By providing contemporary observational data on characteristics and management of patients with cardiomyopathies, the registry provides a platform for the evaluation of guideline implementation. Potential gaps with existing recommendations are discussed as well as some suggestions for improvement of health care provision in Europe.
When compared to stable CAD and healthy subjects, acute coronary syndromes are associated with long-term increase of serum concentrations of pro- and anti-inflammatory cytokines. It seems likely that sudden CAD progression leading to acute coronary syndromes is triggered/accompanied by prolonged immune activation.
The study aimed to evaluate the effects of a 3-week n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on serum nitric oxide (NO), asymmetric dimethyloarginine (ADMA), ultrasound indices of endothelial function and maximal oxygen uptake (VO2 max) of elite cyclists. The effects of dietary supplementation (n-3 PUFA at a dose of 1.3 g twice daily for 3 weeks) and placebo administration on flow-mediated dilatation (FMD), pulse wave velocity, serum markers (NO, ADMA), lipid profile, and ΔVO2max were analysed in 13 cyclists both before and after dietary protocols. Significant differences between pre- and post-intervention baseline NO levels were observed after n-3 PUFA dietary protocol (13.9 ± 4.2 vs. 23.5 ± 3.6 µmol·l(-1); P < 0.001). Higher post-intervention baseline NO level was observed after n-3 PUFA diet compared with placebo (23.5 ± 3.6 vs. 15.3 ± 3.0 µmol·l(-1); P < 0.01, respectively). The n-3 PUFA increased baseline NO concentration (ΔNO) by 6.7 ± 3.8 µmol·l(-1) and placebo by 1.6 ± 4.4 µmol·l(-1). The positive correlation was observed between baseline post-intervention NO concentration and maximal oxygen uptake (r = 0.72; P < 0.01) and also between ΔNO and ΔVO2max (r = 0.54; P < 0.05) in response to omega-3 fatty acids supplementation. There was an association between a 5.25% higher FMD (P < 0.05) and higherΔVO2max (P < 0.001) after n-3 PUFA diet compared with lower values of placebo (r = 0.68; P < 0.05). These findings suggest that an increase in NO release in response to n-3 PUFA supplementation may play a central role in cardiovascular adaptive mechanisms and enhanced exercise performance in cyclists.
Current knowledge of pulmonary arterial hypertension (PAH) epidemiology is based mainly on data from Western populations, and therefore we aimed to characterize a large group of Caucasian PAH adults of Central-Eastern European origin. We analyzed data of incident and prevalent PAH adults enrolled in a prospective national registry involving all Polish PAH centers. The estimated prevalence and annual incidence of PAH were 30.8/mln adults and 5.2/mln adults, respectively and they were the highest in females ≥65 years old. The most frequent type of PAH was idiopathic (n = 444; 46%) followed by PAH associated with congenital heart diseases (CHD-PAH, n = 356; 36.7%), and PAH associated with connective tissue disease (CTD-PAH, n = 132; 13.6%). At enrollment, most incident cases (71.9%) were at intermediate mortality risk and the prevalent cases had most of their risk factors in the intermediate or high risk range. The use of triple combination therapy was rare (4.7%). A high prevalence of PAH among older population confirms the changing demographics of PAH found in the Western countries. In contrast, we found: a female predominance across all age groups, a high proportion of patients with CHD-PAH as compared to patients with CTD-PAH and a low use of triple combination therapy.
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