Non-invasive diagnosis of coronary-subclavian steal: role of the Doppler ultrasound.

Coronary subclavian steal syndrome (CSSS) is a well documented cause of graft function failure in patients after left internal mammary artery (LIMA)--left anterior descending (LAD) coronary artery grafting. We present a case of the CSSS in a patient with cardiac arrest due to ventricular fibrillation. To our knowledge such a case has not yet been described. Patient with a history of LIMA-LAD grafting, complaining only of a mild chronic exertional dyspnoea developed ventricular fibrillation while walking outdoor. After successful resuscitation, blood pressure difference between both arms and abnormal LIMA flow with systolic reversal flow on the Doppler ultrasonography were suggestive of CSSS. Angiography proved the left subclavian artery (LSA) occlusion and coronary angiography confirmed reversal flow in the LIMA graft. Successful percutaneous transluminal angioplasty of the LSA re-established normal LIMA flow and improved the left ventricular hypokinesis and systolic function.

Antioxidant vitamin levels do not exhibit negative correlation with the extent of acute myocardial infarction.

Serum levels of vitamin E (VE), beta-carotene (BC) and vitamin C (VC) were determined in 50 patients with the first acute myocardial infarction (AMI) before starting thrombolytical treatment. VE and BC were determined by HPLC, VC spectrophotometrically. The reperfused patients were divided according to vitamin concentrations into four groups. The lowest quartile was compared with the rest of the studied population (VE: group with high (H)>15.6 microM>group with low (L), BC: H>0.07 microM>L, VC: H>25 microM>L) in the following parameters: extent of myocardial damage (area under the curves of troponin I, CK-MB during 48 h), arrhythmia and congestive heart failure occurrence, size of ejection fraction, positivity of ventricular late potentials. No significant differences between groups H and L for either VE, BC or VC were found (P 0.05). As no correlation between serum concentrations of vitamins E, C and beta-carotene and the extent and clinical course of AMI was found, the actual vitamin concentrations may be important for prevention of ischemic heart a disease, but they do not play a decisive role in the acute phase of myocardial infarction in humans.

Antioxidant vitamin pool in senior population.

AIM: To compare plasma concentration of alpha-tocopherol and ascorbic acid in healthy seniors (age over 65 years), senior patients with either diabetes mellitus, acute myocardial infarction or dyslipidemia and recommended values of these vitamins. METHODS: Studied groups included 30 patients with diabetes mellitus (DM); 30 patients 1 - 2 weeks after acute myocardial infarction (AMI); 11 patients with lipid metabolism disorder (LD, total cholesterol > 6.2 mM); and control group of 27 healthy persons. RESULTS: Concentration of alpha-tocopherol in DM group was 14.6 +/- 5.3 microM, in AMI group 13.7 +/- 5.6 microM, in LD group 15.9 +/- 5.6 microM and in control group 12.9 +/- 4.1 microM. No statistically significant differences were found. However, comparison of determined values with levels recommended for prevention revealed remarkable low plasma concentration of alpha-tocopherol in the Czech population. Plasma concentration of ascorbic acid in DM group was 47.07 +/- 22.80 microM, in AMI group 33.15 +/- 12.81 microM, in LD group 45.59 +/- 23.02 microM and in control group 43.28 +/- 26.57 microM. No statistically significant differences were found between the controls and individual groups of patients. Plasma concentrations of vitamin C reached the recommended value in all cases except the AMI group, where it was significantly lower. CONCLUSION: Seniors in the Czech population were proved to be significantly short of alpha-tocopherol, minor shortage of vitamin C was found only in group of patients with myocardial infarction.

Antioxidant vitamin levels and glutathione peroxidase activity during ischemia/reperfusion in myocardial infarction.

