Soluble Guanylyl Cyclase Activators-Promising Therapeutic Option in the Pharmacotherapy of Heart Failure and Pulmonary Hypertension.

Endogenous nitric oxide (NO)-dependent vascular relaxation plays a leading role in the homeostasis of the cardiovascular, pulmonary, and vascular systems and organs, such as the kidneys, brain, and liver. The mechanism of the intracellular action of NO in blood vessels involves the stimulation of the activity of the soluble cytosolic form of guanylyl cyclase (soluble guanylyl cyclase, sGC), increasing the level of cyclic 3'-5'-guanosine monophosphate (cGMP) in smooth muscle and subsequent vasodilation. In recent years, a new group of drugs, soluble guanylyl cyclase stimulators, has found its way into clinical practice. Based on the CHEST-1 and PATENT-1 trials, riociguat was introduced into clinical practice for treating chronic thromboembolic pulmonary hypertension (CTEPH). In January 2021, the FDA approved the use of another drug, vericiguat, for the treatment of heart failure.

[Alcohol and wine and cardiovascular diseases in epidemiologic studies]. / Alkohol i wino a choroby ukladu sercowo-naczyniowego w swietle badan epidemiologicznych.

Moderate alcohol intake is associated with lower risk of cardiovascular diseases. A large number of epidemiologic studies have demonstrated a U- or J-shaped relation between alcohol consumption and total mortality, coronary heart disease and ischemic stroke. The lowest risk occurs in those who drink one or two drinks per day. Many studies have dealt with the question if specific alcoholic beverage (vodka, beer, wine, liquor) might offer a greater protection. Red wine containing polyphenols is believed to possess exceptional cardioprotective properties, especially if consumed with meals. However, alcohol beverages should not be recommended to patients as a substitute for the well-proven, cardiovascular risk reducing alternatives such as low fat diet, exercise and pharmacotherapy.

[High-risk pulmonary embolism in early post-operative period]. / Zator tetnicy plucnej wysokiego ryzyka u pacjenta we wczesnym okresie pooperacyjnym.

High risk pulmonary embolism remains a major diagnostic and therapeutic challenge. One of the most difficult clinical situation is pulmonary embolism in patients in early postoperative period as most of them has contraindication to fibrinolysis. In this paper we present the case of patient with thrombophilia and pulmonary embolism diagnosed on the third day after cancer-related laparoscopic prostatectomy. Patient was successfully treated by means of percutaneous catheter thrombus defragmentation and intraarterial infusion of the reduced dose of alteplase.