Publications by authors named "Maciej Wójcik"

52 Publications

Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study.

J Clin Med 2021 Apr 22;10(9). Epub 2021 Apr 22.

3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland.

: Hyperuricemia is an established risk factor for cardiovascular disease, including atrial fibrillation (AF). The prevalence of hyperuricemia and its clinical significance in patients with already diagnosed AF remain unexplored. : The Polish Atrial Fibrillation (POL-AF) registry includes consecutive patients with AF hospitalized in 10 Polish cardiology centers from January to December 2019. This analysis included patients in whom serum uric acid (SUA) was measured. : From 3999 POL-AF patients, 1613 were included in the analysis. The mean age of the subjects was 72 ± 11.6 years, and the mean SUA was 6.88 ± 1.93 mg/dL. Hyperuricemia was found in 43% of respondents. Eighty-four percent of the respondents were assigned to the high cardiovascular risk group, and 45% of these had SUA >7 mg/dL. Comparison of the extreme SUA groups (<5 mg/dL vs. >7 mg/dL) showed significant differences in renal parameters, total cholesterol concentration, and left ventricular ejection fraction (EF). Multivariate regression analysis showed that SUA >7 mg/dL (OR 1.74, 95% CI 1.32-2.30) and GFR <60 mL/min/1.73 m (OR 1.94, 95% CI 1.46-2.48) are significant markers of EF <40% in the study population. Female sex was a protective factor (OR 0.74, 95% CI 0.56-0.97). The cut-off point for SUA with 60% sensitivity and specificity indicative of an EF <40% was 6.9 mg/dL. : Although rarely assessed, hyperuricemia appears to be common in patients with AF. High SUA levels may be a significant biomarker of reduced left ventricular EF in AF patients.
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http://dx.doi.org/10.3390/jcm10091829DOI Listing
April 2021

Symptomatic and Asymptomatic Patients in the Polish Atrial Fibrillation (POL-AF) Registry.

J Clin Med 2021 Mar 5;10(5). Epub 2021 Mar 5.

Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland.

Background: Atrial fibrillation (AF) can cause severe symptoms, but it is frequently asymptomatic. We aimed to compare the clinical features of patients with asymptomatic and symptomatic AF.

Methods: A prospective, observational, multicenter study was performed (the Polish Atrial Fibrillation (POL-AF) registry). Consecutive hospitalized AF patients over 18 years of age were enrolled at ten centers. The data were collected for two weeks during each month of 2019.

Results: A total of 2785 patients were analyzed, of whom 1360 were asymptomatic (48.8%). Asymptomatic patients were more frequently observed to have coronary artery disease (57.5% vs. 49.1%, < 0.0001), heart failure with preserved ejection fraction (39.8% vs. 26.5%, < 0.0001), a previous thromboembolic event (18.2% vs. 13.1%, = 0.0002), and paroxysmal AF (52.3% vs. 45.2%, = 0.0002). In multivariate analysis, history of electrical cardioversion, paroxysmal AF, heart failure, coronary artery disease, previous thromboembolic event, and higher left ventricular ejection fraction were predictors of a lack of AF symptoms. First-diagnosed AF was a predictor of AF symptoms.

Conclusions: In comparison to symptomatic patients, more of those hospitalized with asymptomatic AF had been previously diagnosed with this arrhythmia and other cardiovascular diseases. However, they presented with better left ventricular function and were more frequently treated with cardiovascular medicines.
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http://dx.doi.org/10.3390/jcm10051091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961425PMC
March 2021

Characteristics and Treatment of Atrial Fibrillation with Respect to the Presence or Absence of Heart Failure. Insights from the Multicenter Polish Atrial Fibrillation (POL-AF) Registry.

J Clin Med 2021 Mar 24;10(7). Epub 2021 Mar 24.

1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.

Background: We aimed to assess characteristics and treatment of AF patients with and without heart failure (HF).

Methods: The prospective, observational Polish Atrial Fibrillation (POL-AF) Registry included consecutive patients with AF hospitalized in 10 Polish cardiology centers in 2019-2020.

Results: Among 3999 AF patients, 2822 (71%) had HF (AF/HF group). Half of AF/HF patients had preserved ejection fraction (HFpEF). Compared to patients without HF (AF/non-HF), AF/HF patients were older, more often male, more often had permanent AF, and had more comorbidities. Of AF/HF patients, 98% had class I indications to oral anticoagulation (OAC). Still, 16% of patients were not treated with OAC at hospital admission, and 9%-at discharge (regardless of the presence of HF and its subtypes). Of patients not receiving OAC upon admission, 61% were prescribed OAC (most often apixaban) at discharge. AF/non-HF patients more often converted from AF at admission to sinus rhythm at discharge compared to AF/HF patients (55% vs. 30%), despite cardioversion performed as often in both groups. Class I antiarrhythmics were more often prescribed in AF/non-HF than in AF/HF group (13% vs. 8%), but still as many as 15% of HFpEF patients received them.

Conclusions: Over 70% of hospitalized AF patients have coexisting HF. A significant number of AF patients does not receive the recommended OAC.
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http://dx.doi.org/10.3390/jcm10071341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036873PMC
March 2021

Antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, including compliance with current guidelines-data from the POLish Atrial Fibrillation (POL-AF) Registry.