The consequences of increased oxidative stress, measured as the level of malondialdehyde (MDA) during ischemia/reperfusion, were studied in 48 patients in the acute phase of myocardial infarction (AMI) and a control group (21 blood donors). The serum levels of alpha-tocopherol and beta-carotene were followed. Immediately after the treatment onset the level of alpha-tocopherol started to decrease, reaching a plateau after 24 h. The consumption of beta-carotene was delayed by 90 min. Steady decline was detected during the whole time interval studied (48 h). Glutathione peroxidase (GPx) activity, as a representative of antioxidant enzymes, was estimated in whole blood. The influx of oxygenated blood was accompanied by a stimulation of GPx activity, which reached its maximum at the time of completed reperfusion. When comparing the AMI patients with the control group, the levels of MDA were found significantly increased, which indicates that oxidative stress is already increased during ischemia. Lower antioxidant levels found in the patients might either already be the result of vitamin consumption during ischemia or be a manifestation of their susceptibility to AMI. Monitored consumption of alpha-tocopherol and beta-carotene during reperfusion indicated that in the case of patients, whose level of antioxidant vitamins is below the threshold limit, a further substantial decrease of antioxidant vitamins during reperfusion could enhance the oxidative damage of the myocardium.

Selective antioxidant enzymes during ischemia/reperfusion in myocardial infarction.

The study of ischemia/reperfusion injury included 25 patients in the acute phase of myocardial infarction (19 perfused, 6 remained non-reperfused as evaluated according to the time course of creatine kinase and CK-MB isoenzyme activity) and a control group (21 blood donors). Plasma level of malondialdehyde was followed as a marker of oxidative stress. Shortly after reperfusion (within 90 min), a transient increase of malondialdehyde concentration was detected. The return to the baseline level was achieved 6 h after the onset of therapy. The activity of a free radical scavenger enzyme, plasma glutathione peroxidase (GPx), reached its maximum 90 min after the onset of treatment and returned to the initial value after 18 h. The specificity of the GPx response was confirmed by comparing with both non-reperfused patients and the control group, where no significant increase was detected. The erythrocyte Cu,Zn-superoxide dismutase (SOD) did not exhibit significant changes during the interval studied in perfused patients, probably due to the stability of erythrocyte metabolism. In non-reperfused patients, a decrease of SOD was found during prolonged hypoxia. These results help to elucidate the mechanisms of fast activation of plasma antioxidant system during the reperfusion after myocardial infarction.

Stereoselectivity in the synthesis of unnatural disaccharides.

The synthesis of branched-chain sugars with two hexose moieties linked by a -CH2- bridge in the positions (3-->3) is described. The synthesis starts from protected 3-deoxy-3-(formylmethyl)-alpha-D-allofuranose in which the original formyl group is converted in four reaction steps into a new hexopyranose of D- or L-configuration. The relative configuration of the prepared compounds was determined on the basis of coupling constants in the 1H NMR spectra whereas the absolute configuration of the newly created pyranose was unequivocally assigned by single crystal X-ray crystallography of the 3-deoxy-3-[(2R,4R,5S,6R)-2-ethoxy-5-acetoxy-6- acetoxymethyl-tetrahydropyran-4-ylmethyl]-1,2:5,6-di-O-isopropylid ene- alpha-D-allofuranose (10).

An ecological study of determinants of coronary heart disease rates: a comparison of Czech, Bavarian and Israeli men.

