Association between lung opacities and visceral fat in COVID-19 patients.

Purpose: To assess the relationship between the amount of the epigastric visceral fat area and the severity of pneumonia in the course of COVID-19 using chest computed tomography (CT) examinations. Material and methods: 177 patients (54 female), with COVID-19 infection were included. A routine chest CT was performed to assess the severity of pneumonia. The affected lung tissue as well as semi-quantitative scales such as the Chest CT Score and Total Opacity Score were calculated using SyngoVia VB30A CT Pneumonia Analysis software. The epigastric region area of visceral fat (L1) was also determined. Results: The mean value of the visceral adipose tissue area was 196.23 ± 101.36 cm2. The area of adipose tissue significantly correlated with the percentage of the affected lung tissue (r = 0.1476; p = 0.050), the Chest CT Score (r = 0.2086; p = 0.005), and the Total Opacity Score (r = 0.1744; p = 0.200). The mean area of adipose tissue in the age group ≥ 65 years was 216.13 ± 105.19 cm2, while in the group < 65 years, it was 169.18 ± 89.69 cm2. This difference was statistically significant (p = 0.002). Conclusions: The study showed a relationship between the area of visceral adipose tissue and the degree of lung inflammation in COVID-19 disease in patients under 65 years of age.

New Method of Cardiac Lead Evaluation Using Chest Radiography.

Background and Objectives: There is currently no method that can be used for a precise evaluation of pacemaker leads using X-ray images, which could be a valuable add-on in the follow-up of patients. The aim of this paper was to create a simple method to measure selected points and lines using the chest radiography of patients with cardiac pacemakers. Materials and Methods: The study included 99 patients after permanent pacemaker implantation (72.0 ± 12.9 y; 58 W). The newly created method was used to evaluate the course of the leads based on an X-ray of the chest in an AP (posterior-anterior) projection (standing up) with optimization. The chest X-ray was applied to the original measurement grid, which was determined by specific anatomical points. For the purpose of this paper, a number of measurable parameters have been proposed. Results: The technical quality of the images was very good (4.50 ± 0.72). There were no gender-specific differences: women 4.46 ± 0.75/men 4.56 ± 0.67; p = 0.5183. The quality of the imaging of the leads was also good (3.72 ± 0.83), and no statistical differences were found between the genders. After verifying the technical quality of the X-ray images, the tract of the leads was measured. The only significant difference was found in parameter E-this value describing the so-called "death bend", which was significantly lower in women (3.98 ± 1.35) vs. men (4.58 ± 1.49): p = 0.039. Conclusions: The presented method permitted the leads of a cardiac pacemaker to be precisely described with good clinical validity using chest radiography.

Can Frailty Be a Predictor of ICD Shock after the Implantation of a Cardioverter Defibrillator in Elderly Patients?

INTRODUCTION: The aim of the study was to assess the prevalence of frailty among elderly patients who had an implanted cardioverter defibrillator, as well as the influence of frailty on the main endpoints during the follow-up. METHODS: The study included 103 patients > 60 years of age (85M, aged 71.56-8.17 years). All of the patients had an implanted single or dual-chamber cardioverter-defibrillator. In the research, there was a 12-month follow-up. The occurrence of frailty syndrome was assessed using the Tilburg Frailty Indicator scale (TFI). RESULTS: Frailty syndrome was diagnosed in 75.73% of the patients that were included in the study. The mean values of the TFI were 6.55 ± 2.67, in the physical domain 4.06 ± 1.79, in the psychological domain 2.06 ± 1.10, and in the social domain 0.44 ± 0.55. During the follow-up period, 27.2% of patients had a defibrillator cardioverter electric shock, which occurred statistically more often in patients with diagnosed frailty syndrome (34.6%) compared to the robust patients (4%); p = 0.0062. In the logistic regression, frailty (OR: 1.203, 95% CI:1.0126-1.4298; p < 0.030) was an independent predictor of a defibrillator cardioverter electric shock. Similarly, in the logistic regression, frailty (OR: 1.3623, 95% CI:1.0290-1.8035; p = 0.019) was also an independent predictor for inadequate electric shocks. CONCLUSION: About three-quarters of the elderly patients that had qualified for ICD implantation were affected by frailty syndrome. In the frailty subgroup, adequate and inadequate shocks occurred more often compared to the robust patients.

