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.

Mitral valve prolapse (MVP) is the most common cause of primary (degenerative) mitral regurgitation and represents a heterogeneous disease spectrum with generally benign prognosis but potentially serious complications. Advances in imaging have refined diagnostic criteria, reducing historical overdiagnosis and clarifying the morphologic continuum from fibroelastic deficiency to extensive myxomatous degeneration (Barlow's disease). Beyond mitral regurgitation and infective endocarditis, a small but clinically important subset of patients is at increased risk of malignant ventricular arrhythmias and sudden cardiac death, giving rise to the concept of arrhythmogenic MVP. This phenotype is characterized by a combination of clinical, anatomical, myocardial, and electrical features rather than a single abnormality. Key associated findings include bileaflet prolapse, female sex, electrocardiographic repolarization changes, frequent or complex ventricular ectopy, myocardial fibrosis detectable by cardiac magnetic resonance, abnormal tissue Doppler signals, and mitral annular disjunction (MAD). MAD, including both true MAD and the more common pseudo-MAD, contributes to excessive mobility of the mitral valve apparatus, abnormal systolic annular motion ("curling"), and repetitive mechanical stress on the papillary muscles and inferobasal left ventricular myocardium, promoting fibrosis and arrhythmogenesis. Importantly, arrhythmic risk may persist even after surgical correction of mitral regurgitation, likely due to established myocardial substrate. Contemporary registry data confirm the heterogeneity of MVP and suggest that true primary arrhythmogenic MVP is relatively uncommon but identifiable using detailed echocardiographic and electrocardiographic assessment. Overall, arrhythmogenic MVP should be viewed as a syndrome spanning a spectrum from benign to malignant, underscoring the need for integrated risk stratification and targeted follow-up. This review summarizes the recent progress in understanding of this complex entity summarizing recent expert recommendations and novel registry data.