BACKGROUND: The large differences in cardiovascular disease rates between Eastern and Western Europe have largely developed over the last few decades, and are only partly explained by classical risk factors. This study was set up to identify other potential determinants of these differences. METHODS: This was an ecological study comparing random samples of men aged 45-64 years selected from three cities representing populations with different rates of cardiovascular mortality: Pardubice (Czech Republic), Augsburg (Bavaria, Germany), and Jerusalem (Israel). In total, 191 (response rate 70%), 153 (70%) and 162 (62%) men, respectively, participated. All centres followed the same study protocol. Lifestyle, anthropometry and biochemical risk factors were assessed by identical questionnaires, standardized medical examination, and central analyses of fasting blood samples. RESULTS: The mortality rates in the study populations, as well as the prevalence of coronary heart disease in study samples, were highest in Czech, intermediate in Bavarian and low in Israeli men. This pattern was replicated across the three samples by mean blood pressure (P < 0.001), cigarette smoking (not significant), triglycerides (P < 0.05), fibrinogen or D-dimer levels (P < 0.05). On the other hand, the prevalence of diabetes and obesity were similar; total and high density lipoprotein (HDL)-cholesterol, apolipoprotein B, lipoprotein (Lp(a)) and glucose did not differ between Czech and Bavarian men; and Czechs had particularly low levels of serum insulin and factor VIIc. Israelis had low fasting glucose and total cholesterol, as well as HDL-cholesterol levels and a high Lp(a) (each P < 0.001) compared with the two other samples. Striking differences were found for plasma homocysteine (10.5 in Czechs versus 8.9 mumol/l in Bavarians, P < 0.001) and for alpha-carotene (geometric mean in Czechs 16, Bavarians 21 and Israelis 30 micrograms/l), beta-carotene (60, 110 and 102 micrograms/l), and lycopene (84, 177 and 223 micrograms/l), respectively; all P-values < 0.001). Adjustment for obesity or smoking did not change these estimates. There were no differences in the levels of tocopherol and retinol. CONCLUSIONS: Czech men had high levels of blood pressure, triglycerides, fibrinogen and D-dimer but many other traditional risk factors, as well as indicators of metabolic disorders and vitamins A and E, did not differ between the study samples. The low levels of carotenoids and high concentrations of homocysteine in Czech men seem to reflect their low dietary intakes of fruit and vegetables. The results provide indirect support for the importance of dietary factors in the East-West morbidity and mortality divide.

[Antioxidants and cardiovascular diseases in the Czech population]. / Antioxidanty a kardiovaskulární choroby v ceské populaci.

The authors studied the possible association between plasma antioxidants and the high rates of cardiovascular diseases in the Czech Republic. The report has three parts. First, plasma antioxidants levels were compared in a random sample of population of two Czech districts (70 men and 66 women) and in British civil servants (246 men and I 12 women). Second, plasma antioxidants were compared in random samples of men aged 45-64 in Pardubice (Czech Republic, n = 185) and Augsburg (Bavaria, n = 142). Both Breat Britain and Bavaria have substantially lower mortality from cardiovascular disease than the Czech Republic. Third, a case control study examined the relation between low levels of plasma antioxidants and the risk of non-fatal myocardial infarction (52 cases and 144 controls, all males). Blood samples were taken, stored and analysed under strictly standardised conditions. Geometric means of beta-carotene, alpha-tocopherol and the alpha-tocopherol/total cholesterol ratio were substantially lower in Czechs than in Brits (all p-values less than 0.001). For example, the mean concentration of beta carotene in plasma of Czech men was only a half of that in British men (0.39 vs. 0.77 mumol/l). Similarly, mean alpha- and beta-carotene and lycopene among Czech men were substantially lower than in Bavarian men. Mean homocysteine was higher in Czechs (10.5 mumol/l) and in Bavarians (8.9 mumol/l, p < 0.001). Means of vitamin E were similar. In the case-control study, the risk of myocardial infarction was elevated among men with below median plasma levels of beta carotene (age adjusted odds ratio 3.33, 95% confidence interval 1.43-8.33) and alfa-tocopherol (odds ratio 1.89, 95% confidence interval 0.94-3.85). The low levels of carotenoids and high levels of homocysteine in plasma of Czechs may reflect low dietary intakes of fresh fruits and vegetables. Antioxidants or factors related to their dietary intakes may be one of the causes of the high cardiovascular mortality in the Czech Republic.

Selective loss of BoLA class I determinants from the lymphocyte surface after acid treatment.

Acid treatment of bovine lymphocytes by a buffered solution of 0.263 m citric acid and 0.123 M Na2HPO4 at pH = 3.0, originally described for human and murine lymphocytes, selectively eliminated the antigenicity of MHC (BoLA) class I determinants also from bovine lymphocytes. The viability of acid-treated cell suspension was higher than 90%. The reactivity of acid-treated lymphocytes with BoLA class I typing alloantisera was lost in microcytotoxicity test, while their reactions with cross-reactive anti-HLA class II, anti-BoCD2 and BoCD5 monoclonal antibodies, and with antisera detecting two non-MHC lymphocyte alloantigenic specificities (BoLY w1 and R') remained unchanged in the microcytotoxicity and/or indirect immunofluorescence tests. The results thus show that this approach of modulating cell surface expression of MHC class I determinants may be used in cattle.

