (LR) demonstrated strong emotional tension caused by frustration, feeling of inferiority with low self-estimation, as well as many conflicts at super ego level, but they had strong defensive mechanisms of own personality. The patients with high overt restlessness (OR) revealed high degree of intensification of the feeling of isolation, loneliness, and existential emptiness resulting from the lost feeling of the meaning of further existence with the progress of disease. The results of our studies are guidelines for the choice of psychotherapeutic management of patients qualified for operation of valvular heart disease.

Combined hypertension treatment with inhibitors of the converting enzyme (ICE) and diuretocs gives manifold advantages, the most important of them is a synergistic action of both drugs resulting in blood pressure decrease and prevention of hypokaliaemia. The purpose of the present study was assessment of the effect of hydrochlorothiazide in 50 mg daily doses on blood levels of kininogen and prekallikrein and on plasma renin activity (PRA) in hypertensive patients treated during captopril 150 mg daily alone during 3 weeks, without success. The study was carried out on 15 patients with essential hypertension stage III after WHO. A control group comprised 18 healthy subjects. The determinations were done three time: before treatment, after 3 weeks on captopril, and after 2 weeks of combined treatment with captopril and hydrochlorothiazide. It was found combined treatment with captopril and hydrochlorothiazide produced blood pressure normalization in patients insufficiently responding to captopril alone. During the combined treatment normalization of blood pressure was associated with a higher fall of kininogen concentration, higher rise of prekallikrein and PRA in relation to the values obtained with captopril alone. This evidenced a more pronounced reaction of the kinin system and the renin-angiotensin-aldosterone system to the combined treatment as compared with the response of both systems to captopril alone.

In 40 patients (30 men and 10 women) aged to 21 to 48 years (mean 42 years) with essential hypertension stage II, according to WHO classification, blood flow was recorder in the ascending aorta by Doppler echocardiography. The investigation was done in erect position, at rest, and during 30 seconds of each phase of exercise on moving track. The control group comprised 20 healthy males aged 23-45 years (mean 38 years). In essential hypertension the values of the heart rate (T), maximal (MAX-V) and mean (ME-V) flow velocity, and systolic volume index (SVI) were significantly higher at rest than in controls. In the 3rd minute of exercise the values of heart rate (T), mean flow acceleration (ACC) and minute volume index (COI) were significantly higher in the patients than in controls. At the peak exercise MAX-V, ME-V and COI were significantly lower than in controls. On the other hand, in the 5th minute after the exercise the values of all the analysed blood flow parametres in the aorta were significantly higher in the patients. After the exercise the fall of the integral flow (INTG) and SVI greater in controls than in patients, while the rise of the mean flow acceleration (ACC) was higher in hypertension than in health.

The purpose of the study was to find the correlations and to evaluate their strength between the progression of hypertension and age, sex, time between the diagnosis of hypertension and the beginning of treatment, body weight and other characteristics. The study was carried out in the population of patients treated in the Cardiology Department, Medical Academy in Lublin in the period 1981-1984. The computer-assisted analysis of the obtained material was carried out in the Department of Epidemiology, Medical Academy in Lublin. The studied population comprised 320 patients with essential hypertension. In the statistical analysis the chi square test was applied for finding of statistically significant correlations and Pearson test was used for estimation of correlation strength. Statistically significant correlations were obtained between the progression of hypertension and age, sex, time between hypertension diagnosis and present treatment and body weight.

The reported study was carried out in 25 patients aged 21 to 58 years with essential hypertension in second stage of WHO classification. During three months in 10-day courses they were given alternately 1 placebo tablet or 160 mg propranolol retard in one dose daily. The values of the heart rate and blood pressure were compared before and after the treatment. A significant decrease of systolic and diastolic blood pressure and heart rate was noted. The comparison of blood pressure and heart rate values after 10 days on propranolol with those before the treatment showed a statistically significant reduction of these parameters. This is an evidence that the hypotensive action of propranolol retard develops already during 10 days of treatment.

In 90 patients after acute whole-thickness myocardial infarction suffered 3-48 months earlier 24-hour ECG recording was done for assessment of arrhythmias occurring while they were driving cars and for their comparison with the remaining recording hours. In most patients driving cars episodes of sinus tachycardia even up to 130/min were noted, in about half the patients some increase occurred in the frequency of ventricular ectopic beats, in two patients double and in one patient triple ectopic beats (salvoes) appeared, although they had not been recorded when the patients were not driving cars. The study was carried out (and is still continued) in autumn-winter, when the conditions of car driving were worse. None of the patients was in a collision-threatening situation which could increase dangerous arrhythmias.

