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Background: Congenital heart diseases (CHD) are the leading cause of birth defect-related deaths. Multidedector computed tomography (MDCT) plays an important role for imaging CHD in addition to echocardiography and provides a comprehensive evaluation of complex heart malformations for the referring cardiologist. The aim of the study was to evaluate the utility of MDCT in the assessment of CHD. Materials and methods: A 102 patients with CHD were investigated after initial assessment by echocardiography. The information obtained by MDCT and findings of echocardiography were reviewed together by paediatric cardiologists and cardiac radiologists. Perioperative anatomic descriptions, wherever available (n = 34) formed the gold standard for the comparison. Results: The clinical consensus diagnosis defined 154 cardiovascular lesions in the patients. The results were classified in groups. We present the appearance of various congenital cardiac lesions seen in clinical practice. Conclusions: MDCT provides important information about anatomic details of CHD for the referring cardiologist. The evaluation of different anatomic structures such as heart, great vessels, lungs and abdomen is possible in one acquisition with this technique. (Folia Morphol 2013; 72, 3: 188–196)
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Polish thread in the history of circulatory physiology

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A review of the most outstanding achievements in physiology of circulation done by scientists and physicians from Poland and evaluation of their contribution to the world knowledge in this matter is presented in the paper. The authors associate the beginnings of the Polish history of studying heart and its diseases with the brilliant physician from the XIVth century - Thomas of Wrocław, and then in the XVIth century, with the most eminent physician of Polish Renaissance, the expert on pulse, Joseph Struś. The attempts to address the issues related to the circulatory system over historical period of early ages, through baroque and the blooming period in medicine of the XIXth, up to our times, were presented. The memories of the exceptional and the more or less known in the world cardiologic ancestors, associated with Poland, were recalled, such as: Adam.Ch. Thebesius, Robert Remak, Edward Korczyński, Oscar Widmann, Napoleon Cybulski, Joseph Pawiński, Andrew Klisiecki, Adolph Beck, Leon Popielski, Wiesław Hołobut and many others. The analysis of Polish achievements in the field of diagnosing and treatment of the ischaemic heart disease, starting from beginnings of the XIXth century, was performed. The authors also tried to recapitulate the achievements of the last 50 years in cardiological diagnostics, modern interventional cardiology, cardiac surgery along with transplantology and the scientific programmes concerning these issues. The examples of the greatest scientific achievements related to the circulatory system and to myocardial physiology and pathology over the period of recent decade were described.
Nitric oxide (NO) is present in exhaled air in humans and its level may decrease in heart diseases. Nitrates are metabolized to NO. In the present study we prospectively investigated how coronary disease treated with oral nitrates and physical exercise influence the exhaled NO concentration (exNO). The study was performed in 44 patients with stable coronary artery disease (CAD) treated with oral nitrates (31 nonsmokers and 13 smokers) and 34 healthy volunteers (21 nonsmokers and 13 smokers). End-tidal concentration of exhaled NO was measured by the use of a chemiluminescence method. The Bruce protocol of an exercise test was performed in 21 coronary patients and 11 volunteers. NO was measured before and 2-5 min after the test. We found no significant differences in the exNO level between healthy controls and CAD patients as analyzed either for the whole groups or non-smoker and smoker subgroups (6.01 parts per billion (ppb) vs. 4.91 ppb; 7.02 ppb vs. 5.89 ppb; 3.62 ppb vs. 3.33 ppb, respectively). However, the coronary patients group, as a whole, had lower exNO after exercise (4.22 ppb vs. 3.84 ppb, P<0.01). The difference persisted after division of this group into non-smokers and smokers: 5.19 ppb vs. 4.79 ppb, P<0.05 and 3.63 ppb vs. 3.27 ppb, P<0.05, respectively). The level of exNO changed inappreciably after exercise in control subjects. We conclude that coronary disease and oral nitrates, in themselves, do not influence the exhaled NO concentration. Physical exercise, on the other side, lowers the exhaled NO level in coronary patients.