Cardiovasc Diagn Ther 2021 Feb;11(1):14-27

1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland.

Background: Although triple antithrombotic therapy (TAT) is recommended in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), guidelines allow an option of dual antithrombotic therapy (DAT). This study assesses the everyday practice of 10 cardiology departments in antithrombotic therapy in AF patients undergoing PCI and its agreement with current guidelines.

Methods: This analysis included medical data of AF patients enrolled in the prospective, observational registry (The POLish Atrial Fibrillation-POL-AF) that underwent PCI [elective or due to acute coronary syndrome (ACS)].

Results: Of the 3,999 consecutive subjects included, a final analysis was performed on 359 patients that underwent PCI: 148 with urgent PCI due to ACSand 211 patients with elective PCI. Eighty patients in the ACS-group and 120 patients in the elective-PCI group were treated with TAT, although guidelines also allowed DAT. Of 316 patients treated with oral anticoagulants as a part of combination therapy, 275 were on non-vitamin K antagonist oral anticoagulant (NOAC). Reduced doses of NOAC were used in 74 patients treated with rivaroxaban, 60 patients with dabigatran, and 54 patients with apixaban. The proportion of patients treated with reduced NOAC doses adequately to the guidelines was 29%, 100%, and 33% for rivaroxaban, dabigatran, and apixaban, respectively. Inappropriate low doses of NOACs were used in 71% of subjects on rivaroxaban and 67% on apixaban.

Conclusions: In patients with AF undergoing PCI, NOACs are definitely preferred over vitamin-K antagonists (VKAs) in TAT/DAT, and an aggressive antithrombotic strategy with TAT is frequently chosen even if DAT is permissible by the guidelines. Label adherence of using reduced NOAC dose during combination therapy is not satisfactory for apixaban and rivaroxaban and probably results from too cautious an approach to the known indications for reduced therapy. The study is registered in the database Clinical Trials-NCT04419012.
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http://dx.doi.org/10.21037/cdt-20-839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944221PMC
February 2021

The Role of Transcription Factors in Gonad Development and Sex Differentiation of a Teleost Model Fish-Guppy ().

Animals (Basel) 2020 Dec 15;10(12). Epub 2020 Dec 15.

Department of Ichthyology and Biotechnology in Aquaculture, Faculty of Animal Science, Warsaw University of Life Sciences-SGGW (WULS-SGGW), Ciszewskiego 8, 02-786 Warsaw, Poland.

The guppy () is one of the world's most popular ornamental fish. Due to lecithotrophic viviparous, it is commonly used in toxicological studies and environmental monitoring. This study aimed to investigate the molecular mechanisms of gonad development and differentiation during guppy ontogenesis. The study mainly focused on the role and localization of potential specific sex markers and transcription factors: Sox9, Dmrt1, Erβ. For histological analysis, guppies of both sexes were collected at 1, 60, and 360 dph (day post-hatching). The gonads morphology and immunohistochemistry detection of mentioned markers localization were performed. The expression of Sox9 protein was compared between sexes. Histological analysis revelated all types of male germinal cells in 60 dph guppy's testes. Maturated oocytes were visible in the ovaries of 360 dph fish. The Sox9 expression varied in spermatocytes and spermatids, from cellular to nuclear localization, and was higher in ovaries. Dmrt1 was detected in all testes groups and 360 dph ovaries. The Erβ was observed in both sexes at 60 and 360 dph. For the first time, the localization of transcription factors in guppy during ontogenesis was traced. The Sox9 designation as a factor regulating the development of germinal cells in adult guppies may facilitate the analysis of xenobiotics' influence on fish's reproductive system.
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http://dx.doi.org/10.3390/ani10122401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765377PMC
December 2020

Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry.

J Clin Med 2020 11 5;9(11). Epub 2020 Nov 5.

Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland.

Background: Current guidelines do not suggest in which groups of patients with atrial fibrillation (AF) individual non-vitamin K antagonist oral anticoagulants (NOACs) should be used for the prevention of thromboembolic complications. The aim of this study was to evaluate the frequency of use of apixaban, dabigatran, and rivaroxaban, and attempt to identify factors predisposing their administration.

Methods: The Polish Atrial Fibrillation (POL-AF) registry is a prospective, non-interventional study, including consecutive patients with AF hospitalized in ten Polish cardiology centers during the period ranging from January to December 2019. In this study, all patients were treated with NOACs.

Results: Among the 2971 patients included in the analysis, 40.4% were treated with rivaroxaban, 32% with apixaban, and 27.6% with dabigatran. The mean age of the total population was 72 ± 11.5 years and 43% were female. A reduced dose of NOAC was used in 35% of patients treated with apixaban, 39.7% of patients treated with dabigatran, and 34.4% of patients treated with rivaroxaban. Independent predictors of the use of apixaban were previous bleeding (OR 2.37, CI 1.67–3.38), GFR < 60 mL/min (OR 1.38, CI 1.25–1.64), heart failure (OR 1.38, CI 1.14–1.67) and age (per 5 years) (OR 1.14, CI 1.09–1.19). GFR < 60 mL/min (OR 0.79, CI 0.66–0.95), female (OR 0.8, CI 0.67–0.96) and age (per 5 years) (OR 0.95, CI 0.91–0.99) diminished the chance of using dabigatran. Previous bleeding (OR 0.43, CI 0.28–0.64), vascular disease (OR 0.84, CI 0.70–0.99), and age (per 5 years) (OR 0.94, CI 0.90–0.97) diminished the chance of choosing rivaroxaban.

