Kardiol Pol
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Patients with inferior wall ST segment elevation myocardial infarction (STEMI) are considered to be at lower risk than patients with anterior wall STEMI. Nonetheless, 30-40% of all acute inferior wall MI cases have a poor prognosis. ⋯ ST segment changes in lead aVR occurred in approximately half of inferior wall STEMI patients. The presence of such ST segment changes was associated with a poorer prognosis during the hospital stay, and the changes were not associated with the type of reperfusion treatment.
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In order to achieve optimal outcomes when treating ventricular tachyarrhythmias with implantable devices, it is extremely important to identify parameters predisposing to arrhythmia. In view of current restrictions in healthcare funding, there is a growing demand for additional predictors of arrhythmia that would allow better patient selection for implantable cardioverter-defibrillator (ICD) use for primary prevention of sudden cardiac death (SCD). ⋯ Factors associated with a significantly increased risk of ventricular tachyarrhythmia/appropriate ICD intervention included reduced LVEF, increased resting HR, NYHA class II or higher heart failure, and wide QRS. Patients with low LVEF (< 31%) are at particular risk of SCD due to ventricular arrhythmia and this parameter alone can influence the decision regarding ICD implantation. No effect of ICD interventions on total mortality was observed, although more ICD interventions were observed in patients who died due to heart failure.
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Tako-tsubo cardiomyopathy (TTC) is an uncommon transient cardiomyopathy with a clinical and electrocardiographic (ECG) presentation similar to that of ST-elevation myocardial infarction (STEMI). ⋯ Although there is some diversity in ECG, laboratory, and ECHO parameters, none of these patterns alone can reliably distinguish TTC from MI in female patients. TTC and STEMI females have similar in-hospital and long-term outcomes.
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To evaluate long-term outcomes of surgical aortic valve replacement (AVR) due to significant aortic stenosis (AS) and assess changes in factors affecting survival during a 10-year period in patients referred for surgery from a single centre. ⋯ Long-term surgical outcomes in patients with significant AS are very good, with better survival in women compared to men, although these differences attenuated after 3 years. Factors affecting 10-year survival are different in women and men: a significant effect in women was noted only for age and preoperative NYHA class, while in men for age, NYHA class, hypertension, reduced LVEF, and the presence of significant coronary artery stenoses. During 10-year follow-up, longitudinal changes can be noted in factors affecting survival after AVR.