[Echocardiographic evaluation of left ventricular morphology and function in active sportsmen].

INTRODUCTION: Echocardiography is a noninvasive, reliable method for evaluation of left ventricular morphology and function. Judo and wrestling are sports characterized by intensive and high physical and isometric effort, while football is characterized by long-term physical isotonic effort. The key compensatory mechanism with both groups of sportsmen is left ventricular hypertrophy. The aim of this study is evaluate left ventricular morphology and function in a group of judo players, wrestlers and football players during competition season and their interactive comparation. MATERIAL AND METHODS: 42 judo players and wrestlers and 43 football players were examined. RESULTS: An increase in thickness of the septum and posterior wall was established in both groups of sportsmen, but the thickness was statistically more significant in judo players. On the other hand, in football players, a statistically significant left ventricular end-diastolic volume index enlargement was found, compared to reference values and compared to end-diastolic volume index in judo players and wrestlers. High left ventricular ejection fraction was established in both groups, but it was statistically significantly higher in football players. Left ventricular mass index was statistically increased in both groups, but it was higher in judo players and wrestlers.

[The use of low molecular weight heparins in patients with acute ST-elevated myocardial infarction].

UNLABELLED: INTRODUCTION According to the published guidelines for the management of acute coronary syndromes (ACS), treatment of acute ST-elevated myocardial infarction is based on rapid revascularization, either mechanical or pharmacological. Pharmacological revascularization consists of fibrinolytic therapy with antiplatelet and anticoagulant therapy. In regard to the anticoagulant therapy, low molecular weight heparins (LMWHs) are of special importance. LMWHs cause less complications (bleeding, thrombocytopenia, better bioviability) in comparison with unfractionated heparin (UFH). Some studies on use of LMWHs in ACS, show that LMWHs are equally efficient and safe as UFH, causing less complications (different types of hemorrhagic complications) (ESSENCE, TIMI 11B (enoxaparin), FRAXIS-fraxiparin), whereas some studies show better efficacy and safety of enoxaparin in therapy of acute ST-elevated myocardial infarction (ASSENT 3, ASSENT 3 PLUS, HART II, AMI-SK). INCLUSION CRITERIA: acute anterior myocardial infarction with ST-elevation, first myocardial infarction, no other structural heart defects, no signs of cardiogenic shock. Our study included 30 patients receiving fibrinolytic therapy with streptokinase, antiplatelet therapy and LMWH during 6 days, and 30 patients receiving UFH instead of LMWH. The follow-up period lasted for 6 months. RESULTS: Significantly more patients receiving unfractionated heparin presented with major adverse cardiac events (73.3%) in regard to patients in the study group (44.2% nadroparin, 39.8% enoxaparin) (p = 0.025). In the group receiving UFH, 6.7% patients had hemorrhagic complications, while none of patients receiving LMWHs. An equal number of patients died. CONCLUSION: Patients who were treated with LMWHs experienced less major adverse cardiac events and lower mortality. None suffered from hemorrhagic complications.

Fosinopril and amlodipine in the treatment of isolated systolic hypertension.

The aim of this study was to assess the therapeutic effects of fosinopril (F) and amlodipine (A) on regulation and circadian rhythm of blood pressure, and to evaluate left ventricle mass index (LVMI) in patients over 60 years of age with isolated systolic hypertension, after three months of administration period. After one-week placebo run-in period, 60 patients were randomized into two groups, each including 30 patients, to receive either fosinopril or amlodipine for three months. Clinical, echocardiographic examinations and 24 h ambulatory blood pressure measurements were performed at baseline, and after 3 months of therapy. The goal blood pressure was < or = 140/90 mmHg. It was accomplished in more than two thirds of cases (F 76.6%, and A 79.9%), with lower drug doses needed in the group treated with F. In 13 patients goal values were not accomplished, therefore the therapy was prolonged for one additional month, with combination of two drugs. In 10 of these patients (76.9%), adequate regulation of blood pressure was achieved. Both fosinopril and amlodipine efficiently control blood pressure by once-a-day administration, both significantly influencing its circadian rhythm and resulting in regression of myocardial hyperthrophy. Adequate control of blood pressure and beneficial effects on circadian rhythm of blood pressure are achieved with lower doses of fosinopril.