Kardiol Pol
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Diastolic heart failure often coexists with atrial fibrillation (AF). Elevated plasma levels of natriuretic peptides are the left ventricular (LV) marker of diastolic dysfunction. ⋯ The drop in ANP and BNP plasma concentrations after conversion to sinus rhythm in patients with AF depends on the LV diastolic function. Restoration of sinus rhythm is associated with improvement of the heart's haemodynamics, especially in patients with impaired LV diastolic function, which may be inferred from the more pronounced decrease of BNP level after DC cardioversion in this subgroup, as compared to that with normal LV function.
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Randomized Controlled Trial
Variability of aortic blood flow predicts fluid responsiveness in spontaneously breathing healthy volunteers.
Assessment of fluid responsiveness is an important topic in acute cardiology. Echocardiographic measurement of respiratory variations of aortic blood velocity in ventilated shock patients can accurately predict the effect of volume expansion. On the other hand, it remains unclear whether this respiratory variability is a common physiological reaction to hypovolaemia and whether its measurement is applicable also in spontaneously breathing patients. ⋯ DVpeakao and DVTIao reflect preload-dependent changes of CI in healthy spontaneously breathing volunteers and predict fluid responsiveness.
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We present a case of 80-year-old woman with a history of paroxysmal atrial fibrillation admitted to the cardiology department due to syncope and chest pain with suspicion of pulmonary embolism. In course of further diagnostics the initial diagnosis was excluded and anticoagulant treatment was stopped. ⋯ Patient was immediately transferred to the cardiosurgery department and successfully operated. The patient was discharged after 33 days in good condition.
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Mitral valve annuloplasty is frequently performed because of favourable postoperative quality of life, and improved cardiac function. The Carpentier-Edwards mitral annuloplasty ring is implanted to correct annular dilatation, improve cooptation of the valve leaflets and prevent further annular dilatation. We present two cases of mitral annuloplasty complication in the form ring detachment leading to haemolytic anaemia in the first case.