Publications by authors named "Agnieszka Młynarska"

44 Publications

Sexual Function and Sexual Quality of Life in Premenopausal Women with Controlled Type 1 and 2 Diabetes-Preliminary Study.

Int J Environ Res Public Health 2021 03 4;18(5). Epub 2021 Mar 4.

Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland.

Sexual dysfunction is more common in women with diabetes than in women without diabetes. The aim of the study was to determine sexual function and the level of the quality of sex life in premenopausal women with controlled, uncomplicated type 1 and type 2 diabetes taking into account the stages of the menstrual cycle and mood level. The study included 163 women with type 1 and type 2 diabetes and 115 controls without diabetes. Questionnaire studies were conducted using the following surveys: Demographic and Clinical Data Survey, Female Sexual Function Index, Sexual Quality of Life-Female, and Beck Depression Inventory. Both phases of the menstrual cycle-follicular and luteal-were included. It was shown that, in women with type 1 diabetes, sexual function decreased during the luteal phase in comparison with the follicular phase ( < 0.001). In the women with type 2 diabetes and in the controls, sexual function was comparable during both phases of the cycle ( > 0.05). In the women with uncomplicated controlled type 1 diabetes, sexual function and the sexual and relationship satisfaction changed depending on the phase of the menstrual cycle with a decrease during the luteal phase. Sexual function and the quality of the sex life of premenopausal women with controlled type 2 diabetes were comparable during both the follicular and the luteal phases. Sexual function in menstruating women with controlled type 2 diabetes decreased with age and a worsening mood.
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http://dx.doi.org/10.3390/ijerph18052536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967376PMC
March 2021

The Influence of Antiarrhythmic Device Intervention on Biopsychosocial Functioning and Anxiety in Patients with an Implanted Cardioverter Defibrillator.

Medicina (Kaunas) 2021 Jan 27;57(2). Epub 2021 Jan 27.

Department of Gerontology and Geriatric Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland.

The aim of the study was to assess the impact of cardioverter-defibrillator interventions on the psychosocial functioning of a patient and the occurrence of concerns related to ICD. The conducted study was a prospective and observational study that included 158 patients. The study was conducted in two stages: I before ICD implantation and II a follow-up visit six months after the ICD implantation. Standardized questionnaires were used in both stages. In the first six months, a cardioverter-defibrillator discharge occurred in 28 participants, which constituted 17.72% of the study group. The number of ICD discharges positively correlated to insomnia, symptoms of anxiety, symptoms of depression, more discharges, more severe insomnia, anxiety and depression. There was also a negative correlation between the number of discharges and the degree of disease acceptance and in the quality of life domains: somatic, mental, social and environmental. The more discharges, the worse the disease acceptance and assessment of the quality of life. Individuals who experienced discharges assessed their quality of life as worse in all aspects (perception of the quality of life, own health, physical, mental, social and environmental domains), experienced anxiety and depressive disorders more often, were characterized by a worse functioning in a chronic disease, experienced insomnia more often and reported more concerns related to ICD implantation.
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http://dx.doi.org/10.3390/medicina57020113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911262PMC
January 2021

Temporal changes of the diameter of the coronary sinus during the cardiac cycle.

Clin Physiol Funct Imaging 2021 Mar 19;41(2):192-198. Epub 2020 Dec 19.

Department of Radiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland.

Introduction: Currently, there are no studies that analyse the changes in the cardiac venous system that are dependent on the phase (RR interval) of reconstruction. The aim of the study was to assess the size of the coronary sinus at two measurement sites depending on the phase of the heart cycle.

Methods: Fifty patients were included. Cardiac computed tomography was performed in all of the patients due to a suspicion of coronary artery disease (typical indications) using a dual-source Siemens Somatom Force scanner. The "MM reading" presets were used to measure the coronary sinus ostium (measurement 1) and the coronary sinus trunk, which is close to the great cardiac vein (measurement 2) in millimetres. All of the calculations were performed on axial scans using 0%-100% and a 256 × 256 matrix.

Results: The largest CS was found at the 30%, 40% and 50% RR interval-this phenomenon occurred in 37 of the 50 cases (74%). The CS was largest in the 30% phase (9/50 cases; 18%), in the 40% phase (17/50 cases; 34%) and in the 50% phase, and it was the largest in 11 of the 50 cases (22%). There were also no gender-related differences.

Conclusions: The size of the coronary sinus varies with the phase of the heart cycle. At the 40% phase, it is largest in most cases.
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http://dx.doi.org/10.1111/cpf.12685DOI Listing
March 2021

Anomalous coronary sinus ostium on cardiac computed tomography. Authors' reply.

Kardiol Pol 2020 09 25;78(9):948-949. Epub 2020 Sep 25.

Unit of Noninvasive Cardiovascular Diagnostics, Upper Silesian Medical Centre, Katowice, Poland; 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland

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http://dx.doi.org/10.33963/KP.15612DOI Listing
September 2020

Rationing of Nursing Care in Intensive Care Units.

Int J Environ Res Public Health 2020 09 23;17(19). Epub 2020 Sep 23.

Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland.

The nursing practice refers to a wide range of tasks and responsibilities. In a situation where there is a problem of limited resources, nurses are forced to ration the patient's care-that is, minimize and skip some tasks. The main purpose of this work was to assess the rationing level of nursing care among staff in the intensive care units.

Methods: The research included 150 anaesthesiological nurses in the Silesian Region in Poland. The research was conducted from July to October 2019 using the standardized Perceived Implicit Rationing of Nursing Care (PRINCA) questionnaire on rationing nursing care, assessing the quality of patient care, and job satisfaction. The Modified Fatigue Impact Scale (MFIS) standardized questionnaire was used to assess the level of fatigue of respondents in the physical, cognitive, and psychosocial spheres.

