Kardiologia polska最新文献

Micro- and nanoplastics (MNPs) are increasingly reported in human biofluids and tissues, including cardiovascular-relevant specimens, making reliable detection and quantification a prerequisite for clinically meaningful research in cardiology. However, human-derived matrices are analytically challenging because they are often available in limited amounts, rich in lipids and proteins, highly susceptible to background contamination, and subject to matrix-driven interferences that can bias polymer identification and quantification, particularly for submicron fractions. This review provides a method-focused overview of the analytical toolbox most frequently used for MNPs assessment in biologically relevant and human samples, with specific attention to cardiovascular applications. We compare particle-resolved vibrational approaches (μ-Fourier transform infrared spectroscopy, µ-Raman, and quantum cascade laser-based laser direct infrared spectroscopy) that deliver polymer identification alongside particle counts, size proxies, and morphology, and mass-based strategies (double-shot pyrolysis-gas chromatography/mass spectrometry [MS] and targeted depolymerization coupled to liquid chromatography-MS/MS) that provide polymer-specific mass burdens suited to exposure metrics and clinical correlations. Representative studies are discussed, including recent analyses of atheromatous plaques, coronary blood, thrombi, and other human tissue where polymer burden, morphology, and size have been investigated in relation to adverse health outcomes. Finally, we outline the main advantages and limitations of each technique, emphasizing practical factors that influence data quality and comparability across studies. By framing MNP analytics within clinically relevant cardiovascular specimens and endpoints, this review aims to critically appraise current evidence and design robust translational investigations.

Background: Cardiac implantable electronic device (CIED) infections, particularly CIED-associated infective endocarditis (CIED-associated IE), are associated with a high 1-year mortality rate of 14% to 35%, reduced quality of life, and increased burden on the healthcare system.

Aims: In this prospective, single-center, high-volume referral study, we aimed to analyze and compare 3 groups of patients who underwent transvenous lead extraction (TLE): patients with CIED-associated IE, patients with pocket infection (PI), and both.

Methods: This study included all consecutive patients with CIEDs who underwent TLE due to device-related infection at a tertiary referral hospital between 2011 and 2023. Patients were divided into 3 groups (CIED-associated IE, PI and both indications) based on the modified Duke criteria.

Results: A total of 253 consecutive patients underwent TLE. Of these, 135 (53%) were treated for PI, 90 (36%) for CIED-associated IE and 28 (11%) for both indications. Almost all procedures (97%) were completed without complications. Patients with CIED-associated IE had significantly higher mortality than patients in the CIED-associated IE + PI group and patients in the PI group had the lowest. One-year, two-year, and five-year overall survival rates in the CIED-associated IE group were 61%, 49%, and 32%, respectively, compared with 77%, 73%, and 56% in the CIED-associated IE + PI group and with 90%, 86%, 67% in the PI group (P <0.001).

Conclusions: Patients with CIED-associated IE had almost a 4-fold higher 1-year mortality compared to those with PI. Patients with CIED-associated IE and PI had about twice higher one-year mortality compared to those with PI.