Publications by authors named "Mieczyslaw Dutka"

8 Publications

  • Page 1 of 1

Local electromechanical alterations determine the left ventricle rotational dynamics in CRT-eligible heart failure patients.

Sci Rep 2021 Feb 5;11(1):3267. Epub 2021 Feb 5.

Department of Cardiology and Structural Heart Disease, Medical University of Silesia, Ziołowa 45-47, Katowice, Poland.

Left ventricle, LV wringing wall motion relies on physiological muscle fiber orientation, fibrotic status, and electromechanics (EM). The loss of proper EM activation can lead to rigid-body-type (RBT) LV rotation, which is associated with advanced heart failure (HF) and challenges in resynchronization. To describe the EM coupling and scar tissue burden with respect to rotational patterns observed on the LV in patients with ischemic heart failure with reduced ejection fraction (HFrEF) left bundle branch block (LBBB). Thirty patients with HFrEF/LBBB underwent EM analysis of the left ventricle using an invasive electro-mechanical catheter mapping system (NOGA XP, Biosense Webster). The following parameters were evaluated: rotation angle; rotation velocity; unipolar/bipolar voltage; local activation time, LAT; local electro-mechanical delay, LEMD; total electro-mechanical delay, TEMD. Patients underwent late-gadolinium enhancement cMRI when possible. The different LV rotation pattern served as sole parameter for patients' grouping into two categories: wringing rotation (Group A, n = 6) and RBT rotation (Group B, n = 24). All parameters were aggregated into a nine segment, three sector and whole LV models, and compared at multiple scales. Segmental statistical analysis in Group B revealed significant inhomogeneities, across the LV, regarding voltage level, scar burdening, and LEMD changes: correlation analysis showed correspondently a loss of synchronization between electrical (LAT) and mechanical activation (TEMD). On contrary, Group A (relatively low number of patients) did not present significant differences in LEMD across LV segments, therefore electrical (LAT) and mechanical (TEMD) activation were well synchronized. Fibrosis burden was in general associated with areas of low voltage. The rotational behavior of LV in HF/LBBB patients is determined by the local alteration of EM coupling. These findings serve as a strong basic groundwork for a hypothesis that EM analysis may predict CRT response.Clinical trial registration: SUM No. KNW/0022/KB1/17/15.
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http://dx.doi.org/10.1038/s41598-021-82793-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865069PMC
February 2021

Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure.

Heart Fail Rev 2021 May 4;26(3):603-622. Epub 2020 Nov 4.

Faculty of Health Sciences, Department of Emergency Medicine, University of Bielsko-Biała, Willowa St. 2, 43-309, Bielsko-Biała, Poland.

Diabetes is a key independent risk factor in the development of heart failure (HF) and a strong, adverse prognostic factor in HF patients. HF remains the primary cause of hospitalisation for diabetics and, as previous studies have shown, when HF occurs in these patients, intensive glycaemic control does not directly improve the prognosis. Recent clinical studies assessing a new class of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT2is) showed some unexpected beneficial results. Patients treated with SGLT2is had a significant decrease in both cardiovascular (CV) and all-cause mortality and less hospitalisations due to HF compared to those given a placebo. These significant clinical benefits occurred quickly after the drugs were administered and were not solely due to improved glycaemic control. These groundbreaking clinical trials' results have already changed clinical practice in the management of patients with diabetes at high CV risk. These trials have triggered numerous experimental studies aimed at explaining the mechanisms of action of this unique group of drugs. This article presents the current state of knowledge about the mechanisms of action of SGLT2is developed for the treatment of diabetes and which, thanks to their cardioprotective effects, may, in the future, become a treatment for patients with HF.
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http://dx.doi.org/10.1007/s10741-020-10041-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024236PMC
May 2021

Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study.

BMC Emerg Med 2019 11 26;19(1):73. Epub 2019 Nov 26.

Department of Biochemistry and Molecular Biology, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2, 43-309, Bielsko-Biala, Poland.

Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient's side with compression conducted from the 'over-the-head' position.

Methods: The subject of the study were two methods of CPR - 'standard' (STD) and 'over-the-head' (OTH). The STD method consisted of cycles of 30 chest compressions from the patient's side, and two attempts at artificial ventilation after moving round to behind the patient's head. In the OTH method, both compressions and ventilations were conducted from behind the patient's head.

Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50-60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100-120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values.

Conclusions: The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.
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http://dx.doi.org/10.1186/s12873-019-0292-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880354PMC
November 2019

Various aspects of inflammation in heart failure.

Heart Fail Rev 2020 05;25(3):537-548

Faculty of Health Sciences, Department of Emergency Medicine, University of Bielsko-Biala, Willowa St. 2, 43-309, Bielsko-Biala, Poland.

Despite significant advances in the prevention and treatment of heart failure (HF), the prognosis in patients who have been hospitalised on at least one occasion due to exacerbation of HF is still poor. Therefore, a better understanding of the underlying pathophysiological mechanisms of HF is crucial in order to achieve better results in the treatment of this clinical syndrome. One of the areas that, for years, has aroused the interest of researchers is the activation of the immune system and the elevated levels of biomarkers of inflammation in patients with both ischaemic and non-ischaemic HF. Additionally, it is intriguing that the level of circulating pro-inflammatory biomarkers correlates with the severity of the disease and prognosis in this group of patients. Unfortunately, clinical trials aimed at assessing interventions to modulate the inflammatory response in HF have been disappointing, and the modulation of the inflammatory response has had either no effect or even a negative effect on the HF prognosis. The article presents a summary of current knowledge on the role of immune system activation and inflammation in the pathogenesis of HF. Understanding the immunological mechanisms pathogenetically associated with left ventricular remodelling and progression of HF may open up new therapeutic possibilities for HF.
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http://dx.doi.org/10.1007/s10741-019-09875-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181445PMC
May 2020

Serum Concentrations of Osteogenesis/Osteolysis-Related Factors and Micro-RNA Expression in ST-Elevation Myocardial Infarction.

Cardiol Res Pract 2019 2;2019:1420717. Epub 2019 Jun 2.

Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

Background: Atherosclerosis and bone metabolism share similar molecular and cellular mechanisms. This study aims to evaluate (1) serum concentration of osteogenesis/osteolysis factors panel (Dickkopf-related protein 1 (DKK-1), TNF-, -terminal atrial natriuretic peptide (NT-proANP), thrombospondin-2 (TSP-2), osteoprotegerin (OPG), osteocalcin (OCN), osteopontin (OPN), fibroblast growth factor 23 (FGF-23), soluble receptor activator of nuclear factor-kappaB ligand (sRANKL), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), proprotein convertase subtilisin/kexin type 9 (PCSK9)), (2) serum expression levels of micro-RNA- (miR-) 24-1 and miR-6802, and (3) assess their correlation with myocardial injury and LV remodeling and function in the acute phase of STEMI and after 3 months.

Methods: Study enrolled 25 STEMI patients (mean age 55.4 ± 8.96 years). Blood samples were collected 4 days and 3 months after myocardial infarction. Serum concentrations of osteogenesis/osteolysis factors were measured using the Luminex assay. Analysis of miR-24-1, and miR-6802 expression was performed with qPCR. LV function and remodeling were assessed by MRI during index hospitalization and 3 months later.

Results: There were no significant differences in serum levels of osteogenesis/osteolysis factors and expression of miR-24-1 and miR-6802 between the acute phase and 3-month follow-up. The levels were similar in patients with at least ≥5% improvement of LVEF ( = 10) and those without improvement. There was a negative correlation between the OPG serum level and LVEF during the acute phase of myocardial infarction.

Conclusions: In STEMI patients, serum concentrations of osteogenesis/osteolysis factors, as well as miR-24-1 and miR-6802 expression, do not change significantly within the 3-month follow-up and are not correlated with LV remodeling and function.
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http://dx.doi.org/10.1155/2019/1420717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589187PMC
June 2019

Self-regulation of the inflammatory response by peroxisome proliferator-activated receptors.

Inflamm Res 2019 Jun 29;68(6):443-458. Epub 2019 Mar 29.

Department of Biochemistry and Molecular Biology, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2 Str., 43-309, Bielsko-Biała, Poland.

