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Stolarz-Skrzypek K, Czarnecka D. Resistant hypertension: challenges in everyday practice. Pol Arch Intern Med 2023; 133:16624. [PMID: 38088817 DOI: 10.20452/pamw.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Resistant hypertension is defined as not achieving sufficient control of blood pressure (BP), that is, maintaining BP values equal to or above 140/90 mm Hg when using 3 antihypertensive drugs, including diuretics, properly combined and at maximum doses. The uncontrolled treated hypertension should be confirmed in out‑of‑office BP measurements, preferably with 24‑hour ambulatory BP monitoring. Demographic and clinical characteristics indicate that patients with resistant hypertension are older than the general population of patients with arterial hypertension and more often suffer from comorbidities. When resistant hypertension is suspected, it is necessary to assess whether optimal pharmacotherapy has been prescribed, including appropriate combinations of antihypertensive drugs and diuretics at appropriate doses. It is also important to exclude parallel use of drugs that may have unfavorable interactions leading to an increase in BP. A common cause of pseudoresistant hypertension is a patient's failure to comply with therapeutic recommendations, including a lack of lifestyle changes and nonadherence to the prescribed medication regimen. An important step in management of resistant hypertension is targeted screening with diagnostic tests for secondary hypertension. Expanding of the drug therapy beyond a 3‑drug regimen should include a mineralocorticoid receptor antagonist, in particular spironolactone. In selected patients, device‑based hypertension treatment might be considered.
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Affiliation(s)
- Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Pęksa JW, Storman D, Jankowski P, Czarnecka D, Rajzer M. Characteristics of hospitalized patients with established coronary artery disease and trends in their management: Comparing 2013 and 2020. Kardiol Pol 2022; 80:842-845. [PMID: 35781637 DOI: 10.33963/kp.a2022.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Jan W Pęksa
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Dawid Storman
- Systematic Reviews Unit, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland.,Department of Adult Psychiatry, University Hospital, Kraków, Poland
| | - Piotr Jankowski
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.,Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, Warszawa, Poland
| | - Danuta Czarnecka
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Rajzer
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Sinnadurai S, Sowa P, Jankowski P, Gasior Z, Kosior DA, Haberka M, Czarnecka D, Pajak A, Setny M, Jamiolkowski J, Sawicka-Śmiarowska E, Kaminski K. Recollection of Physician Information about Risk Factor and Lifestyle Changes in Chronic Coronary Syndrome Patients. IJERPH 2022; 19:ijerph19116416. [PMID: 35682001 PMCID: PMC9180913 DOI: 10.3390/ijerph19116416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023]
Abstract
A patient’s compliance to a physician’s lifestyle information is essential in chronic coronary syndrome (CCS) patients. We assessed potential characteristics associated with a patient’s recollection of physician information and lifestyle changes. This study recruited and interviewed patients (aged ≤ 80 years) 6–18 months after hospitalization due to acute coronary syndrome or elective myocardial revascularization. A physician’s information on risk factors was recognized if patients recollected the assessment of their diet, weight management, blood pressure control, cholesterol level, diabetes, and other lifestyle factors by the doctor. Of a total of 946 chronic coronary syndrome patients, 52.9% (501) of them declared the recollection of providing information on more than 80% of the risk factors. A good recollection of risk factor information was associated with the following: a patient’s age (OR per year: 0.97; 95% CI: 0.95 to 0.99), obesity (OR: 4.41; 95% CI: 3.09–6.30), diabetes (OR: 4.16; 95% CI: 2.96–5.84), diuretic therapy (OR: 1.41; 95% CI: 1.03–1.91), calcium channel blockers (OR: 1.47; 95% CI: 1.04–2.09), and ACEI/sartan (OR: 0.65; 95% CI: 0.45–0.94) at hospitalization discharge. In terms of goal attainment, better adherence to antihypertensive drugs (OR: 1.80; 95% CI: 1.07–3.03) was observed in the patients with a good compared to a poor recollection of risk factor information. The recollection of physician risk factor information was significantly associated with more comorbidities. Strategies to tailor the conveying of information to a patient’s perception are needed for optimal patient–doctor communication.
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Affiliation(s)
- Siamala Sinnadurai
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, 15-089 Bialystok, Poland; (S.S.); (P.S.); (J.J.); (E.S.-Ś.)
| | - Pawel Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, 15-089 Bialystok, Poland; (S.S.); (P.S.); (J.J.); (E.S.-Ś.)
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Center of Postgraduate Medical Education, 00-416 Warszawa, Poland;
- Department of Epidemiology and Health Promotion, School of Public Health, Center of Postgraduate Medical Education, 01-813 Warszawa, Poland
| | - Zbigniew Gasior
- Department of Cardiology, School of Health Sciences, Medical University Silesia, 40-055 Katowice, Poland; (Z.G.); (M.H.)
| | - Dariusz A. Kosior
- Department of Cardiology and Hypertension with Electrophysiology Lab, Central Research Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (D.A.K.); (M.S.)
- Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University Silesia, 40-055 Katowice, Poland; (Z.G.); (M.H.)
| | - Danuta Czarnecka
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kracow, Poland;
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Institute of Public Health Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Krakow, Poland;
| | - Malgorzata Setny
- Department of Cardiology and Hypertension with Electrophysiology Lab, Central Research Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (D.A.K.); (M.S.)
| | - Jacek Jamiolkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, 15-089 Bialystok, Poland; (S.S.); (P.S.); (J.J.); (E.S.-Ś.)
| | - Emilia Sawicka-Śmiarowska
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, 15-089 Bialystok, Poland; (S.S.); (P.S.); (J.J.); (E.S.-Ś.)
- Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Karol Kaminski
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, 15-089 Bialystok, Poland; (S.S.); (P.S.); (J.J.); (E.S.-Ś.)
- Correspondence: ; Tel.: +48-857468656
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Setny M, Jankowski P, Kamiński K, Gąsior Z, Haberka M, Czarnecka D, Pająk A, Kozieł P, Szóstak-Janiak K, Sawicka E, Stachurska Z, Kosior DA. Secondary prevention of coronary heart disease in Poland: does gender matter? Results from POLASPIRE survey. Pol Arch Intern Med 2021; 132. [PMID: 34935325 DOI: 10.20452/pamw.16179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The adherence to health-promoting behaviors intended to mitigate modifiable risk factors plays an important role in the secondary CV prevention. OBJECTIVES To evaluate gender differences in the prevalence and control of risk factors in patients with coronary heart disease (CHD). PATIENTS AND METHODS The study included 1236 patients with acute coronary syndrome or coronary revascularization within the last 6-24 months. Definitions of risk factors and treatment goals are based on the 2016 ESC guidelines on cardiovascular prevention. RESULTS The prevalence of modifiable risk factors in both sexes was high and their control inadequate. Women were older (P <0.001) and had higher accumulation of multiple CV risk factors than men (P = 0.036). They had more frequently central obesity (P <0.001) and reduced GFR values (P <0.001). Women more often experienced anxiety (P <0.001), reported lower levels of education (P <0.001) and lower income (P = 0.001), and in the youngest age group were more likely to be exposed to the secondhand smoking (P = 0.01). A large fraction of study patients, men and women alike, did not meet the recommended therapeutic goals. For both sexes, participation in cardiac rehabilitation programs was associated with more frequent attainment of the recommended level of physical activity (P = 0.046) and smoking cessation (P = 0.010). CONCLUSIONS The prevalence of CV risk factors in CHD patients is high, especially in women. Therapeutic goals are met infrequently in both genders. This situation calls for widening the access to educational programs and higher attention to their proper implementation.
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Affiliation(s)
- Małgorzata Setny
- Clinical Cardiology Center, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Center of Postgraduate Medical Education, Warsaw, Poland
- Department of Epidemiology and Health Promotion, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Karol Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Maciej Haberka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Kozieł
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Emilia Sawicka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Zofia Stachurska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Dariusz A Kosior
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
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Sinnadurai S, Sowa P, Jankowski P, Gąsior Z, Kosior DA, Haberka M, Czarnecka D, Pająk A, Setny M, Jamiołkowski J, Łapińska M, Kamiński KA. Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: a multicenter cross‑sectional study. Pol Arch Intern Med 2021; 131:617-625. [PMID: 34057335 DOI: 10.20452/pamw.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION While cardiac rehabilitation (CR) improves survival outcomes in patients with ischemic heart disease (IHD), the long‑ term benefits of short term programs are still discussed. OBJECTIVES The aim of the study was to assess the impact of CR on risk factor management in a multicenter real‑ life registry of patients with IHD. PATIENTS AND METHODS We included patients aged 80 years or younger who had been hospitalized due to acute coronary syndrome or for a myocardial revascularization procedure and interviewed 6 to 18 months later. Control of risk factors was compared between patients who participated in CR and those who did not. Propensity score matching was used to account for differences in patient characteristics between the groups. RESULTS Of 1012 interviewed patients (28.6% women), 35.6% were referred for CR and 76.1% of them completed the program. Those referred were younger (P <0.001), employed (P <0.001), have presented with ST‑ segment elevation myocardial infarction (P <0.001), had hypertension (P <0.001), and were current smokers (P <0.001). Logistics regression revealed that patients who participated in CR were more likely to stop smoking (odds ratio [OR], 2.42; 95% CI, 1.33-4.14), achieve acceptable glucose control (OR, 1.70; 95% CI, 1.02-2.83), and better quality of life (β = 0.12; 95% CI, 0.00-0.24) compared with those who did not participate in CR. CONCLUSIONS Cardiac rehabilitation is moderately effective if performed only once and without a continuous support program. Further efforts to increase referrals for CR in patients with IHD must be accompanied by a long‑ term strategy to sustain the beneficial effects.
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Affiliation(s)
- Siamala Sinnadurai
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Białystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Białystok, Poland
| | - Piotr Jankowski
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Dariusz A Kosior
- Department of Cardiology and Hypertension with Electrophysiology Lab, Central Research Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Faculty of Medicine, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Danuta Czarnecka
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Setny
- Department of Cardiology and Hypertension with Electrophysiology Lab, Central Research Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Białystok, Poland
| | - Magda Łapińska
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Białystok, Poland
| | - Karol A Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Białystok, Poland.
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Pęksa JW, Jankowski P, Kozieł P, Bogacki P, Gomuła P, Mirek-Bryniarska E, Nessler J, Podolec P, Wiśniewski A, Rajzer M, Czarnecka D, Pająk A. Changes over time in the prevention of recurrent coronary artery disease in everyday practice. Pol Arch Intern Med 2021; 131:673-678. [PMID: 34002973 DOI: 10.20452/pamw.16001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events, and risk factor control is crucial in this population. OBJECTIVES The aim of the study was to compare the implementation of the European Society of Cardiology guidelines regarding prevention of recurrent CAD in 2011 to 2013 with 2016 to 2017. PATIENTS AND METHODS The study included 5 hospitals with cardiology departments serving the city of Kraków and its surrounding districts. Consecutive patients with established CAD were interviewed 6 to 18 months after hospitalization in the years 2011 to 2013 and 2016 to 2017. RESULTS We examined 616 patients in 2011 to 2013 and 388 in 2016 to 2017 (mean [SD] age, 64.7 [8.8] years vs 66.4 [8.4] years; P <0.01). After adjusting for covariates, the proportion of patients with high blood pressure decreased by 8.9% (95% CI, -15.6% to -2.1%) and the proportion of patients with high level of low‑ density lipoprotein cholesterol declined by 9.5% (95% CI, -16.7% to -2.2%) in 2016 to 2017 compared with 2011 to 2013, whereas the proportion of smoking patients (-0.2% [95% CI, -6% to 5.5%]) and those with high glucose levels (3.9% [95% CI, -2.2% to 10%]) and a body mass index of 25 kg/m2 or greater (3.8% [95% CI, -3.9% to 11.6%]) did not change. More patients were prescribed antiplatelets, β‑ blockers, angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, calcium antagonists, and anticoagulants in the second period. CONCLUSIONS We observed an increase in the proportion of patients with CAD who were prescribed cardiovascular drugs, and consequently a slight improvement in the control of their blood pressure and low‑ density lipoprotein cholesterol. No changes were found regarding other main risk factors.