[Control of hypertension in the Czech part of the Pardubice-Augsburg Study]. / Kontrola hypertenze v ceské cásti studie Pardubice-Augsburg.

Objective of the work is to evaluate the prevalence of arterial hypertension, awareness of it, its treatment and control in the Czech part of the Pardubice-Augsburg Study. A random sample of 191 men aged 45-64 years was invited for examination. Arterial hypertension according to the present definition of WHO/International Society of Hypertension (blood pressure > or = 140/90 mm Hg = 18.8/12kPa) was recorded in 113 subjects, its prevalence being 59% .55% hypertensive patients were aware of their diagnosis. 40% of the hypertensive patients were on pharmacological treatment. Hypertension control was achieved in 9% of the treated and in 4% of all hypertensive subjects. Hypertension Control in the investigated representative population sample is inadequate. The greatest problem the inadequate reduction of blood pressure to target values. Comparison of hypertension control using older (BP > or = 160/95 mm Hg = 21.3/12.6 kPa) and present (BP > or = 140/90 mm Hg = 18.6/12 kPa) definitions of arterial hypertension suggests that the great majority of unsuccessfully treated hypertensive subjects has borderline blood pressure values.

[Late ventricular potentials in patients with arterial hypertension]. / Pozdní komorové potenciály u nemocných s arteriální hypertenzí.

Arterial hypertension is a risk factor of left ventricular hypertrophy, ventricular arrhythmias and sudden cardiac death. Late ventricular potentials are the electric manifestation of an arrhythmogenic substrate. They identify patients threatened with ventricular tachycardia and sudden cardiac death. The objective of the work was to assess the prevalence of late ventricular potentials in patients with essential arterial hypertension and to assess the relationship of their occurrence with the presence of left ventricular hypertrophy and complex ventricular arrhythmias. Late ventricular potentials were detected in 8% patients with arterial hypertension, 68% had left ventricular hypertrophy; complex ventricular arrhythmias were found in 18% patients during Holter monitoring and in 14% patients during bicycle ergometry. Comparison of patients with positive and negative late ventricular potentials did not reveal differences in the incidence of left ventricular hypertrophy and complex ventricular arrhythmias. The only significant difference were more frequent ventricular ectopic contractions in patients with late ventricular potentials. Investigation of late ventricular potentials obviously will not be part of the standard examination in patients with arterial hypertension without syncope or malignant ventricular tachyarrhythmia.

[Decrease in cardiovascular disease mortality in the Czech Republic from 1984 to 1993 and its possible causes]. / Pokles úmrtnosti na kardiovaskulární onemocnení v Ceské republice v období 1984-1993 a jeho mozné príciny.

