Selectin-P and interleukin-8 plasma levels in coronary heart disease patients.

BACKGROUND: Alterations of the immune system are now believed to play crucial role in the pathogenesis of atherosclerosis. The aim of this study was analysis of soluble forms of selectin-P and interleukin-8 levels in patients with different form of coronary heart disease. MATERIALS AND METHODS: In the study took part 18 patients with stable coronary heart disease, 20 patients with unstable coronary heart disease and 15 healthy persons from control group. Soluble selectin-P and interleukin-8 levels were measured in EDTA plasma with the use of enzyme immunoassay ELISA. RESULTS: The level of soluble selectin-P was significantly higher in unstable coronary heart disease patients in comparison to the stable coronary heart disease patients (P < or = 0.01) and nonsignificantly higher in comparison to the control group. The level of interleukin-8 were significantly higher in unstable coronary heart disease patients in comparison to the stable coronary heart disease patients (P < or = 0.01) and in comparison to the control group (P < or = 0.02). CONCLUSION: Our findings suggest that soluble form of selectin-P and interleukin-8 may be useful clinical predictors of unstable coronary heart disease. The assessment of the risk for the development of coronary heart disease requires further serial investigation.

[Subjective quality of life in patients with coronary artery disease after percutaneous coronary angioplasty in elderly patients after 65 years of age]. / Subiektywna ocena jakosci zycia chorych na chorobe wiencowa poddanych przezskórnej angioplastyce wiencowej po 65 r.z.

UNLABELLED: The aim of our study was to determine the quality of life in elderly patients after PTCA using the SF 36 questionnaire measuring post procedural physical and mental health. STUDY GROUP: 71 pts > 65 years (M-46, F-25), mean age 70.92 +/- 3.49, post PTCA were examined with SF 36 questionnaire. CONTROL GROUP: 73 pts < 65 years (M-61, F-12) mean age 53.6 +/- 7.37, post PTCA. The mean follow-up time was 19.3 +/- 3.2 month in the study group and 18.8 +/- 8.5 month in the control group (NS). The mean physical component summary score was 67.2 vs 69.7 points (NS) in the control group. The mean mental component summary score was 72.3 vs 74.4 points (NS) respectively. There were no significant differences between the groups in the following multi item domains: general health, vitality, social functioning, emotional role functioning and mental health, except physical functioning: 73.5 vs 76.3 points, p < 0.008 respectively. Additional questions asked revealed high satisfaction with performed PTCA, similar in both groups: 65 pts (91.6%) vs 71 pts (98.6%) (NS). 70 (99%) elderly pts considered this method most valuable and would undergo this procedure eagerly again, if necessary. During the observation 21 (29.6%) elderly pts required hospitalization because of the chest pain, 2 pts (2.8%) had nonfatal myocardial infarction and 3 pts (4.2%) underwent surgical revascularisation (CABG). In the control group 12 pts (16.4%) were re-hospitalized, 1 pt (1.4%) required CABG and no acute cardiac events were observed. Smoking was continued significantly more frequently in the younger pts: 12 (16.4%) vs 2 (2.8%) p = 0.05. 72 (98.6%) younger pts and 60 (84.5%) elderly pts reported regular cholesterol level control (NS). Our data suggest that PTCA in elderly pts with symptomatic coronary artery disease, is well tolerated and reflects positively in their quality of life after the procedure.

[Long-term observation of exercise capacity and left ventricular function in patients with coronary heart disease treated surgically and conservatively]. / Odlegla obserwacja wydolnosci wysilkowej i funkcji skurczowej lewej komory serca u pacjentów z choroba wiencowa leczonych operacyjnie i zachowawczo.

