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Background: Transcatheter aortic valve implantation (TAVI) is presently a recognized treatment mo­dality for patients with severe aortic stenosis ineligible for surgery. It reduces mortality as compared to the conservative treatment. It is further expected from this therapy to improve quality of life by improving of the cardiovascular function performance. The aim of this study is to compare patients’ cardiovascular system efficiency in the 6-minute walk test (6MWT) made before and after TAVI and at the 6–12-month follow-up. Methods: From January 2009 until February 2012, in the Silesian Center for Heart Diseases in Zabrze, TAVI was performed in 104 patients. Eighty-two patients who underwent 6MWT before surgery were qualified for the analysis. The average age of the patients was 76.0 ± 9.17 years, women made 45.1%. The risk of surgical treatment according to the Logistic Euroscore averaged 22.76 ± 12.63%, and by the Society of Thoracic Surgeons — 5.55 ± 3.34%. The 6MWT was performed within 1 month before the TAVI procedure, up to a month after the procedure and during the 6–12-month follow-up. Results: The 6-minute walk test after TAVI was performed by 64 patients, and after 6–12 month follow-up by 46 patients. The average distance in 6MWT increased from 268.4 ± 89.0 m before treat­ment to 290.0 ± 98.2 m after the procedure (p = 0.008) and 276.1 ± 93.5 m to 343.1 ± 96.7 m after 6–12 months (p < 0.0001). Conclusions: Transcatheter aortic valve implantation procedures significantly improve function of the cardiovascular system evaluated by the 6MWT in 1- and 6–12-month observations. (Cardiol J 2017; 24, 2: 167–175)

The aim of this paper is to provide the methods for automatic detection of the difference in gait features depending on a footwear.Artificial neural networks were applied in the study. The gait data were recorded during the walk with different footwear for testing and validation of the proposed method. The gait properties were analyzed considering EMG (electromyography) signals and using two types of artificial neural networks: the learning vector quantization (LVQ) classifying network, and the clustering competitive network.Obtained classification and clustering results were discussed. For comparative studies, velocities of the leg joint trajectories, and accelerations were used. The features indicated by neural networks were compared with the conclusions formulated analyzing the above mentioned trajectories for ankle and knee joints.The matching between experimentally recorded joint trajectories and the results given by neural networks was studied. It was indicated what muscles are most influenced by the footwear, the relation between the footwear type and the muscles work was concluded.

Background Non-enzymatic coupling of protein and lipid cellular structures with glucose leading to the formation of advanced glycation end products (AGE) plays a role in aging and the development of diabetic complications, but its contribution to myocardial pathology is unclear. We aimed to assess the role of heart failure on AGE formation in patients with or without diabetes mellitus type 2 (DM2). Material/methods Heart tissue specimens from 136 patients undergoing transplantation were grouped as follows: 14 cases of ischemic cardiomyopathy (ICM) and DM2, 8 cases of dilated cardiomyopathy (DCM) and DM2, 67 cases of ICM without DM2, and 47 cases of DCM without DM2. Fourteen heart samples were from the autopsies of patients with DM2 without heart disease, and 20 heart samples were from organ donors in whom the heart was wasted. AGE deposits were localized immunohistochemically counted using a semiquantitative scale and characterized by their staining pattern. Results Positive staining was present in all samples from both cardiomyopathy groups with DM2, in 71% of healthy hearts from the DM2 subjects, in 51% of ICM non-diabetic hearts, and in 38% of DCM non-diabetic hearts, and in only 15% of the organ donors. Mixed-diffuse and granular AGE patterns were characteristic for DM2, while a diffuse pattern was more frequently observed in heart failure patients without diabetes. The semiquantitative results supported increased AGE accumulation in patients with DM2 and/or cardiomyopathy. Conclusions The amount of AGE in cardiomyocytes increases significantly in both diabetes and heart failure, with a staining pattern typical for each condition.

