Analysis of the Results of the Borowiec SLR Station (7811) for the Period 1993-2019 as an Example of the Quality Assessment of Satellite Laser Ranging Stations.

This paper presents the results of an orbital analysis of satellite laser ranging data performed by the Borowiec SLR station (7811) in the period from July 1993 to December 2019, including the determination of the station positions and velocity. The analysis was performed using the GEODYN-II orbital program for the independent monthly orbital arcs from the results of the LAGEOS-1 and LAGEOS-2 satellites. Each arc was created from the results of the laser observations of a dozen or so selected stations, which were characterized by a large number of normal points and a good quality of observations. The geocentric and topocentric coordinates of the station were analyzed. Factors influencing the uncertainty of the measurements were determined: the number of the normal points, the dispersion of the normal points in relation to the orbits, and the long-term stability of the systematic deviations. The position leap at the end of 2002 and its interpretation in ITRF2014 were analyzed. The 3D stability of the determined positions throughout the period of study was equal to 12.7 mm, with the uncertainty of determination being at the level of 4.3 mm. A very high compliance of the computed velocity of the Borowiec SLR station (24.9 mm/year) with ITRF2014 (25.0 mm/year) was found.

Analysis of the Quality of SLR Station Coordinates Determined from Laser Ranging to the LARES Satellite.

The LARES (LAser RElativity Satellite) was built by the Italian Space Agency (ASI) and launched on 13 February 2012 by the European Space Agency. It is intended for studying the Lense-Thirring effect resulting from general relativity as well as for geodynamic studies and satellite geodesy. The satellite is observed by most ground laser stations. The task of this work is to determine the station coordinates and to assess the quality of their determination by comparison with the results from the LAGEOS-1 and LAGEOS-2 satellites. Observation results in the form of normal points (396,105 normal points in total) were downloaded from the EUROLAS Data Center for the period from 29 February 2012 to 31 December 2015. Seven-day orbital arcs were computed by the NASA GSFC GEODYN-II software, determining the coordinates of seventeen selected measuring stations. The average Root Mean Square (RMS) (15.1 mm) of the determined orbits is nearly the same as for LAGEOS (15.2 mm). The stability of the coordinates of each station (3DRMS) is from 9 mm to 46 mm (for LAGEOS, from 5 mm to 15 mm) with the uncertainty of determining the coordinates of 3-11 mm (LAGEOS 2-7 mm). The combined positioning for the LARES + LAGEOS-1 + LAGEOS-2 satellites allows for the stability of 5-18 mm with an uncertainty of 2-6 mm. For most stations, this solution is slightly better than the LAGEOS-only one.

Clinical features, etiology, and survival in patients with restrictive cardiomyopathy: A single-center experience.

BACKGROUND: Numerous prognostic factors have been proposed for cardiac amyloidosis (CA). The knowledge about other subtypes of restrictive cardiomyopathy (RCM) is scant. AIMS: This study aimed to elucidate the etiology and prognostic factors of RCM as well as assess cardiac biomarkers: high-sensitive troponin T (hs-TnT), growth differentiation factor-15 (GDF-15), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and soluble suppression of tumorigenicity 2, as mortality predictors in RCM. METHODS: We enrolled 36 RCM patients in our tertiary cardiac department. All patients were screened for CA. Genetic testing was performed in 17 patients without CA. RESULTS: Pathogenic or likely pathogenic gene variants were found in 86% of patients, including 5 novel variants. Twenty patients died, and 4 had a heart transplantation during the study. Median overall survival was 29 months (8-55). The univariate Cox models analysis indicated that systolic and diastolic blood pressure, GDF-15, hs-TnT, NT-proBNP, left ventricular stroke volume, the ratio of the transmitral early peak velocity (E) estimated by pulsed wave Doppler over the early mitral annulus velocity (e'), tricuspid annulus plane systolic excursion, early tricuspid valve annular systolic velocity, the presence of pulmonary hypertension, and pericardial effusion influenced survival (P <0.05). A worse prognosis was observed in patients with GDF-15 >1316 pg/ml, hs-TnT >42 ng/l, NT-proBNP >3383 pg/ml, and pericardial effusion >3.5 mm (Kaplan-Meier analysis, log-rank test, P <0.001). CONCLUSIONS: Genetic testing should be considered in every RCM patient where light-chain amyloidosis has been excluded. Survival remains poor regardless of etiology. Increased concentrations of GDF-15, hs-TNT, NT-proBNP, and pericardial effusion are associated with worse prognosis. Further studies are warranted.