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Affiliation(s)
- Jan W Pęksa
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Jankowski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Paweł Kozieł
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Bogacki
- Department of Cardiology, Ludwik Rydygier District Hospital, Kraków, Poland
| | - Piotr Gomuła
- Department of Cardiology, Gabriel Narutowicz Memorial General Hospital, Kraków, Poland
| | | | - Jadwiga Nessler
- Department of Coronary Disease, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Wiśniewski
- Department of Internal Medicine and Cardiology, Stefan Żeromski Hospital, Kraków, Poland
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Pająk
- Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
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Jastrzębski M, Moskal P, Hołda MK, Strona M, Bednarek A, Kiełbasa G, Czarnecka D. Deep septal deployment of a thin, lumenless pacing lead: a translational cadaver simulation study. Europace 2021; 22:156-161. [PMID: 31722391 DOI: 10.1093/europace/euz270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/11/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS The recently introduced technique of direct transseptal pacing of the left bundle branch is poorly characterized with many questions with regard to the optimal implantation strategy and safety concerns largely left unanswered. We developed a cadaver model for deep septal lead deployment in order to investigate the depth of penetration in relation to lead behaviour, lead tip position, and the number of rotations. METHODS AND RESULTS Five fresh human hearts and five lumenless, 4.1-Fr pacing leads were used for deep septal deployment simulations. The leads were positioned with the use of a dedicated delivery sheath and screwed into the interventricular septum at several sites progressively more distal from the atrioventricular ring with a predetermined number of lead rotations. During each lead deployment, the depth of tip penetration was measured and the lead behaviour was noted. Four distinct lead behaviours were observed: (i) helix only penetration, no matter how many rotations were performed, due to the 'endocardial entanglement effect' (43.1% cases) or (ii) 'endocardial barrier effect' (19.6% cases), (iii) shallow/moderate penetration, with ensuing 'drill effect' when more rotations were added (9.8% cases), and (iv) deep progressive penetration with each additional rotation, occurring when the 'screwdriver effect' was present (27.4% cases, including three septal perforations). These different lead behaviours seemed to be determined by the lead position-mainly the strength of the initial endocardial layer-and the number of fully transmitted rotations. CONCLUSION New insights into deep septal lead deployment technique were gained with regard to safe and successful implantation.
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Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Mateusz K Hołda
- Department of Anatomy, HEART-Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Strona
- Department of Forensic Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
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8
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Setny M, Jankowski P, Krzykwa A, Kamiński KA, Gąsior Z, Haberka M, Czarnecka D, Pająk A, Kozieł P, Szóstak-Janiak K, Sawicka E, Stachurska Z, Kosior DA. Management of Dyslipidemia in Women and Men with Coronary Heart Disease: Results from POLASPIRE Study. J Clin Med 2021; 10:jcm10122594. [PMID: 34208351 PMCID: PMC8231115 DOI: 10.3390/jcm10122594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in Poland. Starting from 1992, a gradual decrease in mortality due to CVDs has been observed, which is less noticeable in women. Following this notion, we assessed sex differences in the implementation of ESC recommendations regarding lipid control and the use of statins as part of secondary CVDs prevention in 1236 patients with acute coronary syndrome or elective coronary revascularization within the last 6-24 months. During hospitalization women had more frequently abnormal TC levels than men (p = 0.035), with overall higher TC levels (p = 0.009) and lower HDL-C levels (p = 0.035). In the oldest group, they also had more frequently elevated LDL-C levels (p = 0.033). Similar relationships were found during the follow-up visit. In addition, women less often achieved the secondary lipid therapeutic goal for non-HDL-C (p = 0.009). At discharge from hospital women were less frequently prescribed statins (p = 0.001), which included high-intensity statins (p = 0.002). At the follow-up visit the use of high-intensity statins was still less frequent in women (p = 0.02). We conclude that women generally have less optimal lipid profiles than men and are less likely to receive high-intensity statins. There is a need for more organized care focused on the management of risk factors.
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Affiliation(s)
- Małgorzata Setny
- Clinical Cardiology Center, Central Research Hospital the Ministry of The Interior and Administration, 02-507 Warsaw, Poland
- Correspondence: (M.S.); (D.A.K.)
| | - Piotr Jankowski
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (P.J.); (D.C.); (P.K.)
- Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland
| | - Agnieszka Krzykwa
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of The Interior and Administration, 02-507 Warsaw, Poland;
| | - Karol A. Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (K.A.K.); (E.S.); (Z.S.)
| | - Zbigniew Gąsior
- Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (Z.G.); (M.H.); (K.S.-J.)
| | - Maciej Haberka
- Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (Z.G.); (M.H.); (K.S.-J.)
| | - Danuta Czarnecka
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (P.J.); (D.C.); (P.K.)
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, 31-066 Kraków, Poland;
| | - Paweł Kozieł
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (P.J.); (D.C.); (P.K.)
| | - Karolina Szóstak-Janiak
- Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (Z.G.); (M.H.); (K.S.-J.)
| | - Emilia Sawicka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (K.A.K.); (E.S.); (Z.S.)
| | - Zofia Stachurska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (K.A.K.); (E.S.); (Z.S.)
| | - Dariusz A. Kosior
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of The Interior and Administration, 02-507 Warsaw, Poland;
- Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
- Correspondence: (M.S.); (D.A.K.)
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Peksa JW, Jankowski P, Koziel P, Bogacki P, Gomula P, Mirek-Bryniarska E, Nessler J, Podolec P, Wisniewski AK, Rajzer M, Czarnecka D, Pajak A. Temporal changes in the implementation of secondary prevention of coronary artery disease in every day practice. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
-
Introduction
Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events and control of their risk factors is crucial.
Objectives
Comparison of risk factors control in patients with CAD in 2016–2017 and 2011–2013.
Patients and methods
Five hospitals with cardiology departments serving the city and surrounding districts participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or a myocardial revascularization procedure were interviewed 6–18 months after hospitalization. The surveys were carried out in 2011–2013 and 2016–2017.
Results
We examined 616 patients in 2011–2013 and 388 in 2016–2017 (mean age: 64.7 ± 8.8 vs. 66.4 ± 8.4, P <0.01). After adjusting for covariates the proportion of patients with high blood pressure decreased by 8.9% (95% confidence intervals: -2.1% – -15.6%) and proportion of patients with high LDL cholesterol decreased by 9.5% (-2.2% – -16.7%) in 2016/2017 compared to 2011/2013, whereas the proportion of smoking patients (-0.2% [-6.0% – 5.5%]) and those with high glucose level (3.9% [-2.2% - 10.0%]) and with body mass index ≥25 kg/m2 (3.8% [-3.9% – 11.6%]) did not change significantly. The proportion of patients prescribed antiplatelets (6.5% [2.6% - 10.3%]), β-blockers (7.4% [2.2% - 12.6%]), angiotensin converting enzyme inhibitors or sartans (8.6% [2.9% – 14.3%]), calcium antagonists (8.1% [1.3 – 15.0]) and anticoagulants (5.5% [0.7% - 10.2%]) increased significantly.
Conclusions
In CAD patients, there was an increase of the proportion of patients with cardiovascular drugs prescribed and a slight improvement in the control of blood pressure and LDL cholesterol between 2011–2013 and 2016–2017. However, no significant changes were found for the other main risk factors.
Patients who do not reach treatment goal Survey Smoking, % BP not at goal, %a BP ≥140/90 mmHg, % LDL cholesterol ≥1.8 mmol/l, % HbA1c ≥7.0%b, % Fasting glucose ≥7.0 mmol/l, % BMI≥25 kg/m2, % BMI≥30 kg/m2, % 2011-2013 19.0 50.3 43.0 71.9 14.1 15.9 81.2 33.8 2016-2017 16.2 40.7 39.2 60.3 14.9 20.2 83.4 38.3 P value 0.26 <0.01 0.24 <0.001 0.76 0.09 0.37 0.14 Differences adjusted for age, sex, index diagnosis, duration of education, professional activity (95% confidence intervals) 2016-2017 vs 2011-2013 -0.2(-6.0 - 5.5) -8.9(-15.6 - -2.1) -6.7(-14.3 - 1.0) -9.5(-16.7 - -2.2) 2.0(-3.4 - 7.4) 3.9(-2.2 - 10.0) 3.8(-3.9 - 11.6) 1.6 (-5.8 - 9.0) Abbreviations BMI, body mass index; BP, blood pressure; LDL, low-density lipoprotein a BP goal of <140/90mmHg (<130/80 mmHg in diabetics) in 2011–2013 and <140/90 mmHg (<140/85 mmHg in diabetics) in 2016–2017 b available for 362 patients in 2011-2013 and 383 patients in 2016-2017
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Affiliation(s)
- JW Peksa
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Jankowski
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Koziel
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Bogacki
- Ludwik Rydygier District Hospital, Department of Cardiology, Krakow, Poland
| | - P Gomula
- Gabriel Narutowicz Memorial General Hospital, Department of Cardiology, Krakow, Poland
| | | | - J Nessler
- Jagiellonian University Medical College, Department of Coronary Disease, Institute of Cardiology, Krakow, Poland
| | - P Podolec
- Jagiellonian University Medical College, Department of Cardiac and Vascular Diseases, Institute of Cardiology, Krakow, Poland
| | - AK Wisniewski
- Stefan Zeromski Hospital, Department of Internal Medicine and Cardiology, Krakow, Poland
| | - M Rajzer
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - D Czarnecka
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - A Pajak
- Jagiellonian University Medical College, Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Krakow, Poland
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Drobek N, Sowa P, Jankowski P, Haberka M, Gąsior Z, Kosior D, Czarnecka D, Pająk A, Szostak-Janiak K, Krzykwa A, Setny M, Kozieł P, Paniczko M, Jamiołkowski J, Kowalska I, Kamiński K. Undiagnosed Diabetes and Prediabetes in Patients with Chronic Coronary Syndromes-An Alarming Public Health Issue. J Clin Med 2021; 10:1981. [PMID: 34063006 PMCID: PMC8124594 DOI: 10.3390/jcm10091981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 01/08/2023] Open
Abstract
Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male (n = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.
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Affiliation(s)
- Natalia Drobek
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (N.D.); (P.S.); (M.P.); (J.J.)
- Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (N.D.); (P.S.); (M.P.); (J.J.)
| | - Piotr Jankowski
- Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland;
- Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.C.); (P.K.)
| | - Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (M.H.); (Z.G.); (K.S.-J.)
| | - Zbigniew Gąsior
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (M.H.); (Z.G.); (K.S.-J.)
| | - Dariusz Kosior
- Mossakowski Medical Research Centre, Polish Academy of Sciences, 01-224 Warsaw, Poland;
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital the Ministry of the Interior and Administration, 00-124 Warsaw, Poland; (A.K.); (M.S.)
| | - Danuta Czarnecka
- Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.C.); (P.K.)
| | - Andrzej Pająk
- Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, 31-008 Krakow, Poland;
| | - Karolina Szostak-Janiak
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland; (M.H.); (Z.G.); (K.S.-J.)
| | - Agnieszka Krzykwa
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital the Ministry of the Interior and Administration, 00-124 Warsaw, Poland; (A.K.); (M.S.)
| | - Małgorzata Setny
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital the Ministry of the Interior and Administration, 00-124 Warsaw, Poland; (A.K.); (M.S.)
| | - Paweł Kozieł
- Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.C.); (P.K.)
| | - Marlena Paniczko
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (N.D.); (P.S.); (M.P.); (J.J.)
| | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (N.D.); (P.S.); (M.P.); (J.J.)
