Editorial
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article The effects of intracoronary autologous mononuclear bone marrow cell transplantation on cardiac arrhythmia and heart rate variability
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Conclusions: 1. During the first month after the intracoronary injection of BMC, non-significant increase of nsVT was observed. 2. The lack of significant increase in HF power after BMC infusion may be a sign of depressed parasympathetic tone. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Czy komórki macierzyste mają działanie proarytmiczne?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Cardiomyocyte desmin abnormalities – an accurate predictor of long-term survival in patients with chronic heart failure
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Conclusions: Our results suggest that desmin content in cardiomyocytes directly affects the long-term prognosis in HF patients. The low expression of desmin in cardiomyocytes with immunohistochemical assay is associated with unfavourable clinical course. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Desmina jako wskaźnik odległego rokowania u chorych z niewydolnością skurczową serca
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Acute pulmonary embolism registry in the Małopolska region – clinical course
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Conclusions: 1. In our registry mortality rate in patients with APE was 11%. 2. In about 30% of patients APE was under mask of acute coronary syndrome or syncope, 34% of patients had elevated troponin level, and 30% of patients had complication during hospitalisation. 3. In patients treated with thrombolytics mortality rate was 45%. 4. Reperfusion strategy (trombolysis or embolectomy) in the high risk group was used in only 41% of patients. 5. Elevated troponin level in normotensive patient was associated with 4-fold times higher risk of death. 6. New risk stratification according to the ESC guidelines 2008 correctly predicts prognosis in everyday clinical practise. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Czy warto prowadzić rejestry – czyli o diagnostyce i leczeniu zatorowości płucnej
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Is it possible to use standard electrocardiography for risk assessment of patients with pulmonary embolism?
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Conclusions: 21-ECG score is a simple and cheap method which can be used to predict RVD and serious complications in patients with APE. A value Ł 3 points in the 21-ECG score can exclude RVD with high probability and limit the need of echocardiography to 23% of haemodynamically stable patients. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Badanie EKG w ocenie rokowania chorych z zatorowością płucną
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article High monthly temperature as a possible risk factor of local vascular bleeding complications during percutaneous coronary interventions evaluated by ultrasonography – retrospective analysis
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Conclusions: High air temperature during the post-intervention period, besides female gender and advanced age, may be another risk factor for local bleeding complications. This risk remains low (3%), in spite of growing intensity of antiplatelet treatment . (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Powikłania po zabiegach inwazyjnych – jeszcze jeden czynnik ryzyka?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Cardiac surgery and cardiology Has the time come for hybrid revascularisation in multivessel coronary artery disease?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Percutaneous closure of mitral perivalvular leak
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We present a case of successfully completed percutaneous closure of PVL with the use of Amplatzer occluder device in a patient with mitral PVL. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Apicoaortic valved conduit as an alternative metod of surgical treatment of aortic stenosis – a case report
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A case of a 73-year-old patient with critical aortic stenosis, porcelain aorta and occluded femoral arteries is presented. We performed apico-aortic valved conduit (A-AVC) without cardiopulmonary bypass (CPB). Hegar dilator inserted through the apex into the left ventricle allowed anastomosis of dacron tube to the apex. Valved conduit was anastomosed to the descending aorta. Both tubes were connected. Before the operation, maximal gradient through the valve was 95, after operation dropped to 33 mmHg. This method of apical anastomosis allowed to perform A-AVC without CPB in a patient with extremly high peri-operative risk while using CPB. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Catastrophic antiphospholipid syndrome complicated by cardiogenic shock – a case report
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A case of a 29-year-old woman 18 days after delivery with catastrophic antiphospholipid syndrome secondary (CAPS) due to undiagnosed systemic lupus erythematosus, leading to cardiogenic shock is reported. Laboratory evaluation revealed increased anticardiolipin antibodies, lupus anticoagulant, antinuclear antibody and thrombocytopenia. Left ventricular ejection fraction was 20%, neurologic deficit and acute renal failure were also present. Cardiac involvement is common in CAPS, but cardiomyopathy due to microvascular thrombosis is rare. CAPS should be considered as a cause of acute heart failure in a women with systemic lupus erythematosus. In the presented case early therapy with anticoagulants, steroids, immunoglobulins and plasmaferesis was beneficial. (Source: Articles of Polish Heart ...
