[Left ventricle hypertrophy following myocardial infarction. Morphometric evaluation of the infarcted region and the free wall of the left ventricle]. / Przerost lewej komory po zawale serca. Analiza morfometryczna obszaru przebytego zawalu i wolnej sciany lewej komory serca.

UNLABELLED: The aim of the study was to assess the relationship between the left ventricle (LV) hypertrophy and the effect of different morphological and clinical parameters in patients after Q-wave myocardial infarction (QMI). MATERIAL AND METHODS: A morphometric evaluation was performed in 21 patients after QMI (the mean age was 58.8 +/- 9.4). Samples from infarcted region and the free wall of LV obtained during autopsy were measured. Results were compared to parameters observed in the control group that comprised 10 patients who died due to non-cardiac causes (the mean age 52.4 +/- 11.2). The following morphological parameters were assessed: heart weight, LV mass, infarct scar extent, myocytes diameter, myocytes nuclei' diameter, myocytes nuclei' density, coronary capillaries density (immunohistochemical staining for CD34), LV fibrosis. Morphometric measurements were performed with the use of digital image analyser Leica Q500MC. Clinical characteristics such as patients age, duration of the disease, sex and prevalence of hypertension were also evaluated. RESULTS: Postmortem pathological studies showed significant increase in the LV mass in the investigated group when compared to control group (296.0 +/- 81.3 g vs. 150.2 +/- 18.6 g; p < 0.0003). LV hypertrophy was associated with different structural alterations: increase in the myocytes diameter both in the infarcted region (increase 61%) and free LV wall (increase 35%), increase in the myocytes nuclei diameter (increase 28.1% and 11.2%, respectively), reduction in the myocytes nuclei' density (decrease, 52.9% and 34.4%, respectively), reduction in the coronary capillaries density (decrease 48.6% and 4.1%; respectively) and the increase in fibrosis in the free wall of LV (increase 91%). Multiple regression analysis showed the increase in the myocytes' diameter in the infarcted region (beta = 0.355; p = 0.048) and the increase in the myocytes' diameter in the free LV wall (beta = 0.787; p = 0.015) as the only two factors affecting the degree of LV hypertrophy. A linear relationship between the LV mass and the increase in the myocytes' diameter was observed only in the free LV wall (r = 0.695; p < 0.001). Moreover, the increase in myocytes' diameter within the free wall of LV correlated to the infarct scar extent (r = 0.451; p = 0.046). CONCLUSIONS: (1) Compensatory increase in the LV mass following MI is proportionate to the loss of contractility of necrotic myocardium. (2) Increase in the LV mass that occurred after MI is mainly determined by the degree of myocytes' hypertrophy. The significance of correlations between the two parameters depends on the myocytes location (free wall of LV vs. infarcted region).

Subacute stent thrombosis following coronary angioplasty: incidence and risk factors.

BACKGROUND: Subacute stent thrombosis was a significant complication in the early years of coronary stenting, often leading to myocardial infarction, need for urgent surgery or even death. The introduction of intracoronary ultrasound enabled the identification and proper treatment of the main causes of stent thrombosis, reducing the rate of this complication to 1%. AIM: To identify risk factors of subacute stent thrombosis. METHODS: Data concerning 845 procedures with a single stent implantation in patients with stable or unstable angina, undergoing this procedure between 1998 and 2000, were analysed. RESULTS: Subacute stent thrombosis occurred in 13 (1.54%) patients. Risk factors for this complication included urgent procedures (so-called bailout stenting), improper pre-treatment with drugs ("ad hoc" procedures), dissection uncovered by stent, and poor final result of procedure (higher degree of residual stenosis). The majority of these patients developed myocardial infarction in spite of the fact that the patency of stented vessel was quickly achieved in all but one patient. CONCLUSIONS: Urgent stenting, improper drug pre-treatment and suboptimal result of the procedure are the risk factors of subacute stent thrombosis.

[Ear lobe crease as a factor of potential risk for coronary artery disease?--World news review and own research]. / Bruzda platka usznego wskaznikiem potencjalnego zagrozenia choroba wiencowa?--przeglad doniesien swiatowych oraz badania wlasne.

The aim of this study was to define the value of ear-lobe crease as the marker of potential risk of coronary artery disease on the basis of world's reports and own research. The test group consisted of 92 patients who were classified to coronary-artery bypass graft using coronarography. Patients were divided into 3 groups (A-without ELC, B-ELC on one ear, C-ELC bilateral). Detailed statistical analysis of coronarography results and incidence of coronary disease risk factors in each group was done. Obtained data allowed to evaluate the correlation between existence of the crease and extent of atherosclerotic changes in coronary vessels.