BACKGROUND: The objective of the investigation was to evaluate the ten-year development of the cardiovascular mortality rate in two population groups in the age bracket from 25 to 64 years, i.e. in subjects living in six districts which participated in the international WHO project MONICA and in the population of the whole Czech Republic. METHODS AND RESULTS: Data on the mortality rate in 1984-1993 for the age group from 25-64 years were provided by the Institute of Health Information and Statistics, information on the prevalence of risk factors was obtained in three cross-sectional studies implemented in six districts as part of the MONICA project in 1985, 1988 and 1992. In the mortality rate per 100,000 population in the six districts the following changes were revealed (in parentheses the values for 1984 and 1993 are given): men - a statistically significant declining trend in the from all caused mortality (849.3-742.5; p < 0.001) and cardiovascular mortality (367.2-280.4; p < 0.001) and cerebrovascular mortality (69.7-44.8; p < 0.001). In the mortality from ischaemic heart disease (215.7-170.6; ns) a declining trend was not recorded. In women aged 25-64 years in the six districts there was a statistically significant decline of the mortality from all caused (359.5-322.1; p < 0.001), the cardiovascular mortality (115.6-100.6; p < 0.001) and cerebrovascular mortality (31.1-23.6; p < 0.001). The mortality from ischaemic heart disease did not change (49.2-48.8; ns). In the population of the Czech Republic in men the following were detected: a drop of the from all caused mortality (907.1-784.8; P < 0.001), the cardiovascular mortality (383.5-308.4; p < 0.001) and cerebrovascular mortality (76.5-55.3; p < 0.001). Also in women of the Czech Republic a decline of the mortality from all caused was recorded (390.1-328.5; p < 0.001), the cardiovascular mortality (135.3-103.8; p < 0.001), ischaemic heart disease (58.0-48.6; p < 0.001) and cerebrovascular mortality (43.5-27.4; p < 0.001). In 1990 an increased cardiovascular mortality was recorded in men different from the trend during 1984-1993, statistically significant in the Czech Republic (p < 0.05) and in the six districts (p < 0.05). The reasons of this trend are not clear. The role of health services in the mortality drop is not clear, although available data indicate their improvement. Favourable changes were found in risk factors: during the period from 1985-1992 the prevalence of hypercholesterolaemia declined significantly in men and women, the prevalence of hypertension in women and the prevalence of smoking in men declined in the six districts. From nationwide data ensues that after 1989 significant changes occurred in the diet of the Czech population. The meat consumption declined by 1993 by 13%, the milk and dairy product consumption by 26.8% the butter consumption by 43.6% the consumption of vegetable fats increased by 16%, of vegetables by 8%, tropical fruit by 43.2%. These changes probably had an impact on the cholesterol level and BMI of the Czech population. CONCLUSIONS: In the declining cardiovascular mortality trend during 1984-1993 the following may have participated: improved medical care, dietary changes, improvement of the risk profile and other, in particular socioeconomic factors. With regard to the close temporal association of the investigated changes it may be assumed that this development is at least partly associated with changes of the political and economic position in the Czech Republic after 1989.

[Is the recent decrease in cholesterolemia in the Czech Republic convincing evidence?]. / Je nedávný pokles cholesterolémie v Ceské republice prukazný?

BACKGROUND: The objective of the study was to evaluate the 8-year trend of serum cholesterol levels in six districts of the Czech Republic, to assess whether the reduction of mean values of total cholesterol recorded during the period between 1985 and 1992 was convincing and to discuss possible causes and consequences of this development. METHODS AND RESULTS: Three cross-sectional surveys of risk factors were implemented in independent random 1% samples of the population aged 25-64 years. In 1985 1256 men (respondence rate 81.5%) and 1317 women (85%) were examined, In 1988 1357 men (85.2%) and 1412 women (88.4%), in 1992 1142 men (73.2%) and 1211 women (76.7%). A detailed check of the deviations in estimations during different time intervals from reference values provided evidence that the analytical method did not have an impact on the revealed changes. In men the mean total cholesterol level was 6.21 (95% confidence limit 6.14-6.28 mmol/l in 1985; 6.29 (6.23-6.35) mmol/l in 1988; 5.99 (5.91-6.06) mmol/l in 1992. In women the mean value of the total cholesterol level was 6.19 (6.12-6.25) mmol/l in 1985; 6.23 (6.17-6.30) mmol/l in 1988; 5.95 (5.88-6.02) mmol/l in 1992. According to variance analysis (ANOVA) the serum cholesterol in 1992 was lower by 0.22 mmol/l (p < 0.0001) than in 1985 and by 0.28 mmol/l (p < 0.0001) lower than in 1988. The drop of cholesterol between 1988-1992 may have been caused by dietary changes recorded in the population. According to nationwide data after 1990 there was a marked drop of the consumption of meat and meat products, milk and dairy products and animal fats, while the consumption of vegetable fats increased. Despite these dietary improvements, in six districts in 1992 fats accounted for 37% of the energy intake, the P/S ratio was only 0.41 in men and 0.46 in women. In these districts in 1992 and 1993 a decline of the standardized mortality rate from IHD in men was recorded. CONCLUSIONS: During an eight-year period the mean serum cholesterol level of men and women decreased significantly in six districts of the Czech Republic. This change was probably associated with a restricted intake of foods which have an impact on the serum cholesterol level.

