Systolic myocardial volume gain in dilated, hypertrophied and normal heart. CMR study.

AIM: To investigate changes in myocardial tissue volume during the cardiac cycle to verify the hypothesis of non-compressibility of the myocardium in healthy individuals (HI) as well as in patients with hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and aortic stenosis (AS). MATERIALS AND METHODS: The study group included 30 HI, and patients with HCM (n=110), DCM (n=89), and AS (n=78). Left ventricular (LV) function, end-diastolic, and end-systolic volumes were calculated based on cardiac magnetic resonance imaging (CMR) for all participants. RESULTS: End-systolic myocardial volumes were higher than end-diastolic in both controls (91.2±26.6 versus 85.1±24.3 ml, p<0.001) and in all patient groups: HCM (214.3±81.6 versus 176±64.2 ml, p<0.01), DCM (128.4±43.1 versus 115.4±42.9 ml, p<0.001) and AS (155.1±37.1 versus 129.4±34.6 ml, p<0.001). HCM and AS patients had significantly higher systolic volume gain than HI (21.5±8.3 versus 10.6±6.3%, p<0.01 and 18.3±5.7 versus 10.6±6.3% p=0.013, respectively). Conversely, DCM patients had lesser increases in myocardial systolic volume than HCM patients (11.2±4.8% versus 21.5±8.3, p=0.01) and AS patients (11.2±4.8% versus 18.3±5.7, p=0.02). No differences were found in systolic volume gain between AS and HCM patients (p=ns) or between DCM patients and HI (p=ns). CONCLUSION: End-systolic myocardial volume was significantly higher than end-diastolic volume in all subsets of patients. The systolic volume gain was greater in individuals with hypertrophy than in those without.

[Early exercise test in patients with myocardial infarction after nifedipine administration of prolonged duration]. / Wczesny test wysilkowy u chorych z zawalem serca po podaniu nifedypiny o przdluzonym dzialaniu.

In 25 patients with transmural myocardial infarction a mean of 16 days after the onset of infarction an exercise stress test was performed 2 hours after the administration of Corinfar Retard. We evaluated ECG, blood pressure, heart rate, echocardiograms and spirographic parameters before and after drug administration. In the majority of patients ST segment depressions were reduced and duration of the exercise test increased or remained unchanged. In 5 patients the magnitude of ST segment depression was markedly decreased and associated with prolonged duration of exercise and substantial patient comfort. In these patients the drug is continued, as its withdrawal resulted in decreased exercise tolerance with accompanying chess discomfort. Corinfar Retard significantly decreased weigh blood pressure, both systolic and diastolic, whereas its effect on low blood pressure was only slight or none. Heart rate was higher before exercise, during and after exercise it did not differ from that measured without the drug. Ejection fraction increased by a mean of 4%; VC and FEV1 increased or remained unchanged. Exercise testing was safe, did not produce and any side effects and seems to be useful in deciding about the choice of drug after myocardial infarction, especially in patients with counterindications to beta blockers.