Advanced Glycation End-Products (AGEs) and Their Soluble Receptor (sRAGE) in Women Suffering from Systemic Lupus Erythematosus (SLE).

Systemic lupus erythematosus (SLE) is characterized by abnormal action of the immune system and a state of chronic inflammation. The disease can cause life-threatening complications. Neoepitopes arising from interdependent glycation and oxidation processes might be an element of SLE pathology. The groups included in the study were 31 female SLE patients and 26 healthy female volunteers (the control group). Blood serum samples were obtained to evaluate concentrations of advanced glycation end-products (AGEs), carboxymethyllysine (CML), carboxyethyllysine (CEL), pentosidine, and a soluble form of the receptor for advanced glycation end-products (sRAGE). Compared to a healthy control group, the SLE patients exhibited a higher concentration of AGEs and a lower concentration of sRAGE in serum. There were no statistically significant differences in serum CML, CEL, and pentosidine concentrations between the groups. Therefore, SLE patients could be at risk of intensified glycation process and activation of the proinflammatory receptor for advanced glycation end-products (RAGE), which could potentially worsen the disease course; however, it is not clear which compounds contribute to the increased concentration of AGEs in the blood. Additionally, information about the cigarette smoking and alcohol consumption of the study participants was obtained.

Systemic lupus erythematosus and glycation process.

Systemic lupus erythematosus (SLE) is a disease of unclear causes, which leads to major immunological disorders. It is characterized by an abnormal immune system activity resulting in the production of autoantibodies. In patients, antibodies targeting normal nuclear components, double-stranded DNA (dsDNA), and phospholipids (cardiolipin) can be detected. The inflammatory process occurs in various tissues and organs, damaging their functions and structure. Disease's course includes stages of acute symptoms and remissions, and there is no known cure. Pathogenesis and biochemical pathways accompanying systemic lupus erythematosus are widely studied, as existing medication can only bring temporary relief to patients. The recent findings suggest that occurrence of SLE depends on interactions between genetic background of the disease and environmental risk factors such as exposure to tobacco smoke, chemical factors, and hormonal therapy. In the addition, chronic inflammation accompanying SLE disturbs oxidative/antioxidative balance. These processes are linked to intensified advanced glycation end products (AGEs) formation, thus level of AGEs themselves and their receptors (RAGE, sRAGE) are gaining researches attention.

Common origin of all three coronary arteries from the right sinus of Valsalva - first case study accompanied by mitral valve prolapse and vein anomaly, second case study followed by successful percutaneous coronary intervention of right coronary artery stenosis.

Congenital anomalies of the coronary arteries can be divided into two broad categories: those that alter myocardial perfusion and those that do not. In coronary anomalies not altering myocardial perfusion, the coronary arteries originate from the aorta, but their origins are in unusual positions. Although myocardial perfusion is normal, the angiographer may have trouble locating them. Patients with an anomalous left main coronary artery arising from the right sinus of Valsalva are presented. The diagnosis was made by coronary angiography, transesophageal echocardiography and multislice computed tomography (MSCT). We present two cases: the first patient with coronary abnormalities had accompanying venous anomaly of lower extremities and mitral valve prolapse as well. The second patient had a history of anterior wall myocardial infarction and angioplasty with stent implantation. The extraordinary passage of the left coronary artery between the pulmonary trunk and sternum, undetectable in coronarography, was discovered due to MSCT.

Left atrial myxoma in a patient with a biventricular pacemaker.

Myxomas make up about 50% of benign cardiac neoplasms. The most common location is within the left atrium. At the initial stage they do not exhibit any specific clinical symptoms, so they are often diagnosed by accident or during examinations recommended for other reasons. Here we present a case of left atrium myxoma in a patient (a man, age 68 years) with a dual chamber pacemaker. The myxoma did not reveal any clinical symptoms and was discovered in echocardiography during routine diagnostic examination preceding pacemaker implantation. The literature search made by the authors showed that this is the first recorded case of myxoma in a patient after the implantation of a biventricular pacemaker.

Clinical Significance of Viral Genome Persistence in the Myocardium of Patients with Dilated Cardiomyopathy.

BACKGROUND: The impact of myocardial viral persistence on the clinical outcome of patients with dilated cardiomyopathy (DCM) is still open to question. METHODS: Fifty-two patients with DCM were enrolled and followed for a median of 3.8 years with respect to death or heart transplantation. Studied patients were clinically stable for at least 6 months before hospitalization. They underwent coronary angiography and endomyocardial biopsy. Specimens were examined by histo- and immunohistochemistry, and the viral genomes of parvovirus B19, cytomegalovirus (CMV), Coxsackie B virus (CVB), and hepatitis B and C viruses were studied by real-time polymerase chain reaction. RESULTS: Forty-two out of 52 patients were available for clinical follow-up. The viral genome was detected in the myocardium of 32 out of 42 patients. Among the viruses studied, CMV and CVB were the most frequently found. Nine out of 42 patients achieved the predefined study end point. No statistically significant correlation was found between the presence of a persistent viral genome and study end point. No statistically significant relationship between viral genomes studied and immunohistology results was detected. CONCLUSIONS: High prevalence of a viral genome in the myocardium of patients with DCM did not have an influence on their long-term clinical outcome.

