[Kinesiophobia in patients with cardiovascular disease].

OBJECTIVE: Introduction: Kinesiophobia - a fear of physical activity - is a common and worsening rehabilitation outcomes phenomenon in patients with cardiovascular diseases. The aim: To assess the level of kinesiophobia in relation to heart's function evaluated using echocardiography and clinical parameters in patients with cardiovascular disease. PATIENTS AND METHODS: Material and methods:101 patients (28 women) aged 61,9±13,56 years and hospitalized for implantation or replacement of a pacemaker or cardioverter-defibrillator were included in the study. Their heart's function and morphology were evaluated echocardiographically. Level of kinesiophobia was evaluated with the Polish version of Tampa Scale of Kinesiophobia Heart (TSK-Heart) questionnaire. RESULTS: Results: The TSK score in these patients was 41,6±5,39. It's value was increasing with age (p=0,0264), was higher in women than in men (43,5±5,36 vs. 40,8±5,27, p=0,0287) and in patients with coronary artery disease (42,3±6,28 vs. 40,9±4,62, p=0,031). In patients with heart failure, it was decreasing with an increase of body mass index (p=0,0185). Severe mitral insufficiency resulted in higher index value in comparison with moderate or mild one (42,7±4,05 vs. 40,9 ± 5,58, p=0,0369). The TSK index increases with a decrease in tricuspid annular plane systolic excursion (p=0,0033). Patients in NYHA IV class exhibited higher TSK value than those in lower classes (p<0,001). An inverse dependency of TSK index value and hemoglobin level were established (p=0,0041). CONCLUSION: Conclusions: In patients with cardiovascular diseases, kinesiophobia has multicausal nature and is higher in NYHA IV patients. The independent predictors of kinesiophobia are right ventricular dysfunction and anemia.

[Diagnostics enigma: left ventricular noncompaction or systemic right ventricle?]

A case of congenitally corrected transposition of great arteries, a rare congenital heart defect diagnosed in an adult is presented and difficulties in differential diagnosis of congenital heart defects in the adults are described. The crucial point is proper interpretation of the echocardiography examination.