[1] CASS Principal Investigators and their Associates.: Coronary Artery Surgery Study (CASS): a randomized trial of coronary artery bypass surgery. Survival data. Circulation 1983; 68: 951-960. [2] Danchin N i wsp. Effect of late percutaneous angioplastic recanalization of total coronary artery occlusion on left ventricular remodeling, ejection fraction, and regional wall motion. Am J Cardiol 1996; 78: 729-735. [3] Dilsizian V i wsp.: Enhanced regional left ventricular function after distant coronary bypass by means of improved collateral blood flow. J Am Coll Cardiol 1989; 14: 312-318. [4] European Coronary Surgery Study Group.: Long-term results of prospective randomized study of coronary artery bypass surgery in stable angina pectoris. Lancet 1982; 27: 1173-1183. [5] Frick MH, Harjola PT, Valle M. Persistent improvement after coronary bypass surgery: ergometric and angiographic correlations at 5-years. Circulation 1983; 67: 491-496. [6] Gasior Z i wsp. Chirurgiczna rewaskularyzacja miesnia serca a funkcja skurczowa lewej komory. Kardiol Pol 1997; 46: 200-211. [7] Hirnle T i wsp.: Badanie histologiczne wycinków tetnicy piersiowej wewnetrznej, zyly odpiszczelowej wielkiej i aorty pobranych w czasie operacji kardiochirurgicznych. Kardiol Pol 1991; 34: 155-159. [8] Hultgren HN i wsp.: The 5 year effect of bypass on relief of angina and exercise performance. Circulation 1985; 72: (suppl V) 79-89. [9] Kmiec G, Zwirski W, Moczurad K. Ocena odleglych wyników leczenia operacyjnego choroby niedokrwiennej serca w oparciu o testy wysilkowe, badanie polikardiograficzne oraz powrót do pracy zawodowej. Kardiol Pol 1990; 3: 179-183. [10] The Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group.: Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina. N Engl J Med 1984; 311: 1333-1339.

[Normalization of lipid metabolism disturbances and clinical course after percutaneous coronary angioplasty: 6 month observation]. / Normalizacja zaburzen gospodarki lipidowej a przebieg kliniczny po zabiegu przezskórnej angioplastyki wiencowej: 6-miesieczna obserwacja.

UNLABELLED: The recurrent stenosis of previously successfully dilated coronary arteries still remains a matter of concern despite of the improved short and long term results of percutaneous coronary angioplasty. The role of dyslipidaemia in the origin of restenosis after coronary angioplasty is still controversial. The aim of our study was to evaluate the efficacy of hypolipemic treatment in patients undergoing coronary angioplasty and to find out whether successful lowering of lipid parameters to normal limits is related to improvement exercise capacity and systolic function of left ventricle. The study group comprised 152 patients (17 women, 135 men), aged 52 +/- 8.8 years, who were reffered for percutaneous coronary angioplasty (PTCA). The patients were divided, according to the ratio of total cholesterol to HDL cholesterol (CH/ch-HDL), into two subgroups: subgroup I with CH/ch-HDL > 5.0 and subgroup II with CH/ch-HDL < or = 5.0. In all patients following parameters: total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and body mass index were measured before PTCA, 1 month and 6 months after the procedure. At the same times a treadmill test and echocardiography were performed. Baseline total cholesterol, HDL cholesterol and triglycerides were significantly higher in subgroup I. In subgroup I Ch/ch-HDL ratio was at baseline 7.4 +/- 2.0 and decreased 6 months after PTCA to 5.2 +/- 1.7, p < 0.001. The CH/ch-HDL ratio was 4.2 +/- 0.6 in subgroup II before PTCA and remained the same 4.1 +/- 1.2 after 6 months. Before PTCA, the exercise capacity did not differ between groups 9.1 +/- 2.5 vs 9.6 +/- 3.3 MET, p = ns. A significant improvement of exercise capacity was observed in subgroup I 1 month after PTCA 9.1 +/- 2.5 to 11.2 +/- 2.7 MET, p < 0.001, remaining at the same level after 6 months. The differences seen in group II did not reach the statistical significance. Echocardiography revealed improvement of left ventricle contractility in both subgroups, with statistically significant increase in group I (1.24 +/- 0.36 to 1.14 +/- 0.27, p < 0.001). The left ventricle systolic function was within normal limits in all patients before coronary angioplasty and increased significantly 1 month after PTCA in subgroup I (56.1 to 60.4%, p < 0.001). 6 months after PTCA no further significant changes were observed. CONCLUSIONS: The dyslipidaemic state recognised before PTCA does not influence clinical outcomes after the procedure. Lipid lowering therapy should be offered to every patient undergoing coronary angioplasty regardless of the baseline value of total cholesterol to HDL cholesterol ratio. Optimal treatment of dyslipidaemia leading to lower total cholesterol, triglycerides and total cholesterol to HDL cholesterol ratio, to normal limits, is associated with improved exercise capacity and systolic function of left ventricle six months after successful coronary angioplasty.