In Poland Wnioski ze spotkania Krajowego Zespołu Nadzoru Specjalistycznego w Dziedzinie Kardiologii
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Letter to Editor Report from the Annual Scientific Meeting of Eur o CMR the Working Group on Cardiovascular Magnetic Resonance of the ESC, 21-23 May 2009, Athens, Greece
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article How to assess quality of life of cardiological patients?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Electrocardiogram of the month Long QT syndrome in the postpartum period
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We described a case of 22-year-old woman with episode of lost of consciousness 6 months after delivery. Holter monitoring showed episodes of QTc prolongation, max. QTc – 618 ms, medium QTc – 538 ms with different morphology types of T wave. Beta-blocker (BB) therapy (metoprolol was initiated) and titrated up to 200 mg daily. The patient was out of symptoms. After 2 years during the second pregnancy she reduced BB to 50 mg/day. In the postpartum period, 3 months after delivery she had syncopal episodes. Holter monitoring showed polymorphic ventricular tachycardia. The cardioverter-defibrillator was implanted. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Echocardiogram of the month Transthoracic echocardiographic assessment of a biventricular assist device
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We present the results of standard transthoracic echocardiographic assessment of a biventricular assist device implanted in a patient with progressive heart failure caused by acute giant-cell myocarditis. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Angiogram of the month Suspected acute coronary syndrome in a patient with systemic scleroderma
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We present a case of a 53-year-old female with systemic scleroderma who was admitted to the hospital due to suspected acute coronary syndrome. Coronary angiography revealed normal coronary arteries (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Invasive electrophysiology Ventricular bigeminy as a cause of CRT inefficacy and inappropriate cardioverter-defibrillator intervention
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We present a case of 76-year-old man with CRT-D and inappropriate detection and intervention due to ventricular bigeminy. Fortunately, change of device program, potassium and magnesium supplementation was successful, without necessity of RF ablation of the ventricular ectopic beats. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Malignant form of familial hypertrophic cardiomyopathy complicated with ventricular fibrillation in siblings. Electrocardiogram in hypertrophic cardiomyopathy – a review
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A family with hypertrophic cardiomyopathy (HCM) (15-year-old boy, his 17-year-old sister and 45-year-old father) is described. The first sign of HCM was cardiac arrest (CA) due to ventricular fibrillation (VF) in a boy. A few months later sister of proband had the episode of CA due to VF. Both had implanted cardioverter-defibrillator (ICD). Echocardiography revealed HCM in both cases and in a father, who also received prophylactic ICD. During 24-month follow-up fast VT was observed in sister of proband. We review electrocardiographic changes in HCM and their correlation with magnetic resonance. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Epidemiology and prevention The role of patient-related factors in the delay of treatment of acute myocardial infarction
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article PCSK9 – break through in the prevention and treatment of arteriosclerosis?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article Do all patients achieve similar benefit from the usage of different forms of unsaturated omega-3 acids?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Lipomatous hypertrophy of the interatrial septum
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We present a case of a lipomatous hypertrophy of the interatrial septum diagnosed by CMR. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report From gastroenteritis complicated by acute renal failure to... the Moschcowitz syndrome
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A case of a 68-year-old male patient, who was admitted to our department with stomach pain, nausea, vomiting and diarrhea lasting for more than two weeks is presented. In addition, shortly before being admitted, the patient also complained of neurological symptoms, severe hypertension, rash and high fever. Laboratory tests revealed thrombocytopenia, hemolytic anemia and elevated creatinine. After receiving the information, that for the last three weeks the patient was taking ticlopidine, we started to suspect the Moschcowitz syndrome. For this reason the patient was transferred to a Hematological Institute, where the diagnosis was confirmed. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Angiogram of the month Successful rescue of a perforated chronic total occlusion using retrograde technique
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Percutaneous coronary intervention of chronic total occlusion (CTO) is one of the greatest challenges in coronary interventions. Retrograde wiring is suggested as a solution to improve the success rate of intervention for CTO. We experienced the coronary perforation during antegrade wiring at the CTO lesion and sealed it using retrograde wiring and antegrade stenting in a patient who underwent coronary arterial bypass grafting. We found that, in selected cases, the retrograde wire technique may provide a valuable rescue option for perforated CTO in a patient having a retrogradely accessible conduit vessel. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article The use of adosterone antagonists in the cardiovascular diseases
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Renal hypertension. A case report – therapeutic dilemmas
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Hypertension associated with fibromuscular dysplasia of renal artery is the most common form of secondary hypertension among young patients. In this article we present a case of a 27-year-old patient, with drug-resistant hypertension. Stenosis of right renal artery and small right kidney were found on ultrasonography, angio-CT and angiography. There was no sign of renal atrophy therefore we performed percutaneous transluminal angioplasty. After the procedure we observed a decrease in blood pressure and no need to use hypertensive medication. Diagnosis and treatment of this condition are discussed. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Ventricular septum and free wall rupture in a 56-year-old male with myocardial infarction. A case report with follow-up of 7 years
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A case of a 56-year-old male who had unrecognised acute myocardial infarction complicated by a combination of ventricular septum and free wall rupture is presented. He developed symptoms of overt heart failure but initially he was treated out of hospital due to pneumonia. An echocardiographic study disclosed a ventricular septum rupture and ventricular free wall rupture with concomitant formation of pseudoaneurysm. He underwent surgical correction of the double myocardial rupture and successful re-operation due to recanalisation on the 5th day after the surgery. He underwent right coronary artery angioplasty 5 years after cardiac surgery. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Zapalenie mięśnia sercowego – wyzwanie dla współczesnej kardiologii
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Czy można uratować wyniki badania STICH? Oczywiście, że tak!
