Jadwiga Nessler

• Krakowski Szpital Specjalistyczny im. Jana Pawła II

Transcatheter aortic valve implantation (TAVI) is an established treatment method in patients with severe aortic stenosis at high surgical risk. TAVI might reduce thrombin generation and fibrin clot resistance to lysis. We aimed to evaluate the predictive value of thrombin generation and clot lysis time on TAVI outcomes. We screened 135 patients re...

Background/Objectives: Hyponatremia is associated with increased mortality in the general hospital population. We sought to investigate whether hyponatremia affects the long-term survival of patients following a myocardial infarction (MI) in both ST-segment elevation (STEMI) and non-ST elevation (NSTEMI) presentations. Methods: In this study, 862 M...

Background Little is known about the mechanisms underlying the association of the serum phospholipid lipophilic index (LI) with atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes (T2D). Therefore, we investigated whether the LI is associated with glucometabolic control, meta-inflammation, thrombin generation, fibrin clo...

Background Aortic valve stenosis (AS) is the most prevalent valvular heart disease and is associated with a significant increase in mortality. AS has been shown to be linked with numerous coagulation system abnormalities, including increased fibrin deposition on the stenotic aortic valves. Transcatheter aortic valve implantation (TAVI) is the prima...

Background Heart failure (HF) is marked by a poor prognosis, heightened mortality risk, and recurrent hospitalizations. Poland consistently leads among OECD countries with a high hospitalization rate of 616 per 100 000 citizens in 2019, nearly three times the 34-country average. Aim This study aims to provide essential insights into managing HF pa...

Introduction: The intricate management of heart failure (HF), especially in the context of reduced ejection fraction, is compounded by an elevated risk of thromboembolic events. Existing studies offer inconclusive insights into the interplay between MR and the coagulation system. Objectives: This study aimed to investigate the impact of transcat...

Despite improvements over recent years, morbidity and mortality associated with heart failure (HF) are higher in countries in the Central and Eastern Europe and Baltic region than in Western Europe. With the goal of improving the standard of HF care and patient outcomes in the Central and Eastern Europe and Baltic region, this review aimed to ident...

Patients with takotsubo syndrome (TTS) may present coronary slow flow (CSF) in angiography performed in the acute myocardial infarction (MI). However, the detailed clinical relevance and its long-term impact remain poorly understood. Among 7771 MI patients hospitalized between 2012 and 2019, TTS was identified in 82 (1.1%) subjects. The epicardial...

Diagnosis of heart failure with preserved ejection fraction (HFpEF) may be challenging owing to the heterogeneous clinical presentation and comorbidities in this population of patients, along with the limited availability of standard diagnostic tools, including natriuretic peptide tests and functional testing. This expert opinion summarizes the cur...

Aim Aortic stenosis increases left atrial (LA) pressure and may lead to its remodeling. This can cause supraventricular arrhythmia. The aim of this study was to determine if the size of the LA and the presence of atrial fibrillation are related to the prognosis of patients with aortic stenosis. Material and methods Clinical evaluation and standard...

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) may play an important role in the development of atherosclerotic cardiovascular disease (ASCVD). Increased plasma levels of Lp-PLA2 may predict future cardiovascular (CV) events in type 2 diabetes (T2D). The potential beneficial effects of polyunsaturated fatty acids (PUFA) on ASCVD hav...

Background: There is a raising awareness that heart failure (HF) is a highly heterogeneous, multiorgan syndrome with an increasing global prevalence and still poor prognosis. The comorbidities of HF are one of the key reasons for presence of various phenotypes with different clinical profile and outcome. Heterogeneity of skeletal muscles (SMs) qua...

Despite advances in the treatment of heart failure (HF), the rate of hospitalisation for exacerbations of the disease remains high. One of the underlying reasons is that recommended guidelines for the management of HF are still too rarely followed in daily practice. Disease exacerbation requiring inpatient treatment is always afactor that worsens t...

Introduction: The treatment of choice for aortic stenosis is a valve replacement. Some patients have post-procedural increased pressure gradient on the implanted prosthesis because of patient-prosthesis mismatch (PPM), known to adversely influence prognosis. The PPM risk should be initially predicted and effort made to avoid this complication, spe...

Background: Recently two indicators - metabolic score for insulin resistance (METS-IR) and triglyceride glucose-BMI (TyG-BMI) have been proposed as surrogate markers of IR and potential cardiovascular risk factors. The aim of the study was to assess the predictive value of METS-IR and TyG-BMI concerning the incidence of major adverse cardiovascula...

