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An abstract of the study "Depletion in More Than One Endocrine Anabolic Axis Identifies Men With Chronic Heart Failure of Particularly High Long-Term Mortality," by B. Biel and colleagues is presented.

An abstract of the study "Bone Status and Bone Loss Over Time in Men With Chronic Heart Failure, And Their Clinical and Hormonal Determinants," by E. A. Jankowska and colleagues is presented.

An abstract of the study "Serum Hepcidin Is Not Linked to Iron Status in Patients With Chronic Heart Failure," by A. Grzeslo and colleagues is presented.

An abstract of the study "Reduction in Serum Testosterone Deteriorates Exercise Capacity in Men in the Course of Chronic Heart Failure," by E. A. Jankowska and colleagues is presented.

An abstract of the study "Oscillatory Ventilation at Rest Coexisting With Increased Ventilatory Response to Exercise Allow to Identify Heart Failure Patients With Very Poor Outcome," by K. Nowak and colleagues is presented.

An abstract of the study "Iron Deficiency Is a Common Finding in Patients with Stable Chronic Heart Failure," by A Grzeslo et al is presented.

An abstract of the study "Anaemia in Men with Chronic Heart Failure: An Element of Multiple Anabolic Depletion," by B. Biel and colleagues is presented.

An abstract of the study "Oscillatory ventilation during exercise: independent predictor of increased mortality in patients with stable chronic heart failure," by T. Wilkowski and colleagues, is presented.

Introduction: Monitoring of natriuretic peptide concentration may be useful for the identification of high-risk patients presenting with decompensated chronic heart failure (CHF)., Aim: Assessment of the predicting value of a significant decrease (by > or =20% vs. baseline) of N-terminal proBNP (NTpro-BNP, ROCHE) concentration during hospitalisation in patients with decompensated CHF., Methods: This study involved 54 patients admitted to our centre because of CHF decompensation. Concentration of NTpro-BNP was measured on admission and at discharge from hospital. Primary end-points of this study were overall mortality and mortality with a number of cardiovascular-related readmissions., Results: Mean NTpro-BNP concentration on admission was 7435+/-10040 pg/ml and at the time of discharge from hospital -- 4816+/-7822 pg/ml. In 31 (57%) patients a significant decrease (> or =20% vs baseline value) in NTpro-BNP level (mean: -58%+/-21%) was noted, while in the remainder (23 patients; 43%) neither an increase nor a decrease in NTpro-BNP levels was observed (mean: +72%+/-132%) despite optimal treatment and stabilisation of the clinical status. The mean follow-up duration was 358+/-240 days. Cox analysis showed that the absence of significant NTpro-BNP level decrease was associated with an increased risk of death -- RR: 3.69 (95% CI: 1.10-12.37; p=0.035) and was the single independent risk factor for readmission due to cardiovascular-related reasons and/or death -- RR: 2.29 (95% CI: 1.20-4.35; p=0.01). In the group of 23 patients with an increase or decrease in NTpro-BNP concentration of more than or equal to 20%, the survival rate was 65% vs. 87% in the remainder (p=0.02)., Conclusions: The lack of a significant (> or =20%) decrease of NTpro-BNP level during hospitalisation correlates with a higher mortality and rate of readmissions. NTpro-BNP level monitoring may be of clinical importance for risk stratification in patients hospitalised for decompensated CHF.

