Cardiac solitary fibrous tumor - an extremely rare but potentially fatal diagnosis.

The background of this review is a description of the case of a 28-year-old man with an extremely rare cardiac solitary fibrous tumor (SFT). Although this tumor was removed surgically and in the 6-month follow-up examination no relapse was noted, recurrence was observed and confirmed in the magnetic resonance imaging 4 months later. SFT prevalence, symptoms and signs, treatment options and prognosis are reviewed.

The importance of the development of extracorporeal life support simulation centres for improving skills and knowledge during the COVID-19 pandemic.

Introduction: Despite increasing implementation of sophisticated and logistically challenging techniques to support patients in life-threatening conditions in the last years, there were no devoted education centres, especially in coronavirus pandemic. Aim: To assess the value of gaining evidence-based knowledge and improving the skills of physicians by means of simulation techniques in the safe use of extracorporeal technologies to support patients in the life-threatening conditions. Material and methods: In 2019, the National Education Centre for Artificial Life Support and Patient Safety and the frame program of the course of "Artificial Life Support with ECMO". was created. In years 2019-2023, we managed to organise 34 such courses for 405 physicians, which were additionally endorsed by ELSO (Extracorporeal Life Support Organisation). The physicians' cognitive, behavioural, and technical skills were evaluated before and after the courses. Results: The participants' gender was well balanced (54% men and 46% women). Most of them (mainly at the age between 31-40 years) presented more than 5 years of clinical experience, predominantly in anaesthesiology and intensive care (63%). Of note, 54% of them had no experience with ECMO application. In all detailed aspects of cognitive, behavioural, and technical assessment and knowledge scores, significant improvement was observed after the course. Conclusions: The development of a simulation-based education centre was found to be an invaluable achievement that enabled not only successful standardised training and testing of novel or previously accepted procedures, but also the upgrading of technical skills, even in the challenging COVID-19 pandemic period.

Comprehensive proteomics of monocytes indicates oxidative imbalance functionally related to inflammatory response in chronic kidney disease-related atherosclerosis.

Atherosclerosis-induced cardiovascular events are the leading cause of mortality in chronic kidney disease (CKD) patients. Monocytes are involved in the formation of atherosclerotic plaques and mediate in the overproduction of ROS, promoting inflammation and oxidative stress. However, the relationship between monocytes, inflammation, and oxidative status in CKD-associated atherosclerosis has not been thoroughly investigated. Monocytes and plasma derived from two groups of CKD patients with varying degrees of atherosclerosis and two groups of patients with cardiovascular disease (CVD) and non-CKD atherosclerosis were analyzed. This study was designed to perform a comprehensive proteomic analysis of monocytes in combination with functional bioinformatics. In addition, a targeted investigation of oxidative stress- and inflammatory-related factors to explore CKD-associated atherosclerosis was applied. Dysregulation of proteins involved in lipid oxidation, cell survival, ROS synthesis and metabolism, and inflammatory responses has been revealed. The characteristic disturbances in the monocyte proteome changed with the progression of CKD. A closer examination of oxidative stress's triggers, mediators, and effects on protein and lipid levels showed alterations in the oxidative imbalance between CKD and CVD. CKD monocytes demonstrated a significant increase of oxidized glutathione without changing the level of its reduced form. Evaluation of enzymatic antioxidants, sources of ROS, and modifications caused by ROS also revealed significant alterations between the study groups. In CKD, inflammation and oxidative imbalance correlated and drove each other. However, in CVD, oxidative stress-related factors were associated with each other but not to inflammatory proteins. Moreover, lipid abnormalities were more specific to classical CVD and unrelated to CKD. Such a comprehensive characterization of monocytes and oxidative stress in CKD and CVD patients has never been presented so far. Obtained results support the involvement of distinct mechanisms underlying the acceleration of atherosclerotic and non-atherosclerotic CKD.

Single versus multiple arterial coronary artery bypass grafting in men and women: results from Polish National Registry of Cardiac Surgery Procedures.

