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A case of a 57-year-old patient admitted to the hospital due to aggravation of heart failure symptoms is presented. In ECHO examination severe mitral insufficiency was found. During coronary angiography ostium of left coronary artery from pulmonary trunk was found. The patient underwent cardiosurgery: artificial mitral valve implantation, bypass LIMA-LAD grafting and natural opening left coronary artery ligation.

Unlabelled: The aim of study was the separation of the group of patients with the high risk of death based on the risk index (I(R)) calculated with use of C-reactive protein and hemoglobin concentrations measured on the admission., Material and Methods: The initial group consisted 41 patients (16 women and 25 men) hospitalized between 1999 and 2005 with the recognition of the infective endocarditis based on the Duke University criteria. The IR was calculated according to the formula: I(R) = [(CRP[mg/l])/(Hgb[g/dl]-beta)] x 10, and the coefficient beta = 6 g/dl., Results: The I(R) was significantly higher among deceased patients than among patients with good early prognosis (376,6 vs 79,9; p < 0,001). The risk index exceeding 100 is strongly associated with high death risk among patients with infective endocarditis., Conclusion: This index may also be very useful in reaching the diagnosis and the efficacy prognosing of treatment.

We present two new cases of the short QT syndrome--a 23-year-old male and his 42-year-old mother. Invasive electrophysiological study was negative in both patients. Due to polymorphic ventricular tachycardia recorded during Holter ECG monitoring, an ICD was implanted in the male patient for primary prevention. Blood samples were collected for further genetic studies. Diagnosis and management of patients with the short QT syndrome are discussed.

Unlabelled: The aim of this study was to search to the factors favouring the earlier revealing of a coronary artery disease by comparing selected immunological, hormonal and biochemical parameters between two groups--younger and older men with coronary artery disease and with responding control groups., Material and Methods: In the study were included 93 men--60 with stable angina, confirmed by coronarography (at least 6 months after CABG, PTCA or myocardial infraction, with EF > 40%) and 33 men without atherosclerotic changes in the coronary vessels, as the control group. The two groups were divided depending on age: the younger subgroups [under 60-ty years old--group A with CAD (n=30) and B without CAD (n=18)] and the older subgroup [over 70-ty years old group C with CAD (n=30) and D without CAD (n=15)]., Results: Significantly lower concentration were noted for TNF-alpha--in control groups--by about 50% in the younger and 23% in the older group (r = 0.49) and homocysteine (by about 20% and 22% respectively, r = 0.40). Patients with CAD had higher concentration of CRP then in the control groups (by 52% and 54%, r = 0.28). Weak but positive correlation with the presence of a coronary heart disease was show for IgE and anti-gliadin antibodies (r = 0. 22-0.29)., Conclusion: The younger and older men with CAD statistically significantly differed in concentration of TNF-alpha and homocysteine.

The aim of this study was to search for the factors favouring the revealing of a coronary artery disease by comparing selected lipids and carbohydrate parameters between two groups--younger and older men with coronary artery disease. Into the study were included 60 men with stable angina confirmed by coronarography (at least 6 months after CABG, PTC A or myocardial infraction, with EF > 40%) and 33 men without atherosclerotic changes in the coronary vasseles as the control group. The two groups were divided depending on age: the younger subgroup [(under 60-ty years old-group: A with CAD, n = 30) and (B without CAD, n = l8)] and older subgroup [(over 70 years old-group: C with CAD, n = 30) and (D without CAD, n = 15)]. Men of middle age were not included. Serum semples were analyzed for the concentration of lipids parameters including apolipoprotein AI and B. The oral glucose tolerance test was carried out for all patients. In control groups (B and C) in comparison to the groups with CAD (A and C) was observed significantly higher concentration of the HDL cholesterol (by abouth 28% in younger men and 16% in older men (r with CAD = 0.40) and ApoAI (respectively by about 17% and 12.5%, r = 0.47). Weak, but positive corelation with the presence of coronary heart disease was shown for fasting glucose concentration. The younger and older men with CAD (A vs C) statistically significantly differed in concentration of HDL (a.v. 9.1 +/- 6.2 vs 46.7 +/- 11,7 ng/dl) and strongly correlated with HDL ApoAI (av. 137.6 +/- 12.6 vs 146.6 +/- 21.5 ng/dl). The negative family history was more often in younger patients.

The aim of this study was to investigate the work ability in ageing workers suffering from osteoarthritis (OA), coronary heart disease (CHD) or hypertension (H). One hundred and sixty-six OA and 355 CHD/H outpatients were evaluated. The Work Ability Index (WAI) served for work ability assessment. Patients' results were compared with the results of a control group of 225 healthy young workers. Statistical analysis was performed with ANOVA tests. WAI in female and male CHD/H patients was higher than in OA patients (p < .01), better work ability was related to better education (p < .01), white-collar work (p < .01) and better recreation (p < .01); subjective work ability was determined mostly by the objective health status. The promotion of work ability among workers suffering from advanced age-related diseases should be closely related to the promotion of health. It is indicative to improve occupational education and skills, already at an early stage of a disease.

