Publications by authors named "Maciej Tysarowski"

3 Publications

  • Page 1 of 1

Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients.

Healthcare (Basel) 2021 Feb 16;9(2). Epub 2021 Feb 16.

Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, Poland.

Background: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear.

Methods: We analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing to assess EC. Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%.

Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), 64% with heart failure, chronotropic incompetence was present in 80.7%. EC assessed as peak oxygen uptake was lower in the group with chronotropic incompetence, 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, < 0.001. EC correlated positively with CI (β = 0.14, < 0.001) and male gender (β = 5.12, < 0.001), and negatively with age (β = -0.17, < 0.001) and presence of heart failure (β = -3.35, < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI accounted for more than one-third of the variance in EC explained by the model (adjusted R = 59.8%).

Conclusions: In patients taking beta-blockers, presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.
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http://dx.doi.org/10.3390/healthcare9020212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920432PMC
February 2021

Factors Associated with Disparities in Appropriate Statin Therapy in an Outpatient Inner City Population.

Healthcare (Basel) 2020 Sep 24;8(4). Epub 2020 Sep 24.

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.

Lipid-lowering therapies are essential for the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The aim of this study is to identify discrepancies between cholesterol management guidelines and current practice with a focus on statin treatment in an underserved population based in a large single urban medical center. Among 1042 reviewed records, we identified 464 statin-eligible patients. Age was 61.0 ± 10.4 years and 53.9% were female. Most patients were black (47.2%), followed by Hispanic (45.7%) and white (5.0%). In total, 82.1% of patients were prescribed a statin. An appropriate statin was not prescribed in 32.4% of statin-eligible patients who qualified based only on a 10-year ASCVD risk of ≥7.5%. After adjustment for gender and health insurance status, appropriate statin treatment was independently associated with age >55 years (OR = 4.59 (95% CI 1.09-16.66), = 0.026), hypertension (OR = 2.38 (95% CI 1.29-4.38), = 0.005) and chronic kidney disease (OR = 3.95 (95% CI 1.42-14.30), = 0.017). Factors independently associated with statin undertreatment were black race (OR = 0.42 (95% CI 0.23-0.77), = 0.005) and statin-eligibility based solely on an elevated 10-year ASCVD risk (OR = 0.14 (95% CI 0.07-0.25), < 0.001). Hispanic patients were more likely to be on appropriate statin therapy when compared to black patients (86.8% vs. 77.2%). Statin underprescription is seen in approximately one out of five eligible patients and is independently associated with black race, younger age, fewer comorbidities and eligibility via 10-year ASCVD risk only. Hispanic patients are more likely to be on appropriate statin therapy compared to black patients.
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http://dx.doi.org/10.3390/healthcare8040361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712578PMC
September 2020

Right ventricular systolic function as a marker of prognosis after ST-elevation inferior myocardial infarction 5-year follow-up.

Int J Cardiol 2016 Oct 5;221:549-53. Epub 2016 Jul 5.

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.

Background: There is scarce data about clinical value of right ventricular (RV) systolic function assessed in pre-discharge transthoracic echocardiography for predicting long-term prognosis in patients with inferior ST-elevation myocardial infarction (MI).

Methods: The aim of this study was to assess correlations of RV function parameters in patients after inferior ST-elevation MI with preserved or mildly impaired left ventricular ejection fraction with prognosis during 5-year follow-up. Primary endpoint was death from any cause or unscheduled hospitalization for cardiac causes (unstable angina/MI, percutaneous coronary intervention/coronary artery bypass grafting due to progression of coronary artery disease, heart failure exacerbation or pacemaker implantation), secondary endpoints were all listed above components analyzed separately. RV systolic function was measured with pulsed tissue Doppler as systolic myocardial velocity at the basal segment of RV free wall in the acute phase and pre-discharge echocardiography.

Results: Follow-up was conducted in 86 consecutive patients (mean age 61±10years, 74% males). Multivariate regression analysis revealed that only RV systolic function in pre-discharge echocardiography correlated independently with the primary endpoint (OR 0.56, 95% CI 0.34-0.92, p=0.02). A positive predictive value of 44% and a negative predictive value of 83% (sensitivity 80%, specificity 49%, AUC 0.7) for predicting the primary endpoint was established for RV systolic myocardial velocity<13cm/s in pre-discharge echocardiography.

Conclusions: In patients after inferior wall ST-elevation MI with preserved or slightly impaired LV systolic function, pre-discharge RV systolic dysfunction correlated independently with worse long-term prognosis.
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http://dx.doi.org/10.1016/j.ijcard.2016.07.088DOI Listing
October 2016