Background: In patients with chronic heart failure (CHF) augmented exercise ventilation is related to functional severity and increased mortality. Nevertheless, the optimal approach to the assessment of ventilatory response to controlled exercise has not been established., Aim: The study was carried out to evaluate the clinical application of the measurement of ventilatory response to the early phase of exercise in the non-selected group of patients with CHF., Material and Methods: We investigated 180 consecutive patients with CHF (155 men, age: 59 +/- 11 years, left ventricle ejection fraction: 31 +/- 7%; NYHA class I/II/III/IV: 13/90/60/17). All patients underwent the cardiopulmonary exercise testing (CPX) with RER > 1.0 (mean peak oxygen consumption [peakVO2]: 15.5 +/- 4.8 ml/kg/min). Ventilatory response to exercise was assessed: 1) during the whole exercise--expressed as a correlation coefficient of linear regression describing the relationship between minute ventilation (VE) and carbon dioxide production (VCO2) during the whole exercise (VE-VCO2 100%); 2) during the early phase of exercise--expressed as VE-VCO2 derived from VE and VCO2 during first 180 seconds of exercise (VE-VCO2 180 s)., Results: Ventilatory responses to early and maximal exercise were significantly augmented in CHF patients (VE-VCO2 100% -36.1 +/- 9.8, VE-VCO2 180% -34.4 +/- 10.3; p < 0.0001 vs values in the reference group without CHF). Ventilatory responses to early and whole exercise were strongly interrelated (r = 0.88, p < 0.0001). Indices of exercise ventilation correlated with the severity of CHF expressed as NYHA class (for VE-VCO2 100% and VE-VCO2 180 s -r = 0.52 and r = 0.51) and peak VO2 (for VE-VCO2 100% and VE-VCO2 180 s, r = -0.49 and r = -0.47, respectively) (p < 0.0001 for all correlations). Among echocardiographic parameters only right ventricular systolic pressure correlated with indices of exercise ventilation (for VE-VCO2 100% -r = 0.45, p = 0.001; for VE-VCO2 180 s -r = 0.35, p = 0.01). The reproducibility of indices of exercise ventilation was assessed in 19 CHF patients (another CPX during 2-9 days), and variability coefficients reached 7.8% for VE-VCO2 100% and 8.5% for VE-VCO2 180 s., Conclusions: Indices of ventilatory response to both early and maximal exercise can significantly differentiate the CHF patients with regard to their exercise capacity, are highly reproducible, and may therefore constitute useful parameters carrying an important clinical message. The assessment of ventilatory response during the early stage of exercise seems to be of a particular significance in CHF patients who are unable to perform the maximal exercise effort, as diagnostic data obtained during first 180 seconds of exercise are in accordance to those derived from the standard maximal CPX.

Chronic heart failure (CHF) constitutes a significant clinical issue due to its increasing prevalence in general population and still fatal prognosis. During last twenty years the significance of beta-blockers in the treatment of CHF has changed. It resulted from the hypothesis from 1975 that in the course of CHF it comes to the activation of sympathetic system and renin-angiotensin-aldosterone system. Authors presented the actual views on CHF pathogenesis, mechanisms of favourable action of beta-blockers in CHF and the data from clinical trials on effectiveness of beta-blockers in different stages of CHF (among the others in elderly patients and in comparison with other treatment). Nevertheless, there are still several questions related to beta-blockers treatment in patients with CHF waiting to be resolved. Although the number of patients with CHF treated with beta-blockers is still increasing, the usefulness of conclusions resulting from clinical trials--as it has been shown in IMPROVEMENT-HF--is still insufficient. In contrast, following the recommendations of ESC, AHA and the Section of Heart Failure of Polish Cardiology Association both beta-blockers and ACE inhibitors constitute two main groups of medications that should be undoubtedly used in patients with CHF.

The aim of this study was to assess the clinical usage of recording time-domain parameters of atrial signal-averaged electrocardiogram (ASAECG) in diagnosis of paroxysmal atrial fibrillation (PAF) of patients with mitral valve prolapse (MVP). 85 patients with MVP recognized by echocardiography were divided into two groups: group I (MVP-PAG/+/) 41 pts (15 male and 26 female) mean age 37.1 +/- 8.9 with previously electrocardiographically documented episode of PAF, group II (MVP-PAF/-/) 44 pts (20 male, 24 female) mean age 39.1 +/- 14.3 without PAF. The control group III consisted of 35 persons: 24 male and 11 female in mean age 37.7 +/- 6.2 without any cardiovascular diseases. All patients underwent additional investigations included: T3, T4, electrocardiography, exercise-test with moving "running track", 24-hours monitoring ECG with Holter's method and ASAECG recording. The following time-domain parameters of ASAECG were calculated: the root mean square voltage of the terminal 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD). The adaptation of time-domain parameters of atrial signal-average in differential diagnostics of PAF during MVP has appeared as useless from clinical point of view.

The aim of this study was to assess the effects of myocardium organic damage on time-domain parameters of atrial signal-averaged ECG (ASAECG) in patients with electrically induced paroxysmal atrial fibrillation (PAF). The investigation was done in 120 patients with subjective symptoms of cardiac rhythm disorders suggesting atrial fibrillation and for further analysis were selected 51 patients in whom atrial PAF was induced during transoesophageal pacing (TEP). Patients were divided according to organic damage of myocardium-38 pts (24 male and 14 female, mean age 52.1 +/- 11.6-group I) and without-13 pts (9 male and 4 female, mean age 35.4 +/- 9.9 -group II). In all two dimensional echocardiographic examination, 24-hours Holter monitoring, exercise testing and TEP were made. Recording of ASAECG was done with a commercially available system HIPEC-200 HA Aerotel. The following time-domain parameters of ASAECG were calculated: the root mean square voltage of the terminal 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and time duration of filtered P-wave (PWD) and also time duration of P-wave from Frank's leads X, Y, Z (XP, YP, ZP). Atrial late potentials (ALP) were defined as the presence of two parameters: RMS 10 < 4 microV and PWD > 123 ms. If we compared time-domain parameters of ASAECG between examined groups it occurred that only the values of PWD attained statistically significant differences, respectively 123.3 +/- 15.4 ms vs 115 +/- 11.2 ms, p < 0.05. In 14 (36.8%) patients from first group and in 2 (15.4%) patients from second ALP were confirmed. We concluded that presence of myocardium organic damage have essentially influenced on time duration of filtered P-wave.

