Leszek Drabik | Jagiellonian University (original) (raw)

Papers by Leszek Drabik

Research paper thumbnail of Course of fatigue among patients previously hospitalised due to COVID-19

Neurologia i Neurochirurgia Polska, 2023

Introduction. Discrepancies exist regarding the clinical course and prognostic factors for post-C... more Introduction. Discrepancies exist regarding the clinical course and prognostic factors for post-COVID fatigue. Therefore, our aim was to assess the timely course of fatigue and its possible predictors in patients previously hospitalised due to SARS-CoV-2 infection. Material and methods. Patients and employees of the University Hospital in Krakow were assessed with the use of a validated neuropsychological questionnaire. Included were participants aged 18 or more, previously hospitalised due to COVID-19, who completed questionnaires only once > 3 months after the onset of infection. Individuals were retrospectively asked about the presence of eight symptoms of chronic fatigue syndrome at four timepoints: before COVID-19, within 0-4 weeks, 4-12 weeks, and > 12 weeks post-infection. Results. We enrolled 204 patients [40.2% women, median age 58 (46-66) years] evaluated after a median of 187 (156-220) days from the first positive nasal swab test for SARS-CoV-2. The most common comorbidities were hypertension (44.61%), obesity (36.27%), smoking (28.43%), and hypercholesterolemia (21.08%); none of the patients required mechanical ventilation during hospitalisation. Before COVID-19, 43.62% of patients reported at least one symptom of chronic fatigue. Within 4, 4-12, and > 12 weeks after COVID-19, the prevalence of chronic fatigue was 76.96%, 75.49%, and 66.17%, respectively (all p < 0.001). The frequency of chronic fatigue symptoms decreased within > 12 weeks following the onset of infection but did not return to baseline values, except for self-reported lymph node enlargement. In a multivariable linear regression model, the number of fatigue symptoms was predicted by female sex [β 0.25 (0.12; 0.39), p < 0.001 and 0.26 (0.13; 0.39), p < 0.001 for weeks 0-12 and >12, respectively], and age [for < 4 weeks, β-0.12 (-0.28;-0.01), p = 0.029]. Conclusions. Most patients previously hospitalised due to COVID-19 suffer from fatigue > 12 weeks after infection onset. The presence of fatigue is predicted by female sex and-only for the acute phase-age.

Research paper thumbnail of Fatigue after COVID‐19 in non‐hospitalized patients according to sex

Brain and Behavior

Background: Limited evidence exists on sex differences in post-COVID fatigue among non-hospitaliz... more Background: Limited evidence exists on sex differences in post-COVID fatigue among non-hospitalized patients. Therefore, aim of the study was to evaluate the course of chronic fatigue symptoms in non-hospitalized subjects with the SARS-CoV-2 infection, according to sex. Methods: Patients and staff from the University Hospital in Krakow anonymously and retrospectively completed neuropsychological questionnaire that included eight symptoms of chronic fatigue syndrome. The presence of these symptoms was assessed before COVID-19 and 0-4, 4-12, and &gt;12 weeks postinfection. The inclusion criteria were as follows: age 18 or more years, &gt;12 weeks since the onset of the SARS-CoV-2 infection, and diagnosis confirmed by the RT-PCR from anasopharyngeal swab. Results: We included 303 patients (79.53% women, 47.52% medical personnel) assessed retrospectively after a median of 30 (interquartile range: 23-35) weeks since the onset of symptoms. A higher prevalence of at least one chronic fatigue symptom was found in females in all time intervals after the onset of COVID-19 compared to males (p &lt; .036). Women, compared to men, more often experienced persistent fatigue, not caused by effort and persisting after rest (for &lt;4 weeks, odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.13-4.73; for 4-12 weeks, OR = 1.95, 95% CI: 1.06-3.61), non-restorative sleep (for &lt;4 weeks, OR = 2.17, 95% CI: 1.23-3.81; for &gt;12 weeks, This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Neurological Prognostic Factors in Hospitalized Patients with COVID-19

