Paweł Banyś - Academia.edu (original) (raw)

Papers by Paweł Banyś

American Heart Journal, 2008

European Journal of Echocardiography, 2010

European Heart Journal, 2019

Introduction CIRCULATE-Acute Myocardial Infarction Trial (NCT03404063) is a double-blind controll... more Introduction CIRCULATE-Acute Myocardial Infarction Trial (NCT03404063) is a double-blind controlled trial (RCT) that is randomizing consecutive patients with their first, large AMI (LVEF ≤45% and/or cMRI -infarct size ≥10% of LV) successfully treated by infarct-related artery (IRA) primary percutaneous coronary intervention reperfusion (TIMI ≥2) to transcoronary administration of Wharton Jelly Multipotent Stem Cells (WJMSCs) vs. placebo (2:1), preceded by evaluation of safety, WJMSCs myocardial uptake, and echocardiographic, cMRI and SPECT left ventricular remodelling and hemodynamic changes in pilot study cohort (PSC). Purpose To evaluate LV remodelling and hemodynamic features following WJMSCs transplantation in CIRCULATE-AMI PSC. Methods Ten consecutive patients (age 32–65 years) were administered 30 000 000 WJMSCs via the infarct-related artery at ≈5–7 days after AMI using transradial approach and a coronary-non-occlusive catheter dedicated to cell delivery. Within 3 years of fo...

European Heart Journal, 2019

Introduction The three main techniques to evaluate myocardial function and volumes: two-dimension... more Introduction The three main techniques to evaluate myocardial function and volumes: two-dimensional echocardiography (TTE), gated single photon emission computed tomography (SPECT) and cardiac magnetic resonance imaging (cMRI), have important differences in accessibility and practicality. Purpose We aimed to evaluate: TTE, SPECT and cMRI in the measurement of left ventricular ejection fraction (LVEF), left ventricular end-diastolic (LVEDV) and left ventricular end-systolic volumes (LVESV) in patients with acute and chronic myocardial ischemic injury. Methods Consecutive patients with first large acute myocardial infarction (AMI) [LVEF ≤45% and/or cMRI infarct size ≥10% of left ventricle, 2–5 days after pPCI, n=10] and patients with chronic ischemic heart failure (CIHF) [LVEF ≤45% by SPECT, NYHA class II or III, n=10] were enrolled. Multimodality imaging using the study techniques was performed within 36 hours. Results LVEF measured with TTE, SPECT and cMRI did not differ between bot...

European Heart Journal, 2020

Introduction CIRCULATE-Acute Myocardial Infarction is a double-blind controlled trial randomizing... more Introduction CIRCULATE-Acute Myocardial Infarction is a double-blind controlled trial randomizing (RCT) in 105 consecutive patients with their first, large AMI (cMRI-LVEF ≤45% and/or cMRI-infarct size ≥10% of LV) with successful infarct-related artery (IRA) primary percutaneous coronary intervention (pPCI) to transcoronary administration of Wharton's Jelly Mesenchymal Stem Cells (WJMSCs) vs. placebo (2:1). The pilot study cohort (PSC) preceded the RCT. Aim To evaluate WJMSCs long-term safety, and evolution of left-ventricular (LV) function in CIRCULATE-AMI PSC. Material and methods 30 000 000 WJMSCs (50% labelled with 99mTc-exametazime) were administered via IRA in a ten-patient PCS (age 32–65 years, peak hs-Troponin T 17.3±9.1ng/mL and peak CK-MB 533±89U/L, cMRI-LVEF 40.3±2.7% and infarct size 20.1±2.8%) at ≈5–7 days after AMI using a cell delivery-dedicated, coronary-non-occlusive method. Other treatments were per guidelines. WJMSCs showed an unprecedented high myocardial upta...