Results: Sociodemographic factors, such as gender, age, place of residence, education, seniority, and type of employment were not found to affect the rationing level of nursing care in the intensive care unit. The average quality of patient care was 6.05/10 points, while the average job satisfaction rating was 7.13/10 points. Analysis of the MFIS questionnaire showed that respondents experienced fatigue between "rare" and "sometimes", and nursing staff fatigue was the main factor for rationing care.

Conclusions: The higher the level of fatigue, the greater the rationing of care and the less satisfaction from work.
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http://dx.doi.org/10.3390/ijerph17196944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579213PMC
September 2020

The impact of cardiac pacemaker implantation on male sexual function.

Pacing Clin Electrophysiol 2020 12 1;43(12):1508-1514. Epub 2020 Sep 1.

Department of Electrocardiology, Upper Silesian Medical Centre, Katowice, Poland.

Background: The possibility of sexual functioning is an important aspect of human life, and sexual disorders have a negative impact on the quality of life and well-being. The aim of the study was to assess the sexuality and occurrence of sexual dysfunction within 6 months after pacemaker implantation.

Methods And Results: The study sample was a group of 80 patients with heart rhythm disorders who had been qualified for cardiac pacemaker implantation. The International Index of Erectile Function (IIEF)-15 was completed by all the patients at least 1 day before and 6 months after cardiac pacemaker implantation. The average results of the IIEF for all those who were included before implantation were 41.87 ± 7.57 and were statistically the worst after pacemaker implantation 46.76 ± 6.64; P < .0001. After the implantation of a pacemaker, there was an improvement in all of the subcategories of sexual life for all the men: erectile function P < .0001, orgasmic function P < .0001, sexual desire P < .0001, intercourse satisfaction P < .0001, and overall satisfaction P < .0001.

Conclusions: Pacemaker implantation had a positive effect on sexual functioning for all the patients. Pacemaker implantation did not affect sexual desire in the patients who were observed. Erectile dysfunction occurred in most of patients both before and after pacemaker implantation.
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http://dx.doi.org/10.1111/pace.14035DOI Listing
December 2020

Modified Frailty as a Novel Factor in Predicting the Maintenance of the Sinus Rhythm After Electrical Cardioversion of Atrial Fibrillation in the Elderly Population.

Clin Interv Aging 2020 17;15:1193-1199. Epub 2020 Jul 17.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland.

Introduction: Frailty is a common geriatric syndrome that causes an elevated risk of catastrophic declines in the health and function among older adults - we hypothesized that frailty may be related to the maintenance of sinus rhythm after cardioversion.

Methods: The study sample was a group of 199 consecutive patients over 60 (average age 71.41 ± 6.99; 40.2% women) with AF who were hospitalized in order to perform electrical cardioversion. The Tilburg Frailty Indicator (TFI) was used to assess frailty before cardioversion. The six-month visit after the electrical cardioversion was a follow-up. The follow-up period for the maintenance of sinus rhythm after electrical cardioversion was 180 ± 14 days.

Results: Patients in whom cardioversion was effective had a statistically significantly lower severity of frailty syndrome (3.44 ± 1.83 vs 5.87 ± 1.12; p=0.000) and its components: physical components (2.14 ± 1.33 vs 3.62 ± 1.05 p=0.000); emotional components (0.92 ± 0.79 vs 1.29 ± 0.86 p=0.037) and social components (0.37 ± 0.56 vs 0.96 ± 0.46; p=0.000) compared to those patients in which cardioversion was ineffective. In the logistic regression, frailty (OR: 0.65, 95% CI:0.5010-0.8330; p=0.000) was observed to be an independent predictor for maintaining sinus rhythm.

Conclusion: Frailty is a novel, independent factor that can be used to predict the effectiveness of electrical cardioversion and the maintenance of sinus rhythm in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator to a 4 improved the prediction of the effectiveness of electrical cardioversion as well as the maintenance of sinus rhythm.
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http://dx.doi.org/10.2147/CIA.S255853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381784PMC
December 2020

Crosscultural adaptation and reliability testing of the Implantable Cardioverter-Defibrillator Concerns questionnaire to optimize the care of Polish patients with implantable cardioverter-defibrillators.

Kardiol Pol 2020 09 17;78(9):906-912. Epub 2020 Jul 17.

Department of Electrocardiology, Upper Silesian Medical Centre, Katowice, Poland; Department of Electrocardiology and HeartFailure, School of Health Sciences, Medical University of Silesia, Katowice, Poland

Background: Implantable cardioverter‑defibrillator (ICD) placement has now become a standard procedure in patients with ventricular arrhythmias. The primary task of an ICD is to recognize and immediately interrupt life‑threatening ventricular arrhythmia via an intracardiac electrical discharge, known as a shock.

Aims: The aim of this study was to adapt and test the reliability of the Polish version of the Implantable Cardioverter‑Defibrillator Concerns (ICDC) questionnaire, an instrument used to determine the concerns of patients with ICDs.

Methods: Standard guidelines were applied with regard to the translation and cultural adaptation of the English version of the ICDC questionnaire in Poland. The study included 129 Polish patients with ICDs, including 28 women, at a mean (SD) age of 66.24 (12.94) years. The Cronbach α was calculated to analyze the internal consistency of the ICDC questionnaire.

Results: The mean ICDC score for overall concerns was 36.63 (18.56); 9.19 (5.93) for factor 1 assessing the perceived limitations, and 9.72 (5.61) for factor 2 assessing device‑specific concerns. The Cronbach α reliability coefficients ranged from 0.9619 to 0.9647, after each questionnaire item was deleted. The Cronbach α that characterized the internal consistency of the entire questionnaire was 0.96.