Hemorrheological and humoral abnormalities and excessive platelet activity can predict the development of cardiovascular complications in patients with essential hypertension. A study was conducted to assess the influence of gender on these factors and the interrelations between changes in hemorrheology and the sympatho-adrenal system in 54 patients (18 women, 36 men) with essential hypertension (aged 39.6 +/- 9.7 years) and 25 healthy volunteers (10 women, 15 men; aged 36.0 +/- 7.2 years). A decrease in erythrocyte deformability (p < 0.01) was found in the hypertensive men compared with the hypertensive women. Hematocrit (p < 0.01), blood viscosity at the shear rates of 0.3 s-1 (p < 0.01) and 6 s-1 (p < 0.01), plasma viscosity (p < 0.01), erythrocyte aggregation (p < 0.01), and neuropeptide Y (p < 0.02) concentrations were higher in the hypertensive men than in the hypertensive women. A positive correlation between blood fibrinogen and serotonin was found in the pooled hypertensive group and in the hypertensive men (p < 0.01) and between blood viscosity (shear rate 6 s-1) and neuropeptide Y in the pooled hypertensive group (p < 0.01). Neuropeptide Y correlated with filtration time of 1 mL blood in the hypertensive men (p < 0.05) and in the pooled normotensive group (p < 0.01) and with beta-thromboglobulin in the hypertensive women (p < 0.001). A positive correlation was also found in the hypertensive men between erythrocyte and platelet aggregation (p < 0.01) and between beta-thromboglobulin and adrenaline (p < 0.01). Hemorrheological and humoral abnormalities are more pronounced in men than in women with essential hypertension and may contribute to the increased incidence of cardiovascular events in men.

Connection between morbidity and biometeorological changes has been analyzed. Special stress was paid on diseases of the circulatory system.

Investigated group consisted of 28 patients (21 female and 7 male) with pheochromocytoma in mean age of 39.9 +/- 13 years, while control group comprised 25 healthy volunteers in mean age 36.0 +/- 7.2 years. Following parameters were determined: plasma and blood viscosity, erythrocyte and platelets aggregation, erythrocyte deformability, hematocrit, beta-thromboglobulin plasma concentration, plasma fibrinogen concentration, lipids concentration, noradrenaline, adrenaline, serotonin, neuropeptide Y plasma concentrations. Plasma fibrinogen and beta-thromboglobulin were increased in pheochromocytoma before surgery after pharmacological treatment and also after excision of the tumor. Whereas altered erythrocyte deformability before any treatment, only. Plasma neuropeptide Y concentration was higher in pheochromocytoma before surgery and after pharmacological treatment. There was no correlation between plasma catecholamines, plasma fibrinogen, beta-thromboglobulin, and erythrocyte deformability. Our results suggest that rheological abnormalities observed in patients with pheochromocytoma may contribute to vascular complications in this subjects. Sympathetic nervous system seems to influence indirectly observed rheological abnormalities.

The study included 20 patients aged from 50 to 65 years with stable coronary disease. In all patients exercise ECG test in Quinton moving track was performed before the treatment, and after one, three, and eight weeks of therapy. Besides that, before the treatment, and after each exercise, platelet aggregation, viscosity of whole blood and plasma, and filtration time of 1 ml of whole blood were evaluated. It was found that already after one week of treatment indobufen caused a decrease of platelet aggregation, reduction of viscosity of whole blood and plasma, and improvement of erythrocyte compliance which favourable effects increased with the continuation of the therapy up to eight weeks. At the same time as a result of eight weeks of treatment a significant improvement was achieved of exercise tolerance in the treated patients.

Sixty three patients with the acute myocardial infarction, aged between 34 and 85 years, admitted to the Intensive Cardiological Care Unit during the first 12 hours following the infarction were randomly divided into two groups. Patients of group I (20 subjects) were treated with nitroglycerin and additional intravenous infusions of bretylium tosylate in the dose of 5 mg/kg administered every 6 hours for 48-72 hours. Patients of group II (33 subjects) were mainly treated with intravenous nitroglycerin. A type and incidence of the ventricular arrhythmias, conduction disorders in AV node, and hemodynamic complications were analysed during the first 72 hours. It was found that bretylium tosylate reduces the incidence of ventricular arrhythmias accompanying myocardial infarction but after 2-3 hours following its administration (p < 0.05). Therefore, bretylium tosylate should be administrated to patients with the acute myocardial infarction in combination with other rapidly acting anti-arrhythmic drug. Bretylium tosylate increases also the effectiveness of electric defibrillation in patients with ventricular fibrillation or ventricular tachyarrhythmia. No evidence of the effectiveness of bretylium tosylate on atrio-ventricular conduction and hemodynamic complications of myocardial infarction was found.

21 patients with symptoms of chronic congestive heart failure, NYHA classes II-IV, were treated with digoxin and furosemide for at least 14 days. In the next stage of the therapy they additionally received a 200 mg intravenous dosage of pentoxifylline and continued to take pentoxifylline orally for the period of at least 14 days. Before the therapy and after each of its stages echocardiography was performed, rheological and gasometric indices of the blood were determined and the level of physical efficiency was assayed in each patient according to NYHA classification. After the digoxin-furosemide treatment there was a significant increase in viscosity of the blood caused by its condensation. Simultaneously there could be observed a significant increase in physical efficiency in patients and also an improvement in some of indices of the left ventricular functions and in gasometric characteristics of the blood. Due to intravenous administration of pentoxifylline a decrease in blood viscosity occurred. The combined treatment with orally administered digoxin, furosemide and pentoxifylline caused a further decrease of blood viscosity, an improvement in some indices of left ventricular efficiency and gasometric characteristics of blood and also much better physical condition of the patients. The results of the present study show that in chronic congestive heart failure subjects a digoxin-furosemide treatment, besides undoubtedly advantageous haemodynamic effects, also leads to blood viscosity. The addition of pentoxifylline results the reduction of increased blood viscosity and in much better hemodynamic condition of the patients.