Publications by authors named "Maciej Sosnowski"

58 Publications

Microbiological Safety of Food of Animal Origin from Organic Farms.

J Vet Res 2021 Mar 9;65(1):87-92. Epub 2021 Mar 9.

Department of Hygiene of Food of Animal Origin National Veterinary Research Institute, 24-100 Puławy, Poland.

The organic food sector and consumer interest in organic products are growing continuously. The safety and quality of such products must be at least equal to those of conventional equivalents, but attaining the same standards requires overcoming a particular problem identified in organic food production systems: the occurrence of bacterial pathogens such as , , , and pathogenic . These food-borne microorganisms were detected in the production environments of such food. The prevalence of pathogenic bacteria in organic livestock and products may be higher, but may also be the same as or lower than in like material from conventional farms. Furthermore, the incidence of antimicrobial-resistant bacteria was more often detected in conventional than in organic production. The aim of this review was to present the recent information on the microbiological safety of food of animal origin produced from raw materials from organic farms.
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http://dx.doi.org/10.2478/jvetres-2021-0015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009579PMC
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

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

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

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

Antimicrobial resistance and genotypic characteristics of Listeria monocytogenes isolated from food in Poland.

Int J Food Microbiol 2019 Jan 31;289:1-6. Epub 2018 Aug 31.

Department of Hygiene of Food of Animal Origin, National Veterinary Research Institute, Partyzantow 57, 24-100 Pulawy, Poland.

The aim of the study was to determine antimicrobial resistance and genotypic characteristics of L. monocytogenes isolated from food of animal origin from different parts of Poland during years 2013-2016. A total of 146 isolates were tested using a microbroth dilution method, whereas virulence genes and molecular serogroups were identified by PCR. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) methods were used to analyze the genotypic relationship of the strains. Altogether, 102 pulsotypes grouped into 7 clusters and 24 sequence types, including 3 new types, were identified. Most of the strains clustered into individual patterns were originated from different food products and were isolated in different geographical regions at various time. L. monocytogenes was mostly resistant to oxacilin (90.4% strains), clindamycin (54.1%) and ceftriaxone (49.3%). A multiresistance patterns, mainly to ceftriaxone, oxacillin together with other antimicrobials, were observed among 27.4% strains. Antimicrobial resistance and presence of virulence genes suggest that food of animal origin contaminated with L. monocytogenes may present a risk for public health.
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http://dx.doi.org/10.1016/j.ijfoodmicro.2018.08.029DOI Listing
January 2019

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

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

Prognostic value of coronary artery calcium score in patients with symptoms suggestive of coronary artery disease. Results from the Silesian Calcium Score (SILICAS) study.

Pol Arch Med Wewn 2016 Jun 20;126(6):395-401. Epub 2016 Jun 20.

INTRODUCTION    The prognostic value of coronary artery calcium score (CACS) in symptomatic patients with a suspicion of coronary artery disease (CAD) has been poorly defined. OBJECTIVES    The aim of the study was to assess the predictive value of the CACS in the incidence of major adverse coronary events (MACEs) in patients with an intermediate probability of CAD and establish its usefulness as the first-line risk assessment tool. PATIENTS AND METHODS    This single-center, observational, prospective study enrolled consecutive symptomatic patients without a previous diagnosis of CAD, referred to our center for CACS assessment with non-contrast-enhanced cardiac computed tomography (CT). CACS measurements were performed using an electrocardiogram-gated 64-row CT scanner. The CACS measurement was treated as the first‑line noninvasive test. Patients with positive CACS values were divided into 4 subgroups: <100 Agatston units (AU), 100 to 399 AU; 400 to 999 AU; and ≥1000 AU. The incidence of MACEs was analyzed in 2 ways: negative versus positive CACS and by the CACS subgroups. RESULTS    We included 588 patients (mean age, 61.1 ±9.7 years; women, 64%). The median follow-up period was 707 days. There were 239 patients (49.3%) with no coronary calcium. In these patients, no MACEs were observed, while in those with positive CACS values, they occurred in 108 patients (30.9%) (P <0.001). The incidence of MACEs was dependent on the CACS values, reaching 91% in those with a CACS of 1000 or higher AU. CONCLUSIONS    In selected symptomatic patients with an intermediate probability of CAD, the CACS measurement may be used as the first-line test to assess the risk of MACEs.
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http://dx.doi.org/10.20452/pamw.3443DOI Listing
June 2016

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

The Thebesian valve and coronary sinus in cardiac magnetic resonance.

