Marta Wegrzynowska

P-57 Evaluation of Plasma Renin Activity in Acute MI Patients Treated with Primary Percutaneous Coronary Interventions

Aim of Study: Evaluation of plasma renin activity in patients with acute myocardial infarction AMI) treated with primary percutaneous coronary interventions (PCI). We observed 62 pts, (39 man) aged 38 75 yrs with first AMI treated with PCI. Plasma renin activity (PRA) was evaluated on 1st, 3rd and 5th day and 1st and 3rd month after AMI in all pts. Anthropometric parameters: BMI, body weight and body fat concentration, Serum NTproBNP and hsCRP Max TnI concentration, maximal activity of CK and CK-MB were measured within short post-AMI period. Echocardiography with evaluation left ventricles function were performed at 3rd day, 1st and 3rd month after AMI. Cardio-pulmonary exercise test was performed after 3 months of follow-up. Results: Mean value of PRAwas 2.8 at 1st day; 3.4 at 3rd day; 4.5 at 5th day; 4.7 at 1 month, and 3.6 ng/ml/h at 3 months after AMI. Mean valuees of PRA was significantly lower in women than in men only at 1st day (0.9 vs 3.5 ng/ml/h; p = 0.01). Peak value of PRA was observed between 5th day and 1st month after AMI. Values of PRA correlate with serum NTproBNP, body fat concentration, RV diameter and tricuspid annular plane systolic excursion TAPSE. Conclusions: 1. PRA was significantly higher in men than in women at 1st day of acute MI treated with primary PCI. 2. Values of PRA changes within early period after AMI with peak value between 5th day and 1st month after AMI. 3. Values of PRA correlate with serum level of NTproBNP at 1st day of AMI and echocardiography parameters of right ventricle function with 3 month follow up in this group of patients.

P-58 Level of Dehydroepiandrostendione Sulfate in Patients with Acute MI Treated with Primary PCI

Aim of Study: Evaluation of plasma renin activity in patients with acute myocardial infarction AMI) treated with primary percutaneous coronary interventions (PCI). We observed 62 pts, (39 man) aged 38 75 yrs with first AMI treated with PCI. Plasma renin activity (PRA) was evaluated on 1st, 3rd and 5th day and 1st and 3rd month after AMI in all pts. Anthropometric parameters: BMI, body weight and body fat concentration, Serum NTproBNP and hsCRP Max TnI concentration, maximal activity of CK and CK-MB were measured within short post-AMI period. Echocardiography with evaluation left ventricles function were performed at 3rd day, 1st and 3rd month after AMI. Cardio-pulmonary exercise test was performed after 3 months of follow-up. Results: Mean value of PRAwas 2.8 at 1st day; 3.4 at 3rd day; 4.5 at 5th day; 4.7 at 1 month, and 3.6 ng/ml/h at 3 months after AMI. Mean valuees of PRA was significantly lower in women than in men only at 1st day (0.9 vs 3.5 ng/ml/h; p = 0.01). Peak value of PRA was observed between 5th day and 1st month after AMI. Values of PRA correlate with serum NTproBNP, body fat concentration, RV diameter and tricuspid annular plane systolic excursion TAPSE. Conclusions: 1. PRA was significantly higher in men than in women at 1st day of acute MI treated with primary PCI. 2. Values of PRA changes within early period after AMI with peak value between 5th day and 1st month after AMI. 3. Values of PRA correlate with serum level of NTproBNP at 1st day of AMI and echocardiography parameters of right ventricle function with 3 month follow up in this group of patients.

3. Vasovagal Syncope, Tilt Testing

The aim of study was to evaluate a psychological profile (PSP) of patients with diagnosed vaso-vagal syncope (VVS). We observed 30 pts. (12 men and 18 women), aged 19-61 yrs, with history of neurocardiogenic syncope (NS) and positive head-up tilt test (HUTT) acc. to Westminster protocol. All patients, before HUTT, underwent psychological evaluation with the packet of the following tests: Based on results of mentioned tests psychological profile of each patient was performed. Results Vaso-depressive VVS was diagnosed in 17 pts, cardio-inhibitory VVS – 1 pt and mixed VVS 12 pts. There were achieved the following mean results of performed psychological tests: Conclusions Psychological characteristics of patients with vaso-vagal syncope is characterised by:-a reduction in the health related quality of life, -a slight increase in anxiety level and an increase in inner tension, -a slight increase in anxiety level is a result of an increase in inner tension which itself is a result of an inner conflict between urges and a restrictive superego.

The Value of Electrophysiological Testing in Diagnosis of Syncope in Post-infarction Patients, without Complex Ventricular Arrhythmias Detected in 24-hour ECG

The most frequent reasons for syncope in patients after myocardial infarction are complex ventricular arrhythmias (CVA)1–4. Ventricular arrhythmias (VA) are present in approximately 20–50% of patients after myocardial infarction5. On the other hand 90% of sudden cardiac death episodes are caused by VA6. Most patients present with VA in standard 12-lead ECG or in 24-h ECG Holter monitoring. However, in some patients after myocardial infarction, detection of VA is impossible, in spite of repetitive 24-h ECG recordings. In these patients we may observe only symptoms related to VA, such as syncope, presyncope or vertigo. These patients are thus especially in danger of sudden cardiac death because of the impossibility of arrhythmia mechanism assessment; 24-h ECG Holter monitoring is not a sufficient diagnostic tool in such cases. Improvement of suitable diagnostic procedures, for instance programmed electrical stimulation (PES), in this group of patients after myocardial infarction, is very important both for defining the very high sudden cardiac death risk patients and for sufficient anti-arrhythmic treatment7,8.