| 1. |
|
|
| 2. |
|
|
| 3. |
- Fedorowski, Artur, et al.
(författare)
-
Orthostatic hypotension and cardiovascular risk
- 2019
-
Ingår i: Kardiologia Polska. - 1897-4279. ; 77:11, s. 1020-1027
-
Tidskriftsartikel (refereegranskat)abstract
- Orthostatic hypotension (OH) is a cardinal sign of cardiovascular (CV) autonomic dysfunction as a result of autonomic nervous system failure to control the postural hemodynamic homeostasis. The proportion of individuals with OH increases with aging and chronic conditions, such as neurodegenerative diseases, hypertension, heart failure, diabetes, renal dysfunction, autoimmune diseases, and cancer. In individuals over 70 years of age, more than 20% can be affected. It is now increasingly recognized that there is a direct relationship between OH and each step of the CV disease continuum, eventually leading to end‑stage heart disease and CV death. In particular, prevalent OH is associated with cardiac functional and structural remodeling, left ventricular hypertrophy, elevated levels of circulating markers of inflammation, increased intima‑media thickness, subclinical atherosclerosis, and thrombosis. Beyond subclinical changes, the presence of OH independently predicts coronary events, stroke, atrial fibrillation, heart failure, and CV mortality. Furthermore, OH is associated with syncope, falls, and fragility fractures, presenting hurdles to be overcome in the delivery of the best management of CV risk factors. Taken together, OH heralds disruption of global circulatory homeostasis and flags overt autonomic dysfunction. The presence of OH is also an independent risk factor for mortality and CV disease; however, until now, the importance of this highly prevalent disorder has been given insufficient attention by clinicians and other healthcare providers. Consequently, more studies are needed to find effective treatment for this troublesome condition and to identify preventive measures that could reduce the burden of CV risk in OH and autonomic dysfunction.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Legutko, Jacek, et al.
(författare)
-
Similar outcome of ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention regardless of presence of cardiac surgery on-site.
- 2014
-
Ingår i: Kardiologia polska. - : Polskie Towarzystwo Kardiologiczne. - 0022-9032 .- 1897-4279. ; 72:10, s. 949-53
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The growing penetration of mechanical reperfusion in ST-elevation myocardial infarction (STEMI) has been achieved by the creation of new percutaneous coronary intervention (PCI) centres which have helped to shorten delays but have compromised PCI volumes.AIM: To compare the outcomes in STEMI patients treated in PCI centres with or without surgical back-up.METHODS: Data concerning 1,650 registry patients was analysed. The analysis was based on cathlab classification with cardiac surgery on site (n = 996) and without (n = 654).RESULTS: There was a 0.3% rate of transfer (two patients out of 654) for urgent coronary artery bypass grafting from PCI centres without cardiac surgery on site. There were no differences in in-hospital and long-term mortality in patients in both studied groups.CONCLUSIONS: No differences in short and long-term outcomes were noticed for STEMI patients treated in centres with or without cardiac surgery on-site.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Lomper, Katarzyna, et al.
(författare)
-
Psychometric evaluation of the Polish version of the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia: a new tool for symptom and health-related quality of life assessment
- 2019
-
Ingår i: Kardiologia polska. - : VIA MEDICA. - 0022-9032 .- 1897-4279. ; 77:5, s. 541-552
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Atrial fibrillation (AF) is the most common arrhythmia resulting in hospitalization. The assessment of symptoms and health-related quality of life (HRQoL) can provide valuable information before, during, and after health care interventions for AF. AIMS We aimed to perform a translation and cultural adaptation of the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA), and to evaluate the reliability and validity of its Polish version. METHODS The standard forward-backward translation procedure to translate the ASTA questionnaire into Polish was used. A total of 244 patients with AF at a mean (SD) age of 70.7 (10.7) years completed the questionnaire and were included in the study. Reliability was tested using internal consistency (Cronbach alpha) and validity with an item-total correlation, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS The ASTA symptom scale had satisfactory psychometric properties (alpha = 0.718), and the corrected item-total correlation was sufficient for most items (0.361-0.506), except for cold sweats (0.156). The ASTA HRQoL scale showed good psychometric properties (alpha = 0.855). Initial CFA analyses showed that the 1- and 2-factor models had similar properties, with strong factor loadings and satisfactory goodness-of-fit values according to the comparative fit index (0.947 for the 1-factor model vs 0.988 for the 2-factor model). A comparison of the 1-and 2-factor models showed that the close fit for the root-mean-square error of approximation was better for the 2-factor model (0.387 vs 0.193). A 2-factor EFA model was produced, and for factor 1 (physical scale), the varimax low ranged between 0.470 and 0.804, and for factor 2 (the mental scale), it ranged between 0.597 and 0.873. CONCLUSIONS The psychometric properties of the Polish version of the ASTA questionnaire were overall found to be satisfactory.
|
|
| 12. |
|
|
| 13. |
- Nessler, Jadwiga, et al.