J Interv Card Electrophysiol 2015 Aug 12;43(2):197-203. Epub 2015 Apr 12.

Department of Electrocardiology, Upper Silesian Heart Centre, Ziolowa 45/47, 40-635, Katowice, Poland,

Purpose: There is no complex research exploring usefulness of cardiac magnetic resonance in the evaluation of the coronary sinus including Thebesian valve, which can be useful before selected electrophysiology procedures.

Methods: One hundred twenty-two patients aged 49.2 ± 17.2 (42 women) were included in the study; 4 of them were excluded. A steady-state free-precession (SSFP) sequence was the basis of the visualization and analysis of the coronary sinus as well as Thebesian valve. In selected cases, dedicated coronary sinus sequences were created. All data were evaluated by experienced cardiac magnetic resonance investigators.

Results: We were able to visualize the coronary sinus by using basic SSFP sequence in all patients, however in four cases in suboptimal quality. Average length of the coronary sinus was 39.73 ± 16.9 mm, average diameter was 9.81 ± 9.3 mm, and average angle of the entrance of the coronary sinus into the right atrium was 111.37 ± 13.8°. The Thebesian valve as the gate of the coronary sinus was found in 56 cases (45.9%). In 21 patients (17.2% of all), the valve was porous or almost totally covered the coronary sinus ostium, which can potentially create problems during CS cannulation.

Conclusions: In most of the cases, it is possible to visualize and measure the coronary sinus using cardiac magnetic resonance with SSFP sequence. In selected cases, it is necessary to perform additional dedicated short sequences. Thebesian valve was visualized in almost 50% of patients.
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http://dx.doi.org/10.1007/s10840-015-9994-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486412PMC
August 2015

Coronary venous system in cardiac computer tomography: Visualization, classification and role.

World J Radiol 2014 Jul;6(7):399-408

Rafal Mlynarski, Agnieszka Mlynarska, Maciej Sosnowski, Unit of Noninvasive Cardiovascular Diagnostics, Medical University of Silesia, Upper-Silesian Cardiology Center, Katowice 40-635, Poland.

The role of the coronary venous system was underestimated for many years. In the last 20 years, a few percutaneous cardiology techniques in which the anatomy of the coronary venous system was significant were developed and are in use. The most important seems to be cardiac resynchronization therapy, which is an invasive method for the treatment of heart failure. Unfortunately, one of the major problems is the significant anatomical variability of the coronary venous system. The description of the selected anatomical structures is only useful in selected cases such as, for example, the obstruction of selected vessels, a huge Thebesian valve, etc. The 3D images can add significant value; however, their usefulness is limited due to the different points of view that are obtained during intra-operational fluoroscopy. After summarizing all of the articles and guidelines, it can be recommended that the visualization of the coronary venous system be performed in certain patients before cardiac resynchronization. The best option is to use tomography with retrospective gating with the optimal reconstruction of cardiac veins that occurs during the diastolic phases.
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http://dx.doi.org/10.4329/wjr.v6.i7.399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4109091PMC
July 2014

Effect of coronary artery calcium score on the reduction of global cardiovascular risk.

Pol Arch Med Wewn 2014 24;124(3):88-96. Epub 2014 Jan 24.

Introduction: There are no studies evaluating an association between different coronary artery calcium scores (CACS) and reduction of traditional cardiovascular risk.

Objectives: The aim of the study was to evaluate the effect of coronary calcium scoring on the reduction of global cardiovascular risk.

Patients And Methods: This was a prospective single-center study including 180 subjects (mean age, 58.8 years). Calcifications on computed tomography were calculated by 2 experts using the Agatston scale. Selected cardiovascular risk factors and medical procedures used in subjects were analyzed.