Objective: Aim: The analysis of dietary knowledge and habits of patients with aortic stenosis, both prior to and post valve implantation. Patients and methods: Materials and methods: Patient with diagnosed moderate or severe aortic stenosis were included into the study. Telephonic dietary interview was performed. It was based on the standard Kom...

Background: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, numerous cardiology departments were reorganized to provide care for COVID-19 patients. We aimed to compare the impact of the COVID-19 pandemic on hospital admissions and in-hospital mortality in reorganized vs. unaltered cardiology departments. Methods: The presen...

Introduction: Heart failure patients discharged from the hospital are at high risk of death and rehospitalization. Scarce data are available on the use of sacubitril/valsartan in this population in Poland. Objective: To compare the efficacy and tolerability of sacubitril/valsartan in the group of Polish patients who participated in the TRANSITIO...

Objectives: Coronary artery disease (CAD) remains a leading cause of death in elderly patients. Recently, novel lipoproteins- Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC) and Lipoprotein Combine Index (LCI) have been suggested as CAD risk factors; their clinical usefulness, however, remains unknown. The aim of the study was to a...

Introduction: Arginase inhibition increases plasma citrulline, citrulline / ornithine ratio (C / O), and reduces plasma ornithine, ornithine / arginine ratio (O / A) in animal model of myocardial infarction (MI). Objectives: We hypothesize that the presence of thin-cap fibroatheroma (TCFA) in the culprit lesion and increased non-culprit intima-medi...

Chronic exposure to PM2.5 contributes to the pathogenesis of numerous disorders, although the underlying mechanisms remain unknown. The study investigated whether exposure of human monocytes to PM2.5 is associated with alterations in miRNAs. Monocytes were exposed in vitro to PM2.5 collected during winter and summer, followed by miRNA isolation fro...

Aim Concentrations of classical lipoproteines have a well-established role in non-invasive cardiology. The efficacy of the Castelli Risk Index I (CRI I), Castelli Risk Index II (CRI II), and triglycerides to high-density lipoprotein cholesterol (TG / HDL-C) ratio in clinical practice are currently under evaluation. The study aimed to assess the pre...

Background: The biomarkers of atherosclerosis remain insufficiently understood. Purpose: We sought to investigate whether an altered balance of arginine metabolites in patients following myocardial infarction (MI) is associated with remodeling of the adjacent to the culprit segments of an infarct-related artery (IRA) and with clinical outcomes. Met...

Background The coronavirus disease-2019 (COVID-19) pandemic is surging across Poland, leading to many direct deaths and underestimated collateral damage. We aimed to compare the influence of the COVID-19 pandemic on hospital admissions and in-hospital mortality in larger vs. smaller cardiology departments (i.e., with ≥2000 vs. <2000 hospitalization...

Statin use and its impact on long-term clinical outcomes in active cancer patients following acute myocardial infarction (MI) remains insufficiently elucidated. Of the 1011 consecutive acute MI patients treated invasively between 2012 and 2017, cancer was identified in 134 (13.3%) subjects. All patients were observed within a median follow-up of 69...

Background: Clinical characteristics and long-term outcomes of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and cancer are insufficiently elucidated. Objectives: We sought to characterize these patients hospitalized in a tertiary cardio-oncology center and to find the potential determinants affecting their...

Background The prediction of the number of acute coronary syndromes (ACSs) based on the weather conditions in the individual climate zones is not effective. We sought to investigate whether an artificial intelligence system might be useful in this prediction. Methods Between 2008 and 2018, a total of 105,934 patients with ACS were hospitalized in...

Prostacyclin (PGI2) analogues (epoprostenol, treprostonil, iloprost) are the cornerstone of pulmonary arterial hypertension (PAH) treatment. PGI2 analogues inhibit platelet reactivity, but their impact on coagulation and fibrinolysis parameters has not been elucidated. We compared platelet reactivity, thrombin generation, clot permeation, and lysis...

Purpose Clinical practice forces the necessity to conduct a clinical trial concerning the group of outpatients with chronically advanced heart failure in III or IV NYHA functional class, frequently requiring hospitalizations due to HF exacerbation, and often left without any additional therapeutic option. The current trial aims to determine the eff...

Background: Despite the improvement in acute myocardial infarction (AMI) treatment, post-discharge mortality remains high. The outcomes are supposed to be even worse in patients with post-MI heart failure (HF), as only a half of patients with newly diagnosed HF survive four years AIMS: The study aimed to analyze whether managed care after acute my...

The Polish expert opinion of the Heart Failure Association of the Polish Cardiac Society on the 2021 European Society of Cardiology (ESC) guidelines for the diagnosis and treatment of heart failure give the comments pointing to the differences in many aspects related to heart failure in Poland compared to other European countries either population...