Spectrum of transthyretin gene mutations and clinical characteristics of Polish patients with cardiac transthyretin amyloidosis.

BACKGROUND: Transthyretin amyloidosis (ATTR) is a rare, life-threatening systemic disorder. We present first findings on the cardiac hereditary ATTR in Poland. METHODS: Sixty-eight consecutive patients with suspected or known cardiac amyloidosis were evaluated, including blood tests, standard 12-lead electrocardiography (ECG) and transthoracic echocardiography. ATTR was confirmed histologically or non-invasively using 99mTc-DPD scintigraphy. Transthyretin (TTR) gene sequencing was performed. RESULTS: In 2017-2019, 10 unrelated male patients were diagnosed with hereditary ATTR. All patients had very uncommon TTR gene mutations: 7 patients had p.Phe53Leu mutation, 2 patients had p.Glu109Lys mutation and 1 patient had p.Ala101Val mutation. The age of onset ranged from 49 to 67 years (mean [SD] age, 58.7 [6.4] years). On ECG, most patients (70%) had pseudoinfarct pattern and/or low QRS voltage. The maximal wall thickness (MWT) on echocardiography varied considerably among the patients from moderate (16 mm) to massively increased (30 mm). Most patients (90%) had decreased left ventricular ejection fraction (mean [SD], 43 [11] %). On follow-up, we observed progressive heart failure in almost all cases. The first patient with p.Phe53Leu mutation died of heart failure, the second died suddenly, the third successfully underwent combined heart and liver transplant with 15 months survival from the surgery. The patient with p.Ala101Val mutation died of stroke. CONCLUSIONS: According to available data, this is the first time that the types of TTR mutations and the clinical characteristics of Polish patients with cardiac hereditary ATTR have been described. Previous literature data about Polish background in families with p.Phe53Leu mutation and the present results, suggest that this TTR mutation might be endemic in the Polish population.

Clinical efficacy of potassium canreonate-canrenone in sinus rhythm restoration among patients with atrial fibrillation - a protocol of a pilot, randomized, double -blind, placebo-controlled study (CANREN-AF trial).

BACKGROUND: Atrial fibrillation (AF) is the most frequent cardiac arrhythmia which increases the risk of thromboembolic complications and impairs quality of life. An important part of a therapeutic approach for AF is sinus rhythm restoration. Antiarrhythmic agents used in pharmacological cardioversion have limited efficacy and potential risk of proarrhythmia. Simultaneously, underlying conditions of AF should be treated (e.g. electrolyte imbalance, increased blood pressure, neurohormonal disturbances, atrial volume overload). There is still the need for an effective and safe approach to increase AF cardioversion efficacy. This randomized, double-blind, placebo-controlled, superiority clinical study is performed in patients with AF in order to evaluate the clinical efficacy of intravenous canrenone in sinus rhythm restoration. METHODS: Eighty eligible patients with an episode of AF lasting less than 48 h are randomized in a 1:1 ratio to receive canrenone or placebo. Patients randomized to a treatment intervention are receiving canrenone intravenously at a dose of 200 mg within 2-3 min. Subjects assigned to a control group obtain the same volume of 0.9% saline within the same time. The primary endpoint includes return of sinus rhythm documented in the electrocardiogram within 2 h after drug or placebo administration. Other endpoints and safety outcomes analyses, due to expected lack of statistical power, are exploratory. DISCUSSION: Current evidence supports renin-angiotensin-aldosterone system (RAAS) inhibition as an upstream therapy in AF management. Excess aldosterone secretion results in proarrhythmic effects. Among the RAAS inhibitors, only canrenone is administered intravenously. Canrenone additionally increases the plasma level of potassium, lowers blood pressure and reduces preload. It has been already used in primary and secondary hyperaldosteronism in the course of chronic liver dysfunction and in heart failure. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03536806. Registered on 25 May 2018.

[Pseudo atypical atrial flutter or atrial tachycardia dependent on complex substrate in a patient with univentricular heart after palliative operations - mapping and ablation]. / Rzekomo atypowe trzepotanie przedsionków czy czestoskurcz przedsionkowy zalezny od zlozonego podloza u chorej z sercem jednokomorowym po operacjach paliatywnych - opis ablacji.

