Kraków "Kochać życie piękne i młode"-marksistowska i eugeniczna pedagogika Władysława Spasowskiego. Założenia i krytyka personalistyczna W okresie dwudziestolecia międzywojennego obecny był w Polsce nurt myślenia o wychowaniu inspirowany ideologią marksistowską. Wizja przyszłości nakreślona przez Karola Marksa i Fryderyka Engelsa, nazywana marksistowskim komunizmem, jest "wizją królestwa wolności, pojmowanego jako kolektywna kontrola władzy publicznej nad całą sferą produkcji i wymiany oraz urzeczywistnienia w ten sposób ideału wolności jako świadomego panowania nad zbiorowym losem" 1. Najwyższą wartość stanowi w niej idea równości i sprawiedliwości społecznej, rozumianej jako zanik społeczeństwa klasowego i zniesienie własności prywatnej środków produkcji 2. Z perspektywy personalistycznej u podstaw marksistowskiego komunizmu stoi błąd filozoficzny i antropologiczny, późniejsi zaś teoretycy (neo)
Background
Patients with ischemia and non-obstructive coronary arteries (INOCA) account for 30–70% of all patients undergoing elective coronary angiography for angina. In these group of patients various mechanisms may be responsible for myocardial ischemia, including increased microvascular resistance, epicardial spasm or microvascular spasm. There are limited data on the prevalence and coexistence of different mechanisms in patients with INOCA.
Purpose
The primary objective was to assess the occurrence of coronary microcirculatory disease (CMD), epicardial vasospastic angina (EVSA), microvascular vasospastic angina (MVSA) and their coexistance in patients with INOCA. The secondary objective was the analysis of subgroups' clinical characteristics.
Methods
This was a single-center, prospective, observational study. In the absence of significant coronary artery stenosis, a complex functional coronary assessment was performed. Values of fractional flow reserve (FFR), RFR, coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were determined. Coronary artery and microvascular vasoreactivity was tested using the provocative acetylcholine test.
Results
We enrolled 90 consecutive patients with INOCA. Overlapping of CMD and CMD/EVSA phenomenon was observed. Accordingly, we distinguished 6 subgroups of INOCA patients in comparison to the CorMicA trial. Mixed pathophysiology (CMD+EVSA and CMD+MVSA) was diagnosed in 33% of patients. In the CMD+EVSA subgroup, 73% of subjects were male, while in the CMD+MVSA only 7.1% were male (p=0.005). Typical cardiovascular risk factors were common in the whole INOCA group.
Conclusions
The INOCA population is a heterogeneous group with various pathophysiology of myocardial ischemia. Overlapping of different pathomechanisms is a frequent phenomenon, which has to be consider for treatment optimization and future research.
Funding Acknowledgement
Type of funding sources: None.
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