BACKGROUND: The objective of this multicenter study aimed to investigate the impact of sex on long-term survival among patients with multivessel coronary artery disease undergoing coronary artery bypass grafting (CABG) using multiple arterial grafting (MAG) or a single artery with saphenous vein grafts. MATERIALS AND METHODS: Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. This study included 81 136 patients who underwent CABG for multivessel disease between January 2012 and December 2020 (22.9 were women and 77.1% were men). MAG was performed in 8.3 and 11.7% of female and male patients, respectively. A 1:1 propensity score (PS)-matching was performed. Long-term mortality was compared between matched groups of men and women. Subgroup analyses of patients aged <70 and ≥70 years, with an ejection fraction (EF) >40% and ≤40%, and with and without diabetes, obesity, peripheral artery disease (PAD), or chronic lung disease (CLD) were performed separately in women and men. RESULTS: MAG was associated with lower long-term mortality than saphenous vein grafts in 1528 PS-matched female pairs [hazard ratio (HR): 0.74; 95% CI: 0.59-0.92; P =0.007) and 7283 PS-matched male pairs (HR: 0.80; 95% CI: 0.72-0.88; P <0.001). Subgroup analyses confirmed the results among female patients aged <70 years, with diabetes and EF >40%, and without PAD or CLD, and of male patients aged <70 and ≥70 years; with EF >40%; with or without diabetes, obesity, or PAD; and without CLD. CONCLUSIONS: In patients undergoing CABG, MAG was associated with significantly improved survival in both sexes. The long-term benefits of MAG observed across subgroups of men and women support the consideration of a multiarterial revascularization strategy for a broader spectrum of patients.

Do we correctly calculate doses of cardioplegia during aortic valve replacement procedures? A preliminary report.

Introduction: Intraoperative myocardial protection during aortic valve replacement (AVR) for aortic stenosis (AS) is of paramount importance for outcomes. The dose of cardioplegia is usually calculated with reference to body mass. Aim: To assess whether such a strategy should be applied to all AS patients undergoing AVR. Material and methods: The study included 94 patients who underwent elective isolated AVR in cardiopulmonary bypass with cold cardioplegic arrest, with a mean age of 65.4 ±7.8 years. They were divided into two subgroup: A with an infusion of high (above median) and subgroup B with a low (below median) volume of cardioplegia indexed for left ventricular mass (LVM). Their doses were referred to the maximal postoperative release of cardiac troponin I (cTnI max). Eventually, it was examined whether the extent of intraoperative myocardial injury translated into long-term survival stratified according to the Kaplan-Meier method. Results: The mean volume of cardioplegia was 1381 ±279 ml (4.9 ±1.6 ml/g of LV myocardium). cTnI max was much higher in group A than in group B (medians: 14.918 vs. 9.876 µg/l; p = 0.005). Moreover, a negative correlation between the index cardioplegia volume and cTnI max (r = 0.345) was noted. The five-year probability of survival in subgroup A (95.7%) was significantly better than that in subgroup B individuals (82.6%, p = 0.044). Conclusions: Calculating cardioplegic doses during AVR solely based on body mass may be suboptimal and have a significant impact on postoperative outcomes.

Monocyte-to-lymphocyte ratio correlates with parathyroid hormone concentration in patients with severe symptomatic aortic stenosis.