[Changes in the cardiovascular risk profile of the population of the Czech Republic--MONICA 1992]. / Zmeny v kardiovaskulárním rizikovém profilu obyvatelstva Ceské republiky--MONIKA 1992.

BACKGROUND: The cardiovascular risk profile of the population in the Czech Republic is unfavourable, the mortality of the population from cardiovascular diseases is among the highest in the world. The objective of the present work was to compare the prevalence of the most serious risk factors in 1988 and 1992 and to find out whether the change of the political and economic system in 1989 had an impact on the risk profile of the population. Within the framework of the international WHO project MONICA independent 1% random population samples, age bracket 25-64 years, were examined in six districts of the Czech Republic. METHODS AND RESULTS: In 1988 1,357 men (response rate 85.5%) and 1,412 women (88.4%) were examined; in 1992 1,139 men (71.2%) and 1,214 women (75.0%) attended the examination. The prevalence of smokers (regular consumption of more than 1 cigarette per day) did not differ significantly in men: 41.8% in 1988, 40.3% in 1992 nor in women: 25.3%-24.1%. Also the prevalence of elevated blood pressure levels (BPs > 21.3 and/or BPd > 12.7 kPa) did not reveal a significant difference neither in men: 19.1%-20.4% nor in women 14.0%-15.0%. The prevalence of hypercholesterolaemia (total cholesterol > 6.5 mmol/l) was in 1992 significantly lower than in 1988--in men by 9% (39.6%-30.6%, p < 0.001) and in women by 6.3% (36.3%-30.0%, p < 0.001). Also in the prevalence of obesity (BMI men > 30, women > 29) a significant drop was recorded in men by 5.2% (23.8%-18.6%, p < 0.01) in women by 5.1% (33.3%-28.2%, p < 0.01). CONCLUSIONS: The probable reason for this partial improvement of the risk profile in 1992, as compared with data in 1988, are dietary changes which may be the result of the introduced market economy and global transformation of society after the political change in 1989.

Development of the cardiovascular risk in the population of the Czech Republic.

Population surveys of the major cardiovascular risk factors were conducted in six districts of the Czech Republic in 1988 and 1992 as part of the WHO MONICA Project. One-percent independent random samples of the population aged 25-64 years were examined and investigated; in 1988, the survey included 1357 men and 1412 women (response rates of 85.5% and 88.4%, respectively); 1139 men and 1214 women with the response rate 71.2% and 75.0%, respectively, were enrolled in 1992. Over the four years, the mean levels of diastolic blood pressure rose from 83.8 mmHg to 85.5 mmHg (p < 0.001) in men; the rise in women from 80.7 mmHg to 81.6 mmHg was non-significant. Systolic blood pressure between the two surveys did not differ significantly. Mean total cholesterol levels declined from 6.24 mmol/l to 5.91 mmol/l (p < 0.001) in men and from 6.16 mmol/l to 5.87 mmol/l (p < 0.001) in women. Mean BMI decreased from 27.5 to 26.9 (p < 0.001) in men and from 27.4 to 26.5 (p < 0.001) in women. The authors assume that the significant decreases in cholesterolaemia and BMI may be caused by changes in the dietary pattern resulting from the market economy principles setting in after the 1989 revolution, and by an increased attention of the population to their health in the new socioeconomic conditions. If the trend continues, one might expect a decrease in mortality from IHD. On the other hand, the rise in diastolic blood pressure may be due to deteriorated control of hypertension.

Detection of T-lymphocytes in the peripheral blood and lymphoid tissues of cattle using a variant of the E-rosette test and monoclonal antibodies.

A simple and efficient variant of the E-rosette test based on addition of dextran to the incubation media is described. This variant 1) does not include B cells 2) involves some CD2+ null cells as described 3) is not inhibited by anti-CD5 antibody 4) correlates with CD2 expression 5) detects specific changes in the relative proportion of T-lymphocytes under the different conditions. In a group of calves the mean percentage of RFC in the peripheral blood lymphocytes was 53.59 +/- 8.70 and in cows there was 72.57 +/- 3.85. The proportion of RFC detected in bovine leukemia virus (BLV)--infected cows with lymphocytosis was less than one third of that in BLV--negative animals and vice versa in B (MHC class II+) lymphocytes.

