Improved outcomes in survivors of cardiac arrest qualified for early coronary angiography: A single tertiary center study.

Introduction: Most cardiac arrests in adults are related to coronary artery disease (CAD), and the role of early invasive cardiology procedures remains unclear.

Aims: We investigated the prognosis for patients hospitalized for out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who were referred within 24 hours to a tertiary cardiology department, with a focus on the role of early coronary angiography (CA) and percutaneous coronary intervention (PCI).

Methods: This was an observational, single-center study using retrospective and prospective cohorts.

Inter- and Intraobserver Repeatability of Myocardial Flow Reserve Values Determined with SPECT Study Using a Discovery NM530c Camera and Corridor 4DM Software.

Background: Myocardial blood flow (MBF) and flow reserve (MFR) examination, especially useful in the diagnosis of multivessel coronary artery disease (CAD), can be assessed with a cadmium-zinc-telluride (CZT) SPECT gamma camera, as an alternative to the expensive and less available PET. However, study processing is not free from subjective factors. Therefore, this paper aims to evaluate intra- and interobserver repeatability of MBF and MFR values obtained by the same operator and two independent operators.

Treatment of chronic thromboembolic pulmonary hypertension in a multidisciplinary team.

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) may be treated with pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapy (MT). Assessment in a multidisciplinary team of experts (CTEPH team) is currently recommended for treatment decision making. The aim of the present study was to report the effects of such an interdisciplinary concept.

The feasibility and clinical implication of tricuspid regurgitant velocity and pulmonary flow acceleration time evaluation for pulmonary pressure assessment during exercise stress echocardiography.

Aims: Echocardiography can estimate pulmonary arterial pressure (PAP) from tricuspid regurgitation velocity (TRV) or acceleration time (ACT) of pulmonary flow. We assessed the feasibility of TRV and ACT measurements during exercise stress echocardiography (ESE) and their correlation in all stages of ESE.

Methods And Results: We performed ESE in 102 subjects [mean age 49 ± 17 years, 50 females, 39 healthy, 30 with cardiovascular risk factors, and 33 with pulmonary hypertension (PH)] referred for the assessment of exercise tolerance and ischaemia exclusion.

Arrhythmic manifestation of peripartum cardiomyopathy-Case report.

We report a case of 26-year-old woman, with arrhythmic manifestation of peripartum cardiomyopathy with moderate heart failure. Ventricular arrhythmia recorded in ambulatory Holter ECG (premature ventricular contractions) was most severe during pregnancy, reduced when beta-blocker therapy was initiated and almost completely resolved after delivery. Then, 1 year after hospitalization in Cardiology Department, recurrence was observed with recorded short episode of nonsustained ventricular tachycardia.

Diabetes as an independent predictor of left ventricular longitudinal strain reduction at rest and during dobutamine stress test in patients with significant coronary artery disease.

Aims: Diabetes (DM) is a strong cardiovascular risk factor modifying also the left ventricular (LV) function that may be objectively assessed with echocardiographic strain analysis. Although the impact of isolated DM on myocardial deformation has been already studied, few data concern diabetics with coronary artery disease (CAD), especially in all stages of dobutamine stress echocardiography (DSE). We compared LV systolic function during DSE in CAD with and without DM using state-of-the art speckle-tracking quantification and assessed the impact of DM on LV systolic strain.

Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher - Role of automated function imaging in diagnostic workflow.

Takotsubo cardiomiopathy (TTC) (known also as "ampulla cardiomyopathy," "apical ballooning" or "broken heart syndrome") is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise in cardiac troponin, and contractility abnormalities in echocardiography.

Preventive echocardiographic examination in athletes and workers - Quadricuspid aortic valve and atrial septal aneurysm in a young basketball player.

Ensuring safety of young athletes and employees who perform hard physical work within the scope of their professional duties, with a special focus on prevention of a sudden cardiac death at sports fields or during hard physical work is one of the most important tasks, which demands joint effort of cardiologists and sport physicians or occupational physicians, who qualify patients for a job or a sport discipline. Apart from hypertrophic and arhythmogenic right ventricular cardiomyopathy, coronary anomalies and aortic dissection belong to the most frequent causes of dramatic complications during competitive exercise or work with an increased energy expenditure. Although a detailed medical history and a physical examination combined with 12-lead ECG assessment may significantly improve the safety in competitive sports, adding echocardiography examination gives a detailed and noninvasive insight into the heart morphology and function.

Cardiotoxic effect due to accidental ingestion of an organic solvent.

Toxic myocardial injury can be misdiagnosed as a myocardial infarction, resulting in the patient undergoing standard treatment for cardiac rehabilitation. However, such inadequate therapeutic strategies can lead to cardiovascular complications including dilated cardiomyopathy. This study presents a case of a 65-year-old man after accidental ingestion of organic solvents (toluene and xylene), whose condition demonstrated all the criteria for diagnosis of myocardial infarction.