Background: The purpose of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) in terms of outflow tract gradient reduction and functional improvement in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) requiring implantable cardioverter-defibrillator (ICD) implantation. Methods: Eleven consecutive symptomatic HOCM patients with a significant (≥40 mmHg) gradient and indications for ICD, but without indications for resynchronization, underwent CRT-D implantation. Nine of them (four female, median age of 50 years) in whom the procedure succeeded were screened for New York Heart Association (NYHA) class, outflow gradient, mechanical dyssynchrony, QRS-width change, and 6-minute walking distance (6MWD) and peak oxygen consumption (VO2peak) improvement after 6 months and remotely. Results: After 6 months of pacing, NYHA class decreased (median 1 vs 2, respectively); peak (33 vs 84 mmHg) and mean (13 vs 38 mmHg) outflow tract gradients were reduced; and QRS width (143 vs 105 ms), intraventricular dyssynchrony (35 vs 55 ms), and VO2peak (19.5 vs 14.2 mL/kg/min) increased significantly (all P 50% and reached

Background Disturbed glucose metabolism, particularly in diabetes, is an important but not the sole factor leading to advanced glycation end-product (AGE) formation. The AGE amount and its distribution in cardiopathic myocardial tissues in the presence or absence of diabetes are not well documented. The aim of this study was to assess AGE deposition in unaffected myocardial vessels in heart failure patients with and without diabetes mellitus type 2 (DM2) undergoing transplantation. Methods The following groups were established: 14 hearts harvested from subjects with ischemic cardiopathy and DM2; 8 hearts from subjects with dilated cardiopathy with DM2; 67 hearts from subjects with ischemic cardiopathy; 47 hearts from subjects with dilated cardiopathy; and 14 hearts from autopsy cases with diagnosed DM2. A control group consisted of 20 heart donors. AGE localization was determined immunohistochemically in tissue sections. A semi-quantitative scale was used to assess reaction intensity in arteries, arterioles, capillaries, venules and veins. Results Both types of cardiomyopathy increased AGE accumulation in intramyocardial veins more than in arteries. The presence of DM2 significantly increased AGE in arterioles and capillaries, especially when coexisting with cardiomyopathy. The type of cardiopathy did not influence the pattern of AGE accumulation in myocardial vessels. Conclusion Both chronic heart failure and DM2 intensified AGE pathology and changed the susceptibility of myocardial vasculature to glycation. However, chronic heart failure increases AGE deposition mostly in veins, whereas DM2 predisposes arterioles to AGE accumulation.

Triple-Site Cardiac Resynchronization Therapy. Background: Cardiac resynchronization therapy(CRT)reducesmorbidityandmortalityinpatientswithheartfailure(HF),loweredLVejectionfraction, and wide QRS. However, many patients (≤40%) do not respond to this form of pacing. TRUST CRT is a prospective, single-center, randomized, single-blind, parallel, and controlled study that has been designed to treat patients with moderate to severe HF (NYHA III-IV), QRS ≥120 ms, sinus rhythm, LV dysfunction (EF ≤ 35%), and signs of mechanical dyssynchrony. Objective: The primary objective will evaluate the 6-month’s combined endpoint of alive status, freedom fromhospitalizationforHForheart transplantation,relative ≥10%increaseinLVejectionfraction, ≥10% in peak oxygen consumption, and ≥10% in 6-minute walking distance. Methods:PatientswithHFreceivingoptimalpharmacotherapy,withLVdysfunction,mechanicaldyssynchrony, wide QRS and sinus rhythm will be randomized in a 1:1 fashion to standard or triple-site CRT-D. Patients will be followed for 1 week, 1, 3, and 6 months during a blind phase, then every 6 months until study completion. One hundred patients will be enrolled by the study center. Conclusions: TRUST CRT is a randomized, clinical trial in CRT candidates to evaluate the effectiveness of triple-site pacing versus standard resynchronization in patients with HF. (J Cardiovasc Electrophysiol