Brain Sciences, 2022

We aimed to search whether neurological symptoms or signs (NSS) and the MEWS (Modified Early Warn... more We aimed to search whether neurological symptoms or signs (NSS) and the MEWS (Modified Early Warning Score) score were associated with in-hospital mortality or oxygen requirement during the first 14 days of hospitalization in COVID-19 patients recruited at the University Hospital in Krakow, Poland. The detailed clinical questionnaires on twenty NSS were either filled out by patients prospectively or retrospectively assessed by neurologists based on daily medical records. NSS were considered high or low-risk if they were associated with increased or decreased mortality in the univariable analysis. This cohort study included 349 patients with COVID-19 (median age 64, interquartile range (51–77), women 54.72%). The presence of high-risk NSS (decreased level of consciousness, delirium, seizures, and symptoms of stroke or transient ischemic attack) or its combination with the absence of low-risk NSS (headache, dizziness, decreased mood, and fatigue) increased the risk of in-hospital mort...

Research paper thumbnail of The prognostic role of exercise echocardiography in heart failure

Kardiologia polska, 2011

Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is k... more Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is known as to which cardiac contributors of poor exercise capacity carry an independent prognostic information in HF. We investigated the prognostic role of exercise echocardiography (ex-echo) in HF patients. We studied 85 consecutive, symptomatic HF patients (66 males, mean age 62.5 ± 11.8 [range 21-83] years, mean left ventricular ejection fraction [LVEF] 27.2 ± 9.5%). The end-point was all-cause mortality. During the follow-up period (mean 43 ± 21 months) 21 patients died. Resting echocardiography and ex-echo, with the simultaneous measurement of peak oxygen uptake (VO(2peak)), was performed in each patient using a semi-supine ergometer (20 W, 2-min increments). Apart from conventional assessment of systolic and diastolic function (EF, E/A, DT, IVRT) or right ventricular systolic pressure (RVSP), tissue Doppler imaging was used for the assessment of LV and RV peak velocity (IVV) as well ...

Research paper thumbnail of The prognostic role of exercise echocardiography in heart failure

PubMed, 2011

Background: Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF).... more Background: Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is known as to which cardiac contributors of poor exercise capacity carry an independent prognostic information in HF. Aim: We investigated the prognostic role of exercise echocardiography (ex-echo) in HF patients. Methods: We studied 85 consecutive, symptomatic HF patients (66 males, mean age 62.5 ± 11.8 [range 21-83] years, mean left ventricular ejection fraction [LVEF] 27.2 ± 9.5%). The end-point was all-cause mortality. During the follow-up period (mean 43 ± 21 months) 21 patients died. Resting echocardiography and ex-echo, with the simultaneous measurement of peak oxygen uptake (VO(2peak)), was performed in each patient using a semi-supine ergometer (20 W, 2-min increments). Apart from conventional assessment of systolic and diastolic function (EF, E/A, DT, IVRT) or right ventricular systolic pressure (RVSP), tissue Doppler imaging was used for the assessment of LV and RV peak velocity (IVV) as well as acceleration during isovolumic contraction (IVA), peak velocity during ejection phase (S'), peak early diastolic velocity (E'), peak late diastolic velocity (A'), and ratio of early diastolic mitral/tricuspid velocity to peak early diastolic velocity (E/E'). Results: Patients who died were significantly older, had lower exercise capacity, more advanced HF, greater impairment of baseline systolic function, higher baseline pulmonary artery systolic pressure, and most importantly a lack of improvement in EF, diastolic function, and further increase of RVSP during exercise. Out of all echocardiographic parameters, only peak stress EF (x(2) 6.1; p = 0.01), baseline and peak exercise RVSP (x(2) 12.5 and c(2) 18.7; p 〈 0.001; respectively), and mitral E/E' ratio (x(2) 8.9; p 〈 0.01) were univariate predictors of prognosis and remained independently prognostic when adjusted for age and sex but were eliminated from the model by NT-proBNP. Conclusions: During exercise, more severe systolic and diastolic dysfunction with the elevation of pulmonary arterial pressure is more prevalent in HF patients who have a poorer outcome. The estimation of common parameters such as EF, RVSP and E/E' using ex-echo, provides prognostic information in HF.