European Heart Journal, 2017

Advances in Interventional Cardiology

Introduction: CIRCULATE-AMI (NCT03404063), a cardiac magnetic resonance imaging (cMRI) infarct si... more Introduction: CIRCULATE-AMI (NCT03404063), a cardiac magnetic resonance imaging (cMRI) infarct size-reduction-powered double-blind randomized controlled trial (RCT) of standardized Wharton jelly multipotent stem cells (WJMSCs, CardioCell Investigational Medical Product) vs. placebo (2 : 1) transcoronary transfer on acute myocardial infarction (AMI) day ~5-7, is preceded by safety and feasibility evaluation in a pilot study cohort (CIRCULATE-AMI PSC). Aim: To evaluate WJMSC transplantation safety and evolution of left ventricular (LV) remodeling in CIRCULATE-AMI PSC. Material and methods: In 10 consecutive patients (32-65 years, peak CK-MB 533 ±89 U/l, cMRI-LVEF 40.3 ±2.7%, cMRI-infarct size 20.1 ±2.8%), 30 × 10 6 WJMSCs were administered using a novel cell delivery-dedicated, coronary-non-occlusive method (CIRCU-LATE catheter). Other treatment was guideline-based. Results: WJMSC transfer was safe and occurred in the absence of coronary (TIMI-3 in all) or myocardial (corrected TIMI frame count (cTFC) 45 ±8 vs. 44 ±9, p = 0.51) flow deterioration or troponin elevation. By 3 years, one patient died from a new, non-index territory AMI; there were no other major adverse cardiovascular and cerebrovascular events (MACCE) and no adverse events that might be related to WJMSCs. cMRI infarct size was reduced from 33.2 ±7.6 g to 25.5 ±6.4 g at 1 year and 23.1 ±5.6 g at 3 years (p = 0.03 vs. baseline). cMRI, SPECT, and echo showed a consistent, statistically significant increase in LVEF at 6-12 months (41.9 ±2.6% vs. 51.0 ±3.3%, 36.0 ±3.9% vs. 44.9 ±5.0%, and 38.4 ±2.5% vs. 48.0 ±2.1% respectively, p < 0.01 for all); the effect was sustained at 3 years. Conclusions: CIRCULATE-AMI PSC data suggest that WJMSC transcoronary application ~5-7 days after large AMI in humans is feasible and safe and it may be associated with a durable LVEF improvement. CIRCULATE-AMI RCT will quantify the magnitude of LV adverse remodeling attenuation with CardioCell/placebo administration.

European Heart Journal, 2018

Pharmacologic treatment of acute coronary syndromes 765 an early switch from prasugrel to clopido... more Pharmacologic treatment of acute coronary syndromes 765 an early switch from prasugrel to clopidogrel was recently identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Of note, differences in antiplatelet drug response in smokers and non-smokers were reported in prior studies and clinical outcomes of ACS patients undergoing PCI depend on smoking status. Thus, the safety and efficacy of any DAPT de-escalation strategy may differ in relation to smoking status. Purpose: This post-hoc analysis of the TROPICAL-ACS trial aimed to assess the impact of smoking on clinical outcomes following guided de-escalation of DAPT in ACS patients. Methods: The multicentre TROPICAL-ACS trial randomised 2610 biomarkerpositive ACS patients 1:1 to either standard treatment with prasugrel for 12 months (control group) or a platelet function testing (PFT) guided de-escalation of DAPT. For this post-hoc analysis, we used univariate and multivariate Cox proportional hazards models to assess the association and interaction of smoking status on clinical endpoints across study groups. Results: In non-smokers (n=1428) a guided DAPT de-escalation was associated with a lower 1-year incidence of the primary endpoint (cardiovascular death, myocardial infarction, stroke, or bleeding ≥ grade 2 according to BARC criteria) compared to control group patients (7.9% vs. 11.0%; HR 0.71, 95% CI 0.50-0.99, p=0.048). Current smokers (n=1182) showed similar event rates between study groups (6.6% vs. 6.6%; HR 1,95% CI 0.64-1.56, p>0.99; see Figure). Of note, outcomes in non-smokers for guided de-escalation vs. control group patients were mainly driven by a reduction in bleeding events (BARC ≥ grade 2) (5.2% vs. 7.7%; HR 0.68, 95% CI 0.45-1.03, p=0.066). A Cox proportional hazards model revealed no significant interaction of smoking status with treatment effects of guided DAPT de-escalation (p value for interaction=0.23). Conclusion: Guided de-escalation of DAPT appears to be equally safe and effective in smokers and non-smokers. Regardless of smoking status and especially for those patients deemed unsuitable for 1 year potent platelet inhibition this DAPT strategy may be used as an alternative antiplatelet treatment regimen.