Results: Invasive coronary angiography was performed in 60 patients (33.2%). It did not show significant coronary lesions in 26 patients (43.3%), while in the other 26 patients (43.3%), coronary angioplasty (stent implantation, balloon angioplasty) was performed. Eight subjects (13.3%) were referred for coronary artery bypass grafting (CABG), and the procedure was performed only in patients with a CACS of 400 AU and higher. Angioplasty was performed 10 times more often in these patients compared with patients with a CACS of 1 to 399 AU. A significant correlation between the CACS and cardiovascular risk was observed in relation to age, weight, and systolic and diastolic blood pressure.

Conclusions: Coronary calcium scoring allows to identify patients requiring invasive coronary angioplasty, or, in some cases, CABG, with greater precision. This can strengthen the role of the CACS as a complement to a classic evaluation of cardiovascular risk factors.
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http://dx.doi.org/10.20452/pamw.2130DOI Listing
November 2014

Every patient with atrial fibrillation has his (her) own optimal heart rate.

Med Hypotheses 2013 Dec 21;81(6):972-5. Epub 2013 Sep 21.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Heart rate control is an important part of atrial fibrillation (AF) treatment and the recommendation for the target rate has become lenient in the recent guideline. Since heart rhythm of AF patients is irregularly irregular with great rate variation, the number of effective ventricular contractions may be different within a given time period among patients with similar heart rates and it may further lead to different levels of cardiac output. Therefore, we propose that every AF patient has his (her) own optimal heart rate, or to say that, the target for rate control in each AF patient should be individualized. This optimal heart rate can be defined by pulse counting, echocardiography or cardiopulmonary exercise test. With this new target, patients will achieve higher cardiac output with better exercise tolerance and life quality, even an improved prognosis.
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http://dx.doi.org/10.1016/j.mehy.2013.09.002DOI Listing
December 2013

Traditional, forgotten and new left ventricular systolic function parameters on a 64-row multidetector cardiac computed tomography: a reproducibility study.

Cardiol J 2013 ;20(4):385-93

Unit for Noninvasive Cardiovascular Diagnostics, 3rd Chair of Cardiology, Medical University of Silesia, Katowice, Poland.

Background: Multidetector computed tomography angiography (MDCT) can provide data regarding cardiac function if a retrospective scanning is applied. We aimed at examination of the reproducibility of traditional and more sensitive parameters of the left ventricular (LV) contractility by means of a 64-row CT in order to establish errors of measurement and to determine limits that allow for a reliable detection of their changes.

Methods And Results: A random sample of 25 individuals, including 15 females (aged 64 ± 13 years) and 10 males (54 ± 13 years), who had MDCT examination were retrospectively included in this study. Data reconstructions were performed on a dedicated workstation. In each case, axial image series were created with a 10% step from 0% to 90% of the RR interval using a 2 mm slice thickness. LV volume was determined in each phase. Detailed LV volume changes within phases were analyzed to determine the largest difference between the neighbor phases (peak ejection volume, PEV, mL) during systole and to calculate the peak ejection rate (PER i.e. PEV/phase duration [1/10th of RR interval], mL/s). The derived parameters were calculated as the PER normalized for LVEDV (PER-V, 1/s), the PER normalized for LVM (PER-M, mL/g × s) and the PER normalized for LVEDV times the PER normalized for LVM product (PER-VM, ml/g × s2). Considering the errors percentages, the respective values for intra- and inter-observer errors were around 5% and 8% for standard LV systolic measures. The percentage intra-observer errors' ranged between -7.8% and -10.8%, and the inter-observer errors' ranged between -11.8% and -15.7% for both PEV and PER. For the same reader, the percentage errors ranged between -8.7% and +11.9% for PER-V, -10% and +12.7% for PER-M and -18.2% and +24% for PER-VM. For the independent reader the corresponding values were -15.2% and +15.5%, -12.3% and +16.3%, and -26.6% and +30.9%. The intra- -class coeffi cients for repeated measurements for both the same reader (intra-observer) or independent reader (inter-observer) did reach values above 0.9 and around 0.8, respectively.