Factors that influence marital satisfaction in men with a heart rhythm disorders.

BACKGROUND: A diagnosis of a cardiac arrhythmia can affect marital relations and diminish libido and satisfaction with a patient's sex life. The aim of the study was to assess the factors that affect marital satisfaction in men with an arrhythmias who had qualified for cardiac pacemaker implantation. METHODS: The study included 103 men (aged 58.28 ± 8.72) with recognized heart rhythm disorders who were hospitalized in Department of Electrocardiology. The Hospital Anxiety and Depression Scale (HADS), the International Erectile Function Index (IIEF) and the Index of Marital Satisfaction (IMS) were used in this research. RESULTS: The greater the severity of the anxiety (r = 0.2492, p = 0.011) and depression symptoms (r = 0.3735, p = 0.000), the less satisfied a patient was with the relationship. An analysis showed that depression (p = 0.000), sexual desire (p = 0.001), overall satisfaction (p = 0.009), erectile function (p = 0.0162) and intercourse satisfaction (p = 0.026) are important predictors of marital satisfaction. Only sexual desire was an important predictor of marital satisfaction in patients with sinus node dysfunction, while the depression, sexual desire and overall satisfaction results were predictors in patients with atrioventricular blocks. CONCLUSION: Anxiety and depression symptoms affect the assessment of marital satisfaction in men with a heart rhythm disorder. Different factors influence marital satisfaction for different heart rhythm disorders.

Attitude towards sexuality and sexual behaviors among men with heart rhythm disorders.

AIM: Symptoms of cardiac arrhythmias and the perception of the implantation of a cardiac pacemaker can negatively affect mental health including sexuality and sexual behaviors. The aim of this study was to assess the attitude towards sexuality and sexual behaviors among men with cardiac arrhythmias. METHODS: The study included 80 men (aged 58.6 ± 9.23 years) with heart rhythm disorders who had qualified for cardiac pacemaker implantation. The International Index of Erectile Function IIEF-15 was completed at least one day before cardiac pacemaker implantation by all of the patients. RESULTS: The average results of the IIEF for all of the included patients was 41.87 ± 7.57 and were statistically worse in the population with atrioventricular blocks (39.60 ± 7.79) compared to those with sinus node dysfunction (44.15 ± 6.71) (p = .0110). The same relationships were found in the subcategory of orgasmic function (p = .0108) as well as intercourse satisfaction (p = .0111). Erectile dysfunction occurred in 88.75% of the patients with diagnosed arrhythmias. There was no statistically significant difference between the occurrence of erectile dysfunction in patients with sinus node dysfunction (87.5%) compared to patients with atrioventricular blocks (90%); p = .7236. CONCLUSION: We demonstrated that sexuality and sexual behaviors among men with cardiac arrhythmias was found to be statistically worse in the population with atrioventricular blocks compared to those with sinus node dysfunction. It was especially marked in the area of orgasmic function as well as for intercourse satisfaction.

The impact of cardiac pacemaker implantation on male sexual function.

