[Detection of Signs of Thrombus Formation in Patients With Typical Atrial Flutter].

AIM: to assess rate of detection of markers of thrombi formation and to determine whether transthoracic echocardiography data or clinical characteristics predict severe left atrial appendage [LAA] dysfunction (low LAA velocity, severe spontaneous echo contrast [SEC], LAA thrombus) in patients with typical atrial flutter (AFl). MATERIAL AND METHODS: Consecutive 406 patients (299 with atrial fibrillation [AFib] and 107 with AFl) underwent transesophageal echocardiography before cardioversion. Mean age was 59.3 years, mean CHA2DS2-VASc score- 1.86, mean LAA velocity - 37.02 cm/s. RESULTS: Compared with patients with AF those with AFl had lower rate of detection of markers of thrombi formation (p<0.05). Among patients with AFl 1.8% had SEC grade 4+, 7.4% - LAA velocity less or equal 25 cm/s. LAA thrombus was found in 2.8 and 8.1% of patients with AFl and AFib, respectively. Prevalence of thrombi in left ventricular (LV) cavity was significantly higher inpatients with AFl (3.13 vs. 0.3% in patients with AFib, p=0.02). In patients with AFl systolic LV dysfunction was the main and ost significant predictor of severe LAA dysfunction and presence LV thrombus. CONCLUSION: AFl associated high risk of embolic events is primarily determined by its adverse effect on LV function.

[Right ventricular function and the hemodynamic status of patients with unstable stenocardia]. / Funktsiia pravoho shlunochka i stan hemodynamiky u khvorykh z nestabil'noiu stenokardiieiu.

With the purpose of studying the condition of haemodynamics and function of the right ventricle in 28 patients with unstable stenocardia paired transesophageal electrocardiostimulation and bicycle ergometry [correction of veloergometry] were done with recording of echocardiographic indicators at the height of stress-tests. Important changes were identified in the right ventricular ejection fraction peculiar to changes of end-diastolic and end-systolic volumes in conditions of simulating myocardial infarction.

[The clinico-functional status of patients with unstable stenocardia (based on Holter electrocardiographic monitoring data)]. / Kliniko-funktsional'nyi stan khvorykh na nestabil'nu stenokardiiu (za danymy kholterivs'koho elektrokardiohrafichnoho monitorynhu).

As many as 50 patients presenting with unstable angina were examined for clinicofunctional status, using bicycle ergometry [correction of veloergometry], transesophageal electrocardiostimulation and 24-hour Holter ECG monitoring during 1-yr follow-up. The results of exercise tests at enrollment into the study suggested a dramatic decrement in the patients' exercise tolerance, as to Holter, with the painless myocardial ischemia tending to be more common among them than the painful one. A follow-up study a year later showed the course of the illness to be most variable among those cases presenting with unstable angina. A correction of their management being warranted, the latter was then tailored to the individual on the basis of findings from a comprehensive evaluation of each of them at the original admission to a hospital.