Conclusions: We concluded that traditional LV systolic parameters, as well as more sensitive measures of cardiac contractility could be determined reliably by means of a 64-row MDCT. The errors for global LV systolic function measures amount to about 5%, for PEV and PER about 15% and for the PER-derived parameters about 25%. The measurement errors established might help to assess the signifi cance of changes in repeated MDCT examinations.
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http://dx.doi.org/10.5603/CJ.2013.0097DOI Listing
August 2014

Anatomical variants of left circumflex artery, coronary sinus and mitral valve can determine safety of percutaneous mitral annuloplasty.

Cardiol J 2013 ;20(3):235-40

Background: The anatomical variants of the relations of the left circumflex artery (LCx) andthe coronary sinus (CS) determine the safety of percutaneous mitral annuloplasty (PMA) as an occlusion of the LCx and its consequences might occur in some cases. Thus, knowledge ofthe anatomy of cardiac anatomy and any variations are important for surgeons.

Methods: In 320 (126 women, age 59 ± 11) patients, a 64-slice computed tomography (MSCT) (Aquilion 64) was performed due to a suspicion of coronary artery disease. A scanwith ECG-gating was performed using a slice thickness of 0.5 mm during a breath-hold. The helical pitch was 12.8, rotation time: 0.4 s and average tube voltage: 135 kV at 380 mA.100 mL of non-ionic contrast agent was given in three phases at an average rate of 4.5 mL/s.In each case, ten 3D volume rendering and 2D multiplanar reconstructions of the vessels were created (Vitrea 2).

Results: The CS was visualized in all cases and the LCx in 315 (98.4%). In 302 (95.8%)cases, the CS was the dominant vessel; in 10 (3.17%) cases both vessels were equal and the LCxwas dominant in only 3 (0.9%) cases. 52 anatomical variants were identified; 3 of them werethe most common (in 164/315 cases; 50.8%). The CS usually lies above the atrioventricular(AV) sulcus (239-75.9%) and the LCx within the AV sulcus (173-54.9%). In 235 (74.6%)cases, the LCx was closer (than the CS) to the mitral valve. It was found that in 78 (24.7%) cases, the LCx was beneath the CS in selected phases (a risk of LCx occlusion by a PMA device).The LCx closer to the mitral valve, which is considered as a safe feature for PMA, was observed in only 75 (23.8%) of the cases. The most dangerous pattern was found in 19 cases(6.1%) - 2 or 3 CS/LCx crosses.

Conclusions: The huge anatomical variability of the anatomy of the CS/LCx strengthens the role of MSCT before PMA implantation.
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http://dx.doi.org/10.5603/CJ.2013.0067DOI Listing
August 2014

Can multi-slice computed tomography of the heart be useful in patients with epicardial leads?

Cardiol J 2013 ;20(1):87-9

New visualization methods are helpful in the noninvasive diagnosis of heart diseases. However, sometimes epicardial and endocardial leads can cause problems due to a large number of artifacts. Based on the presented case, we conclude that it is possible to perform multi-slice computed tomography of coronary arteries despite the coexistence of transvenous and epicardial leads.
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http://dx.doi.org/10.5603/CJ.2013.0014DOI Listing
August 2014

The influence of oral water load on energy expenditure and sympatho-vagal balance in obese and normal weight women.

Arch Med Sci 2012 Dec 19;8(6):1003-8. Epub 2012 Dec 19.

Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.

Introduction: Oral water load may increase the energy expenditure (EE) by stimulation of sympathetic dependent thermogenesis. Thus, drinking of water may be helpful in weight reduction. The aim of the study is to assess the influence of water load on energy expenditure and sympathetic activity in obese and normal weight women.

Material And Methods: Forty-five women were included. Energy expenditure was measured twice, in the morning and after oral water load, by the indirect calorimetric method. The heart rate variability parameters low frequency (LF), high frequency (HF), LF/HF index, standard deviation of normal RR intervals (SDNN) and root mean square difference among successive RR normal intervals (rMSSD) were used for the indirect assessment of the sympatho-vagal balance.

Results: Resting energy expenditure (REE) was significantly higher in obese than in normal weight women (1529 ±396 kcal/day vs. 1198 ±373 kcal/day; p = 0.02). In both study groups after water load EE increased significantly (by 20% and by 12%, corresponding to 8.6 kcal/h and 5.2 kcal/h respectively), while, LF/HF index increased simultaneously. The increase of energy expenditure (EE) did not exceed the energetic cost of water heating, from room to body temperature - 15 kcal/1000 ml. There was no correlation between changes of energy expenditure (EE) and heart rate variability (HRV) parameters.