BACKGROUND: The possibility of sexual functioning is an important aspect of human life, and sexual disorders have a negative impact on the quality of life and well-being. The aim of the study was to assess the sexuality and occurrence of sexual dysfunction within 6 months after pacemaker implantation. METHODS AND RESULTS: The study sample was a group of 80 patients with heart rhythm disorders who had been qualified for cardiac pacemaker implantation. The International Index of Erectile Function (IIEF)-15 was completed by all the patients at least 1 day before and 6 months after cardiac pacemaker implantation. The average results of the IIEF for all those who were included before implantation were 41.87 ± 7.57 and were statistically the worst after pacemaker implantation 46.76 ± 6.64; P < .0001. After the implantation of a pacemaker, there was an improvement in all of the subcategories of sexual life for all the men: erectile function P < .0001, orgasmic function P < .0001, sexual desire P < .0001, intercourse satisfaction P < .0001, and overall satisfaction P < .0001. CONCLUSIONS: Pacemaker implantation had a positive effect on sexual functioning for all the patients. Pacemaker implantation did not affect sexual desire in the patients who were observed. Erectile dysfunction occurred in most of patients both before and after pacemaker implantation.

Frailty as a predictor of negative outcomes after cardiac resynchronization therapy.

AIM: To assess the prevalence of frailty among patients who had cardiac resynchronization as well as the influence of frailty on the main endpoints during follow-up. METHODS: The study included 156 patients (aged 74.33 ± 6.75; 27 W) with diagnosed heart failure who were hospitalized for the implantation of a cardiac resynchronization device. The Tilburg Frailty Indicator questionnaire was used to evaluate frailty syndrome. RESULTS: Frailty syndrome was diagnosed in 75.64% of patients who were included. The average value of frailty for the whole group was 6.21 ± 1.94, for the physical domain 4.29 ± 1.32, for the psychological domain 1.40 ± 1.04, and for the social domain 0.51 ± 0.57. During the follow-up period, 5.7% of the patients died, and the mortality rate was not statistically higher (P  =  0.5795) among patients who were diagnosed with frailty syndrome (6.78%) compared to robust patients (2.63%). Analysis of the complications and first electrical storm episodes demonstrated that these events did not occur in patients with no identifiable frailty syndrome. These occurred at a rate of 4.24% (complications) and 2.54% (electric storm) in patients with frailty syndrome. CONCLUSIONS: Frailty syndrome can be an important predictor of negative outcomes in patients with heart failure who undergo cardiac resynchronizations.

Anxiety, age, education and activities of daily living as predictive factors of the occurrence of frailty syndrome in patients with heart rhythm disorders.

OBJECTIVES: Frailty is one of the geriatric syndromes that are caused by subclinical impairment of many organs, leading to the loss of reserves and the ability to maintain homeostasis. Aim of the study was to assess which factors including anxiety and depression can be predictive factors for the occurrence of frailty syndrome in patients with heart rhythm disorders. METHODS: The study included 171 consecutive patients >64 years (73.91 ± 6.72; 48.5% W) with diagnosed cardiac arrhythmias who had been qualified for pacemaker implantation. The Tilburg Frailty Indicator scale as well as the Hospital Anxiety and Depresion Scale (HADS) were used. RESULTS: The average HADS results in the frailty group was significantly higher 7.42 ± 2.63 compared to the robust patients 6.33 ± 2.83; p =0.0019. Similar results were observed in patients with atrio-ventricular blocks (AVB): HADS-A: frail 8.23 ± 2.13 vs. robust 6.62 ± 2.27; p = 0.0036 and HADS-D: frail 8.84 ± 2.85 vs. robust 7.17 ± 2.48; p =0.0086. The multiple regression model showed that age (p =0.0023), education (p =0.0001), ADL (p =0.0001) and the severity of the anxiety (p = 0.0414) were important predictors of the dependent variable and predicted higher levels of frailty syndrome. CONCLUSION: Anxiety, age, education and the activities of daily living can be predictive factors of the occurrence of frailty syndrome in patients with heart rhythm disorders who have been qualified for pacemaker implantation.

Influence of frailty on the quality of life patients qualified for pacemaker implantation.

