[Diagnostic and prognostic significance of homocysteine determined in acute phase of myocardial infarction]. / Znaczenie rozpoznawczo-prognostyczne homocysteiny oznaczanej w ostrej fazie zawalu.

THE AIM: Of this study was to assess the serum homocysteine concentration in subjects with acute myocardial infarction and its correlation with the course of infarction and further prognosis considering particularly left ventricle dysfunction, heart rate and conduction disorders as well as to assess the usefulness of metionin load test as a prognostic test in patients with myocardial infarction. MATERIAL AND METHODS: 66 patients were studied: 36 with recent myocardial infarction and 30 healthy individuals as a control group. Fasting serum homocysteine and its concentration two hours after metionin load were determined in all patients. They all underwent echocardiographic examination, stress test and 24-hour Holter monitoring. The study revealed a significant positive correlation between increased serum homocysteine concentration in patients with myocardial infarction and worsening of contractility parameters, extent of infarction area, and negative correlation between homocysteine concentration and ejection fraction. CONCLUSIONS: On the basis of the study outcome we can make a statement that increased homocysteine concentration in patients with acute phase of myocardial infarction indicates its more severe course, more extensive disorders of myocardium kinetics, more significant left ventricle diastolic and systolic dysfunction. Increased serum homocysteine in metionin load test indicates higher death risk in patients with myocardial infarction.

[Remote repeatability of tilt test]. / Powtarzalnosc odlegla testu pionizacyjnego.

The aim of this study was the assessment of long-term repeatability of tilt-table test and parameters of heart rate variability analysis. Westminster protocol tilt-table test extended with nitroglycerin test was combined with analysis of heart rate variability. Five-minute intervals of ECG record were evaluated before and after the upright tilting, before syncope and 24-hour record was analysed. The test was performed in duplicate in 27 persons including 14 men (mean age 33 +/- 13.5) at interval of 29 +/- 13 months. The patients were then observed for 14 +/- 11.4 months. The study subjects were divided into groups with and without the recurrence of syncope. Repeatability was observed in 76.5% in positive test result and in 70% in negative test result. A low repeatability of positive test was observed. Blood pressure, heart rate and heart rate variability analysis parameters demonstrated a high repeatability during both tests. The recurrence of syncope was observed in 10 (37%) persons. The patients with both tilt tests positive, demonstrated recurrence of syncope two times more frequently what makes that the identification of the patients at risk for syncope return is easier.

[Selected inflammatory markers in patients with acute coronary syndrome]. / Wybrane wskazniki zapalenia u chorych z ostrymi zespolami wiencowymi.

The aim of the study was the assessment of selected inflammatory markers in patients with stable and unstable angina pectoris, in comparison to patients with dyslipidemia without coronary artery disease. The study group included 61 patients (37-79 years old), divided into three subgroups: group I. 26 (43%) with unstable angina, group 2. 19 (26%) with stable angina, group III. 16 (26%) dyslipidemia without coronary artery disease. We measured serum levels of cytokines (IL-1B, IL-1Ra, IL-2, IL-6, TNF-alpha), immunoglobulins (IgG, IgE, IgM), fibrinogen. C-reactive protein and subclass of lymphocytes T CD4 and T CD8. In stable and unstable angina pectoris group we found lower percentage of T CD4, T CD8 and higher level of TNF-alpha. In unstable angina group the level of IL-1 beta was lower and the concentration of C-reactive protein, IgE was higher in comparison to group without coronary artery disease. Observed immunoregulatory disorders confirm immune mechanism in the origin of unstable angina pectoris.