Ewa Straburzynska-migaj - Academia.edu (original) (raw)
Papers by Ewa Straburzynska-migaj
Kardiologia Polska, 2019
of experts from the Working Group on Cardiac Rehabilitation and Exercise Physiology of the Polish... more of experts from the Working Group on Cardiac Rehabilitation and Exercise Physiology of the Polish Cardiac Society concerning the indications, performance technique, and interpretation of results for CPET in adult cardiology. Cardiopulmonary exercise testing CPET is an electrocardiographic exercise test expanded with exercise evaluation of ventilation and
Folia Cardiologica …, 2005
Background: Adult patients with atrial septal defect in most cases describe their physical perfor... more Background: Adult patients with atrial septal defect in most cases describe their physical performance as normal. This fact may further delay the decision to close the defect. Subjective perception of resting physical fitness does not fully relate to patient's clinical status. The aim of the study was to determine exercise capacity using spiroergometry, in adult asymptomatic patients with atrial septal defects. Material and methods: Thirty-six patients (25 F), mean age 44.7 ± 8.2 years with patent ASD II were studied. The control group consisted of 25 healthy individuals (15 F), mean age 45,6 ± 6,1 years. Echocardiographic examination included end diastolic dimensions (EDD) of left ventricle (LV) and right ventricle (RV) measurements and also ejection fraction of left ventricle (LVEF), degree of mitral insufficiency, right ventricular end-systolic pressure (RVSP), and pulmonary perfusion to systemic perfusion ratio (Qp:Qs) were calculated. Exercise test on a moving track according to modified Bruce protocol was performed as well as resting spirometry, where forced vital capacity (FVC) was measured along with tidal volume (TV), minute ventilation equivalent (VE), forced expiratory volume (FEV 1), forced expiratory flow (FEF 25-75%), and peak oxygen consumption (peak VO 2). Analysis of VE/VCO 2 slope was also performed. Conclusion: As a result of analysis of the above parameters, following conclusions were formulated: Exercise capacity was significantly reduced among patients with ASD, contrary to their subjective perception. Decreased exercise capacity results from decreased heart ejection due to altered anatomy and functional pathologies of lungs consequent to increased pulmonary blood flow.
Journal of Clinical Medicine
Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart fa... more Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and ...
Advances in Interventional Cardiology, 2020
Annals of Transplantation, 2020
Departmental sources Background: Antiproliferative drugs including mycophenolate mofetil (MMF) ar... more Departmental sources Background: Antiproliferative drugs including mycophenolate mofetil (MMF) are widely accepted part of an immunosuppressive therapy following heart transplantation. Proton pump inhibitors (PPIs) are routinely administered after cardiac surgery procedures including transplantation. They may also have impact on mycophenolate acid (MPA) serum levels. Material/Methods: There were 30 consecutive patients (28 male and 2 female patients) with a mean age of 45±12 years who were enrolled into this study. MPA serum levels were studied; PPIs were intravenously and orally administered. Results: The mean MPA plasma concentrations were statistically significantly different between parenteral group (2.3±1.4 umg/mL) and oral group (3.1±2.2 umg/mL) (P=0.036) before immunosuppressive drug administration (C-0 time). There was a statistically significant different drug concentration at the second sample time C-30 (30 minutes after drug intake) reaching 4.4±2.8 umg/mL versus 7.9±4.5 umg/mL (P<0.05). There was no statistically significant difference in MPA plasma concentration at the 3 rd measurement C-120 (10.7±4,9 umg/mL versus 9.8±5 umg/mL) (P=0.3). There is a statistically significant different MMF serum concentration after oral intake and intravenous infusion at C-30 (2.4±1.4 in group 1 versus 3.3±2.5 in group 2, P<0.036) but not at C-120 time interval (8.9±5.0 versus 9.8±5.3 in group 1 and 2, respectively) (P=0.3). Conclusions: Our study was the first study that compared different routes of PPI co-administration on MPA serum levels in a transplant recipient group. Our study revealed that the parenteral route of administration only slowed not decreased MPA pharmacokinetics within 120 minutes following MMF administration.