We describe a case of persistent atrial tachycardia/flutter in a 19-year old female with corrected transposition of great arteries (ccTGA) and dual inlet left ventricle (DILV), treated with surgical palliative operations. The arrhythmia became persistent and symptomatic with dyspnea and severe cyanosis. During the EP study, the right atrial isthmus-dependent reentry was identified. In electroanatomical maps large areas of low voltage and electrical silence were localised. Due to these areas of slow conduction the isthmus dependent arrhythmia had long CL. Linear RF applications closed the isthmus, resulting in flutter termination. During 3 months of follow-up the patient remained free of arrhythmia.

[RF ablation of longstanding persistent atrial fibrillation in patient with familial dilated cardiomyopathy]. / Ablacja RF podloza dlugotrwale przetrwalego migotania przedsionków u chorego z rodzinna kardiomiopatia rozstrzeniowa odwraca zaawansowany remodeling serca--opis przypadku.

A vicious circle of interactions between dilated cardiomyopathy and longstanding persistent AF/AFL may cause symptoms of advanced congestive heart failure. In a 31-year-old patient with diagnosis of familial dilated cardiomyopathy and permanent AF lasting for five years, gradually decreased left ventricular ejection fraction (LVEF) and increased diameter of heart chambers - left ventricular diastolic dimension (LVdD) 7.7 cm, left atrium (LA) 5.4 cm, and LVEF 15% were noted. Pharmacological treatment was ineffective Successful RF ablation of AF/AFL substrate (CTI block, PVs isolation, CFAE ablation, roof and MIG line, CS applications) reversed symptoms of significant heart remodeling (LVdD 5.9 cm, LA 4.3 cm, LVEF 50%).

[Radiofrequency ablation of long standing persistent atrial fibrillation and post-incisional macroreentrant right atrial tachycardia in patient with advanced biventricular heart failure--case raport]. / Ablacja dlugotrwale przetrwalego migotania przedsionków oraz prawoprzedsionkowego czestoskurczu pokardiotomijnego u chorego z zaawansowana niewydolnoscia serca jako propozycja terapeutyczna - opis przypadku.

We present a case of a 54 year old male with a long-standing atrial fibrillation (AF) who was scheduled for cardiac transplantation due to the progression of heart failure. Previous treatment included pacemaker implantation, mitral valvuloplasty, a-v node modification using RF ablation, and pharmacological therapy. This time the patient underwent complex AF ablation which consisted of pulmonary vein isolation, mitral and left atrial roof line creation, cavo-tricuspid isthmus ablation and ablation of complex fractionated atrial electrograms, which resulted in restoration of sinus rhythm. Because of the right atrial post-incisional tachycardia the patient underwent second ablation session. This complex invasive approach occurred successful. The patient remains in sinus rhythm with improved left ventricular function and better NYHA class over a 12-month follow-up.

Can angiotensin II +1675 G/A type 2 receptor gene polymorphism be a marker of left ventricular hypertrophy in patients with aortic stenosis?

BACKGROUND AND AIM OF THE STUDY: Activation of the angiotensin II type 2 receptor (AT2R) gene lowers blood pressure, inhibits endothelial and smooth muscle proliferation, and modifies left ventricular hypertrophy (LVH) and fibrosis. Recently, several studies on the presence and importance of AT2R polymorphism for cardiovascular pathology have been reported. The study aim was to investigate any relationship between +1675 G/A AT2R polymorphism and the degree of LVH in patients with aortic stenosis (AS). METHODS: The influence of +1675 G/A AT2R gene polymorphism on AS severity, degree of LVH and systolic function was analyzed in 308 patients (185 men, 123 women; mean age 61.5 +/- 10 years) with significant AS. RESULTS: Due to chromosome X localization of the AT2R gene, the analysis was performed separately in males and females. The prevalence of genotypes was 32.8% for AA, 40.8% for AG, and 26.4% for GG in females; and 52.9% and 47.1% for the A and G alleles, respectively, in males. No correlation was found between +1675 G/A AT2R polymorphism and LVH. The only significant difference was a lower left ventricular ejection fraction (LVEF) and a greater end-systolic LV dimension in males carrying the A allele as compared to allele G carriers. The A allele was more frequently observed in patients with LVEF < 40%. In the multivariate analysis, presence of the A allele was significantly related to LVEF (adjusted for age, hypertension, coronary artery disease), although the impact was of borderline statistical significance (p = 0.04) and explained only 2% of LVEF variance. CONCLUSION: The study results indicate that the +1675 G/A AT2R gene polymorphism cannot be considered as a marker of LVH in patients with AS, but its negative influence on LVEF in A allele carriers may be considered as a marker of premature left ventricular decompensation in males.