Research paper thumbnail of Routinely Performed Echocardiography and its Impact on Everyday Clinical Practice in Patients admitted to an Internal Medicine Ward

International Journal of Cardiovascular Research, May 30, 2020

Objectives: The aim of this study was to evaluate the frequency of significant heart abnormalitie... more Objectives: The aim of this study was to evaluate the frequency of significant heart abnormalities detected by routinely applied echocardiography in patients hospitalized in the internal medicine ward due to any medical disease and assess its impact on everyday clinical practice. Methods: Transthoracic Echocardiography (TTE) examinations were performed routinely in a cohort of 2756 patients admitted to the internal medicine ward. Demographic and clinical variables were collected retrospectively. Results: A total of 2756 patients (48.1%; n=1201 females) with a mean age of 76.3 ± 4.3 years were enrolled in the study. Almost half of the patients (41.8%; n=1153) showed significant heart pathology: Left Ventricular Ejection Fraction (LVEF) 36 mmHg, or pericardial effusion, which required further diagnosis and/or therapy. LVEF 50 mmHg. RVSP >50 mmHg was associated with lung disease (49.2%, n =87), left heart disease (29.6%, n=56), and pulmonary embolism (7.3%, n=13). In the examined group, 28.3% (n=781) of patients required specialist consultation and 10.7% (n=295) were considered as candidates for surgery. Conclusion: TTE is an essential non-invasive tool to evaluate heart structure and function. Routinely performed echocardiography has a significant impact on the decision-making process or treatment in almost half of the patients admitted to the internal medicine ward.

Research paper thumbnail of C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Journal of Clinical Medicine, Apr 10, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Ischemic Versus Non-Ischemic (Neurogenic) Myocardial Contractility Impairment in Acute Coronary Syndromes: Prevalence and Impact on Left Ventricular Systolic Function Recovery

Medical Science Monitor, Jun 2, 2018

Research paper thumbnail of Fasting Hyperglycemia and Long-term Outcome in Patients with Acute Ischemic Stroke Treated with Mechanical Thrombectomy

Journal of stroke and cerebrovascular diseases, May 1, 2020

Research paper thumbnail of Author response for "Fatigue after COVID‐19 in non‐hospitalized patients according to sex

Research paper thumbnail of Trans-endocardial delivery of progenitor cells to compromised myocardium using the “needle technique”and risk of myocardial injury

Advances in Interventional Cardiology, 2022

Research paper thumbnail of Prognostic significance of age in patients with acute ischaemic stroke treated with intravenous thrombolysis

Neurologia I Neurochirurgia Polska, Jan 21, 2022

Research paper thumbnail of Relationship between left ventricular global longitudinal strain, infarct size and left ventricular function in patients with acute myocardial infarction in a stem cell therapy study

European Heart Journal, Oct 1, 2021

Research paper thumbnail of Clinically silent, right and left ventricular outflow tract obstructions in an adult patient (RCD code: IV-3A)

Journal of Rare Cardiovascular Diseases, 2017

Right ventricular outflow tract obstruction is a narrowing of the way that conducts blood from th... more Right ventricular outflow tract obstruction is a narrowing of the way that conducts blood from the right ventricle to the pulmonary artery. Left ventricular outflow tract obstruction is a stenosis of the path that leads blood from the left ventricle to the aorta. Combination of right and left ventricular outflow tract obstruction is a very rare finding. We report a case of a 67-year-old male with asymptomatic biventricular outflow tract obstruction. We discuss the clinical presentation, diagnostic procedures, treatment opportunities for the patient based on review of literature and actual recommendations.

Research paper thumbnail of Arterial stiffness and atherosclerosis in systemic lupus erythematosus patients