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In the Word Heart Rhythm Society Conference – Boston, 13–16 May 2009
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Evidence-based cardiology Chirurgiczna rekonstrukcja lewej komory nie przynosi dodatkowych korzyści u chorych z obniżoną frakcją wyrzutową poddanych operacji pomostowania aortalno-wieńcowego – pierwsze wyniki badania STICH
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Commentary to the article: Jones RH, Velazquez EJ, Michler RE, et al. Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 2009; 360: 1705-17. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Invasive electrophysiology Unusual induction of the typical slow-fast AVNRT in a patient with multiple slow atrioventricular pathways
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A case of a male patient with a history of supraventricular tachycardia confirmed by electrophysiological study and treated by RF ablation is presented. The features of multiple slow atrioventricular nodal pathways were found as well as the unusual induction mechanism of the slow-fast atrioventricular nodal reentry tachycardia – 1 : 2 AV conduction. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
In Poland Sprawozdanie z niezależnego panelu ekspertów na temat związku chorób przyzębia z chorobami ogólnoustrojowymi
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Cardiac surgery and cardiology Leveling down to worse – parametrical evaluation of scientific journals by Polish Ministry of Science and Higher Education, that is why high quality and recognised medical journals, including Polish Heart Journal, cannot have 10 points?
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Echocardiogram of the month Acute myocardial infarction complicated by severe mitral regurgitation during incomplete rupture of the postero-medial papillary muscle – a case report
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A case of acute severe mitral regurgitation with serious hemodynamic impairment in the setting of an inferior ST-elevation myocardial infarction is presented. Both transthoracic and transesophageal echocardiography demonstrated a posteriorly directed eccentric jet of severe mitral regurgitation with flail anterior mitral valve leaflet. The rupture of the postero-medial papillary muscle attached via chords to the anterior mitral valve leaflet was found. The direction and eccentricity of the mitral regurgitant jet on transthorasic and transesophageal echocardiography helped to point the leaflet involved, but not necessarily the coexisting papillary muscle pathology. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Electrocardiogram of the month Atrial fibrillation in the long QT syndrome
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A case of a 58-year-old woman with occasionally diagnosed persistent atrial fibrillation (AF) is presented. The patient for many years experienced palpitations relived by oral propranolol treatment. After electrical cardioversion of AF to sinus rhythm prolongation of the QTc interval up to 520 ms became evident. Molecular screening of LQTS-related genes revealed the presence of R231S mutation in the KCNQ1 gene. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Podwyższone stężenie czynników reakcji zapalnej wskaźnikiem restenozy w stencie. I co dalej?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article Influenza vaccination in the secondary prevention of coronary artery disease. The review of current guidelines
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Plasma levels of C-reactive protein and interleukin-10 predict late coronary in-stent restenosis 6 months after elective stenting
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Conclusion: We demonstrated that elevated inflammatory markers 6 months after PCI are associated with late angiographic in-stent restenosis. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article The incidence of paradoxical response to orthostatic stress in patients with cardiovascular diseases
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Atorwastatyna zmniejsza aktywność współczulną i poprawia czułość odruchu z baroreceptorów u osób z hipercholesterolemią i nadciśnieniem tętniczym
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Atorvastatin reduces sympathetic activity and increases baroreceptor reflex sensitivity in patients with hypercholesterolaemia and systemic arterial hypertension
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Conclusion: Atorvastatin reduces MSNA and increases BRS in hypertensive and hypercholesterolaemic patients. Decrease in sympathetic activity may be the result of improvement of baroreceptor function by atorvastatin. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Uwarunkowania genetyczne reakcji zapalnej a choroba niedokrwienna serca
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Original article Myocarditis – clinical course and 2-year outcome in 32 patients
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Conclusions: Diagnosis of myocarditis is still challenging. Careful history taking, serial laboratory, ECG and echocardiographic examinations are helpful in therapeutic decisions making and assessing prognosis. Patient with subacute myocarditis are more symptomatic than patients with acute myocarditis. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Interleukin-1b and interleukin-1 receptor inhibitor gene cluster polymorphisms in patients with coronary artery disease after percutaneous angioplasty or coronary artery bypass grafting
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Conclusion: The data presented here suggest that carriers of the two relatively frequent variants of the IL-1b gene at -31 and -511 position, i.e. -31TT and -511CC, are at a higher risk of developing coronary artery disease requiring surgical treatment or two-stage percutaneous angioplasty. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Ambulatoryjna rehabilitacja kardiologiczna – czy można poprawić jej skuteczność?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Comment to article Badania podstawowe przed badaniami klinicznymi, czyli dlaczego warto wrócić do laboratorium
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Original article Thrombin formation and platelet activation at the site of vascular injury in patients with coronary artery disease treated with clopidogrel combined with aspirin
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Conclusion: Our study shows that clopidogrel combined with aspirin does not reduce thrombin formation following vascular injury, but attenuates platelet sCD40L and P-selectin release. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Why patients after acute coronary syndromes do not participate in an early outpatient rehabilitation programme?