PURPOSE: The normal healthy valve is devoid of inflammatory cells, however background of aortic stenosis (AS) may include inflammatory processes. Moreover, the link between hyperparathyroidism and heart failure is postulated. Simple whole blood analysis with indices is a beneficial tool in cardiovascular diseases' assessment. The purpose of the study was to evaluate correlation between parathyroid hormone (PTH) and simple blood parameters in severe AS. MATERIAL AND METHODS: The study included 62 patients with severe AS. Patients with inflammatory or autoimmune co-morbidities were excluded. Blood samples were collected, and clinical and demographic data were analyzed. RESULTS: The final study group comprised 55 patients (31 females, 56.4%; mean age 77.13 (SD 6.76)). In 23 patients (41.8%), PTH concentration was markedly increased. The study group was divided into two subgroups according to the PTH concentration. Patients from both groups did not differ significantly in terms of age and co-morbidities. PTH concentration correlated positively with monocyte-lymphocyte ratio (MLR) (p â€‹= â€‹0.008, Spearman rho 0.356) and platelet-lymphocyte ratio (PLR) (p â€‹= â€‹0.047, Spearman rho 0.269), creatinine level (p â€‹= â€‹0.001, Spearman rho 0.425) and glomerular filtration rate (GFR-MDRD) (p â€‹= â€‹0.009, Spearman rho -0.349). The multivariable logistic regression with backward analysis revealed MLR (p â€‹= â€‹0.029) and GFR (p â€‹= â€‹0.028) as independent significant predictors of abnormal PTH values. The receiver operator characteristics (ROC) curve was performed for the model of MLR and GFR-MDRD (AUC â€‹= â€‹0.777), yielding the sensitivity of 60.9% and specificity of 90.6%. CONCLUSIONS: PTH concentration correlates with monocyte-to-lymphocyte and platelet-to-lymphocyte ratios in calcified AS.

Prognostic Impact of Residual Moderate Mitral Regurgitation Following Valve-in-Valve Transcatheter Aortic Valve Implantation.

INTRODUCTION: The impact of mitral regurgitation (MR) on valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) in patients with failed bioprostheses remains unclear. The purpose of this study was to assess the prognostic impact of residual moderate MR following VIV-TAVI. METHODS: We retrospectively analyzed 127 patients who underwent VIV-TAVI between March 2010 and November 2021. At least moderate MR was observed in 51.2% of patients before the procedure, and MR improved in 42.1% of all patients. Patients with postoperative severe MR, previous mitral valve intervention, and patients who died before postoperative echocardiography were excluded from further analyses. The remaining 114 subjects were divided into two groups according to the degree of postprocedural MR: none-mild MR (73.7%) or moderate MR (26.3%). Propensity score matching yielded 23 pairs for final comparison. RESULTS: No significant differences were found between groups before and after matching in early results. In the matched cohort, survival probabilities at one, three, and five years were 95.7% vs. 87.0%, 85.0% vs. 64.5%, and 85.0% vs. 29.0% in the none-mild MR group vs. moderate MR-group, respectively (log-rank P=0.035). Among survivors, patients with moderate MR had worse functional status according to New York Heart Association (NYHA) class at follow-up (P=0.006). CONCLUSION: MR is common in patients with failed aortic bioprostheses, and improvement in MR-status was observed in over 40% of patients following VIV-TAVI. Residual moderate MR after VIV-TAVI is not associated with worse early outcomes, however, it was associated with increased mortality at five years of follow-up and worse NYHA class among survivors.

A comparative study of minimally invasive aortic valve replacement with sutureless biological versus mechanical prostheses.

Introduction: The ministernotomy approach with sutureless aortic bioprosthesis may provide an attractive and safe option for aortic valve disease patients. Aim: To assess the early and mid-term outcomes of minimally invasive aortic valve replacement (miniAVR) with sutureless vs. standard prostheses. Material and methods: The study involved 76 consecutive patients (51 males and 25 females) with mean age of 63.2 years who were treated with miniAVR between 2015 and 2022. They were divided into 2 subgroups: group I (n = 40) subjects with sutureless bioprostheses and group II (n = 36) with standard prostheses implanted. Early and mid-term outcomes were evaluated. A probability of survival was estimated by means of the Kaplan-Meier method. Results: No conversion to complete sternotomy was necessary. The median (minimum; maximum) aorta cross clamping and cardio-pulmonary bypass times were 49 (27; 84) and 70 (40; 188) minutes in group I whereas 69 (50; 103) and 95 (69; 170) minutes in group II, respectively (p < 0.001). In-hospital mortality was 5.0% (n = 2) and 2.8% (n = 1) in group I vs. II, respectively (ns). Permanent ICD implantation was performed in 8 (20.0%) in group I and in 3 (8.3%) subjects in group II. In the discharge echocardiography, the function of all prostheses was correct. Five-year probability of survival was much lower in group I (0.75 ±0.10) than in group II (0.94 ±0.04). No wound infection or sternum instability was noted. Conclusions: Intraoperative advantages of miniAVR procedures for aortic valve patients with sutureless bioprostheses do not translate directly into improved early and middle-term outcomes.