Reumatologia, Jul 6, 2022

Introduction: Systemic lupus erythematosus (SLE) is characterized by early atherothrombosis. Puls... more Introduction: Systemic lupus erythematosus (SLE) is characterized by early atherothrombosis. Pulse wave velocity (PWV) is a promising tool for the diagnosis of early vascular remodelling and initial atherosclerotic plaque formation. Our objective was to evaluate PWV and its relationship with coronary atherosclerosis and thrombotic biomarkers in patients with SLE. Material and methods: In 26 patients with SLE with stable clinical conditions, mean age of 39.1 ±11.7 years and without a history of coronary artery disease, multidetector computed tomography (MDCT)-based coronary calcium scoring (CACS) was performed and PWV measured. Laboratory evaluation included serum levels of anticardiolipin and anti-β2-glycoprotein antibodies (anti-β2-GPI), lupus anticoagulant (LA), D-dimers, thrombin-antithrombin complexes (TAT), and von Willebrand factor (vWF). Results: Multidetector computed tomography revealed coronary calcifications in 8 (30.8%) patients and the median CACS was 52.4 HU (range 2-843.2). The mean PWV was 9.0 ±3.2 m/s and was higher in patients aged > 50 years (+33.7% vs. < 50 years), those with positive LA (+28.2% vs. LA negative), TAT ≥ 10 µg/l (+18.1% vs. < 10 µg/l), vWF ≥ 200 IU/dl (+51.8% vs. < 200 IU/dl) and with coronary atherosclerosis (CACS > 0; +21.4% vs. CACS = 0). In contrast, the duration of the disease, D-dimers, anticardiolipin, and anti-β2-GPI antibodies did not influence PWV. In the group without atherosclerosis (CACS = 0, n =18), patients with vWF ≥ 200 IU/dl had a 19.3% higher PWV compared to the rest. Conclusions: In patients with SLE, PWV was associated with the presence of coronary atherosclerotic lesions in MDCT. Furthermore, arterial stiffness was higher in patients with markers of endothelial dysfunction and a prothrombotic state, suggesting their contribution to the early stages of arterial remodelling in SLE.

Research paper thumbnail of Brain Fog and Quality of Life at Work in Non-Hospitalized Patients after COVID-19

International Journal of Environmental Research and Public Health, Oct 6, 2022

Research paper thumbnail of Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke

Journal of Clinical Medicine

Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thr... more Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (DM) was not performed. Therefore, we assessed whether fasting normoglycemia (FNG) next morning after AIS treated with IVT was associated with 90-day functional outcome in diabetic and non-diabetic patients. Methods: We retrospectively analyzed 362 AIS patients treated with IVT at The University Hospital in Krakow. FNG was defined as glucose below 5.5 mmol/L. A favorable outcome was defined as modified Rankin score (mRS) of 0–2 at day 90 after AIS onset. Results: At 3-month follow-up, FNG was associated with favorable outcome (87.5% vs. 60.8%, p < 0.001) and decreased risk of death (3.1% vs. 18.1%, p = 0.002). Independent predictors of a favorable outcome for the whole group were: younge...

Research paper thumbnail of Response to Letter to the Editors regarding article entitled ‘Sex-related patient-reported brain fog symptoms in nonhospitalised COVID-19 patients’

Neurologia i Neurochirurgia Polska

Research paper thumbnail of C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Journal of Clinical Medicine

Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced d... more Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced divergent results. We evaluated whether C-reactive protein (CRP) and white blood cell count (WBC) measured fasting 12–24 h after intravenous thrombolysis (IVT) were associated with outcome in AIS patients without concomitant infection. Methods: The study included 352 AIS patients treated with IVT. Excluded were patients with community-acquired or nosocomial infection. Outcome was measured on discharge and 90 days after stroke onset with the modified Rankin scale (mRS) and defined as poor outcome (mRS 3–6) or death (mRS = 6). Results: Final analysis included 158 patients (median age 72 years (interquartile range 63-82), 53.2% (n = 84) women). Poor outcome on discharge and at day 90 was 3.8-fold and 5.8-fold higher for patients with CRP ≥ 8.65 mg/L (fifth quintile of CRP), respectively, compared with first quintile (<1.71 mg/L). These results remained significant after adjustment for pot...

Research paper thumbnail of SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

Clinical Rheumatology

An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue... more An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue diseases. Endothelial dysfunction is the basis for the initiation and progression of atherosclerosis and thrombosis. We present systemic lupus erythematosus (SLE) as a model rheumatic disease with endothelial dysfunction and discuss its mechanisms, factors that influence the early onset and rapid progression of atherosclerosis, and the increased risk of thromboembolic events. We focus on established methods to improve endothelium function, including statins, antiplatelet, and antithrombotic therapy. Hypercoagulable and hypofibrinolitic states and a hyperinflammatory response characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathogenic mechanisms are typical for an acute phase of Covid-19 post-Covid syndrome and connective tissue diseases: endothelial dysfunction, elevated antiphospholipid antibody titer, activation of the complement system, and...