Conclusions: The increase of EE induced by water load is mostly related to the heating of the consumed water to body temperature. The assessment of autonomic balance by means of standard HRV indices had been found insufficient for detection of actually operating mechanisms.
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http://dx.doi.org/10.5114/aoms.2012.32406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542490PMC
December 2012

Coronary artery calcium in type 2 diabetes: a nested case‑control study.

Pol Arch Med Wewn 2013 20;123(1-2):38-44. Epub 2012 Nov 20.

3rd Division of Cardiology, 3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland.

Introduction: The use of classic risk scores in patients with type 2 diabetes have numerous limitations. Relationships between coronary artery calcium score (CACS) and traditional risk factors are derived from statistical analyses. At present, there are no data on the evaluation of the CACS on 64‑slice multi-detector computed tomography in patients with type 2 diabetes and ischemic symptoms based on a head‑to‑head comparison with matched nondiabetics.

Objectives: We aimed to examine the associations between traditional risk factors and the CACS in a nested case‑control study.

Patients And Methods: We performed a retrospective analysis of data from 2482 consecutive symptomatic subjects with known CACS. We identified 325 patients with type 2 diabetes. From the remaining subjects, 325 controls matched for age, sex, and risk factors were selected.

Results:  Higher CACS values were observed in patients with diabetes (median, 50 Agatston units [AU]; range, 0-4330) compared with nondiabetic controls (9 AU, 0-3036, P <0.001). Positive CACS values were more common in diabetic patients (73.5%) compared with nondiabetic controls (60.9%, P <0.001). The highest CACS value was observed in men (95.5 AU, 0-3755). The median CACS value in nondiabetic men was comparable to those in diabetic women (24.5 AU, 0-3036 vs. 24.5 AU, 0-3755). The lowest CACS values were observed in control women (3 AU, 0-2144). Coronary artery calcium was more diffused in diabetic patients compared with controls (P <0.01). A multivariate analysis showed that older age and male sex were independent predictors of the CACS. Traditional risk factors accounted only for 10% of interindividual variance in the presence of calcified atherosclerotic plaques.

Conclusions: Coronary calcified lesions are more frequent in symptomatic patients with type 2 diabetes compared with matched nondiabetic subjects. Our results seem to provide evidence that traditional risk factors do not explain more common, diffuse, and extensive calcified lesions in diabetic subjects.
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http://dx.doi.org/10.20452/pamw.1589DOI Listing
January 2014

Association between changes in coronary artery circulation and cardiac venous retention: a lesson from cardiac computed tomography.

Int J Cardiovasc Imaging 2013 Apr 18;29(4):885-90. Epub 2012 Oct 18.

Department of Electrocardiology, Upper-Silesian Medical Centre, ul Ziolowa 45/47, 40-635 Katowice, Poland.

To use computed tomography (CT) image data to measure a potential association between the implantation of coronary artery bypass grafts (CABG) and changes in the coronary venous system has not yet been examined. In 112 (aged 59.4 ± 9.0; 45F) patients (pts.), a 64-slice CT angiography was performed. Patients were divided into 2 groups: CABG (56 pts.) and control (56 pts.)--without changes in coronaries. In each case, ten multi-planar reconstructions (MPR) and 3D volume rendering reconstructions using a 2 mm layer with ECG-gating, helical pitch: 12.8; rotation time: 0.4 s and average tube voltage: 135 kV at 380 mA. The visualization of the coronary veins was independently graded by 2 experts trained in CT. In the CABG group, the average number of visible coronary veins was 5.3 ± 1.3, while in the control group it was 3.1 ± 1.1 (p < 0.001). Statistical differences were also observed for the following coronary veins: posterolateral (control 2.1 ± 1.9 vs. CABG 2.9 ± 1.9; p < 0.05), lateral (control 2.2 ± 1.7 vs. CABG 3.1 ± 1.3; p < 0.01) and anterolateral (control 0.5 ± 0.9 vs. CABG 1.3 ± 1.0; p < 0.001). Implantation of CABG influences the coronary venous system. In patients after CABG, the number of identifiable coronary veins is significantly higher as compared to that in subjects without changes in coronaries. This might suggest an association between changes in coronary artery circulation and cardiac venous retention.
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http://dx.doi.org/10.1007/s10554-012-0139-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644407PMC
April 2013

Optimal visualization of heart vessels before percutaneous mitral annuloplasty.