Badania krucyfiksu z belki teczowej w kościele św. Wojciecha w Krakowie przy uzyciu dwuźrodlowej ... more Badania krucyfiksu z belki teczowej w kościele św. Wojciecha w Krakowie przy uzyciu dwuźrodlowej tomografii komputerowej

Polskie Archiwum Medycyny Wewnetrznej-polish Archives of Internal Medicine, Dec 10, 2014

Advances in Interventional Cardiology, 2022

Polish Journal of Radiology, 2006

Journal of Rare Cardiovascular Diseases, 2015

Left ventricular non-compaction (LVNC) or "spongy myocardium", is a rare form of a primary geneti... more Left ventricular non-compaction (LVNC) or "spongy myocardium", is a rare form of a primary genetic cardiomyopathy considered to be the result of abnormal intrauterine arrest of the myocardial compaction process. Left ventricular noncompaction belongs to the group of unclassified cardiomiopathies by the ESC Position Statement. It is is a rare disorder characterised by a thin, compacted epicardial layer and an extensive non-compacted endocardial layer, with prominent trabeculation and deep recesses that communicate with the left ventricular cavity but not with the coronary circulation. Clinical presentation of patients with LVNC is highly variable-it ranges from completely asymptomatic patients who are accidentally diagnosed (e.g. during familial screening) to patients in need of heart transplantation. Most commonly patients present with symptoms from the spectrum of the classic triad of LVNC complications: heart failure, arrhythmias and systemic thromboembolic events. We describe a case of accidental discovery of isolated left ventricular non-compaction in a patient with an acute coronary syndrome. JRCD 2015; 2 (4): 123-126

Stem Cells International, Apr 22, 2021

Aims. A major clinical concern is the continuous increase in the number of patients diagnosed wit... more Aims. A major clinical concern is the continuous increase in the number of patients diagnosed with advanced coronary artery disease, ischemic heart failure, and refractory angina, and one of the most promising treatment options for these conditions is stem cell-based therapy. The aim of this study was to assess the functional improvement following intramyocardial injection of adipose-derived stromal cells, using cardiac magnetic resonance. Methods and Results. Thirteen patients with ischemic heart failure, reduced left ventricular ejection fraction, refractory angina, and who have been disqualified from any form of direct revascularization were enrolled in the study with transthoracic autologous adipose-derived stromal cell implantation. All patients underwent cardiac magnetic resonance prior to the procedure and after 12 months of follow-up. A significant increase in stroke volume (83:1 ± 8:5 mL vs 93:8 ± 13:8 mL, p = 0:025) and stroke volume index (43:3 ± 7:6 mL/m 2 vs 48:7 ± 9:1 mL/m 2 , p = 0:019), a statistical trend toward an increase in left ventricle ejection fraction (36:7 ± 13:2 vs 39:7 ± 14:9, p = 0:052), and cardiac output improvement (5:0 ± 0:7 vs 5:5 ± 0:9, p = 0:073) was observed in the patient postprocedure. Enhanced relative regional thickening was noted in the segments with adipose-derived stromal cell implantation. Conclusions. Intramyocardial adipose-derived stromal cell implantation is a promising therapeutic option for selected, symptomatic patients with ischemic heart failure, who have preserved myocardial viability despite being unsuitable for direct revascularization.

Journal of Medical Informatics and Technologies, 2012

In this paper the quality and analysis of the compu ted tomography scan sets are presented in the... more In this paper the quality and analysis of the compu ted tomography scan sets are presented in the conte xt of creating a 3D/4D model of a heart for the ultrasono graphy simulator. Data was collected during regular patients examination, using various equipment and technique, therefore not every set has required quality. CT d ata can be fast characterized with histogram that can show if the b rightness ranges of objects (heart structures) are selective. This makes CT data usable for simulation by applying a t ransform function on the CT images to produce ultra sonographylike images. The aim is to use a PACS system of Hospital, which is the source of data. Therefore a pro per technique and system for analysis is needed.