[Arrhythmias originating from coronary sinus with multi-level conduction block as a cause of tachyarrhythmic cardiomyopathy reversed by successful RF ablation]. / Zespól ogniskowych tachyarytmii z zatoki wiencowej przyczyna kardiomiopatii, która ustapila po skutecznej ablacji ogniska.

A patient with a 6-year history of drug-resistant, recurrent arrhythmias (AT/AFL, single SVEBs, pairs and series) developed arrhythmogenic cardiomyopathy. Conduction block between coronary sinus (CS) and atria caused periodical change of tachycardia's rate. Successful RF ablation performed in the middle of CS at a place of spike potentials of a 284 ms CL. During a 6-years follow-up after ablation, ejection fraction increased from 38 to 59% and the quality of life improved significantly.

Impaired right ventricular function as a predictor of early mortality in patients with light­ chain cardiac amyloidosis assessed in a cardiology department.

INTRODUCTION    Light­chain (AL) amyloidosis is the most common cardiac amyloidosis. Despite progress in treatment, early mortality remains a substantial problem in these patients. OBJECTIVES    The aim of this study was to determine a clinical profile of patients diagnosed with AL amyloidosis in a cardiology department, as well as to define the cut­off point for early mortality and identify predictors of early mortality in this population. PATIENTS AND METHODS    The study included 30 patients (14 women; median age, 61.5 years) with AL amyloidosis confirmed by echocardiography and biopsy of 2 organs. RESULTS    Six patients were diagnosed with stage II amyloidosis according to the Mayo 2004 classification, and 24 patients-with stage III. Early mortality was defined as death during 102 days after diagnosis and was observed in 14 patients. Patients who died earlier were younger and more frequently reported a weight loss of more than 10 kg and orthostatic hypotension than patients who died later. Moreover, they had higher concentrations of high­sensitivity troponin T and N­terminal pro­B­type natriuretic peptide (NT­proBNP) and worse left and right ventricular (RV) contractility. In the Cox models, the age of less than 64 years, NT­proBNP levels exceeding 4968 pg/ml, RV end­diastolic diameter of less than 34 mm, and tricuspid annular plane systolic excursion lower than 13 mm were significant predictors of mortality within 102 days after diagnosis. CONCLUSIONS    We presented the results of the first Polish prospective noninterventional study on AL amyloidosis diagnosed in the cardiology department. We found that patients have advanced disease at the time of diagnosis. Younger age, impaired RV function, and higher concentrations of cardiac markers are predictors of worse prognosis.

[Partial papillary muscle ruptures complicating acute myocardial infarctions. Diagnosis by transesophageal echocardiography]. / Czesciowe pekniecie miesnia brodawkowatego w ostrym zawale miesnia sercowego--rozpoznanie przy uzyciu echokardiografii przezprzelykowej.

Partial papillary muscle rupture is a rare but fatal mechanical complication of acute myocardial infarction. Survival depends on prompt recognition and immediate medical and surgical therapy. The partial rupture of an anterolateral papillary muscle was clearly diagnosed by transgastric two-chamber view during TEE in a 64-year-old man who suffered from acute myocardial infarction.

The impact of transcatheter aortic valve implantation on left ventricular performance and wall thickness - single-centre experience.

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is a treatment alternative for the elderly population with severe symptomatic aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR). AIM: To assess the impact of TAVI on echocardiographic parameters of left ventricular (LV) performance and wall thickness in patients subjected to the procedure in a single-centre between 2009 and 2013. MATERIAL AND METHODS: The initial group consisted of 170 consecutive patients with severe AS unsuitable for SAVR. Logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 21.73 ±12.42% and mean age was 79.9 ±7.5 years. RESULTS: The TAVI was performed in 167 (98.2%) patients. Mean aortic gradient decreased significantly more rapidly after the procedure (from 58.6 ±16.7 mm Hg to 11.9 ±4.9 mm Hg, p < 0.001). The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively). Significant regression of interventricular septum diameter at end-diastole (IVSDD) and end-diastolic posterior wall thickness (EDPWth) was noted in early (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post-TAVI period (15.1 ±2.5 mm to 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm to 12.4 ±1.9 mm, p < 0.007, respectively). Significant paravalvular leak (PL) was noted in 21 (13.1%) patients immediately after TAVI and in 13 (9.6%) patients in follow-up (p < 0.001). Moderate or severe mitral regurgitation (msMR) was seen in 24 (14.9%) patients from the initial group and in 19 (11.8%) patients after TAVI (p < 0.001). CONCLUSIONS: The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR. The results of the procedure are comparable with those described in other centres.