Cardiol J 2012 ;19(5):459-65

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

Background: Multi-slice computed tomography (MSCT) can be useful before percutaneous mitral annuloplasty (PMA) procedures to visualize the relations between the mitral valve (MV), left circumflex artery (LCx) and coronary sinus (CS).

Methods And Results: We performed a 64-slice MSCT in 196 patients (109 male; age 56.6 ± 11.4) with suspected coronary artery disease. A retrospective scan with ECG-gating was performed in each. In each case 3D VR and 2D MPR reconstructions were created. We used a subjective assessment of the quality of visualization to find the optimal phases of visualization for LCx, CS and both vessels together (relations). The quality of visualization were graded by 2 experts on 6-points scale. LCx was usually optimally visualized in the diastolic phases (70-80-90%) - 126/196 (64.3%). CS was usually optimally visualized in the systolic phases (30-40-50%) - 177/196 (90.3%). The optimal phase for parallel visualization of LCx/CS (to observe anatomical relations) was 70-80% - 140/196 (71.4%). Good quality visualization was obtained for both vessels: LCx: 3.6 ± 1.4/CS: 4.1 ± 1.1.

Conclusions: Reconstructions of parallel visualization of LCx/CS for PMA procedures to observe the relations between those vessels should be considered during diastole. In addition, independent reconstructions should also be performed optimized for the LCx and the CS.
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http://dx.doi.org/10.5603/cj.2012.0085DOI Listing
March 2013

Coronary venous retention-a feature in heart failure as evidenced by mean of cardiac computed tomography.

Pacing Clin Electrophysiol 2012 Dec 4;35(12):1472-9. Epub 2012 Oct 4.

Department of Electrocardiology, Upper-Silesian Medical Center, Katowice, Poland.

Background: Whether the functional status of the heart can influence the coronary venous system itself has not yet been examined. In order to answer this question, we used multislice computed tomography (CT) imaging.

Purpose: To answer the question of whether the heart failure (HF) is associated with significant anatomical changes in the coronary venous system?

Methods: In 136 (aged 56.6 ± 11.5) patients, a 64-slice CT was performed. Patients were divided into three groups according their ejection fraction. In each case, nine 3D volume rendering reconstructions, using a 2-mm layer with electrocardiographic-gating, were created at 0% to 90% R-R intervals (step 10%). The visualization of coronary veins (CVs) was graded independently by two experts trained in multislice computed tomography on a 0-5 point scale (0-not visible/lack of vein; 5-smoothly bordered vascular structure).

Results: The average number of visible CVs per case was 3.44 in the HF group and 2.72 in patients with a normal ejection fraction (P = 0.0246). The statistical correlation between a reduction in ejection fraction and the increase in the number of veins was found (r =-0.2446, P < 0.05). For two of seven common variants of the coronary venous system at least two target veins (posterolateral and lateral) for cardiac resynchronization were presented.

Conclusions: The statistically higher number of veins in patients with heart failure may suggest an association between a failing heart and cardiac venous retention.
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http://dx.doi.org/10.1111/pace.12000DOI Listing
December 2012

Complete percutaneous obliteration of a post-infarction left ventricular inferior wall pseudoaneurysm.

JACC Cardiovasc Interv 2012 Aug;5(8):886-7

Structural Heart Diseases Department, Upper Silesian Medical Center, Katowice, Poland.

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http://dx.doi.org/10.1016/j.jcin.2012.02.022DOI Listing
August 2012

Traditional risk factors and coronary artery calcium in young adults.

Cardiol J 2012 ;19(4):402-7

Unit of Noninvasive Cardiovascular Diagnostics, 3rd Chair of Cardiology, Medical University of Silesia, Katowice, Poland.