Conclusion: The Polish adaptation of the ICDC questionnaire proved to be a useful and quick tool to assess patients' concerns after ICD placement. Its use is recommended in the evaluation of all patients after device implantation in order to optimize therapy.
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http://dx.doi.org/10.33963/KP.15520DOI Listing
September 2020

Factors that influence marital satisfaction in men with a heart rhythm disorders.

Aging Male 2020 Dec 28;23(5):1374-1380. Epub 2020 May 28.

Department of Electrocardiology, Upper Silesian Medical Centre, Katowice, Poland.

Background: A diagnosis of a cardiac arrhythmia can affect marital relations and diminish libido and satisfaction with a patient's sex life. The aim of the study was to assess the factors that affect marital satisfaction in men with an arrhythmias who had qualified for cardiac pacemaker implantation.

Methods: The study included 103 men (aged 58.28 ± 8.72) with recognized heart rhythm disorders who were hospitalized in Department of Electrocardiology. The Hospital Anxiety and Depression Scale (HADS), the International Erectile Function Index (IIEF) and the Index of Marital Satisfaction (IMS) were used in this research.

Results: The greater the severity of the anxiety ( = 0.2492,  = 0.011) and depression symptoms ( = 0.3735,  = 0.000), the less satisfied a patient was with the relationship. An analysis showed that depression ( = 0.000), sexual desire ( = 0.001), overall satisfaction ( = 0.009), erectile function ( = 0.0162) and intercourse satisfaction ( = 0.026) are important predictors of marital satisfaction. Only sexual desire was an important predictor of marital satisfaction in patients with sinus node dysfunction, while the depression, sexual desire and overall satisfaction results were predictors in patients with atrioventricular blocks.

Conclusion: Anxiety and depression symptoms affect the assessment of marital satisfaction in men with a heart rhythm disorder. Different factors influence marital satisfaction for different heart rhythm disorders.
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http://dx.doi.org/10.1080/13685538.2020.1770211DOI Listing
December 2020

Presence of the Vieussens valve on cardiac computed tomography.

Kardiol Pol 2020 08 7;78(7-8):703-708. Epub 2020 May 7.

Unit of Noninvasive Cardiovascular Diagnostics, Upper Silesian Medical Centre, Katowice, Poland; 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland

Background: The Vieussens valve is a venous valve often found between the coronary sinus ostium and the great cardiac vein.

Aims: This study aimed to analyze the Vieussens valve in vivo using cardiac computed tomography (CT).

Methods: A total of 325 patients (120 women; mean [SD] age, 58 [11] years) were included into the study. Retrospective scanning using 64 slices of 0.5 mm in thickness was performed and multiplanar reformatted reconstructions and 3‑dimensional volume renderings were used. As the Vieussens valve is difficult to find in standard reconstructions owing to its very small thickness, we decided to prepare and use indirect analyses in order to determine the presence of the valve. The basis for the analysis was the fact that even a very thin valve is an obstacle to the flow of the contrast agent in the same way as the much larger valves are.

Results: The Vieussens valve was present on CT in 141 of the 325 study patients (43.38%). No sex differences were found (P = 0.83): the valve was present in 88 of 205 men (42.92%) and in 53 of 120 women (44.17%). The mean (SD) distance between the Vieussens valve and the coronary sinus ostium was 38.89 (7.47) mm. We determined 3 types of the Vieussens valve: varicose, diminutive, and Marshall vein type.

Conclusions: It is possible to visualize the Vieussens valve on CT. Due to the usually small size of the valve, the best way to find it is to analyze the distribution (density) of a contrast agent in the coronary sinus. Differentiating the proposed valve types can facilitate further analysis.
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http://dx.doi.org/10.33963/KP.15341DOI Listing
August 2020

Polish adaptation and validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) questionnaire: a cross-sectional validation study.

BMJ Open 2020 04 6;10(4):e031994. Epub 2020 Apr 6.

Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA.

Objectives: To develop a Polish adaptation of the Perceived Implicit Rationing of Nursing Care (PIRNCA)questionnaire.

Design: Cross-sectional validation study.

Settings: Nurses working in surgical and cancer wards in Poland.

Participants: A sample of 513 professionally active nurses was enrolled in the study.

Intervention: To complete a Polish translation of the full original PIRNCA questionnaire.

Primary And Secondary Outcome Measures: The primary outcome was translation and adaptation of the full original PIRNCA tool and its validation to the Polish conditions. The secondary outcome was determination of relationships between sociodemographic variables, nurses' assessment of patient care quality and their overall job satisfaction on the one hand, and PIRNCA scores on the other.

Results: The respondents' mean score was 1.27 points (SD=0.68) on a scale from 0 to 3. Cronbach's alpha for the entire instrument was 0.957. All items of the questionnaire were found to have a positive item-total correlation. The developed linear regression model showed that nurses' assessment of patient care quality and their overall job satisfaction were independent predictors of PIRNCA scores (p<0.05). 94.15% of nurses reported rationing at least one of the 31 care activities.

Conclusions: The present findings indicate a high level of reliability and validity of the translated PIRNCA questionnaire, fully comparable to that of the original. The questionnaire can be used for the assessment of PIRNCA in Polish hospitals.
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http://dx.doi.org/10.1136/bmjopen-2019-031994DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245423PMC
April 2020

The Relationship between Frailty Syndrome and Concerns about an Implantable Cardioverter Defibrillator.

Int J Environ Res Public Health 2020 03 17;17(6). Epub 2020 Mar 17.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice 40-635, Poland.

Frailty syndrome may cause cognitive decline and increased sensitivity to stressors. This can result in an increased incidence of anxiety and depression, and thus, concerns about life with an implantable cardioverter defibrillator (ICD). The aim of the study was to assess the impact of frailty syndrome on the increase in the number of device-related concerns after the implantation of an ICD.

