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The coronary disease is nowadays one of the main causes of death in Poland. To fight epidemy of the coronary disease, not only the prevention and proper treatment are necessary, but the sufficient availability of the diagnostic methods, as well. The aim of our work was to evaluate the availability of coronarography among the patients from Northern Poland. We analysed the data of the patients who underwent the coronarography in years 1997-1998. During that time there were 3916 examined patients. In the analysis the sex, age and place of residence were taken into consideration. Women were 28.93% of all the diagnosed patients. The sex structure basically didn't differ according to the place of residence (city--women 28.7%, village--30.64%). The average age of the diagnosed patients was 58 years. There was a statistically significant difference between the average age of women and men (women 59 years, while men 57 years). The age distribution varied also in the statistically significant degree according to the place of living--the average age of village people was 56 years, little cities 58 years, big cities 59 years. The village people were only 10% of all diagnosed patients. In the analysis of the collected data significant differences in availability of coronarography were found-especially between rural and urban areas. Also the age and sex of the diagnosed patients varied significantly-most probably due to the distribution of the risk factors.

The objective of the present study was to analyse the potential synergistic influence of the insertion/deletion polymorphism of the angiotensin-converting enzyme gene (I/D ACE) and the A1166C polymorphism of the angiotensin-II type 1 receptor gene polymorphisms (A1166C AT1R) on the left ventricular size and performance. Three hundred sixty and one consecutive, Caucasian patients with angiographically confirmed coronary artery disease (CAD) were enrolled into the study. Left ventricular diameter, mass and function were evaluated by echocardiography. Screening for the I/D ACE and A1166C AT1R genotypes was performed by polymerase chain reaction of genomic DNA, followed by restriction enzyme digestion and agarose gel electrophoresis. The I/D ACE and A1166C AT1R genotypes separately were not significantly associated with the left ventricular size and function parameters in CAD patients. However, trends towards decreased left ventricular ejection fraction (LVEF) as well as increased left ventricular end-diastolic diameter (LVEDD) and left ventricular mass index (LVMI) were observed when patients with genotype DD+CC/AC and DD+CC were compared to patients homozygous only in one locus (DD or CC). Significant increase in LVEDD and LVMI was observed only in patients with a history of anterior myocardial infarction with combined genotype DD+CC/AC or DD+CC. This study does not support the role of the ACE I/D and AT1R A1166C polymorphisms in the determination of the left ventricular size and performance in patients with significant coronary atherosclerosis. However, it indicates that the influence of polymorphisms may be present in specific patient populations.

Background There is growing evidence from recent studies that atrial natriuretic peptide (ANP) plays an important part in coronary blood flow regulation and in atherosclerosis. Transition T2238→C in the atrial natriuretic peptide ( ANP ) precursor gene, which leads potentially to the translation of ANP with 2 additional arginines, has been suggested to be associated with salt-sensitive hypertension. According to our knowledge, this study is the first to look for the potential association of the ScaI ANP gene polymorphism with the history of nonfatal myocardial infarction and the extent of coronary artery disease (CAD). Methods The study was performed in 847 consecutive, white patients (719 men and 128 women) with significant coronary artery stenosis confirmed by means of elective coronary angiography (at least 1 coronary artery with ≥50% lumen narrowing). Screening for the T2238→C substitution was performed by means of polymerase chain reaction of genomic DNA, followed by ScaI digestion and agarose gel electrophoresis. Results We found a significant association of the A2A2 ScaI ANP genotype with a higher incidence of positive history of nonfatal myocardial infarction (odds ratio 1.85, 95% CI 1.33-2.58) and multiple-vessel CAD (odds ratio 1.45, 95% CI 1.02-2.06). The ScaI ANP genotype distribution did not differ with age, sex, body mass index, plasma lipids, hypertension, diabetes mellitus, and family history of CAD in studied groups. Conclusions Our results suggest that the ScaI ANP polymorphism may be associated with nonfatal myocardial infarction and the extent of CAD. However, the precise mechanism of this association remains to be determined. (Am Heart J 2003;145:125-31.)

76 patients with chest pain including 27 men and 49 women from 25 to 75 (mean 49.96 +/- 11.36) years old, were examined by means of the psychological test. All the patients showed positive exercise test and no changes in coronary arteries. Psychological test was done by the use of personality--MMPI--2 (Minnesota Multiphasic Personality Inventory) test and depression was diagnosed by GDS (Geriatric Depression Scale) by J. Yesavage--15 questions version. The highest mean values in MMPI--2 were obtained in neurotic scales. It indicates that emotional disorders in these patients emerge as hypochondriacal and hysterical neurosis. In 37 patients (48.7%) neurotic scales showed typical "conversion valley" and these who show such a change in MMPI--2 talk mainly about somatic complains (not psychological) during long-term stress situation. In 25 (32.9%) patients single psychological symptoms of depression could be seen and depression episodes were diagnosed in 17 patients (22.4%).

Background The aim was to assess the influence of menstrual cycle on results of exercise echocardiography and electrocardiography. Methods Premenopausal women (n = 28) with regular monthly menses, presented typical angina, positive electrocardiogram (ECG) exercise stress test, and normal coronary angiogram were recruited. Exercise supine bicycle echocardiography with simultaneous recording of 12-lead ECG was performed once a week for 4 consecutive weeks. Occurrence of angina, time to angina, time to significant ST deviation, and segmental myocardial contractility were analyzed. Blood samples were drawn to estimate follicle-stimulating hormone, luteinizing hormone, β-estradiol, progesterone concentration and confirm the position in menstrual cycle. In correlation analysis, linear and logistic regression were used as appropriate. Qualitative variables were categorized into quartiles in logistic regression analysis. Results Exercise ST depression was more frequently observed in both luteal phases (early luteal 78%, late luteal 86%) compared to the late follicular phase (50%, P Conclusion In women with typical angina and normal coronary angiogram, the position in menstrual cycle influences the ST depression but not myocardial contractility during exercise echocardiography.

Decreased cardiac vagal activity is a known risk factor in coronary artery disease. The aim of our study was to determine the effect of coronary artery bypass grafting (CABG) on heart rate variability (HRV) before and 6 weeks after CABG. The study group consisted of 34 patients (4 women, 30 men, mean age 56 +/- 9 years). ECGs were recorded in 10 minutes periods in both supine and standing position with controlled breathing rate (0.25Hz). The analysis of HRV power spectrum was done by means of fast Fourier transformation. The total spectral power (TPS), power in very low frequency band (VLF: < 0.05 Hz), low frequency band (LF:0.05-0.15Hz), high frequency band (HF:0.15-0.5Hz), LF/HF ratio and percentage fraction of total power in these frequency bands (%VLF, %LF, %HF) were analysed. Significant attenuation of all spectral components of HRV were found during orthostatic load before CABG (p < 0.05). TPS, VLF, LF, %HF decreased in standing position to about half of their level in supine position, HF decreased to as little as one fourth, while LF/HF ratio and %LF increased significantly (p < 0.05). After the CABG these changes were not significant. We have found significant increase of HF (p < 0.05) and %HF (p < 0.01) in standing position after the CABG. The results suggest that CABG causes an improvement in cardiac vagal activity especially in standing position.