The peroxisome proliferator-activated receptor (PPAR) family includes three transcription factors: PPARα, PPARβ/δ, and PPARγ. PPAR are nuclear receptors activated by oxidised and nitrated fatty acid derivatives as well as by cyclopentenone prostaglandins (PGA and 15d-PGJ) during the inflammatory response. This results in the modulation of the pro-inflammatory response, preventing it from being excessively activated. Other activators of these receptors are nonsteroidal anti-inflammatory drug (NSAID) and fatty acids, especially polyunsaturated fatty acid (PUFA) (arachidonic acid, ALA, EPA, and DHA). The main function of PPAR during the inflammatory reaction is to promote the inactivation of NF-κB. Possible mechanisms of inactivation include direct binding and thus inactivation of p65 NF-κB or ubiquitination leading to proteolytic degradation of p65 NF-κB. PPAR also exert indirect effects on NF-κB. They promote the expression of antioxidant enzymes, such as catalase, superoxide dismutase, or heme oxygenase-1, resulting in a reduction in the concentration of reactive oxygen species (ROS), i.e., secondary transmitters in inflammatory reactions. PPAR also cause an increase in the expression of IκBα, SIRT1, and PTEN, which interferes with the activation and function of NF-κB in inflammatory reactions.
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http://dx.doi.org/10.1007/s00011-019-01231-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517359PMC
June 2019

The relevance of microRNA in post-infarction left ventricular remodelling and heart failure.

Heart Fail Rev 2019 07;24(4):575-586

Department of Biochemistry and Molecular Biology, University of Bielsko-Biala, Faculty of Health Sciences, Willowa St. 2, 43-309, Bielsko-Biała, Poland.

Myocardial infarction and post-infarction left ventricular remodelling involve a high risk of morbidity and mortality. For this reason, ongoing research is being conducted in order to learn the mechanisms of unfavourable left ventricular remodelling following a myocardial infarction. New biomarkers are also being sought that would allow for early identification of patients with a high risk of post-infarction remodelling and dysfunction of the left ventricle. In recent years, there has been ever more experimental data that confirms the significance of microRNA in cardiovascular diseases. It has been confirmed that microRNAs are stable in systemic circulation, and can be directly measured in patients' blood. It has been found that significant changes occur in the concentrations of various types of microRNA in myocardial infarction and heart failure patients. Various types of microRNA are also currently being intensively researched in terms of their usefulness as markers of cardiomyocyte necrosis, and predictors of the post-infarction heart failure development. This paper is a summary of the current knowledge on the significance of microRNA in post-infarction left ventricular remodelling and heart failure.
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http://dx.doi.org/10.1007/s10741-019-09770-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560007PMC
July 2019

[Osteoprotegerin – is it only a cardiovascular risk marker?].

Przegl Lek 2016;73(9):667-70

Osteoprotegerin is a glycoprotein contributing to the regulation of bone rebuilding. It has been documented that osteoprotegerin regulates the activity of osteoclasts by blocking the interaction between the receptor, activator nuclear factor kappa B (RANK) and its ligand (RANKL). Osteoprotegerin, by blocking the connection between RANKL and its receptor (RANK), inhibits the maturation of osteoclasts and osteoclastogenesis and because of this, it inhibits the osteolytic processes. The participation of osteoprotegerin in regulating the function of immune system cells has also been confirmed. More and more studies confirm, that osteoprotegerin is associated with cardiovascular diseases. In many studies it has been confirmed that high plasma concentration of osteoprotegerin and low concentration of TNF – related apoptosis inducing ligand (TRAIL) and high OPG/TRAIL ratio are predictors of a poor prognosis in patients with myocardial infarction. High plasma concentration and high OPG/TRAIL ratio in the acute phase of myocardial infarction are mainly prognostic indicators of adverse left ventricular remodelling and the development of postinfarction heart failure. In a group of patients with high plasma concentration of osteoprotegerin in the acute phase of myocardial infarction, it has also been established that there are a lower number of mesenchymal stem cells (MSC) recruited from bone marrow and circulating in peripheral blood. Pathogenic mechanisms which involve osteoprotegerin and which are responsible for both postinfarction left ventricular remodelling and prognosis after myocardial infarction are being researched amid great excitement. This is mainly because it offers the possibility of identifying the defence mechanisms which protect the left ventricular against adverse remodelling after myocardial infarction. This would offer us the possibility of using osteoprotegerin not only as a prognostic marker in cardiovascular diseases but also as a potential therapeutic target in cardiovascular diseases. This review presents the current knowledge about this.
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May 2018