Kardiologia polska最新文献

{"title":"Predictive profiles for poor functional improvement and mortality after transcatheter aortic valve replacement. Value of 6-minute walk test and myocardial work analysis.","authors":"Jerzy Rychlewski, Monika Przewlocka-Kosmala, Thomas H Marwick, Jonathan Sen, Krzysztof Aleksandrowicz, Grzegorz Golanski, Karolina Kubisz, Erwan Donal, Marcin Protasiewicz, Piotr Kubler, Wojciech Kosmala","doi":"10.33963/v.phj.113742","DOIUrl":"https://doi.org/10.33963/v.phj.113742","url":null,"abstract":"<p><strong>Background: </strong>Clinical improvement and survival after transcatheter aortic valve replacement (TAVR) remain difficult to predict. Although multiple predictors of both outcomes have been identified, prognostic algorithms for patients undergoing TAVR are not well established.</p><p><strong>Aims: </strong>This study aimed to identify factors associated with the lack of meaningful improvement in exercise capacity after TAVR and to determine whether the predictive profile for poor functional response (PFR) also relates to mortality.</p><p><strong>Methods: </strong>We enrolled 220 patients (78.0 [6.4] years) with severe aortic stenosis undergoing TAVR. Pre‑ and post-procedural (3 months) assessments included clinical evaluation, echocardiography with myocardial work analysis, and the 6‑minute walk test (6MWT). PFR was defined as an increase in 6MWT distance <40 m.</p><p><strong>Results: </strong>Only age and atrial fibrillation independently predicted both mortality and PFR. Mortality was associated with lower global work index (HR, 0.99; P <0.001) and shorter 6MWT distance (HR, 0.99; P = 0.008). PFR was associated with higher global wasted work (OR, 1.003; P = 0.04) and less impaired baseline 6MWT relative to predicted values (OR, 0.29; P <0.001 for <80% predicted). Unsupervised machine‑learning analysis (Partition Around Medoids) identified clusters linked to mortality but not to PFR.</p><p><strong>Conclusions: </strong>Predictive profiles for PFR and mortality after TAVR show limited overlap, indicating that these outcomes require distinct prognostic approaches. The 6MWT may inform both endpoints: lower absolute values predict mortality, whereas higher percentage‑predicted values identify patients less likely to experience significant symptomatic improvement. Myocardial work analysis may further refine prognostic assessment in this population.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse - results of the MITPROL AR-PL Registry.","authors":"Katarzyna Mizia-Stec, Dominika Dziadosz, Ludmila Danilowicz-Szymanowicz, Paulina Wejner-Mik, Monika Kowalczyk-Domagala, Agnieszka Boruc, Karina Wierzbowska-Drabik, Mateusz Staciwa, Krzysztof Jaworski, Dorota Kustrzycka-Kratochwil, Beata Uzieblo-Zyczkowska, Danuta Sorysz, Anna Polewczyk, Barbara Brzezinska, Katarzyna Kurnicka, Jacek Bil, Olga Mozenska, Radoslaw Piatkowski, Piotr Duchnowski, Karolina Golinska-Grzybala, Tomasz Kukulski, Ewa Wołoszyn-Horak, Marek Kozinski, Renata Wachnicka-Truty, Malgorzata Knapp, Klaudia Mickiewicz, Zofia Oko-Sarnowska, Michal Plewka, Ireneusz Jedliński, Malgorzata Kamela, Kamil Barański, Andrzej Gackowski, Piotr Szymanski, Jaroslaw D Kasprzak","doi":"10.33963/v.phj.113744","DOIUrl":"https://doi.org/10.33963/v.phj.113744","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve prolapse (MVP) may increase ventricular arrhythmic burden.</p><p><strong>Aims: </strong>To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population.</p><p><strong>Methods: </strong>454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed.</p><p><strong>Results: </strong>The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001).</p><p><strong>Conclusions: </strong>The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic fistula following device implantation in a patient post coronary artery bypass grafting.","authors":"Lidia Chmielewska-Michalak, Marta Kałużna-Oleksy, Filip Waśniewski, Anna Szałek-Goralewska, Marcin Kiszka, Aneta Klotzka, Maciej Lesiak, Przemysław Mitkowski","doi":"10.33963/v.phj.113846","DOIUrl":"https://doi.org/10.33963/v.phj.113846","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased soluble glycoprotein VI is associated with plasminogen activator inhibitor-1 driven hypofibrinolysis in patients with atrial fibrillation: a potential impact of enhanced oxidative stress.","authors":"Anna Waśniowska, Joanna Natorska, Małgorzata Konieczyńska, Paweł T Matusik, Wiktoria Wojciechowska, Marek Rajzer, Renata Rajtar-Salwa, Stanisław Bartuś, Andrzej Surdacki, Aleksandra