[Use of fourier row as a method for analyzing the course of circadian heart rate in patients with left ventricular ejection fraction impairment]. / Zastosowanie szeregu Fouriera do analizy dobowego przebiegu akcji serca u pacjentów z uposledzeniem frakcji wyrzutowej lewej komory serca.

The circadian heart rate course was assessed in 3 groups of patients with left ventricular ejection fraction (LVEF) 10-15%, 20-25% and 30-35%. The study comprised 36 persons. In 9 patients heart failure was due to MI and in 17--to dilated cardiomyopathy. Those with atrial fibrillation, ventricular tachycardia, supraventricular tachycardia, diabetes, valvular heart diseases and with central system disorders were excluded from the study. Left ventricular ejection fraction was evaluated by echocardiography. Heart rate, calculated as a mean value every 5 minutes, was taken in patients during 24 hour recordings. For each patient separately, mean value of all measurement was calculated. Then a ratio of each actual value to the mean value was calculated. This ratio was defined as relative heart rate; [formula: see text] Circadian heart rate courses were approximated by Fourier row: [formula: see text]. The 24 harmonics were analyzed. Statistically significant differences in circadian courses were closed to amplitudes of 1st, 12th, 13th, 14th, 16th, 18th harmonics. Using test of variance homogeneity it has been demonstrated that variability of amplitudes of 12th and 17th harmonics as well as phase of 5th harmonic depend on left ventricular ejection fraction.

[Early results and many years of observing treatment of unstable angina]. / Wyniki wczesnej oraz kilkuletniej obserwacji leczenia zabiegowego niestabilnej choroby wiencowej.

Immediate effect of PTCA and CABG for unstable angina then followed-up for PTCA and CABG several years are analyzed in 112 patients selected out of 204 unstable angina patients hospitalized from 1990 to 1991. Fifty three patients, aged 25-68 (mean 51) were assigned to PTCA, fifty nine aged 33-69 (mean 53) were subjected to CABG. Both groups comprised of 72% and 83% males respectively. Nine patients with de novo angina, forty with crescendo angina and four with prolonged stenocardia were assigned to PTCA. 28% of patients have had myocardial infarction. Nine patients with de novo angina and fifty with crescendo angina were assigned to CABG. 56% of them have had myocardial infarction. Left ventricular ejection fraction (LVEF) less than 40% was found in 8 (15%) PTCA patients and in 18 (31%) patients who underwent CABG. Full revascularization was achieved in 38 (73%) patients treated with PTCA and 46 (78%) CABG patients. In 9/17% patients only critical stenosis in multivessel disease was subjected to PTCA. Four cases of myocardial infarction underwent intervention and all of these patients died: one (2%) after PTCA, and three (5%) after CABG. Fifty two patients after PTCA and fifty six after CABG were followed for one to four (mean 3) years. Thirty one percent of patients after PTCA and 41% after CABG were asymptomatic, 61% and 54% respectively had little to moderate symptoms. Left ventricular systolic function improved in most patients, predominantly in those with LVEF less than 40% (p < 0.05) treated with PTCA. Hospitalization due to anginal pain was needed in 46% of patients after PTCA and 15% after CABG (p < 0.05). Coronary artery restenosis after PTCA was successfully treated with re-PTCA or CABG in 9 (17%) patients. Venous graft stenoses were dilated in two cases. Myocardial infarction occurred in 3 (6%) patients after PTCA and 2 (4%) patients after CABG. One patient died after redilatation CABG treated patients required nonsignificantly less antianginal drugs. Four week survival rate in PTCA group and CABG group was 98% and 95% respectively; three year survival was 95% in both groups. We conclude, that unstable angina patients requiring either angioplasty or surgery may expect good procedural and long term prognosis. Remarkably good results may be expected in successfully revascularised patients with low ejection fraction.

[Congenital methemoglobinemia found in an adult. Case report]. / Methemoglobinemia wrodzona wykryta u doroslej chorej. Opis przypadku.

Cyanosis in a 36 year old patient which persisted 20 years after a successful surgical closure of her patent foramen ovale has been finally diagnosed as due to congenital methemoglobinemia: a 28% level of methaemoglobin and no activity od NAD-dependent methaemoglobin reductase were found. Erythrocyte antioxidative system was studied i.e. glutathione peroxidase, reductase, transferase, superoxidase dismutase and glucose-6-phosphate dehydrogenase. Increased activity was disclosed of superoxide dismutase and glucose-6-phosphate dehydrogenase in erythrocytes in comparison to normal individuals as well as increased concentration of lipid peroxidation products coexisting with methaemoglobin reductase deficiency.

[Value of endomyocardial biopsy in the assessment of the degree of the changes in myocarditis]. / Znaczenie biopsji endomiokardialnej dla oceny nasilenia zmian w stanach zapalnych miesnia sercowego.

Right ventricular diagnostic biopsy was performed in 25 patients (12 females and 13 males) aged 19-48 (mean 32) with suspicion of acute or subacute myocarditis for definitive diagnosis verification and to determine indications for therapy with corticosteroids or azathioprine. 3-4 specimens taken from different sites of ventricle were estimated under the light microscope according to Dallas classification distinguishing active myocarditis with or without fibrosis from borderline myocarditis with inflammatory infiltration not causing myocytes damage. Routine clinical and laboratory tests, echocardiographic examination, ECG Holter monitoring and nuclear examination to evaluate left ventricular ejection fraction were performed in all patients. 6 patients underwent coronarography to exclude atherosclerotic changes in coronary arteries. Bioptic examination result confirmed myocarditis suspicion in all patients. Active inflammation was stated in 18 patients including 7 with coexisting fibrosis. Borderline myocarditis was stated in 7 cases. Comparison of clinical examination results with those of pathomorphologic study made possible to state, that tachycardia, cardiac murmur, arrhythmias and left ventricular function impairment were frequent observed in the group of active myocarditis. Ejection fraction less than 30% was observed only in patients with active myocarditis and mainly in those with coexisting fibrosis. Based on performed study we consider that myocardial biopsy allows not only to diagnose myocarditis but also is helpful for lesion extent assessment in myocardium with all clinical implications.

Glycogen content in the brain stem neurons during hyperthermia in cats.

Using the histochemical method of McManus the authors investigated the glycogen content in neurons in the reticular formation of brain stem in animals subjected to hyperthermia. For comparison certain nuclei outside the reticular formation were tested in the same region. A significant fall in glycogen content of reticular formation neurons was observed in hyperthermic animals. Changes in the neurons outside the reticular formation were negligible.