Journal of the American College of Cardiology, 2016

PCI; cardiogenic shock; severity of coronary artery disease; pretreatment with ASA, heparin; type... more PCI; cardiogenic shock; severity of coronary artery disease; pretreatment with ASA, heparin; type of P2Y12 agent, clopidogrel, ticagrelor, prasugrel. RESULTS The total of 31,760 patients were included in the study of which 12,951 (41%) were pretreated with UH/LMWH and 1,154 (4%) were pretreated with GP. The number of treated segments was 61,011 of which 32,446 (53%) were occluded prior to primary PCI. Non-patent IRA was associated with higher risk of death at 30 days (adjusted OR

Circulation, Oct 31, 2006

European Urology Supplements, 2011

ratio (0.9 ± 0.1) is inversely related to age and BMI. Conclusions: The dimensions of the kidney ... more ratio (0.9 ± 0.1) is inversely related to age and BMI. Conclusions: The dimensions of the kidney vary among a wide interval. Among the highest predictors were found age, body size and absence of the controlateral kidney.

Scientific Reports, Dec 14, 2021

The current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Car... more The current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Cardiac fibrosis is involved in the pathology of arrhythmias; however, the relationship between cardiovascular magnetic resonance (CMR) derived extracellular volume (ECV) and arrhythmic burden (AB) in DCM is unknown. This study sought to evaluate the presence and extent of replacement and interstitial fibrosis in DCM and to compare the degree of fibrosis between DCM patients with and without AB. This is a prospective, single-center, observational study. Between May 2019 and September 2020, 102 DCM patients underwent CMR T1 mapping. 99 DCM patients (88 male, mean age 45.2 ± 11.8 years, mean EF 29.7 ± 10%) composed study population. AB was defined as the presence of VT or a high burden of PVCs. There were 41 (41.4%) patients with AB and 58 (58.6%) without AB. Replacement fibrosis was assessed with late gadolinium enhancement (LGE), whereas interstitial fibrosis with ECV. Overall, LGE was identified in 41% of patients. There was a similar distribution of LGE (without AB 50% vs. with AB 53.7%; p = 0.8) and LGE extent (without AB 4.36 ± 5.77% vs. with AB 4.68 ± 3.98%; p = 0.27) in both groups. ECV at nearly all myocardial segments and a global ECV were higher in patients with AB (global ECV: 27.9 ± 4.9 vs. 30.3 ± 4.2; p < 0.02). Only indexed left ventricular end-diastolic diameter (HR 1.1, 95%CI 1.0-1.2; p < 0.02) and global ECV (HR 1.12, 95%CI 1.0-1.25; p < 0.02) were independently associated with AB. The global ECV cutoff value of 31.05% differentiated both groups (AUC 0.713; 95%CI 0.598-0.827; p < 0.001). Neither qualitative nor quantitative LGE-based assessment of replacement fibrosis allowed for the stratification of DCM patients into low or high AB. Interstitial fibrosis, expressed as ECV, was an independent predictor of AB in DCM. Incorporation of CMR parametric indices into decision-making processes may improve arrhythmic risk stratification in DCM. Ventricular arrhythmias, including premature ventricular contractions (PVCs) and non-sustained ventricular tachycardia (NSVT), occur in 40% of patients with dilated cardiomyopathy (DCM) 1. The bulk of evidence indicates that runs of NSVT and frequent PVCs, defined as arrhythmic burden (AB), lead to an increased sudden cardiac death (SCD) risk in DCM patients 2. Susceptibility to ventricular arrhythmias in DCM relies on the combined presence of an anatomic substrate (i.e. genetic or acquired abnormalities in the electrical or mechanical properties of the heart) and triggering mechanisms. Profound cardiac remodeling and fibrosis provide ample substrate for the initiation of ventricular arrhythmias. Cardiac fibrosis is typically observed in 40-60% of DCM patients 3,4. Broadly, two types of fibrosis have been identified. Replacement or scarring fibrosis develops as a consequence of local myocytes death and serves to preserve the integrity and function of the heart after injury 5. DCM is typically characterized with widespread interstitial fibrosis given that the need for cardiac repair is minimal and, ultimately, fibrosis is a maladaptive event 5 .