The primary objectives of this study were to compare the implantation course of triple-site (double left-single right) and conventional cardiac resynchronization devices. The secondary target was to assess mid-term outcomes of both types of cardiac resynchronization therapy (CRT).Fifty-four patients with NYHA classes III-IV, left ventricular EFor=35% and QRSor=120 ms were included; 27 received triple-site pacemakers (TRIV group), 27 conventional CRT devices (BIV group). Procedural course, clinical data, QRS duration, echocardiographic parameters, peak oxygen consumption (VO2max) and 6-minute walking distance (6MWD) were screened for inter-group differences.Procedure duration was higher in TRIV than in BIV group (197.6 vs. 137.6 min, P0.001), fluoroscopy exposure and complication-rates were similar. After 3 months of CRT, triple-site pacing was associated with a more significant (P0.05) NYHA class reduction (by 1.4 vs. 1.0 class, respectively), increase in VO(2) max (2.9 vs. 1.1 mL/kg/min) and 6MWD (98.7 vs. 51.6 m) than conventional CRT. A higher EF and more improved intraventricular synchrony were observed in the TRIV than in the BIV group. The response rate in the TRIV group was 96.3% vs. 62.9% in the conventional group (P=0.002). Triple-site stimulation was an independent predictor of response to CRT (adjusted odds ratio 26.4, P=0.01).Triple-site resynchronization appears to be more beneficial than conventional CRT. Upgrade to triple-site CRT may be considered in non-responders to standard resynchronization.

Aims To evaluate implantation safety and efficiency of triple-site (double left–single right) cardiac resynchronization therapy (CRT) and to assess the outcome of this procedure. Methods and results Twenty-six patients with New York Heart Association (NYHA) class III–IV, left ventricular ejection fraction (EF) ≤ 35%, and QRS ≥ 120 ms underwent triple-site CRT. Procedural course and complications were analysed. NYHA class, QRS duration, echocardiographic parameters, peak oxygen consumption ( V O2max), and 6 min walking distance (6MWD) were assessed at baseline and after 3 months. Responders were defined by survival, by no re-hospitalization for heart failure, and by >10% EF, V O2max, and 6MWD increase. Implantation was successful in 22 patients (84.6%). Procedure duration (199.1 min) and fluoroscopy time (38.7 min) were higher than in standard procedures. Two clinically silent coronary sinus dissections occurred intra-operatively; one phrenic nerve stimulation and one pocket infection were observed during follow-up. After 3 months of CRT, a significant reduction ( P < 0.05) of NYHA class, increment of V O2max, 6MWD, EF, and improvement of indices of dyssynchrony were observed. Response rate in the studied group was 95.4%. Conclusion Triple-site resynchronization appears to be a safe and efficient treatment method, with high response rate. Further studies are needed to evaluate the role of this pacing mode in CRT.

Background: We sought to evaluate the influence of atrio-ventricular reentrant tachycardia (AVRT) on atrial pressures during tachycardia and the presence of atrial fibrillation (AF) in patients with preexcitation syndrome. Methods: The study population consisted of 88 patients (37 females, mean age 37.3 years) with left-sided accessory pathway and AVRT induced during electrophysiologic study. The AF-inducible group consisted of 32 patients with sustained episodes of AF provoked during electrophysiologic study, whereas the noninducible group comprised 56 patients without AF. Results: We found significantly higher values of maximal and mean left (LAP) and right (RAP) atrial pressures in the AF group compared with noninducible group: LAP max 32.0 versus 20.8, LAP mean 21.6 versus 13.2, RAP max 15.2 versus 11.5, RAP mean 8.2 versus 6.2 respectively (P < 0.001). When analyzing the effect of AVRT on atrial pressures, we found a significant (P < 0.001) negative correlation between anterograde conduction times during tachycardia and LAP max and LAP mean in the whole population, but a significant positive correlation between retrograde conduction time and left atrial pressures. Similar effects of AVRT on the right atrial pressures were found. Conclusions: Atrial pressures during AVRT, which depend on the electrophysiological features of tachycardia, play an important role in the genesis of atrial fibrillation in patients with preexcitation syndrome.