Material And Methods: The study sample was a group of 103 consecutive patients (85 M; aged 71.6 ± 8.2) with an implanted ICD. The ICD Concerns Questionnaire (ICDC) was used to analyze their concerns about life with an ICD, and the Tilburg Frailty Indicator scale (TFI) was used to diagnose frailty.

Results: In the group of patients with an ICD implanted, 73% had recognized frailty (83.3% women, 74.1% men); the average point value was 6.55 ± 2.67. The total ICDC questionnaire score for the patients with an implanted cardioverter defibrillator was 34.06 ± 18.15. Patients with frailty syndrome had statistically ( = 0.039) higher scores (36.14 ± 17.08) compared to robust patients (27.56 ± 20.13). In the logistic regression analysis, the presence of frailty was strongly associated with the total questionnaire score (OR = 1.0265, = 0.00426), the severity of the concerns (OR = 1.0417, = 0.00451), and device-specific concerns (OR = 1.0982, = 0.00424).

Conclusion: Frailty syndrome occurs in about 80% of patients after ICD implantation. The presence of frailty syndrome was strongly associated with concerns about an implantable cardioverter defibrillator.
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http://dx.doi.org/10.3390/ijerph17061954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142564PMC
March 2020

Prevalence of Depressive Symptoms in Patients with Type 1 and 2 Diabetes Mellitus.

Patient Prefer Adherence 2020 3;14:443-454. Epub 2020 Mar 3.

Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland.

Purpose: Patients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables.

Patients And Methods: The studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined.

Results: The mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM.

Conclusion: The prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.
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http://dx.doi.org/10.2147/PPA.S237767DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060793PMC
March 2020

Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland.

J Nurs Manag 2020 Nov 5;28(8):1948-1959. Epub 2020 May 5.

Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.

Aims: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses.

Background: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care.

Methods: A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA.

Results: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'.

Conclusion: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing.

Implications For Nursing Management: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.
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http://dx.doi.org/10.1111/jonm.12974DOI Listing
November 2020

Usefulness of the Coronary Artery Calcium Score in Predicting Subsequent Coronary Interventions-A Ten-Year Single-Center Perspective.

Int J Environ Res Public Health 2019 06 16;16(12). Epub 2019 Jun 16.

Unit of Noninvasive Cardiovascular Diagnostics, Upper Silesian Medical Centre, 40-635 Katowice, Poland.

There is no consensus as to whether the Coronary Artery Calcium Score (CACS) results can affect the therapeutic approach that is selected for coronary artery disease. The aim of this study was to follow patients' management over a period of ten years after application of the CACS. : The research was conducted as a prospective, single-center, long-distance study. In 174 asymptomatic patients (78M; aged 58.9 ± 7.86), a CACS examination using 64-slice computed tomography was performed between 2008 and 2009. The patients were divided into three subgroups according to the CACS results using Agatston Units (AU)-G1: CACS = 0 AU (52 pts); G2: CACS = 1-399 AU (64 pts) and G3: CACS ≥ 400 AU (58 pts). During the ten years of follow-up, the classical cardiovascular risk factors, drugs, diseases, and information about the therapeutic approach that was used (PCI-Percutaneous Coronary Intervention; CABG-Coronary Artery Bypass Graft) were also analyzed. : The average time until a percutaneous intervention (PCI) was 825.2 ± 1111.7 and for CABG, it was 529.0 ± 833.6. PCI was performed in 5.8% (G1), 4.7% (G2) and 32.6% (G3) of the cases, respectively; = 0.0000. CABG was performed in 0% (G1), 1.6% (G2) and 18.9% (G3) of the cases, respectively; 0.0035 Yates. The area under the curve in PCI was 0.783 (95% CI: 0.714-0.841); in CABG, it was 0.825 (95% CI: 0.760-0.878) and the average for both groups was 0.838 (95% CI: 0.774-0.889). : The coronary artery calcium score can potentially help to predict the best therapeutic approach for coronary artery disease in a ten-year perspective.
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http://dx.doi.org/10.3390/ijerph16122132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617306PMC
June 2019

Attitude towards sexuality and sexual behaviors among men with heart rhythm disorders.

Aging Male 2020 Dec 29;23(5):764-769. Epub 2019 Mar 29.

Department of Electrocardiology, Upper Silesian Medical Centre, Katowice, Poland.

Aim: Symptoms of cardiac arrhythmias and the perception of the implantation of a cardiac pacemaker can negatively affect mental health including sexuality and sexual behaviors. The aim of this study was to assess the attitude towards sexuality and sexual behaviors among men with cardiac arrhythmias.

Methods: The study included 80 men (aged 58.6 ± 9.23 years) with heart rhythm disorders who had qualified for cardiac pacemaker implantation. The International Index of Erectile Function IIEF-15 was completed at least one day before cardiac pacemaker implantation by all of the patients.

Results: The average results of the IIEF for all of the included patients was 41.87 ± 7.57 and were statistically worse in the population with atrioventricular blocks (39.60 ± 7.79) compared to those with sinus node dysfunction (44.15 ± 6.71) ( = .0110). The same relationships were found in the subcategory of orgasmic function ( = .0108) as well as intercourse satisfaction ( = .0111). Erectile dysfunction occurred in 88.75% of the patients with diagnosed arrhythmias. There was no statistically significant difference between the occurrence of erectile dysfunction in patients with sinus node dysfunction (87.5%) compared to patients with atrioventricular blocks (90%);  = .7236.

Conclusion: We demonstrated that sexuality and sexual behaviors among men with cardiac arrhythmias was found to be statistically worse in the population with atrioventricular blocks compared to those with sinus node dysfunction. It was especially marked in the area of orgasmic function as well as for intercourse satisfaction.
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http://dx.doi.org/10.1080/13685538.2019.1592152DOI Listing
December 2020

Modified frailty as a novel factor in predicting the response to cardiac resynchronization in the elderly population.

