In our middle-aged cohort with high prevalence of hypertension cPP is more closely correlated with cardiovascular phenotypes than pPP. When adjusted for relevant cofactors, however, cPP does not provide additional information beyond pPP.

The study aimed to compare arterial and echocardiographic parameters in subjects with newly diagnosed masked (MH) or white-coat hypertension (WCH) to subjects with sustained normotension or sustained hypertension, defined according to the 2014 European Society of Hypertension practice guidelines for ambulatory blood pressure (BP) monitoring. We recruited 303 participants (mean age 46.9 years) in a family-based population study. SpaceLabs monitors and oscillometric sphygmomanometers were used to evaluate ambulatory and office BP, respectively. Central pulse pressure (PP) and aortic pulse-wave velocity (PWV) were measured with pulse-wave analysis (SphygmoCor software). Carotid intima-media thickness (IMT) and cardiac evaluation were assessed by ultrasonography. Analysing participants without antihypertensive treatment (115 sustained normotensives, 41 sustained hypertensives, 20 with WCH, 25 with MH), we detected significantly higher peripheral and central PP, PWV, IMT and left ventricular mass index in hypertensive subgroups than in those with sustained normotension. The differences between categories remained significant for peripheral PP and PWV after adjustment for confounding factors, including 24 h systolic and diastolic BP. Participants with WCH and MH, defined according to strict criteria, had more pronounced arterial and heart involvement than normotensive participants. The study demonstrates a high prevalence of these conditions in the general population that deserves special attention from physicians.

BackgroundThere are two main reasons for drug withdrawals at the various levels of the development path – hepatic and cardiac toxicity. The latter one is mainly connected with the proarrhythmic potency and according to the present practice is supposed to be recognized at the pre-clinical (in vitro and animal in vivo) or clinical level (human in vivo studies). There are, although, some limitations to all the above mentioned methods which have led to novel in vitro – in vivo extrapolation methods being introduced. With the use of in silico implemented mathematical and statistical modelling it is possible to translate the in vitro findings into the human in vivo situation at the population level. Human physiology is influenced by many parameters and one of them which needs to be properly accounted for is a heart rate which follows the circadian rhythm. We described such phenomenon statistically which enabled the improved assessment of the drug proarrhythmic potency.MethodsA publicly available data set describing the circadian changes of the heart rate of 18 healthy subjects, 5 males (average age 36, range 26–45) and 13 females (average age 34, range 20–50) was used for the heart rate model development. External validation was done with the use of a clinical research database containing heart rate measurements derived from 67 healthy subjects, 34 males and 33 females (average age 33, range 17–72). The developed heart rate model was then incorporated into the ToxComp platform to simulate the impact of circadian variation in the heart rate on QTc interval. The usability of the combined models was assessed with moxifloxacin (MOXI) as a model drug.ResultsThe developed heart rate model fitted well, both to the training data set (RMSE = 128 ms and MAPE = 12.3%) and the validation data set (RMSE = 165 ms and MAPE = 17.1%). Simulations performed at the population level proved that the combination of the IVIVE platform and the population variability description allows for the precise prediction of the circadian variation of drugs proarrhythmic effect.ConclusionsIt can be concluded that a flexible and practically useful model describing the heart rate circadian variation has been developed and its performance was verified.

We found that the influence of oxidative stress on the structure and function of large arteries was independent of hypertension. Therefore oxidative stress may play a significant role in the development of arterial stiffness. Higher oxidative stress is associated with more advanced arterial remodelling in hypertension.

Using novel equipment with adequate experience allowed high rates of successful revascularisation. The retrograde technique for CTO revascularisation showed good overall success and was safe.

In this retrospective study of patients with myocardial infarction treated with percutaneous coronary intervention primarily admitted to the Emergency Department we confirmed that acid-base balance parameters obtained from peripheral venous blood sample and assessed in point-of-care test (POCT) analyzers may be a reliable tool for early risk stratification.Elevated lactate level is associated with worse clinical condition and it can be suspected that lactic acidosis is a consequence of more severe derangement (i.e.: in patients with out-ofhospital cardiac arrest). In contrast, base excess may be considered as a marker of significant importance even in subtle degrees of acidosis, because it predicts both mortality in short-and long-term observation in the whole study group as well as in-hospital mortality in patients without out-of-hospital cardiac arrest.