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Conclusions: Only a small proportion of patients after an ACS decides to participate in outpatient rehabilitation after completing a short-term inpatient programme. Psychological status, employment and smoking status are among the factors that differentiate OutCR attenders and non-attenders. Continuous medical care, lack of commuting problems, and convenience were the most frequently given advantages of inpatient rehabilitation, while commuting problems and conflict with job were the most frequently perceived barriers to outpatient rehabilitation. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Editorial
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Wanda Wysznacka-Aleksandrow (1920–2009)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Echocardiogram of the month Cor triatriatum diagnosed in a 55-year-old man
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We describe an adult patient, in whom this anomaly was diagnosed in 55 year of life. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Angiogram of the month Primary percutaneous coronary intervention complicated by left anterior descending artery perforation – a case report
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A case of a 72-year-old man with anterior wall myocardial infarction and PCI procedure complicated by coronary artery perforation, is presented. Life-threatening complication was successfully treated percutaneously with graft-stent implantation, and the patient was discharged home five days later in a good condition. Control coronary angiography after 3 months was scheduled. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Invasive electrophysiology Necessity of endocardial lead removal in device upgrade in a patient with left subclavian vein occlusion – a case report
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We describe a method of regaining venous access to the heart in a patient with permanent atrial stimulation, in whom the pacing system upgrade to the atrio-ventricular one was necessary. However, left subclavian vein occlusion was found. We used an existing lead as a conduit. During such treatment the lead was removed. After a recanalisation the therapeutic aim was achieved – there were two new leads implanted. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Electrocardiogram of the month Sinus node activity retrogradely blocked by active atrioventricular nodal rhythm
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review articles Peripartum cardiomyopathy – description of the condition and case presentation
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review articles Supplementation of unsaturated omega-3 acids: do the type of pharmaceutic matters?
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Dressler syndrome following pulmonary embolism
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A case of a 73-year-old woman with fibrinous pericardial effusion which developed four weeks following severe pulmonary embolism. Clinical and echocardiographic data as well as an inclination to self-limited course were suggestive of Dressler syndrome diagnosis. Although there were no data that oral vitamin K antagonist use was involved in presented pericardial syndrome, pericardial effusion size required its temporary substitution by heparin. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Case reports Closure of major aorto-pulmonary collateral artery with the Amplatzer vascular plug in an infant with pulmonary atresia and ventricular septal defect – a difficult therapeutic problem
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A case of a 2-day-old newborn with congenital heart disease, pulmonary atresia and ventricular septal defect is described. The Blalock-Taussig shunt was created 6 days after birth. After the procedure, the newborn developed symptoms of increased pulmonary blood flow and respiratory distress. We decided to close one of the major aortopulmonary collateral arteries with the Gianturco coil on the 41st day after birth, however the results were not satisfactory. On the 66th day of infant life (by that time the patient weighted 3 kg), another procedure with the Amplatzer vascular plug was performed. This procedure was successful. After a few days the infant was discharged from hospital. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports A large thrombus in the right atrium and in the inferior vena cava associated with a portal vein thrombosis in a patient with hepatic cirrhosis – a case report
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A case of a 54-year-old female with hepatic cirrhosis, who developed a large thrombus in the inferior vena cava that extended up to the right atrium and was associated with a portal vein thrombosis. She was admitted to our hospital because of symptoms of overt heart failure. A two-dimensional echocardiogram demonstrated a large mass in the right atrium originated from the inferior vena cava system. Computed tomography scans revealed tumor of the liver and a portal vein thrombosis. The patient was discharged on oral anticoagulation. Her remaining 1-year course has been uncomplicated. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Churg-Strauss syndrome: diagnostic and therapeutic challenge – a case report
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This report describes the Churg-Strauss syndrome (CSS) in a 23-year-old asthmatic man treated with a leukotriene antagonists-montelukast. The Churg-Strauss syndrome is now defined as one of the ANCA-associated vasculitis and is characterised by eosinophilia, asthma, chronic sinusitis, cardiomyopathy, pulmonary infiltrates, cutaneous vasculitis, gastrointestinal complaints and a muliplex neuropathy. The pathogenesis is not clear, but it has been reported in patients treated with leukotriene antagonists. We describe a case of CSS with severe pulmonary and cardiovascular complications. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Successful recanalisation of chronic total occlusion using retrograde approach
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Chronic total occlusion (CTO) is defined as an occlusion of a coronary vessels (TIMI 0 flow) lasting longer than 3 months. Successful recanalisation of CTO improves left ventricular function and survival. Retrograde technique can be used in patients, who have well-developed collaterals, when the antegrade approach is ineffective or difficult to perform. A 68-year-old male was referred for coronary angiography because of exercise angina chest pain. Coronary angiogram showed a CTO of RCA with collaterals from LAD. Following the unsuccessful traditional antegrade approach in 2004, we attempted a retrograde approach. The PCI procedure was performed successfully and without complications. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article The effects of left ventricular diastolic function on natriuretic peptide levels after cardioversion of atrial fibrillation
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Conclusions: The drop in ANP and BNP plasma concentrations after conversion to sinus rhythm in patients with AF depends on the LV diastolic function. Restoration of sinus rhythm is associated with improvement of the heart’s haemodynamics, especially in patients with impaired LV diastolic function, which may be inferred from the more pronounced decrease of BNP level after DC cardioversion in this subgroup, as compared to that with normal LV function. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Management and mortality in patients with non-ST-segment elevation vs. ST-segment elevation myocardial infarction. Data from the Malopolska Registry of Acute Coronary Syndromes
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Background: According to the presenting electrocardiogram, acute myocardial infarction (MI) can by categorised generally as non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). Aim: To assess the impact of the different acute MI categories on in-hospital management and mortality in hospitals without on-site invasive facilities. Methods: We identified 380 NSTEMI and 334 STEMI patients treated in the Malopolska Registry of Acute Coronary Syndromes from February to March 2005 and from December 2005 to January 2006. Data concerning in-hospital management and mortality were assessed. Results: Patients with NSTEMI were older and were more likely to have prior angina, prior MI and prior heart failure symptoms than STEMI patients. The NSTEMI patients were less likely to be tra...