American Heart Journal, 2008

European Journal of Echocardiography, 2010

European Heart Journal, 2019

Introduction CIRCULATE-Acute Myocardial Infarction Trial (NCT03404063) is a double-blind controll... more Introduction CIRCULATE-Acute Myocardial Infarction Trial (NCT03404063) is a double-blind controlled trial (RCT) that is randomizing consecutive patients with their first, large AMI (LVEF ≤45% and/or cMRI -infarct size ≥10% of LV) successfully treated by infarct-related artery (IRA) primary percutaneous coronary intervention reperfusion (TIMI ≥2) to transcoronary administration of Wharton Jelly Multipotent Stem Cells (WJMSCs) vs. placebo (2:1), preceded by evaluation of safety, WJMSCs myocardial uptake, and echocardiographic, cMRI and SPECT left ventricular remodelling and hemodynamic changes in pilot study cohort (PSC). Purpose To evaluate LV remodelling and hemodynamic features following WJMSCs transplantation in CIRCULATE-AMI PSC. Methods Ten consecutive patients (age 32–65 years) were administered 30 000 000 WJMSCs via the infarct-related artery at ≈5–7 days after AMI using transradial approach and a coronary-non-occlusive catheter dedicated to cell delivery. Within 3 years of fo...

European Heart Journal, 2019

Introduction The three main techniques to evaluate myocardial function and volumes: two-dimension... more Introduction The three main techniques to evaluate myocardial function and volumes: two-dimensional echocardiography (TTE), gated single photon emission computed tomography (SPECT) and cardiac magnetic resonance imaging (cMRI), have important differences in accessibility and practicality. Purpose We aimed to evaluate: TTE, SPECT and cMRI in the measurement of left ventricular ejection fraction (LVEF), left ventricular end-diastolic (LVEDV) and left ventricular end-systolic volumes (LVESV) in patients with acute and chronic myocardial ischemic injury. Methods Consecutive patients with first large acute myocardial infarction (AMI) [LVEF ≤45% and/or cMRI infarct size ≥10% of left ventricle, 2–5 days after pPCI, n=10] and patients with chronic ischemic heart failure (CIHF) [LVEF ≤45% by SPECT, NYHA class II or III, n=10] were enrolled. Multimodality imaging using the study techniques was performed within 36 hours. Results LVEF measured with TTE, SPECT and cMRI did not differ between bot...

European Heart Journal, 2020

Introduction CIRCULATE-Acute Myocardial Infarction is a double-blind controlled trial randomizing... more Introduction CIRCULATE-Acute Myocardial Infarction is a double-blind controlled trial randomizing (RCT) in 105 consecutive patients with their first, large AMI (cMRI-LVEF ≤45% and/or cMRI-infarct size ≥10% of LV) with successful infarct-related artery (IRA) primary percutaneous coronary intervention (pPCI) to transcoronary administration of Wharton's Jelly Mesenchymal Stem Cells (WJMSCs) vs. placebo (2:1). The pilot study cohort (PSC) preceded the RCT. Aim To evaluate WJMSCs long-term safety, and evolution of left-ventricular (LV) function in CIRCULATE-AMI PSC. Material and methods 30 000 000 WJMSCs (50% labelled with 99mTc-exametazime) were administered via IRA in a ten-patient PCS (age 32–65 years, peak hs-Troponin T 17.3±9.1ng/mL and peak CK-MB 533±89U/L, cMRI-LVEF 40.3±2.7% and infarct size 20.1±2.8%) at ≈5–7 days after AMI using a cell delivery-dedicated, coronary-non-occlusive method. Other treatments were per guidelines. WJMSCs showed an unprecedented high myocardial upta...

