Cardiology Journal 2013, tom 20, nr 5

Diabetes mellitus (DM) is a metabolic disease with increasing incidence and prevalence. In DM, there is an alteration in the cardiovascular reflex response and one of the key elements of this alteration is the impaired response from arterial baroreceptors. The deterioration in the baroreflex function in diabetic patients, its features, clinical and prognostic consequences and the potential for its reversal are discussed in this article...

Restoration of blood flow to an infarct-related artery (IRA) in the first 12 h of evolution is a cornerstone of contemporary treatment of acute myocardial infarction (MI) [1, 2]. It decreases the infarct size, preventing the expansion of myocardial necrosis and its consequences [1, 2]. However, due to their late presentation, up to one third of patients do not receive reperfusion therapy [3]...

Patients with type 2 diabetes (T2DM) have a 2- to 4-fold higher risk for cardiovascular (CV) disease as compared with non-diabetic individuals [1]. It is caused partly by hypercoagulable state as evidenced by high platelet reactivity (HPR) [2]. Etiology of HPR is complex, and seems to be a result of hyperglycemia, metabolic disorders, oxidative stress and inflammation [3]...

A high rate of unexplained syncope in various clinical settings, involving enormous resources for diagnosis and therapy, justifies the constant search for effective evaluation strategies. In most patients with syncope, electrocardiography (ECG) findings established as diagnostic [1] do not recur during the 24-h ECG monitoring period. Thus, the true yield of the standard Holter ECG assessment in an unselected population is as low as 1–2%...

Various mechanisms involved in the formation of thrombosis and regulation of coagulation have been identified to stabilize coronary atheromatous plaques. Recent research has supported the central role of coagulative factors in advancing atherosclerosis and causing coronary artery disease (CAD) [1–3]. In this regard, coagulation factor VII seems to have an essential role in the initiation and extension of coronary atherosclerosis [4, 5]...

Impaired renal function is a well-known independent risk factor for mortality and morbidity in patients with myocardial infarction (MI) [1, 2]. Several studies reported that impaired renal function is more prevalent in women, while female MI patients are generally older and have more comorbidity than male patients [2, 3]. The impact of gender difference on prognosis after ST-segment elevated MI (STEMI) has been a popular and debated topic in clinical practice [4–10]...

Obstructive sleep apnea syndrome (OSAS) is a respiratory disease characterized by recurrent complete or partial obstruction of upper respiratory tract with accompanying intermittent hypoxemia and reactive waking reactions during sleep. Chronic intermittent hypoxemia during respiratory events may result in cardiovascular (CV) disorders by causing autonomic dysfunction [1, 2], endothelial dysfunction [3], oxidative stress, intrathoracic pressure variations [3, 4], metabolic dysregulation [5, 6] and inflammation [3, 5]...

Even with normal aging process, changes in myocardium occur and may modify lusitropic function of the heart. These changes include a remodeling of the myocardial interstitium, an increase in myocardium collagen content and a prominence of myocardial fibrosis, probably due to the activation of the renin–angiotensin–aldosterone axis [1]. This heart aging phenomenon surely affects the diastolic function of our patients and needs to be readily and easily assessed...

Hyponatremia defined as serum sodium level < 135 mmol/L, is a common electrolyte abnormality in hospitalized patients, and it is associated with increasing morbidity and mortality. Patients with heart failure (HF) are not exempt from this association, and 19% to 25% of patients with acute decompensated heart failure (ADHF) have hyponatremia [1, 2]...

Lack of normal atrial systolic function in patients suffering from atrial fibrillation (AF) decreases cardiac output by as much as 30% and may be symptomatic. AF increases the risk of stroke 5 to 8 times with a 2-fold higher risk of death [1, 2]. Treatment of AF currently involves strategies of sinus rhythm maintenance or control of ventricular rhythm frequency...