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Outcomes of a single centre registry of patients with ischaemic heart disease, qualified for an RF ablation of ventricular arrhythmia after ICD intervention
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Conclusions: 1. Ablation might not be suitable as a routine treatment for all patients with ICD interventions, as a significant group prefers not to undergo RF ablation as a routine treatment or there are contraindications for the ablation. 2. There are obstacles in prospective and randomised evaluation of the role of ablation in patients with CAD and ICD interventions, which are related both to patients’ medical conditions and to patients’ will. These limitations should be taken into account when designing further studies. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Original article Changes in heart rate variability caused by coronary angioplasty depend on the localisation of coronary lesions
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Conclusion: Changes in heart rate variability caused by coronary angioplasty depend on the localisation of coronary lesions. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Original article Factors predicting discontinuation of a hospital-based cardiac rehabilitation programme
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Background: Cardiac rehabilitation (CR) programmes play an important role in the management of patients with coronary artery disease. However, a significant proportion of patients do not participate or do not complete CR. Aim: To asses the prevalence and predictors of discontinuation of a hospital-based CR programme and to investigate whether or not the completers and dropouts differed in relation to their baseline characteristics. Methods: Data used for analysis were from a hospital-based CR programme involving 1986 discharged patients at Tehran Heart Centre between July 2004 and January 2006. The patients who completed all 24 sessions of the CR programme were compared with the dropouts. Results: The CR completion rate was 18.1% (average of 11.4±8.1, ranging from 1 to 78 sessions) in...
Original article Left ventricular diastolic function assessed with cardiovascular magnetic resonance imaging and exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy
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Background: In patients with non-obstructive hypertrophic cardiomyopathy (HCM) and preserved left ventricular (LV) systolic function, diastolic dysfunction is one of the major factors contributing to limited exercise capacity. Cardiovascular magnetic resonance (CMR) imaging has become a useful tool in diagnosis, risk stratification and treatment monitoring in patients with HCM. Aim: To assess the relationship between simple CMR parameters of LV diastolic function at rest and exercise capacity measured by means of cardiopulmonary exercise testing on a treadmill in patients with non-obstructive HCM and preserved LV systolic function. Methods: The study included 13 patients with non-obstructive HCM and preserved LV systolic function who underwent cardiopulmonary exercise testing on a treadm...
Od redakcji
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Polkard 2005–2008
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Cardiac surgery and cardiology Transapical aortic valve implantation – hope for high risk patients with severe, symptomatic aortic stenosis – a case report from the first procedures performed in Poland
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Invasive electrophysiology Glass of water or ablation? – episodes of malignant atrial tachyarrhythmias during swimming in a lake in a woman with overt Wolff-Parkinson-White syndrome and benign palpitations for several decades of life
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We present a case of a 41 year old woman with overt Wolff-Parkinson-White syndrome (WPW) and benign palpitations for over four decades of life who suffered from a malignant atrial tachyarrhythmias (typical atrial flutter concomitant with left atrial fibrillation) during swimming in a lake. Loading dose of amiodarone increased frequency of attacks of sustained AVRT. In spite of treatment with amiodarone, effective refractory period of accessory pathway was still short. After ablation of accessory pathway, during five years of follow-up, there was no arrhytmia recureence. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Komentarz redakcyjny
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Angiogram of the month Percutaneous closure of a congenital coronary artery fistula with the use of graftstent – a case report
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The congenital coronary fistula is a rare anomaly revealed sometimes during diagnostic procedures. Although it is rarely symptomatic many authors consider elective procedure of closure, because of relatively low risk of procedure. This case demonstrate the percutaneous closure of a congenital coronary artery fistula using graftstent. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Echocardiogram of the month Giant left ventricular postinfarction pseudoaneurysm – an echocardiographic case report
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We present a rare case of a 71-year-old man who had myocardial infarction 9 years ago. Transthoracic and transesophageal echocardiography revealed presence of a large pseudoaneurysm of the left ventricular (LV) apex and anterior wall with thrombus. The diagnosis of LV pseudoaneurysm was confirmed by electrocardiography – gated multidetector computed tomography. The patient did not consent for surgery and remained on pharmacological treatment. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Electrocardiogram of the month QTc duration in the long QT syndrome type 2 – diagnostic dilemma
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We present a case of a 43-year old woman with a long QT syndrome (LQTS). Despite her family history of several sudden deaths in close relatives the patient was misdiagnosed, being treated many years for epilepsy. Finally, after another series of syncopal spells she was diagnosed with LQTS. Although QTc interval was normal on surface ECG, the presence of notched T-waves and QT prolongation up to 543 ms on Holter recording were helpful in establishing the correct diagnosis, which was later confirmed by genotyping revealing G601S mutation in the HERG gene. The patient refused an ICD and despite beta-blocker treatment died suddenly several months later. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article Depression in patients with chronic heart failure