Conclusions: In hospitalized patients with AF, the most frequently chosen NOAC was rivaroxaban. Apixaban was chosen more often in patients after bleeding, and in those who were advanced in years, with heart failure and impaired renal function. Impaired renal function and female gender were factors that diminished the chance of using dabigatran. Previous bleeding and vascular disease was the factor that diminished the chance of using rivaroxaban. Dabigatran and rivaroxaban have been used less frequently in elderly patients.
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http://dx.doi.org/10.3390/jcm9113565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694480PMC
November 2020

Effect of Acute and Prolonged Inflammation on the Gene Expression of Proinflammatory Cytokines and Their Receptors in the Anterior Pituitary Gland of Ewes.

Int J Mol Sci 2020 Sep 21;21(18). Epub 2020 Sep 21.

The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, 03-105 Jabłonna, Poland.

An acute and prolonged inflammation inhibits the reproduction process by the disruption of the neurohormonal activity of the hypothalamic-pituitary-gonadal axis. It is thought that these changes may be caused by proinflammatory cytokines, i.e., interleukin (IL) -1β, IL-6 and tumor necrosis factor (TNF) α. The aim of this study was to determine the effect of an acute and prolonged inflammation on the expression of genes encoding cytokine and their receptors, gonadotropin releasing hormone receptor (), beta subunits of luteinizing hormone () and follicle-stimulating () in the anterior pituitary (AP). Moreover, the circulating concentration of LH and FSH was also assayed. Two experiments were carried out on adult ewes which were divided into two control groups and treated with lipopolysaccharide (LPS; 400 ng / kg). Acute inflammation was caused by a single injection of LPS into the external jugular vein, while the chronic inflammation was induced by seven times LPS injection (one a day). In both experiments, animals were euthanized 3h after the last LPS / NaCl injection and the blood samples collected 15 min before euthanasia. An acute inflammation stimulates the expression of the , and genes and their receptors in the AP of sheep. Prolonged inflammation increased gene expression and both types of and receptors. Both an acute and prolonged inflammation inhibited LHβ gene expression in the AP and reduced LH level in blood. A sevenfold LPS injection raises FSH concentration. The gene expression of was reduced in the ovine AP only after a single injection of endotoxin. Our results suggest that there are important differences in the way how an acute and prolonged inflammation influence proinflammatory cytokines and their receptors gene expression in the AP of anestrous ewes, which could be reflected by differences in the AP secretory activity during these states.
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http://dx.doi.org/10.3390/ijms21186939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554822PMC
September 2020

The Impact of Photoperiod on the Leptin Sensitivity and Course of Inflammation in the Anterior Pituitary.

Int J Mol Sci 2020 Jun 10;21(11). Epub 2020 Jun 10.

The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, ul. Instytucka 3, 05-110 Jabłonna, Poland.

Leptin has a modulatory impact on the course of inflammation, affecting the expression of proinflammatory cytokines and their receptors. Pathophysiological leptin resistance identified in humans occurs typically in sheep during the long-day photoperiod. This study aimed to determine the effect of the photoperiod with relation to the leptin-modulating action on the expression of the proinflammatory cytokines and their receptors in the anterior pituitary under physiological or acute inflammation. Two in vivo experiments were conducted on 24 blackface sheep per experiment in different photoperiods. The real-time PCR analysis for the expression of the genes , , , , , , , and was performed. Expression of all examined genes, except and , was higher during short days. The leptin injection increased the expression of all examined genes during short days. In short days the synergistic effect of lipopolysaccharide and leptin increased the expression of , , , , and and decreased expression of . This mechanism was inhibited during long days for the expression of and The obtained results suggest the occurrence of leptin resistance during long days and suggest that leptin modulates the course of inflammation in a photoperiod-dependent manner in the anterior pituitary.
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http://dx.doi.org/10.3390/ijms21114153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312887PMC
June 2020

The Influence of Diet Containing Wheat Gluten Supplemented with Dipeptides or Amino Acids on the Morphology of White Muscle of Yellow Perch ().

Animals (Basel) 2020 Feb 27;10(3). Epub 2020 Feb 27.

Department of Ichthyobiology, Fisheries and Aquaculture Biotechnology, Faculty of Animal Science, Warsaw University of Life Sciences-SGGW (WULS-SGGW), Ciszewskiego 8, 02-786 Warsaw, Poland.