Background And Methods: 362 symptomatic subjects of 45 years of age or younger were selected from a large database of around 4100 persons who underwent coronary artery calcium (CAC) scoring by means of a 64-multidetector computed tomography (MDCT). Amongst them, a group with the CAC > 0 Agatston units (n = 65) and a group with no detectable calcium (CAC = 0, n = 297) were compared in terms of risk factors presence. Risk factors considered were gender, body mass index, smoking habits, blood pressure level, blood lipids, presence of diabetes mellitus, family history of cardiovascular disease, and physical activity.

Results: The vast majority of subjects with a positive CAC were males (54, 83.1%) compared to those with a negative CAC (147, 49.5%, p < 0.001, χ2). More frequent results of CAC < 0 were observed in obese subjects (38.5% vs. 24.2%, p < 0.05), among smokers (41.5% vs. 27.6%, p < 0.05). Presence of arterial hypertension coexisted with a more frequent CAC > 0 (76.9% vs. 60.6%, p < 0.05). Also, the frequency of a positive CAC was significantly higher in patients with diabetes mellitus (10.8%), compared to those without diabetes mellitus (4.0%, p < 0.05). Effects of high lipids, family history, and physical activity were not observed. Accumulation of at least 4 risk factors was associated with more frequent positive CAC (26.0 vs. 15.9%, p < 0.05). Multivariate regression analysis showed that only male gender and presence of diabetes mellitus were independent predictors of a positive CAC in younger subjects (F = 5.06, p < 0.001, multiple R = 0.321).

Conclusions: Traditional risk factors, apart from gender and diabetes mellitus, do not seem to allow for distinguishing young persons with a premature coronary atherosclerosis. Therefore, CAC scoring might be considered justified in symptomatic young men with diabetes mellitus.
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http://dx.doi.org/10.5603/cj.2012.0072DOI Listing
December 2012

The new oral adenosine A1 receptor agonist capadenoson in male patients with stable angina.

Clin Res Cardiol 2012 Jul 28;101(7):585-91. Epub 2012 Feb 28.

Third Division of Cardiology, Medical University of Silesia, Katowice, Poland.

Background: Anti-ischaemic effect of A1 adenosine receptor agonists was shown in animal and preclinical studies. The present proof-of-concept study aimed at evaluation of the efficacy and safety of a new adenosine A1 receptor agonist capadenoson in patients with stable angina.

Methods: This was a randomized, double-blind, placebo-controlled, single dose-escalating, multicenter trial comparing the effect of capadenoson at 1, 2.5, 5, 10, and 20 mg versus placebo. For each dose step patients were randomized to receive single doses of either capadenoson or matching placebo in a 5:1 ratio. The primary efficacy variable was the absolute difference in heart rate (HR) at maximum comparable level of workload between baseline and post dose exercise tolerance test at maximum concentration of capadenoson. Capadenoson effect on total exercise time and time to 1-mm ST-segment depression were also measured.

Results: Sixty-two male patients with stable angina were enrolled in the study. There was a consistent trend for HR reduction at comparable maximum work load in active treatment groups, with significant differences against placebo for 10 and 20 mg (HR reduction by 12.2 and 6.8 beats per min, p = 0.0002 and p = 0.032, respectively). A statistically significant trend (p = 0.0003) for a reduction in HR with increasing doses of capadenoson was shown. Increases in total exercise time and time to 1-mm ST-segment depression were also observed.

Conclusions: In patients with stable angina capadenoson lowers exercise HR at comparable maximum workload, which is associated with improved total exercise time and prolongation of time to ischaemia.
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http://dx.doi.org/10.1007/s00392-012-0430-8DOI Listing
July 2012

Two-point left ventricle pacing and cardiac computed tomography.

Case Rep Cardiol 2012 9;2012:347189. Epub 2012 Sep 9.

Unit of Noninvasive Cardiovascular Diagnostics, Upper-Silesian Medical Centre, 40-635 Katowice, Poland ; 3rd Division of Cardiology, Medical University of Silesia, 40-752 Katowice, Poland.

Endocardial leads can potentially cause problems during coronary vessels visualization in multislice computed tomography (MSCT) due to a large number of artifacts. Based on presented case, we conclude that it is possible to perform MSCT of coronary arteries and leads visualization despite coexistence of four endocardial leads.
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http://dx.doi.org/10.1155/2012/347189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007785PMC
May 2014

Determinants of a reduced heart rate variability in chronic atrial fibrillation.