Transcatheter aortic valve implantation in patients with bicuspid aortic valve: a series of cases.

BACKGROUND: Bicuspid aortic valve (BAV) has been considered a relative contraindication for transcatheter aortic valve implantation (TAVI). Due to more oval shape of the BAV annulus compared to tricuspid aortic valve, the procedure has been discouraged because of an increased risk of stent assembly displacement, uneven expansion, post-procedure paravalvular leakage, stent valve distortion, or other malfunction after implantation. For the same reasons patients with BAV have been excluded from the majority of clinical TAVI trials. AIM: To evaluate the efficacy and safety of TAVI in patients with BAV stenosis. METHODS: We analysed a group of 104 patients admitted to our institution for TAVI between January 2009 and May 2012. During pre-procedure evaluation, transthoracic and transoesophageal (TEE) echocardiography as well as angio-computed tomography (CT) scan were performed to assess aortic valve anatomy and morphology. Appropriate measurements and detailed analyses of imaging data have been accomplished to select optimal access site, prosthesis size as well as to plan the procedure. BAVs were recorded in seven patients (6.7%; mean age 77.7 years). These patients presented with severe symptomatic aortic valve stenosis with a mean aortic valve area of 0.55 cm² (0.46-0.7 cm²) as measured in TEE. All of the patients had been disqualified from surgical valve replacement due to high surgical risk with a mean logistic Euroscore of 19.9%. All of them successfully underwent TAVI using CoreValve (n = 5) or Sapien (n = 2) valves. Follow-up was completed at 30 days, and six and 12 months after the procedure. RESULTS: During follow-up one patient developed an elliptic distortion of the aortic prosthesis in CT, although it did not result in significant malfunctioning of the implant. One patient died of infective endocarditis 30 days after the procedure. Survivors at 30-day follow-up had mild to moderate aortic insufficiency, and it did not deteriorate after six months. At one year follow-up six out of seven patients remained alive. They achieved significant functional improvement by New York Heart Association class compared to baseline. CONCLUSIONS: TAVI may constitute an alternative treatment option for high-risk patients with BAV, resulting in a low periprocedural mortality rate, and good 30-day, six-month, and one-year outcomes.

Prediction of paroxysmal atrial fibrillation after aortic valve replacement in patients with aortic stenosis: identification of potential risk factors.

BACKGROUND AND AIM OF THE STUDY: Paroxysmal atrial fibrillation (AF) is a frequent complication after cardiac surgery. The study aim was to identify preoperative predictors of risk for this condition in patients with aortic stenosis after aortic valve replacement. METHODS: The influence of clinical, echocardiographic and 24 h electrocardiogram (ECG) parameters on episodes of paroxysmal AF after aortic valve replacement (AVR) in 423 patients (156 women, 267 men; mean age 58 +/- 10 years) with aortic stenosis was analyzed. Episodes of postoperative paroxysmal AF were noted in 120 patients (28%). RESULTS: Univariate analyses identified the following variables as risk factors for arrhythmia: age, NYHA functional class, history of preoperative paroxysmal AF, left ventricular mass index, >300 supraventricular beats on 24h ECG before surgery, presence of supraventricular tachycardia (SVT), SVT of >5 beats or with a rate >120 beats/min. Concomitant coronary artery bypass (CABG) grafting and presence of enlarged left atrium had no impact. By multivariate analysis, four variables were identified as independent predictors: age (odds ratio 1.7; 95% CI 1.2-2.1); history of paroxysmal AF (OR 3.2; CI 1.4-7.3); presence of >300 supraventricular beats/24 h (OR 1.9; CI 1.1-3.4); and presence of SVT (OR 2.1; CI 1.3-3.4). Discriminatory analysis revealed that a model comprising these four parameters enabled risk prediction in 68% of patients. CONCLUSION: In patients with isolated aortic stenosis, age, past history of paroxysmal AF episodes, >300 supraventricular beats/24 h and presence of SVT during 24 h before AVR were predictors of postoperative paroxysmal AF episodes. Left atrial diameter and simultaneous CABG during AVR did not influence the likelihood of postoperative paroxysmal AF.

Influence of ACE I/D genotypes on left ventricular hypertrophy in aortic stenosis: gender-related differences.