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Review article Do angiotensin receptor blockers increased the risk of myocardial infarction? The landscape after ONTARGET study
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Komentarz redakcyjny
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Case reports Acute aortic dissection type A with concomitant myocardial infarction
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The authors describe a patient with acute aortic dissection type A complicated by left main coronary artery occlusion and acute myocardial infarction. The patient underwent urgent surgery, however, died 4 hours after operation. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Heparin-induced thrombocythopenia in a patient with massive pulmonary embolism and dilated cardiomyopathy, successfuly treated with fondaparinux – a case report
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We present a case of a 38-year-old woman with dilated cardiomyopathy and massive pulmonary embolism treated with alteplase and unfractionated heparin. On 12th day an unexpected fall in platelet count was observed, without new signs of thrombosis. The HIT type II was diagnosed. Patient was treated effectively and safely by 7.5 mg of fondaparinux given subcutaneously once daily for 10 days. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Acute myocardial infarction due to thrombosis of coronary artery aneurysm in a 29-year-old women during postpartum period
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Acute myocardial infarction during pregnancy and postpartum period is rare. A case of a 29-year-old female who developed acute myocardial infarction during postpartum period is presented. Coronary angiography revealed thrombosis of a coronary artery aneurysm of the marginal branch. The patients was treated conservatively and during 5 months of follow-up the clinical course was uneventful. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case reports Persistent left and absent right superior vena cava
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Persistent left and absent right superior vena cava is a rare congenital anomaly, which is usually asymptomatic and discovered incidentally. A 57-year-old female patient was referred to this hospital for valvular surgery. Preoperative echocardiography and computed tomography revealed the diagnosis of persistent left and absent right superior vena cava. Mitral and aortic valve replacements were successfuly performed using aortic and single inferior vena cava cannulations with antegrade cardioplegic infusion. Cardiovascular surgeons or cardiologists should be aware of its presence in advance of a pertinent manoeuvre. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Editorial
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Original article Left ventricular performance and exercise capacity in patients aged 65 years and older treated by primary coronary angioplasty or conservatively for acute myocardial infarction – a one-year follow-up
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Background: Elderly patients hospitalised for congestive heart failure (CHF) due to myocardial infarction (MI) have very poor prognosis, particularly if CHF symptoms are caused by left ventricular (LV) systolic dysfunction. Early invasive strategy is considered the best method of preventing post-MI LV dysfunction. The clinical impact of early invasive strategy on prognosis in elderly patients with acute MI has yet to be completely defined because of the poor enrolment of elderly patients in large randomised trials. Aim: To asses whether treatment of acute MI in patients aged >65 years using percutaneous coronary intervention (PCI) results in significantly better long-term cardiovascular performance in comparison with conservative treatment (CT). Methods: Our study involved 90 MI patients w...
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Original article Acute coronary syndrome – how to reduce the time from the onset of chest pain to treatment?
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Background: Enormous progress in treating acute coronary syndrome (ACS) and shortening the time between the onset of pain and intervention has been made in recent years. However, the time from the beginning of pain to the call for help is still too long. Aim: To establish the causes of delayed call for help by ACS patients and to answer the question how to shorten that time. An additional aim was to examine the knowledge about myocardial infarction (MI) among patients with ACS. Methods: The study group consisted of 349 patients treated for ACS at the CCU. Nurses interviewed the patients using a questionnaire focused on demographic data, ACS characteristics, risk factors and situations which occurred between pain onset and arrival at the CCU. The data were analysed in relation to sex, place...
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Original article Novel atherogenesis markers for identification of patients with a multivessel coronary artery disease
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Background: Patients with advanced coronary artery disease (CAD) have an unfovourable prognosis. Therefore, early identification of this high-risk group is important. Aim: To asses the utility of clinical, electrographic and echocardiographic parameters, supported by novel atherogenesis markers, to identify patients with triple vessel coronary artery disease (CAD). Methods: The study group comprised 37 patients (29 males, mean age 64±8 years) suffering from multivessel CAD and a control group of 16 patients (8 males, mean age 60±10 years), in whom – despite typical stenocardial symptoms, positive exercise stress test and segmental contractility disturbances – coronary angiography did not reveal any haemodynamically significant CAD. Apart from coronary angiography, eac...