AIMS The CHA2DS2-VASc score is widely used to stratify the risk of stroke in patients with nonvalvular atrial fibrillation. The aim of the study was to assess whether the CHA2DS2-VASc score might be useful to identify patients at a high risk of ischemic stroke and death among individuals after acute myocardial infarction and with no history of atrial fibrillation. METHODS We analysed consecutive patients with acute myocardial infarction admitted to our centre between 2003 and 2008. On the basis of the CHA2DS2-VASc score, four groups were distinguished: low-risk (1 point), intermediate-risk (2-3 points), high-risk (4-5 points) and very high-risk (>5 points). Data on long-term follow-up were screened to identify patients who experienced stroke or died during remote observation. RESULTS Out of 2980 registry participants, 333 were excluded because of atrial fibrillation and/or ongoing therapy with oral anticoagulants. Finally, 2647 individuals were included into the analysis. An ischemic stroke occurred in 71 (2.68%) patients, whereas 439 (16.58%) died during a median follow-up of 41.5 months. The risk of stroke and death increased four-fold in the high-risk group compared with the low-risk group (P

INTRODUCTION Impaired glucose tolerance (IGT) has a negative impact on the outcome of patients with acute myocardial infarction (AMI). OBJECTIVES The aim of the study was to compare the effect of IGT on early and late prognosis in women and men with AMI treated with percutaneous coronary intervention (PCI). PATIENTS AND METHODS Based on the results of oral glucose tolerance test, 560 patients with IGT (395 men, 165 women) were selected out of a single center registry of 2733 consecutive patients with AMI. Sex‑related mortality and major adverse cardiovascular events (MACEs) including myocardial reinfarction, stroke, or repeat revascularization during hospitalization and long‑term follow‑up were compared in the whole study population and within the high‑risk subgroups. RESULTS Mortality and MACE rates were comparable between men and women except for a higher stroke rate in women (4.8% vs. 1.5%, P

Glucose abnormalities are frequent comorbidities influencing prognosis in patients with cardiovascular diseases. The objective of this study was to evaluate prognostic role of HbA1c in patients with acute myocardial infarction (AMI) treated invasively, who had newly detected glucose abnormalities.Single-centre registry encompassed 2146 survivors of AMI. In all patients without diabetes mellitus (DM), oral glucose tolerance test was performed before hospital discharge and interpreted according to the guidelines.From the study population, two major groups with defined new glucose abnormalities and estimated HbA1c were selected: 457 patients with impaired glucose tolerance (IGT) and 306 patients with newly detected DM (newDM). In each of these groups, the median value of HbA1c was calculated and established as the cut-off point for further analysis. The median HbA1c for IGT group was 5.9% and for newDM was 7.0%.Patients with IGT and HbA1c ≤ 5.9% had significantly lower posthospital mortality (4.5%) than those with HbA1c5.9% (25.0%; p0.001). Similarly, patients with newDM and HbA1c ≤7.0% had lower mortality (6.4%) than those with HbA1c7.0% (14.3%; p0.05). Multivariate regression analysis revealed that increase of HbA1c was one of the strongest independent risk factors of death among IGT patients (HR 2.9, 95% CI 2.7-3.1; p0.001) and newDM (HR 1.53, 95% CI 1.39-1.66; p0.05).Increase of HbA1c in patients with newly detected glucose abnormalities was associated with significantly reduced survival after AMI treated invasively. Moreover, increase of HbA1c in patients with IGT and newDM was one of the strongest independent risk factors of death in these populations.

The purpose of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) in terms of outflow tract gradient reduction and functional improvement in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) requiring implantable cardioverter-defibrillator (ICD) implantation.Eleven consecutive symptomatic HOCM patients with a significant (≥40 mmHg) gradient and indications for ICD, but without indications for resynchronization, underwent CRT-D implantation. Nine of them (four female, median age of 50 years) in whom the procedure succeeded were screened for New York Heart Association (NYHA) class, outflow gradient, mechanical dyssynchrony, QRS-width change, and 6-minute walking distance (6MWD) and peak oxygen consumption (VO(2)peak) improvement after 6 months and remotely.After 6 months of pacing, NYHA class decreased (median 1 vs 2, respectively); peak (33 vs 84 mmHg) and mean (13 vs 38 mmHg) outflow tract gradients were reduced; and QRS width (143 vs 105 ms), intraventricular dyssynchrony (35 vs 55 ms), and VO(2)peak (19.5 vs 14.2 mL/kg/min) increased significantly (all P0.05) compared to baseline. In six of nine patients (67%), the peak gradient was reduced50% and reached40 mmHg. After a median of 36 months, the outflow gradient decreased even more (8 mmHg) and was significantly (P0.05) lower than after 6 months of CRT.These preliminary data suggest that CRT seems to be an effective method of reducing the outflow tract gradient and improving the functional status of symptomatic HOCM patients requiring ICD implantation. Our findings need to be confirmed by more extensive studies.