European Heart Journal, 2017

Advances in Interventional Cardiology

Introduction: CIRCULATE-AMI (NCT03404063), a cardiac magnetic resonance imaging (cMRI) infarct si... more Introduction: CIRCULATE-AMI (NCT03404063), a cardiac magnetic resonance imaging (cMRI) infarct size-reduction-powered double-blind randomized controlled trial (RCT) of standardized Wharton jelly multipotent stem cells (WJMSCs, CardioCell Investigational Medical Product) vs. placebo (2 : 1) transcoronary transfer on acute myocardial infarction (AMI) day ~5-7, is preceded by safety and feasibility evaluation in a pilot study cohort (CIRCULATE-AMI PSC). Aim: To evaluate WJMSC transplantation safety and evolution of left ventricular (LV) remodeling in CIRCULATE-AMI PSC. Material and methods: In 10 consecutive patients (32-65 years, peak CK-MB 533 ±89 U/l, cMRI-LVEF 40.3 ±2.7%, cMRI-infarct size 20.1 ±2.8%), 30 × 10 6 WJMSCs were administered using a novel cell delivery-dedicated, coronary-non-occlusive method (CIRCU-LATE catheter). Other treatment was guideline-based. Results: WJMSC transfer was safe and occurred in the absence of coronary (TIMI-3 in all) or myocardial (corrected TIMI frame count (cTFC) 45 ±8 vs. 44 ±9, p = 0.51) flow deterioration or troponin elevation. By 3 years, one patient died from a new, non-index territory AMI; there were no other major adverse cardiovascular and cerebrovascular events (MACCE) and no adverse events that might be related to WJMSCs. cMRI infarct size was reduced from 33.2 ±7.6 g to 25.5 ±6.4 g at 1 year and 23.1 ±5.6 g at 3 years (p = 0.03 vs. baseline). cMRI, SPECT, and echo showed a consistent, statistically significant increase in LVEF at 6-12 months (41.9 ±2.6% vs. 51.0 ±3.3%, 36.0 ±3.9% vs. 44.9 ±5.0%, and 38.4 ±2.5% vs. 48.0 ±2.1% respectively, p < 0.01 for all); the effect was sustained at 3 years. Conclusions: CIRCULATE-AMI PSC data suggest that WJMSC transcoronary application ~5-7 days after large AMI in humans is feasible and safe and it may be associated with a durable LVEF improvement. CIRCULATE-AMI RCT will quantify the magnitude of LV adverse remodeling attenuation with CardioCell/placebo administration.

European Heart Journal, 2018

Pharmacologic treatment of acute coronary syndromes 765 an early switch from prasugrel to clopido... more Pharmacologic treatment of acute coronary syndromes 765 an early switch from prasugrel to clopidogrel was recently identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Of note, differences in antiplatelet drug response in smokers and non-smokers were reported in prior studies and clinical outcomes of ACS patients undergoing PCI depend on smoking status. Thus, the safety and efficacy of any DAPT de-escalation strategy may differ in relation to smoking status. Purpose: This post-hoc analysis of the TROPICAL-ACS trial aimed to assess the impact of smoking on clinical outcomes following guided de-escalation of DAPT in ACS patients. Methods: The multicentre TROPICAL-ACS trial randomised 2610 biomarkerpositive ACS patients 1:1 to either standard treatment with prasugrel for 12 months (control group) or a platelet function testing (PFT) guided de-escalation of DAPT. For this post-hoc analysis, we used univariate and multivariate Cox proportional hazards models to assess the association and interaction of smoking status on clinical endpoints across study groups. Results: In non-smokers (n=1428) a guided DAPT de-escalation was associated with a lower 1-year incidence of the primary endpoint (cardiovascular death, myocardial infarction, stroke, or bleeding ≥ grade 2 according to BARC criteria) compared to control group patients (7.9% vs. 11.0%; HR 0.71, 95% CI 0.50-0.99, p=0.048). Current smokers (n=1182) showed similar event rates between study groups (6.6% vs. 6.6%; HR 1,95% CI 0.64-1.56, p>0.99; see Figure). Of note, outcomes in non-smokers for guided de-escalation vs. control group patients were mainly driven by a reduction in bleeding events (BARC ≥ grade 2) (5.2% vs. 7.7%; HR 0.68, 95% CI 0.45-1.03, p=0.066). A Cox proportional hazards model revealed no significant interaction of smoking status with treatment effects of guided DAPT de-escalation (p value for interaction=0.23). Conclusion: Guided de-escalation of DAPT appears to be equally safe and effective in smokers and non-smokers. Regardless of smoking status and especially for those patients deemed unsuitable for 1 year potent platelet inhibition this DAPT strategy may be used as an alternative antiplatelet treatment regimen.

