Publications by authors named "Danuta Loboda"

4 Publications

  • Page 1 of 1

The beneficial impact of cardiac rehabilitation on obstructive sleep apnea in patients with coronary artery disease.

J Clin Sleep Med 2021 Mar;17(3):403-412

Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.

Study Objectives: To assess the impact of cardiac rehabilitation for decreasing sleep-disordered breathing in patients with coronary artery disease.

Methods: The study included 121 patients aged 60.01 ± 10.08 years, 101 of whom were men, with an increased pretest probability of OSA. The cardiac rehabilitation program lasted 21-25 days. The improvement in cardiorespiratory fitness was assessed using the changes in peak metabolic equivalents, the maximal heart rate achieved, the proportion of the age- and sex-predicted maximal heart rate, and the Six-Minute Walk Test distance. Level 3 portable sleep tests with respiratory event index assessments were performed in 113 patients on admission and discharge.

Results: Increases were achieved in metabolic equivalents (Δ1.20; 95% confidence interval [CI], 0.95-1.40; P < .0001), maximal heart rate (-Δ7.5 beats per minute; 95% CI, 5.00-10.50; P < .0001), proportion of age- and sex-predicted maximal heart rate (Δ5.50%; 95% CI, 4.00-7.50; P < .0001), and the Six-Minute Walk Test distance (Δ91.00 m; 95% CI, 62.50-120.00; P < .0001). Sleep-disordered breathing was diagnosed in 94 (83.19%) patients: moderate in 28 (24.8%) patients and severe in 27 (23.9%) patients, with a respiratory event index of 19.75 (interquartile range, 17.20-24.00) and 47.50 (interquartile range, 35.96-56.78), respectively. OSA was dominant in 90.40% of patients. The respiratory event index reduction achieved in the sleep-disordered breathing group was -Δ3.65 (95% CI, -6.30 to -1.25; P = .003) and was in parallel to the improvement in cardiorespiratory fitness in the subgroups with the highest effort load and with severe sleep-disordered breathing: -Δ6.40 (95% CI, -11.40 to -1.90; P = .03) and -Δ11.00 (95% CI, -18.65 to -4.40; P = .003), respectively.

Conclusions: High-intensity exercise training during cardiac rehabilitation resulted in a significant decrease in OSA, when severe, in parallel with an improvement in cardiorespiratory fitness in patients with coronary artery disease.
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http://dx.doi.org/10.5664/jcsm.8900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927323PMC
March 2021

Survival of patients with pacing-induced cardiomyopathy upgraded to CRT does not depend on defibrillation therapy.

Pacing Clin Electrophysiol 2020 05 15;43(5):471-478. Epub 2020 Apr 15.

Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.

Background: Permanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing-induced cardiomyopathy (PICM) if upgraded to CRT.

Methods: One hundred fifteen patients, 75.0 years old (IQR 67.0-80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long-term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the National Health System.

Results: The prior percentage of RVP was 100.0% (IQR 97.0-100.0), with a QRS duration of 180.0 ms (IQR 160.0-200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0-32.75). The mean follow-up was 980 ± 522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age > 82 years (HR 5.96; 95% CI 2.24-15.89; P = .0004) and pre-CRT implantation LVEF < 20% (HR 5.63; 95%CI 2.19-14.47; P = .0003), but neither the cardioverter-defibrillator (ICD) implantation (HR 1.00; 95%CI 0.45-2.22; P = 1.00), nor the presence of atrial fibrillation (HR 1.22; 95%CI 0.56-2.64; P = .62), were independently associated with all-cause mortality.

Conclusion: Advanced age and an extremely low LVEF, but neither the presence of atrial fibrillation nor implanting an additional high voltage lead, influence the all-cause mortality in patients after long-term RVP, when upgraded to CRT.
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http://dx.doi.org/10.1111/pace.13906DOI Listing
May 2020

[How to avoid cardiovascular consequences of the obstructive sleep apnea syndrome?]

Wiad Lek 2018;71(6):1254-1261

1 Oddział Elektrokardiologii, Górnośląskie Centrum Medyczne Im. Prof. Leszka Gieca Śląskiego Uniwersytetu Medycznego W Katowicach, Katowice, Polska, Klinika Elektrokardiologii I Niewydolności Serca Śląskiego Uniwersytetu Medycznego W Katowicach, Katowice, Polska.

Obstructive sleep apnea syndrome (OSAS) is caused by periodical upper airway occlusion during sleep resulting in snoring, episodes of apnea and excessive daytime sleepiness. OSAS is a risk factor for hypertension, arrhythmias, conduction disorders as well as stroke, coronary artery disease, chronic heart failure and pulmonary hypertension. Early polygraphy and polysomnography and continuous positive airway pressure (CPAP) treatment reduce risks of cardiovascular diseases (CVD) in patients with OSAS.
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June 2019

[Diagnostics enigma: left ventricular noncompaction or systemic right ventricle?]

Wiad Lek 2015 ;68(3 pt 2):410-412

Klinika Elektrokardiologii i Niewydolności Serca Wydziału Nauk o Zdrowiu Śląskiego Uniwersytetu Medycznego, Katowice.

A case of congenitally corrected transposition of great arteries, a rare congenital heart defect diagnosed in an adult is presented and difficulties in differential diagnosis of congenital heart defects in the adults are described. The crucial point is proper interpretation of the echocardiography examination.
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January 2015