[Diurnal variation of blood pressure in type II diabetic patients]. / Profil dobowy cisnienia tetniczego u chorych na cukrzyce typu II.

The aim of the study was to evaluate diurnal variation of blood pressure in type II diabetic patients and to reveal important factors influencing 24-hour blood pressure profile in these patients. Investigations were carried out in 52 patients with type II diabetes mellitus including 28 patients with hypertension. Control group was 26 healthy men. In all subjects 24-hour ambulatory blood pressure monitoring was performed. In patients with diabetes mellitus both with and without concomitant hypertension significantly smaller night drop in blood pressure and heart rate was found out. There was no significant differences between subgroup of patients with diabetes mellitus with and without concomitant hypertension in night drop in blood pressure and heart rate. In patients with microalbuminuria where was smaller night drop in blood pressure and heart rate compared to patients with normal renal function.

[QT dispersion in patients with acute myocardial infarction]. / Dyspersja QT u chorych ze swiezym zawalem miesnia serca.

The aim of the study was the evaluation of the QT dispersion interval in patients with acute myocardial infarction, taking into consideration its location, treatment provided and coronary artery reperfusion. Investigations were performed in 75 patients treated because of acute myocardial infarction, including 57 men and 18 women, age 40-84 years. Acute myocardial infarction was recognised on a base of generally accepted criteria. At the reception standard 12-outputs ECG was performed. Next ECG testing was performed after 3 hours from the start of the thrombolytic therapy. In case of patients which were not qualified for thrombolytic therapy next ECG was applied within 3 hours after reception. For further observation of changes in QT dispersion ECG generally provided within 2, 3, 4 and 5 day of hospitalization were used. Taking as a location criterium of infarction the method of provided treatment and obtained reperfusion in the infarcted area, patients were classified to the one of 6 groups. To the first group (I)-patients with inferior wall infarction, treated thrombolytically with obtained reperfusion-15 patients were included, age 41-69 years. To the second group (II)-patients with inferior wall infarction, treated thrombolytically without obtained reperfusion-18 persons were included, age 43-84 years. To the third group (III)-patients with inferior wall infarction, not treated thrombolytically-9 patients were included, age 49-72 years. To the fourth group (IV)-patients with anterior wall infarction, treated thrombolytically with obtained reperfusion-9 persons were included, age 40-73 years. To the fifth group (V)-patients with anterior wall infarction, treated thrombolytically without obtained reperfusion-10 persons were included, age 47-78 years. To the sixth group (VI)-patients with anterior wall infarction, not treated thrombolytically-14 patients were included, age 44-81 years. Control group for the comparison of initial evaluation of the QT and QTc dispersion interval was group of 11 healthy persons, age 27-64 years. There was proved, that in patients with acute myocardial infarction, independently of its location, QT and QTc dispersion was increased. Thrombolytic therapy in patients with acute inferior wall myocardial infarction with reperfusion obtained causes extension of QT dispersion. In patients with acute anterior wall myocardial infarction thrombolytic therapy with obtained reperfusion causes reduction of QT and QTc dispersion. In patients not treated thrombolytically, which had anterior wall myocardial infarction, in first days of observation QT and QTc dispersion was increased. This effect was not observed in patients with inferior wall infarction.

[Pharmacological treatment of lipid disorders according to present clinical studies]. / Farmakologiczne leczenie zaburzen lipidowych w swietle wspólczesnych badan klinicznych.

Hyperlipidemia beside hypertension, diabetes mellitus and smoking, is considered as the most serious factor of atherosclerosis. Studies performed in Poland indicated that only 28% of men and 32% of women has proper lipids concentration in blood serum. In 1992 the European Atherosclerosis Society (EAS) divided hyperlipoproteinemia into three types: hypercholesterolemia, hypertriglyceridemia and mixed hyperlipidemia, and each of them into mild and significant. Starting treatment attention should be paid not only on kind of lipid disorders, degree of its intensity, but also there should be evaluated other existing risk factors. Priority in treatment of hyperlipidemia consist of patients with established coronary heart disease and other forms of atherosclerotic disease. Clinical studies of last years for example like CARE, 4S, LCAS indicated plenty of advantages of lipid-lowering therapy in this group of patients, resulting in reduction total mortality coronary mortality, and recurrent coronary events. Second group consist of patients without clinical atherosclerotic disease, with high risk category. Advantages of lipid-lowering therapy in primary prevention resulting in reduction of coronary heart disease frequency proved between others study: LRC-CPPT, Oslo Study, WOSCOPS. Another groups consist postmenopausal women, in whose estrogen replacement therapy has an effect not only on improvement of lipides parameters, but also has beneficial effect on vassals endothelium and reduces risk of heart coronary disease down to 50%. Finally, there was described also problem of hypercholesterolemia treatment in young and older patients. New trends in treatment of lipid disorders were also presented.

[QT dispersion]. / Dyspersja QT.

The study presents the modern concepts on QT dispersion which is regarded as one of the reasons of potentially dangerous cardiac arrhythmias. The measurement of QT interval is based on standard 12-lead electrocardiogram or 24-hours Holter monitoring record. The study describes the rules of QT dispersion measurement and the most common problems connected with it. The changes of QT dispersion in ischaemic heart disease, heart failure, cardiac arrhythmia and prolonged QT interval syndrome were discussed. The study presents also the influence of such drugs as amiodarone, sotalol, beta-adrenolytics on QT dispersion. It was found out that QT dispersion measurement in patients with cardiac diseases seems to be the easy predictor of life-threatening cardiac arrhythmias. The problem is still very controversial and needs further clinical investigations.