Nutrition affects the metabolism of muscle cells and myogenic progenitor cells which play a crucial role in the growth and development of the muscle tissue. Because of the fact that the development process of yellow perch muscle tissue is not well known, the study aimed to analyze the influence of diets containing wheat gluten and supplemented with Lys and Gly in dipeptides or free form. Fish were allocated into 12 tanks and divided into four groups. Two of the experimental diets were supplemented Lys-Gly in the dipeptide form (DP group) or free amino acids (FAA group). The third was not supplemented with lysine (LF group). The fourth group of fish was fed commercial starter Bio-Oregon (C group). Histological or histomorphometric analyses were conducted: white muscle area, the total number of muscle fibers, the total number of white muscle nuclei, muscle fiber area, number of proliferating myonuclei. Fish fed LF diet showed the lowest number of nuclei and satellite cells proliferation. Results in DP and FAA groups were similar to that observed in fish fed C diet. Summarizing, wheat gluten-based diets supplemented with Lys-Gly dipeptide or free Lys and Gly amino acids exert beneficial effects on the morphology of yellow perch white muscle.
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http://dx.doi.org/10.3390/ani10030388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143557PMC
February 2020

Small-Angle X-ray Scattering Curves of Detergent Micelles: Effects of Asymmetry, Shape Fluctuations, Disorder, and Atomic Details.

J Phys Chem Lett 2020 Feb 22;11(3):945-951. Epub 2020 Jan 22.

Saarland University , Theoretical Physics and Center for Biophysics , Campus E2 6 , 66123 Saarbrücken , Germany.

Small-angle X-ray scattering (SAXS) is a widely used experimental technique, providing structural and dynamic insight into soft-matter complexes and biomolecules under near-native conditions. However, interpreting the one-dimensional scattering profiles in terms of three-dimensional structures and ensembles remains challenging, partly because it is poorly understood how structural information is encoded along the measured scattering angle. We combined all-atom SAXS-restrained ensemble simulations, simplified continuum models, and SAXS experiments of a -dodecyl-β-d-maltoside (DDM) micelle to decipher the effects of model asymmetry, shape fluctuations, atomic disorder, and atomic details on SAXS curves. Upon interpreting the small-angle regime, we find remarkable agreement between (i) a two-component triaxial ellipsoid model fitted against the data and (ii) a SAXS-refined all-atom ensemble. However, continuum models fail at wider angles, even if they account for shape fluctuations, disorder, and asymmetry of the micelle. We conclude that modeling atomic details is mandatory for explaining SAXS curves at wider angles.
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http://dx.doi.org/10.1021/acs.jpclett.9b03154DOI Listing
February 2020

Monomorphic ventricular premature contractions originating in the vicinity of the His bundle in a young patient: should we always ablate?

Authors:
Maciej Wójcik

Kardiol Pol 2018;76(12):1743

Department of Cardiology, Medical University of Lublin, Lublin, Poland, Poland.

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http://dx.doi.org/10.5603/KP.2018.0236DOI Listing
June 2019

Neostigmine Attenuates Proinflammatory Cytokine Expression in Preoptic Area but Not Choroid Plexus during Lipopolysaccharide-Induced Systemic Inflammation.

Mediators Inflamm 2018 9;2018:9150207. Epub 2018 Oct 9.

Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland.

The study was designed to examine whether the administration of neostigmine (0.5 mg/animal), a peripheral inhibitor of acetylcholinesterase (AChE), during an immune/inflammatory challenge provoked by intravenous injection of bacterial endotoxin-lipopolysaccharide (LPS; 400 ng/kg)-attenuates the synthesis of proinflammatory cytokines in the ovine preoptic area (POA), the hypothalamic structure playing an essential role in the control of the reproduction process, and in the choroid plexus (CP), a multifunctional organ sited at the interface between the blood and cerebrospinal fluid in the ewe. Neostigmine suppressed ( < 0.05) LPS-stimulated synthesis of cytokines such as interleukin- (IL-) 1, IL-6, and tumor necrosis factor (TNF) in the POA, and this effect was similar to that induced by the treatment with systemic AChE inhibitor-donepezil (2.5 mg/animal). On the other hand, both AChE inhibitors did not influence the gene expression of these cytokines and their corresponding receptors in the CP. It was found that this structure seems to not express the neuronal acetylcholine (ACh) receptor subunit alpha-7, required for anti-inflammatory action of ACh. The mechanism of action involves inhibition of the proinflammatory cytokine synthesis on the periphery as well as inhibition of their de novo synthesis rather in brain microvessels and not in the CP. In conclusion, it is suggested that the AChE inhibitors incapable of reaching brain parenchyma might be used in the treatment of neuroinflammatory processes induced by peripheral inflammation.
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http://dx.doi.org/10.1155/2018/9150207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198615PMC
January 2019

High-density bipolar voltage mapping for substrate-guided ablation of atrial fibrillation.

Kardiol Pol 2018 ;76(7):1115

Katedra i Klinika Kardiologii, Uniwersytet Medyczny w Lublinie, SPSK Nr 4, ul. Jaczewskiego 8, 20-954 Lublin.

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http://dx.doi.org/10.5603/KP.2018.0138DOI Listing
November 2018

Post-Receptor Inhibitors of the GHR-JAK2-STAT Pathway in the Growth Hormone Signal Transduction.

Int J Mol Sci 2018 06 22;19(7). Epub 2018 Jun 22.

The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, ul. Instytucka 3, 05-110 Jabłonna, Poland.