[The evaluation of the coronary artery sufficiency in myocardial infarction patients after cardiac surgery and preventive therapy]. / Ocena wydolnosci wiencowej u chorych po zawale serca leczonych operacyjnie lub zachowawczo.

During 5 years period (1989-1993) the authors investigated a group of 40 patients with coronary artery disease after myocardial infarction treated in the Silesian Center of Cardiology in Katowice. 20 patients were operated on (CABG), 20 were medically-treated. It was evaluated the history, physical status, stress-test, echocardiography and 24-hours ECG. Stress test was estimated according to Mark's test. In the echocardiographic examination it was observed wall motion score index (WMSI) and the left ventricular abnormal contraction area (AA). In the operated group it was noticed higher physical ability and no influence of CABG on left ventricular contractability.

[Effect of aorto-coronary bypass on function of cardiac ventricles as evaluated by non-invasive techniques during a two year observation]. / Wplyw pomostowania aortalno-wiencowego na czynnosc komór serca oceniany metodami nieinwazyjnymi w dwuletniej obserwacji.

In 1989-1990, 892 patients with ischemic heart disease were treated at the III Department of Cardiology in Katowice-Ochojec. Aortocoronary bypass was performed in 51 (5.7%) of these patients. Thirty five out of these patients were followed-up for 24 months after surgery. They reported to the hospital for evaluation after 3, 6, 12 and 14 months following a discharge. Efficiency of revascularization was checked with physical examination, and non-invasive tests such as electrocardiography, echocardiography and exercise tolerance testing. Diastolic and symbolic functioning of left and right ventricle was assessed separately. All patients suffered from anginal pain before surgery whereas 85% of operated patients were free from pain. No correlation between incomplete revascularization and recurrence of the anginal pain was noted. Surgery produced an increase in exercise tolerance and maximal load. No significant improvement in the right ventricle was seen during a 2-year follow-up. In the group of patients without previous myocardial infarction measured parameters of cardiac ventricles functioning were better than those in patients who had myocardial infarction. Therefore, the former are better candidates to coronary vessels revascularization.

[Congestive cardiomyopathy after a 10-year observation]. / Kardiomiopatia zastoinowa w 10-letniej obserwacji.

A progress in the Polish cardiosurgery promising survival has led to the analysis of patients with congestive cardiomyopathy diagnosed with non-invasive techniques. The study involved 44 patients treated at the III Department of Cardiology in Katowice-Ochojec in 1980-1989. Sixty six percent of these patients were men. Etiology remained unknown in half of them, suggesting the primary cardiomyopathy (group I). As a cause of the secondary cardiomyopathy (group II) infections were considered (bacterial, fungal, and tuberculous), systemic diseases, and ischemic heart disease. Clinical status and results of all non-invasive diagnostic procedures performed since the beginning of therapy to the end of 1989 were analysed. Ultimate examination were performed at the Voivodeship Cardiologic Out-patient Clinic. Dynamics of the disease and effectiveness of the treatment were evaluated. In case of death its direct cause was sought. All results were compared in both groups.