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Sökning: L773:1897 4279 > (2015-2019) > Tidskriftsartikel

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  • 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.
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  • 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.
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