Research paper thumbnail of Course of fatigue among patients previously hospitalised due to COVID-19

Neurologia i Neurochirurgia Polska, 2023

Introduction. Discrepancies exist regarding the clinical course and prognostic factors for post-C... more Introduction. Discrepancies exist regarding the clinical course and prognostic factors for post-COVID fatigue. Therefore, our aim was to assess the timely course of fatigue and its possible predictors in patients previously hospitalised due to SARS-CoV-2 infection. Material and methods. Patients and employees of the University Hospital in Krakow were assessed with the use of a validated neuropsychological questionnaire. Included were participants aged 18 or more, previously hospitalised due to COVID-19, who completed questionnaires only once > 3 months after the onset of infection. Individuals were retrospectively asked about the presence of eight symptoms of chronic fatigue syndrome at four timepoints: before COVID-19, within 0-4 weeks, 4-12 weeks, and > 12 weeks post-infection. Results. We enrolled 204 patients [40.2% women, median age 58 (46-66) years] evaluated after a median of 187 (156-220) days from the first positive nasal swab test for SARS-CoV-2. The most common comorbidities were hypertension (44.61%), obesity (36.27%), smoking (28.43%), and hypercholesterolemia (21.08%); none of the patients required mechanical ventilation during hospitalisation. Before COVID-19, 43.62% of patients reported at least one symptom of chronic fatigue. Within 4, 4-12, and > 12 weeks after COVID-19, the prevalence of chronic fatigue was 76.96%, 75.49%, and 66.17%, respectively (all p < 0.001). The frequency of chronic fatigue symptoms decreased within > 12 weeks following the onset of infection but did not return to baseline values, except for self-reported lymph node enlargement. In a multivariable linear regression model, the number of fatigue symptoms was predicted by female sex [β 0.25 (0.12; 0.39), p < 0.001 and 0.26 (0.13; 0.39), p < 0.001 for weeks 0-12 and >12, respectively], and age [for < 4 weeks, β-0.12 (-0.28;-0.01), p = 0.029]. Conclusions. Most patients previously hospitalised due to COVID-19 suffer from fatigue > 12 weeks after infection onset. The presence of fatigue is predicted by female sex and-only for the acute phase-age.

Research paper thumbnail of Fatigue after COVID‐19 in non‐hospitalized patients according to sex

Brain and Behavior

Background: Limited evidence exists on sex differences in post-COVID fatigue among non-hospitaliz... more Background: Limited evidence exists on sex differences in post-COVID fatigue among non-hospitalized patients. Therefore, aim of the study was to evaluate the course of chronic fatigue symptoms in non-hospitalized subjects with the SARS-CoV-2 infection, according to sex. Methods: Patients and staff from the University Hospital in Krakow anonymously and retrospectively completed neuropsychological questionnaire that included eight symptoms of chronic fatigue syndrome. The presence of these symptoms was assessed before COVID-19 and 0-4, 4-12, and &gt;12 weeks postinfection. The inclusion criteria were as follows: age 18 or more years, &gt;12 weeks since the onset of the SARS-CoV-2 infection, and diagnosis confirmed by the RT-PCR from anasopharyngeal swab. Results: We included 303 patients (79.53% women, 47.52% medical personnel) assessed retrospectively after a median of 30 (interquartile range: 23-35) weeks since the onset of symptoms. A higher prevalence of at least one chronic fatigue symptom was found in females in all time intervals after the onset of COVID-19 compared to males (p &lt; .036). Women, compared to men, more often experienced persistent fatigue, not caused by effort and persisting after rest (for &lt;4 weeks, odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.13-4.73; for 4-12 weeks, OR = 1.95, 95% CI: 1.06-3.61), non-restorative sleep (for &lt;4 weeks, OR = 2.17, 95% CI: 1.23-3.81; for &gt;12 weeks, This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Neurological Prognostic Factors in Hospitalized Patients with COVID-19