(författare)
-
Concentration of BNP, endothelin 1, pro-inflammatory cytokines (TNF-alpha, IL-6) and exercise capacity in patients with heart failure treated with carvedilol
- 2008
-
Ingår i: Kardiologia Polska. - 1897-4279. ; 66:2, s. 144-153
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Recent studies on the pathophysiology of heart failure indicate the role of neurohormones and immune and inflammatory processes as potential mechanisms involved in the pathogenesis and clinical course of chronic heart failure (CHF). Aim: To analyse the relationship between concentrations of brain natriuretic peptide (BNP), endothelin-1 (ET-1), inflammatory cytokines (TNF-alpha, IL-6) and cardiopulmonary stress test parameters, and to evaluate their changes during carvedilol treatment. Methods: The study included 86 patients (81 men and 5 women) aged from 35 to 70 years (56.8 +/- 9.19) with symptomatic heart failure and left ventricular ejection fraction < 40%, receiving an inhibitor of angiotensin II converting enzyme, diuretic and/or digoxin but not beta-blockers. All patients at baseline, and then at 3 and 12 months after treatment, underwent a panel of studies to assess functional capacity according to NYHA, echocardiographic and cardiopulmonary stress test (CPX) parameters, and serum concentrations of BNP, ET-1, TNF-alpha and IL-6. Before introducing carvedilol we found a weak relationship between concentrations of BNP, ET-1, IL-6 and decreased VO2 (peak). Results: At 12 months exercise tolerance was significantly improved (exercise stress testing prolonged by 143.9 s, p=0.001) and an increase in metabolic equivalent (MET) by 1.41 (p=0.001) was observed. The VO2 (peak) was nonsignificantly increased by a mean of 0.9 ml/kg/min. In patients with baseline VO2 (peak) < 14 ml/kg/min the concentrations of ET-1 and TNF-alpha were significantly higher than in the remaining ones, and after treatment they were significantly reduced. In these patients VO2 (peak)%N was also significantly increased (39.5 +/- 7.5 vs. 50.1 +/- 15,0; p=0.013). The number of patients with VO2 (peak) < 14 ml/kg/min also significantly decreased from 39 to 21 (p=0.013). Conclusions: In patients with HF decreased value of VO2 (peak) is associated with LV systolic function disorders and increased levels of BNP, ET-1, TNF-alpha and IL-6. Chronic treatment with carvedilol improves LV systolic function, exercise tolerance and peak oxygen consumption and is associated with significant decrease of BNP, ET-1, TNF-alpha and IL-6 concentrations.
|
|
| 14. |
- Nessler, Jadwiga, et al.
(författare)
-
Sudden cardiac death risk factors in patients with heart failure treated with carvedilol
- 2007
-
Ingår i: Kardiologia Polska. - 1897-4279. ; 65:12, s. 1417-1424
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCID). Most frequently SCID occurs in patients with NYHA class II and III. Aim: To evaluate the influence of prolonged carvedilol therapy on SCID risk in CHF patients. Methods: The study included 86 patients (81 men and 5 women) aged 56.8 +/- 9.19 (35-70) years with CHF in NYHA class II and III receiving an ACE inhibitor and diuretics but not beta-blockers. At baseline and after 12 months of carvedilol therapy the following risk factors for SCID were analysed: in angiography - occluded infarct-related artery; in echocardiography - left ventricular ejection fraction (LVEF) < 30%, volume of the left ventricle (LVEDV) > 140 ml; in ECG at rest - sinus heart rate (HRs) > 75/min, sustained atrial fibrillation, increased QTc; in 24-hour ECG recording - complex arrhythmia, blunted heart rate variability (SDNN < 100 ms) and abnormal turbulence parameters (TO and TS or one of them); in signal-averaged ECG - late ventricular potentials and prolonged QRS > 114 ms. The analysis of SCD risk factors in basic examination in patients who suddenly died was also performed. Results: During one-year carvedilol therapy heart transplantation was performed in 2 patients; 5 patients died. At 12 months the following risk factors for SCID were significantly changed: HRs > 75/min (50 vs. 16 patients, p=0.006), LVEF < 30% (37 vs. 14 patients, p=0.01), SDNN < 100 ms (19 vs. 9 patients, p=0.04). At 12 months the number of risk factors for SCD in each patient was significantly reduced (p=0.001). In patients who suddenly died we found a greater amount of SCID risk factors in basic examination (7 vs. 5) as compared to alive patients. Conclusions: Prolonged beta-adrenergic blockade reduces risk of sudden cardiac death through significant LVEF increase, reduction of HR at rest and improvement of HRV.