Lenart-Migdalska, Maria Olszowska, Anetta Undas, Michał Ząbczyk","doi":"10.33963/v.phj.113771","DOIUrl":"https://doi.org/10.33963/v.phj.113771","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic right ventricular size and function remain constant during a 10-year follow-up in patients with transposition of the great arteries after atrial switch surgery.","authors":"Magdalena Lipczyńska, Mateusz Śpiewak, Magdalena Marczak","doi":"10.33963/v.phj.113722","DOIUrl":"10.33963/v.phj.113722","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical sparing strain (cherry-on-top sign) and the associated amyloidosis red-flag profile in patients with a hypertrophic phenotype: A single-center pilot.","authors":"Renata Rajtar-Salwa, Agata Krawczyk-Ożóg, Michał Susuł, Jakub Batko, Paweł Petkow-Dimitrow, Stanisław Bartuś, Artur Dziewierz","doi":"10.33963/v.phj.113668","DOIUrl":"https://doi.org/10.33963/v.phj.113668","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endo-epicardial strategy in persistent and longstanding persistent atrial fibrillation: Clinical outcomes in terms of atrial fibrillation recurrences and burden during continuous monitoring.","authors":"Massimiliano Marini, Stefano Branzoli, Manuela Iseppi, Luigi Pannone, Roberto Rordorf, Domenico Catanzariti, Mauro Fantinel, Giammario Spadacini, Silvia Quintarelli, Francesco Onorati, Roberto Bonmassari, Bart Maesen, Mark La Meir, Carlo de Asmundis, Giuseppe Boriani","doi":"10.33963/v.phj.113623","DOIUrl":"https://doi.org/10.33963/v.phj.113623","url":null,"abstract":"<p><strong>Background: </strong>In patients with persistent and long-standing persistent atrial fibrillation (AF), staged endo-epicardial ablation is increasingly used to treat complex arrhythmogenic substrates. However, rhythm outcomes are traditionally assessed using binary recurrence definitions that may not reflect the clinical relevance of residual arrhythmia.</p><p><strong>Aims: </strong>Our aim was to evaluate AF recurrence and AF burden using continuous implantable loop recorder (ILR) monitoring after staged endo-epicardial ablation.</p><p><strong>Methods: </strong>In this prospective study, 89 consecutive patients with symptomatic non-paroxysmal AF undergoing staged thoracoscopic and transcatheter ablation at Santa Chiara Hospital, Trento, between 2019 and 2023 were included. All patients received continuous rhythm monitoring with an ILR. The primary endpoint was freedom from AF episodes lasting >30 seconds after the blanking period. AF burden was assessed using predefined thresholds of 0.1% and 5%.</p><p><strong>Results: </strong>89 patients (mean age 65 [± 9] years; 85% male) were analyzed. Freedom from AF recurrence was 84.2% at 6 months and 48.5% at 36 months. Continuous monitoring showed a substantial discrepancy between binary AF recurrence and cumulative AF burden. Despite documented recurrences, most patients maintained AF burden <5% during follow-up. Several patients classified as failures by the >30-second criterion showed minimal cumulative AF burden. An AF burden >0.1% was associated with cardiovascular rehospitalization. Symptoms improved markedly during follow-up, including in patients with ILR-documented recurrence.</p><p><strong>Conclusions: </strong>Continuous monitoring after staged endo-epicardial ablation shows a substantial and durable reduction in AF burden despite recurrences detected by conventional criteria. AF burden may represent a more clinically meaningful measure of rhythm control than traditional recurrence definitions.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting 3-year mortality after myocardial infarction in a structured care program: A comparative analysis of Cox regression and machine learning models.","authors":"Cyntia Szymańska-Łyczkowska, Rafał Dankowski, Julita Fedorowicz, Joanna Loda, Aleksandra Loda, Helena Krysztofiak, Wojciech Telec, Piotr Kałmucki, Małgorzata Małek-Elikowska, Martyna Sobiś, Artur Baszko","doi":"10.33963/v.phj.113620","DOIUrl":"https://doi.org/10.33963/v.phj.113620","url":null,"abstract":"<p><strong>Background: </strong>Accurate risk stratification after myocardial infarction (MI) remains essential for optimizing long-term management. The advantage of machine learning (ML) over conventional statistical models in real-world clinical settings remains uncertain.</p><p><strong>Aims: </strong>Our aim was to compare the performance of Cox proportional hazards regression and ML models in predicting 3-year all-cause mortality after MI.