Introduction: Echocardiography plays a pivotal role in the diagnosis of left ventricular diastolic function. There has been only limited data on effects of age on different parameters of left ventricular diastolic function. Methods: We retrospectively searched and analysed a computerised echocardiography database data of subjects investigated at our department. We enrolled only subjects with sinus rhythm, normal left ventricular ejection fraction, without any valvular disease or any other signifi cant echocardiographic pathology. By a subsequent manual search of hospital records we divided subjects into three groups based on their clinical history - group of healthy patients, group of patients with arterial hypertension and a group with coronary artery disease. Results: We enrolled a total of 999 subjects, mean age 60.1 +/- 14.4 years, 48.5% were men. There were 363 healthy subjects, 429 subjects with arterial hypertension and 207 subjects with coronary artery disease. Transmitral E/A ratio decreased with age from mean 1.65 in subjects aged under 30 years to 0.78 in subjects over 80 years of age (p < 0.001). Tissue doppler velocities of septal and lateral mitral anulus (Em sep and Em lat) decreased with age, as did the septal and lateral e'/a' ratio. The septal, lateral and average E/Em ratio increased with age, as did the E wave deceleration time (DtE) (all parameters with p < 0.001). Except for DtE, Chi-square goodness of fit test did not find any statistically signifi cant differences in the measured parameters between the three compared groups. Conclusions: Echocardiographic parameters of diastolic function physiologically deteriorate with age. Based on this study, more exact cut-off values can be adopted for different age groups and measured diastolic parameters, than are currently available.

BACKGROUND To compare the number of severe periprocedural bleeding complications from the total number of bleeding complications associated with diagnostic selective coronary angiography or percutaneous coronary intervention (PCI) when using different classifications (TIMI, GUSTO, PLATO, BARC) and to relate these classifications to real hemodynamic status of evaluated patients. METHODS We analyzed data from 106 patients who underwent invasive procedure for ischemic heart disease (selective coronary angiography/PCI) and suffered from any type of bleeding complication. RESULTS The number of bleeding according to impacts on hemodynamic status and consequent treatment shows that 54.7% of all bleedings did not need any specific therapy. Bleeding leading to death, hemorrhagic shock, hemodynamic instability, administration of blood transfusion, surgical procedure and local treatment occurred in 6.6%, 1.9%, 5.7%, 14.2%, 2.8%, and 14.2%, respectively. The results comparing bleeding classifications demonstrate that the rate of severe bleeding complications may increase up to 4 times when different classifications are used on the same group of patients (TIMI 9.4%, GUSTO 15.1%, PLATO 39.2% and BARC 35.9%). The power of association between severe bleeding determined by these classifications and real hemodynamic compromise using Kendall's tau-c correlation is -0.4106 (95% CI -0.599 to -0.222), -0.5355 (95% CI -0.718 to -0.353), -0.5513 (95% CI -0.729 to -0.374) and -0.7552 (95% CI -0.897 to -0.612) for TIMI, GUSTO, PLATO and BARC, respectively. CONCLUSIONS The data show significant dependence of percentage of severe periprocedural bleeding complications on selected classification. The strongest association between severe bleeding and real hemodynamic status was found for BARC classification as this classification seems to be promising for future general use.

Background: Incidence of cardioembolic stroke (CS) is still considered being underestimated, because reliable detection requires extensive and time-consuming diagnostic setting. Objective: Aim was to assess cardioembolic etiology of acute ischemic stroke (IS) in patients admitted for revascularization. Methods: In this prospective study (Clinicaltrials.gov No. NCT01541163), 535 (314 males, mean age 68.4 ± 12.3 years) consecutive acute IS patients were enrolled within first 6 h after stroke onset. CT/MRI, laboratory tests, repeated ECG, 24 h ECG Holter monitoring, transthoracic and transoesophageal echocardiography, and ultrasound of cervical and intracranial arteries were performed in all patients. Etiology of IS was assessed using the TOAST and ASCOD classifications. Demographic and baseline clinical parameters were compared between cardioembolic (ASCOD C1) and non-cardioembolic (ASCOD C0) strokes. Results: According to the TOAST; 228 (42.6%) patients were identified as CS. According to the ASCOD; 243 (45.4%) patients were classified as C1 (potentially causal). Atrial fibrillation (AF) was detected in 208 (85.6%); in 119 (57.2%) patients was newly diagnosed. Other cause of cardioembolism was present in 35 (14.4%) patients. Patients with CS were significantly older (72.4 vs. 56.1 years, P < 0.001) and admitted earlier (102 vs. 126 min, P = 0.005) than patients with other etiology of IS. No differences was found between groups in performed revascularization (42.2% vs. 41.0% P = 0.43). Conclusions: Cardiac source of emboli was detected in 45% acute IS patients indicated to revascularization. AF was the most frequent cause; in most patients newly diagnosed. Supported by the IGA MH CR grants NT/11046-6/2010 and NT/14288-3/2013, and by RVO FNOl 00098892.

