Publications by authors named "Radosław Kurzelowski"

4 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

The influence of scar on the spatio-temporal relationship between electrical and mechanical activation in heart failure patients.

Europace 2020 05;22(5):777-786

Center for Computational Medicine in Cardiology, Università della Svizzera italiana, Via G. Buffi 13, CH-6900 Lugano, Switzerland.

Aims: The aim of this study was to determine the relationship between electrical and mechanical activation in heart failure (HF) patients and whether electromechanical coupling is affected by scar.

Methods And Results: Seventy HF patients referred for cardiac resynchronization therapy or biological therapy underwent endocardial anatomo-electromechanical mapping (AEMM) and delayed-enhancement magnetic resonance (CMR) scans. Area strain and activation times were derived from AEMM data, allowing to correlate mechanical and electrical activation in time and space with unprecedented accuracy. Special attention was paid to the effect of presence of CMR-evidenced scar. Patients were divided into a scar (n = 43) and a non-scar group (n-27). Correlation between time of electrical and mechanical activation was stronger in the non-scar compared to the scar group [R = 0.84 (0.72-0.89) vs. 0.74 (0.52-0.88), respectively; P = 0.01]. The overlap between latest electrical and mechanical activation areas was larger in the absence than in presence of scar [72% (54-81) vs. 56% (36-73), respectively; P = 0.02], with smaller distance between the centroids of the two regions [10.7 (4.9-17.4) vs. 20.3 (6.9-29.4) % of left ventricular radius, P = 0.02].

Conclusion: Scar decreases the association between electrical and mechanical activation, even when scar is remote from late activated regions.
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http://dx.doi.org/10.1093/europace/euz346DOI Listing
May 2020

Multimodality intravascular imaging of bioresorbable vascular scaffolds implanted in vein grafts.

Postepy Kardiol Interwencyjnej 2019 26;15(2):151-157. Epub 2019 Jun 26.

Department of Cardiology and Structural Heart Diseases, 3 Division of Cardiology, Medical University of Silesia, Katowice, Poland.

Introduction: There are no data presenting a serial assessment of vein graft healing after bioresorbable vascular scaffold (BVS) implantation at long-term follow-up.

Aim: To describe ABSORB BVS healing in vein grafts by optical coherence tomography (OCT) and high-definition intravascular imaging (HD-IVUS) at long-term follow-up.Material and methods: The study group consisted of 6 patients. The first patient had serial OCT assessment of BVS implanted in the saphenous vein grafts (SVG) at baseline and at 3-, 6-, 18-month follow-up and the second patient had OCT assessment of BVS implanted in the SVG at baseline and 24-, 48-month follow-up. The second and the third patients had OCT and HD-IVUS imaging at baseline and 48-month follow-up. The last 3 patients had OCT imaging of BVS implanted in the native coronary artery at 48-month follow-up.

Results: There were no differences in neointimal hyperplasia after BVS implantation between each time point. However, complete scaffold coverage was observed only 48 months after implantation. Out of 202 analyzed scaffold struts, there were 67 (33%) black boxes detectable at 48-month follow-up. HD-IVUS presented plaque burden up to 67% at the segment of BVS implantation at 48-months follow-up. There was a difference in neointimal hyperplasia thickness (1.27 (0.953-1.696) vs. 0.757 (0.633-0.848), < 0.001) between a native coronary artery and BVS scaffolds at 48-month follow-up.

Conclusions: Bioresorbable vascular scaffold implanted in SVG characterized moderate neointimal hyperplasia as excessive as compared to native coronary arteries at long-term follow-up. The complete scaffold coverage was observed only 48 months after implantation.
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http://dx.doi.org/10.5114/aic.2019.86010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727228PMC
June 2019

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