In this paper, the method of generating biped robot motion using recorded human gait is presented. The recorded data were modified taking into account the velocity available for robot drives. Data includes only selected joint angles, therefore the missing values were obtained considering the dynamic postural stability of the robot, which means obtaining an adequate motion trajectory of the so-called Zero Moment Point (ZMT). Also, the method of determining the ground reaction forces' distribution during the biped robot's dynamic stable walk is described. The method was developed by the authors. Following the description of equations characterizing the dynamics of robot's motion, the values of the components of ground reaction forces were symbolically determined as well as the coordinates of the points of robot's feet contact with the ground. The theoretical considerations have been supported by computer simulation and animation of the robot's motion. This was done using Matlab/Simulink package and Simulink 3D Animation Toolbox, and it has proved the proposed method.

One of the methods used in clinical setting to assess the balance function is the measurement of the centre of pressure trajectory (COP). The COP trajectory is strongly dependent on the body centre of mass trajectory (COM), but in case of balance problems the corrective signals influence this dependence. The aim of the present study is to explore the possibility of using power spectral density function of the COP vs. COM signal in assessing the amount of correction signals. As the aim was a methodological one, only one healthy adult subject participated in the study. This subject performed five balance tasks of increasing difficulty. The COP trajectory was recorded using the Kistler force plate, and COM trajectory was calculated based on the marker trajectories placed on the subject's body and simultaneously recorded with VICON 460 system. The COM data were subtracted from COP trajectory in anteroposterior (AP) and lateral direction. Next the power spectral density (PSD) was calculated for the new signals. The power spectral density is very low for easiest condition, but increases with the difficulty of task. Moreover, it also provides information in which plane (sagittal or frontal) more correction movements are needed to maintain stability.

Objective - The objective of the study was to verify, if the particular sequence of electrical atrioventricular activation during tachycardia is associated with the development of atrial remodelling and predisposition to atrial fibrillation (AF) in patients with nodal reentry tachycardia (AVNRT). Methods and results - We assessed 117 consecutive patients with AVNRT identified during electrophysiological study. Two groups were identified: the AF group, n = 21 (17.9%, median age 46.0, 15 women), with clinically documented AF, and the control group, n = 96, without AF (median age 48.5, 69 women). Tachycardia cycle length (VV), anterograde AV, retrograde VA activation intervals and indexes (AV/VV, VA/VV) during AVNRT, atrial refractory period (AERP), intraatrial (IntraCT) and interatrial conduction time (InterCT) of the sinus beat and premature stimuli were analysed. The longer retrograde and shorter anterograde activation was found in AF patients with typical AVNRT, the opposite relations showed the subjects with atypical tachycardia. Intra and InterCT of sinus beat, and of paced extrastimuli were longer,AERP was borderline shorter in the AF-group than in the controls.The longest conduction times and shortest AERP were seen in the patients with VA/VV within 20-40% of the tachycardia cycle, this group comprised 71% of all AF-patients (P< 0.001).VA was predictive for AF in typical (OR/unit 1.04) and atypical AVNRT (OR/unit 0.93, P< 0.05). Conclusions - The particular sequence of electrical atrioventricular activation, seen in some patients during AVNRT is associated with disturbances of atrial conduction, refractoriness and predisposes to atrial fibrillation.

