[Left ventricular geometry in inhabitants of Tallinn (an echocardiographic population study)]. / Osobennosti geometrii levogo zheludochka po dannym ékhokardiografii v populiatsii Tallina.

Echocardiography was performed in 325 men and 398 women in the framework of a population survey of inhabitants of Tallinn aged 35 to 59 years in 1999-2001. Left ventricular geometry was analyzed according to generally recognized four types. Prevalence of concentric hypertrophy was similar in men and women (7.7% and 9.1%, respectively). In all age groups prevalence of eccentric hypertrophy in women was 4-10-fold higher than in men (33.3 and 4.9%, respectively). Concentric remodeling was also more frequent in women than in men (9.5 and 5.5%; respectively, p<0.05). Regardless of sex and age, concentric hypertrophy was never found in participants with normal blood pressure. In hypertensives there was a tendency for age-related increase of prevalence of concentric hypertrophy: the latter was higher in women than in men (39.1% and 25.5%; respectively, p<0.05). In examinees with body mass index (BMI) <30 this type was rare. In obese persons its frequency increased with age in both sexes reaching 26.5% in men and 21.2% in women (p<0.05). Prevalence of eccentric hypertrophy in men increased with age, especially in the presence of hypertension and obesity. In men the prevalence of concentric remodeling was not related to BMI; it was significantly more often found in older age groups and in hypertensives. In women the prevalence of eccentric hypertrophy and concentric remodeling was not related to age, hypertension and BMI. The frequency of normal geometry decreased with age in both sexes.

[QT interval dispersion and hypertension in different variants of left ventricular geometry (population study)]. / Dispersiia intervala Q-T i arterial'naia gipertenziia pri raznykh variantakh geometrii levogo zheludochka (populiatsionnoe issledovanie).

AIM: To assess relationship between QT dispersion, hypertension, and different variants of left ventricular geometry (concentric or eccentric hypertrophy, concentric remodeling). MATERIAL AND METHODS: Blood pressure measurement, electro- and echocardiography were used in the study of a random sample of Tallinn population (321 men and 396 women) aged 35-59 years. Corrected QT dispersion (QT(c)D) equal to or exceeding 70 ms was considered increased. RESULTS: Increase of QT(c)D was associated with left ventricular hypertrophy, especially with its concentric variant. QT(c)D prolongation was significantly more frequent in subjects with hypertension.

[Myocardial mass and geometry in population study of women in Tallinn (echocardiography data)]. / Opredelenie massy miokarda levogo zheludochka i ego geometrii po dannym ékhokardiografii v populiatsionnom issledovanii zhenshchin Tallina.

In a framework of a population study in Tallinn triple blood pressure measurements, electro- and echocardiography were carried out in 398 women (82.6% of all participants) aged 35-59. Left ventricular hypertrophy (left ventricular mass >or=198 g, left ventricular mass/height ratio >or=121 g/m, left ventricular mass/body surface area ratio >or=120 g/m2) was found in 43% of these women. Distribution of variants of left ventricular remodeling was as follows: concentric hypertrophy - 9.1%, eccentric hypertrophy - 33.9%, concentric remodeling - 9.5%, normal myocardial geometry - 47.5%. Only concentric hypertrophy was associated with elevated blood pressure and obesity frequency of both of which increased with age.

Screening for a prothrombotic diathesis in patients attending family planning clinics.

AIMS: 1. To determine the frequency of prothrombotic markers in young women seeking a new or a repeat prescription of the oral contraceptive pill and perceived to be at high risk of thrombosis. 2. To assess cost-effectiveness of thrombophilia testing within this population. 3. To determine the frequency of acquired activated protein C (APC) resistance. METHODS: Results of thrombophilia testing were retrospectively reviewed on 220 consecutively referred patients' plasmas. Women tested were clients attending local family planning clinics for a new or repeat contraceptive prescription. Samples for testing were collected by the Community Laboratory Service. Investigations included: antithrombin III (AT III), protein C, protein S, APC resistance, factor V Leiden mutation analysis and anti-cardiolipin antibodies. RESULTS: Abnormalities were detected in 35 (15.9%) of the 220 women tested. No patient had all tests performed. The most frequently detected abnormality was an increased APC resistance in 6.8% of the women tested. Three of the 13 patients with an abnormal APC resistance had a discrepancy between the low APC ratio and a negative mutation analysis result for factor V Leiden, suggesting acquired APC resistance. Deficiency of protein C was found in 1.2% (of 162), protein S in 2.0% (of 140), antithrombin III in 0.6% (of 159). Low-titre anti-cardiolipin antibodies were detected in 13.9% of this group (115 tested). CONCLUSIONS: The frequency of abnormal thrombophilia markers detected in this cohort of young women is not significantly different from that seen in a control population. This low incidence suggests that testing has been applied on a population screening basis, rather than preselecting a high-risk group. Thrombophilia screening in this patient group cannot be justified when the clinically relevant end-point is death from pulmonary embolism. The cost of preventing one fatal pulmonary embolism arising as a consequence of screening for activated protein C resistance due to the commonly occurring factor V Leiden is a minimum $25,000,000. This compares very unfavourably with the estimated cost per life saved in the National Breast Screening Programme.