The growth hormone (GH) plays a key role in the regulation of metabolic processes in an organism. Determination of the correct structure and functioning of the growth hormone receptor (GHR) allowed for a more detailed research of its post-receptor regulators, which substantially influences its signal transduction. This review is focused on the description of the post-receptor inhibitors of the GHR-JAK2-STAT pathway, which is one of the most important pathways in the transduction of the somatotropic axis signal. The aim of this review is the short characterization of the main post-receptor inhibitors, such as: cytokine-inducible SH2-containing protein (CIS), Suppressors of Cytokine Signaling (SOCS) 1, 2 and 3, sirtuin 1 (SIRT1), protein inhibitors of activated STAT (PIAS) 1, 3 and PIAS4, protein tyrosine phosphatases (PTP) 1B and H1, Src homology 2 (SH2) domain containing protein tyrosine phosphatase (SHP) 1, 2 and signal regulatory protein (SIRP) α1. The equilibrium between these regulators activity and inhibition is of special concern because, as many studies showed, even slight imbalance may disrupt the GH activity causing serious diseases. The regulation of the described inhibitors expression and activity may be a point of interest for pharmaceutical industry.
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http://dx.doi.org/10.3390/ijms19071843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073700PMC
June 2018

Review: Apelin in disease.

Clin Chim Acta 2018 Aug 8;483:241-248. Epub 2018 May 8.

The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Department of Genetic Engineering, Instytucka 3, 05-110 Jabłonna, Poland.

Apelin, a regulatory peptide, is a ligand of the APJ receptor that belongs to the G protein-coupled receptor family. Apelin and APJ are widely distributed in the body and play potential physiological roles in the cytoprotection of many internal organs. This review article summarizes information about the roles of the apelin/APJ system in neurological, metabolic, hypertension, respiratory, gastrointestinal, hepatic, kidney and cancerous diseases. It is suggested that apelin positively affects the treatment of non-cancerous diseases and may be considered as a therapeutic drug in many illnesses. However, in cancers, apelin appears as a tumour growth stimulator, and its suggested role is as a marker in the diagnosis of tumour cancers in tissues. In summary, apelin has certain therapeutic abilities and can be useful in the treatment of, e.g., insulin resistance, hypertension, etc., but it also can sometimes serve as a negative factor.
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http://dx.doi.org/10.1016/j.cca.2018.05.012DOI Listing
August 2018

A study to evaluate the prevalence and determinants of stress coping strategies in heart failure patients in Poland (CAPS-LOCK-HF sub-study).

Kardiol Pol 2016 8;74(11):1327-1331. Epub 2016 Jul 8.

I Katedra i Klinika Kardiologii Śląski Uniwersytet Medyczny w Katowicach.

Background And Aim: We aimed to evaluate the prevalence and determinants of different stress coping strategies in Polish patients suffering from heart failure with reduced ejection fraction (HFREF).

Methods: This manuscript is a sub-study of the CAPS-LOCK-HF multicentre psychological status assessment of patients with HFREF. Patients with > six-month history of HFREF and clinical stability for ≥ three months and left ventricular ejection fraction (LVEF) < 45% were enrolled in the study. Demographic and clinical variables were obtained from medical records, while a standardised Coping Inventory for Stressful Situations (CISS) was applied to all subjects.

Results: The study comprised 758 patients (599 men; 79%) with a median age of 64 years (IQR 58-71). Median LVEF was 33% (25-40). Subjects most commonly used task-oriented coping strategies (median CISS score 55 points; IQR 49-61), followed by avoidance (45 points; 39-50) and emotion-oriented coping strategies (41 points; 34-48). Distraction-based avoidance coping strategies (20 points; 16-23) were more pronounced than social diversion strategies (16 points; 14-19). Multiple regression analysis showed that higher New York Heart Association (NYHA) class and lower systolic blood pressure were independent predictors of task-oriented style. Emotion-oriented coping was more common among females and higher NYHA classes, and in patients who did not take angiotensin-converting enzyme inhibitors. Patients who used avoidance-oriented strategies were more frequently those in sinus rhythm on assessment and those who had less history of neoplastic disease.

Conclusions: Patients with HFREF most commonly use favourable task-oriented coping strategies. However, female patients and those with higher NYHA classes tend to use potentially detrimental emotion-oriented coping strategies.
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http://dx.doi.org/10.5603/KP.a2016.0109DOI Listing
April 2017

Differences of psychological features in patients with heart failure with regard to gender and aetiology - Results of a CAPS-LOCK-HF (Complex Assessment of Psychological Status Located in Heart Failure) study.

Int J Cardiol 2016 Sep 15;219:380-6. Epub 2016 Jun 15.

Laboratory for Applied Research on Cardiovascular System, Wroclaw Medical University, Wroclaw, Poland; Department of Cardiology, Center for Heart Diseases, Military Hospital in Wroclaw, Wroclaw, Poland;

Objective: Objective of the study was to assess the psychological state of HF patients with reduced ejection fraction (HFrEF) with regard to gender and aetiology.

Methods: 758 patients with HFrEF (mean age - 64±11years, men - 79%, NYHA class III-IV - 40%, ischemic aetiology - 61%) in a prospective Polish multicenter Caps-Lock-HF study. Scores on five different self-report inventories: CISS, MHLC, GSES, BDI and modified Mini-MAC were compared between the sexes taking into account the aetiology of HFrEF.