Background: Cardiac resynchronization therapy (CRT) becomes a “gold standard” in therapy of selected patients with advanced heart failure. We set out to evaluate the feasibility and safety of percutaneous interventions within coronary sinus (CS) and their effect on the success rate of left ventricular (LV) lead implantation during CRT. Methods: The study analyzed eight consecutive patients with the indications for CRT, who needed additional procedures within CS to overcome technical problems during left ventricular (LV) electrode implantation. The analyzed group consisted of three subgroups: patients in whom percutaneous balloon angioplasty within CS was needed (n = 4); patients with acute instability of the lead, requiring stenting of the vein to fix the electrode (n = 2); and patients with the stenting of CS due to late dislocation of the lead (n = 2). Success rate, procedure duration, fluoroscopy, complications, and electrical parameters of leads were analyzed. Results: Success rate of the procedures was 87.5%; additional interventions increased overall efficacy of CRT implantation at our center from 88% to 98% (P < 0.05). Procedure duration (155.0 minute) and fluoroscopy time (42.5 minute) remained acceptable for the patient and operator; however, both were higher than in the procedures performed routinely in our hospital. Electrical properties of the LV leads were stable and within normal ranges during the observation period. We noted two local dissections of CS during the procedure, which remained clinically silent. Conclusion: Percutaneous interventions within CS seem to be feasible and safe treatment options, which can improve the short- and long-term success rates of CRT.

Radiofrequency (RF) ablation of typical atrial flutter (AFL) is a well-established method of treatment. Although its efficacy is high, a search for new, more effective techniques is continuing. These new methods include modern systems for electro-anatomical mapping and new types of ablating electrodes such as cooled-tip or dual-sensor catheters.To assess the efficacy of RF ablation of typical AFL with the use of electro-anatomical mapping system CARTO and to compare the effectiveness of various ablating catheters.The study group consisted of 60 consecutive patients who underwent RF ablation of typical AFL with the use of the CARTO system. In 35 patients standard ablating electrodes were used, in 15 -- cooled-tip catheters (Thermo-Cool), and in 10 -- Dual-Sensor catheters.Overall efficacy of RF ablation was 96.6%. In two procedures which occurred ineffective, standard ablating electrodes were used. In 4 (6.6%) patients a recurrence of AFL was noted -- also these patients had RF ablation performed with the use of standard ablating electrodes. None of the patients had procedure-related complications.RF ablation of typical AFL with the use of electro-anatomical system CARTO is effective, safe and associated with reduced fluoroscopy time. The use of cooled-tip or dual sensor ablating electrodes further enhances efficacy of the procedure.

Pulmonary embolism is a common disease which may cause diagnostic difficulties. To establish a diagnosis additional examinations are needed. Except typical for pulmonary embolism EKG changes the value of untypical ST-T changes connected with cardiac ischaemia is appreciated. The case below presents the usefulness of EKG monitoring in acute pulmonary embolism.

We present a case of 38-year-old patient with a large left ventricular aneurysm, which was filled by the thrombus, separated from the rest of the left ventricle by a hyperdensive area. After careful invasive and non-invasive assessment, the patient was selected for conservative treatment. Patients after myocardial infarction, especially with low ejection fraction and young age, should undergo a complete noninvasive diagnostic procedures and a cardiac catheterization in order to establish indications for surgical treatment. The described case is an example of the difficulty in final selection of the patient to a surgical treatment.

Diabetes mellitus is a very well recognized risk factor for coronary artery disease in non-transplant patients. With the introduction of new immunosuppressive agents in solid organ recipients, there is an interest in medical complications of immunosuppressive therapy. An influence of long-term cyclosporine-A (CyA) therapy on glucose metabolism was analyzed in a group of 122 heart transplant recipients who developed hyperglycemia after heart transplantation. Based on WHO criteria for diagnosis of diabetes two groups were identified: group 1 (102 pts) included pts with impaired glycemic control and group 2 (20 pts) with clinical diabetes. Fasting insulin, proinsulin, C-peptide, HbA1c and cyclosporine-A trough levels were determined 12-18 months post surgery in clinically stable period without transplant rejection. The immunosuppressive treatment in both groups was the same and consisted of cyclosporine A, azathioprine and prednisone. We observed a statistically significant negative correlation between CyA concentration and insulin in both groups, a statistically significant negative correlation between CyA concentration and proinsulin, C-peptide blood level in group 1 and statistically significant positive correlation between CyA and glucose blood level in both groups.