Kardiologia Polska, 2019
in particular, leads to worsening of the condition and hospitalization. This is of particular imp... more in particular, leads to worsening of the condition and hospitalization. This is of particular importance for patients released from the hospital after acute decompensated HF, for whom the risk of repeated exacerbation is very high but could be prevented by optimizing treatment. Also noticeable is the lack of coordination between medical units providing care to patients, including limited communication, leading to repeated examinations and suboptimal therapeutic decisions. The fact that certain services are unavailable as one-day procedures or without hospitalization, on the other hand, leads to unnecessary hospital admissions. Limitations persist after hospitalization, mainly in terms of access to advanced therapy-caused by a budget ceiling-which lengthens the waiting time for some procedures (such as ablation, implantation of devices like pacemakers or implantable cardioverter-defibrillators and some valve procedures). This has significant implications for patient survival rates, especially
European Journal of Heart Failure, 2019
AimsTo assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF)... more AimsTo assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM‐HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes.Methods and resultsOutpatients with HFrEF in the ESC‐EORP‐HFA Long‐Term Heart Failure (HF‐LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM‐HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM‐HF and guideline criteria, respectively. Absent PARADIGM‐HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub‐optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%...
Acta Biochimica Polonica, 2012
There is an increasing interest in the role of adipocytokines in cardiovascular pathophysiology. ... more There is an increasing interest in the role of adipocytokines in cardiovascular pathophysiology. The aim of the study was to compare visfatin levels, a novel adipokine, in patients with heart failure (HF) due to the left ventricular systolic dysfunction with those in age- and body mass index (BMI) - matched healthy controls in relation to the parameters of glucose metabolism and high sensitivity C-reactive protein (hsCRP) levels. The study population consisted of 28 males with systolic HF referred for cardiopulmonary exercise testing, divided into two subgroups based on their NYHA class (HF patients NYHA(I+II), n=17, and HF patients NYHA(III+IV,) n=11), and 23 controls. The following indices were measured in a serum samples: visfatin, hsCRP, glucose and lipid metabolism parameters, and the insulin resistance index HOMA(IR) (homeostasis model assessment insulin resistance) was calculated. Concentrations of visfatin and high-density lipoprotein cholesterol (HDL-cholesterol) in the HF ...
![Research paper thumbnail of [Coordinated heart failure care in Poland: towards optimal organisation of the health care system]](https://attachments.academia-assets.com/105968232/thumbnails/1.jpg)
](Kardiologia polska, 2018
Heart failure has becoming an increasing medical, economic, and social problem globally. The prev... more Heart failure has becoming an increasing medical, economic, and social problem globally. The prevalence of this syndrome is rising, and despite unequivocal positive effects of modern therapy, reduction of mortality has been achieved at the cost of more frequent hospitalisations. Unlike in many European countries, in Poland heart failure is usually recognised later, at a more advanced stage of the disease, leaving less time for ambulatory treatment and resulting in a high number of hospitalisations. The current paper presents the most important data regarding morbidity and mortality due to heart failure in Poland. The experts in the field focus on the key source of high costs of therapy and highlight several critical organisational deficits present in the Polish health care system. This background information builds a basis for a concept of coordinated care for patients with heart failure. The paper discusses the fundamental elements of the system of coordinated care for patients wit...
Polish Archives of Internal Medicine, 2014
Polish archives of internal medicine, Jan 28, 2017
Polish Journal of Cardio-Thoracic Surgery, 2016