Coronary Artery Bypass Surgery: Comparing the Long-Term Impact of Total Arterial Grafting With Multiarterial Plus Saphenous Vein Grafting.

INTRODUCTION: This study aimed to compare the long-term outcomes in a propensity matched population receiving total arterial grafting (TAG) and multiple arterial grafts (MAG) in addition to saphenous vein graft (SVG) following multivessel coronary artery bypass grafting requiring at least three distal anastomoses. METHODS: In this retrospective study, 655 patients from two centers met the inclusion criteria and were divided into two groups: TAG group (n = 231) and MAG + SVG group (n = 424). Propensity score matching was performed resulting in 231 pairs. RESULTS: No significant differences were observed between both groups in terms of early outcomes. Survival probabilities at 5, 10, and 15 y were 89.1% versus 94.2%, 76.2% versus 76.1%, and 66.7% versus 69.8% in the TAG and MAG + SVG groups, respectively (hazard ratio stratified on matched pairs: 0.90; 95% confidence interval [0.45-1.77]; P = 0.754). Freedom from major adverse cardiac and cerebral events (MACCE) in the matched cohort did not show any significant difference between both groups. Probabilities at 5, 10, and 15 y were 82.7% versus 85.6%, 62.2% versus 75.3%, and 48.8% versus 59.5% in the TAG and MAG + SVG groups, respectively (hazard ratio stratified on matched pairs: 1.12; 95% confidence interval [0.65-1.92]; P = 0.679). Subgroup analyses of the matched cohort showed no significant difference between TAR with three arterial conduits compared to TAR with two arterial conduits with sequential grafting and MAG + SVG in terms of long-term survival and freedom from MACCE. CONCLUSIONS: Multiple arterial revascularizations in addition to SVG may yield comparable long-term outcomes in terms of survival and freedom from MACCE compared to total arterial revascularization.

Emergency Endovascular Interventions on Descending Thoracic Aorta: A Single-Center Experience.

Background: Implementation of emergency endovascular aortic repair provides an attractive opportunity in the treatment of complicated acute aortic syndromes involving descending aorta. Aim: The aim of this study was to analyze the effectiveness of thoracic endovascular aortic repair (TEVAR) for the treatment of acute surgical emergencies involving the descending thoracic aorta. Methods: A retrospective review of the medical records of all patients undergoing TEVAR in a single center since 2007 was undertaken. Patients with the aortic disease treated on emergency inclusion criteria were complicated spontaneous acute aortic syndrome (csAAS), traumatic aortic acute injuries (TAIs), and other indications requiring emergent intervention. Technical and clinical success with patient mortality, survival, and reoperation rate was evaluated according to Society for Vascular Surgery reporting standards for thoracic endovascular aortic repair (TEVAR). Results: The emergency interventions were necessary in 74 cases (51.0%), including patients with the complicated spontaneous acute aortic syndrome (csAAS) (64.8%; n = 48) and traumatic aortic acute injuries (TAIs) (31.1%). In addition, in one case aortic iatrogenic dissection (AID) and in 2 other fistulas after the previous stent graft, implantations were diagnosed. All procedures were done through surgically exposed femoral arteries while 2 hybrid procedures required additional approaches. The primary technical success rate was 95.9%, in 3 cases endoleak was reported. The primary clinical success occurred in 94.5%. All patients survived the endovascular interventions, whereas during in-hospital stay one of them died due to multiorgan failure (early mortality 1.3%). During the follow-up period, lasting 6 through 164 months (median 67), 11 patients died. Annual, five- and ten-year probability of survival was 86.4 ± 0.04%, 80.0 ± 0.05%, and 76.6 ± 0.06%, respectively. However, the rate of 5-year survivors was significantly higher after TAI (95.2%) than scAAS (63.4%) (p=0.008). Early after the procedure, one individual developed transient paraparesis (1.3%). No other serious stent-graft-related adverse events were noted within the postdischarge follow-up period. Conclusions: Descending aortic pathologies requiring emergent interventions can be treated by endovascular techniques with optimal results and low morbidity and mortality in an experienced and dedicated team.