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-089 Białystok, Poland;
| | - Karol Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland; (N.D.); (P.S.); (M.P.); (J.J.)
- Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland
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Huang Q, Aparicio L, Thijs L, Wei FF, Melgarejo J, Cheng YB, Sheng CS, Yang WY, Gilis-Malinowska N, Boggia J, Niiranen T, Wojciechowska W, Stolarz-Skrzype K, Barochiner J, Tikhonoff V, Casiglia E, Narkiewicz K, Filipovský J, Czarnecka D, Kawecka-Jaszcz K, Jula A, Vanassche T, Verhamme P, Struijker-Bouder H, Wang JG, Zhang ZY, Li Y, Staessen J. ASSOCIATION OF CARDIOVASCULAR ENDPOINTS AND MORTALITY WITH CENTRAL AND PERIPHERAL PULSATILE BLOOD PRESSURE COMPONENTS. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000744940.59060.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cwynar M, Stolarz-Skrzypek K, Gasowski J, Gryglewska B, Wojciechowska W, Olszanecka A, Dzieza A, Bednarski A, Barton H, Czarnecka D, Grodzicki T. SEX, METABOLIC AND PHARMACOLOGICAL MODULATORS OF SODIUM HANDLING IN POPULATION WITH PREVAILING SODIUM INTAKE. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000747952.71562.c8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bijak M, Olszanecka A, Pałczyńska E, Czarnecka D, Rajzer M, Stolarz-Skrzypek K. Factors determining acceptance of illness in patients with arterial hypertension and comorbidities. Kardiol Pol 2021; 79:426-433. [PMID: 33687869 DOI: 10.33963/kp.15860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hypertension is one of the most common chronic diseases. The need to undergo indefinite treatment combined with the risk of complications affecting the cardiovascular system impose significant psychological and somatic burden on the patient. Arterial hypertension (AH) is rarely an isolated disease and the most commonly observed comorbidities include metabolic disorders as well as clinically apparent complications associated with polypharmacy, which increases the risk of drug‑induced adverse events. AIMS The aim of the study was to determine factors that have an impact on illness acceptance in patients with AH. METHODS The study included 532 patients diagnosed with AH. A standardized Acceptance of Illness Scale questionnaire and a questionnaire prepared by the authors were used. The Acceptance of Illness Scale allows to classify the illness acceptance as high (30-40 points), average (19-29 points), or low (8-18 points). RESULTS A high level of illness acceptance was noted in 45% of participants and an average level in 46%. Patients with different levels of illness acceptance showed disparities in: duration of AH, number of cardiovascular and all diseases, frequency of mental disorders, and number of drugs taken. The number of cardiovascular diseases was significantly lower in patients with high levels of illness acceptance than in those with poor acceptance. Disease duration in patients with a high level of illness acceptance was significantly shorter than in patients with average acceptance. CONCLUSIONS The level of illness acceptance is correlated with disease duration, number of diseases, and number of medications taken.
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Affiliation(s)
- Magdalena Bijak
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Olszanecka
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Ewa Pałczyńska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Stolarz-Skrzypek
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
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Kozieł P, Jankowski P, Kosior DA, Sowa P, Szóstak-Janiak K, Krzykwa A, Sawicka E, Haberka M, Setny M, Kamiński K, Gąsior Z, Kubica A, De Bacquer D, De Backer G, Kotseva K, Wood D, Czarnecka D, Pająk A. Smoking cessation in patients with established coronary artery disease: data from the POLASPIRE survey. Kardiol Pol 2021; 79:418-425. [PMID: 33687865 DOI: 10.33963/kp.15854] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Smoking cessation in patients with coronary artery disease (CAD) is related to decreased risk of cardiovascular events. AIMS To evaluate factors related to persistent smoking in patients with established coronary artery disease. METHODS Patients aged 80 years or younger and hospitalized for acute coronary syndrome or a myocardial revascularization procedure were interviewed 6 to 18 months after the recruiting event. Medical history, smoking behavior, and exposure to environmental smoke were assessed during the interview. Self--reported smoking status was validated by carbon monoxide in exhaled air measurement. Persistent smoking was defined as smoking at the time of interview among those who smoked during the month prior to the recruiting event. RESULTS We analyzed the data of 1034 patients, including 764 (73.9%) who reported smoking at any time in the past and 296 (28.6%) who smoked within 1 month before the recruiting hospitalization. At the time of the interview, the overall smoking rate was 17.2%, whereas 54.7% of patients were persistent smokers. Secondhand smoke exposure and duration of smoking were associated with lower likelihood whereas older age, high socioeconomic status, cardiac rehabilitation following a cardiovascular event, and consultation with a cardiologist were associated with higher likelihood of smoking cessation. CONCLUSIONS Over half of all smokers hospitalized for CAD are still smoking 6 to 18 months after discharge. Older age, secondhand smoking, low socioeconomic status, lack of consultation with a cardiologist, and cardiac rehabilitation following hospitalization were related to persistent smoking. Our findings may help develop strategies aimed at assisting smoking cessation in patients with CAD.
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Affiliation(s)
- Paweł Kozieł
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Jankowski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland; Polish Mother’s Memorial Hospital Research Institute, Łódź, Poland.
| | - Dariusz A Kosior
- Faculty of Medicine, Medical College, Cardinal Stefan Wyszyński University, Warsaw, Poland,Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Paweł Sowa
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | | | - Agnieszka Krzykwa
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Emilia Sawicka
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Maciej Haberka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Setny
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Karol Kamiński
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Aldona Kubica
- Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Guy De Backer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kornelia Kotseva
- Imperial College Healthcare NHS Trust, London, United Kingdom,National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
| | - David Wood
- National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland,Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Pająk
- Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
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Rojek M, Wojciechowska W, Januszewicz A, Czarnecka D, Skalski P, Rajzer M. The relation of nocturnal exposure to aircraft noise and aircraft noise-induced insomnia with blood pressure. Pol Arch Intern Med 2021; 131:33-41. [PMID: 33314876 DOI: 10.20452/pamw.15716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Nighttime environmental noise exposure leads to unconscious stress reactions and autonomic arousals. These may disturb overnight sleep and the diurnal blood pressure (BP) profile, contributing to an increased risk of developing hypertension. OBJECTIVES This study aimed to investigate the effects of chronic nighttime exposure to aviation noise on sleep disturbances and the relationship with annoyance and the BP profile. PATIENTS AND METHODS Based on acoustic maps, we selected 2 groups of normotensive participants: exposed (n = 48; mean age, 50.9 years; 29 women) and unexposed (n = 50; mean age, 49.7 years; 35 women) to nocturnal aircraft noise. We collected anthropometric and demographic data using a standardized questionnaire. Insomnia symptoms were evaluated using the Athens Insomnia Scale (AIS). In both study groups, we performed office BP measurements and 24‑hour ambulatory BP monitoring. RESULTS Noise‑exposed participants showed distinctive sleep disturbances, higher AIS scores (4.3 vs 2.3; P = 0.01), and an increased insomnia risk (odds ratio, 2.62; P = 0.046). With increased noise annoyance, a higher AIS score was observed (PANOVA = 0.02). Noise‑exposed individuals had higher diastolic BP at night than those unexposed (64.6 mm Hg vs 61.7 mm Hg; P = 0.03). Insomnia among noise‑exposed participants resulted in higher 24‑hour (115.2 mm Hg vs 122.2 mm Hg; P = 0.03) and nighttime (103.7 mm Hg vs 112.2 mm Hg; P = 0.02) systolic BP. A significant interaction was noted between aircraft noise exposure and the AIS score. The association of the AIS score with 24‑hour systolic BP (P = 0.048) and pulse pressure (P = 0.04) was stronger in the exposed group. CONCLUSIONS The study results may indicate different pathomechanisms affecting BP in terms of nighttime noise and noise‑related insomnia.
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Affiliation(s)
- Marta Rojek
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
- Medical Faculty, Dresden University of Technology, Dresden, Germany
| | - Wiktoria Wojciechowska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Skalski
- Łukasiewicz Research Network—Institute of Aviation, Warsaw, Poland
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland.
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16
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Kozieł P, Jankowski P, Mirek-Bryniarska E, Nessler J, Podolec P, De Bacquer D, Kotseva K, Wood D, Czarnecka D, Kawecka-Jaszcz K, Pająk A. Obesity in patients with established coronary artery disease over a 20-year period (1997-2017). Pol Arch Intern Med 2021; 131:26-32. [PMID: 33522218 DOI: 10.20452/pamw.15742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Body mass reduction in overweight and obese people so as to reduce blood pressure, low‑density lipoprotein cholesterol level, and the risk of type 2 diabetes as well as to lower the risk of recurrent cardiovascular events is strongly recommended in current guidelines. OBJECTIVES To evaluate changes in body mass index (BMI) and waist circumference in patients with established coronary artery disease over a 20‑year period (1997-2017). PATIENTS AND METHODS Consecutive patients younger than 71 years of age and hospitalized for acute coronary syndrome or myocardial revascularization procedures were recruited and interviewed 6 to 18 months after their discharge from hospital. Weight, height, and waist circumference were measured in 1997 to 1998, 1999 to 2000, 2006 to 2007, 2011 to 2013, and 2016 to 2017. The same 5 hospitals took part in the surveys each time. RESULTS We examined 412 patients in 1997 to 1998 (survey 1), 427 in 1999 to 2000 (survey 2), 422 in 2006 to 2007 (survey 3), 462 in 2011 to 2013 (survey 4), and 272 in 2016 to 2017 (survey 5). The proportion of obese patients was 24.5% in survey 1, 27.2% in survey 2, 34.1% in survey 3, 35.9% in survey 4, and 40.4% in survey 5 (P <0.001). The proportion of patients with central obesity also increased significantly (32.5% in survey 1, 40.5% in survey 2, 51.4% in survey 3, 48.6% in survey 4, and 61.3% in survey 5; P <0.001). BMI increased significantly in men, but not in women, whereas the mean waist circumference increased in both sexes. BMI and waist circumference increased irrespective of age and education. CONCLUSIONS The analysis of 5 multicenter surveys showed a gradual increase in BMI and waist circumference in patients with established coronary artery disease over the course of 2 decades.
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Affiliation(s)
- Paweł Kozieł
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Jankowski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | | | - Jadwiga Nessler
- Department of Coronary Heart Disease, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kornelia Kotseva
- Imperial College Healthcare NHS Trust and National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
| | - David Wood
- Imperial College Healthcare NHS Trust and National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Kalina Kawecka-Jaszcz
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Andrzej Pająk
- Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
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Pizoń T, Rajzer M, Wojciechowska W, Drożdż T, Drożdż D, Rojek M, Gruszka K, Czarnecka D. Plasma renin activity, serum aldosterone concentration and selected organ damage indices in essential arterial hypertension. Arch Med Sci 2021; 17:9-18. [PMID: 33488850 PMCID: PMC7811306 DOI: 10.5114/aoms.2018.73333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/06/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to assess the relations between plasma renin activity (PRA), serum aldosterone concentration (ALDO) and selected asymptomatic organ damage (AOD) indices in mild primary arterial hypertension (AH). MATERIAL AND METHODS We measured PRA, ALDO, and selected AOD indices (carotid-femoral pulse wave velocity (cfPWV), central aortic pulse pressure (cPP), estimated glomerular filtration rate (eGFR)) in 122 patients with untreated AH. RESULTS Patients with high PRA (≥ 0.65 ng/ml/h) were characterized by lower plasma sodium and aldosterone to renin ratio (ARR), higher ALDO, but a similar level of AOD indices compared to patients with low PRA. cfPWV (p = 0.04) and cPP (p = 0.019) increased with ARR, while eGFR decreased with ALDO (p = 0.008). Only eGFR was independently correlated with ALDO. In subjects with simultaneously high PRA and ARR values, we found significantly higher cfPWV (p = 0.02) and cPP (p = 0.04) and lower eGFR (p = 0.02) than in those with high PRA but low ARR values. CONCLUSIONS Assessment of the influence of the renin-angiotensin-aldosterone system (RAAS) on AOD should include the relationship between renin and aldosterone. The PRA itself has no predictive value for AOD. More advanced arterial stiffness and renal impairment are associated with increased PRA and ARR. The RAAS activity might be useful in AOD prediction and hypertension severity assessment.