Invasive aspergillosis is becoming increasingly prevalent, especially following transplantation. ... more Invasive aspergillosis is becoming increasingly prevalent, especially following transplantation. Invasive aspergillosis is associated with mortality. Successful therapy is related to early diagnosis and proper therapy. We present the case of a 61-year-old man suffering from invasive aspergillosis 2 months following heart transplantation. He was suffering from hypertrophic cardiomyopathy and he underwent orthotropic heart transplantation. He was readmitted to the Department of Cardiology 69 days following transplantation due to symptoms of productive cough for 5 days. It was accompanied by chest pain, shortness of breath, and fever up to 39°C. He was slightly cyanotic and confused on physical examination. The patient's status deteriorated within the following 2 days. On bronchoscopic specimen examinations Aspergillus mould filaments were detected and the serum galactomannan index was 12.162. His blood saturation decreased to 85%. C-reactive protein serum level increased to 273 mg/l. The patient was admitted to the intensive care unit and intubated due to severe respiratory insufficiency. Computed tomography revealed massive, mostly homogeneous consolidation. The patient was treated with 200 mg of voriconazole and 50 mg of caspofungin daily. Caspofungin therapy was continued for 23 days and voriconazole was administered parenterally for 62 days. Voriconazole therapy was continued orally for 9 months. During combined antifungal therapy, the galactomannan serum index constantly decreased from 12.1 to 0.33 (end-point of caspofungin therapy) and to 0.23 (end-point of voriconazole parenteral administration). His immunosuppressive therapy was limited to calcineurin inhibitor (tacrolimus) monotherapy. Post-treatment imaging 9 months after diagnosis confirmed the efficacy of therapy as a lack of pulmonary infiltration associated with left apical peribronchial scarring as a result of treatment. The CASE REPORT
Polish Archives of Internal Medicine, 2016
Choroby lewego serca stanowią najczęstszą przyczynę nadciśnienia płucnego (PH). Uważa się, że nad... more Choroby lewego serca stanowią najczęstszą przyczynę nadciśnienia płucnego (PH). Uważa się, że nadciśnienie płucne występujące w niewydolności serca związane jest z gorszym rokowaniem w tej grupie pacjentów. W ocenie wstępnej pacjentów z HF wykorzystuje się metody nieinwazyjne, jak echokardiografia oraz oznaczanie stężeń peptydów natriuretycznych (BNP) natomiast ostateczne rozpoznanie PH wymaga wykonania cewnikowania prawego serca (RHC). Przeanalizowano retrospektywnie dokumentację 59 pacjentów (zarówno kobiet, jak i mężczyzn) z HFrEF(EF<40%) hospitalizowanych w latach 2012-2013 w Klinice Kardiologii w celu kwalifikacji do przeszczepienia serca. Inwazyjna ocena hemodynamiczna obejmowała cewnikowanie prawego serca metodą termodylucji. Wykonano ocenę korelacji RHC z wybranymi parametrami echokardiograficznymi i BNP. Analizę statystyczną przeprowadzono przy pomocą programu Statistica, wykorzystując do oceny korelacji test Spearmana. Istotność statystyczna: p<0,05. Wykazano istotne...
Kardiologia Polska, 2019
of experts from the Working Group on Cardiac Rehabilitation and Exercise Physiology of the Polish... more of experts from the Working Group on Cardiac Rehabilitation and Exercise Physiology of the Polish Cardiac Society concerning the indications, performance technique, and interpretation of results for CPET in adult cardiology. Cardiopulmonary exercise testing CPET is an electrocardiographic exercise test expanded with exercise evaluation of ventilation and
Folia Cardiologica …, 2005
Background: Adult patients with atrial septal defect in most cases describe their physical perfor... more Background: Adult patients with atrial septal defect in most cases describe their physical performance as normal. This fact may further delay the decision to close the defect. Subjective perception of resting physical fitness does not fully relate to patient's clinical status. The aim of the study was to determine exercise capacity using spiroergometry, in adult asymptomatic patients with atrial septal defects. Material and methods: Thirty-six patients (25 F), mean age 44.7 ± 8.2 years with patent ASD II were studied. The control group consisted of 25 healthy individuals (15 F), mean age 45,6 ± 6,1 years. Echocardiographic examination included end diastolic dimensions (EDD) of left ventricle (LV) and right ventricle (RV) measurements and also ejection fraction of left ventricle (LVEF), degree of mitral insufficiency, right ventricular end-systolic pressure (RVSP), and pulmonary perfusion to systemic perfusion ratio (Qp:Qs) were calculated. Exercise test on a moving track according to modified Bruce protocol was performed as well as resting spirometry, where forced vital capacity (FVC) was measured along with tidal volume (TV), minute ventilation equivalent (VE), forced expiratory volume (FEV 1), forced expiratory flow (FEF 25-75%), and peak oxygen consumption (peak VO 2). Analysis of VE/VCO 2 slope was also performed. Conclusion: As a result of analysis of the above parameters, following conclusions were formulated: Exercise capacity was significantly reduced among patients with ASD, contrary to their subjective perception. Decreased exercise capacity results from decreased heart ejection due to altered anatomy and functional pathologies of lungs consequent to increased pulmonary blood flow.