AIMS AND OBJECTIVES: An important question is whether frailty syndrome affects the assessment of quality of life or whether frailty syndrome may reduce the benefits of a cardiac pacemaker implantation. BACKGROUND: Frailty syndrome is known risk factor for quality of life evaluation after selected cardiology invasive procedures. DESIGN: The study was designed as single-centre prospective study. METHODS: The study included 171 patients aged ≥60 years who were qualified for pacemaker implantation. Quality of life was evaluated twice-before and 6 months after implantation using MLHF questionnaire. A frailty syndrome evaluation using the Tilburg Frailty Indicator (TFI) was performed prior to pacemaker implantation. A DDDR pacemaker was implanted in each patient. RESULTS: Frailty syndrome was identified in half of the patients with indications for cardiac pacemaker implantation. There was an improvement in quality of life in the six months after pacemaker implantation in all of the robust and frailty syndrome-affected patients that were included into the study-in general, physical and emotional domains. CONCLUSION: Implantation of cardiac pacemaker influences the compensation quality of life evaluation in patients with sinus node dysfunction. Presence of frailty influences worse quality of life of patients when evaluated before cardiac pacemaker implantation. RELEVANCE TO CLINICAL PRACTICE: Frailty should be evaluated in all older patients qualified for pacemaker implantation to evaluate high-risk group, optimise therapeutic approach and to intense education activities for patients and family.

Older age and a higher EHRA score allow higher levels of frailty syndrome to be predicted in patients with atrial fibrillation.

BACKGROUND: There is no research that evaluates the relationship between the severity of the symptoms of atrial fibrillation (AF), the presence of frailty syndrome and acceptance of the illness. METHODS: The study included 132 patients aged 72.7 ± 6.73 with diagnosed AF. The severity of the symptoms of AF was determined according to European Heart Rhythm Association (EHRA) guidelines, frailty syndrome was assessed using the Tilburg frailty indicator (TFI) and the acceptance of the illness was assessed using the acceptance of illness scale (AIS). A standard statistical comparison and multiple regression analysis using the stepwise method were performed. RESULTS: In patients with AF, frailty was 5.31 ± 2.69 (TFI). Frailty syndrome was diagnosed in 59.8% of the AF patients who had a score of 7.17 ± 1.72. A higher level of EHRA score was connected with a smaller degree of the acceptance of the illness p = 0.0000. The multiple regression model indicated that age (p = 0.0009) and the severity of the symptoms (p = 0.0001) are important predictors of frailty syndrome. CONCLUSIONS: There is a relationship between the presence of frailty syndrome and the intensity of the symptoms and the acceptance of AF. Age and the EHRA score permitted higher levels of frailty syndrome to be predicted.

Frailty Syndrome in Heart Failure Patients who are Receiving Cardiac Resynchronization.

BACKGROUND: We hypothesized that patients with de novo cardiac resynchronization therapy (CRT) implantation had a more intense frailty syndrome when compared to the patients who qualified for a system upgrade. METHODS: One hundred and six patients aged ≥65 years were included. They were divided into two groups: de novo CRT implantation--74 patients and upgrade from standard right heart pacing--32 patients. A CRT was finally implanted in all of the patients. Frailty was evaluated using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). RESULTS: The average results in CSHA-CFS were statistically higher (5.3 ± 0.8) in the de novo patients when compared to the patients who qualified for a system upgrade (4.9 ± 0.8); P = 0.027. Frailty syndrome was recognized in 81.1% of the patients in the de novo group and in 68.7% of the patients in the upgrade group; P = 0.164. Only one patient of the 106 had no attributes of frailty (or exposed ones) syndrome. CONCLUSIONS: Frailty syndrome is a common phenomenon in patients with heart failure and over 65 years of age. The syndrome is most often recognized in patients who are de novo qualified for cardiac resynchronization.

Variation in Cardiac Vein System is Associated with Coronary Artery Calcium - A Venous-Atherosclerosis Paradox?