Clin Interv Aging 2019 25;14:437-443. Epub 2019 Feb 25.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland,

Background: The response to cardiac resynchronization therapy (CRT) is an important element of the treatment of advanced heart failure, especially in the geriatric population. The aim of the study was to examine the impact of frailty syndrome on the response to treatment with CRT.

Methods: Two hundred and forty-six patients of 60 years or older (aged 73.35±6.95; 22.4% women) with an implanted CRT were included in this single-center prospective study. There was a 12-month follow-up. The Tilburg Frailty Indicator was used to determine frailty (5 or more points). The response to CRT was evaluated based on an analysis of clinical criteria.

Results: One hundred and sixty-nine of 246 (68.9%) patients were found to be clinical CRT responders. Frailty syndrome was recognized in 173 (70.32%). There were 63.0% responders in the frailty-affected group, whereas there were statistically more responders (79.5%) in the robust group (=0.0116). In the logistic regression, frailty emerged as an independent predictor of the response to CRT (OR=0.81, 95% CI=0.71-0.92; =0.0008). The area under the curve of the ROC curve for frailty in the responders to CRT was 0.62. The cut-off value for a designation of frailty was 6 (=0.0014).

Conclusion: Frailty is a novel independent factor that can be used to predict the clinical response to CRT in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator can improve the prediction of a response to CRT.
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http://dx.doi.org/10.2147/CIA.S193577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394238PMC
April 2019

Heart Failure and Problems with Frailty Syndrome: Why it is Time to Care About Frailty Syndrome in Heart Failure.

Card Fail Rev 2019 Feb;5(1):37-43

Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences Amsterdam, the Netherlands.

Frailty syndrome (FS) is an independent predictor of mortality in cardiovascular disease and is found in 15-74% of patients with heart failure (HF). The syndrome has a complex, multidimensional aetiology and contributes to adverse outcomes. Proper FS diagnosis and treatment determine prognosis and support the evaluation of treatment outcomes. Routine FS assessment for HF patients should be included in daily clinical practice as an important prognostic factor within a holistic process of diagnosis and treatment. Multidisciplinary team members, particularly nurses, play an important role in FS assessment in hospital and primary care settings, and in the home care environment. Raising awareness of concurrent FS in patients with HF patients and promoting targeted interventions may contribute to a decreased risk of adverse events, and a better prognosis and quality of life.
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http://dx.doi.org/10.15420/cfr.2018.37.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396065PMC
February 2019

[Kinesiophobia in patients with cardiovascular disease].

Wiad Lek 2018;71(9):1653-1660

Oddział Elektrokardiologii Górnośląskiego Centrum Medycznego im. Prof. Leszka Gieca Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Polska, Katedra Elektrokardiologii, Klinika Elektrokardiologii i Niewydolności Serca Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Polska.

Objective: Introduction: Kinesiophobia - a fear of physical activity - is a common and worsening rehabilitation outcomes phenomenon in patients with cardiovascular diseases. The aim: To assess the level of kinesiophobia in relation to heart's function evaluated using echocardiography and clinical parameters in patients with cardiovascular disease.

Patients And Methods: Material and methods:101 patients (28 women) aged 61,9±13,56 years and hospitalized for implantation or replacement of a pacemaker or cardioverter-defibrillator were included in the study. Their heart's function and morphology were evaluated echocardiographically. Level of kinesiophobia was evaluated with the Polish version of Tampa Scale of Kinesiophobia Heart (TSK-Heart) questionnaire.

Results: Results: The TSK score in these patients was 41,6±5,39. It's value was increasing with age (p=0,0264), was higher in women than in men (43,5±5,36 vs. 40,8±5,27, p=0,0287) and in patients with coronary artery disease (42,3±6,28 vs. 40,9±4,62, p=0,031). In patients with heart failure, it was decreasing with an increase of body mass index (p=0,0185). Severe mitral insufficiency resulted in higher index value in comparison with moderate or mild one (42,7±4,05 vs. 40,9 ± 5,58, p=0,0369). The TSK index increases with a decrease in tricuspid annular plane systolic excursion (p=0,0033). Patients in NYHA IV class exhibited higher TSK value than those in lower classes (p<0,001). An inverse dependency of TSK index value and hemoglobin level were established (p=0,0041).

Conclusion: Conclusions: In patients with cardiovascular diseases, kinesiophobia has multicausal nature and is higher in NYHA IV patients. The independent predictors of kinesiophobia are right ventricular dysfunction and anemia.
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June 2019

Capability for self-care of patients with heart failure.

Clin Interv Aging 2018 8;13:1919-1927. Epub 2018 Oct 8.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland,

Background: A thorough analysis of the capability for self-care in patients with heart failure (HF) reduces the frequency of hospitalizations that are caused by decompensation. The aim of the study was to assess the effect of the method of therapy for HF, the degree of the acceptance of illness, and the occurrence of frailty syndrome on adherence to the therapeutic recommendations and self-care in patients with HF.

Methods: The study included 180 patients who were hospitalized after being diagnosed with HF. In all, we used the Polish versions of three validated instruments: the nine-item European Heart Failure Self-care Behavior Scale, Illness Acceptance Scale, and The Tilburg Frailty Indicator.

Results: The capability for self-care of patients with HF was 27.8%. More than 65% of the patients followed the recommendations for taking medication and also followed a low-sodium diet, while only 5.5% of the patients followed the recommendations for physical exercise. Positive correlations were found between the capability for self-care and frailty syndrome and its components: general frailty components vs the capability for self-care: =0.4449, =0.0000; physical frailty components vs the capability for self-care: =0.3974, =0.0000; emotional frailty components vs the capability for self-care: =0.2831, =0.0001; social frailty components vs the capability for self-care: =0.2180, =0.0032, and a negative correlation between the capability for self-care and the degree of the acceptance of the illnesses (=-0.4662, =0.0000).