Long-term outcomes of patients receiving right internal thoracic artery or radial artery as a second arterial conduit. A propensity score matching study.

OBJECTIVE: This study aimed to compare the long-term outcomes in propensity matched patients receiving right internal thoracic artery(RITA) or radial artery(RA) as second arterial conduit during coronary artery bypass grafting(CABG) with internal thoracic artery to the left anterior descending artery(LAD). METHODS: In this retrospective study, propensity score matching was performed including 1198 patients from 3 centers resulting in 389-pairs who received either RITA or RA. RESULTS: In the matched cohort, median follow-up time was 7.53 years(interquartile range, 4.35-11.81). Survival probabilities at 5, 10 and 15-years were 93.8% versus 94.5%, 81.2% versus 76.2% and 63.2% vs 62.5% in the RITA and RA groups, respectively(HR: 1.11; 95%CI;0.80-1.53; P = 0.533) Freedom from MACCE in the matched cohort at 5, 10 and 15-years were 92.0% versus 93.7%, 75.0% versus 73.8%, 72.2% and 46.9% vs 47.2% in the RITA and RA groups, respectively(HR: 0.96; 95%CI;0.74-1.26; P = 0.774). Subgroup analyses of the matched cohort showed comparable long-term outcomes in terms of MACCE at follow-up in patients with age older than 65-years, obese patients, diabetics, female patients and with impaired EF. As for target vessel revascularization, RITA and RA had comparable outcomes in terms of MACCE when the conduit was used to graft either the left coronary system or the right coronary system. CONCLUSIONS: The use of RITA or RA as second arterial conduit during CABG with internal thoracic artery to the LAD is safe and associated with comparable long-term clinical outcomes. The choice of optimal second arterial conduit should be guided mainly by patients' characteristics and surgeons' preferences.

Impact of Second Arterial Conduit on Outcomes Following Coronary Bypass Grafting.

BACKGROUND: The aim of this study was to compare short-term outcomes and long-term survival in patients following coronary artery bypass grafting in whom second arterial conduit or saphenous vein was used as well as to find out the most optimal second arterial graft. METHODS: Between January 2006 and June 2018, 7,857 patients met the inclusion criteria and were divided into two groups: single internal thoracic artery (SITA) + Vein group (n = 7,140) and second arterial conduit group (n = 717), of these 537 patients received right internal thoracic artery (RITA) and 180 patients received radial artery (RA). We obtained 701 propensity-matched pairs for final comparison. Short-term outcomes included: 30-day mortality and major adverse cardiac and cerebral events (MACCE), reoperation for bleeding, and deep sternal wound infection (DSWI). The long-term outcome was all-cause mortality. RESULTS: No significant differences were observed between second arterial conduit versus SITA + Vein groups and between RITA versus RA groups in terms of 30-day mortality, 30-day MACCE, reoperation for bleeding, and incidence of DSWI in the matched cohort. The use of second arterial conduit was associated with a significant reduction in long-term mortality by 24% in the matched cohort (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.60-0.96; p = 0.02). RA and RITA as second arterial conduit had comparable long-term mortality (HR: 1.12; 95% CI: 0.69-1.82; p = 0.62). CONCLUSION: The use of second arterial conduit, irrespective of type, is safe and associated with improved long-term survival compared with the second venous aortocoronary graft.

