[Stress echocardiography: methods, indications, clinical application]. / Echokardiografia obciazeniowa--metody, wskazania, zastosowanie kliniczne.

Stress echocardiography is an accepted alternative method for non-invasive assessment of coronary artery disease--diagnosis, risk stratification and prognosis. Myocardial ischaemia triggers a cascade of events resulting first in regional relaxation abnormalities (or diastolic dysfunction) followed by regional motion abnormalities (or diastolic dysfunction). The basic principle in stress echocardiography is to provoke myocardial ischemia by exercise, pharmacologic interventions (like dobutamine, dipirydamole, enoximone, adenosine) or less often atrial pacing and subsequently to evaluate regional wall motion abnormalities in segments vascularized by coronaries with flow--limiting stenosis. Myocardial viability can be identified at the low dose dobutamine or dipirydamole stage as a functional improvement in regions with rest dyssynergy and myocardial ischaemia can be recognized at high doses as well motion dysfunction. The ideal test for evaluation of the patient with CAD remains exercise stress testing, pharmacologic stress should be reserved only for those patients in whom optimal workload of stress cannot be obtained. This article reviews the current status of stress echocardiography in clinical practice and assesses the possible indications for the tests in a modern cardiac department.

[Adenosine deaminase: isoenzymes ADA1 and ADA2]. / Deaminaza adenozyny: izoenzymy ADA1 i ADA2.

The isoenzymes ADA1 and ADA2 of the enzyme adenosine deaminase (ADA 3.5.4.4) deaminate mainly two nucleotides: adenosine and 2'-deoxyadenosine, molecules with many effects on human cells. Thus, the ADA1 and ADA2 in human cells are of extreme importance. Biochemical and biological properties of the isoenzymes ADA1 and ADA2 as well as their usefulness in diagnostic of many diseases were described.