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
- Rakowski, Tomasz, et al.
(författare)
-
Impact of infarct related artery patency after early abciximab administration on one-year mortality in patients with ST-segment elevation myocardial infarction (data from the EUROTRANSFER Registry)
- 2012
-
Ingår i: Kardiologia polska. - : Polskie Towarzystwo Kardiologiczne. - 0022-9032 .- 1897-4279. ; 70:3, s. 215-221
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Spontaneous early infarct related artery (IRA) recanalisation before primary percutaneous coronary intervention (pPCI) has a favourable impact on outcome. However, the role played by pharmacotherapy driven patency prior to pPCI is still a matter of debate. less thanbrgreater than less thanbrgreater thanAim: To assess the role of early IRA patency (TIMI flow 2 or 3) after early abciximab administration in patients with ST-segment elevation myocardial infarction (STEM!) transferred for pPCI. less thanbrgreater than less thanbrgreater thanMethods: Data was gathered for 1,650 consecutive sTEMI patients transferred for pPCI from hospital networks in seven countries in Europe between November 2005 and January 2007. We identified 691 patients who were pretreated with abciximab before transportation to a cathlab hospital and underwent PCI. less thanbrgreater than less thanbrgreater thanResults: Angiography showed early IRA patency (TIMI flow 2 or 3) in 233 (33.7%) patients, and occluded IRA (TIMI flow 0 or 1) in 458 (66.3%) patients. In patients with patent IRA, in baseline angiography the rate of TIMI 3 flow and ECG ST-segment resolution andgt; 50% after PCI was higher compared to patients with occluded IRA. One year mortality was significantly lower in patients with patent IRA, 1.3% vs 7% (OR 0.17; CI 0.05-0.6; p = 0.001). In multivariable Cox regression analysis, IRA patency at baseline was identified as an independent predictor of one-year mortality. less thanbrgreater than less thanbrgreater thanConclusions: Infarct related artery recanalisation after early pharmacological pretreatment in STEMI patients undergoing transportation for pPCI is associated with better post-procedural myocardial perfusion and lower one-year mortality.
|
|
| 20. |
|
|
| 21. |
- Rivasi, Giulia, et al.
(författare)
-
Syncope : new solutions for an old problem
- 2021
-
Ingår i: Kardiologia Polska. - 1897-4279. ; 79:10, s. 1068-1078
-
Tidskriftsartikel (refereegranskat)abstract
- Syncope is a frequent event in the general population. Approximately 1%-2% of all emergency department admissions are due to syncope and at least one third of all people experience fainting in their life. Although consequences of cardiac syncope are generally feared, non-cardiac syncope is much more common and may be associated with severe injuries and quality of life impairment, particularly in older adults. Various diagnostic and therapeutic strategies have been created and implemented over decades, leading to significant improvements in diagnostic accuracy and treatment effectiveness. In recent years, diagnosis and treatment have further evolved according to an innovative approach focused on the hemodynamic mechanism underlying syncope, based upon the assumption that knowledge of syncope mechanism is a prerequisite for effective syncope prevention and treatment. Therefore, a new classification of syncope has been proposed, which defines two main syncope phenotypes with different predominant mechanisms: the hypotensive phenotype, where hypotension or vasodepression prevails, and the bradycardic phenotype, where cardioinhibition prevails. Identification of syncope phenotype - bradycardic or hypotensive/vasodepressive - represents the first step towards a personalized management of syncope, characterized by customized interventions for prevention. The present review is aimed at illustrating these new developments in diagnosis and therapy of non-cardiac syncope within a mechanism-based perspective. Diagnosis and therapy of bradycardic and hypotensive phenotypes are discussed, with a focus on recent evidence.
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
|
|
| 25. |
- Steffel, Jan, et al.