Background Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear. Aims To assess the incidence and impact of GA on clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI). Methods A single-center, prospective registry encompassed 2733 consecutive AMI subjects treated with PCI. In all in-hospital survivors (n = 2527, 92.5%) without the history of DM diagnosed before or during index hospitalization standard oral glucose tolerance test (OGTT) was performed during stable condition before hospital discharge and interpreted according to WHO criteria. The mean follow-up period was 37.5 months. Results The incidence of GA was as follows: impaired fasting glycaemia - IFG (n = 376, 15%); impaired glucose tolerance - IGT (n = 560, 22%); DM (n = 425, 17%); new onset DM (n = 384, 15%); and normal glucose tolerance – NGT (n = 782, 31%). During the long-term follow-up, death rate events for previously known DM, new onset DM and IGT were significantly more frequent than those for IFG and NGT (12.3; 9.6 and 9.4 vs. 5.6 and 6.4%, respectively, P Conclusions Glucose abnormalities are very common in AMI patients. DM, new onset DM and IGT increase remote mortality. Impaired glucose tolerance bears similar long-term prognosis as diabetes.

Cardiac resynchronisation therapy (CRT) is the method of treatment in patients (PTS) with chronic heart failure. Using electrocardiographic criteria for the procedure some PTS dont present clinical improvement. The aim of the study was to compare ultrasonographic methods of qualifications to CTR (intravetricular asynchrony – in tissue doppler, interventricular asynchrony - Echo) and analysis of importance of left ventricular pacing site. Method oxygen consumption test (VO2max) and 6-minutes walikng test (6MWT) was performed in 24 patients before and 3 month after resynchronization. We analysed two group of patients: 1. PTS with LV pacing through lateral vein, 2. with LV pacing from posterior region. Results In Group 1 improvement of interventricular resynchronization in Echo was greater (improvement 30,0ms vs 8,9ms), but intraventricular resynchronization and clinical condition was similar in both groups. Optimal interventricular resynchronization (in 3 PTS 0-5ms in Echo) didn't reveal major improvement in VO2max and 6MWT. In 3 PTS with optimal intraventricular resynchronization (0-5ms in tissue doppler) clinical improvement was singnificantly higher comparing with other PTS (VO2max 5,6 vs 3,6, 6MWT 81,6m vs 63,3m). Conclusions Improvement of clinical condition of PTS with both localisations of LV pacing was similar. Intraventricular asynchrony analysed in tissue doppler is the best parameter for qualification to CRT and for programming of pacemaker.

Purpose of the study to assess the SDB in pts with advanced chronic heart failure (CHF) treated with CRT in 3 months follow-up. Methods: The study group consisted of 17 pts (3F, 14M, aged 53±9 years) with CHF at NYHA class III, EF 5 and≤15) or Apneic (Est.AHI >15). The Est.AHI as well as the percentage of pts qualified for Normal, Borderline or Apneic class from baseline recordings and after 3 months follow-up were calculated. Results Mean value of the Est.AHI before BIV implantation was 7,5±4,6 (range: 23,3-0) and decreased significantly in 3 months follow-up having then the value of 4,6±5,5 (range: 13,0-0); p=0,003. After 3 months follow-up the total and significant reduction of Apneic class and the tendency to increase of Borderline class were observed. View this table: Conclusions In pts treated with CRT therapy in three months follow-up the improvement of sleep apnea parameters is observed. CRT therapy may have beneficial influence on sleep disordered breathing.

The influence of cardiac resynchronization therapy (CRT) on heart rate variability (HRV) and therefore on autonomic nervous system in the heart has been discussed recently. Purpose of the study to assess the behaviour of HRV parameters in patients (pts) with chronic heart failure (CHF) treated with CRT therapy in three months follow-up. Methods The study group consisted of 17 pts (3F,14M, aged 53±9 years) with CHF at NYHA class III, EF