[Effect of postinfarct left ventricular dysfunction on late occurrence of mitral regurgitation--two year experience]. / Wplyw pozawalowego uszkodzenia lewej komory na wystepowanie póznej niedomykalnosci mitralnej--obserwacja 2-letnia.

The aim of this study was to evaluate factors that might influence on the occurrence of mitral regurgitation (MR) in patients (pts) following myocardial infarction (MI) after fibrinolysis--two year experience. The study group comprised 118 pts: 40 women and 78 men (mean age: 58 +/- 9 years) following MI, who underwent Doppler echocardiography which revealed no MR 3 weeks after the MI. The second echocardiographic examination was performed after 2 years. We evaluated the following parameters: presence and stage of MR, left ventricular end-diastolic diameter (LVDD), left atrial diameter (LA), end-diastolic volume (EDV), wall motion score index (WMSI), asynergic area (AA) and ejection fraction (EF). Results after 2 years were as follows: 43 pts (36%) presented without MR, 45 (38%) MR I degree, 27 (23%) MR II degree, 3 (3%) MR III degree. Echocardiographic parameter comparison after 2 years demonstrated the following changes: LVDD increase from 5.0 +/- 0.5 cm to 5.3 +/- 4.6 cm (p < 0.005), LA increase from 3.7 +/- 0.4 cm to 4.3 +/- 0.4 cm (p < 0.00001), EDV increase from 130 +/- 29 ml to 147 +/- 39 ml (p < 0.005), WMSI increase from 1.37 +/- 0.23 to 1.45 +/- 0.21 (p < 0.05), AA increase from 23.5 +/- 10.1% to 27.8 +/- 7.9% (p < 0.005) and significant EF decrease 50.4 +/- 7.9% to 46.9 +/- 7.1% (p < 0.005). These results demonstrate that the occurrence of MR 2 years after the MI is caused by left ventricular remodelling, as well as segmental and global function deterioration.

[Coronary disease and hormonal treatment during the perimenopausal period]. / Choroba wiencowa a leczenie hormonalne w okresie okolomenopauzalnym.

Hormone replacement therapy (HRT) is widely recognized as probably most advisable treatment of perimenopausal women with cardiovascular disorders. Whenever HRT is administered for gynecological reasons, special attention should be paid to the presence of cardiological risk factors as these may be potentiated by high doses of gestogens. The authors undertake this problem inspired by a cases of a 53-years old patient (given oral lynestrol fair persisting uterine bleedings) who suffered from several complications, including venous thrombosis and myocardial infarction.

[Evaluation of treating anemia in patients undergoing chronic dialysis with small doses of human recombinant erythropoietin]. / Ocena leczenia niedokrwistosci u chorych przewlekle dializowanych malymi dawkami ludzkiej rekombinowanej erytropoetyny.

The aim of the study was to assess the efficacy of low dose subcutaneous (sc) recombinant human erythropoietin (rHuEpo) therapy in hemodialysis (hd) patients, with particular emphasis on their quality of life. 25 anemic (Ht < 25%) hd patients with end-stage renal disease were given small sc doses of rHuEpo once or twice weekly for 12 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5 vs 28.5 +/- 0.6%; p < 0.0001) and serum hb (6.68 +/- 0.12 vs 8.51 +/- 0.18 g/dl; p < 0.0001) at mean induction dose of 52.5 +/- 2.5 IU/kg/week and this was maintained with a mean dose 67.0 +/- 10.5 IU/kg/week. RHuEpo was effective in 24 patients; all of them required no blood transfusions after starting the therapy. In majority of patients an substantial (p < 0.01) improvements in exercise tolerance, well-being, cold tolerance, sexual satisfaction and libido were observed, although sexual hormones profile revealed no significant changes during the treatment. Within first 6 months of the study cardiac index decreased substantially (p < 0.01), mainly because of stroke volume reduction, but after one year this hemodynamic improvement was noted only in patients who maintained a stable blood pressure. Hypertension worsened in 31% of patients. Low-dose s.c. rHuEpo: (1) is effective and safe treatment for anemia in hds patients, sufficient to abolish blood transfusion requirements; (2) produces significant improvements in quality of life; and (3) allows for 50% costs reduction.