Brain Sciences, 2022

We aimed to search whether neurological symptoms or signs (NSS) and the MEWS (Modified Early Warn... more We aimed to search whether neurological symptoms or signs (NSS) and the MEWS (Modified Early Warning Score) score were associated with in-hospital mortality or oxygen requirement during the first 14 days of hospitalization in COVID-19 patients recruited at the University Hospital in Krakow, Poland. The detailed clinical questionnaires on twenty NSS were either filled out by patients prospectively or retrospectively assessed by neurologists based on daily medical records. NSS were considered high or low-risk if they were associated with increased or decreased mortality in the univariable analysis. This cohort study included 349 patients with COVID-19 (median age 64, interquartile range (51–77), women 54.72%). The presence of high-risk NSS (decreased level of consciousness, delirium, seizures, and symptoms of stroke or transient ischemic attack) or its combination with the absence of low-risk NSS (headache, dizziness, decreased mood, and fatigue) increased the risk of in-hospital mort...

Research paper thumbnail of The prognostic role of exercise echocardiography in heart failure

Kardiologia polska, 2011

Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is k... more Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is known as to which cardiac contributors of poor exercise capacity carry an independent prognostic information in HF. We investigated the prognostic role of exercise echocardiography (ex-echo) in HF patients. We studied 85 consecutive, symptomatic HF patients (66 males, mean age 62.5 ± 11.8 [range 21-83] years, mean left ventricular ejection fraction [LVEF] 27.2 ± 9.5%). The end-point was all-cause mortality. During the follow-up period (mean 43 ± 21 months) 21 patients died. Resting echocardiography and ex-echo, with the simultaneous measurement of peak oxygen uptake (VO(2peak)), was performed in each patient using a semi-supine ergometer (20 W, 2-min increments). Apart from conventional assessment of systolic and diastolic function (EF, E/A, DT, IVRT) or right ventricular systolic pressure (RVSP), tissue Doppler imaging was used for the assessment of LV and RV peak velocity (IVV) as well ...

Research paper thumbnail of The prognostic role of exercise echocardiography in heart failure

PubMed, 2011

Background: Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF).... more Background: Gradual impairment of exercise tolerance is the commonest sign of heart failure (HF). Little is known as to which cardiac contributors of poor exercise capacity carry an independent prognostic information in HF. Aim: We investigated the prognostic role of exercise echocardiography (ex-echo) in HF patients. Methods: We studied 85 consecutive, symptomatic HF patients (66 males, mean age 62.5 ± 11.8 [range 21-83] years, mean left ventricular ejection fraction [LVEF] 27.2 ± 9.5%). The end-point was all-cause mortality. During the follow-up period (mean 43 ± 21 months) 21 patients died. Resting echocardiography and ex-echo, with the simultaneous measurement of peak oxygen uptake (VO(2peak)), was performed in each patient using a semi-supine ergometer (20 W, 2-min increments). Apart from conventional assessment of systolic and diastolic function (EF, E/A, DT, IVRT) or right ventricular systolic pressure (RVSP), tissue Doppler imaging was used for the assessment of LV and RV peak velocity (IVV) as well as acceleration during isovolumic contraction (IVA), peak velocity during ejection phase (S'), peak early diastolic velocity (E'), peak late diastolic velocity (A'), and ratio of early diastolic mitral/tricuspid velocity to peak early diastolic velocity (E/E'). Results: Patients who died were significantly older, had lower exercise capacity, more advanced HF, greater impairment of baseline systolic function, higher baseline pulmonary artery systolic pressure, and most importantly a lack of improvement in EF, diastolic function, and further increase of RVSP during exercise. Out of all echocardiographic parameters, only peak stress EF (x(2) 6.1; p = 0.01), baseline and peak exercise RVSP (x(2) 12.5 and c(2) 18.7; p 〈 0.001; respectively), and mitral E/E' ratio (x(2) 8.9; p 〈 0.01) were univariate predictors of prognosis and remained independently prognostic when adjusted for age and sex but were eliminated from the model by NT-proBNP. Conclusions: During exercise, more severe systolic and diastolic dysfunction with the elevation of pulmonary arterial pressure is more prevalent in HF patients who have a poorer outcome. The estimation of common parameters such as EF, RVSP and E/E' using ex-echo, provides prognostic information in HF.

