Determinants of left ventricular systolic function recovery after an acute coronary syndrome.

INTRODUCTION: Ischemic heart disease is a major cause of heart failure in western societies. However, the factors that may influence left ventricular function (LVF) recovery after an acute coronary syndrome (ACS) are still unclear. OBJECTIVE: To identify variables that may influence LVF evolution one year after ACS. METHODS: 104 patients hospitalized with ACS between 7/1/2001 and 12/31/2002 and with systolic dysfunction--defined as an echocardiographic ejection fraction (EF) < or = 45%--were randomly allocated to a planned coronary follow-up program (FUP) or a general cardiology clinic (GC); patients from both groups were also randomly referred to a structured cardiac rehabilitation program (CRP). EF was re-assessed at one year. We compared differences between patients who recovered left ventricular function (EF > 45%; group 1) and those who did not (group 2). RESULTS: One year after discharge, 44.2% of the patients had recovered function. There were no significant differences between the groups in gender (77.7 vs. 76.5% male), age (56 vs. 59 years), hypertension, diabetes, dyslipidemia, smoking habits or family history. A previous history of cardiovascular events was more frequent in group 2 (11.1% vs. 35.3%, p = 0.03). Cardiac catheterization was performed before discharge in 88.8% and 88.2% in groups 1 and 2 respectively (p = NS); no differences were found in coronary anatomy between the two groups. Angioplasty was performed in 54.2% in group 1 and 50% in group 2 (p = NS). There were no differences in the use of angiotensin-converting enzyme inhibitors (83.3% vs. 87.5%), beta-blockers (87.5% vs. 87.5%), nitrates (37.5% vs. 33.3%), aspirin (95.8% vs. 95.8%), statins (79.1% vs. 75%) or diuretics (20.8% vs. 45.8%). There was no significant difference in LVF recovery between patients randomized to FUP or GC (38.5% vs. 54.5%). 87.5% of patients who completed the CRP had normal EF at one year compared to 32.7% of patients not referred to the program (p = 0.009). Although EF improved in both groups, this improvement was greater in patients who completed a CRP (EF 8% vs. 5%, p = 0.003). CONCLUSION: A previous cardiovascular event and completion of a CRP were the only variables that influenced LVF recovery. Thus, enrollment in a CRP, in addition to standard therapy, could be an important therapeutic measure in patients with systolic dysfunction after ACS; our data suggest that these programs should be more widely used.     

Sero- and subtypes of group B meningococci causing invasive infections in Finland in 1976-87

Neisseria meningitidis group B (MenB) strains isolated from 1976 to 1987 in Finland in 339 patients with invasive infection were sero/subtyped by whole cell enzyme immunoassay using monoclonal antibodies to class 1 and 2/3 outer membrane proteins. 66.7% of the strains could be serotyped (class 2/3) and 70.2% subtyped (class 1). No single phenotype was clearly predominant. The most common serotypes were 4 (18.6%) and 14 (17.4%) and the most common subtypes P1.16 (20.1%) and P1.2 (12.1%). The Norwegian phenotype B:15:P1.16 was seen only rarely (a total of 18 strains). Strains from Northern Finland did not differ from those from Southern Finland: no single phenotype caused the slight increase seen in the incidence of MenB infections in the end of 1970s in the North.     

Hygienic bases, goals and structure of data banks on hazards of polymers

The first phase of data bank of hazard (DBH) of polymers has been developed and put into operation on the basis of CM-computers. DBH is a factographical computer-based system of data collection, storage and processing aimed at complex assessment of material and substance hazard. Systems approach to the analysis of material's characteristics serves as a methodological basis. DBH data base includes a set of input and output documents according to 5 types of biological hazards involving sanitary and chemical surveillance, fire hazard and thermodestruction, the data on material's microbiologic resistance, their electrifying and toxicohygienic characteristics. DUAMC-3 operational system, DUAMC. DBH software are included into the system of data banks of materials' technological properties.     

The influence of different levels of dietary fat on the incidence and growth of MNU-induced mammary carcinoma in rats

This study describes the influence of isocalorically fed diets (containing different amounts of fat) on tumor incidence and parameters of fat metabolism in female Sprague-Dawley rats. Comparisons are made between rats induced with methylnitrosourea (25 mg/kg body wt) and untreated controls (Group I). The animals received either control diets (3.9% fat by weight, Groups I and II) or fat-enriched diets (10.7%, Group III; 15.6%, Group IV; 21.4%, Group V) over a period of 180 days. At the termination of the experiment, intake of the diet containing 10.7% fat by weight (24% fat per total calories) was associated with the highest tumor incidence. Comparing the different diets, liver lipid concentrations in the individual groups increased with increasing dietary fat, whereas the total lipid in plasma decreased. During the feeding period, total lipid of the liver and plasma, and plasma cholesterol, increased in all groups, but triglycerides of plasma decreased. However, when plasma cholesterol and triglycerides were calculated as a relative amount of total lipid in plasma, cholesterol was found to be significantly decreased in Groups III and IV, and triglycerides were increased in Group III but decreased significantly in Groups I, II, and V at the end of the experiment.     

"Lysostrip" experiments with HLA class-II antigens. I. Independent surface mobility of DQ and DR molecules

We report on results of lysostrip experiments designated to analyse the molecular relations between DQ and DR antigens. The purpose of lysostrip application was to determine whether these antigens can independently be redistributed on B-cell surface by incubation with a specific antibody followed by incubation with F(ab')2 fragments of rabbit antihuman Ig. The obtained results have clearly shown that DQ antigens, and supertypic and narrow DR antigens, move independently, indicating that they are located on separate molecules, supporting the concept of different DQ and DR loci.     

Effect of extracellular fluid volume contraction and expansion on plasma atrial natriuretic peptide (ANP) concentration in patients with acromegaly

Atrial natriuretic peptide (ANP) is a hormone release into the circulation by atrial cardiocytes (Gutkowska et al. 1984). Extracellular fluid volume expansion acts as a powerful stimulus for ANP secretion and results in the augmentation of its plasma concentration (Lang et al. 1985). Patients with active acromegaly demonstrate the increased extracellular fluid volume (Falkheden et al. 1964), while a successful treatment of the disease results in the disappearance of hypervolemia (Strauch et al. 1977). We have recently demonstrated that in patients with active acromegaly the increased total body plasma volumes are accompanied by the elevated plasma ANP concentrations, whereas, in the successfully treated patients, both: total plasma volumes and plasma ANP levels do not differ significantly from these in healthy subjects (Czekalski et al. 1988b).