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Affiliation(s)
- Tomasz Pizoń
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Rajzer
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Wiktoria Wojciechowska
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Drożdż
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Dorota Drożdż
- Department of Pediatric Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | - Marta Rojek
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Krystian Gruszka
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Danuta Czarnecka
- 1 Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
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Jastrzębski M, Moskal P, Curila K, Fijorek K, Kukla P, Bednarek A, Kiełbasa G, Bednarski A, Baranchuk A, Czarnecka D. Electrocardiographic characterization of non-selective His-bundle pacing: validation of novel diagnostic criteria. Europace 2020; 21:1857-1864. [PMID: 31596476 DOI: 10.1093/europace/euz275] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/13/2019] [Indexed: 11/12/2022] Open
Abstract
AIMS Permanent His-bundle (HB) pacing is usually accompanied by simultaneous capture of the adjacent right ventricular (RV) myocardium-this is described as a non-selective (ns)-HB pacing. It is of clinical importance to confirm HB capture using standard electrocardiogram (ECG). Our aim was to identify ECG criteria for loss of HB capture during ns-HB pacing. METHODS AND RESULTS Patients with permanent HB pacing were recruited. Electrocardiograms during ns-HB pacing and loss of HB capture (RV-only capture) were obtained. Electrocardiogram criteria for loss/presence of HB capture were identified. In the validation phase, these criteria and the 'HB ECG algorithm' were tested using a separate, sizable set of ECGs. A total of 353 ECG (226 ns-HB and 128 RV-only) were obtained from 226 patients with permanent HB pacing devices. QRS notch/slur in left ventricular leads and R-wave peak time (RWPT) in lead V6 were identified as the best features for differentiation. The 'HB ECG algorithm' based on these features correctly classified 87.1% of cases with sensitivity and specificity of 93.2% and 83.9%, respectively. The criteria for definitive diagnosis of ns-HB capture (no QRS slur/notch in Leads I, V1, V4-V6, and the V6 RWPT ≤ 100 ms) presented 100% specificity. CONCLUSION A novel ECG algorithm for the diagnosis of loss of HB capture and criteria for definitive confirmation of HB capture were formulated and validated. The algorithm might be useful during follow-up and the criteria for definitive confirmation of ns-HB capture offer a simple and reliable ancillary procedural endpoint during HB device implantation.
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Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Karol Curila
- Cardiocenter, Department of Cardiology, Third Faculty of Medicine, Charles University, Praque, Czech Republic
| | - Kamil Fijorek
- Department of Statistics, Cracow University of Economics, Kraków, Poland
| | - Piotr Kukla
- Department of Cardiology, H. Klimontowicz Specialistic Hospital, Gorlice, Poland
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Adam Bednarski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston Health Sciences Center, Kingston, Ontario, Canada
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland
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19
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Jankowski P, Kozieł P, Bogacki P, Gomuła P, Mirek-Bryniarska E, Nessler J, Podolec P, De Bacquer D, De Backer G, Kotseva K, Wood D, Czarnecka D, Kawecka-Jaszcz K, Pająk A. Pharmacotherapy in patients with chronic coronary syndromes over a 20-year period (1997-2017). Kardiol Pol 2020; 78:1156-1158. [PMID: 32897036 DOI: 10.33963/kp.15591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Pęksa JW, Storman D, Jankowski P, Staśkiewicz W, Jasińska KW, Czarnecka D, Bała MM. Mortality in patients after acute myocardial infarction managed by cardiologists and primary care physicians: a systematic review. Pol Arch Intern Med 2020; 130:860-867. [PMID: 32749827 DOI: 10.20452/pamw.15542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Mortality following acute myocardial infarction (AMI) remains high despite of progress in invasive and noninvasive treatments. OBJECTIVES This study aimed to compare the outcomes of ambulatory treatment provided by cardiologists versus general practitioners (GPs) in post‑AMI patients. PATIENTS AND METHODS We conducted a systematic search in 3 electronic databases for interventional and observational studies that reported all‑cause mortality, mortality from cardiovascular causes, stroke, and myocardial infarction at long‑term follow‑up following AMI. We assessed the risk of bias of the included studies using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS‑I) tool. For randomized trials, we used the revised Cochrane risk of bias tool (RoB 2.0). RESULTS Two nonrandomized studies fulfilled the inclusion criteria. We assessed these studies as having a moderate risk of bias. We did not pool the results owing to significant heterogeneity between the studies. Patients consulted by both a cardiologist and a GP were at lower risk of all‑cause death as compared with patients consulted by a cardiologist only (risk ratio [RR], 0.92; 95% CI, 0.85-0.99). Patients consulted by a cardiologist with or without GP consultation were at lower risk of all‑cause death compared with those consulted by a GP only in both studies (RR, 0.8; 95% CI, 0.75-0.85 and RR, 0.44; 95% CI, 0.41-0.47). CONCLUSIONS Patients after AMI consulted by both a cardiologist and a GP may be at lower risk of death compared with patients consulted by a GP or a cardiologist only. However, these findings are based on moderate‑quality nonrandomized studies. We found no evidence on the relation between the specialization of the physician and the risk of cardiovascular death, stroke, or myocardial infarction in AMI survivors.
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Affiliation(s)
- Jan W Pęksa
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Dawid Storman
- Systematic Reviews Unit, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland,Department of Adult Psychiatry, University Hospital, Kraków, Poland
| | - Piotr Jankowski
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Wojciech Staśkiewicz
- Students’ Scientific Group of Systematic Reviews, Systematic Reviews Unit–Polish Cochrane Branch, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna W Jasińska
- Students’ Scientific Group of Systematic Reviews, Systematic Reviews Unit–Polish Cochrane Branch, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata M Bała
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland
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Huang QF, Aparicio LS, Thijs L, Wei FF, Melgarejo JD, Cheng YB, Sheng CS, Yang WY, Gilis-Malinowska N, Boggia J, Niiranen TJ, Wojciechowska W, Stolarz-Skrzypek K, Barochiner J, Ackermann D, Tikhonoff V, Ponte B, Pruijm M, Casiglia E, Narkiewicz K, Filipovský J, Czarnecka D, Kawecka-Jaszcz K, Jula AM, Bochud M, Vanassche T, Verhamme P, Struijker-Boudier HAJ, Wang JG, Zhang ZY, Li Y, Staessen JA. Cardiovascular End Points and Mortality Are Not Closer Associated With Central Than Peripheral Pulsatile Blood Pressure Components. Hypertension 2020; 76:350-358. [PMID: 32639894 PMCID: PMC7340226 DOI: 10.1161/hypertensionaha.120.14787] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Supplemental Digital Content is available in the text. Pulsatile blood pressure (BP) confers cardiovascular risk. Whether associations of cardiovascular end points are tighter for central systolic BP (cSBP) than peripheral systolic BP (pSBP) or central pulse pressure (cPP) than peripheral pulse pressure (pPP) is uncertain. Among 5608 participants (54.1% women; mean age, 54.2 years) enrolled in nine studies, median follow-up was 4.1 years. cSBP and cPP, estimated tonometrically from the radial waveform, averaged 123.7 and 42.5 mm Hg, and pSBP and pPP 134.1 and 53.9 mm Hg. The primary composite cardiovascular end point occurred in 255 participants (4.5%). Across fourths of the cPP distribution, rates increased exponentially (4.1, 5.0, 7.3, and 22.0 per 1000 person-years) with comparable estimates for cSBP, pSBP, and pPP. The multivariable-adjusted hazard ratios, expressing the risk per 1-SD increment in BP, were 1.50 (95% CI, 1.33–1.70) for cSBP, 1.36 (95% CI, 1.19–1.54) for cPP, 1.49 (95% CI, 1.33–1.67) for pSBP, and 1.34 (95% CI, 1.19–1.51) for pPP (P<0.001). Further adjustment of cSBP and cPP, respectively, for pSBP and pPP, and vice versa, removed the significance of all hazard ratios. Adding cSBP, cPP, pSBP, pPP to a base model including covariables increased the model fit (P<0.001) with generalized R2 increments ranging from 0.37% to 0.74% but adding a second BP to a model including already one did not. Analyses of the secondary end points, including total mortality (204 deaths), coronary end points (109) and strokes (89), and various sensitivity analyses produced consistent results. In conclusion, associations of the primary and secondary end points with SBP and pulse pressure were not stronger if BP was measured centrally compared with peripherally.
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Affiliation(s)
- Qi-Fang Huang
- From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
| | - Lucas S Aparicio
- Shanghai Jiao Tong University School of Medicine, China; Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Argentina (L.S.A., J.B.)
| | - Lutgarde Thijs
- Research Unit Hypertension and Cardiovascular Epidemiology (L.T., F.-F.W., J.D.M., Z.-Y.Z., J.A.S.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Fang-Fei Wei
- Research Unit Hypertension and Cardiovascular Epidemiology (L.T., F.-F.W., J.D.M., Z.-Y.Z., J.A.S.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Jesus D Melgarejo
- Research Unit Hypertension and Cardiovascular Epidemiology (L.T., F.-F.W., J.D.M., Z.-Y.Z., J.A.S.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Yi-Bang Cheng
- From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
| | - Chang-Sheng Sheng
- From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
| | - Wen-Yi Yang
- Department of Cardiology, Shanghai General Hospital (W.-Y.Y.)
| | - Natasza Gilis-Malinowska
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland (N.G.-M., K.N.)
| | - José Boggia
- Shanghai Jiao Tong University School of Medicine, China; Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Argentina (L.S.A., J.B.)
| | - Teemu J Niiranen
- Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.).,Department of Medicine, Turku University Hospital and University of Turku, Finland (T.J.N.)
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (W.W., K.S.-S., D.C., K.K.-J.)
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (W.W., K.S.-S., D.C., K.K.-J.)
| | - Jessica Barochiner
- Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay (J.B.)
| | - Daniel Ackermann
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Switzerland (D.A.)
| | | | - Belen Ponte
- Division of Nephrology, University Hospital of Geneva, Geneva, Switzerland (B.P.).,Center for Primary Care and Public Health (B.P.), Unisanté, University of Lausanne, Switzerland
| | - Menno Pruijm
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Switzerland (M.P.)
| | | | - Krzysztof Narkiewicz
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland (N.G.-M., K.N.)
| | - Jan Filipovský
- Faculty of Medicine, Charles University, Pilsen, Czech Republic (J.F.)
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (W.W., K.S.-S., D.C., K.K.-J.)
| | - Kalina Kawecka-Jaszcz
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland (W.W., K.S.-S., D.C., K.K.-J.)
| | - Antti M Jula
- Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (T.J.N., A.M.J.)
| | - Murielle Bochud
- Center for Primary Care and Public Health (M.B.), Unisanté, University of Lausanne, Switzerland
| | - Thomas Vanassche
- Centre for Molecular and Vascular Biology (T.V., P.V.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology (T.V., P.V.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Harry A J Struijker-Boudier
- Department of Pharmacology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, the Netherlands (H.A.J.S.-B.)
| | - Ji-Guang Wang
- From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
| | - Zhen-Yu Zhang
- Research Unit Hypertension and Cardiovascular Epidemiology (L.T., F.-F.W., J.D.M., Z.-Y.Z., J.A.S.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Yan Li
- From the Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital (Q.-F.H., Y.-B.C., C.-S.S., J.-G.W., Y.L.)
| | - Jan A Staessen
- Research Unit Hypertension and Cardiovascular Epidemiology (L.T., F.-F.W., J.D.M., Z.-Y.Z., J.A.S.), KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium.,NPA Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (J.A.S.)
