Abstract Short-term exposure to air pollutants may contribute to an increased risk of acute coronary syndrome (ACS). This study assessed the role of short-term exposure to fine particulate matter (PM ...2.5 ) as well as fine and coarse PM (PM 10 ) air pollution in ACS events and the effect of blood groups on this phenomenon. A retrospectively collected database of 9026 patients was evaluated. The study design was a case-crossover using a conditional logistic regression model. The main analysis focused on PM 2.5 levels with a 1 day lag until the ACS event, using threshold-modelled predictor for all patients. Secondary analyses utilized separate threshold-modelled predictors for 2–7-days moving averages and for patients from specific ABO blood groups. Additional analysis was performed with the non-threshold models and for PM 10 levels. Short-term exposure to increased PM 2.5 and PM 10 levels at a 1-day lag was associated with elevated risks of ACS (PM 2.5 : OR = 1.012 per + 10 µg/m 3 , 95% CI 1.003, 1.021; PM 10 : OR = 1.014 per + 10 µg/m 3 , CI 1.002, 1.025) for all patients. Analysis showed that exposure to PM 2.5 was associated with increased risk of ACS at a 1-day lag for the A, B or AB group (OR = 1.012 per + 10 µg/m 3 , CI 1.001, 1.024), but not O group (OR = 1.011 per + 10 µg/m 3 , CI 0.994, 1.029). Additional analysis showed positive associations between exposure to PM 10 and risk of ACS, with 7-days moving average models stratified by blood group revealing that exposures to PM 2.5 and PM 10 were associated with elevated risk of ACS for patients with group O. Short-term exposures to PM 2.5 and PM 10 were associated with elevated risk of ACS. Short-term exposure to PM 2.5 was positively associated with the risk of ACS for patients with A, B, or AB blood groups for a 1-day lag, while risk in O group was delayed to 7 days.
Cardiac sarcoidosis Niemiec, Małgorzata; Gruchlik, Bartosz; Niemiec, Jan ...
Annales Academiae Medicae Silesiensis,
12/2023, Letnik:
77
Journal Article
Recenzirano
Odprti dostop
Sarkoidoza serca (cardiac sarcoidosis – CS) jest rzadkim i trudnym do zdiagnozowania schorzeniem prowadzącym do zaburzeń przewodzenia, rytmu i nagłej śmierci sercowej.
Rozpoznanie CS jest niezwykle ...trudne, ponieważ we wczesnych stadiach może nie dawać objawów i często imituje inne stany. Narzędziami diagnostycznymi wykorzystywanymi w diagnostyce CS są: echokardiografia, rezonans magnetyczny, pozytonowa tomografia emisyjna oraz biopsja zmienionej tkanki. Leczenie polega na zastosowaniu leków hamujących układ odpornościowy. Niektóre zaburzenia rytmu serca i przewodzenia związane z CS mogą mieć charakter odwracalny, jednak częściej wymagają one zabezpieczenia urządzeniami takimi jak rozruszniki serca czy defibrylatory.
Konieczne są dalsze badania w celu opracowania skuteczniejszych strategii diagnostycznych dla poprawy wykrywania i leczenia tego stanu.
Cardiac sarcoidosis (CS) is a rare and difficult-to-diagnose condition that leads to conduction disorders, arrhythmias, and sudden cardiac death.
Diagnosing CS is extremely difficult because it can be asymptomatic in its early stages and often mimics other conditions.
The diagnostic tools used in the diagnosis of CS are: echocardiography, magnetic resonance imaging, positron emission tomography and biopsy of the affected tissue. Treatment involves the use of drugs that suppress the immune system. Some of the arrhythmias and conduction disturbances associated with CS may be reversible, but more often they require protection with devices such as pacemakers or defibrillators.
More research is needed to develop more effective diagnostic strategies to improve the detection and treatment of this condition.
Aortic valve stenosis (AS) is a common heart valve disease in the elderly population, and its pathogenesis remains an interesting area of research. The degeneration of the aortic valve leaflets ...gradually progresses to valve sclerosis. The advanced phase is marked by the presence of extracellular fibrosis and calcification. Turbulent, accelerated blood flow generated by the stenotic valve causes excessive damage to the aortic wall. Elevated shear stress due to AS leads to the degradation of high-molecular weight multimers of von Willebrand factor, which may involve bleeding in the mucosal tissues. Conversely, elevated shear stress has been associated with the release of thrombin and the activation of platelets, even in individuals with acquired von Willebrand syndrome. Moreover, turbulent blood flow in the aorta may activate the endothelium and promote platelet adhesion and activation on the aortic valve surface. Platelets release a wide range of mediators, including lysophosphatidic acid, which have pro-osteogenic effects in AS. All of these interactions result in blood coagulation, fibrinolysis, and the hemostatic process. This review summarizes the current knowledge on high shear stress-induced hemostatic disorders, the influence of AS on platelets and antiplatelet therapy.