Background: Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and consequently lead to better patient outcomes. Objectives: To assess the effectiveness of "The Weak Heart" educational model in enhancing the level of disease knowledge and self-care behaviors among patients hospitalized with acute decompensated...

Aims The coronavirus disease-2019 (COVID-19) pandemic has changed the landscape of medical care delivery worldwide. We aimed to assess the influence of COVID-19 pandemic on hospital admissions and in-hospital mortality rate in patients with acute heart failure (AHF) in a retrospective, multicentre study. Methods and results From 1 January 2019 to...

Introduction: We hypothesize that acute phase of myocardial infarction (MI) is associated with suppression of nitric oxide synthase (NOS) and enhanced arginase activity. Moreover, this altered metabolic balance might correlate with the composition of vulnerable culprit lesion in the infarct-related coronary artery (IRA). Methods: Arginine metaboli...

Several mechanisms have been suggested to explain positive cardiovascular effects observed in studies with sodium-glucose co-transporter 2 (SGLT2) inhibitors. The reduction in glucose reabsorption in proximal tubuli induced by SGLT2 inhibitors increases urinary glucose and sodium excretion resulting in increased osmotic diuresis and consequently in...

Background: The triglyceride-glucose index (TyG index) is a novel metabolic marker initially used as an indicator of insulin resistance. Recently, its use as a cardiovascular risk factor has been taken into consideration; however, there is a shortage of evidence for its clinical importance. Aim: The aim of the study was to assess the relationshi...

Introduction Coronary artery disease is associated with impaired clot structure. The aim of this study was to investigate acute phase myocardial infarction (AMI) and provide detailed quantitative analysis of clot ultrastructure. Materials and methods Clot formation and breakdown, pore size, fiber density, fiber radius and protofibril packing were...

Purpose As insufficient adherence to recommendations is a major cause of poor health outcomes in patients with heart failure (HF), it is important to identify the factors that improve disease knowledge and self-care behaviors. We aimed to identify factors associated with HF knowledge and self-care behaviors in patients hospitalized due to acute dec...

Because of its frequent occurrence, poor prognosis, low quality of life of patients accompanying the disease and high costs associated with treatment heart failure is a significant health problem in modern cardiology. The treatment of patients with heart failure and reduced ejection fraction (HFrEF) is supported by large-scale randomized clinical t...

Introduction: Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events and control of their risk factors is crucial. Objectives: To compare the implementation of the ESC guidelines regarding prevention of recurrent CAD in 2016-2017 with their implementation in 2011-2013. Patients and methods: Five hospita...

Heart failure (HF) is a global health problem inherent in an ageing population with coexisting cardiovascular diseases. Based on the data from the National Health Fund (NFZ) currently, approximately 1.2 million Polish people suffer from HF, and 140,000 of them die annually. Recently Poland was ranked 5th among the European Union countries in terms...

Background: Body mass reduction in overweight and obese people so as to reduce blood pressure, low‑density lipoprotein cholesterol level, and the risk of type 2 diabetes as well as to lower the risk of recurrent cardiovascular events is strongly recommended in current guidelines. Objectives: To evaluate changes in body mass index (BMI) and waist...

The arginine metabolism as a target for cardioprotection in patients with ST-segment elevation myocardial infarction (STEMI) remains insufficiently understood. Arginine, ornithine, citrulline, asymmetric dimethylarginine (ADMA) and proline plasma levels were measured using liquid chromatography and tandem mass spectrometry in 70 consecutive STEMI p...

Objectives Failure to increase cardiac output owing to suboptimal cardiac performance in obese women may contribute to placental hypoperfusion, and therefore subsequently to the abnormal placental development. The aim of this study was to evaluate the relationship between left ventricle (LV) function in overweight and obese pregnant women and param...

Introduction: Well-organized, effective secondary prevention of coronary artery disease (CAD) has a potential to improve the patients' prognosis following myocardial revascularization procedures. Aim: To evaluate overtime changes in the implementation of the ESC guidelines for secondary prevention by assessing control of the main risk factors an...

Introduction: The weekend effect in Polish myocardial infarction (MI) patients treated in the current network of cathlabs is poorly understood. Objectives: We sought to investigate long-term prognosis of MI admissions on weekends or public holidays (NWD) and on working days (WD). Patients and methods: Enrolled were 865 MI patients hospitalized...

A treated patient with heart failure (HF), whose signs and symptoms have remained generally unchanged for at least 1 month is said to be 'stable'. Majority of patients with heart failure who are properly treated complain of slight symptoms described as functional class I and II NYHA. There is a belief that oligosymptomatic patients with heart failu...

Objectives This study examined the effects of sacubitril/valsartan on N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response. Background NT-proBNP levels reflect cardiac wall stress and predict event risk in patients with acute decompensated heart f...

