[Clinical significance of transesophageal and epiaortal echocardiography of ascending aorta in risk estimation of neurological complications in coronary artery by-pass patients]. / Znaczenie badania echokardiograficznego przezprzelykowego i epiaortalnego aorty wstepujacej w prognozowaniu ryzyka powiklan neurologicznych u chorych poddanych zabiegowi pomostowania tetnic wiencowych.

UNLABELLED: Advanced atherosclerotic changes in aortal wall are an important factor in taking decision to use minimal-invasive method of coronary artery by-pass grafting. There are some methods for diagnosing atherosclerotic changes in ascending aorta, i.e.: roentgenogram, computer tomography, magnetic resonance imaging, transthoracic echocardiography and especially transesophageal echocardiography and epiaortal echocardiography. THE AIM OF THE STUDY: To define usefulness of transesophageal and epiaortal echocardiography as a method of prognosing neurological complications in patients during coronary artery by-pass grafting. MATERIAL AND METHODS: Study group consisted of 32 consecutive patients who had coronary surgery in II Chair and Department of Cardiosurgery, Silesian Medical University in Katowice due to ischemic heart disease in whom before the surgery ascending aorta wall was evaluated with transesophageal and epiaortal echocardiography and then monitoring of microembolism was performed. Transesophageal examination was performed with Philips Sonos 7500 device with 5 MHz transducer in anesthetized patient. Ascending aorta from level of aortic valve to the aortic arch in long and short axis was evaluated. Epiaortal echocardiography was performer with 7.5 MHz vesseltransducer and Hewlett-Packard Sonos 100 CF H-P device immediately after chest opening. Transesophageal echocardiography of ascending aorta evaluated: intima-media complex thickness and presence of atherosclerotic plaques and calcifications. Microembolism monitoring was performed in 18 patients before and during surgery. Using 2 MHz transducer placed in left and right temporal region number of microembolic incidents were evaluated. RESULTS: Analysis of relationship between aortic wall thickness and microembolic signals during cardiopulmonary by-pass was performed. During cardiopulmonary by-pass microembolic signals (from 7 to 698 signals) were detected in 7 patients. During analysis number of microembolic signals was normalized to cardiopulmonary by-pass duration time. CONCLUSIONS: There was found correlation between number of microembolic signals during cardiopulmonary by-pass and thickness of aortic posterior wall in all of it's levels, using epiaortal method in short axis. This same was found using lateral wall measurements. There was no correlation between aortic wall thickness evaluated with transesophageal echocardiography and numbers of microembolic signals.

[Natriuretic peptides: anything new in cardiology?]. / Peptydy natriuretyczne: cos nowego w kardiologii?

Twenty-five years after the first publication of the strong natriuretic effect of rat cardiac atria extract, natriuretic peptides play an important part in everyday, not only cardiological, practice. In the current review the authors briefly describe the role of natriuretic peptides (ANP, BNP, and CNP) in clinical practice, concentrating on the possibilities of their therapeutic use. They also summarize their role in the mechanisms of endogenous cardioprotection and regulation of LVH, which is the endpoint of many cardiovascular pathologies.

[New face of modified reperfusion: postconditioning]. / Nowe oblicze modyfikowanej reperfuzji: postconditioning.

In this review authors describe the mechanisms and possibilities of attenuation of ischaemia reperfusion injury in the myocardium. They describe modified reperfusion (postconditioning) and discuss its use in basic and clinical research. The proposed effects of modified reperfusion on the reperfusion injury were also depicted and compared to the mechanisms and action of ischemic preconditioning.