We aimed to evaluate the rate and risk factors of in-hospital mortality in patients undergoing coronary angiography/angioplasty with IABP use as support. We included 214 patients (mean age: 67.5 ± ...7.5 years, M/F: 143/71) with an IABP used as the periprocedural support between 2012 and 2020. The main indications for an IABP were cardiogenic shock (143 pts; 66.8%: 55 survivors (51.9%)/88 non-survivors (81.5%);
< 0.001) and infarction with an initial significant impairment of ventricular function (34 pts; 15.9%: 21 (19.8%)/13 (12%);
= 0.12). In-hospital death was the endpoint of this study. In-hospital death occurred in 108 (50.5%, M/F: 69.4%/30.6%) patients. The mean hospitalization time was 7 days (2-13); deaths occurred more frequently on the first day after the procedure (1 (1-3 days) vs. 3 (1-8),
< 0.001); and the mean hospitalization time was 2 days (1-6) for non-survivors vs. 11 days (7-17) for survivors (
< 0.001). Regarding the patients who did not survive, they were older (69 vs. 66.5,
= 0.043), their LVEF was lower (0-15%: 15 (13.9%) vs. 12 (11.3%); 16-40%: 73 (67.6%) vs. 65 (61.3%); >40%: 14 (13%) vs. 29 (27.4%);
= 0.007), and hyperlipidemia was less common (30 (27.8%) vs. 55 (51.9%) pts,
= 0.001) than in those who survived. The IABP is still a method for cardiac support; however, mortality limits its use.
Cardiac amyloidosis Niemiec, Małgorzata; Balwierz, Magdalena; Gruchlik, Bartosz ...
Annales Academiae Medicae Silesiensis,
6/2024, Letnik:
78
Journal Article
Recenzirano
Amyloidoza jest rzadką chorobą charakteryzującą się nieprawidłowym gromadzeniem się białka amyloidowego w tkankach. Amyloidozę można podzielić na dwa główne podtypy: amyloidozę transtyretynową ...(ATTR-CA) i amyloidozę łańcuchów lekkich immunoglobulin (AL-CA). Nagromadzenie białka amyloidu w mięśniu sercowym może doprowadzić do zaburzeń przewodzenia, kardiomiopatii restrykcyjnej i w konsekwencji niewydolności serca. Objawy mogą obejmować spadek tolerancji wysiłku, duszność, obrzęki oraz omdlenia. Rozpoznanie opiera się na badaniach laboratoryjnych, obrazowych oraz biopsji. Leczenie koncentruje się głównie na spowolnieniu postępu choroby oraz leczeniu objawowym.
Amyloidosis is a rare disease characterized by an abnormal accumulation of the amyloid protein in tissues. Amyloidosis can be divided into two main subtypes: transthyretin amyloidosis (ATTR-CA) and immunoglobulin light chain amyloidosis (AL-CA). Accumulation of the amyloid protein in the heart muscle may lead to conduction disturbances, restrictive cardiomyopathy, and consequently, heart failure. The symptoms may include decreased exercise tolerance, shortness of breath, swelling and fainting. The diagnosis is based on laboratory tests, imaging and biopsy. Treatment focuses mainly on slowing the progression of the disease and treating the symptoms.
We present an unusual clinical case of a 39-year-old woman admitted to the Department of Cardiology due to stenocardial pain accompanied by hypertensive crisis. The patient presented with severe ...chest pain and high blood pressure, along with a history of type 2 diabetes, hyperlipidemia, smoking, and hypertension. Initial tests showed elevated troponin T, glucose, CRP, and D-dimer levels, and electrocardiography and transthoracic echocardiography showed abnormalities suggesting acute myocardial infarction, but angiography did not reveal any significant coronary artery blockages. Further tests and imaging led to a diagnosis of takotsubo syndrome (TTS) and suspicion of pheochromocytoma, which was confirmed later biopsy. The presented case is very rare because the coexistence of TTS and pheochromocytoma is not common due to the rarity of the tumor. It is very important to make a quick and accurate diagnosis, because improperly treated cases can lead to death.