Research paper thumbnail of Routinely Performed Echocardiography and its Impact on Everyday Clinical Practice in Patients admitted to an Internal Medicine Ward

International Journal of Cardiovascular Research, May 30, 2020

Objectives: The aim of this study was to evaluate the frequency of significant heart abnormalitie... more Objectives: The aim of this study was to evaluate the frequency of significant heart abnormalities detected by routinely applied echocardiography in patients hospitalized in the internal medicine ward due to any medical disease and assess its impact on everyday clinical practice. Methods: Transthoracic Echocardiography (TTE) examinations were performed routinely in a cohort of 2756 patients admitted to the internal medicine ward. Demographic and clinical variables were collected retrospectively. Results: A total of 2756 patients (48.1%; n=1201 females) with a mean age of 76.3 ± 4.3 years were enrolled in the study. Almost half of the patients (41.8%; n=1153) showed significant heart pathology: Left Ventricular Ejection Fraction (LVEF) 36 mmHg, or pericardial effusion, which required further diagnosis and/or therapy. LVEF 50 mmHg. RVSP >50 mmHg was associated with lung disease (49.2%, n =87), left heart disease (29.6%, n=56), and pulmonary embolism (7.3%, n=13). In the examined group, 28.3% (n=781) of patients required specialist consultation and 10.7% (n=295) were considered as candidates for surgery. Conclusion: TTE is an essential non-invasive tool to evaluate heart structure and function. Routinely performed echocardiography has a significant impact on the decision-making process or treatment in almost half of the patients admitted to the internal medicine ward.

Research paper thumbnail of C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Journal of Clinical Medicine, Apr 10, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Ischemic Versus Non-Ischemic (Neurogenic) Myocardial Contractility Impairment in Acute Coronary Syndromes: Prevalence and Impact on Left Ventricular Systolic Function Recovery

Medical Science Monitor, Jun 2, 2018

Research paper thumbnail of Fasting Hyperglycemia and Long-term Outcome in Patients with Acute Ischemic Stroke Treated with Mechanical Thrombectomy

Journal of stroke and cerebrovascular diseases, May 1, 2020

Research paper thumbnail of Author response for "Fatigue after COVID‐19 in non‐hospitalized patients according to sex

Research paper thumbnail of Trans-endocardial delivery of progenitor cells to compromised myocardium using the “needle technique”and risk of myocardial injury

Advances in Interventional Cardiology, 2022

Research paper thumbnail of Prognostic significance of age in patients with acute ischaemic stroke treated with intravenous thrombolysis

Neurologia I Neurochirurgia Polska, Jan 21, 2022

Research paper thumbnail of Relationship between left ventricular global longitudinal strain, infarct size and left ventricular function in patients with acute myocardial infarction in a stem cell therapy study

European Heart Journal, Oct 1, 2021

Research paper thumbnail of Clinically silent, right and left ventricular outflow tract obstructions in an adult patient (RCD code: IV-3A)

Journal of Rare Cardiovascular Diseases, 2017

Right ventricular outflow tract obstruction is a narrowing of the way that conducts blood from th... more Right ventricular outflow tract obstruction is a narrowing of the way that conducts blood from the right ventricle to the pulmonary artery. Left ventricular outflow tract obstruction is a stenosis of the path that leads blood from the left ventricle to the aorta. Combination of right and left ventricular outflow tract obstruction is a very rare finding. We report a case of a 67-year-old male with asymptomatic biventricular outflow tract obstruction. We discuss the clinical presentation, diagnostic procedures, treatment opportunities for the patient based on review of literature and actual recommendations.

Research paper thumbnail of Arterial stiffness and atherosclerosis in systemic lupus erythematosus patients