IntroductionIn past studies, it has been questioned whether success of recanalization of chronic total occlusion (CTO) depends on the location of the occlusion – the circumflex artery (Cx) was considered as the most difficult to open.AimTo determine whether the effectiveness of recanalization of CTO depends on the location of the obstruction.Material and methodsFrom January 2011 to January 2016, a single operator dedicated to chronic total occlusions performed in our center 357 procedures on 337 patients.ResultsAmong 337 patients included in the study, 83.4% were male. Mean age was 62.8 ±9.3 years. Most of the patients had hypertension (86.4%) and hyperlipidemia (99.4%), and 28.8% of them had diabetes. The most frequently opened artery was the right coronary artery (RCA; 52.4%), followed by the left anterior descending artery (LAD; 29.4%), and last the Cx (18.2%). The mean J-CTO score was comparable between the three groups. The success rate of recanalization of CTO was similar for all arteries: 84.5% in the RCA, 81.9% in the LAD and 89.2% in the Cx (overall p = 0.437). Neither procedural complications nor adverse events depended on the location of the CTO.ConclusionsOur study shows the same efficacy of CTO procedures of all epicardial arteries. We did not observe that effectiveness of recanalization of CTO depends on the location of the obstruction.

Introducion Percutaneus coronary intervenions (PCI) has evolved to the mainstream revascularizaion method far outnumbering coronary artery bypass grating (CABG). However, the major drawback of PCI is a higher rate of target lesion revascularizaion (TLR) in comparison to CABG due to in-stent restenosis. Restenosis ater angioplasty has always been a signiicant problem in intervenional cardiology and is associated with signiicant morbidity and costs, with a wide spectrum of clinical presentaion. The disadvantages of balloon angioplasty has been removed when bare metal stents (BMS) were invented. The introducion of these devices significantly reduced restenosis after angioplasty. Development of drug eluing stents (DES) an another milestone in treatment of patients with coronary artery disease. The high eicacy of these devices in prevenion of restenosis compared with bare metal stents has allowed percutaneus coronary intervenion to be used in complex lesions. Introduction of DES reduced the number of target lesion revascularizaions but did not eliminate the in-stent restenosis (ISR). The populaion treated with BMS and DES is very large 1 and because of the complex subset of paients and lesions the overall rate of ISR remains significant. Although several treatment opions are available nowadays such as repeat stening, balloon angioplasty (BA), drug-coated balloons (DCB) there it is always a dilemma for intervenional cardiologist which devices to use, so management remains challenging. We provide comprehensive review of novel technique in ISR treatment: drug eluting balloons (DEBs). DeiniionRestenosis is deined as reducion of ≥50% of lumen diameter ater PCI at follow-up angiography. Although this deiniion was used as end point in large number of clinical trials it has to be emphasized that apart from angiographic indings clinical manifestaion of ischemia plays signiicant role in decision of treatment. PathophysiologyAter stent implantaion, which damages the endothelium and leads to regional and systemic inlammatory reacion, process of neoinima proliferaion begins and in months leads to neoinimal hyperplasia 2 . Stent underexpansion or not opimal atheroscleroic plaque coverage with stent favors ISR. But according to the latest indings it seems that one more factor is responsible for ISR, especially in late stage -neoatherosclerosis 3 . What is interesing novel atheroscleroic plaques are formed faster in drug eluing stent (ater one year) than in bare metal stent (ater four years). Detailed descripion of pathophysiology of ISR is will not be the subjects of this paper. Type of ISR and cause of its occurrence determines its treatment. TreatmentWhen treaing ISR we should take several possibiliies into consideraion and these are: opimal medical therapy (OMT),balloon angioplasty, stening (BMS, the same DES, diferent DES), DEB and cardiac surgery. In irst human trial on DEB -a PACCOCATH ISR I/II paients with BMS-ISR were randomized to Paccocath DEB versus standard balloon angioplasty. Ater 6 months major cardiac Srce i krvni s...