BACKGROUND: The factors that determine the different patterns of venous anatomy are not well understood. This study was designed to evaluate the relationship between variation in the cardiac vein system and the extent of coronary artery calcium score (CACS). METHODS: We reviewed the results of 64-slice CTs of 226 subjects (age 57.2 ± 11.2; 133M) enrolled in our study. The subjects were divided into 3 groups based on coronary artery calcium: 92 patients. with CACS = 0 AU (Agatston Unit, AU); 56 with CACS = 1-100 AU; and 78 patients with CACS > than 100 AU. The cardiac venous system was reconstructed during the optimal phase of the cardiac cycle in each subject. RESULTS: Subjects with a higher CACS had a better quality of vein images (p < 0.01). The number of visible veins differed between the groups. Eight subjects (8.7%) in the group with CACS = 0 AU, 7 (12.5%) in the group with CACS = 1-100 AU, and 23 (29.5%) in the group with CACS > 100 AU had five or more visible veins (p < 0.001), whereas the proportion of subjects with less than three visible veins was 56 (60.8%), 31 (55.4%) and 30 (38.4%), respectively (p < 0.05). The number of visible veins correlated with CACS (r = 0.28; p < 0.05). In a multivariate regression analysis, which included age, gender, CACS, LV ejection fraction, myocardial volume and heart rate, the CACS was found to be an independent determinant of the number of visible veins (p < 0.05). CONCLUSIONS: The results of our study suggested that there is a link between a variation in the cardiac venous system and the extent of atherosclerosis. KEY WORDS: Coronary artery calcium score (CACS); Computed tomography; Coronary veins.

[Terminology concerning intravenous ports]. / Próba usystematyzowania terminologii dotyczacej portów dozylnych.

Ports are more and more often applied with patients requiring the permanent intravenous access, not only in the cancer treatment. Very devices, as well as procedures associated with applying them are determined in the heterogeneous way. Therefore during the last conference "Intravenous Port--implantation, care, complications" an attempt to systematize the applied terminology was made.

Coronary venous retention-a feature in heart failure as evidenced by mean of cardiac computed tomography.

BACKGROUND: Whether the functional status of the heart can influence the coronary venous system itself has not yet been examined. In order to answer this question, we used multislice computed tomography (CT) imaging. PURPOSE: To answer the question of whether the heart failure (HF) is associated with significant anatomical changes in the coronary venous system? METHODS: In 136 (aged 56.6 ± 11.5) patients, a 64-slice CT was performed. Patients were divided into three groups according their ejection fraction. In each case, nine 3D volume rendering reconstructions, using a 2-mm layer with electrocardiographic-gating, were created at 0% to 90% R-R intervals (step 10%). The visualization of coronary veins (CVs) was graded independently by two experts trained in multislice computed tomography on a 0-5 point scale (0-not visible/lack of vein; 5-smoothly bordered vascular structure). RESULTS: The average number of visible CVs per case was 3.44 in the HF group and 2.72 in patients with a normal ejection fraction (P = 0.0246). The statistical correlation between a reduction in ejection fraction and the increase in the number of veins was found (r =-0.2446, P < 0.05). For two of seven common variants of the coronary venous system at least two target veins (posterolateral and lateral) for cardiac resynchronization were presented. CONCLUSIONS: The statistically higher number of veins in patients with heart failure may suggest an association between a failing heart and cardiac venous retention.

Computed tomography in patients with cardiac pacemakers: difficulties and solutions.

The presence of cardiac pacemaker systems may significantly limit interpretation of multi-slice computed tomography (MSCT) images. In 80 patients (45 men; aged 69.5 ± 13.4) with previously implanted anti-arrhythmic devices, a 64-slice CT (Aquilion-64) was performed. In 61 patients (76.3%), ECG gating was used (coronaries visualization) and in 19 patients (23.7%) without ECG gating (not coronaries visualization). In all 19 patients without ECG gating MSCT images were diagnostic. In 37 (60.6%) patients of 61, there was no problem with gating process and image quality was diagnostic. In 24 (39.4%) with visible spikes in the ECG-gating group, there were difficulties in differentiating the R spike from an artificial spike (unipolar pacing) by MSCT software. In 15 patients (24.6%) after reprogramming, it was possible to obtain good quality images. In nine (14.7%) patients, it was not possible to reprogram devices due to old unipolar leads, but in two cases (3.3%), ECG gating was corrected manually and good image quality was obtained. In seven (11.5%) patients, it was not possible to perform ECG gating. The ECG gating process was identified as the main cause of the imaging problems. Bipolar leads working as bipolar pacing seem to be necessary to perform MSCT with ECG gating. A unipolar system lead may cause serious problems with reconstructions.