The aim of the presented electrophysiological and histological study was the investigation of unexplained syncopal spells in a dog of Boxer breed. The dog underwent non-invasive procedures, which turned out to be insufficient for a complete diagnosis. Invasive procedures showed paroxysmal atrial fibrillation. In post-mortem examination, intensive extravascular fibrosis in the both atria, mostly in the endocardium, as well as a local loss of the cross-striation in cardiomyocytes, the presence of giant nuclei, and penetration of adipose tissue, especially in the left ventricle, were found. These changes might be the cause of arrhythmias. Paroxysmal atrial arrhythmias can be the mechanism of syncope in dogs. The electrophysiological properties of the myocardium predispose to both supraventricular and ventricular arrhythmias in dogs. Invasive electrophysiological study is a valuable diagnostic tool in dogs with syncope.
High plasma levels of fibrinogen and plasminogen activator inhibitor (PAI-1) are reported to be correlated with coronary heart disease. Therefore the level of fibrinogen concentration in plasma was examined and verified for the possible correlation with the previously explored PAI-1 antigen and PAI-1 activity in the pathogenesis of premature atherosclerosis (Grzywaczet al., 1998,Blood Coagul Fibrinol. 9, 245-249). Examination included only men, aged 33-46 years, who were in a stable condition for at least six months after the acute event. They were divided into two subgroups: group A (n = 14) with and group B (n = 15) without ischaemic changes in 24 h Holter electrocardiogram. The number of involved vessels visible on the coronarography picture was similar in both groups. In the patients of group A the mean level of fibrinogen (3.92 vs 3.23 g/l, P < 0.05) was higher than in the controls (n = 15). No statistically differences were found between group B and control healthy subjects in any of the parameters measured. There were no correlation between fibrinogen concentration and PAI-1 antigen and activity levels, which were elevated in both groups of patients according to our previous study. Our results indicate that elevated levels of plasma fibrinogen and PAI-1 appeared in the group of patients with more severe disease, as revealed by silent myocardial ischaemia.
Resveratrol (3,4',5-trihydroxystilbene), a compound found in many plants, has been shown to prevent coronary heart diseases and to exert a variety of antiinflammatory and anticancerogenic effects. It is effective in lowering the level of serum lipids and in inhibiting platelet aggregation. We evaluated the effect of trans-resveratrol on the production of free radicals in pig blood platelets and showed that resveratrol inhibited the production of different reactive oxygen species (O·2H2O2, singlet oxygen and organic radicals) measured by the luminol-dependent chemiluminescence in resting platelets (P < 0.05). Resveratrol inhibited also the generation of radicals in platelets activated by thrombin (P < 0.05). Treatment of platelets with resveratrol at concentrations of 6.25 and 12.5 μg/ml caused a statistically insignificant increase in the production of O·->2 in these cells, as measured by reduction of cytochrome c; however, at higher doses (25, 50 and 100μg/ml) resveratrol distinctly reduced the generation of O·->2 in platelets (P < 0.05). We suggest that free radicals play an important role in the reduced reactivity of blood platelets induced by resveratrol.
The long QT syndrome (LQTS) is an inherited cardiac arrhythmia that may lead to sudden death in the absence of structural heart disease. Mutations in the cardiac potassium and sodium channel genes can be found in approximately 70% of patients with a highly probable clinical diagnosis. In this study, we aimed to genotype and explore the yield of genetic testing of LQTS patients from Greece, for whom there are no collective published data available. We clinically evaluated and genetically screened 17 unrelated patients for mutations in the KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2 cardiac ion channel genes. Genetic testing was positive in 6 out of 8 patients with a highly probable clinical diagnosis of LQTS and negative for all the other patients. Two patients carried KCNQ1 mutations (c.580G>C, c.1022C>T), while 4 patients carried KCNH2 mutations (c.202T>C, c.1714G>A, c.3103delC, c.3136C>T). To the best of our knowledge, the last mentioned mutation (c.3136C>T) is novel. Moreover, 27 single-nucleotide polymorphisms (SNPs) were detected, 5 of which are novel. Our preliminary data indicate a low genetic diversity of the Greek LQTS genetic pool, and are in accordance with international data that genetic testing of the major LQTS genes is efficient in genotyping the majority of patients with a strong clinical diagnosis. Therefore, the transition of an LQTS genetic screening program from research to the diagnostic setting within our ethnic background is feasible.
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