Feasibility and correlation of standard 2D speckle tracking echocardiography and automated function imaging derived parameters of left ventricular function during dobutamine stress test.

Speckle tracking echocardiography (STE) is a method of quantitative assessment of myocardial function complementary to ejection fraction and visual evaluation. Standard STE analysis, demands manual tracing of the myocardium whereas automated function imaging (AFI) offers more convenient (based on selection of three points) assessment of longitudinal strain. Nevertheless, feasibility and correlation between both methods were not thoroughly examined, especially during tachycardia at peak stage of dobutamine stress echocardiography (DSE).

Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention.

Background: Mean platelet volume (MPV) is a strong predictor of impaired angiographic reperfusion and 6-month mortality in ST-elevation myocardial infarction (MI) treated with primary percutaneous coronary intervention (PCI). No data is available for other platelet volume indices: platelet distribution width (PDW) and platelet large cell ratio (P-LCR). The aim was to assess the impact of 3 platelet volume indices on long-term prognosis in patients treated with primary PCI in acute MI.

Characteristics, management and five-year outcomes of patients with high risk, stable multivessel coronary heart disease.

Background: Multivessel coronary artery disease (MCAD) is a common manifestation of advanced coronary atherosclerosis.

Aim: To determine the clinical characteristics and long term follow up prognostic factors in patients with high risk, stable MCAD from a single institution.

Methods: We included in the final analysis 270 patients with stable MCAD.

[Critical stenosis left main coronary artery in 39-year-old woman treated with percutaneous angioplasty].

Isolated critical stenosis of left main coronary artery (LMCA) due to atherosclerosis is very rare and affects about 0.2% of patients. We present the case of a 39-year-old, non-smoker women with risk factors for diseases of the cardiovascular system in the form of hypercholesterolaemia and hypertension, in addition to positive family history and chronic oral contraception.

[Severe coronary artery disease in premenopausal woman with familial hypercholesterolaemia].

We present a case of a 51 year-old, premenopausal, non-smoker for many years woman with severe, two-coronary artery disease in the form of acute coronary syndrome (ACS), and severe hypercholesterolaemia as the predominant risk factor. The first clinical diagnosis of familial hypercholesterolaemia has been established at the time of diagnosis of ACS. Satisfactory effect of pharmacological treatment is achieved by a complex lipid-lowering therapy.

Influence of treatment strategy on serum adiponectin, resistin and angiogenin concentrations in patients with stable multivessel coronary artery disease after one-year follow-up.

Background: Adiponectin and resistin, as well as the novel angiogenetic factor angiogenin, may be associated with inflammation and atherosclerosis. However, the available data are limited regarding adipocytokines and angiogenesis factors long-term serum concentration changes in patients with coronary artery disease (CAD).

Aim: To evaluate the treatment strategy-dependent changes in serum concentrations of adiponectin, resistin and angiogenin in patients with stable multivessel CAD (MCAD) and their association with cardiovascular events.

Elevated resistin opposed to adiponectin or angiogenin plasma levels as a strong, independent predictive factor for the occurrence of major adverse cardiac and cerebrovascular events in patients with stable multivessel coronary artery disease over 1-year follow-up.

Background: Adipokines such as adiponectin and resistin, as well as angiogenin, may be associated with inflammation and atherosclerosis. The relationship between their levels and prognosis in high risk patients is, however, still unclear. The aim of this study was to evaluate the prognostic value of these adipokines in patients with stable multivessel coronary artery disease (MCAD).

Effect of intracoronary injection of mononuclear bone marrow stem cells on left ventricular function in patients with acute myocardial infarction.

To investigate the effect of intracoronary injection of autologous mononuclear bone marrow stem cells (BMSCs) in patients with ST-elevation myocardial infarction (STEMI) on left ventricular (LV) systolic and diastolic function using standard echocardiography and 2-dimensional systolic strain. A total of 60 patients with first anterior wall STEMI and LV ejection fraction of <40%, treated with successful primary percutaneous coronary intervention were randomly assigned to the treatment group (BMSC group) or the control group in a 2:1 ratio. Transcatheter intracoronary injection of BMSCs into the infarct-related artery was performed 7 days after STEMI.

Implantation of a Occlutech Figulla PFO occluder in a patient with patent foramen ovale and history of embolic stroke.

The most common interventions in structural heart diseases for various age groups are percutaneous occlusions of septal defects. We present the case of a woman with patent foramen ovale (PFO) periodically causing a right-to-left shunt, after an incident of stroke, with migraine attacks, treated by percutaneous closure of PFO with use of a novel occluder device--an Occlutech Figulla. The procedure was performed under X-ray and transesophageal echocardiographic monitoring.