Coronary Sinus Diameter as a Potential Marker of Right Ventricle Impairment.

The aim of this study was to assess the influence of the parameters of the coronary sinus (CS) on the parameters that describe the function of the right ventricle (RV), which were calculated using cardiac computed tomography. METHODS: A CT scan of the heart was performed on 150 patients due to suspicion of coronary artery disease using a Siemens Somatom Force (2 × 192 × 0.6) and a syngo.via workstation. The "CT coronary" and in some cases the generic presets were used to measure the CS ostium in millimeters (mm). The functional measurements of right heart ventricles were examined using the "CT cardiac function" automatic function on a 256 × 256 matrix. RESULTS: The average diameter of the CS ostium was 16.29 ± 4.37 mm. In the group with RV impairment, it was 16.56 ± 4.76, whereas in the group with normal values of the RV, it was 15.98 ± 3.88 mm, p = 0.4199. The average angle of the entrance of the CS into the right atrium was 107.25° ± 9.68°. In the group with an RV impairment, it was 105.91° ± 9.22°, while in the patients with normal values of the RV, it was 108.82° ± 10.04°; p = 0.0682. A multiple regression showed that end systolic volume (p = 0.0017) and stroke volume (p = 0.0144) are important predictors of the CS ostium. CONCLUSIONS: Some relationships were found between the CS and the selected parameters that describe the function of the RV. This may suggest a role for the CS as a right ventricular buffer, which could potentially be treated as a marker of an RV impairment.

Determinants of Sleep Disorders and Occupational Burnout among Nurses: A Cross-Sectional Study.

Background: The aim of the study was to assess the determinants of the sleep disorders that occur among nurses working in a shift system by assessing the influence of sociodemographic factors, the impact of shift work, and the occurrence of occupational burnout. Methods: The study included 300 nurses who work shifts in the Silesian Region (Poland). The research was conducted using standardized research tools: the Karolinska Sleepiness Scale (KSS), the Epworth Sleepiness Scale (ESS), the Athens Insomnia Scale (AIS), and the Maslach Burnout Inventory (MBI). Results: Among the sociodemographic factors, in the KSS analysis, sleep disorders were most common in men (CI: 0.038; p < 0.001), in divorced individuals (CI: 1.436; p = 0.045), and in individuals who were overweight (CI: 1.927; p = 0.026). Multiple linear regression showed that sleep disorders (p < 0.001) were an independent predictor of MBI among nurses who worked shifts. Conclusions: Sleep disturbances affect the burnout of nurses who work shifts.

Predictors of Early Cardiac Implantable Electronic Device Lead Dislodgement in the Elderly.

