[ECG markers in patients with hypertrophic cardiomyopathy]. / Elektrokardiografické markery u pacientov s hypertrofickou kardiomyopatiou.

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant inherited disease of the heart muscle whose main characteristic is unexplained hypertrophy of the left ventricle and/or right ventricle. It is considered to be the most common genetically determined cardiovascular disease with the prevalence in the population approximately 1 to 500 inhabitants. The disease is associated with severe complications such as heart failure, arrhythmias and sudden cardiac death (SCD). Nowadays the aim of intensive clinical research is to judge the contribution of noninvasive methods in the risk stratification of HCM patients. Abnormal electrocardiogram occurs in 75-95% and it often presents the first point for HCM suspicion although it is nonspecific. AIM: The aim of our study was to evaluate the electrocardiographic (standard 12-lead) and certain echocardiographic markers in patients with recurrent syncope of unknown origin in comparison with patients without these episodes. PATIENTS AND METHODS: 42 patients (17 men a 25 women) with verified HCM diagnosis underwent extensive clinical, standard 12-lead electrocardiographic and echocardiographic testing to compare these parameters in the subgroup of patients with syncope (n = 17) of unknown origin and patients without syncope (n = 23). RESULTS: As for the electrocardiographic signs we found that more than one half of patients had positive Sokolow-Lyon index (55.6%), prolonged QTc interval (63.2%). Depression of ST segment was present in 60.5%. We also found positive correlation between prolonged QTc interval and maximal left ventricle thickness. We observed that patients with syncope had statistically significantly left ventricle end-diasotlic diameter in comparison with patients without syncope. CONCLUSION: Standard electrocardiography represents a "gold standard" in the diagnostics of HCM patients. We found positive correlation between prolonged QTc interval and maximal left ventricle thickness. Patients with syncope had statistically significantly smaller left ventricle end-diastolic diameter in comparison with patients without syncope.

Genetic screening of patients with hypertrophic cardiomyopathy--a new diagnostic strategy for risk stratification?

Hypertrophic cardiomyopathy (HCM) is an autosomal dominant inherited disease of the heart muscle and its main characteristic is unexplained hypertrophy of the left and/or the right ventricle. HCM is the most common genetically determined cardiovascular disease and is prevalent in approximately in 1 of 500 of the population. The most serious complication of HCM is sudden cardiac death (SCD) which can be the first manifestation of the disease. However, there are other forms of benign prognosis which do not jeopardize patient's health or life. The clinical symptoms of HCM are partly dependent on mutations in affected sarcomere genes. Different mutations in the same gene can present as malign with a high risk of SCD, while other mutations can be benign. The clinical symptomatology can also be influenced by other factors such as the presence of polymorphisms in other genes. Nowadays the aim of intensive clinical research is to access the contribution of molecular genetic methods in HCM diagnostics as well as in risk stratification of SCD. It is expected that genetic analyses will have an important consequence in the screening the relatives of HCM patients and also in the prenatal diagnostics and genetic counseling (Tab. 2, Fig. 1, Ref. 45). Full Text (Free, PDF) www.bmj.sk.

[The risk of cardiovascular diseases induced by radiotherapy]. / Riziko vzniku kardiovaskulárnych ochorení v súvislosti s rádioterapiou.

At present the number of cancer survivors is still increasing. However, their long-term quality of life after anticancer treatment can be decreased. Radiotherapy may represent a risk for the future of some oncologic patients. The late cardiovascular effects of radiotherapy to the area of thorax, cranium and to the abdominal area are the actual multidisciplinary problem. The unique problem is mediastinal radiotherapy which may induce the development of the cardiomyopathy, constrictive pericarditis, coronary artery disease, myocardial infarction, valvular defects, arrhythmias and other complications. Exact knowledge of pathophysiological mechanisms of radiation induced cardiovascular damage after radiotherapy as well as using of new diagnostic cardiologic methods might be useful for the detection of subclinical abnormalities and their early treatment already in the asymptomatic patients.