Results: There were differences in the CISS and BDI score between the genders - women had higher CISS (emotion- and avoidance-oriented) and BDI (general score - 14.2±8.7 vs 12.3±8.6, P<0.05; subscale - somatic score - 7.3±3.7 vs 6.1±3.7, P<0.05). In the ischemic subpopulation, women had higher BDI (general and subscales) than men. In the non-ischemic subpopulation the differences between genders were limited to CISS scale. In a multivariable analysis with demographic and clinical data female sex, NYHA class, atrial fibrillation and diabetes mellitus determined BDI score. Similarly, in the ischemic subpopulation, the female sex, NYHA class and atrial fibrillation determined the BDI, while in the non-ischemic population NYHA class was the only factor that influenced the BDI score. Adding the psychological data made a significant additional contribution to the prediction of depression status.

Conclusions: There are distinct differences in psychological features with regard to gender in patients with HFrEF. Women demonstrate less favourable psychological characteristics. Gender-related differences in BDI score are especially explicit in patients with ischemic aetiology of HF. The BDI score is related to psychological predisposition.
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http://dx.doi.org/10.1016/j.ijcard.2016.06.036DOI Listing
September 2016

Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: long-term follow-up.

Cardiol J 2015 23;22(5):557-66. Epub 2015 Jul 23.

Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany Department of Cardiology, Justus-Liebig University of Giessen, Germany.

Background: The aim of the study was identification of the predictors of left atrial tachycardia and left atrial flutter (LATAFL) after radiofrequency catheter ablation of atrial fibrillation (CAAF).

Methods: We followed 598 patients (71% male, 41% paroxysmal AF; median follow-up: 36 months) after a single step-wise CAAF procedure. The time to first documented LATAFL lasting longer than 30 s, documented in any kind of electrocardiography (ECG), was defined as an end-point.

Results: A single CAAF procedure resulted in LATAF in 58 (10%) patients. Additional lesions were performed in 275 (46%) patients. Early LATAFL recurrence (£ 3 months since the index procedure) was observed in 11 (2%) patients. Late LATAFL (> 3 months) was noted in 47 (8%) patients. The univariate predictors of LATAFL recurrence were: type of AF (p = 0.003), the size of LA (p = 0.002) and the type of procedure (p = 0.0001). The identified single independent predictors of LATAFL recurrence were enlarged LA (p = 0.001) and mul-tiple (≥ 2) additional lesions performed during the index procedure (p < 0.0001).

Conclusions: Higher rate of LATAFL recurrence was observed in patients with non-paroxysmal AF, enlarged LA and any additional lesions performed. Two independent predictors of LATAFL recurrence after CAAF were: the enlarged LA and multiple (≥ 2) additional lesions performed during the index procedure.
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http://dx.doi.org/10.5603/CJ.a2015.0040DOI Listing
August 2016

Perception of health control and self-efficacy in heart failure.

Kardiol Pol 2016 ;74(2):168-178

Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland Department of Physiology, Wroclaw Medical University, Wroclaw, Poland Department of Cardiology, Centre for Heart Disease, Military Hospital, Wroclaw, Poland.

Background: The issue of self-perceived health control and related sense of self-efficacy has not received any attention in patients with heart failure (HF), although these psychological features have been established to determine the patients' approach towards healthcare professionals and their recommendations, which strongly affects compliance.

Methods: A total of 758 patients with systolic HF (age: 64 ± 11 years, men: 79%, NYHA class III–IV: 40%, ischaemic aetiology: 61%) were included in a prospective Polish multicentre Caps-Lock-HF study. A Multidimensional Health Locus of Control (MHLC) scale was used to assess subjective perception of health control in three dimensions (internal control, external control by the others, and by chance); the Generalised Self Efficacy scale (GSES) was used to estimate subjective sense of self-efficacy; and the Beck Depression Inventory (BDI) was used to determine depressive symptoms.

Results: The majority of patients perceived the external control (by the others) and internal control of their health as high (77% and 63%, respectively) or moderate (22% and 36%, respectively), whereas self-efficacy was perceived as high or moderate (63% and 27%), which was homogenous across the whole spectrum of the HF cohort, being unrelated to HF severity, HF duration, the presence of co-morbidities, and the applied treatment. The stronger the perception of internal health control, the higher the self-efficacy (p < 0.05); both features were related to less pronounced depressive symptoms (p < 0.05).

Conclusions: The established pattern of self-perceived control of own health and self-efficacy indicates that patients with HF acknowledge the role of others (i.e. healthcare providers) and themselves in the process of the management of HF, and are convinced about the high efficacy of their undertaken efforts. Such evidence supports implementation of a partnership model of specialists’ care of patients with HF.
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http://dx.doi.org/10.5603/KP.a2015.0137DOI Listing
February 2017

The Impact of Left Atrial Surface Area and the Second Generation Cryoballoon on Clinical Outcome of Atrial Fibrillation Cryoablation.

Pacing Clin Electrophysiol 2015 Jul 15;38(7):815-24. Epub 2015 May 15.

Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.

Aims: In this observational study, we examine the significance of the left atrial (LA) surface area and compare the clinical usage of the Arctic Front Advance (CBA) versus Arctic Front (CB) cryoballoon with the intent to investigate the impact of each in terms of long-term freedom from atrial fibrillation (AF) for patients with nonvalvular AF.