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Moskal P, Bednarski A, Kiełbasa G, Czarnecka D, Jastrzębski M. Increased preexcitation on electrocardiography improves accuracy of algorithms for accessory pathway localization in Wolff-Parkinson-White syndrome. Kardiol Pol 2020; 78:567-573. [PMID: 32438794 DOI: 10.33963/kp.15378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Several electrocardiographic (ECG) algorithms have been developed for predicting accessory pathway (AP) location in Wolff-Parkinson-White syndrome. However, their accuracy may be related to the manifested degree of preexcitation on ECG. AIMS Our goal was to assess the effect of the degree of preexcitation on the accuracy of 4 traditional AP localization algorithms and to compare them with the algorithm specifically designed for ECGs with maximal preexcitation (Pambrun) Methods: The study included 300 patients who underwent successful ablation of an overt atrioventricular AP. Resting and maximally preexcited ECGs obtained during incremental atrial pacing were assessed using 4 traditional AP localization algorithms: Xie, d'Avila, Iturralde, and Taguchi. Maximally preexcited ECGs were additionally assessed with the Pambrun algorithm. We compared the precision of the algorithms to predict accurate or anatomically adjacent AP location. RESULTS Theoverall accuracy of traditional AP localization algorithms using resting ECG ranged between 26% and 53.7% and improved to a range of 47.3% to 69.7% when adjacent locations were accepted. When used with maximal preexcitation, all algorithms had significantly higher accuracy, with a mean improvement of 14.3 and 15.6 percentage points for precise and adjacent sites, respectively. The Pambrun algorithm for maximally preexcited ECGs had the highest precision for both accurate and adjacent locations of the APs (89.7% and 97%, respectively). CONCLUSIONS Greater preexcitation on ECG improved the accuracy of the traditional AP localization algorithms. The algorithm designed to use maximally preexcited ECGs has the best accuracy. Maximally preexcited ECG recordings should preferably be used in clinical practice to facilitate the ablation procedure.
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Affiliation(s)
- Paweł Moskal
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Adam Bednarski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, University Hospital, Kraków, Poland
| | - Grzegorz Kiełbasa
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Jastrzębski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Jankowski P, Kosior DA, Sowa P, Szóstak-Janiak K, Kozieł P, Krzykwa A, Sawicka E, Haberka M, Setny M, Kamiński K, Gąsior Z, Kubica A, De Bacquer D, De Backer G, Kotseva K, Wood D, Pająk A, Czarnecka D. Secondary prevention of coronary artery disease in Poland. Results from the POLASPIRE survey. Cardiol J 2020; 27:533-540. [PMID: 32436589 DOI: 10.5603/cj.a2020.0072] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The highest priority in preventive cardiology is given to patients with established coronary artery disease (CAD). The aim of the study was to assess the current implementation of the guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates in patients following hospitalization for CAD. METHODS Fourteen departments of cardiology participated in the study. Patients (aged ≤ 80 years) hospitalized due an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6-18 months after the hospitalization. RESULTS Overall, 947 patients were examined 6-18 months after hospitalization. The proportion of patients with high blood pressure (≥ 140/90 mmHg) was 42%, with high low-density lipoprotein cholesterol (LDL-C ≥ 1.8 mmol/L) 62%, and with high fasting glucose (≥ 7.0 mmol/L) 22%, 17% of participants were smokers and 42% were obese. The proportion of patients taking an antiplatelet agent 6-18 months after hospitalization was 93%, beta-blocker 89%, angiotensin converting enzyme inhibitor or sartan 86%, and a lipid-lowering drug 90%. Only 2.3% patients had controlled all the five main risk factors well (non-smoking, blood pressure < 140/90 mmHg, LDL-C < 1.8 mmol/L and glucose < 7.0 mmol/L, body mass index < 25 kg/m2), while 17.9% had 1 out of 5, 40.9% had 2 out of 5, and 29% had 3 out of 5 risk factors uncontrolled. CONCLUSIONS The documented multicenter survey provides evidence that there is considerable potential for further reductions of cardiovascular risk in CAD patients in Poland. A revision of the state funded cardiac prevention programs seems rational.
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Affiliation(s)
- Piotr Jankowski
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
| | - Dariusz A Kosior
- Mossakowski Medical Research Centre, Polish Academy of Science, Warsaw, Poland.,Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of The Interior and Administration, Warsaw, Poland
| | - Paweł Sowa
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | | | - Paweł Kozieł
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Krzykwa
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of The Interior and Administration, Warsaw, Poland
| | - Emilia Sawicka
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Haberka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Setny
- Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of The Interior and Administration, Warsaw, Poland
| | - Karol Kamiński
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Zbigniew Gąsior
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Aldona Kubica
- Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz , Poland
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Belgium
| | - Guy De Backer
- Department of Public Health and Primary Care, Ghent University, Belgium
| | - Kornelia Kotseva
- Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London and National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
| | - David Wood
- Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London and National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
| | - Andrzej Pająk
- Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Danuta Czarnecka
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
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24
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Stopa M, Łobacz M, Niemczyk M, Rudowska K, Radko A, Mikunda A, Czarnecka D, Olszanecka A. Influence of energy drinks on acute hemodynamic parameters in young healthy adults: a randomized double-blind placebo-controlled crossover pilot study. Kardiol Pol 2020; 78:335-337. [PMID: 32165605 DOI: 10.33963/kp.15231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Marek Stopa
- 1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Łobacz
- Department of Oncology, University Hospital, Kraków, Poland
| | | | | | - Agata Radko
- Department of Pulmonology, 5th Military Hospital with Polyclinic in Kraków, Poland
| | | | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Olszanecka
- 1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
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Curila K, Prochazkova R, Jurak P, Jastrzebski M, Halamek J, Moskal P, Stros P, Vesela J, Waldauf P, Viscor I, Plesinger F, Sussenbek O, Herman D, Osmancik P, Smisek R, Leinveber P, Czarnecka D, Widimsky P. Both selective and nonselective His bundle, but not myocardial, pacing preserve ventricular electrical synchrony assessed by ultra-high-frequency ECG. Heart Rhythm 2020; 17:607-614. [DOI: 10.1016/j.hrthm.2019.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 10/25/2022]
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Moskal P, Jastrzębski M, Pitak M, Fijorek K, Weryński P, Czarnecka D. Malignant ventricular arrhythmias and other complications of untreated accessory pathways: an analysis of prevalence and risk factors in over 600 ablation cases. Kardiol Pol 2020; 78:203-208. [PMID: 31994490 DOI: 10.33963/kp.15161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The presence of accessory pathways (APs) is a risk factor for sudden cardiac death and other
clinical complications. AIMS We aimed to characterize all adverse events likely related to the presence of APs in patients referred for AP ablation and to identify risk factors for malignant arrhythmias. METHODS We performed a retrospective analysis of consecutive patients referred for AP ablation from 2002 to 2017. Electrocardiograms, electrophysiological system records, and hospital discharge notes were reviewed. We collected data concerning symptoms before ablation, occurrence of ventricular fibrillation or malignant atrial fibrillation (AF), as well as other complications related to APs. RESULTS We identified 602 patients with APs. Serious AP‑related events were observed in 41 patients, including 14 sudden cardiac arrests (1 death) and 16 pre–cardiac arrest events. Other complications included strokes, pulmonary edema, heart failure, and unnecessary device implantation. The risk of malignant arrhythmias decreased with a longer shortest preexcited RR interval (per 10 ms: odds ratio [OR], 1.3; 95% CI, 1.16–1.47) and increased with age (per 10 years: OR, 1.29; 95% CI, 1.06–1.57). The presence of inducible AF, but not sole atrioventricular reentrant tachycardia, increased the risk for malignant arrhythmias when compared with patients without any inducible arrhythmias. CONCLUSIONS Patients with APs referred for ablation commonly present with various adverse events. The predictive value of clinical risk factors for malignant arrhythmias is too low to prevent devastating consequences. When high safety and efficacy of AP ablation are ensured, even a low risk of sudden death is unacceptable and a lower threshold for prophylactic ablation should be used to prevent AP‑related adverse events.
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Affiliation(s)
- Paweł Moskal
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Marek Jastrzębski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Pitak
- Department of Cardiology, Institute of Paediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Kamil Fijorek
- Department of Statistics, Cracow University of Economics, Kraków, Poland
| | - Piotr Weryński
- Department of Cardiology, Institute of Paediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Jastrzębski M, Stec J, Fijorek K, Pavlinec C, Czarnecka D. CHADS2 and CHA2DS2-VASc scores as tools for long-term mortality prognosis in patients with typical atrial flutter after catheter ablation. Kardiol Pol 2020; 78:59-64. [PMID: 31827060 DOI: 10.33963/kp.15102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The CHADS2 and CHA2DS2-VASc scores were shown to predict mortality in patients with atrial fibrillation. However, pathophysiology and treatment outcomes of atrial fibrillation and typical atrial flutter (AFL) differ. Consequently, the prognosis of patients with AFL can also be different. AIMS The aim of the study was to assess CHADS2 and CHA2DS2‑VASc scores as mortality predictors in patients with typical AFL. METHODS Large cohort of consecutive patients with typical AFL who underwent catheter ablation was retrospectively analyzed. The CHADS2 and CHA2DS2‑VASc were calculated using hospital record data. All-cause mortality data was obtained from the registry of national personal identification numbers. The Kaplan-Meier method and multivariable Cox proportional hazard models were applied for survival and hazard ratio analyses, respectively. RESULTS A total of 469 patients hospitalized for typical AFL ablation were enrolled (mean [SD] age, 63.7 [12.2] years; male sex, 69.1%). Patients were followed from 2 to 12 years resulting in 2974 patient‑years of follow‑up. The Kaplan-Meier survival analysis revealed a negative impact of each component of the CHADS2 and CHA2DS2‑VASc scores on survival with the exception of stroke (not significant) and female sex (related to abetter survival). Consequently, higher scores were predictive of higher all‑cause mortality rates (2.7%-54% at 10 years); the CHA2DS2‑VASc score was equally predictive as the CHADS2 score. CONCLUSIONS In patients referred for typical AFL ablation, the CHADS2 score can be applied for prognostic assessment. A successful AFL ablation procedure should not divert the attention from recognizing and addressing other medical issues that have an impact on long‑term mortality, which remains very high in this population of patients.
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Affiliation(s)
- Marek Jastrzębski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland. mcjastrz@cyf‑kr.edu.pl
| | - Jakub Stec
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Kamil Fijorek
- Department of Statistics, Cracow University of Economics, Kraków, Poland
| | - Christopher Pavlinec
- International PhD Program of Medical Science, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Jastrzębski M, Moskal P, Bednarek A, Kiełbasa G, Kusiak A, Sondej T, Bednarski A, Vijayaraman P, Czarnecka D. Programmed deep septal stimulation: A novel maneuver for the diagnosis of left bundle branch capture during permanent pacing. J Cardiovasc Electrophysiol 2020; 31:485-493. [PMID: 31930753 DOI: 10.1111/jce.14352] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/13/2019] [Accepted: 12/23/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Permanent deep septal stimulation with capture of the left bundle branch (LBB) enables maintenance/restoration of the physiological activation of the left ventricle. However, it is almost always accompanied by the simultaneous engagement of the local septal myocardium, resulting in a fused (nonselective) QRS complex, therefore, confirmation of LBB capture remains difficult. METHODS We hypothesized that programmed extrastimulus technique can differentiate nonselective LBB capture from myocardial-only capture as the effective refractory period (ERP) of the myocardium is different from the ERP of the LBB. Consecutive patients undergoing pacemaker implantation underwent programmed stimulation delivered from the lead implanted in a deep septal position. Responses to programmed stimulation were categorized on the basis of sudden change in the QRS morphology of the extrastimuli, observed when ERP of LBB or myocardium was encroached upon, as: "myocardial," "selective LBB," or nondiagnostic (unequivocal change of QRS morphology). RESULTS Programmed deep septal stimulation was performed 269 times in 143 patients; in every patient with the use of a basic drive train of 600 milliseconds and in 126 patients also during intrinsic rhythm. The average septal-myocardial refractory period was shorter than the LBB refractory period: 263.0 ± 34.4 vs 318.0 ± 37.4 milliseconds. Responses diagnostic for LBB capture ("myocardial" or "selective LBB") were observed in 114 (79.7%) of patients. CONCLUSIONS A novel maneuver for the confirmation of LBB capture during deep septal stimulation was developed and found to enable definitive diagnosis by visualization of both components of the paced QRS complex: selective paced LBB QRS and myocardial-only paced QRS.