Badania krucyfiksu z belki teczowej w kościele św. Wojciecha w Krakowie przy uzyciu dwuźrodlowej ... more Badania krucyfiksu z belki teczowej w kościele św. Wojciecha w Krakowie przy uzyciu dwuźrodlowej tomografii komputerowej

Polskie Archiwum Medycyny Wewnetrznej-polish Archives of Internal Medicine, Dec 10, 2014

Advances in Interventional Cardiology, 2022

Polish Journal of Radiology, 2006

Journal of Rare Cardiovascular Diseases, 2015

Left ventricular non-compaction (LVNC) or "spongy myocardium", is a rare form of a primary geneti... more Left ventricular non-compaction (LVNC) or "spongy myocardium", is a rare form of a primary genetic cardiomyopathy considered to be the result of abnormal intrauterine arrest of the myocardial compaction process. Left ventricular noncompaction belongs to the group of unclassified cardiomiopathies by the ESC Position Statement. It is is a rare disorder characterised by a thin, compacted epicardial layer and an extensive non-compacted endocardial layer, with prominent trabeculation and deep recesses that communicate with the left ventricular cavity but not with the coronary circulation. Clinical presentation of patients with LVNC is highly variable-it ranges from completely asymptomatic patients who are accidentally diagnosed (e.g. during familial screening) to patients in need of heart transplantation. Most commonly patients present with symptoms from the spectrum of the classic triad of LVNC complications: heart failure, arrhythmias and systemic thromboembolic events. We describe a case of accidental discovery of isolated left ventricular non-compaction in a patient with an acute coronary syndrome. JRCD 2015; 2 (4): 123-126

Stem Cells International, Apr 22, 2021

Aims. A major clinical concern is the continuous increase in the number of patients diagnosed wit... more Aims. A major clinical concern is the continuous increase in the number of patients diagnosed with advanced coronary artery disease, ischemic heart failure, and refractory angina, and one of the most promising treatment options for these conditions is stem cell-based therapy. The aim of this study was to assess the functional improvement following intramyocardial injection of adipose-derived stromal cells, using cardiac magnetic resonance. Methods and Results. Thirteen patients with ischemic heart failure, reduced left ventricular ejection fraction, refractory angina, and who have been disqualified from any form of direct revascularization were enrolled in the study with transthoracic autologous adipose-derived stromal cell implantation. All patients underwent cardiac magnetic resonance prior to the procedure and after 12 months of follow-up. A significant increase in stroke volume (83:1 ± 8:5 mL vs 93:8 ± 13:8 mL, p = 0:025) and stroke volume index (43:3 ± 7:6 mL/m 2 vs 48:7 ± 9:1 mL/m 2 , p = 0:019), a statistical trend toward an increase in left ventricle ejection fraction (36:7 ± 13:2 vs 39:7 ± 14:9, p = 0:052), and cardiac output improvement (5:0 ± 0:7 vs 5:5 ± 0:9, p = 0:073) was observed in the patient postprocedure. Enhanced relative regional thickening was noted in the segments with adipose-derived stromal cell implantation. Conclusions. Intramyocardial adipose-derived stromal cell implantation is a promising therapeutic option for selected, symptomatic patients with ischemic heart failure, who have preserved myocardial viability despite being unsuitable for direct revascularization.

Journal of Medical Informatics and Technologies, 2012

In this paper the quality and analysis of the compu ted tomography scan sets are presented in the... more In this paper the quality and analysis of the compu ted tomography scan sets are presented in the conte xt of creating a 3D/4D model of a heart for the ultrasono graphy simulator. Data was collected during regular patients examination, using various equipment and technique, therefore not every set has required quality. CT d ata can be fast characterized with histogram that can show if the b rightness ranges of objects (heart structures) are selective. This makes CT data usable for simulation by applying a t ransform function on the CT images to produce ultra sonographylike images. The aim is to use a PACS system of Hospital, which is the source of data. Therefore a pro per technique and system for analysis is needed.

