The concentration of NT-proBNP is useful in the diagnosis of syncope and may initially guide the diagnostic process. The NT-proBNP value exceeding 200 pg/ml seems to be the most rational in determining cardiac syncope.

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Background: Heart failure (HF) has become an epidemic. A similar situation is also observed for atrial fibrillation (AF). The CHA 2 DS 2 -VASc score is one of the most useful tools for thromboembolic risk assessment. Aim:The aim of the study was to assess the prevalence of AF in patients with decompensated HF, who were divided into subgroups according to the CHA 2 DS 2 -VASc score. Methods:We analysed the prevalence of AF in a group of 1108 patients (327 women) hospitalised due to HF decompensation in medical centres of different referral levels. Twenty-one patients refused to participate in the registry. The data were collected from Polish centres included in the European Society of Cardiology Heart Failure Long-Term Registry. The recruitment period was from 2011 to 2014. The data were analysed retrospectively. Patients were divided into groups according to the CHA 2 DS 2 -VASC score. Results:The study sample was characterised by a high occurrence of AF (44.3%), with the highest prevalence in patients with a CHA 2 DS 2 -VASC score ≥ 6 (61.3%, p = 0.01). Conclusions:The CHA 2 DS 2 -VASc score may be a useful tool for detecting patients with HF characterised by the highest risk of AF.

SummaryIdiopathic hypereosinophilic syndrome (IHES) is characterized by sustained, nonreactive hypereosinophilia with eosinophilia-associated organ damage. Cardiac involvement occurs in about 60% of patients with HES and it is the major cause of mortality in these patients. Cardiac dysfunction is reversible only after early corticosteroid (CS) initiation.Herein we report a 33-year old male who was referred to our Cardiology Department with electrocardiographic and echocardiographic abnormalities suggesting myocardial infarction. At presentation he complained of dyspnea, cough and persistent fever. His white blood cell (WBC) count was elevated, with eosinophil predominance in the differential. After cardiological and haematological work-up, the final diagnosis of HES-associated cardiac involvement was established. Early treatment with CS led to eosinophil count normalization with only moderate cardiac function improvement. Currently, the patient is in good condition overall and is in NYHA class II while still on prednisone. (Int Heart J 2011; 52: 194-196) Key words: Hypereosinophilic syndrome, Eosinophilic myocarditis, Endomyocardial biopsy, Corticosteroid treatment I diopathic hypereosinophilic syndrome (IHES) is a rare disorder characterized by persistent, unexplained peripheral eosinophilia of > 1.5 × 10g/L for longer than 6 months with evidence of organ damage. 1) Case reportA 33-year-old white male was referred to our Cardiology Department because of symptoms of heart failure and abnormalities present on a routine electrocardiogram (ECG).His history started several months earlier when he was admitted to our Pulmonary Unit because of progressing dyspnoea and cough. Blood tests showed an elevated white blood cell (WBC) count of 27.3 × 10 9 /L (normal range, 4-10 × 10 9 / L) with an absolute eosinophil count (AEC) of 15.1 × 10 9 /L (normal range, 0.1-0.7 × 10 9 /L). Arterial blood analysis also revealed hypoxemic respiratory insufficiency (pH-7.52, pCO2-27.0 mmHg, pO2-56.8 mmHg, satO2-91.6%). A chest X-ray showed bilateral pulmonary infiltrates in the basal and middle lung fields, without cardiomegaly. No cardiac dysfunction was noted at that time and there were no ECG changes suggesting prior myocardial infarction (Figure 1). Since the cause of the pulmonary abnormalities was suspected to be infectious, the patient was initially treated with antibiotics, without any improvement. Taking under consideration the presence of hypereosinophilia in peripheral blood and pulmonary abnormalities suggesting eosinophil infiltrates, the patient was started on prednisone at a daily dose of 0.5 mg/kg. In the meantime, all reactive causes of hypereosinophilia were excluded. Steroid treatment resulted in a significant clinical improvement with normalization of his temperature, peripheral eosinophilia and complete resolution of chest X-ray changes. He was discharged from the hospital and recommended to taper the prednisone dose slowly. After CS withdrawal a deterioration of his clinical condition was observed, with progress...