Methods: Pulmonary vein isolation (PVI) was performed while using a cryoballoon ablation catheter in conjunction with an intraluminal circular diagnostic mapping catheter, Achieve. The consecutive patients ablated with CBA were matched with patients previously ablated with CB, using propensity score matching. The primary endpoint of this observational single-center retrospective study was the first observation of electrocardiogram-documented recurrence of atrial arrhythmias lasting >30 seconds.

Results: The patient demographic data were similar in the CBA- and CB-group (N = 188 patients each group). In all patients in the CBA-group and in 95% of the patients in the CB group, acute procedural PVI of all veins was achieved with the single usage of a 28-mm cryoballoon. The one-year freedom from atrial arrhythmias was significantly better in the CBA- versus the CB-group of patients, 90% versus 64%, respectively. During 15-month clinical follow-up in CBA group, patients with LA area above 23 cm(2) were more likely to experience recurrence of AF (23%) than patients with LA area below 23 cm(2) (7%).

Conclusions: Comparing one-year outcomes, the CBA is superior to the CB with regards to maintenance of normal sinus rhythm. When using the CBA catheter, an enlarged LA is associated with a higher recurrence of arrhythmia.
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http://dx.doi.org/10.1111/pace.12637DOI Listing
July 2015

Cryoballoon ablation of atrial fibrillation: How important is the proper selection of patients?

Cardiol J 2015 7;22(2):194-200. Epub 2015 Jan 7.

Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.

Background: Relation between pre-procedural selection of patients and the success rate after a single cryoballoon ablation (CAB) procedure is unknown.

Methods: CAB was performed in 378 (65% male, median age 58 years, 85% paroxysmal atrial fibrillation [AF]) consecutive patients with symptomatic and drug refractory AF. The combined ALARMEc (Atrial fibrillation type, Left Atrium size, Renal insufficiency, Metabolic syndrome, cardiomyopathy) risk score was calculated for each individual patient. The end-point of the study was the first AF, atrial flutter or atrial tachycardia recurrence after the 3-month blanking period in the 1-year follow-up since the index procedure, in the absence of anti-arrhythmic (class I and III) therapy.

Results: Single and multi-catheter approach was used in 79% and 21% of patients, respectively. The acute success rate with single and multi-catheter approach was 79% and 99%, respectively. The overall 1-year success rate after a single CAB procedure was 70%. The 1-year outcome was: 83%, 70%, 60%, 40% and 29% in patients with ALARMEc risk score: 0, 1, 2, 3 and 5, respectively. Total rate of complications was 11%, including transient phrenic nerve palsy in 9.5% of cases.

Conclusions: Multi-catheter approach was needed in 21% of patients to achieve acute pulmonary vein isolation. Patients with low (≤ 1) ALARMEc risk score, preferably young individuals with sole paroxysmal AF (ALARMEc = 0), are best candidates for CBA procedure. Performing CBA in patients with higher (> 2) ALARMEc risk score should be avoided. Phrenic nerve palsy was a transient complication.
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http://dx.doi.org/10.5603/CJ.a2014.0100DOI Listing
August 2016

Atrial fibrillation ablation: Limitations of pulmonary vein ablation catheter technology.

Cardiol J 2014 ;21(5):583

Department of Cardiology, Medical University of Lublin; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Ger.

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http://dx.doi.org/10.5603/CJ.2014.0077DOI Listing
September 2015

Cryoballoon ablation in young patients with lone paroxysmal atrial fibrillation.

Rev Esp Cardiol (Engl Ed) 2014 Jul 26;67(7):558-63. Epub 2014 Apr 26.

Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.

Introduction And Objectives: Long-term efficacy following cryoballoon ablation of lone paroxysmal atrial fibrillation remains unknown. We describe long-term follow-up results of the single cryoballoon ablation procedure.

Methods: Pulmonary vein isolation was performed in 103 patients (72 male; median age 52 years) with symptomatic lone paroxysmal atrial fibrillation. The end-point of this observational cohort study was first electrocardiogram-documented recurrence of arrhythmia (atrial fibrillation, atrial tachycardia, or atrial flutter) during the 5-year follow-up, in the absence of anti-arrhythmic treatment.

Results: Acute complete pulmonary vein isolation was achieved in 86% of the patients with a single cryoballoon. The 6-month, 1-year, and 5-year success rate after a single procedure was 94%, 91%, and 77%, respectively. Arrhythmia recurrence was observed in 24 cases at a median of 14.8 months [range, 8.0-16.8 months]. Thirteen symptomatic patients were well controlled on beta-blockers only. Seven symptomatic patients had anti-arrhythmic treatment (class IC in 5 patients; dronedarone in 2 patients) introduced during the blanking period. Two of them had early arrhythmia recurrence within the blanking period only; they were arrhythmia-free in further follow-up on dronedarone. The rate of complications was relatively low and included a 4.8% incidence of transient phrenic nerve palsy.

Conclusions: A single cryoballoon ablation procedure for lone paroxysmal atrial fibrillation resulted in high rates of acute, medium-term, and long-term efficacy. The rate of complications is relatively low and includes a 4.8% incidence of transient phrenic nerve palsy.
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http://dx.doi.org/10.1016/j.rec.2013.11.024DOI Listing
July 2014

Learning curve in cryoballoon ablation of atrial fibrillation: eight-year experience.

Circ J 2014 19;78(7):1612-8. Epub 2014 May 19.