INTRODUCTION: One of the most frequent cardiac implantable electronic device (CIED) implantation complications is lead dislodgement, especially in the older adult population. Little evidence is available about the influence of frailty on the risk of lead dislodgment after CIED implantation procedures; thus, the evaluation of frailty could be relevant for the course and safety of the implantation procedure, especially among the elderly with cardiovascular diseases. This study aimed to assess the risks and predictors of early lead dislodgement in the elderly population. METHODS: Between 2008 and 2021, 14,293 patients underwent implantations. In 400 elderly patients, lead dislodgement was confirmed, and frailty was retrospectively calculated. RESULTS: The most frequent dislodgement according to the lead position was that of the atrial lead (133; 33.3%). In the logistic regression, frailty (OR: 1.8196, 95% CI:1.4991-2.2086; p < 0.0001) and age (OR: 1.0315, 95% CI:1.0005-1.0634; p < 0.0461) were independent predictors of early dislodgement. In the female group, frailty (OR: 2.1185, 95% CI: 1.5530-2.8899; p < 0.0001) was an independent predictor of early dislodgement. Similarly, in the male group, frailty (OR: 1.6321, 95% CI:1.2725-2.0934; p < 0.0001) was an independent predictor of early dislodgement. CONCLUSION: Lead dislodgement often occurs in the elderly. Frailty in both men and women is a predictive factor of early lead dislodgment. Evaluating frailty may be an essential element of proper selection, especially in the elderly undergoing CIED procedures, and, consequently, it could help prevent further complications.

Kinesiophobia in Elderly Polish Patients After Ischemic Stroke, Including Frailty Syndrome.

Introduction: In patients after stroke, the relationship between the occurrence of kinesiophobia and the accompanying frailty syndrome, as well as the acceptance of the disease and the level of mood, has not been recognized so far. The aim of this study was to determine the prevalence of kinesiophobia in elderly Polish people after ischemic stroke, including the frailty syndrome and the associations between the prevalence of kinesiophobia and feelings of anxiety and degree of the illness acceptance. Methods: A cross-sectional study was used to achieve the study objectives. The study involved 152 hospitalized patients aged of minimum 60 (mean age 63), qualified for post-stroke rehabilitation, including 76 women and 76 men. The patients were divided into two groups, with kinesiophobia (119 persons) and without kinesiophobia (33 persons). The Tampa Scale of Kinesiophobia (TSK), the Tilburg Frailty Indicator (TFI), the Hospital Anxiety Depression Scale (HADS) and the Acceptance of Illness Scale (AIS) were used. Study results were calculated using MedCalc Software. Results: Kinesiophobia has been demonstrated in 78% of people after ischemic stroke. The values of TFI and HADS were higher in the patients with kinesiophobia (p<0.001). In patients with ischemic stroke, it was shown that the level of kinesiophobia increased with higher anxiety (p<0.001), higher total TFI score, (p<0.05), and a lower level of illness acceptance (p<0.001). Conclusion: The occurrence of kinesiophobia in elderly Polish people after ischemic stroke is common and the determinants of its development are the coexistence of the frailty syndrome, anxiety and a low level of illness acceptance. In post-stroke patients, the presence of kinesiophobia should be considered, especially in the situation of comorbid frailty syndrome. The issue of kinesiophobia in patients after stroke requires further in-depth research, especially in the field of cognitive-behavioral prevention aimed at ways to reduce this phenomenon.

Anatomical variants of coronary venous system on cardiac computed tomography.

BACKGROUND: In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT). METHODS AND RESULTS: In 199 patients (114 males, age 56.6±11.5 years), a 64-slice computed tomography (Aquilion 64) was performed due to coronary artery disease suspicion. A scan with electrocardiogram-gating was performed using a slice thickness of 0.5mm during a breath-hold. In each case, 3D volume rendering and 2D multi-planar reformatting reconstructions of CVS were created (Vitrea 2). As target veins for cardiac resynchronization therapy (CRT), the posterolateral, lateral and anterolateral veins were recognized. Coronary sinus was well visualized in all cases. A total of 27 anatomical variants of CVS were identified, 9 of them are most common (in 148/199 cases; 74.4%). In 4 out of these 9 variants, a single coronary vein in the target area for CRT appeared, 2 target veins in 3 variants and 3 veins in 2 variants occurred. In 6 cases (2 seldom variants-3.0%) no veins in the target area were identified. CONCLUSIONS: In the majority of the examined patients, at least one vein in the target area for CRT was observed. Anatomical variability of CVS strengthen the potential role of MSCT in CVS visualization before CRT implantation.