Kardiologia polska最新文献

Background: Transcatheter mitral edge-to-edge repair (TEER) is an effective and safe therapeutic option for patients with severe mitral regurgitation (MR) and may be used in the treatment of both primary and secondary MR.

Aims: To provide insights into patients' characteristics, in-hospital procedural outcomes, and 1-year follow-up for 1204 patients with severe MR treated with TEER in Poland.

Methods: A comprehensive, all-comers, administrative database that covers the whole population of Poland was searched for all reimbursed TEER procedures performed since 2019. Electronic health records provided details regarding baseline study group characteristics as well as the in-hospital and 1-year outcomes.

Results: The in-hospital mortality was 3.2% with no difference between sexes. Blood transfusion was required in 7.8% of patients, more frequently in women (11.1% vs. 6.1%; P = 0.004). Patients with atrial fibrillation had a higher rate of in-hospital heart failure (HF) in New York Heart Association functional class II-IV vs. I (66.8% vs. 42.5%; P < 0.001). Mean follow-up was 336.7 days. The mortality rate was 13.9% and was comparable between males and females and between patients with and without atrial fibrillation. 54.5% of patients required a HF hospitalization and 65.0% a cardiovascular hospitalization. Mortality was comparable to other European registries, but rates of HF hospitalization were higher in the Polish population.

Conclusions: The Polish TEER registry provides real-world data on transcatheter edge-to-edge repair procedures, demonstrating outcomes comparable to other European registries despite a higher-risk patient population.

Background: Exercise capacity is frequently reduced in patients with hypertrophic cardiomyopathy (HCM), but structured training has historically been limited due to concerns about arrhythmias and sudden cardiac death. Recent data suggest that supervised, individualized exercise may be safe in selected patients; however, evidence for hybrid cardiac telerehabilitation (HCT) in non-obstructive HCM remains lacking.

Aims: To evaluate the efficacy and safety of a 12-week HCT program in patients with non-obstructive HCM and preserved left ventricular ejection fraction.

Methods: In this single-center randomized controlled trial, 60 patients were allocated (1:1) to HCT or usual care. The HCT program consisted of supervised center-based exercise sessions combined with remotely monitored home training. The primary endpoint was the change in peak oxygen uptake (pVO₂) after 3 months. Secondary endpoints included changes in 6-minute walk distance, perceived health status, and safety parameters. Follow-up continued for 12 months after program completion.

Results: Fifty-eight patients completed the 3-month assessment (HCT n = 28; control n = 30). HCT resulted in a significantly greater improvement in pVO₂ compared with usual care (between-group difference: +1.35 ml/kg/min; P <0.01). Additional significant improvements were observed in 6-minute walk test distance. Perceived health status improved in both groups, with a greater increase in the HCT group. No serious adverse events occurred, and adherence to the training program was high.

Conclusions: HCT is feasible, safe, and effective in improving functional capacity and perceived health status in carefully selected patients with non-obstructive HCM. These findings support the use of structured, telemonitored exercise training in low-risk HCM populations, although larger multicenter trials are needed to confirm generalizability.

Despite spectacular progress in the treatment of patients diagnosed with cancer, cardiovascular diseases are the second leading cause of death in cancer patients, after cancer itself. According to the CONNECT-POL registry, cardiovascular risk factors are very often detected in cancer patients even before starting oncological treatment. The rapidly expanding range of new life-saving cancer therapies is unfortunately characterized by a wide range of both early and late cardiovascular complications. These include not only the classic complications long described as heart failure, but also hypertension, dyslipidemia, diabetes, and accelerated atherosclerosis. Preventive strategies aimed at their prevention and optimal treatment are crucial for improving both oncological and cardiological prognosis. Unfortunately, as is widely known, the presence of cancer negatively impacts the quality and intensity of preventive measures. In our expert opinion, after a cancer diagnosis, in addition to promptly initiating oncological therapy, prevention or addressing existing cardiovascular risk factors is also of great importance for the patient's further treatment and prognosis. This should generally be done in accordance with the principles adopted for the general population, but with certain differences for cancer patients, especially if this is a group of patients with advanced cancer. It is crucial that these activities are not conducted solely by cardiologists, but also with the support of primary care physicians and other specialties, including oncologists, with the full cooperation and acceptance of the patient. According to the authors of this document, there is a need to emphasize the role of primary prevention of cardiovascular disease in cancer patients, which has been neglected until now, and our expert opinion summarizes these recommendations.