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Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.,Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksander Kusiak
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.,Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania
| | - Tomasz Sondej
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Bednarski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Pugazhendhi Vijayaraman
- Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Wassertheurer S, Protogerou A, Sharman J, Rodilla Sala E, Jankowski P, Muiesan ML, Giannattasio C, Hametner B, Pascual JM, Zweiker R, Argyris A, Paini A, Wilkinson I, Czarnecka D, Salvetti M, Maloberti A, McEniery C, Li Y, Nemcsik J, Pucci G, Ablasser C, Blacher J, Valleé A, de la Sierra A, Zhang Y, Ji H, McDonnell B, Mota M, Paiva A, Brandao A, Weber T. P34 24-Hour Ambulatory Brachial Versus Aortic Systolic Blood Pressure: Relationship with Left Ventricular Mass Significantly Differs. Pooled Results from the International 24 Hour Aortic Blood Pressure Consortium (i24ABC). Artery Res 2020. [DOI: 10.2991/artres.k.191224.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kusiak A, Jastrzębski M, Bednarski A, Kułakowski P, Piotrowski R, Koźluk E, Baszko A, Czarnecka D. Diagnostic value of implantable loop recorder in patients undergoing cryoballoon ablation of atrial fibrillation. Ann Noninvasive Electrocardiol 2019; 25:e12733. [PMID: 31863721 PMCID: PMC7358840 DOI: 10.1111/anec.12733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Due to limited data, implantable loop recorders (ILR) are not currently recommended by the guidelines to routinely monitor patients after atrial fibrillation (AF) ablation. AIMS To validate the diagnostic value of ILR after AF ablation, modern generation ILRs (LINQ) were implanted in patients scheduled for cryoballoon ablation of AF (CBA). METHODS We included 29 patients with frequent and symptomatic episodes of paroxysmal AF. ILR was implanted 3 months prior to CBA, and data were collected before and for 6 months after the procedure. The device was programmed to maximize sensitivity of AF/ atrial tachycardia (AT) detection. All EGM recordings were "manually" assessed and annotated as true AF, pseudo AF, unrecognized AF, and episodes with no EGM available. Duration and episode-based standard performance metrics were evaluated. RESULTS A total number of 5,842 episodes were recorded. A total of 4,403 episodes were true AF, 453 episodes were pseudo AF, and 986 episodes had no EGM available. The device did not recognize 144 episodes of AF. Duration-based sensitivity was 95.2%, duration-based specificity 99.9%, duration-based PPV 99.2%, duration-based NPV 99.9%, episode-based sensitivity 98.0%, and episode-based PPV 91.0%. Misdiagnosis happened in 1 in 10 episodes. Total data review time was 166 hr. CONCLUSIONS Implantable loop recorders is a valuable tool in evaluation of AF episodes in patients undergoing CBA. However, for high precision all recorded episodes need to be evaluated "manually." The memory storage space is too low for frequent AF episodes, resulting in overwriting of stored EGMs and data loss.
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Affiliation(s)
- Aleksander Kusiak
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, University Hospital in Krakow, Krakow, Poland
| | - Marek Jastrzębski
- College of Medicine, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Krakow, Poland
| | - Adam Bednarski
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, University Hospital in Krakow, Krakow, Poland
| | - Piotr Kułakowski
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Roman Piotrowski
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Edward Koźluk
- Department of Cardiology, Warsaw Medical University, Warszawa, Poland
| | - Artur Baszko
- 2nd Department of Cardiology, Medical University in Poznan, Poznan, Poland
| | - Danuta Czarnecka
- College of Medicine, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Krakow, Poland
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Stolarz-Skrzypek K, Czarnecka D. Predicting future cardiovascular risk from blood pressure response to dynamic exercise: a neglected risk factor? Pol Arch Intern Med 2019; 129:850-851. [PMID: 31868862 DOI: 10.20452/pamw.15114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Katarzyna Stolarz-Skrzypek
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Moskal P, Jastrzębski M, Krakowiak A, Su L, Huang W, Czarnecka D. Rate-related block during permanent His bundle pacing. J Cardiovasc Electrophysiol 2019; 31:240-242. [PMID: 31746053 DOI: 10.1111/jce.14261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Krakowiak
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, University Hospital, Krakow, Poland
| | - Lan Su
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weijian Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
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Jastrzębski M, Moskal P, Bednarek A, Kiełbasa G, Vijayaraman P, Czarnecka D. Programmed His Bundle Pacing: A Novel Maneuver for the Diagnosis of His Bundle Capture. Circ Arrhythm Electrophysiol 2019; 12:e007052. [PMID: 30707037 DOI: 10.1161/circep.118.007052] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND During permanent nonselective His bundle (ns-HB) pacing, it is crucial to confirm HB capture/exclude that only right ventricle (RV) myocardial septal pacing is present. Because the effective refractory period (ERP) of the working myocardium is different than the ERP of the HB, we hypothesized that it should be possible to differentiate ns-HB capture from RV myocardial capture using programmed extrastimulus technique. METHODS In consecutive patients during HB pacemaker implantation, programmed HB pacing was delivered from the screwed-in HB pacing lead. Premature beats were introduced at 10-ms steps during intrinsic rhythm and also after a drive train of 600 ms. The longest coupling interval that resulted in an abrupt change of QRS morphology was considered equal to ERP of HB or RV myocardium. RESULTS Programmed HB pacing was performed from 50 different sites in 32 patients. In 34 of 36 cases of ns-HB pacing, the RV myocardial ERP was shorter than HB ERP (271.8±38 versus 353.0±30 ms; P<0.0001). Programmed HB pacing using a drive train resulted in a typical abrupt change of paced QRS morphology: from ns-HB to RV myocardial QRS (34 of 36 cases) or to selective HB QRS (2 of 36 cases). Programmed HB pacing delivered during native conduction resulted in obtaining selective HB QRS in 20 of 34 and RV myocardial QRS in 14 of 34 of the ns-HB cases. In RV myocardial-only pacing cases (false ns-HB pacing, n=14), such responses were not observed-the QRS morphology remained stable. Therefore, the programmed HB pacing correctly diagnosed all ns-HB cases and all RV myocardial pacing cases. CONCLUSIONS A novel maneuver for the diagnosis of HB capture, based on the differences in ERP between HB and myocardium, was formulated, assessed, and found as diagnostically valuable. This method is unique in enabling to visualize selective HB QRS in patients with otherwise obligatory ns-HB pacing (RV myocardial capture threshold <HB capture threshold).
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Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M., A.B., G.K., D.C.)
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M., A.B., G.K., D.C.)
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M., A.B., G.K., D.C.)
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M., A.B., G.K., D.C.)
| | - Pugazhendhi Vijayaraman
- Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, PA (P.V.)
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M., A.B., G.K., D.C.)
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Jastrzebski M, Moskal PJ, Bednarek A, Kielbasa G, Czarnecka D. P6019His-Purkinje system pacing in single centre experience after 324 cases. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
His-Purkinje system pacing preserves or restores physiologic depolarization of the left ventricle during permanent pacing. It consists of two complementary techniques: His bundle pacing (HB-P) and the recently introduced left bundle branch pacing (LBB-P). There is limited data on HB-P outcomes and only a few reports of LBB-P results.
Purpose
Our aim was to investigate success rate, complications, acute and early pacing parameters in patients undergoing HB-P and LBB-P in the setting of a cardiology tertiary centre that routinely implants HB-P and LBB-P pacemakers.
Methods
On the basis of a prospective database we performed a longitudinal cohort study of all consecutive patients with His-Purkinje system devices implanted in the years 2014–2019. In all cases, model 3830 lumen-less 4.1 Fr pacing lead was used. HB-P was achieved via HB mapping or pace mapping, LBB-P was achieved via deep septal lead deployment under electrophysiological and 12-lead ECG guidance.
Results
Since 2014 there were 324 implantations of His-Purkinje system pacemakers. Baseline patients' characteristics are presented in Table. The overall success rate was 81.5%. Selective HB-P, non-selective HB-P and LBB-P were achieved in 53%, 19% and 28% of successful cases. The mean fluoroscopy time was 11±9 min. The lead delivery was performed using single sheath (C315His) in 83% cases, while in 17% extra steerable sheath was necessary (C304XL). The acute mean LBB-P capture threshold @0.5 ms was significantly lower than in HB-P (0.65±0.43V vs. 1.47±0.8V). The mean chronic LBB-P capture threshold @1.0 ms was also lower than in HB-P (0.45±0.3V vs. 0.95±0.7V, p<0.001). The acute sensing amplitude was significantly higher in LBB-P vs HB-P (10±5mV vs 4±3mV). The mean paced QRS duration was significantly shorter for selective HB-P (113±22 ms) and LBB-P (108±12 ms) vs. non-selective HB-P (132±22 ms). The complications included: 4 cases of threshold increase that required lead revision; 3 early lead dislodgments; 1 loss of LBB capture, 3 pocket hematomas, 2 system infections and 1 pneumothorax.
Baseline characteristics Age; sex 73±12 years (19–95 years); 64% males Mean EF; mean QRS duration; Presence of heart failuire or ischemic heart disease 47±15%; 128±32 ms; 48%; 37.5% Pacing indication AV block 31%; sinus node disease 12%; atrial fibrillation with bradycardia 37%; CRT 20% QRS morphology narrow QRS 61%; LBBB 20%; other 14%; IVCD 6% CRT, Cardiac Resynchronization Therapy; IVCD, Interventricular Conduction Delay.
Conclusion
His-Purkinje system pacing in routine practice has an acceptable success rate, pacing parameters and complication rate; the LBB-P provides better pacing parameters than HB-P. We believe that such single-centre experience paves the way for a large randomized trial of physiologic pacing.