Journal of Clinical Medicine
Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart fa... more Frailty syndrome (FS) has recently attracted attention as one of the major predictors of heart failure (HF) course severity. We aimed to develop a simple tool for predicting frailty in hospitalized HF patients using routine clinical parameters. A total of 153 hospitalized patients diagnosed with heart failure with reduced ejection fraction (HFrEF) were included in the study. Presence of FS was assessed with the SHARE-FI questionnaire. Clinical and biochemical parameters were collected. Using ROC curves and logistic regression analysis, a model predicting FS presence was developed and tested. Proposed model includes five variables with following cut-off values (1 point for each variable): age > 50 years, systolic pressure on admission < 110 mmHg, total cholesterol < 4.85 mmol/L, bilirubin ≥ 15.5 mmol/L, and alanine aminotransferase ≤ 34 U/L. Receiving 5 points was considered a high risk of FS with positive and negative predictive values (NPV), 83% and 72%, respectively, and ...
Advances in Interventional Cardiology, 2020
Annals of Transplantation, 2020
Departmental sources Background: Antiproliferative drugs including mycophenolate mofetil (MMF) ar... more Departmental sources Background: Antiproliferative drugs including mycophenolate mofetil (MMF) are widely accepted part of an immunosuppressive therapy following heart transplantation. Proton pump inhibitors (PPIs) are routinely administered after cardiac surgery procedures including transplantation. They may also have impact on mycophenolate acid (MPA) serum levels. Material/Methods: There were 30 consecutive patients (28 male and 2 female patients) with a mean age of 45±12 years who were enrolled into this study. MPA serum levels were studied; PPIs were intravenously and orally administered. Results: The mean MPA plasma concentrations were statistically significantly different between parenteral group (2.3±1.4 umg/mL) and oral group (3.1±2.2 umg/mL) (P=0.036) before immunosuppressive drug administration (C-0 time). There was a statistically significant different drug concentration at the second sample time C-30 (30 minutes after drug intake) reaching 4.4±2.8 umg/mL versus 7.9±4.5 umg/mL (P<0.05). There was no statistically significant difference in MPA plasma concentration at the 3 rd measurement C-120 (10.7±4,9 umg/mL versus 9.8±5 umg/mL) (P=0.3). There is a statistically significant different MMF serum concentration after oral intake and intravenous infusion at C-30 (2.4±1.4 in group 1 versus 3.3±2.5 in group 2, P<0.036) but not at C-120 time interval (8.9±5.0 versus 9.8±5.3 in group 1 and 2, respectively) (P=0.3). Conclusions: Our study was the first study that compared different routes of PPI co-administration on MPA serum levels in a transplant recipient group. Our study revealed that the parenteral route of administration only slowed not decreased MPA pharmacokinetics within 120 minutes following MMF administration.
Kardiologia Polska, 2019
in particular, leads to worsening of the condition and hospitalization. This is of particular imp... more in particular, leads to worsening of the condition and hospitalization. This is of particular importance for patients released from the hospital after acute decompensated HF, for whom the risk of repeated exacerbation is very high but could be prevented by optimizing treatment. Also noticeable is the lack of coordination between medical units providing care to patients, including limited communication, leading to repeated examinations and suboptimal therapeutic decisions. The fact that certain services are unavailable as one-day procedures or without hospitalization, on the other hand, leads to unnecessary hospital admissions. Limitations persist after hospitalization, mainly in terms of access to advanced therapy-caused by a budget ceiling-which lengthens the waiting time for some procedures (such as ablation, implantation of devices like pacemakers or implantable cardioverter-defibrillators and some valve procedures). This has significant implications for patient survival rates, especially
European Journal of Heart Failure, 2019
AimsTo assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF)... more AimsTo assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM‐HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes.Methods and resultsOutpatients with HFrEF in the ESC‐EORP‐HFA Long‐Term Heart Failure (HF‐LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM‐HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM‐HF and guideline criteria, respectively. Absent PARADIGM‐HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub‐optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%...
Acta Biochimica Polonica, 2012
There is an increasing interest in the role of adipocytokines in cardiovascular pathophysiology. ... more There is an increasing interest in the role of adipocytokines in cardiovascular pathophysiology. The aim of the study was to compare visfatin levels, a novel adipokine, in patients with heart failure (HF) due to the left ventricular systolic dysfunction with those in age- and body mass index (BMI) - matched healthy controls in relation to the parameters of glucose metabolism and high sensitivity C-reactive protein (hsCRP) levels. The study population consisted of 28 males with systolic HF referred for cardiopulmonary exercise testing, divided into two subgroups based on their NYHA class (HF patients NYHA(I+II), n=17, and HF patients NYHA(III+IV,) n=11), and 23 controls. The following indices were measured in a serum samples: visfatin, hsCRP, glucose and lipid metabolism parameters, and the insulin resistance index HOMA(IR) (homeostasis model assessment insulin resistance) was calculated. Concentrations of visfatin and high-density lipoprotein cholesterol (HDL-cholesterol) in the HF ...