OBJECTIVE: To investigate the possible correlation between the location and volume of brain infarction and the cardiac troponin T (cTnT) serum level in AIS patients. BACKGROUND: cTnT is frequently elevated in in acute ischemic stroke patients. However, the relationship, if any, between the cTnT level and brain infarction remains to be established. DESIGN/METHODS: The prospective hospital-based study (Clinicaltrials.gov No.NCT01541163) consisted of consecutive AIS patients admitted within 12h of stroke onset. The location and volume of the acute brain ischemic lesion was assessed with magnetic resonance imaging. Standard laboratory tests, including cTnT and repeated electrocardiograms, were performed at admission and after 4h. Correlations between the cTnT level and the location and volume of brain infarction and baseline parameters were tested with a Spearman correlation coefficient. Univariate and multiple logistic regression analysis (LRA) were used to determine the possible predictors of cTnT elevation. RESULTS: Out of the 200 enrolled patients, elevated cTnT was present in 71 (36[percnt]). No correlation was found between the cTnT serum levels and the location (P>0.05) nor volume of brain infarction (P=0.48). LRA identified creatinine (OR:1.26 per 10µmol/L increase; 95[percnt]CI:1.043-1.524), NT-proBNP (OR:1.05 per 100μg/L increase; 95[percnt]CI:1.018-1.093) and male gender (OR:3.674; 95[percnt]CI:1.025-13.164) as significant independent predictors of pathological elevation of cTnT. CONCLUSIONS: Although elevated cTnT serum level is relatively frequent in AIS patients within the first 12h of stroke onset, it is not related to the location or volume of brain infarction. Study Supported by: MHCR grants NT/11046-6/2010, NT/14288-3/2013 and by RVO FNOL 00098892.

Background: The troponin T (cTnT) is frequently elevated in acute ischemic stroke (AIS) patients. However, the relationship, if any, between the cTnT level and brain infarction remains to be established. The aim was to investigate the possible correlation between the location and volume of brain infarction and the cardiac cTnT serum level in AIS patients.Methods: The study consisted of consecutive AIS patients admitted within 12 h of stroke onset. The location and volume of the acute ischemic lesion was assessed with magnetic resonance imaging. Standard laboratory tests, including cTnT and repeated electrocardiograms, were performed at admission and after 4 h. Correlations between the cTnT level and the location and volume of brain infarction and baseline parameters were tested with a Spearman correlation coefficient. Univariate and multiple logistic regression analysis (LRA) were used to determine the possible predictors of cTnT elevation.Results: Out of the 200 enrolled patients, elevated cTnT was present in 71 (36%). No correlation was found between the cTnT serum levels and the location (P > 0.05) nor volume of brain infarction (r = 0.05, P = 0.48). LRA identified creatinine (OR: 1.26 per 10 mu mol/ L increase; 95% CI: 1.043-1.524), NT-proBNP (OR: 1.05 per 100 mu g/ L increase; 95% CI: 1.018-1.093) and male gender (OR: 3.674; 95% CI: 1.025-13.164) as significant independent predictors of pathological elevation of cTnT.Conclusions: Although elevated cTnT serum level is relatively frequent in AIS patients within the first 12 h of stroke onset, it is not related to the location or volume of brain infarction. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Background: Multiple interactions are considered to occur between the various forms of cardiovascular and cerebrovascular diseases. The aim of the study was to assess the serum level profile of cardiac troponin T (cTnT) in acute ischemic stroke (AIS) patients to evaluate factors associated with increased serum level of cTnT.