Transcatheter aortic valve replacement in the management of aortic insufficiency secondary to left ventricular assist device implantation: a case report.

Background: Left ventricular assist device (LVAD) is considered either a destination therapy for patients with end-stage heart failure or heart transplantation bridging. LVAD implantation often causes aortic insufficiency (AI), which requires aortic valve repair. However, severe acute AI does not respond well to medication, and re-operation means higher risk to the patients; the most effective therapeutic strategies for LVAD-induced AI still need further exploration. In this report, we present the first described case of new-onset, severe LVAD-induced AI in China with a patient who underwent transcatheter aortic valve replacement (TAVR) and achieved significant improvement in functional capacity and symptoms with lower operation risk. Case Description: A 55-year-old male patient was diagnosed with dilated cardiomyopathy for 14 years. The effect of the medication gradually deteriorated, LVAD (HeartCon®) was implanted one year earlier. The patient complained of intermittent chest tightness for one week, which had been aggravated for two days before hospitalization. Echocardiographic findings revealed new-onset, severe LVAD-induced AI. TAVR was performed with a self-expandable stent-valve (TAV30, Vitaflow Liberty). Within minutes, the patient recovered with rapid disappearance of chest tightness and stable vital signs. Before discharge, the position of the artificial valve was fixed without incomplete closure nor thrombus attachment, yielding a left ventricular ejection fraction (LVEF) of 35%. The patient was hospitalized for 38 days, and followed up with outpatient treatment, the condition was stable until 19 June 2023. Conclusions: TAVR could be an effective, safe, and less invasive means of restoring ejection fraction for patients with a LVAD who develop severe AI.

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization.

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59-64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17-17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

High Residual Gradient Following a Self-Expandable Transcatheter Aortic Valve-in-Valve Implantation — Risk Factor Analysis, Outcomes, and Survival

Abstract Introduction: Transcatheter aortic valve-in-valve implantation (TAVI-ViV) can be associated with unfavorable hemodynamic outcomes. This study aimed to estimate the prevalence, identify the risk factors, and evaluate the outcomes and survival of patients with high residual gradients after TAVI-ViV. Methods: A total of 85 patients were included in the study. The cohort was divided into group A, with postprocedural mean pressure gradient (PG) ≥ 20 mmHg, and group B, with mean PG < 20 mmHg. Results: Postprocedural PG ≥ 20 mmHg was observed in 24.7% of the patients. In a univariate analysis, preoperative gradient, pre-existing patient-prosthesis mismatch (PPM), deep valve implantation, small degenerated valves, and an older generation of transcatheter aortic valves were found to be risk factors for high residual gradient. Multivariate analysis showed that preexisting maxPG > 60 mmHg, implantation level of 4 mm below neo-annulus, and degenerated valve size ≤ 23 mm were independent predictors of high residual gradient. There were no differences in early morbidity (myocardial infarction, pacemaker implantation, stroke, acute renal insufficiency) between groups. Kaplan-Meier estimated that the survival rate was comparable at one and five years regardless of postoperative gradient. Survivors with high residual mean gradient were significantly affected by a high New York Heart Association (NYHA) class. Conclusion: High residual transvalvular gradient after TAVI-ViV is not rare, but it does not significantly affect mortality. High residual mean gradient has a negative impact on NYHA functional class improvement after the procedure. High preoperative gradient, implantation level, and small failed bioprosthesis may predispose to increased residual gradient.

Serum copper concentration reflect inflammatory activation in the complex coronary artery disease - A pilot study.