Department of Cardiology, Kerckhoff Heart and Thorax Center.

Background: We analyzed the procedural experience cryoballoon ablation (CBA) of atrial fibrillation (AF) gained over 8 years in a high-volume centre to understand the influence of the learning curve on feasibility, safety and clinical outcome.

Methods And Results: In 424 patients (62% male) with drug-refractory AF, CBA was performed between 2005 and 2012. The analyzed period was divided into 8 calendar years. The endpoint of the study was arrhythmia recurrence after the 3-month blanking period in the 1-year follow-up since the index procedure, in the absence of anti-arrhythmic drugs class I and III. A combined AF type, Left Atrium size, Renal insufficiency, MEtabolic syndrome, cardiomyopathy (ALARMEc) risk score was calculated for each patient. The overall 1-year success rate of a single CBA was 73%. Continuous increase in 1-year success rate was observed with successive years of the study. The gradual improvement in outcome was related to gradual fall in ALARMEc risk score in successive patients. A continuous decrease in fluoroscopy and procedure time was observed in each subsequent year.

Conclusions: CBA, followed by the proper selection of patients, facilitates a satisfactory outcome, especially in patients at an early stage of PV-trigger-dependent AF. Still, as with each new technology, it requires completion of a learning curve.
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http://dx.doi.org/10.1253/circj.cj-13-1253DOI Listing
September 2015

Synthesis, quality control and determination of metallic impurities in F-fludeoxyglucose production process.

Rep Pract Oncol Radiother 2014 May 16;19(Suppl):S22-S31. Epub 2014 Apr 16.

University of Warsaw, Heavy Ion Laboratory, Pasteur 5a, 02-093 Warsaw, Poland.

Aim: The aim of this study was to synthesize FDG in some consecutive runs and check the quality of manufactured radiopharmaceuticals and to determine the distribution of metallic impurities in the synthesis process.

Background: For radiopharmaceuticals the general requirements are listed in European Pharmacopeia and these parameters have to be checked before application for human use.

Materials And Methods: Standard methods for the determination of basic characteristics of radiopharmaceuticals were used. Additionally, high resolution γ spectrometry was used for the assessment of nuclidic purity and inductively coupled plasma with mass spectrometry to evaluate metallic content.

Results: Results showed sources and distribution of metallic and radiometallic impurities in the production process. Main part is trapped in the initial separation column of the synthesis unit and is not distributed to the final product in significant amounts.

Conclusions: Produced FDG filled requirements of Ph.Eur. and the content of radionuclidic and metallic impurities was in the acceptable range.
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http://dx.doi.org/10.1016/j.rpor.2014.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394716PMC
May 2014

Dynamic left ventricular outflow tract obstruction.

Kardiol Pol 2014 ;72(3):287

Department of Cardiology, Medical University of Lublin, Lublin, Poland.

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http://dx.doi.org/10.5603/KP.2014.0058DOI Listing
December 2016

Score associated with the outcome after multiple ablation procedures in patients with atrial fibrillation.

Pacing Clin Electrophysiol 2014 Jun 5;37(6):682-90. Epub 2014 Feb 5.

Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; Department of Cardiology, Medical University of Lublin, Lublin, Poland.

Background: Catheter ablation (CA) of atrial fibrillation (AF) is now established therapeutic option. Multiple procedures (MPs) are often needed to achieve the satisfactory outcome. The aim of the study was to assess the outcome after MPs in AF patients categorized to risk-score groups.

Methods: We followed a cohort of consecutive 911 (69% male; median 59 years) patients with AF (58% paroxysmal) who had CAAF performed. ALARMEC (Atrial fibrillation type, Left Atrium size, Renal insufficiency, MEtabolic syndrome, cardiomyopathy) risk score was calculated for each patient. The end point was maintenance of sinus rhythm at the follow-up of 60 months.

Results: We performed 1,199 CAAF procedures. One, two, and three procedures were performed in 663 (73%), 208 (23%), and 40 (4%) patients, respectively. Outcome after the first procedure (56%) was improved with MPs (76%). MPs > 2 were performed in 1%, 3%, 5%, 6%, and 10% patients with ALARMEC score of 0, 1, 2, 3, and 4, respectively. MPs were successful in 89%, 86%, 81%, 65%, and 43% of patients with ALARMEC score of 0, 1, 2, 3, and 4, respectively. Outcome in 174 (19%) patients on antiarrhythmic drugs (AADs) was 85%, 68%, 75%, 44%, and 39% in ALARMEC score: 0, 1, 2, 3, and 4, respectively. Outcome in 737 (81%) patients without AAD was 90%, 85%, 80%, 77%, and 69% in ALARMEC score of 0, 1, 2, 3, and 4, respectively.

Conclusion: The moderate success rate after index procedure of CAAF can be further improved with multiple ones and AAD.
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http://dx.doi.org/10.1111/pace.12356DOI Listing
June 2014

Atrial tachycardia after cryoballoon ablation of paroxysmal atrial fibrillation.

Europace 2014 Feb 17;16(2):306. Epub 2013 Oct 17.

Department of Cardiology, Medical University of Lublin, SPSK Nr 4, ul. Jaczewskiego 8, 20-954 Lublin, Poland.

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http://dx.doi.org/10.1093/europace/eut216DOI Listing
February 2014