Conclusion: A relatively low capability for self-care was found in patients with HF. The presence of frailty syndrome and a low level of the acceptance of illness are connected with a low capability for self-care.
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http://dx.doi.org/10.2147/CIA.S178393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6183697PMC
December 2018

Visualisation of the oblique vein of the left atrium (vein of Marshall) using cardiac computed tomography: is the game worth the candle?

Kardiol Pol 2018;76(9):1344-1349

Department of Electrocardiology, Upper Silesian Medical Centre, Poland.

Background: The vein of Marshall (VoM) is a small vessel that descends obliquely on the back of the left atrium and ends in the coronary sinus near the area where the great cardiac vein continues into the coronary sinus.

Aim: The aim of the study was to examine the frequency of occurrence and anatomical aspects as well as the possibility of visualising the VoM, including an evaluation of the quality of the visualisation, on computed tomography (CT).

Methods: Three hundred patients aged 58.8 ± 11.5 years (111 women) were included into this single-centre study. Cardiac CT was performed in all patients. The search for the VoM was performed by two experienced researchers using two- and three-dimensional techniques. A dedicated Likert-based scale was used to evaluate the quality of the visualisations.

Results: The VoM was found in 61 (20.33%) of 300 patients. Its average diameter was 1.72 ± 0.69 mm with no sex-related differences (men: 1.71 ± 0.69 mm; women: 1.73 ± 0.57 mm; p = 0.91). The average length of the vessel was 9.24 ± 7.58 mm. The VoM was more frequently (p = 0.01) visualised in the systolic phases (68.85% of cases) compared to the diastolic phases (27.86% of cases). Occasionally it was visualised in other phases (3.29%).

Conclusions: Although it was possible to visualise the VoM using cardiac CT in about 20% of the population, this method of visualisation requires that special attention be paid to the quality of the images, especially in the systolic phases. Visualisation may be useful before certain electrophysiology procedures.
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http://dx.doi.org/10.5603/KP.a2018.0131DOI Listing
December 2018

Frailty as a predictor of negative outcomes after cardiac resynchronization therapy.

Pacing Clin Electrophysiol 2018 06 23;41(6):572-577. Epub 2018 Apr 23.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland.

Aim: To assess the prevalence of frailty among patients who had cardiac resynchronization as well as the influence of frailty on the main endpoints during follow-up.

Methods: The study included 156 patients (aged 74.33 ± 6.75; 27 W) with diagnosed heart failure who were hospitalized for the implantation of a cardiac resynchronization device. The Tilburg Frailty Indicator questionnaire was used to evaluate frailty syndrome.

Results: Frailty syndrome was diagnosed in 75.64% of patients who were included. The average value of frailty for the whole group was 6.21 ± 1.94, for the physical domain 4.29 ± 1.32, for the psychological domain 1.40 ± 1.04, and for the social domain 0.51 ± 0.57. During the follow-up period, 5.7% of the patients died, and the mortality rate was not statistically higher (P  =  0.5795) among patients who were diagnosed with frailty syndrome (6.78%) compared to robust patients (2.63%). Analysis of the complications and first electrical storm episodes demonstrated that these events did not occur in patients with no identifiable frailty syndrome. These occurred at a rate of 4.24% (complications) and 2.54% (electric storm) in patients with frailty syndrome.

Conclusions: Frailty syndrome can be an important predictor of negative outcomes in patients with heart failure who undergo cardiac resynchronizations.
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http://dx.doi.org/10.1111/pace.13329DOI Listing
June 2018

Three-dimensional visualisation of coronary sinus ostium from the inside right atrium perspective.

Kardiol Pol 2018 19;76(3):536-541. Epub 2018 Jan 19.

Department of Electrocardiology, Upper Silesian Medical Centre.

Background: There is no in vivo method of coronary sinus visualisation from the right atrium perspective.

Aim: The objective of the study was to create a cardiac computed tomography (CT) angiography-based method of visualising the coronary sinus ostium and the Thebesian valve from the inside right atrium perspective.

Methods: In 78 consecutive patients, a cardiac CT angiography (Aquilion 64, Toshiba) with retrospective gating (slice 0.5 mm) was performed. Raw data were reconstructed on Vitrea 2 workstations (Vital Images). In order to create the three-dimensional (3D) coronary sinus visualisation from the "inside view" perspective, patented "Fly Through" algorithms were used, and the anatomical positions on the multiplanar reconstruction images were marked. A dedicated, Likert-based five-point scale was developed and used to evaluate the quality of the visualisations.

Results: The average quality of the visualisations of the coronary sinus ostium in two-dimensional multiplanar reconstruction images was good (4.17 ± 0.85 points) and was clinically interpretable in all cases. The image quality of the "inside view" 3D images was 3.61 ± 1.12 points. In 57.7% of cases we obtained high scores (4 and 5 points). The main diameter was 10.72 ± 2.48 mm, and the entrance angle of the coronary sinus into the right atrium was 103.76 ± 10.71°.

Conclusions: Cardiac CT angiography is a useful method that permits the coronary sinus ostium and Thebesian valve to be visualised in vivo from the inside of the right atrium in a comparable manner.
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http://dx.doi.org/10.5603/KP.a2017.0246DOI Listing
November 2018

Anxiety, age, education and activities of daily living as predictive factors of the occurrence of frailty syndrome in patients with heart rhythm disorders.

Aging Ment Health 2018 09 10;22(9):1179-1183. Epub 2017 Jul 10.

b Department of Electrocardiology , Upper Silenian Heart Center , Katowice , Poland.

Objectives: Frailty is one of the geriatric syndromes that are caused by subclinical impairment of many organs, leading to the loss of reserves and the ability to maintain homeostasis. Aim of the study was to assess which factors including anxiety and depression can be predictive factors for the occurrence of frailty syndrome in patients with heart rhythm disorders.