INTRODUCTION: Coronary artery disease possess inflammatory background related to enzymatic processes with trace elements involvements as co-factors. The aim of the study was to compare serum, urine and salivary copper, magnesium, calcium and zinc levels with inflammatory indices obtained from the whole blood count in patients with complex coronary artery disease. MATERIAL AND METHOD: Fifty-two (42(81 %) males, 10 (19 %) females) consecutive patients (mean (SD) age 68 (9) years with symptomatic complex coronary artery disease were enrolled into prospective single center study in 2021. Serum, saliva and urine samples were collected at the day of admission for trace elements concentration (copper, zinc, magnesium, calcium) and compared with inflammatory indexes obtained from preoperative and perioperative period. RESULTS: Multivariable regression analysis revealed relation between the copper serum concentration and neutrophil to lymphocyte ratio (NLR) and systemic inflammatory index (SII). CONCLUSION: Serum copper concentration interplay with preoperative inflammatory activation in complex coronary disease measured by NLR and SII. The copper serum concentration possesses the strongest relation to preoperative inflammatory activation in patients reffered for off-pump coronary artery bypass grafting.

Changes in treatment of aortic valve diseases for acute and elective indications during the COVID-19 pandemic: A retrospective single-center analysis from 2019 to 2020.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic had an impact on the quality of healthcare services and led to many changes in the treatment of cardiac pathologies. OBJECTIVES: To assess the differences in the clinical manifestations, management and outcomes of patients with aortic valve diseases (AVDs) treated invasively before and during the pandemic. MATERIAL AND METHODS: This retrospective single-center study involved patients with AVDs treated by means of balloon aortic valvuloplasty (BAV), transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) in 2019 and 2020. They were divided into groups with respect to the year of intervention (2019 compared to 2020) and the priority of admission (urgent compared to elective). Preoperative characteristics, early outcomes and probability of annual survival were compared between the groups. RESULTS: The number of patients admitted urgently increased from 37 in 2019 to 54 in 2020, with a higher prevalence of men in 2020 (83.3% compared to 56.8%, respectively). Elective cases, on the other hand, declined from 279 in 2019 to 256 in 2020. Among the latter, more subjects had manifestations of heart failure (p < 0.001), coronary artery disease (CAD; p = 0.002), hypertension (p = 0.006), as well as had a history of a stroke (p = 0.002). In the meantime, more TAVI and fewer SAVR procedures were performed in 2020 (86 compared to 127 and 192 compared to 125, respectively; p < 0.001). In 2020, TAVI individuals had risk of death (according to the EuroSCORE scale) than in 2019 (p < 0.001). The probability of annual survival was comparable (p = 0.769) among AVD patients treated before and during the coronavirus pandemic (91.3% compared to 88.3%, respectively). CONCLUSION: Although during the COVID-19 pandemic more nonelective and higher-risk AVD individuals received interventional treatment, the outcomes were comparable to the pre-pandemic era (2019). Our findings support highly valuable, less invasive therapeutic methods for treating aortic pathologies during the pandemic.

Transcriptomic Profile of Genes Regulating the Structural Organization of Porcine Atrial Cardiomyocytes during Primary In Vitro Culture.

Numerous cardiovascular diseases (CVD) eventually lead to severe myocardial dysfunction, which is the most common cause of death worldwide. A better understanding of underlying molecular mechanisms of cardiovascular pathologies seems to be crucial to develop effective therapeutic options. Therefore, a worthwhile endeavor is a detailed molecular characterization of cells extracted from the myocardium. A transcriptomic profile of atrial cardiomyocytes during long-term primary cell culture revealed the expression patterns depending on the duration of the culture and the heart segment of origin (right atrial appendage and right atrium). Differentially expressed genes (DEGs) were classified as involved in ontological groups such as: "cellular component assembly", "cellular component organization", "cellular component biogenesis", and "cytoskeleton organization". Transcriptomic profiling allowed us to indicate the increased expression of COL5A2, COL8A1, and COL12A1, encoding different collagen subunits, pivotal in cardiac extracellular matrix (ECM) structure. Conversely, genes important for cellular architecture, such as ABLIM1, TMOD1, XIRP1, and PHACTR1, were downregulated during in vitro culture. The culture conditions may create a favorable environment for reconstruction of the ECM structures, whereas they may be suboptimal for expression of some pivotal transcripts responsible for the formation of intracellular structures.