Postepy W Kardiologii Interwencyjnej最新文献

Introduction: Aortic stenosis (AS) is associated with alterations in the concentrations of nitric oxide (NO)-related pathway molecules, including arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA).

Aim: We aimed to determine the effect of transcatheter aortic valve implantation (TAVI) on the concentrations of arginine, ADMA, and SDMA and to evaluate their predictive value for post-TAVI outcomes.

Material and methods: In total, 128 patients with AS referred for TAVI were enrolled in the study. Blood samples were collected 1 day before TAVI and at hospital discharge. Concentrations of arginine, ADMA, and SDMA were measured using ultra performance liquid chromatography coupled with mass spectrometry.

Results: Plasma concentrations of arginine, ADMA, and SDMA did not change after TAVI, compared to baseline (p ≥ 0.70 for all). The median time of follow-up was 13.5 months. Arginine, ADMA, and SDMA did not predict post-TAVI MACE during the follow-up time (p ≥ 0.88). There were significant negative correlations between the concentrations of ADMA and SDMA and echocardiographic parameters of AS severity before TAVI (p < 0.01 for all).

Conclusions: Plasma concentrations of arginine, ADMA, and SDMA were not affected by TAVI and did not predict post-TAVI MACE. ADMA and SDMA negatively correlated with AS severity, which might indicate alterations in the NO/L-arginine pathway in patients with AS.

Introduction: Myocardial infarction (MI) is a complex clinical syndrome that significantly influences long-term outcomes through its effects on myocardial remodeling, heart failure progression, and mortality. Despite extensive research, there is still no consensus regarding optimal biomarkers for risk stratification of MI patients in terms of long-term outcomes.

Aim: The study aimed to assess neutrophil-to-lymphocyte ratio (NLR) and evaluate the association between this ratio and long-term clinical and echocardiographic outcomes in patients hospitalized for MI.

Material and methods: A total of 412 patients hospitalized for MI between 2016 and 2019 were screened. Demographic data, baseline clinical characteristics, typical biochemical parameters, and angiographic and echocardiographic findings were analyzed. Patients underwent long-term clinical and echocardiographic follow-up.

Results: NLR correlated negatively with both baseline and follow-up left ventricular ejection fraction (LVEF) (r = -0.214; p = 0.043 and r = -0.3; p < 0.001, respectively). In regression analysis, NLR was a significant predictor of long-term reduced LVEF (defined as a value < 40%) (OR = 4.01; p < 0.001) as well as all-cause mortality (OR = 1.16; p = 0.008). In receiver operating characteristic (ROC) analysis, NLR demonstrated significant predictive value for mortality (AUC = 0.65; p = 0.04) with an optimal cut-off point of 8.7 (Youden index = 0.4). Kaplan-Meier analysis revealed that patients with NLR > 8.7 had significantly poorer survival compared to those with lower NLR values (p < 0.001).

Conclusions: Elevated NLR was associated with poorer left ventricular function and increased mortality in patients after MI during long-term observation.

Introduction: When used by experienced operators, excimer laser coronary artery angioplasty is a well-established therapy that can be used during percutaneous coronary intervention to treat a wide range of coronary lesions including heavily calcified stenosis.

Aim: This study sought to analyze the safety and effectiveness of laser angioplasty with the Auryon laser system for the treatment of heavily calcified coronary lesions.

Material and methods: A pragmatic sample of 20 patients with heavily calcified stenosis gave informed consent to participate in the study; we evaluated patient characteristics including age, cardiovascular risk factors, angiographic data (lesion complexity, number of stenoses, chronic total occlusion), calcium arch, thrombolysis in myocardial infarction (TIMI) flow before and after revascularization, percutaneous coronary intervention (PCI) success, and acute-stent thrombosis.

Results: A total of 20 subjects (20 lesions) were enrolled. A successful result, defined as < 30% residual stenosis and TIMI 3 flow after PCI, was achieved in 95% of cases.

Conclusions: This study introduced the successful use of this innovative device to treat high calcium and complex epicardial stenosis in 20 patients. The positive impressions include the ease of use and the safety and effectiveness in the treatment of severely calcified lesions.

Introduction: New standards for cardiac rehabilitation are currently being established worldwide.

Aim: To evaluate the effectiveness of in-hospital rehabilitation models in patients after coronary artery bypass grafting (CABG).

Material and methods: One hundred men with stable coronary artery disease were randomly assigned to two groups: standard model (SM) and intense model (IM). Subjects then underwent CABG and were rehabilitated according to the assigned model. Effects were verified by the 6-minute walk test (6MWT), which was performed before and after the intervention.

Results: In the initial 6MWT, subjects in the SM group achieved a higher SpO₂ (Me: SM = 97%, 98%; IM = 96%, 97%). In the final 6MWT, subjects in the IM group achieved a higher SpO₂ (Me: SM = 96%, 97%; IM = 97%, 98%), a lower initial HR (Me: SM = 84; IM = 78) and a lower post-exercise HR (Me: SM = 92.5; IM = 84.5), a longer distance covered (Me: SM = 312 m; IM = 359 m), a lower fatigue (Me: SM = 3; IM = 1) and a shorter hospitalization time. Group differences between initial and final 6MWT; In IM: SBP and SpO₂ in the initial 6MWT were higher than in the final 6MWT, HR in the initial 6MWT was lower than in the final 6MWT, distance travelled in the initial 6MWT was longer than in the final 6MWT, reported fatigue in the initial 6MWT was lower than in the final 6MWT. In IM: SBP in the initial 6MWT was higher than in the final 6MWT, SpO₂ and HR in the initial 6MWT were lower than in the final 6MWT.

Conclusions: The intense model showed a more favorable effect on the physical and functional status. Increasing the load, extending the duration of training sessions, and expanding the range of functionality are safe.