(författare)
-
The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation : executive summary
- 2018
-
Ingår i: Kardiologia polska. - : VIA MEDICA. - 0022-9032 .- 1897-4279. ; 76:9, s. 1283-1298
-
Tidskriftsartikel (refereegranskat)abstract
- Poniższy tekst jest streszczeniem drugiej aktualizacji oryginalnego praktycznego przewodnika opublikowanego w 2013 roku. Leki przeciwkrzepliwe niebędące antagonistami witaminy K (NOAC) stanowią cenną alternatywę dla antagonistów witaminy K (VKA) w zapobieganiu udarom u pacjentów z migotaniem przedsionków (AF) i uznano je za leki preferowane, szczególnie dla osób rozpoczynających leczenie przeciwkrzepliwe. Zarówno lekarze, jak i pacjenci przyzwyczajają się do ich stosowania w praktyce klinicznej, istnieje jednak wiele nierozwiązanych kwestii dotyczących optymalnego stosowania tych leków w określonych sytuacjach klinicznych. Europejskie Stowarzyszenie Zaburzeń Rytmu Serca (EHRA, European Heart Rhythm Association) podjęło się koordynacji opracowania jednolitego sposobu komunikowania się z lekarzami na temat stosowania różnych preparatów NOAC. Grupa określiła 20 tematów zawierających konkretne scenariusze kliniczne, w odniesieniu do których sformułowano praktyczne wskazówki na podstawie dostępnych dowodów. Do problemów klinicznych należą: 1) odpowiednia kwalifikacja pacjentów do leczenia; 2) praktyczne schematy rozpoczynania oraz monitorowania terapii za pomocą NOAC; 3) zagwarantowanie przestrzegania zaleceń przyjmowania doustnych leków przeciwkrzepliwych; 4) zmiana schematów leczenia przeciwkrzepliwego; 5) farmakokinetyka oraz interakcje lekowe; 6) stosowanie NOAC u osób z przewlekłą chorobą nerek i zaawansowaną chorobą wątroby; 7) sposoby pomiaru efektu przeciwkrzepliwego NOAC; 8) pomiar stężenia NOAC w surowicy: rzadkie wskazania, środki ostrożności, potencjalne „pułapki”; 9) postępowanie w przypadku pomyłki w dawkowaniu; 10) postępowanie w przypadku (podejrzenia) przedawkowania bez krwawienia lub badania krzepnięcia wskazujące na potencjalne ryzyko krwawienia; 11) postępowanie w przypadku krwawienia w trakcie terapii za pomocą NOAC; 12) postępowanie u pacjentów poddanych planowym zabiegom chirurgicznym, procedurom inwazyjnym czy ablacji; 13) postępowanie u pacjentów wymagających pilnej interwencji chirurgicznej; 14) pacjenci z AF oraz chorobą wieńcową; 15) unikanie pomyłek w dawkowaniu NOAC w różnych wskazaniach; 16) kardiowersja u pacjenta leczonego NOAC; 17) AF u pacjentów z ostrym udarem mózgu leczonych NOAC; 18) NOAC w sytuacjach szczególnych; 19) leczenie przeciwkrzepliwe w przypadku AF u pacjentów z nowotworami złośliwymi; 20) optymalizacja leczenia za pomocą VKA. Dodatkowe informacje oraz materiały do pobrania, jak również karty leczenia przeciwkrzepliwego w kilku językach można znaleźć na stronie internetowej EHRA (www.NOACforAF.eu).
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
- Sutton, R, et al.
(författare)
-
Artur Pietrucha (1964-2020)
- 2021
-
Ingår i: Kardiologia polska. - 1897-4279. ; 79:6, s. 720-721
-
Tidskriftsartikel (refereegranskat)
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
|
|
| 33. |
- Zyśko, Dorota, et al.
(författare)
-
The importance of the longest R-R interval on 24-hour electrocardiography in mortality prediction in patients with atrial fibrillation
- 2021
-
Ingår i: Kardiologia Polska. - 1897-4279.
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Heart rate control in atrial fibrillation (AF) is typically assessed by 24-hour electrocardiography (ECG). There are scarce data on the use of 24-hour ECG parameters to predict mortality in AF.AIMS: We aimed to identify 24-hour ECG parameters that predict mortality in AF.METHODS: We enrolled 280 ambulatory patients (mean [SD] age, 72.0 [8.7] years; 57.9% men) with permanent or persistent AF. Data on mortality and pacemaker or defibrillator implantation during follow-up were collected. Predictors of mortality were assessed using the Cox proportional hazards model and C-statistic.RESULTS: Compared with survivors, 78 (28%) patients who died were older, more often had comorbidities, left bundle branch block (LBBB), reduced left ventricular ejection fraction, lower maximum heart rate, a higher number of ventricular extrasystoles, and the longest R-R interval below 2 seconds. Univariate analysis revealed higher mortality in patients with the longest R-R intervals below 2 seconds compared with those with the R-R intervals of 2 seconds or longer (P <0.001). Independent mortality predictors in the regression model included older age, renal failure, history of coronary intervention, chronic obstructive pulmonary disease, LBBB, and a high number (≥770) or absence of R-R intervals of at least 2 seconds. The area under curve (AUC) for mortality prediction increased after inclusion of ECG parameters 0.748 [95% CI, 0.686-0.810] vs 0.688 [95% CI, 0.618-0.758]; P = 0.02).CONCLUSIONS: A high number of R-R intervals longer than 2 seconds or their absence on 24-hour ECG may predict mortality in AF.
|
|