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Affiliation(s)
- M Jastrzebski
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
| | - P J Moskal
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
| | - A Bednarek
- University Hospital of Krakow, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
| | - G Kielbasa
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
| | - D Czarnecka
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
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De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Z, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, Kotseva K, De Backer G, Abreu A, Aguiar C, Badariene J, Bruthans J, Castro Conde A, Cifkova R, Crowley J, Davletov K, Bacquer DD, De Smedt D, De Sutter J, Deckers J, Dilic M, Dolzhenko M, Druais H, Dzerve V, Erglis A, Fras Z, Gaita D, Gotcheva N, Grobbee D, Gyberg V, Hasan Ali H, Heuschmann P, Hoes A, Jankowski P, Lalic N, Lehto S, Lovic D, Maggioni A, Mancas S, Marques-Vidal P, Mellbin L, Miličić D, Mirrakhimov E, Oganov R, Pogosova N, Reiner Ž, Rydén L, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tsioufis K, Vulic D, Wood D, Wood D, Kotseva K, Jennings C, Adamska A, Adamska S, Rydén L, Mellbin L, Tuomilehto J, Schnell O, Druais H, Fiorucci E, Glemot M, Larras F, Missiamenou V, Maggioni A, Taylor C, Ferreira T, Lemaitre K, Bacquer DD, De Backer G, Raman L, Sundvall J, DeSmedt D, De Sutter J, Willems A, De Pauw M, Vervaet P, Bollen J, Dekimpe E, Mommen N, Van Genechten G, Dendale P, Bouvier C, Chenu P, Huyberechts D, Persu A, Dilic M, Begic A, Durak Nalbantic A, Dzubur A, Hadzibegic N, Iglica A, Kapidjic S, Osmanagic Bico A, Resic N, Sabanovic Bajramovic N, Zvizdic F, Vulic D, Kovacevic-Preradovic T, Popovic-Pejicic S, Djekic D, Gnjatic T, Knezevic T, Kovacevic-Preradovic T, Kos L, Popovic-Pejicic S, Stanetic B, Topic G, Gotcheva N, Georgiev B, Terziev A, Vladimirov G, Angelov A, Kanazirev B, Nikolaeva S, Tonkova D, Vetkova M, Milicic D, Reiner Ž, Bosnic A, Dubravcic M, Glavina M, Mance M, Pavasovic S, Samardzic J, Batinic T, Crljenko K, Delic-Brkljacic D, Dula K, Golubic K, Klobucar I, Kordic K, Kos N, Nedic M, Olujic D, Sedinic V, Blazevic T, Pasalic A, Percic M, Sikic J, Bruthans J, Cífková R, Hašplová K, Šulc P, Wohlfahrt P, Mayer O, Cvíčela M, Filipovský J, Gelžinský J, Hronová M, Hasan-Ali H, Bakery S, Mosad E, Hamed H, Ibrahim A, Elsharef M, Kholef E, Shehata A, Youssef M, Elhefny E, Farid H, Moustafa T, Sobieh M, Kabil H, Abdelmordy A, Lehto S, Kiljander E, Kiljander P, Koukkunen H, Mustonen J, Cremer C, Frantz S, Haupt A, Hofmann U, Ludwig K, Melnyk H, Noutsias M, Karmann W, Prondzinsky R, Herdeg C, Hövelborn T, Daaboul A, Geisler T, Keller T, Sauerbrunn D, Walz-Ayed M, Ertl G, Leyh R, Störk S, Heuschmann P, Ehlert T, Klocke B, Krapp J, Ludwig T, Käs J, Starke C, Ungethüm K, Wagner M, Wiedmann S, Tsioufis K, Tolis P, Vogiatzi G, Sanidas E, Tsakalis K, Kanakakis J, Koutsoukis A, Vasileiadis K, Zarifis J, Karvounis C, Crowley J, Gibson I, Houlihan A, Kelly C, O'Donnell M, Bennati M, Cosmi F, Mariottoni B, Morganti M, Cherubini A, Di Lenarda A, Radini D, Ramani F, Francese M, Gulizia M, Pericone D, Davletov K, Aigerim K, Zholdin B, Amirov B, Assembekov B, Chernokurova E, Ibragimova F, Kodasbayev A, Markova A, Mirrakhimov E, Asanbaev A, Toktomamatov U, Tursunbaev M, Zakirov U, Abilova S, Arapova R, Bektasheva E, Esenbekova J, Neronova K, Asanbaev A, Baigaziev K, Toktomamatov U, Zakirov U, Baitova G, Zheenbekov T, Erglis A, Andrejeva T, Bajare I, Kucika G, Labuce A, Putane L, Stabulniece M, Dzerve V, Klavins E, Sime I, Badariene J, Gedvilaite L, Pečiuraite D, Sileikienė V, Skiauteryte E, Solovjova S, Sidabraite R, Briedis K, Ceponiene I, Jurenas M, Kersulis J, Martinkute G, Vaitiekiene A, Vasiljevaite K, Veisaite R, Plisienė J, Šiurkaitė V, Vaičiulis Ž, Jankowski P, Czarnecka D, Kozieł P, Podolec P, Nessler J, Gomuła P, Mirek-Bryniarska E, Bogacki P, Wiśniewski A, Pająk A, Wolfshaut-Wolak R, Bućko J, Kamiński K, Łapińska M, Paniczko M, Raczkowski A, Sawicka E, Stachurska Z, Szpakowicz M, Musiał W, Dobrzycki S, Bychowski J, Kosior D, Krzykwa A, Setny M, Kosior D, Rak A, Gąsior Z, Haberka M, Gąsior Z, Haberka M, Szostak-Janiak K, Finik M, Liszka J, Botelho A, Cachulo M, Sousa J, Pais A, Aguiar C, Durazzo A, Matos D, Gouveia R, Rodrigues G, Strong C, Guerreiro R, Aguiar J, Abreu A, Cruz M, Daniel P, Morais L, Moreira R, Rosa S, Rodrigues I, Selas M, Gaita D, Mancas S, Apostu A, Cosor O, Gaita L, Giurgiu L, Hudrea C, Maximov D, Moldovan B, Mosteoru S, Pleava R, Ionescu M, Parepa I, Pogosova N, Arutyunov A, Ausheva A, Isakova S, Karpova A, Salbieva A, Sokolova O, Vasilevsky A, Pozdnyakov Y, Antropova O, Borisova L, Osipova I, Lovic D, Aleksic M, Crnokrak B, Djokic J, Hinic S, Vukasin T, Zdravkovic M, Lalic N, Jotic A, Lalic K, Lukic L, Milicic T, Macesic M, Stanarcic Gajovic J, Stoiljkovic M, Djordjevic D, Kostic S, Tasic I, Vukovic A, Fras Z, Jug B, Juhant A, Krt A, Kugonjič U, Chipayo Gonzales D, Gómez Barrado J, Kounka Z, Marcos Gómez G, Mogollón Jiménez M, Ortiz Cortés C, Perez Espejo P, Porras Ramos Y, Colman R, Delgado J, Otero E, Pérez A, Fernández-Olmo M, Torres-LLergo J, Vasco C, Barreñada E, Botas J, Campuzano R, González Y, Rodrigo M, de Pablo C, Velasco E, Hernández S, Lozano C, González P, Castro A, Dalmau R, Hernández D, Irazusta F, Vélez A, Vindel C, Gómez-Doblas J, García Ruíz V, Gómez L, Gómez García M, Jiménez-Navarro M, Molina Ramos A, Marzal D, Martínez G, Lavado R, Vidal A, Rydén L, Boström-Nilsson V, Kjellström B, Shahim B, Smetana S, Hansen O, Stensgaard-Nake E, Deckers J, Klijn A, Mangus T, Peters R, Scholte op Reimer W, Snaterse M, Aydoğdu S, Ç Erol, Otürk S, Tulunay Kaya C, Ahmetoğlu Y, Ergene O, Akdeniz B, Çırgamış D, Akkoyun H Kültürsay S, Kayıkçıoğlu M, Çatakoğlu A, Çengel A, Koçak A, Ağırbaşlı M, Açıksarı G, Çekin M, Tokgözoğlu L, Kaya E, Koçyiğit D, Öngen Z, Özmen E, Sansoy V, Kaya A, Oktay V, Temizhan A, Ünal S, İ Yakut, Kalkan A, Bozkurt E, Kasapkara H, Dolzhenko M, Faradzh C, Hrubyak L, Konoplianyk L, Kozhuharyova N, Lobach L, Nesukai V, Nudchenko O, Simagina T, Yakovenko L, Azarenko V, Potabashny V, Bazylevych A, Bazylevych M, Kaminska K, Panchenko L, Shershnyova O, Ovrakh T, Serik S, Kolesnik T, Kosova H, Wood D, Adamska A, Adamska S, Jennings C, Kotseva K, Hoye P Atkin A, Fellowes D, Lindsay S, Atkinson C, Kranilla C, Vinod M, Beerachee Y, Bennett C, Broome M, Bwalya A, Caygill L, Dinning L, Gillespie A, Goodfellow R, Guy J, Idress T, Mills C, Morgan C, Oustance N, Singh N, Yare M, Jagoda J, Bowyer H, Christenssen V, Groves A, Jan A, Riaz A, Gill M, Sewell T, Gorog D, Baker M, De Sousa P, Mazenenga T, Porter J, Haines F, Peachey T, Taaffe J, Wells K, Ripley D, Forward H, McKie H, Pick S, Thomas H, Batin P, Exley D, Rank T, Wright J, Kardos A, Sutherland SB, Wren L, Leeson P, Barker D, Moreby B, Sawyer J, Stirrup J, Brunton M, Brodison A, Craig J, Peters S, Kaprielian R, Bucaj A, Mahay K, Oblak M, Gale C, Pye M, McGill Y, Redfearn H, Fearnley M. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis 2019; 285:135-146. [DOI: 10.1016/j.atherosclerosis.2019.03.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
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Jastrzębski M, Moskal P, Bednarek A, Kiełbasa G, Czarnecka D. First Polish experience with permanent direct pacing of the left bundle branch. Kardiol Pol 2019; 77:580-581. [DOI: 10.33963/kp.14850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gruszka K, Rajzer M, Drożdż T, Wojciechowska W, Pizoń T, Migacz-Gruszka K, Czarnecka D. Selected matrix metalloproteinases activity and hypertension-mediated organ damage in relation to uric acid serum level. Cardiol J 2019; 28:905-913. [PMID: 30994184 PMCID: PMC8747807 DOI: 10.5603/cj.a2019.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/26/2019] [Accepted: 03/20/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Atherosclerosis is as a systemic inflammatory disease associated with the activation of many mediators, including matrix metalloproteinases (MMPs), and may be amplified by abnormal high serum uric acid (UA) concentration (hyperuricemia, HU). The aim of the study was to determine the relationship between serum UA concentration and activity of MMPs and their correlation with the hypertension-mediated organ damage (HMOD) intensity. METHODS 109 patients untreated with antihypertensive, hypolipemic or urate-lowering drugs with diagnosed stage 1-2 essential hypertension were included in this study. In all participants blood pressure (BP) was measured, carotid-femoral pulse wave velocity (PWV), intima-media thickness (IMT), echocardiography and blood tests including UA, lipids and serum concentrations of MMPs (1, 2, 3, 9) were observed. The participants were divided into hyper- and normuricemic groups. RESULTS Uric acid concentration in the whole study group positively correlated with some HMOD parameters (IMT, PWV, left ventricular mass index, left atrial dimension). Among the studied metalloproteinases only MMP-3 activity positively correlated with serum UA concentration independently of age, body mass index and serum lipids (R2 = 0.11, p = 0.048). Multivariate regression analysis showed positive association between IMT and BP, UA concentration and MMP-3 activity, independently of waist circumference and serum lipids (R2 = 0.328, p < 0.002). Patients with HU were characterized by higher activity of MMP-3 than those without (19.41 [14.45; 21.74] vs. 13.98 [9.52; 18.97] ng/mL, p = 0.016). CONCLUSIONS The present results may support the thesis that UA and the increased by UA activity of MMPs may take part in the development of HMOD, especially IMT.