Ann Noninvasive Electrocardiol 2011 Oct;16(4):321-6

Unit of Noninvasive Cardiovascular Diagnostics 3rd Chair and Division of Cardiology, Medical University of Silesia, Ziolowa St 47, Katowice, Poland.

Background: We aimed to evaluate whether clinical factors, which influence heart rate variability (HRV) in the presence of undisturbed sinus rhythm, have any associations with HRV in patients with permanent atrial fibrillation (AF).

Methods: One hundred ninety-seven consecutive patients with permanent AF were included (122 males, 75 females, aged 64 ± 11 years, range 25-85). In each patient a 24-hour electrocardiographic recording was performed and an HRV fraction (HRVF)-the index based on scatter plot numerical processing-was calculated. Additionally, standard HRV measures were analyzed. Reduced HRVF was defined as its value lower than lower normal limit. Demographic and clinical factors were examined for their association with a reduced HRVF by means of a univariate and multivariate logistic regression analysis.

Results: The reduced HRVF was associated with advanced age, clinical diagnosis of a previous MI or dilated cardiomyopathy, presence of diabetes, depressed left ventricular function, NYHA class > II, treatment regimen, use of digoxin, diuretics or antiarrhythmic agents, nonuse of beta-blockers, and increased heart rate. The independent determinants that sustained after multivariate analysis were: heart rate (per 10 bpm increase, odds ratio 2.77 [1.88-4.07]), age (per 5 years increase 1.43 [1.1-1.85]), depressed left ventricular EF (<30% vs higher 2.26 [1.19-4.31]), and presence of diabetes (3.45 [1.1-10.85]). The HRVF correlated moderately with standard HRV measures. This index showed also the strongest correlation with left ventricular ejection fraction.

Conclusion: We concluded that advanced age, left ventricular systolic dysfunction, increased heart rate, and presence of diabetes are cofactors of a reduced HRV in AF patients. Thus, the determinants of heart rate variability in the presence of atrial fibrillation are the same as those in sinus rhythm.
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http://dx.doi.org/10.1111/j.1542-474X.2011.00458.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932332PMC
October 2011

Relationship between R-R interval variation and left ventricular function in sinus rhythm and atrial fibrillation as estimated by means of heart rate variability fraction.

Cardiol J 2011 ;18(5):538-45

3rd Chair of Cardiology, Medical University of Silesia, Katowice, Poland.

Background: Reduced heart rate variability (HRV) is associated with a poor outcome in patients with sinus rhythm (SR) or atrial fibrillation (AF). However, cut-off points for HRV measures differ between SR and AF. We hypothesized that a global index of 24-hour HRV based on evaluation of scatterplot would describe HRV irrespective of cardiac rhythm.

Methods: 407 patients with ischemic heart disease (317 male, 90 female, mean age 57 ± 9 years) were studied. 331 patients had SR and 76 patients had AF. 24-hour ECGs were recorded, and standard HRV indices were calculated. Scatterplots was used to determine the HRV fraction (HRVF, %). HRV measures were compared in respect to left ventricular ejection fraction (LVEF £ 35% or 〉 35%).

Results: Standard HRV measures were higher in AF-patients despite the mean RR interval was lower. In patients with LVEF £ 35%, standard HRV indices were lower in SR group, in AF group only SDNN and RMSSD were reduced. The HRVF was comparably reduced (SR 39.3 ± 15.3%, AF 37.3 ± 17.9%). In patients with LVEF 〉 35%, HRVF did not differ between SR (47.2 ± ± 10.5%) and AF (46.1 ± 12.1%). The HRVF correlated with SDNN and SDANN (~0.85) in SR. Correlations were weaker in AF (~0.6). Standard HRV indices and HRVF showed similar relations with LVEF, but only in AF at the same range.

Conclusions: The HRV fraction allows for HRV evaluation irrespective of cardiac rhythm. The index elicited a similar dependence of HRV on left ventricular function in SR and AF.
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http://dx.doi.org/10.5603/cj.2011.0010DOI Listing
January 2012