Left ventricular mass in patients with hyperthyroidism.

BACKGROUND: The mechanisms of increased left ventricular mass (LVM) in hyperthyroidism are complex. The aim was to determine the effects of hyperthyroidism and thyreostatic therapy on LVM regarding its interrelationship with factors responsible for the heart's hemodynamic workload. MATERIAL/METHODS: The study included 51 hyperthyroid subjects and 30 healthy controls. Left heart ventricle parameters evaluated using standard ultrasonocardiography were: left ventricular volume (end-systolic and end-diastolic), left ventricle posterior wall thickness at systole (LVPWs) and diastole (LVPWd) with the respective interventricular septal thicknesses (IVSs, IVSd), LVM, stroke volume (SV), cardiac output (CO), output-pressure index (OPI), and total peripheral resistance (TPR). Systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), and body mass index (BMI) were investigated. Measurements were repeated after two weeks of thiamazole treatment and after attaining euthyreosis. RESULTS: Compared with controls, the hyperthyroid subjects had significant thickening of LVPWd, LVPWs, and IVSs, increased LVM, augmented SV, CO, OPI, SBP, and HR, but reduced TPR and DBP. Hyperthyroid treatment did not normalize LVM. LVM showed positive correlations with SV, CO, OPI, SBP, BMI, and serum triiodothyronine concentration and negative correlation with TPR. In multivariate regression analysis, LVM correlated with SBP, SV, and BMI (R=0.64, p<0.001). CONCLUSIONS: 1) In hyperthyroid patients, LVM is increased, mainly due to its eccentric remodeling, probably caused by volume overload; the increased LVM does not seem to be reversible despite attainment of euthyreosis. 2) The increased LVM is probably related to the heart's hemodynamic workload and reflects adaptive changes.

[Does coffee drinking influence serum uric acid concentration?]. / Czy picie kawy ma wplyw na stezenie kwasu moczowego w surowicy krwi?

The drinking of coffee, a commonly used beverage, was a subject of many studies, mainly regarded to coffee influence on cardiovascular system. However, only one study indicates that coffee drinking in male adults may lead to decrease in serum uric acid level. Hyperuricaemia is a risk factor of many diseases. The aim of this study was to examine the influence of coffee drinking on serum uric acid concentration. 1955 working persons aged from 18 to 65 years were included into research. There were 571 women among them. We determined energy expenditure during professional work, blood pressure, body mass index, and measured serum levels of uric acid, glucose and creatinine. The amount of coffee and ethanol consumption was evaluated on the ground of an interview. It was showed that persons drinking coffee have lower serum uric acid concentration than non-drinkers, especially among women, who drank more coffee then men. Uricaemia was correlated negatively with number of cups of coffee consumed and positively with body mass index, ethanol consumption and diastolic blood pressure. The author conclude that: 1) among women drinking on an average 10 cups of coffee per week appeared a decrease in serum uric acid concentration and a lower risk of development of hyperuricaemia, 2) elevated serum uric acid concentration is accompanied by elevated blood pressure and increased body mass index.

Pulmonary functional abnormalities in asymptomatic patients with systemic sclerosis.

BACKGROUND: Systemic sclerosis (SSc) is a disease characterized by widespread fibrosis of the skin and multiple organs, including the lungs. This study was designed to evaluate pulmonary function in SSc patients without symptoms of lung involvement. METHODS: Spirometric measurements were done in 26 female SSC patients without symptoms of pulmonary involvement. RESULTS: Maximal voluntary ventilation was found to be decreased in half of the patients, and forced vital capacity was decreased in 23% of the patients. Forced expiratory flow rate was impaired in about half of the SSc patients, especially the flow at 50-75% of forced vital capacity. Peak expiratory flow rate was decreased in 77% of asymptomatic patients. CONCLUSIONS: A functional defect, mainly of the restrictive type, was observed in the majority of asymptomatic patients with SSc. Pulmonary function testing is recommended for all SSc patients.

[Is use of nitric oxide (NO) synthase inhibitors justified for therapy of septic shock?]. / Czy stosowanie inhibitorów syntetaz tlenku azotu (NO) jest uzasadnione w leczeniu wstrzasu septycznego?

NO mediates many systemic reactions in humans and animals. It is produced by constitutive synthases (cNOS) and one inducible by cytokines and endotoxines (iNOS). We summarize, on the base of experimental and clinical data, the pathophysiological role of NO in septic shock as well as the effects of pharmacological application of NOS inhibitors. The analysed data show, that the contribution of NO to the pathomechanism of septic shock is rather heterogenous, therefore the clinical therapeutical application of selective iNOS inhibitors is impossible without adequate new monitoring tools.

Changes of arterial pressure in patients with hyperthyroidism during therapy.

BACKGROUND: Hyperthyroidism affects the circulatory system, producing an increase in cardiac output and an enhanced vascular bed volume. These phenomena are important in the regulation of blood pressure. The present study was designed to evaluate the effects of short- and long-term treatment of hyperthyroidism on arterial pressure, taking into account the indices of cardiac function and peripheral vessel resistance. MATERIAL/METHODS: Fifty-one patients with hyperthyroidism and 30 healthy controls were investigated. The patients were examined before treatment, two weeks after initiation of therapy, and after attainment of a euthyroid state. Thiamazole was used as the antithyroid agent. Blood pressure and serum thyroid hormones were determined and ultrasonographic examination was performed on all the subjects, after the application of a diet containing 120 mmol of sodium and 70 mmol of potassium for three days. RESULTS: Patients with hyperthyroidism had higher systolic blood pressure and lower diastolic blood pressure than the healthy controls. After short-term treatment, systolic blood pressure returned to normal, while diastolic blood pressure was normalized only after long-term treatment. CONCLUSIONS: Regulation of blood pressure in patients with hyperthyroidism is a complex process. Systolic blood pressure is mainly related to cardiac output and returns to normal range shortly after the initiation of therapy, while diastolic blood pressure is related to peripheral vascular resistance and is normalized after long-term treatment.