Methods: The study included 171 consecutive patients >64 years (73.91 ± 6.72; 48.5% W) with diagnosed cardiac arrhythmias who had been qualified for pacemaker implantation. The Tilburg Frailty Indicator scale as well as the Hospital Anxiety and Depresion Scale (HADS) were used.

Results: The average HADS results in the frailty group was significantly higher 7.42 ± 2.63 compared to the robust patients 6.33 ± 2.83; p =0.0019. Similar results were observed in patients with atrio-ventricular blocks (AVB): HADS-A: frail 8.23 ± 2.13 vs. robust 6.62 ± 2.27; p = 0.0036 and HADS-D: frail 8.84 ± 2.85 vs. robust 7.17 ± 2.48; p =0.0086. The multiple regression model showed that age (p =0.0023), education (p =0.0001), ADL (p =0.0001) and the severity of the anxiety (p = 0.0414) were important predictors of the dependent variable and predicted higher levels of frailty syndrome.

Conclusion: Anxiety, age, education and the activities of daily living can be predictive factors of the occurrence of frailty syndrome in patients with heart rhythm disorders who have been qualified for pacemaker implantation.
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http://dx.doi.org/10.1080/13607863.2017.1348468DOI Listing
September 2018

Influence of frailty on the quality of life patients qualified for pacemaker implantation.

J Clin Nurs 2018 Feb 17;27(3-4):555-560. Epub 2017 Jul 17.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland.

Aims And Objectives: An important question is whether frailty syndrome affects the assessment of quality of life or whether frailty syndrome may reduce the benefits of a cardiac pacemaker implantation.

Background: Frailty syndrome is known risk factor for quality of life evaluation after selected cardiology invasive procedures.

Design: The study was designed as single-centre prospective study.

Methods: The study included 171 patients aged ≥60 years who were qualified for pacemaker implantation. Quality of life was evaluated twice-before and 6 months after implantation using MLHF questionnaire. A frailty syndrome evaluation using the Tilburg Frailty Indicator (TFI) was performed prior to pacemaker implantation. A DDDR pacemaker was implanted in each patient.

Results: Frailty syndrome was identified in half of the patients with indications for cardiac pacemaker implantation. There was an improvement in quality of life in the six months after pacemaker implantation in all of the robust and frailty syndrome-affected patients that were included into the study-in general, physical and emotional domains.

Conclusion: Implantation of cardiac pacemaker influences the compensation quality of life evaluation in patients with sinus node dysfunction. Presence of frailty influences worse quality of life of patients when evaluated before cardiac pacemaker implantation.

Relevance To Clinical Practice: Frailty should be evaluated in all older patients qualified for pacemaker implantation to evaluate high-risk group, optimise therapeutic approach and to intense education activities for patients and family.
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http://dx.doi.org/10.1111/jocn.13897DOI Listing
February 2018

Older age and a higher EHRA score allow higher levels of frailty syndrome to be predicted in patients with atrial fibrillation.

Aging Male 2017 Mar 12;20(1):23-27. Epub 2016 Nov 12.

c Department of Electrocardiology and Heart Failure , School of Health Sciences, Medical University of Silesia , Katowice , Poland.

Background: There is no research that evaluates the relationship between the severity of the symptoms of atrial fibrillation (AF), the presence of frailty syndrome and acceptance of the illness.

Methods: The study included 132 patients aged 72.7 ± 6.73 with diagnosed AF. The severity of the symptoms of AF was determined according to European Heart Rhythm Association (EHRA) guidelines, frailty syndrome was assessed using the Tilburg frailty indicator (TFI) and the acceptance of the illness was assessed using the acceptance of illness scale (AIS). A standard statistical comparison and multiple regression analysis using the stepwise method were performed.

Results: In patients with AF, frailty was 5.31 ± 2.69 (TFI). Frailty syndrome was diagnosed in 59.8% of the AF patients who had a score of 7.17 ± 1.72. A higher level of EHRA score was connected with a smaller degree of the acceptance of the illness p = 0.0000. The multiple regression model indicated that age (p = 0.0009) and the severity of the symptoms (p = 0.0001) are important predictors of frailty syndrome.

Conclusions: There is a relationship between the presence of frailty syndrome and the intensity of the symptoms and the acceptance of AF. Age and the EHRA score permitted higher levels of frailty syndrome to be predicted.
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http://dx.doi.org/10.1080/13685538.2016.1241761DOI Listing
March 2017

Gender-related differences in coronary venous anatomy: a potential basis for various response to cardiac resynchronisation therapy.

Kardiol Pol 2017 17;75(3):247-254. Epub 2016 Oct 17.

Department of Internal Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland Department of Electrocardiology, Upper Silesian Cardiology Centre, Katowice, Poland.

Background And Aim: We hypothesised that small differences in the anatomy of the coronary venous tree might be one of the factors responsible for the differences in the response for cardiac resynchronisation depending on a patient's gender.

Methods: Cardiac computed tomography scans with retrospective gating were performed on 315 subjects (aged 58.3 ± 11.6 years; 117 women) according to the clinical criteria. The standard protocol for coronary arteries was used during scanning. Additional reconstructions that were focused on the coronary veins during post processing were used to analyse the data. Gender-related anatomical variants were identified.

Results: The average of 3.6 ± 1.4 veins per case were visualised. The posterolateral vein was visualised more frequently in men than in women (p < 0.05). Eight variants were identified as being more frequent - they were found in 237 out of 315 cases (75.24%). Those variants occurred in 95 (81.19%) of the women and in 142 (71.72%) of the men, p = 0.080. Six variants occurred more frequently in women; however, the differences were not significant.