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Original article Heart rate turbulence in patients with chronic heart failure
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Background: Heart rate turbulence (HRT) has been shown to predict the prognosis after myocardial infarction (MI), but its prognostic value in patients with chronic heart failure (CHF) has not yet been well established. Aim: To evaluate HRT in patients with CHF and assess the prognostic significance of HRT in this group. Methods: The study group consisted of 82 patients with CHF and left ventricular ejection fraction (LVEF) 0% and TS (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Original article Impairment of arterial distensibility in premenopausal women with systemic lupus erythematosus
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This study aimed to investigate arterial distensibility using carotid-femoral (aortic) PWV measurements in premenopausal women with SLE. Methods: We recruited 24 premenopausal women with SLE (SLE duration: 5.3±4.6 years) and 24 age- and sex-matched controls. Aortic PWV was determined by using an automatic device, the Complior Colson (France), which allowed on-line pulse wave recording and automatic calculation of PWV. Results: The carotid-femoral PWV (8.98±2.05 vs. 8.05±0.94 m/s), systolic blood pressure (117.08±17.12 vs. 106.87±11.96 mmHg), pulse pressure (45.62±11.91 vs. 38.33±9.04 mmHg), heart rate (81.41±9.20 vs. 71.12±10.32 beat/min) and serum glucose levels (89.68±8.12 vs. 73.80±10.72 mg/dl) were significantly higher in premenopa...
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Case report Triple therapy. Bad luck... or don’t we still know how to treat?
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A case of a 65 year old male with acute myocardial infarction treated with primary angioplasty and stent implantation is presented. Following infarction, the patient suffered twice from the in-stent thrombosis in spite of triple antiplatelet/anticoagulant therapy. The problem of recurrent restenosis in spite of optimal therapy is discussed. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Electrocardiogram of the month Proarrhythmic effect of propafenone in patients with atrial fibrillation and atrial flutter
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We present two cases of proarrhythmia after propafenone treatment. In the first case slowing of the flutter cycle length from 205 ms to 290 ms resulted in a change from well tolerated two to one atrioventricular conduction to one to one conduction with hypotension and presyncope. In the second case organization of atrial fibrillation to atypical atrial flutter and use-dependent left bundle branch block resulted in fast broad QRS tachycardia that mimicked ventricular tachycardia. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Editorial
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Original article Characteristics and prognosis of patients with decompensated right ventricular failure during the course of pulmonary hypertension
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Background: New therapies for pulmonary arterial hypertension have prolonged survival but simultaneously increased the number of hospital admissions because of decompensated right heart failure (DRHF). The optimal approach in DRHF has not been established yet. Aim: Analysis of clinical course of DRHF in a group of patients with pulmonary hypertension treated in a single referral centre. Methods: We retrospectively analysed 60 episodes of DRHF in 37 patients (29 females, mean age 44±17 years) with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension admitted to our hospital between 2005 and 2007. We assessed the cause of decompensation, vital signs at admission, functional class and laboratory values. We classified all episodes into four haemodynamic profil...
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Original article Gene polymorphisms and antigen levels of matrix metalloproteinase-1 in type 2 diabetes mellitus coexisting with coronary heart disease
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Background and aim: Diabetes mellitus is a major risk factor for coronary heart disease (CHD). Matrix metalloproteinases (MMPs) can play a pivotal role in the remodelling of extracellular matrix associated with the development of atherosclerosis. Therefore, the aim of the study was to compare the distribution of genotypes and frequency of alleles of two polymorphisms of the MMP-1 gene promoter, an A/G substitution and a 1G/2G insertion, in correlation with antigen levels of matrix metalloproteinase-1 (MMP-1) in type 2 diabetic patients with or without CHD as well as individuals with normal glucose level without CHD. Methods: Genotypes of 115 patients with type 2 diabetes mellitus (T2DM) and a subpopulation of 66 patients with coexisting CHD as well as 120 non-diabetic control subjects were...
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Original article Psychological and clinical problems in young adults with implantable cardioverter-defibrillators
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Conclusions: Patients with ICD have problems in different spheres of their activity (physical, psychological, and social). Such patients need to be informed appropriately about the ICD itself and its functioning. They should be granted psychological support from health professionals who are familiar with the specific problems of ICD recipients. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Original article Comparison of early and long-term impact of percutaneous transluminal renal artery angioplasty alone or with brachytherapy on renal function in patients with reno-vascular hypertension
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Conclusions: PTRA improves renal function in patients with ischaemic nephropathy. In long-term observation the positive effect of PTRA on renal function is especially visible in patients with ILBT after PTRA. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Original article The relationship between resting heart rate and atherosclerosis risk factors
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Conclusions: Resting heart rate is correlated with cardiovascular risk factors (body mass index, blood pressure, glucose and cholesterol level) and with high hsCRP. Heart rate is positively associated with hypertension, obesity and diabetes which indirectly confirms the autonomic nervous system contribution to the pathogenesis of these diseases. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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Case report Surgical correction of the Bland-White-Garland syndrome with anomalous origin of right coronary artery – a case report
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We report on the surgical treatment of an adult type BWG syndrome in a 59-year-old male patient. The reason for angiography was anginal pain which occurred 7 years prior to the operation. At that time patient did not agree to undergo surgery, however, symptom aggravation brought him to the hospital again. Because of the vessel anatomy the operator decided to implant a vein graft. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report From premature birth to cardiac surgery – severe heart failure due to infective endocarditis in pregnancy – a case report