In 6 patients treated with repeated peritoneal dialyses 48-hour ECG monitoring was carried out. In no patient significant heart rhythm disturbances were demonstrated during the dialysis and 24 hours after its completion. On the ground of pathological results of Valsalva's manoeuvre function disturbances of the autonomic nervous system were disclosed but these showed no correlation with premature ventricular and supraventricular++ ectopic beats appearing periodically in some patients. The study showed that under conditions of sufficient control of electrolyte balance (especially potassium) the patients treated with peritoneal dialyses are not a group at risk for arrhythmia development.

The systolic and diastolic left-ventricular myocardium function was assessed by Doppler echocardiography in patients with hypertension. The study was carried out on 40 patients (26 men and 14 women) aged 21-50 years (mean 45 years) with essential hypertension, stage II according to WHO classification. The control group comprised 20 healthy subjects aged 19-48 years (mean 43 years). In patients with hypertension, as compared to controls, the Doppler curve of aortic flow showed an increased maximal and mean velocity of flow, the ejection time was shortened, and the ejection time to acceleration time index was decreased. The Doppler curve of the mitral flow in the patients showed reduced maximal velocity of early diastolic flow, increased velocity of maximal end-diastolic flow, decreased fraction of rapid left-ventricular filling, and lower ration of maximal early diastolic to end-diastolic flow. Doppler echocardiography is a useful method for assessment of left-ventricular myocardium functions in hypertension.

On the basis of echocardiographic investigations changes were analysed of certain haemodynamic parameters in 40 patients aged 21-50 years, mean 44 years, with primary arterial hypertension in stage II according to WHO classification. All patients were randomly chosen to receive for 6-9 weeks propranolol 120-480 mg daily, mean dose 280 mg, or pindolol 10-35 mg daily, mean dose 22 mg daily. The changes developing during the treatment with both drugs in relation to the initial values included the mean arterial blood pressure, the heart rate, the index of cardiac output and the systolic left-ventricular tension. In the studied patients treated with propranolol the heart rate and the ejection volume were decreased more than during pindolol treatment. Propranolol increased evidently the total peripheral vascular resistance and decreased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol decreased slightly the peripheral vascular resistance and increased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol, in relation to propranolol, had a more favourable effect on haemodynamics in patients with primary hypertension.

The reported study was carried out in 30 men with myocardial infarction. In all cases after completion of rehabilitation treatment in hospital the exercise test was done on cycle ergometer and echocardiographic examination was performed (TM, 2D and Doppler). The patients were divided into two groups depending on the size of the necrotic zone (limited or extensive infarction in ECG) and physical fitness (low and high) determined by means of the PCW-170 test. In such formed groups certain left-ventricular contraction parameters (PEP, PEPI, LVET, LVETI, PEP/LVET, CO) were calculated by means of Doppler echocardiography. It was found that after hospital rehabilitation the patients with extensive myocardial infarction had significantly lower values of LVETI, SV, CO and higher PEP/LVET value in relation to patients with limited infraction zone, which suggested worse left-ventricular contraction. Moreover, patients with lower physical fitness had worse left ventricular contraction activity (significantly lower values of LVET, LVETI, SV, CO, and higher value of PEP/LVET) than patients with better fitness. Thus the indices describing the left-ventricular contraction activity calculated by means of Doppler echocardiography correlated well with fitness and infraction zone size. The method of Doppler echocardiography is useful for determination of left-ventricular contraction activity after myocardial infraction and for programming of exercises during rehabilitation treatment in hospital.

In 40 patients aged 25-52 years (mean 36 years) with mitral valve disease but without overt circulatory failure haemodynamic studies and echocardiographic examinations were carried out recording the blood flow in the pulmonary artery and the blood flow through the tricuspid valve by pulsating and continuous-wave methods. From the obtained curves the time was calculated from the beginning of the flow to its maximum (TPV), the pre-ejection time (RPEP) and the right-ventricular ejection time (RVET), and the indices TPV/RVET and RPEP/RVET. Moreover, in 14 patients with coexistent insufficiency of the tricuspid valve the systolic pressure in the pulmonary artery was calculated by determining the systolic gradient across the tricuspid valve. On the basis of the results of haemodynamic examination the patients were divided into two groups: with normal (24 patients) and with raised (16 patients) pressure in the pulmonary artery. In the group of mitral valve disease and pulmonary hypertension a significantly shorter TPV, lower values of the TPV/RVET index and greater values of the RPEP/RVET index were found as compared with the patients with mitral disease and normal value of the systolic arterial pressure in the pulmonary artery. The systolic arterial pressure in the pulmonary artery determined on the basis of Doppler echocardiography with measurement of the regurgitation wave in tricuspid valve insufficiency showed a high agreement (r = 0.94) with the pressure recorded during cardiac catheterization.