Conclusions: In women a more frequent presence of favourable coronary vein variants in the target area for cardiac resynchronisation can be seen. Anatomical findings may help to explain why women more frequently respond to cardiac resyn-chronisation therapy compared to men.
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http://dx.doi.org/10.5603/KP.a2016.0153DOI Listing
May 2017

Frailty syndrome in patients with heart rhythm disorders.

Geriatr Gerontol Int 2017 Sep 25;17(9):1313-1318. Epub 2016 Aug 25.

Department of Electrocardiology, Upper Silesian Heart Center, Katowice, Poland.

Aim: To assess the prevalence of frailty syndrome in patients with heart rhythm disorders that qualified for pacemaker implantation.

Methods: The study included 171 patients (83 women, aged 73.9 ± 6.7 years) who qualified for pacemaker implantation as a result of sinus node dysfunction (81 patients) or atrio-ventricular blocks (AVB; 90 patients). A total of 60 patients (25 women, aged 72.40 ± 7.09 years) without heart rhythm disorders were included in the control group. Frailty syndrome was diagnosed using the Canadian Study of Health and Aging Clinical Frailty Scale test.

Results: Frailty syndrome was diagnosed in 25.15% of the patients, and pre-frailty in 36.84% of the patients. Frailty syndrome was diagnosed in 10% of the control group, and the average value of frailty was 3.35 ± 0.92. Frailty occurred significantly more often among patients with AVB (33.34%) compared with patients who were diagnosed with sinus node dysfunction (16.05%); P = 0.0081. The average score of frailty for sinus node dysfunction was 3.71 ± 0.89, and for AVB it was 4.14 ± 0.93; P = 0.0152. In the case of AVB, the women had a statistically more intense level of frailty of 4.54 ± 0.90 as compared with the men 3.87 ± 0.85; P = 0.0294. In the multiple logistic analysis, the presence of any arrhythmia was strongly associated with frailty syndrome (OR 2.1286, 95% CI 1.4594 - 3.1049; P = 0.0001).

Conclusions: Frailty syndrome was diagnosed in one-quarter of patients with cardiac arrhythmias, whereas a further 40% were at a higher risk of frailty syndrome, and its occurrence was significantly higher if compared with the control group. Frailty occurred significantly more often among patients with atrio-ventricular blocks, especially in women. The results of the present research showed that there is a statistical association between frailty and arrhythmias. Geriatr Gerontol Int 2017; 17: 1313-1318.
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http://dx.doi.org/10.1111/ggi.12868DOI Listing
September 2017

Variation in Cardiac Vein System is Associated with Coronary Artery Calcium - A Venous-Atherosclerosis Paradox?

Acta Cardiol Sin 2015 Nov;31(6):536-42

Unit of Noninvasive Cardiovascular Diagnostics, Upper Silesian Medical Centre; ; 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland.

Background: The factors that determine the different patterns of venous anatomy are not well understood. This study was designed to evaluate the relationship between variation in the cardiac vein system and the extent of coronary artery calcium score (CACS).

Methods: We reviewed the results of 64-slice CTs of 226 subjects (age 57.2 ± 11.2; 133M) enrolled in our study. The subjects were divided into 3 groups based on coronary artery calcium: 92 patients. with CACS = 0 AU (Agatston Unit, AU); 56 with CACS = 1-100 AU; and 78 patients with CACS > than 100 AU. The cardiac venous system was reconstructed during the optimal phase of the cardiac cycle in each subject.

Results: Subjects with a higher CACS had a better quality of vein images (p < 0.01). The number of visible veins differed between the groups. Eight subjects (8.7%) in the group with CACS = 0 AU, 7 (12.5%) in the group with CACS = 1-100 AU, and 23 (29.5%) in the group with CACS > 100 AU had five or more visible veins (p < 0.001), whereas the proportion of subjects with less than three visible veins was 56 (60.8%), 31 (55.4%) and 30 (38.4%), respectively (p < 0.05). The number of visible veins correlated with CACS (r = 0.28; p < 0.05). In a multivariate regression analysis, which included age, gender, CACS, LV ejection fraction, myocardial volume and heart rate, the CACS was found to be an independent determinant of the number of visible veins (p < 0.05).

Conclusions: The results of our study suggested that there is a link between a variation in the cardiac venous system and the extent of atherosclerosis.

Key Words: Coronary artery calcium score (CACS); Computed tomography; Coronary veins.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804979PMC
http://dx.doi.org/10.6515/acs20150204bDOI Listing
November 2015

Frailty Syndrome in Heart Failure Patients who are Receiving Cardiac Resynchronization.

Pacing Clin Electrophysiol 2016 Apr 21;39(4):370-4. Epub 2016 Jan 21.

Department of Electrocardiology, Upper Silesian Heart Centre, Katowice, Poland.

Background: We hypothesized that patients with de novo cardiac resynchronization therapy (CRT) implantation had a more intense frailty syndrome when compared to the patients who qualified for a system upgrade.

Methods: One hundred and six patients aged ≥65 years were included. They were divided into two groups: de novo CRT implantation--74 patients and upgrade from standard right heart pacing--32 patients. A CRT was finally implanted in all of the patients. Frailty was evaluated using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS).

Results: The average results in CSHA-CFS were statistically higher (5.3 ± 0.8) in the de novo patients when compared to the patients who qualified for a system upgrade (4.9 ± 0.8); P = 0.027. Frailty syndrome was recognized in 81.1% of the patients in the de novo group and in 68.7% of the patients in the upgrade group; P = 0.164. Only one patient of the 106 had no attributes of frailty (or exposed ones) syndrome.

Conclusions: Frailty syndrome is a common phenomenon in patients with heart failure and over 65 years of age. The syndrome is most often recognized in patients who are de novo qualified for cardiac resynchronization.
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http://dx.doi.org/10.1111/pace.12800DOI Listing
April 2016