Kardiologia polska, 2018
Heart failure has becoming an increasing medical, economic, and social problem globally. The prev... more Heart failure has becoming an increasing medical, economic, and social problem globally. The prevalence of this syndrome is rising, and despite unequivocal positive effects of modern therapy, reduction of mortality has been achieved at the cost of more frequent hospitalisations. Unlike in many European countries, in Poland heart failure is usually recognised later, at a more advanced stage of the disease, leaving less time for ambulatory treatment and resulting in a high number of hospitalisations. The current paper presents the most important data regarding morbidity and mortality due to heart failure in Poland. The experts in the field focus on the key source of high costs of therapy and highlight several critical organisational deficits present in the Polish health care system. This background information builds a basis for a concept of coordinated care for patients with heart failure. The paper discusses the fundamental elements of the system of coordinated care for patients wit...
Polish Archives of Internal Medicine, 2014
Polish archives of internal medicine, Jan 28, 2017
Polish Journal of Cardio-Thoracic Surgery, 2016
Invasive aspergillosis is becoming increasingly prevalent, especially following transplantation. ... more Invasive aspergillosis is becoming increasingly prevalent, especially following transplantation. Invasive aspergillosis is associated with mortality. Successful therapy is related to early diagnosis and proper therapy. We present the case of a 61-year-old man suffering from invasive aspergillosis 2 months following heart transplantation. He was suffering from hypertrophic cardiomyopathy and he underwent orthotropic heart transplantation. He was readmitted to the Department of Cardiology 69 days following transplantation due to symptoms of productive cough for 5 days. It was accompanied by chest pain, shortness of breath, and fever up to 39°C. He was slightly cyanotic and confused on physical examination. The patient's status deteriorated within the following 2 days. On bronchoscopic specimen examinations Aspergillus mould filaments were detected and the serum galactomannan index was 12.162. His blood saturation decreased to 85%. C-reactive protein serum level increased to 273 mg/l. The patient was admitted to the intensive care unit and intubated due to severe respiratory insufficiency. Computed tomography revealed massive, mostly homogeneous consolidation. The patient was treated with 200 mg of voriconazole and 50 mg of caspofungin daily. Caspofungin therapy was continued for 23 days and voriconazole was administered parenterally for 62 days. Voriconazole therapy was continued orally for 9 months. During combined antifungal therapy, the galactomannan serum index constantly decreased from 12.1 to 0.33 (end-point of caspofungin therapy) and to 0.23 (end-point of voriconazole parenteral administration). His immunosuppressive therapy was limited to calcineurin inhibitor (tacrolimus) monotherapy. Post-treatment imaging 9 months after diagnosis confirmed the efficacy of therapy as a lack of pulmonary infiltration associated with left apical peribronchial scarring as a result of treatment. The CASE REPORT
Polish Archives of Internal Medicine, 2016
Choroby lewego serca stanowią najczęstszą przyczynę nadciśnienia płucnego (PH). Uważa się, że nad... more Choroby lewego serca stanowią najczęstszą przyczynę nadciśnienia płucnego (PH). Uważa się, że nadciśnienie płucne występujące w niewydolności serca związane jest z gorszym rokowaniem w tej grupie pacjentów. W ocenie wstępnej pacjentów z HF wykorzystuje się metody nieinwazyjne, jak echokardiografia oraz oznaczanie stężeń peptydów natriuretycznych (BNP) natomiast ostateczne rozpoznanie PH wymaga wykonania cewnikowania prawego serca (RHC). Przeanalizowano retrospektywnie dokumentację 59 pacjentów (zarówno kobiet, jak i mężczyzn) z HFrEF(EF<40%) hospitalizowanych w latach 2012-2013 w Klinice Kardiologii w celu kwalifikacji do przeszczepienia serca. Inwazyjna ocena hemodynamiczna obejmowała cewnikowanie prawego serca metodą termodylucji. Wykonano ocenę korelacji RHC z wybranymi parametrami echokardiograficznymi i BNP. Analizę statystyczną przeprowadzono przy pomocą programu Statistica, wykorzystując do oceny korelacji test Spearmana. Istotność statystyczna: p<0,05. Wykazano istotne...