Evaluation of the intima-media complex in patients with systemic lupus erythematosus.

THE AIM OF THE STUDY: The aim of the study was to determine whether there are any differences in the intima-media thickness (IMT) of carotid arteries between the group of patients with systemic lupus erythematosus (SLE) and the control group, and whether these differences are a consequence of SLE or independent factors of atherosclerosis development. MATERIAL AND METHODS: The patients were divided into three groups: the study group (n = 25, mean age: 39.8 years) consisting of patients suffering from SLE; the subgroup (n = 13, mean age: 39.2 years) consisting of patients suffering only from SLE without any accompanying diseases; and the control group (n = 25, mean age: 37.1 years) consisting of healthy patients (not suffering from SLE or any other disease of the connective tissue). The IMT of the left and right common carotid arteries (LCCA, RCCA) was measured by means of ultrasound. RESULTS: The analysis performed with the Mann-Whitney U test showed that a statistically significant difference of IMT occurs between the control group and the study groups (p = 0.006 for LCCA and p < 0.001 for RCCA), while there is no such relation (p = 0.86 for RCCA and p = 0.095 for LCCA) between the control group and the subgroup. CONCLUSIONS: The group of patients with SLE was found to have an increased IMT in comparison with the reference group. The unfavorable influence of independent factors of atherosclerosis development on the increase of the IMT value in patients with lupus was thus indicated. This observation suggests a faster atherosclerotic process in this group of patients.

Analysis of myocardial infarction time course in women compared with men in Upper Silesia population in 30 day follow-up.

The aim of the study was to compare the course of myocardial infarction in women versus men in Upper Silesia, an industrial region in the south of Poland. The study comprised 1003 patients with either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). The patients were divided into group 1 (300 females) and group 2 (control, 703 males). The groups differed significantly with respect to age, incidence of hypertension, diabetes, and smoking. In group 1 STEMI occurred significantly less frequently than NSTEMI. Taking this into account, we divided the studied cohort into group A (STEMI patients) and group B (NSTEMI patients), each subdivided into women and men. In the 30 day long follow-up, group 1 patients had significantly lower creatine kinase activity, higher occurrence of ventricular tachycardia, lower percentage of intra-aortic balloon pump use, and longer hospital stay compared with group 2. Group 1 was characterized by significantly higher mortality and target lesion reocclusion (TLR). The medical course of myocardial infarction in women is similar to that in men, as is the treatment of acute coronary syndrome. In our study, patients from both groups underwent invasive examination with consecutive interventional treatment with similar frequency. However, this finding is not reflected in the outcomes. Women had higher risks of death and TLR in 30 day follow-up. Taking this into consideration, we should attempt to identify the factors responsible for this situation by expanding the analysis to a larger population to allow firm conclusions to be drawn.

[The importance of bisoprolol in prevention of heart left ventricular hypertrophy in patients with long term L-thyroxin suppressive therapy, after the operation of differentiated thyroid carcinoma]. / Znaczenie bisoprololu w profilaktyce przerostu miesnia sercowego u chorych leczonych supresyjnie L-tyroksyna po operacji zróznicowanego raka tarczycy.

INTRODUCTION: Patients with differentiated thyroid carcinoma have to undergo radical surgical treatment, which includes total thyreoidectomy, radioiodine therapy and a life-time suppressive therapy with L-thyroxine. The aim of this study was a prospective evaluation of left ventricular hypertrophy during L suppressive-thyroxine treatment in patients treated for differentiated thyroid carcinoma. MATERIAL AND METHODS: The examined group comprised 50 patients with differentiated thyroid carcinoma, treated by total thyroidectomy and 131I therapy. Echocardiographic measurements were needed for estimation of left ventricular mass and its index, according to recommendations of American Echocardiography Society. RESULTS: During two-years long suppressive therapy we observed a significant rise in left ventricular mass. In woman group left ventricular mass was increased from 168+/-39 g to 204+/-45 g (p<0.001) and in men from 205+/-60 to 320+/-21 g. Likewise, left ventricular mass index was increased in women group from 96+/-18 g/m(2) to 116+/-25 g/m(2) (p<0.001) and in men group from 107+/-37 g/m(2) to 158+/-28 g/m(2). Simultaneous treatment with bisoprolol caused a regression of left myocardial hypertrophy. Already after 6 months of simultaneous treatment with L-thyroxin and bisoprolol, for left ventricular mass was reduced to normal: in woman 165+/-35 g, and in men to 178+/-38 g. Analogous results were obtained left ventricular mass index. After 6 months it was reduced to 94+/-12 g/m(2) in woman and in men to 132+/-32 g/m(2). CONCLUSIONS: 1. In differentiated thyroid cancer patients, treated postoperatively with L-thyroxine suppressive therapy, left ventricular hypertrophy is observed already during the first year of suppressive therapy and progresses during the next year of treatment. 2 Addition of a beta-adrenergic antagonist to suppressive doses of L-thyroxine causes a regression of left ventricular hypertrophy, thus, beta-adrenergic antagonists should be administered in this group of patients.