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Affiliation(s)
- Krystian Gruszka
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland.
| | - Marek Rajzer
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland
| | - Tomasz Drożdż
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland
| | - Wiktoria Wojciechowska
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland
| | - Tomasz Pizoń
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland
| | - Kamila Migacz-Gruszka
- 2. Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- 1. 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, 17 Kopernika Street, 31-501 Kraków, Poland
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Schönborn M, Trynkiewicz A, Cebeńko M, Czarnecka D, Olszanecka A. Variability of subsequent blood pressure measurements carried out among adult volunteers. Arterial Hypertension 2019. [DOI: 10.5603/ah.a2018.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Styczkiewicz K, Spadacini G, Tritto M, Perego GB, Facchini M, Bilo G, Kawecka-Jaszcz K, Czarnecka D, Malfatto G, Parati G. Cardiac autonomic regulation in patients undergoing pulmonary vein isolation for atrial fibrillation. J Cardiovasc Med (Hagerstown) 2019; 20:297-305. [PMID: 30921268 DOI: 10.2459/jcm.0000000000000791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Ablation procedures for the treatment of atrial fibrillation lead to changes in autonomic heart control; however, there are insufficient data on the possible association of these changes with atrial fibrillation recurrence. The study aim was to assess the effects of pulmonary vein isolation (PVI) on cardiac autonomic modulation and atrial fibrillation recurrence. METHODS We screened 52 patients with atrial fibrillation referred for PVI, of whom 20 patients met inclusion and exclusion criteria, and were enrolled in the study and followed over 6 months. Beat-to-beat blood pressure monitoring was performed 1-2 days before PVI, 1 and 6 months after PVI. We estimated pulse interval variability and spontaneous baroreflex sensitivity (BRS) both in the time and frequency domains, and performed the Valsalva manoeuvre assessing the Valsalva ratio. RESULTS During 6 months after PVI, atrial fibrillation recurrence was observed in six patients. One month after PVI, pulse interval variability and BRS (sequence method) significantly decreased in all patients, returning to preintervention values by 6 months. Patients without atrial fibrillation recurrence at 1 month showed a transient reduction in pulse interval variability (frequency domain) and in BRS (both methods) in contrast to those with atrial fibrillation recurrence. A significant decrease in the Valsalva ratio observed at 1 month was maintained at 6 months after PVI in both groups. CONCLUSION Successful PVI may lead to transient autonomic alterations reflected by a reduction in pulse interval variability and BRS, with more prolonged changes in the Valsalva ratio. The efficacy of PVI in preventing atrial fibrillation recurrence seems to be related to transient parasympathetic atrial denervation.
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Affiliation(s)
- Katarzyna Styczkiewicz
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy.,The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Giammario Spadacini
- Electrophysiology and Cardiac Pacing Operative Unit, Humanitas Mater Domini Hospital, Castellanza (VA)
| | - Massimo Tritto
- Electrophysiology and Cardiac Pacing Operative Unit, Humanitas Mater Domini Hospital, Castellanza (VA)
| | - Giovanni B Perego
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy
| | - Mario Facchini
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy
| | - Grzegorz Bilo
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy.,Department of Medicine and Surgery, University of Milano- Bicocca, Milan, Italy
| | - Kalina Kawecka-Jaszcz
- The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Czarnecka
- The First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Gabriella Malfatto
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy
| | - Gianfranco Parati
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy.,Department of Medicine and Surgery, University of Milano- Bicocca, Milan, Italy
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Wojciechowska W, Terlecki M, Rajzer M, Czarnecka D. Anomalous origin of the circumflex artery from the right Valsalva sinus on transthoracic echocardiography. Kardiol Pol 2019; 77:394. [PMID: 30912112 DOI: 10.5603/kp.2019.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/18/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Wiktoria Wojciechowska
- 1st Department of Cardiology, Interventional Electrocardiology, and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland.
| | - Michał Terlecki
- 1st Department of Cardiology, Interventional Electrocardiology, and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology, and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Danuta Czarnecka
- 1st Department of Cardiology, Interventional Electrocardiology, and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
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Kisiel R, Fijorek K, Moskal P, Kukla P, Pavlinec C, Stec J, Czarnecka D, Jastrzębski M. True left bundle branch block and long-term mortality in cardiac resynchronisation therapy patients. Kardiol Pol 2019; 77:371-379. [DOI: 10.5603/kp.a2019.0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/26/2019] [Accepted: 02/20/2019] [Indexed: 11/25/2022]
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Pęksa JW, Jankowski P, Czarnecka D. [Control of cardiovascular risk factors in patients after myocardial infarction]. Wiad Lek 2019; 72:472-483. [PMID: 31051001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite significant improvements in the diagnosis and treatment of cardiovascular diseases that have occurred in recent years, they remain the main cause of morbidity and mortality in the population. In many European countries, the incidence of coronary heart disease is currently 50% lower than it was in the early 1980s, which is the result of cardiovascular prevention. A special group of patients are people after myocardial infarction with very high cardiovascular risk. They should definitely implement activities at the individual level e. g. work on improving the unhealthy lifestyle and pharmacologically control other risk factors. A diet low in saturated fats should be recommended, i.e. mainly containing whole grains, vegetables, fruits and fish, recommend regular physical exercise: 150 min / week of moderate, aerobic physical activity, reducing the supply of calories in order to get rid of overweight or obesity. Help in quitting tobacco addiction should take place through the minimal nicotine intervention and, if necessary, pharmacological therapy. Another thing is the control of other risk factors, i. e. the appropriate treatment of dyslipidemia (the primary target is LDL cholesterol <1.8 mmol/l or reduction by ≥ 50%, if the initial concentration is between 1.8 and 3.5 mmol/l, treatment hypertension (target arterial pressure for most people aged 18-65 is in the range: 120-130/70-79 mmHg, if it is well tolerated, while for older people it is in the range: 130-139/70-79mmHg, if it is well tolerated), optimal diabetes therapy (target glycated hemoglobin <7%) and appropriate antiplatelet therapy (in most patients double antiplatelet therapy is recommended for 12 months after acute coronary syndrome). These activities lead to a significant improvement in quality of life and a decrease in mortality due to cardiovascular diseases.
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Affiliation(s)
- Jan W Pęksa
- I Klinika Kardiologii i Elektrokardiologii Interwencyjnej Oraz Nadciśnienia Tętniczego, Uniwersytet Jagielloński w Krakowie, Kraków, Polska
| | - Piotr Jankowski
- I Klinika Kardiologii i Elektrokardiologii Interwencyjnej Oraz Nadciśnienia Tętniczego, Uniwersytet Jagielloński w Krakowie, Kraków, Polska
| | - Danuta Czarnecka
- I Klinika Kardiologii i Elektrokardiologii Interwencyjnej Oraz Nadciśnienia Tętniczego, Uniwersytet Jagielloński w Krakowie, Kraków, Polska
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Jastrzębski M, Moskal P, Bednarek A, Kiełbasa G, Czarnecka D. His bundle pacing: Still much to learn. Pacing Clin Electrophysiol 2018; 41:1692. [DOI: 10.1111/pace.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension; Medical College, Jagiellonian University; Krakow Poland
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension; Medical College, Jagiellonian University; Krakow Poland
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension; Medical College, Jagiellonian University; Krakow Poland
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension; Medical College, Jagiellonian University; Krakow Poland
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension; Medical College, Jagiellonian University; Krakow Poland
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Jastrzębski M, Moskal P, Czarnecka D. Massive His bundle injury current corresponds with acute trauma and slowing of conduction that has to subside before pacing threshold assessment. J Cardiovasc Electrophysiol 2018; 30:440-441. [DOI: 10.1111/jce.13789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Marek Jastrzębski
- First Department of CardiologyInterventional Electrocardiology and Hypertension, Jagiellonian University, Medical CollegeKrakow Poland
| | - Paweł Moskal
- First Department of CardiologyInterventional Electrocardiology and Hypertension, Jagiellonian University, Medical CollegeKrakow Poland
| | - Danuta Czarnecka
- First Department of CardiologyInterventional Electrocardiology and Hypertension, Jagiellonian University, Medical CollegeKrakow Poland
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Pizoń T, Rajzer M, Wojciechowska W, Wach-Pizoń M, Drożdż T, Wróbel K, Gruszka K, Rojek M, Kameczura T, Jurczyszyn A, Kąkol J, Czarnecka D. The relationship between plasma renin activity and serum lipid profiles in patients with primary arterial hypertension. J Renin Angiotensin Aldosterone Syst 2018; 19:1470320318810022. [PMID: 30404585 PMCID: PMC6240969 DOI: 10.1177/1470320318810022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction: The aim of the study was to evaluate clinical and biochemical differences between patients with low-renin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations. Materials and methods: In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis. Results: Patients with high-renin hypertension (N = 58) were characterized by higher heart rate (p = 0.04), lower serum sodium (p < 0.01) and aldosterone-to-renin ratio (p < 0.01), and significantly higher serum aldosterone (p = 0.03), albumin (p < 0.01), total protein (p < 0.01), total cholesterol (p = 0.01) and low-density lipoprotein cholesterol (LDL-C) (p = 0.04) than low-renin subjects (N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C (R2 = 0.15, β = 1.53 and p = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations. Conclusions: Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.
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Affiliation(s)
- Tomasz Pizoń
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland.,2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Marek Rajzer
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Wiktoria Wojciechowska
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Wach-Pizoń
- 3 Department of Clinical and Environmental Allergology, University Hospital, Kraków, Poland
| | - Tomasz Drożdż
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Wróbel
- 2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Krystian Gruszka
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Rojek
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | | | - Artur Jurczyszyn
- 5 Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Janusz Kąkol
- 2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Danuta Czarnecka
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
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Jastrzębski M, Baranchuk A, Fijorek K, Kisiel R, Kukla P, Sondej T, Czarnecka D. Cardiac resynchronization therapy-induced acute shortening of QRS duration predicts long-term mortality only in patients with left bundle branch block. Europace 2018; 21:281-289. [DOI: 10.1093/europace/euy254] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/11/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Kopernika str. 17, Krakow 31-052, Poland
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston Heart Sciences Center, Kingston, ON, Canada
| | - Kamil Fijorek
- Department of Statistics, Cracow University of Economics, Krakow, Poland
| | - Roksana Kisiel
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Kopernika str. 17, Krakow 31-052, Poland
| | - Piotr Kukla
- Department of Cardiology, H. Klimontowicz Specialistic Hospital, Gorlice, Poland
| | - Tomasz Sondej
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Kopernika str. 17, Krakow 31-052, Poland
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Kopernika str. 17, Krakow 31-052, Poland
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Jastrzębski M, Moskal P, Bednarek A, Kiełbasa G, Czarnecka D. His-bundle pacing as a standard approach in patients with permanent atrial fibrillation and bradycardia. Pacing Clin Electrophysiol 2018; 41:1508-1512. [DOI: 10.1111/pace.13490] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/18/2018] [Accepted: 08/29/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College; Jagiellonian University; Krakow Poland
| | - Paweł Moskal
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College; Jagiellonian University; Krakow Poland
| | - Agnieszka Bednarek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College; Jagiellonian University; Krakow Poland
| | - Grzegorz Kiełbasa
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College; Jagiellonian University; Krakow Poland
| | - Danuta Czarnecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College; Jagiellonian University; Krakow Poland
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Olszanecka A, Reczek Ł, Schönborn M, Janiec S, Cebeńko M, Pałasz I, Czarnecka D. Stosowanie leków przeciwbólowych u pacjentów z chorobą niedokrwienną serca. Folia Cardiologica 2018. [DOI: 10.5603/fc.2018.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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49
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Moskal P, Klima Ł, Jastrzębski M, Czarnecka D. Arteriovenous fistula imitating myocardial ischaemia on electrocardiogram. Kardiol Pol 2018; 76:1376. [DOI: 10.5603/kp.2018.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/23/2018] [Accepted: 05/08/2018] [Indexed: 11/25/2022]
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Olszanecka A, Fedak D, Czarnecka D. P1570Chemerin as a marker of cardiometabolic risk and subclinical cardiac remodeling in postmenopausal women. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Olszanecka
- Jagiellonian University Medical College, Ist Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
| | - D Fedak
- Jagiellonian University Medical College, Department of Clinical Biochemistry, Krakow, Poland
| | - D Czarnecka
- Jagiellonian University Medical College, Ist Department of Cardiology, Interventional Electrocardiology and Hypertension, Krakow, Poland
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