Background: Recently heart failure (HF) has been found to be a new dementia risk factor, nevertheless their relations in patients following HF decompensation remain unknown. We sought to investigate whether a screening diagnosis for dementia (SDD) in this high-risk population may predict unfavorable long-term clinical outcomes. Methods: 142 pati...

Background Recently, novel ischemic electrocardiographic changes have been described, which may be clinically significant in the identification of the culprit coronary vessel in patients with non-ST-elevation myocardial infarction (NSTEMI). We sought to determine the predictive value of N-wave, T-wave precordial instability, de-Winter ST/T-wave co...

The high rates of mortality and morbidity of heart failure (HF) will increase significantly over the next 10 years due to an ageing population and will be the highest of all cardiovascular diseases. In order to meet the expectations for the rapidly progressing problem, which is the prevalence of HF and care of patients with this disease, an attempt...

Background: Previous studies have shown that red blood cell distribution width (RDW) is an independent predictor of poor prognosis in type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). The mechanisms underlying increased anisocytosis in patients with T2D and confirmed ASCVD remain poorly understood. Aims: We sought to evalua...

New coronavirus (SARS-CoV-2, severe acute respiratory syndrome coronavirus) acute respiratory failure is the cause of the rapidly spreading coronavirus disease 2019 (COVID-19, coronavirus disease 2019), affecting thousands of people around the world. Due to the limited information on heart dysfunction in patients with COVID-19, a synthetic summary...

Many cardiovascular diseases lead to heart failure, which is a progressive syndrome causing significant distress and limiting the quality of life, despite optimal cardiologic treatment. It is estimated that about 26 000 people in Poland suffer from advanced heart failure, and this number is growing. That is why palliative care (PC) dedicated to peo...

Introduction. Kompleksowa opieka nad chorymi z niewydolnością serca (KONS) is the name of a Polish programme for the coordinated care for patients with heart failure that has been proposed as a complex heart failure management solution based on European Society of Cardiology (ESC) Heart Failure recommendations. The challenge is that there are curre...

Levofloxacin is a broad-spectrum, third-generation fluoroquinolone antibiotic used in the treatment of respiratory and urinary tract infections. Although it is usually well-tolerated, it may cause life-threatening adverse effects, including severe hypoglycemia. We present a case of levofloxacin-induced life-threatening hypoglycemia in a 87-year-old...

Takotsubo cardiomyopathy (TCM) represents an acute systolic left ventricular dysfunction typically triggered by severe psychological or physical stress. Oncological patients due to emotional distress of the diagnosis, proinflammatory and prothrombotic nature of cancer and also physical stress often following complex anticancer therapies are at high...

Introduction: Spontaneous recanalization of the infarct-related artery (IRA) in ST-segment elevation myocardial infarction (STEMI) before primary angioplasty (PCI) improves clinical outcomes. Aim: To investigate the impact of ST-segment re-elevation (reSTE) following PCI in patent IRA on left ventricular (LV) function recovery and remodeling. M...

Exacerbation of chronic heart failure (HF) is the most common cause of hospitalization in adults, which is associated with high morbidity and mortality, mainly in the mechanism of exacerbation of chronic HF or sudden cardiac death (SCD). A novelty in the treatment of HF with reduced left ventricular ejection fraction (HFrEF) in recent years has bee...

Both glutathione peroxidase and deiodinases are selenoproteins requiring selenium. Oxidative stress accompanying acute myocardial infarction (MI) may lead to activation of peroxidase and relative selenium deficiency. That may impair conversion of tetraiodothyronine (T4) to triiodothyronine (T3). Aim: The aim of the study was the evaluation of the...

Background: A recent improvement of optimal cardiovascular therapy challenged the beneficial effects of polyunsaturated fatty acids (PUFAs) observed in previous data. Aims: We sought to investigate the FAs composition in serum phospholipids in patients with established acute phase myocardial infarction (MI) and high-risk stable atherosclerotic c...

Objective The tightly packed arrays of polyhedral erythrocytes, polyhedrocytes, formed during thrombus contraction, have been detected in some intracoronary thrombi (ICT) obtained from patients with ST-segment elevation myocardial infarction (STEMI). We sought to investigate determinants of polyhedrocyte content in ICT and its association with repe...

Aims: In ST-segment-elevation myocardial infarction (STEMI), cardiovascular magnetic resonance (CMR) holds the potentiality to improve risk stratification in addition to Thrombolysis in Myocardial Infarction (TIMI) risk score. Nevertheless, the optimal timing for CMR after STEMI remains poorly defined. We aim at comparing the prognostic performanc...