Kardiol Pol
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Comparative Study
Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?
The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland in recent years is scarce. ⋯ We noted a modest improvement in the implementation of CAD secondary prevention guidelines in everyday clinical practice: blood pressure was better controlled, although the control of all other main risk factors did not change significantly. Our data provides evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients.
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The Patient Perception of Arrhythmia Questionnaire (PPAQ) is a disease-specific questionnaire designed to measure symptoms and health-related quality of life in patients suffering from a group of arrhythmias collectively known as supraventricular tachycardias (SVT). There is no valid translation of PPAQ available in Poland, which hinders research in this area with Polish arrhythmia patients. ⋯ The Polish translation was well accepted by patients during this translation and initial content validity testing. Issues arising during the translation process may recur in other translations and be resolved in a similar manner.
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Anaesthetic drugs and internal electrical shock may alter the haemodynamic status of patients undergoing implantable cardioverter-defibrillator (ICD) testing. Comparative data on the mechanisms of etomidate and propofol-induced changes in haemodynamic parameters are inconsistent. Also the effects of ICD shock on haemodynamics have not been extensively studied. ⋯ Propofol significantly decreased BP probably by both reducing CO and causing vasodilatation, whereas etomidate only slightly decreased dBP and mBP without affecting other parameters. Propofol-induced changes were independent of LVEF or NYHA class. Induction of VF and internal defibrillation did not cause clinically significant changes apart from very modest drops in dBP and mBP values.
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Although moderate to severe diastolic dysfunction (DD) seems to be associated with poor prognosis after isolated coronary bypass surgery, the impact of mild DD has not been investigated extensively in this group of patients. ⋯ The results from this study indicate that mild LV DD is not associated with adverse outcome after coronary bypass surgery in patients with preserved LV systolic function, thus should not be considered as a preoperative risk factor.
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Obstructive sleep apnoea (OSA) and atrial fibrillation (AF) are two conditions highly prevalent in the general population. OSA is known to cause haemodynamic changes, oxidative stress, and endothelial damage, and therefore promote vascular and heart remodelling which results in AF triggering and exacerbation. Coexistence of OSA and AF influences the course of both diseases, and therefore should be taken into consideration in patient management strategy planning. ⋯ OSA is highly prevalent in patients with AF in the Polish population, and affects approximately half of the patients. OSA patients are more likely to be older, have higher BMI, and greater waist and neck circumference. Persistent AF is the most common form of the arrhythmia in patients with OSA, while patients without OSA are more likely to have paroxysmal AF.