BACKGROUND AND AIM OF THE STUDY: Factors responsible for cardiac hypertrophy in patients with aortic stenosis (AS) are not well defined. The study aim was to examine the relationship between angiotensin-converting enzyme (ACE) I/D polymorphism and the degree of cardiac hypertrophy in patients with AS. METHODS: A total of 392 white patients (159 women, 233 men; age range: 32-82 years) with AS was analyzed, with clinical data, echocardiographic parameters and ACE I/D polymorphism being assessed. RESULTS: Left ventricular mass index (LVMI) and wall thickness (LVWT) were greater in men than in women (226 +/- 66 versus 200 +/- 68 g/m2, p <0.0001; and 28.4 +/- 4.5 versus 27.3 +/- 4.1 mm, p = 0.02, respectively). In all patients, LVMI was significantly correlated with the maximal aortic gradient, ejection fraction and gender, whereas LVWT was dependent upon maximal aortic gradient, ejection fraction, gender and history of hypertension. In women, cardiac hypertrophy increased with age. Hypertrophy in women aged <66 years correlated with an absence of the DD genotype. In men, a reverse correlation of both LVMI and LVWT with age was observed (higher in younger patients). The presence of a DD genotype in men seemed to have a significant impact on the degree of cardiac hypertrophy. CONCLUSION: The degree of left ventricular hypertrophy in patients with AS was higher in men than in women. ACE I/D polymorphism appeared to have a modulating impact on cardiac hypertrophy in patients with AS, notably those aged <66 years. A higher degree of cardiac hypertrophy was seen in men with the DD genotype, and in women without the DD genotype.

Changes in the response of hibernated myocardium to inotropic stimulation after angioplasty: a Doppler myocardial imaging study.

BACKGROUND: Angioplasty of an infarct related artery (IRA) performed several weeks or months after myocardial infarction (MI) may improve myocardial function. HYPOTHESIS: We hypothesized that, as Doppler myocardial imaging (DMI) allows for the quantitative assessment of the systolic movement of myocardial segments, it may be a sensitive method for assessing changes in regional myocardial contraction and contractile reserve pre and post angioplasty of the IRA. METHODS: In all, 39 patients (30 men, mean age 53.4 +/- 8.3 years), 1 to 6 months after MI, who qualified for IRA angioplasty on the basis of myocardial viability in the infarcted zone as demonstrated by dobutamine stress echocardiography, were included in the study. Peak regional myocardial systolic velocities (S wave) of the infarcted segments were measured at rest and during low-dose dobutamine infusion (15 microg/kg/min) 1 day before angioplasty (Exam 1), 2 to 5 days (Exam 2), and 30 days (Exam 3) after successful angioplasty. The long-axis movement of the mitral annulus and of the basal and medial segments of the posterior (20 patients), anterior (17 patients), and lateral walls (2 patients) was evaluated. RESULTS: At rest, S-wave velocity of the infarcted segments increased between Exams 1 and 2, without further improvement between Exams 2 and 3 (4.9 +/- 1.2 vs. 5.6 +/- 1.3 cm/s, p < 0.05 and 5.6 +/- 1.3 vs. 5.5 +/- 1.3 cm/s, NS, respectively). However, S-wave velocities measured during low-dose dobutamine infusion differed significantly both between Exams 1 and 2, and 2 and 3 (7.0 +/- 1.5 vs. 7.8 +/- 1.8 cm/s; p < 0.01; 7.8 +/- 1.8 vs. 8.5 +/- 1.6 cm/s; p < 0.05). CONCLUSIONS: Resting contractility at an infarct zone demonstrated rapid initial improvement after angioplasty of the IRA with no further change, whereas contractile reserve improved not only immediately after angioplasty but also during the next month.

[Univentricular heart, common atrium, single atrio-ventricular valve--is it possible in humans?]. / Czynnosciowo wspólny przedsionek i pojedyncza komora, pojedyncza zastawka przedsionkowo-komorowa. Czy to mozliwe u czlowieka? Opis dwóch przypadków.

Two extremely rare cases of adults with univentricular hearts of right ventricular morphology are presented. Pathogenesis and pathophysiology of univentricular circulation as well as anatomic variants, short information on prognosis and management are briefly discussed. Echocardiographic diagnosis of univentricular heart is described. The first case was a 23-year-old housewife with univentricular heart, functionally common atrium, single atrio-ventricular valve of tricuspid morphology, transposition of great arteries and significant subvalvular pulmonary stenosis. The second case was a 19-year-old student with univentricular heart with moderately depressed systolic function, common atrium, single atrio-ventricular valve of tricuspid morphology, mitral atresia, and non-communication residual left ventricle. Both patients led a normal life with little to moderate limitations of everyday activity.