Assessment of thromboembolic risk is crucial for proper management of atrial fibrillation (AF) patients. Currently used risk score base only on scarce clinical data and do not take into consideration parameters including echocardiographic findings. The aim of this study was to evaluate if left atrium (LA) enlargement is associated with higher thromboembolic risk assessed by CHADS2 and CHA2DS2-VASc scores in a cohort of unselected non-valvular AF patients. Data from 582 AF hospitalizations occurring between November 2012 and January 2014 were analyzed. All patients underwent a standard transthoracic echocardiography and had their thromboembolic risk assessed in both CHADS2 and CHA2DS2-VASc scores. In 494 enrolled patients (48.5 % male; mean age 73.4 ± 11.5 years) AF was classified as paroxysmal in 233 (47.3 %), as persistent in 109 (22.1 %), and as permanent in 151 (30.6 %) patients. LA was enlarged in 426 (86.2 %) patients. Enlargement was classified as mild in 99 (20.0 %) patients, as moderate in 130 (26.3 %) patients, and as severe in 196 (39.7 %) patients. Patients with enlarged LA had higher mean CHADS2 score (2.0 ± 1.5 vs. 2.6 ± 1.3; p = 0.0005) and CHA2DS2-VASc (3.8 ± 2.0 vs. 4.4 ± 1.8; p = 0.02) score than patients with normal LA. The both mean scores rose along with rising LA diameter. LA enlargement is highly prevalent in AF patients. Higher thromboembolic risk assessed by both CHADS2 and CHA2DS2-VASc scores is associated with presence of LA enlargement. Echocardiographically assessed LA size may be an additional parameter useful in thromboembolic risk stratification of AF patients.
Sexual dysfunctions are highly prevalent in AF patients and are not only limited to ED, but also include dysfunction of orgasmic function, desire, or general satisfaction. In part, the presence of the sexual dysfunctions is probably caused by classical cardiovascular risk factors highly prevalent in AF patients, but the impact of AF itself cannot be underestimated.
The aim of this study was to validate the Polish adaptation of the Treatment Self-Regulation Questionnaire
(TSRQ; Ryan, Conell, 1989), which measures the degree of self-determination in risk behaviour changes (diet, exercise
and smoking). The study comprised 219 patients (101 after acute coronary syndrome and 118 with type 2 diabetes),
beginning to undergo treatment. The Global Motivation Scale was used to test a convergent validity. The confirmatory
factor analysis (CFA) did not support the theoretical four-factor model, thus an exploratory analysis was conducted to
determine an optimal model across risk behaviours. The adopted two-factor model matched original TSRQ subscales:
autonomous motivation and external regulation (it did not contain the items from the introjected regulation and amotivation
subscales). The internal consistency of factors (Cronbach’s α) ranging from .78 to .89. Structural equation modeling
revealed the impact of global motivation on contextual motivation, limited to the equivalent type of regulation. The action
aimed at supporting patient’s autonomy should consider the particular behaviour and the global motivation as a resource
in disease.
We present a case report of a 60-year-old woman with a long history of leiomyosarcoma in different locations. She was admitted to the clinic due to a left ventricular tumor diagnosed in ECHO examination. The patient was qualified for radical tumor resection. The early postoperative period was complicated due to low cardiac output syndrome and bradyarrhythmia requiring temporary cardiac pacing. Optimized pharmacological therapy resulted in a gradual reduction of symptoms and a clinical improvement of congestive heart failure (NYHA III – NYHA II). Due to the radical nature of the surgery, the patient was not referred for supplementary treatment. The follow-up currently exceeds 12 months – no new metastases have been found. This case provides an example of how to diagnose and treat heart tumors.
Peripartum cardiomyopathy is a type of dilatated cardiomyopathy, occuring with symptoms of heart failure (HF) during last month of pregnancy or within 5 months after labour. Authors are presenting the case of patient admitted to hospital primary with diagnosis of non-high risk pulmonary embolism 6 weeks after delivery, who developed episode of sudden cardiac death followed by symptoms of cardiogenic shock. Peripartum cardiomyopathy was additionally diagnosed. After HF treatment with bromocriptine supply, gradual clinical improvement was achieved. The patient was discharged after 15 days of hospitalisation with diagnosis of peripartum cardiomyopathy with non-high risk pulmonary embolism.
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