Flow-mediated skin fluorescence: A novel method for the estimation of sleep apnea risk in healthy persons and cardiac patients.

BACKGROUND: A pilot study revealed a relationship between the results of flow mediated skin fluorescence (FMSF) and of ECG-Holter-based estimated apnea/hypopnea index (eAHI) in asymptomatic individuals. The aim of this study was to test whether the results of FMSF show a relationship with the eAHI in patients with coronary artery disease or aortic stenosis. METHODS: Twenty-one patients (12 coronary disease, 9 aortic stenosis) and 37 healthy volunteers were included. FMSF was assessed before, during and after the pressure occlusion of the brachial artery, using a prototype device allowing the quantification of skin fluorescence. The values of FMSF expressed as baseline (BASE), maximum (MAX), and minimum (MIN) were analyzed. The percentages of ischemic response (IR) and hyperemic response (HR) were calculated. The eAHI was assessed from night ECG-Holter recordings. Differences between the groups and the relationships between the parameters were analyzed statistically. RESULTS: Mean ± standard deviation of BASE, MAX, MIN and IR were not significantly different in both groups (p > 0.05). HR was significantly lower in cardiac patients (14.7 ± 7.5 vs. 11.8 ± 5.1; p = 0.048), whose eAHI was significantly higher (11.0 ± 7.4 vs. 36.3 ± 16.5; p < 0.01). Negative correlation for MAX and eAHI was found in volunteers and patients: r = -0.38, p = 0.02 and r = -0.47, p = 0.03, respectively. In volunteers, HR had a negative correlation with eAHI: r = -0.34, p = 0.04. CONCLUSIONS: This pioneer study confirms that FMSF can be used to detect the negative correlation between MAX fluorescence and eAHI not only among healthy volunteers, but also among cardiac patients with coronary artery disease or aortic stenosis.

Arrhythmic manifestation of peripartum cardiomyopathy-Case report.

We report a case of 26-year-old woman, with arrhythmic manifestation of peripartum cardiomyopathy with moderate heart failure. Ventricular arrhythmia recorded in ambulatory Holter ECG (premature ventricular contractions) was most severe during pregnancy, reduced when beta-blocker therapy was initiated and almost completely resolved after delivery. Then, 1 year after hospitalization in Cardiology Department, recurrence was observed with recorded short episode of nonsustained ventricular tachycardia.

[Prevention of cardiovascular diseases - Prophylactic program in a selected enterprise]. / Zapobieganie chorobom ukladu krazenia ­ program profilaktyczny wdrozony w wybranym przedsiebiorstwie.

BACKGROUND: In Poland cardiovascular diseases (CVD), classified as work-related diseases, are responsible for 25% of disability and cause 50% of all deaths, including 26.9% of deaths in people aged under 65 years. The aim of the study was to analyze employee expectations regarding CVD- oriented prophylactic activities in the selected enterprise. MATERIAL AND METHODS: A questionnaire, developed for this study, consists of: socio-demographic data, job characteristics, occupational factors, and questions about the respondents' expectations concerning the prevention program. The study group comprised 407 multi-profile company employees aged (mean) 46.7 years (standard deviation (SD) = 9.1), including 330 men (81.1%), mean age = 46.9 (SD = 9.2) and 77 women (18.9%), mean age = 45.9 (SD = 8.2) The study was performed using the method of auditorium survey. RESULTS: Employees declared the need for actions related to physical activity: use of gym, swimming pool, tennis (56.5%), smoking habits - education sessions on quitting smoking (24.6%). A few people were interested in activities related to healthy diet. According to the majority of the study group, the scope of preventive examinations should be expanded. Based on our own findings and literature data CVD- -oriented preventive program, addressed to the analyzed enterprise was prepared. The program will be presented in another paper. CONCLUSIONS: The results showed significant quantitative and qualitative differences in the classic and occupational CVD risk factors between men and women, as well as in preferences for participation in prevention programs. Therefore, gender differences should be taken into account when planning prevention programs. Med Pr 2017;68(6):757-769.

Impedance cardiography - Old method, new opportunities. Part I. Clinical applications.

Monitoring of cardiovascular hemodynamic changes requires a very expensive and highly specialized equipment and skilled medical personnel. Up to the present time, an inexpensive, non-invasive and easy-to-use method which, like Doppler echocardiography, magnetic resonance angiography or radionuclide imaging, would assess hemodynamics of the cardiovascular system was not available. A method known as impedance cardiography (ICG) or thoracic electrical bioimpedance cardiography (TEBC) meets those criteria. It is non-invasive, which is of a particular advantage over the conventional methods that require catheterization. As a result, the patient is not at risk of possible complications and the procedure is less expensive and easier. Impedance cardiography, despite its non-invasive character, has not been so far extensively used for monitoring of hemodynamic parameters in hospitalized patients. Various authors report that attempts have been continued to compare the results from ICG and those obtained by other diagnostic methods. This paper presents the use of impedance cardiography in diagnosis of hypertension, cardiac insufficiency, differentiating the causes of acute dyspnea, as well as in assessing the effects of cardiac rehabilitation in patients with heart failure.

Impedance cardiography - Old method, new opportunities. Part II. Testing of cardiovascular response to various factors of work environment.

Impedance cardiography seems to be a very good, although underappreciated diagnostic method. What may distinguish it from among the many research methods is the fact that it enables non-invasive monitoring of cardiac output, stroke volume and systemic vascular resistance. Holter recording of the hemodynamic parameters makes it possible to study them not only in stationary (hospital, outpatient clinic) conditions, but also during household or professional activities, e.g., during road vehicle driving. Assessment of the trends of changes in the circulatory system of the employee at work makes it possible to judge whether the type of work performed by the worker is well tolerated - whether it is not too hard or too stressful. This is important, therefore, impedance cardiography can be extensively used in occupational medicine. Provision of preventive care to workers according to current standards requires, on the one hand, the use of the latest diagnostic methods while, on the other hand, the methods must be inexpensive, because otherwise the employer would not be able or willing to pay the associated costs. Impedance cardiography meets those criteria; however, few data is available in literature worldwide on the use of this method in the research on the impact of occupational work on cardiovascular responses of the employees. This work reports the use of impedance cardiography in studies on the various aspects of work environment.