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A 25-year-old woman, gravida 2, para 1, without any previous medical history was admitted to the hospital because of the signs and symptoms of fetal distress. After a caesarean section the woman developed an acute heart failure. Echocardiography demonstrated massive vegetations attached to aortic and mitral valves with their destruction. Surgical treatment was performed immediately. The postoperative period was complicated by chronic atrioventricular third degree heart block, requiring implantation of a pacemaker. Finally the woman was discharged from hospital and is followed regularly in the out–patient cardiac clinic. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Right atrial tumour in a patient with chest pain – a case report
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Intracardiac masses present an important problem in cardiology. Echocardiography became a main non-invasive diagnostic method in identifying these abnormalities. Most often there are thrombuses, less often – vegetations in course of infective endocarditis, and rarely – tumours or congenital abnormalities. This case report presents difficulties in diagnosing intracardiac mass in a 70-year-old female presenting with atypical chest pain. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Case report Oral contraceptives use increases venous thromboembolic risk even for minor surgical procedure – a case report
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A case of a 25-year-old woman with life-threatening pulmonary embolism, which occurred on fourth day after appendectomy and was safely treated with alteplase infusion. Before surgery, oral contraceptive use history, as a sole venous thromboembolic risk factor has been missed and the patient did not receive perioperative, pharmacologic antithrombotic prophylaxis. Further screening for thrombophilia was negative. This case proves that contraceptives use may create, irrespectively of the woman age, a possibility of perioperative thromboembolic complications, even for such minor procedure as appendectomy. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article Patophysiology of diastolic heart failure
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article Periodontal disease as a potential risk factor for cardiovascular diseases
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Review article The influence of ban on smoking on admissions due to acute coronary syndromes – a systematic review
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Electrocardiogram of the month Ventricular fibrillation in acute myocardial infarction – do genes play a role?
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We present two patients with ventricular fibrillation (VF) during acute myocardial infarction (AMI). First patient had torsade de pointes ventricular tachycardia episodes degenerating into VF 10 days after AMI treated with primary angioplasty. Second patient had multiple episodes of VF during the first day of AMI. He showed ST-segment elevation resembling Brugada pattern. We hypothesise that shape of ST-segment elevation during AMI might be important in assessing risk for VF. We propose that such ‘arrhythmogenic’ ST elevation might result more from systolic rather than diastolic current of injury during AMI. We discuss genetic predispositions (latent channellopathies) for VF during AMI. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Echocardiogram of the mont The Gerbode defect – a left ventricle to right atrium communication
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We report this case because this congenital defect is very rare, more often this pathology was reported after trauma, endocarditis or aortic valve replacement. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Angiogram of the month Subintimal recanalisation of chronic superficial femoral artery occlusion with the use of a re-entry system
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We report, for the first time in Poland, our use of the Outback catheter for a successful intraluminal re-entry. There were no procedure-related complications. We indicate that the Outback catheter can be used safely in case of an unsuccessful conventional re-entry to the true lumen artery. This catheter can allow reduction the time of the procedure and minimize potential complications. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Invasive electrophysiology Successful ablation of left atrial flutter with a single RF application in a patient after atrial fibrillation ablation – when is it possible?
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We describe a case of a 49-year-old patient with left atrial flutter after atrial fibrillation ablation. Left atrium activation map (CARTO) and entrainment mapping revealed local reentry on the posterior wall of the left atrium, close to the proximal coronary sinus. Arrhythmia was terminated with a single RF application and remained noninducible. However, after 6-weeks follow-up patient presented with a roof line and mitral isthmus – dependent atrial flutters which were successfully ablated. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Evidence-based cardilogy Badanie CHF AF. Commentary to the article: Roy D, Talajic M, Nattel S, et al. Atrial Fibrillation and Congestive Heart Failure Investigators. Rhythm control versus rate control for atrial fibrillation and heart failure. N Engl J Med 2008; 358: 2667-77.
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Editorial
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Cost-effectiveness of mini-circuit cardiopulmonary bypass in newborns and infants undergoing open heart surgery
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Conclusions: Miniaturisation of the extracorporeal circulation significantly improve post-operative outcome in infants undergoing open heart surgery. The mini-circuit significantly reduces cost of treatment in small children undergoing open heart surgery. (Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)
Original article Efficacy of intra-operative radiofrequency ablation in patients with permanent atrial fibrillation undergoing concomitant mitral valve replacement
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Background: Permanent atrial fibrillation (AF) is present before operation and persists after surgery in 30-40% of patients undergoing mitral valve surgery. Using the maze procedure, 75-82% of patients can be cured of AF, but the procedure is difficult and long lasting. Percutaneous radiofrequency (RF) ablation has emerged as an effective therapy for AF in recent years. Aim: To assess the efficacy of intra-operative RF ablation of AF in patients undergoing mitral valve surgery. Methods: 100 adults with permanent AF underwent mitral valve replacement. Patients were divided into two groups: the RF group – 50 patients qualified for mitral valve replacement and RF ablation; and the control group – 50 patients selected for mitral valve replacement without ablation. Odds ratio and 95...
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(Source: Articles of Polish Heart Journal - TERMEDIA publishing house)