Relation of various degrees of body mass index to systolic and diastolic dysfunctions.

OBJECTIVES: This study was designed to identify any associations between left ventricular function and obesity using clinical two-dimensional echocardiographic and Doppler studies. METHODS: We retrospectively evaluated 260 consecutive clinical echocardiographic findings. Key echocardiographic variables of systolic and diastolic function were related to various degrees of body mass index. RESULTS: In multiple regression analysis in the whole group of patients there was significant relation of body mass index to left ventricular mass and its indexed value (p < 0.0001). Multiple regression analyses in subgroups of patients according to systolic and diastolic function or dysfunction revealed similarly the strongest association of body mass index to mainly left ventricular mass. In subgroups of patients classified on the basis of their body mass indices significant differences were found also in case of left ventricular mass as well as left atrial volume (p = 0.0001, and p = 0.003, respectively). There was no association between body mass index and systolic or diastolic dysfunction. CONCLUSION: We found strong association between obesity and left ventricular mass. Obesity was not related to systolic and diastolic function or dysfunction.

[Dobutamine exercise echocardiography versus SPECT in diagnosing ischemic heart disease]. / Dobutamínová zát'azová echokardiografia vs SPECT pri diagnostikovaní ischemickej choroby srdca.

UNLABELLED: The aim of the study was comparison of dobutamine stress echocardiography with SPECT in the assessment of ischemic heart disease. METHODS: It is a retrospective study analysing 119 patients (72 women and 47 men, mean age 56.9 +/- 10.68 years), who underwent dobutamine stress echocardiography and SPECT. Because of inconclusive findings (LBBB, decreased myocardial perfusion by SPECT depending on the position of the body), 23 patients were excluded. RESULTS: In the whole group of 96 patients the diagnostic validity of dobutamine stress echocardiography was as follows: sensitivity 78%, specificity 93%, positive predictive value 89%, negative predictive value 85%, and kappa value 0.71. In women the sensitivity was 69%, specificity 93%, positive predictive value 79%, negative predictive value 89%, and kappa value 0.64. In men the diagnostic validity was: sensitivity 83%, specificity 92%, positive predictive value 95%, negative predictive value 73%, and kappa value 0.70. CONCLUSION: In conclusion, dobutamine stress echocardiography is highly sensitive and specific method in the diagnosis of ischemic heart disease with good agreement when compared with SPECT. Because of availability and lower cost in comparison with SPECT, dobutamine stress echocardiography is an optimal method in the diagnosis and management of patients with ischemic heart disease in routine clinical practice.

The use of heart rate variability in cardiology.

Heart rate variability is the marker of the heart's response to the autonomic nervous system activity. The decrease in HRV is a clinical predictive factor of overall cardiac mortality, and especially that of arrhythmia complications in the population after infarction. The parameters most significantly used in practice include SDNN and HRV index. Twenty-four-hour measurements are of higher predictive value, and an increase in the positive predictive value can be accomplished by multifactorial stratification. HRV is most frequently combined with ejection fraction and baroreflex sensitivity. The possibilities of HRV assessment are interesting also in coincidence with heart failure, arterial hypertension and atrial fibrillation also after heart transplantation. (Tab. 2, Ref. 63.).

[Atrial natriuretic factor as a marker of clinical severity in cardiac failure]. / Predsienový nátriuretický faktor ako marker klinickej závaznosti srdcového zlyhania.

The authors examined plasma levels of the atrial natriuretic factor (ANF) in 26 patients with manifestations of cardiac failure. The ANF levels were high as compared with reference values (21 +/- 16.7 fmol/ml vs. 4.9 +/- 2.1 fmol/ml) and different in relation to individual functional NYHA classes, i.e. the lowest ones were in the second and the highest ones in the fourth class. Concurrently the authors revealed a statistically significant negative exponential correlation between plasma ANF levels and the left ventricular ejection fraction (r = 0.550, p < 0.01) and a bordeline correlation between ANF and the stroke volume (r = -0.45, p = 0.05). The results indicate that the plasma ANF level is a good indicator of severity of cardiac weakness and can be used in clinical work as a prognostic indicator in patients with heart failure.