Plasma adiponectin in patients with acute myocardial infarction treated with percutaneous coronary intervention.

BACKGROUND: Even up-to-date reperfusion therapy using primary percutaneous intervention (PCI) in acute myocardial infarction does not result in improvement of the left ventricular (LV) function in all patients. Cellular myoblasty, a novel method using mononuclear bone marrow cells (BMC), can be applied in the infarcted myocardium area to stimulate regeneration and to limit the organ damage. However, the impact of intracoronary BMC administration on the effect of PCI is not clear. AIM: To assess angiographic outcomes in patients with anterior myocardial infarction and LV dysfunction, undergoing intracoronary BMC administration after a successful primary PCI. METHODS: The study group consisted of 40 patients (mean age 56.2 years) with LV ejection fraction below 40%, in whom 20 ml of BMC were administered to the infarct-related artery (IRA) distally to the occlusion. The control group comprised 25 age- and sex-matched patients with similar values of LV ejection fraction undergoing bare metal stenting of IRA without BMC administration. Quantitative coronary angiography was performed 6 months later to assess IRA patency. RESULTS: The reference diameter of the stented artery decreased in the study group from 3.22 +/- 0.28 mm to 3.16 +/- 0.18 mm (p < 0.05) and in the control group from 3.22 +/- 0.31 mm to 3.15 +/- 0.28 mm (p < 0.082); also in the area of the implanted stent the diameter decreased from 3.57 +/- 0.21 mm to 2.96 +/- 0.79 mm in the study group vs. 3.48 +/- 0.22 mm to 3.01 +/- 0.35 mm in the control group. For lumen diameter measured 10 mm distally to the stent, the diameter loss was similar in both groups. In 6 patients from the BMC treated group and in 3 patients from the control group there was asymptomatic lumen reduction > 70% (NS). CONCLUSION: The results of our study show that BMC administration into IRA is safe. The degree of lumen loss in the stent area was larger in the BMC group than in the control group. There was no significant difference in the lumen change distally to the stent; the artery diameter loss in both groups was similar, and the improvement in LV ejection fraction was greater in the BMC-treated group.

Preliminary cardiological examinations in deaf children.

There is some evidence that deaf children are more threatened than the general population by dangerous heart arrhythmias. An example is Jervell-Lange-Nielsen syndrome (one of the forms of long QT syndrome) which is characterised primarily by congenital deafness and prolongation of the QT interval. The aim of this study was to perform preliminary cardiological examinations on 162 deaf children (76 girls and 86 boys, 3-15 years old, mean age 10.5 +/- 2.8 years) who attend the Regional School Centre for Deaf Children in Katowice. The data in our analysis was obtained from case histories (school records and special questionnaires sent to parents), physical examinations with special regard to the cardiovascular system, double blood pressure measurement and 12 lead surface electrocardiogram. In the studied group, 90 children (55.5%) were congenitally deaf. Within this group, 24 children manifested tachycardia while 4 children manifested-bradycardia. A-V block of I degree was found in 3 children. Incomplete right bundle branch block (RBBB) was observed in 44 children while a complete RBBB was noticed in 1 child. QTc interval was prolonged (> 0.44s) in 12 children suffering from congenital form of deafness and in 16 children suffering from all causes of deafness. On the basis of case history, physical examination, and standard 12-lead electrocardiogram, we established the occurrence of risk factors according to the new diagnostic criteria of Schwartz et al. with relative points assigned to the electrocardiographical, clinical and familial findings. These points when summed up represent the risk of sudden death caused by ventricular arrhythmia due to long QT syndrome. In the studied group (according to the Schwartz criteria), 2 (1.2%) children had high probability (> or = 4 points) of long QT syndrome (LQTS), 25 (15.4%) children had intermediate probability of LQTS (2-3 points) and 135 children had low probability of LQTS (< or = 1 point).