Journal of the American College of Cardiology, 2016

PCI; cardiogenic shock; severity of coronary artery disease; pretreatment with ASA, heparin; type... more PCI; cardiogenic shock; severity of coronary artery disease; pretreatment with ASA, heparin; type of P2Y12 agent, clopidogrel, ticagrelor, prasugrel. RESULTS The total of 31,760 patients were included in the study of which 12,951 (41%) were pretreated with UH/LMWH and 1,154 (4%) were pretreated with GP. The number of treated segments was 61,011 of which 32,446 (53%) were occluded prior to primary PCI. Non-patent IRA was associated with higher risk of death at 30 days (adjusted OR

Circulation, Oct 31, 2006

European Urology Supplements, 2011

ratio (0.9 ± 0.1) is inversely related to age and BMI. Conclusions: The dimensions of the kidney ... more ratio (0.9 ± 0.1) is inversely related to age and BMI. Conclusions: The dimensions of the kidney vary among a wide interval. Among the highest predictors were found age, body size and absence of the controlateral kidney.

Scientific Reports, Dec 14, 2021

The current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Car... more The current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Cardiac fibrosis is involved in the pathology of arrhythmias; however, the relationship between cardiovascular magnetic resonance (CMR) derived extracellular volume (ECV) and arrhythmic burden (AB) in DCM is unknown. This study sought to evaluate the presence and extent of replacement and interstitial fibrosis in DCM and to compare the degree of fibrosis between DCM patients with and without AB. This is a prospective, single-center, observational study. Between May 2019 and September 2020, 102 DCM patients underwent CMR T1 mapping. 99 DCM patients (88 male, mean age 45.2 ± 11.8 years, mean EF 29.7 ± 10%) composed study population. AB was defined as the presence of VT or a high burden of PVCs. There were 41 (41.4%) patients with AB and 58 (58.6%) without AB. Replacement fibrosis was assessed with late gadolinium enhancement (LGE), whereas interstitial fibrosis with ECV. Overall, LGE was identified in 41% of patients. There was a similar distribution of LGE (without AB 50% vs. with AB 53.7%; p = 0.8) and LGE extent (without AB 4.36 ± 5.77% vs. with AB 4.68 ± 3.98%; p = 0.27) in both groups. ECV at nearly all myocardial segments and a global ECV were higher in patients with AB (global ECV: 27.9 ± 4.9 vs. 30.3 ± 4.2; p < 0.02). Only indexed left ventricular end-diastolic diameter (HR 1.1, 95%CI 1.0-1.2; p < 0.02) and global ECV (HR 1.12, 95%CI 1.0-1.25; p < 0.02) were independently associated with AB. The global ECV cutoff value of 31.05% differentiated both groups (AUC 0.713; 95%CI 0.598-0.827; p < 0.001). Neither qualitative nor quantitative LGE-based assessment of replacement fibrosis allowed for the stratification of DCM patients into low or high AB. Interstitial fibrosis, expressed as ECV, was an independent predictor of AB in DCM. Incorporation of CMR parametric indices into decision-making processes may improve arrhythmic risk stratification in DCM. Ventricular arrhythmias, including premature ventricular contractions (PVCs) and non-sustained ventricular tachycardia (NSVT), occur in 40% of patients with dilated cardiomyopathy (DCM) 1. The bulk of evidence indicates that runs of NSVT and frequent PVCs, defined as arrhythmic burden (AB), lead to an increased sudden cardiac death (SCD) risk in DCM patients 2. Susceptibility to ventricular arrhythmias in DCM relies on the combined presence of an anatomic substrate (i.e. genetic or acquired abnormalities in the electrical or mechanical properties of the heart) and triggering mechanisms. Profound cardiac remodeling and fibrosis provide ample substrate for the initiation of ventricular arrhythmias. Cardiac fibrosis is typically observed in 40-60% of DCM patients 3,4. Broadly, two types of fibrosis have been identified. Replacement or scarring fibrosis develops as a consequence of local myocytes death and serves to preserve the integrity and function of the heart after injury 5. DCM is typically characterized with widespread interstitial fibrosis given that the need for cardiac repair is minimal and, ultimately, fibrosis is a maladaptive event 5 .