Reumatologia, Jul 6, 2022

Introduction: Systemic lupus erythematosus (SLE) is characterized by early atherothrombosis. Puls... more Introduction: Systemic lupus erythematosus (SLE) is characterized by early atherothrombosis. Pulse wave velocity (PWV) is a promising tool for the diagnosis of early vascular remodelling and initial atherosclerotic plaque formation. Our objective was to evaluate PWV and its relationship with coronary atherosclerosis and thrombotic biomarkers in patients with SLE. Material and methods: In 26 patients with SLE with stable clinical conditions, mean age of 39.1 ±11.7 years and without a history of coronary artery disease, multidetector computed tomography (MDCT)-based coronary calcium scoring (CACS) was performed and PWV measured. Laboratory evaluation included serum levels of anticardiolipin and anti-β2-glycoprotein antibodies (anti-β2-GPI), lupus anticoagulant (LA), D-dimers, thrombin-antithrombin complexes (TAT), and von Willebrand factor (vWF). Results: Multidetector computed tomography revealed coronary calcifications in 8 (30.8%) patients and the median CACS was 52.4 HU (range 2-843.2). The mean PWV was 9.0 ±3.2 m/s and was higher in patients aged > 50 years (+33.7% vs. < 50 years), those with positive LA (+28.2% vs. LA negative), TAT ≥ 10 µg/l (+18.1% vs. < 10 µg/l), vWF ≥ 200 IU/dl (+51.8% vs. < 200 IU/dl) and with coronary atherosclerosis (CACS > 0; +21.4% vs. CACS = 0). In contrast, the duration of the disease, D-dimers, anticardiolipin, and anti-β2-GPI antibodies did not influence PWV. In the group without atherosclerosis (CACS = 0, n =18), patients with vWF ≥ 200 IU/dl had a 19.3% higher PWV compared to the rest. Conclusions: In patients with SLE, PWV was associated with the presence of coronary atherosclerotic lesions in MDCT. Furthermore, arterial stiffness was higher in patients with markers of endothelial dysfunction and a prothrombotic state, suggesting their contribution to the early stages of arterial remodelling in SLE.

Research paper thumbnail of Brain Fog and Quality of Life at Work in Non-Hospitalized Patients after COVID-19

International Journal of Environmental Research and Public Health, Oct 6, 2022

Research paper thumbnail of Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke

Journal of Clinical Medicine

Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thr... more Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (DM) was not performed. Therefore, we assessed whether fasting normoglycemia (FNG) next morning after AIS treated with IVT was associated with 90-day functional outcome in diabetic and non-diabetic patients. Methods: We retrospectively analyzed 362 AIS patients treated with IVT at The University Hospital in Krakow. FNG was defined as glucose below 5.5 mmol/L. A favorable outcome was defined as modified Rankin score (mRS) of 0–2 at day 90 after AIS onset. Results: At 3-month follow-up, FNG was associated with favorable outcome (87.5% vs. 60.8%, p < 0.001) and decreased risk of death (3.1% vs. 18.1%, p = 0.002). Independent predictors of a favorable outcome for the whole group were: younge...

Research paper thumbnail of Response to Letter to the Editors regarding article entitled ‘Sex-related patient-reported brain fog symptoms in nonhospitalised COVID-19 patients’

Neurologia i Neurochirurgia Polska

Research paper thumbnail of C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Journal of Clinical Medicine

Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced d... more Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced divergent results. We evaluated whether C-reactive protein (CRP) and white blood cell count (WBC) measured fasting 12–24 h after intravenous thrombolysis (IVT) were associated with outcome in AIS patients without concomitant infection. Methods: The study included 352 AIS patients treated with IVT. Excluded were patients with community-acquired or nosocomial infection. Outcome was measured on discharge and 90 days after stroke onset with the modified Rankin scale (mRS) and defined as poor outcome (mRS 3–6) or death (mRS = 6). Results: Final analysis included 158 patients (median age 72 years (interquartile range 63-82), 53.2% (n = 84) women). Poor outcome on discharge and at day 90 was 3.8-fold and 5.8-fold higher for patients with CRP ≥ 8.65 mg/L (fifth quintile of CRP), respectively, compared with first quintile (<1.71 mg/L). These results remained significant after adjustment for pot...

Research paper thumbnail of SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis

Clinical Rheumatology

An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue... more An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue diseases. Endothelial dysfunction is the basis for the initiation and progression of atherosclerosis and thrombosis. We present systemic lupus erythematosus (SLE) as a model rheumatic disease with endothelial dysfunction and discuss its mechanisms, factors that influence the early onset and rapid progression of atherosclerosis, and the increased risk of thromboembolic events. We focus on established methods to improve endothelium function, including statins, antiplatelet, and antithrombotic therapy. Hypercoagulable and hypofibrinolitic states and a hyperinflammatory response characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathogenic mechanisms are typical for an acute phase of Covid-19 post-Covid syndrome and connective tissue diseases: endothelial dysfunction, elevated antiphospholipid antibody titer, activation of the complement system, and...