[Late ventricular potentials in patients with recurrent ventricular tachycardia after myocardial infarct]. / Pozdní komorové potenciály u nemocných s recidivující komorovou tachykardií po infarktu myokardu.

In 26 patients who had at least two documented attacks of persisting ventricular tachycardia for 48 hours or longer after a myocardial infarction and whose standard QRS complex during sinus rhythm was < or = 120 ms, the authors examined late ventricular potentials using an Arrhythmia Research Technology apparatus EPX 1200. Positive finding were obtained in 19 (73%) of the patients. The finding is comparable with data in the literature on the prevalence of late ventricular potentials in patients with recurrent persisting ventricular tachycardia after myocardial infarction.

[Late ventricular potentials in patients without ventricular tachycardia 3 years after myocardial infarct]. / Pozdní komorové potenciály u nemocných bez komorové tachykardie 3 roky po infarktu myokardu.

In 57 patients who in the course of 29-48 months (mean 36 months) after myocardial infarction did not develop sustained ventricular tachycardia, late ventricular potentials were investigated. Positive findings were revealed in 13 (22.8%) patients using a 25-250 Hz filter and in 14 patients resp. (24.6%) using a 40-250 Hz filter. Late ventricular potentials were significantly more frequent in patients after myocardial infarction of the lower rather than the anterior wall (p less than 0.05). No differences were revealed between groups with positive and negative late ventricular potentials as regards the occurrence of repeated infarction, left-side cardiac failure, ectopic ventricular contractions, diabetes mellitus, arterial hypertension and cardiothoracic index. The assembled data are comparable with data in the literature pertaining to the incidence of late ventricular potentials in patients after myocardial infarction without sustained ventricular tachycardia.

Cardiovascular risk factors in the Czech population.

In 1985 and 1988 as part of the WHO's MONICA project two surveys of cardiovascular risk factors were conducted in the population aged 25 to 64 years and resident in the six districts of the Czech Republic collaborating in MONICA. Over a period of three years, the prevalence of smoking decreased from 46% to 41.8% (p less than 0.05) in men. Daily cigarette consumption declined from 17.9 to 15.1 (p less than 0.001) in men and from 11.1 to 10.1 (p less than 0.05) in women. Despite the unchanged prevalence of hypertension during the three years' period the proportion of population with elevated BP levels declined from 22.25% to 19.1% in men (p less than 0.05), and from 16.8% to 14.0% (p less than 0.05) in women as a result of better hypertension control. The prevalence of obesity in men rose from 18.5% to 23.9% (p less than 0.001). The proportion of individuals with a total cholesterol level over 5.2 mmol/l rose from 78.0% to 83.1% (p less than 0.001) in men and from 75.9% to 80.6% in women (p less than 0.01). The changes were favourable only in those risk factors that were actively influenced by the preventive programmes "A Chance for Three Million" in smoking habits, and the "National Programme of Hypertension Control". The authors believe that consistent nationwide preventive programmes might exert a beneficial effect on the profile of risk factors of the whole Czech population.

[Trends in body weight in the population of the Czech Republic]. / Vývoj telesné hmotnosti v populaci Ceské republiky.

The authors investigated the development of body weight of the population from six districts in the Czech Republic participating in the international WHO project MONICA. The examinations were made within the framework of epidemiological studies of risk factors of IHD in 1985 and 1988 in 1% independent population samples (range 25-64 years). The mean values of body mass index, BMI, increased in the above three-year period in men from 26.9 to 27.5 (p less than 0.001) in women from 26.9 to 27.4 (n. s.). The prevalence of obesity increased during the same period from 19.9% to 25.4% (p less than 0.001) in men and from 33.8% to 35.7% (n. s.) in women. In all decades of men and women there was a rising trend of body weight and increasing prevalence of obesity. With regard to the adverse effects of overweight on health and life span, the authors consider prevention of obesity as one of the foremost tasks of preventive medicine.