The purpose of this study was to compare ischemic heart disease (IHD) patients with and without late potentials (LP) by using noninvasive diagnostic methods as: echocardiographic examination, exercise testing, 24-hours Holter ambulatory monitoring, recording of atrial and ventricular signal-averaged ECG. Examination covered 25 IHD pts (12 male and 13 female) with LP, mean age 58.6 +/- 7.3 (group I) and 100 IHD pts (65 male and 35 female) without LP, mean age 56.8 +/- 8.5 (group II). Summing up, it should be stated that despite showing tendencies to much often occurrences of ventricular arrhythmias on Holter monitoring and silent ischemia during exercise testing in IHD pts with LP we were unable to indicate distinctive differentiating parameters between investigated groups.

The aim of this study was evaluation of pharmacologic autonomic blockade on time-domain parameters of atrial (ASAECG) and ventricular signal-averaged ECG (SAECG) in patients with mitral valve prolapse syndrome (MVP) regarded 20 subjects with MVP (mean age 34.9 +/- 5.3) (group I) were studied as well as a control group consisting of 20 healthy subjects (mean age 37.5 +/- 4.6) (group II). Initially, two dimensional echocardiography with color doppler examination, ambulatory Holter monitoring, multistage treadmill exercise test, transoesophageal pacing (TEP), recording of ASAECG and SAECG were made. Subsequently, pharmacologic autonomic system blockade was done by using intravenously propranolol (0.1 mg/kg) and atropine (0.02 mg/kg). The following time-domain parameters of ASAECG were calculated: the root mean square voltage for the last 10, 20, 30 ms of filtered P-wave (RMS 10, 20, 30) and time duration of filtered P-wave (PWD). Moreover, the following parameters of SAECG were analyzed: the root mean square voltage of the signals in the last 40 and 50 ms of the filtered QRS (RMS 40, 50), the total time duration of QRS(t-QRS) and the duration of low amplitude signals < 40 microV (LPD). The autonomic blockade did not change significantly the obtained values of RMS 10, 20, 30 in subjects with MVP as follows: RMS 10 from 5.5 +/- 2.9 microV to 6.3 +/- 2.4 microV, RMS 20 from 8 +/- 3.7 microV to 8.5 +/- 2.4 microV and RMS30 from 10.2 +/- 4.9 microV to 10.3 +/- 3.3 microV. On the other hand, also the values of RMS 10 did not change statistically significant after blockade in control group (from 5.8 +/- 2.2 microV to 5.6 +/- 1.7 microV, p > 0.05), but the values of RMS20 i RMS30 increased significantly in this group, respectively from 7 +/- 3.1 microV to 8.3 +/- 3 microV (p < 0.02) and from 8.4 +/- 3.1 microV to 10.1 +/- 3.6 microV, (p < 0.05). The values of PWD have changed differently in the examined groups being under the influence of the autonomic blockade: in group I decreased from 119 +/- 12 ms to 114 +/- 28 ms (p > 0.05), whereas in group II increased from 110 +/- 13 ms to 116 +/- 9 ms (p < 0.02).(ABSTRACT TRUNCATED AT 400 WORDS)

An ECG examination, prolonged over several hours was carried out in 30 patients aged from 29 to 66 years (mean age 51.3) with the diagnosis of rheumatoid arthritis made on the basis of the WHO criteria, before, and in the second and third month of treatment with penicillamine. The values were evaluated of the mean, minimal, and maximal heart rate per minute, and supraventricular and ventricular heart rhythm disturbances, and also conduction disturbances were assessed. In the study no statistically significant changes were recorded in the individual periods of the examination of the values of mean, minimal and maximal heart rate/min. In the initial examination, supraventricular arrhythmia occurred in 80% of patients, and ventricular arrhythmia in 33% of cases. As a result of the applied treatment a decrease was observed of incidence of arrhythmia both supraventricular and ventricular.