</p><p><strong>Methods: </strong>This retrospective cohort study included 965 patients enrolled in a structured post-MI care program between 2018 and 2022, all with complete 3-year follow-up. A development cohort (n = 740) and a temporal validation cohort (n = 225) were defined. A Cox model and three ML models (Random Forest, XGBoost, and Random Survival Forest) were developed using baseline clinical variables. Performance was assessed at a fixed 3-year horizon using area under the receiver operating characteristic curve, calibration, and the Brier score.</p><p><strong>Results: </strong>During the 3-year follow-up, 126 patients (13%) died. In temporal validation, discrimination was similar across models, with area under the receiver operating characteristic curves of 0.742 (Cox), 0.738 (Random Survival Forest), 0.727 (Random Forest), and 0.712 (XGBoost) (P = 0.59). Random Survival Forest achieved the lowest Brier score (0.105). In multivariable Cox analysis, age, comorbidity index, log-transformed creatinine, and log-transformed C-reactive protein were independently associated with mortality.</p><p><strong>Conclusions: </strong>In a moderate-sized real-world cohort with limited predictors, ML models did not outperform Cox regression in predicting 3-year mortality after MI. Age, comorbidity burden, renal dysfunction, and inflammatory status emerged as the most important predictors of mortality. These findings require external validation in independent cohorts before clinical implementation.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension is the most common cardiovascular risk factor in cancer patients - data from the CONNECT-POL registry.","authors":"Katarzyna Styczkiewicz, Mateusz Tajstra, Aleksandra Liżewska-Springer, Bartosz Krakowiak, Maciej Dyrbuś, Sławomir Blamek, Maria Olszowska, Radosław Grabysa, Anna Tomaszuk-Kazberuk, Małgorzata Lelonek, Jarosław Drożdż, Marek Styczkiewicz, Mateusz A Iwański, Agnieszka Olszanecka, Waldemar Banasiak, Andrzej Sokołowski, Anna Kochańska, Zuzanna Lewicka-Potocka, Tomasz Rutkowski, Ewa Lewicka","doi":"10.33963/v.phj.113621","DOIUrl":"https://doi.org/10.33963/v.phj.113621","url":null,"abstract":"<p><strong>Background: </strong>Arterial hypertension is a major cardiovascular risk factor (CVRF) associated with increased risk of cardiotoxicity in cancer patients.</p><p><strong>Aims: </strong>The aim of this study was to determine the prevalence of hypertension in patients with newly diagnosed cancer and compare it with the prevalence in the general population.</p><p><strong>Methods: </strong>Data were derived from the CONNECT-POL registry, the largest prospective Polish study assessing the burden of cardiovascular problems among cancer patients. Inclusion criteria were adult age and newly diagnosed breast, lung, colorectal, or prostate cancer. The occurrence of CVRF and cardiovascular diseases were recorded during a cardiology consultation.</p><p><strong>Results: </strong>Between October 2023 and February 2025 in 11 centers 1523 patients were enrolled - 951 women, 572 men, at median age 67 (interquartile range 16) years. The most frequent CVRF was arterial hypertension, present in 949 patients (62.3%). The prevalence of hypertension reached 79.1% in colorectal, 75.1% in prostate, 69.4% in lung, and 50.1% in breast cancer. In multivariable analysis, hypertension was independently associated with age, body weight, dyslipidemia, diabetes, obesity and colon cancer compared to other cancer types. After age standardization to the structure of the WOBASZ II study, the prevalence of hypertension was higher among patients with colorectal (P = 0.045) and lung (P = 0.002) cancer compared with general population.</p><p><strong>Conclusions: </strong>The prevalence of hypertension in cancer patients is very high compared to the general population and varies by cancer type, being highest in colorectal cancer and lowest in breast cancer patients. These results highlight the importance of routine blood pressure monitoring and encouraging home blood pressure monitoring in patients scheduled for oncological therapy.</p>","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantation of a leadless pacemaker in a patient after suicidal self-extraction of a transvenous pacing system.","authors":"Maciej Kempa, Szymon Budrejko, Grzegorz Sławiński, Elżbieta Wabich, Ludmiła Daniłowicz-Szymanowicz","doi":"10.33963/v.phj.113586","DOIUrl":"https://doi.org/10.33963/v.phj.113586","url":null,"abstract":"","PeriodicalId":17784,"journal":{"name":"Kardiologia polska","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}