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Article ; Online: Comparison of Nonclassic and Classic Phenotype of Hypertrophic Cardiomyopathy Focused on Prognostic Cardiac Magnetic Resonance Parameters

Magdalena Stachera / Paweł Przybyło / Katarzyna Sznajder / Marek Gierlotka

Diagnostics, Vol 12, Iss 1104, p

A Single-Center Observational Study

2022 Volume 1104

Abstract: Patients with nonclassic phenotypes (NCP)—more advanced stages of hypertrophic cardiomyopathy (HCM)—constitute an intriguing and heterogeneous group that is difficult to diagnose, risk-stratify, and treat, and often neglected in research projects. We ... ...

Abstract	Patients with nonclassic phenotypes (NCP)—more advanced stages of hypertrophic cardiomyopathy (HCM)—constitute an intriguing and heterogeneous group that is difficult to diagnose, risk-stratify, and treat, and often neglected in research projects. We aimed to compare cardiac magnetic resonance (CMR) parameters in NCP versus classic phenotypes (CP) of HCM with special emphasis given to the parameters of established and potential prognostic importance, including numerous variables not used in everyday clinical practice. The CMR studies of 88 patients performed from 2011 to 2019 were postprocessed according to the study protocol to obtain standard and non-standard parameters. In NCP, the late gadolinium enhancement extent expressed as percent of left ventricular mass (%LGE) and left ventricular mass index (LVMI) were higher, left atrium emptying fraction (LAEF) was lower, minimal left atrial volume (LAV min) was greater, and myocardial contraction fraction (MCF) and left ventricular global function index (LVGFI) were lower than in CP ( p < 0.001 for all). In contrast, HCM risk score and left ventricular maximal thickness (LVMT) were similar in NCP and CP patients. No left ventricular outflow tract obstruction (LVOTO) was observed in the NCP group. Left ventricular outflow tract diameter (LVOT), aortic valve diameter (Ao), and LVOT/Ao ratio were significantly higher and anterior mitral leaflet (AML)/LVOT ratio was lower in the NCP compared to the CP group. In conclusion, significant differences in nonstandard CMR parameters were noted between the nonclassic and classic HCM phenotypes that may contribute to future studies on disease stages and risk stratification in HCM.
Keywords	magnetic resonance imaging ; late gadolinium enhancement ; hypertrophic cardiomyopathy ; phenotype ; sudden cardiac death ; new imaging techniques ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Percutaneous transaxillary approach through the first segment of the axillary artery for the Impella-supported PCI Versus TAVR

Jerzy Sacha / Krzysztof Krawczyk / Witold Gwóźdź / Przemysław Lipski / Wojciech Milejski / Piotr Feusette / Marek Cisowski / Marek Gierlotka

Scientific Reports, Vol 14, Iss 1, Pp 1-

2024 Volume 9

Abstract: Abstract Percutaneous transaxillary approach (PTAX) through the first segment of the axillary artery is not widely recognized as a safe method. Furthermore, PTAX has never been directly compared between Impella-supported percutaneous coronary ... ...

Abstract	Abstract Percutaneous transaxillary approach (PTAX) through the first segment of the axillary artery is not widely recognized as a safe method. Furthermore, PTAX has never been directly compared between Impella-supported percutaneous coronary interventions (Impella-PCI) and transcatheter aortic valve replacement (TAVR). This study evaluated the feasibility and safety of PTAX through the first axillary segment in Impella-PCI versus TAVR. In cases where standard imaging guidance was insufficient, a technique involving puncturing the axillary artery “on-the-balloon” was employed. The endpoints were bleeding and vascular complications, as defined by BARC and VARC-3 criteria. PTAX was successfully performed in all 46 attempted cases: 23 for Impella-PCI and 23 for TAVR. Strict adherence to BARC and VARC-3 criteria led to the frequent identification of major bleeding (57%) and a moderately frequent diagnosis of vascular complications (17%). These incidences were primarily based on post-procedural hemoglobin reduction (> 3 g/dl) but not overt bleeding. The Impella group exhibited a higher rate of BARC 3b bleeding due to a greater hemoglobin decline resulting from the prolonged implant duration and PCI itself. Left axillary access was linked to smaller blood loss. Bleeding and vascular complications, as per BARC and VARC-3 definitions, did not affect short-term prognosis, with only 3 Impella patients succumbing to heart failure unrelated to the procedures during one-month follow-up period.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Fully percutaneous insertion and removal of the Impella CP via a subclavian approach

Jerzy Sacha / Krzysztof Krawczyk / Marek Gierlotka

Advances in Interventional Cardiology, Vol 16, Iss 3, Pp 343-

2020 Volume 346

Abstract: The Impella (Abiomed) is a mechanical circulatory support device which augments cardiac output, but may also unload a left ventricle during venoarterial extracorporeal membrane oxygenation (ECMO) [1]. However, the Impella requires an access to a large ... ...

Abstract	The Impella (Abiomed) is a mechanical circulatory support device which augments cardiac output, but may also unload a left ventricle during venoarterial extracorporeal membrane oxygenation (ECMO) [1]. However, the Impella requires an access to a large artery and this may be problematic in a severe peripheral arterial disease. The presented case demonstrates how to insert and remove the Impella CP via a subclavian approach without surgical cutting.
Keywords	Medicine ; R
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Balloon aortic valvuloplasty, Impella insertion and complex coronary intervention

Jerzy Sacha / Krzysztof Krawczyk / Maciej Gawor / Joanna Płonka / Marek Gierlotka

Advances in Interventional Cardiology, Vol 17, Iss 1, Pp 126-

is this all feasible fully percutaneously via upper limb access?

2021 Volume 128

Abstract: Complex high-risk indicated patients (CHIP) with a limited vascular access constitute a real challenge for percutaneous coronary interventions (PCI), particularly if they require mechanical circulatory support devices. A 73-year-old man with recent non- ... ...

Abstract	Complex high-risk indicated patients (CHIP) with a limited vascular access constitute a real challenge for percutaneous coronary interventions (PCI), particularly if they require mechanical circulatory support devices. A 73-year-old man with recent non-ST segment elevation myocardial infraction, depressed left ventricular function (ejection fraction, 40%), aortic stenosis (max/mean gradient, 50/32 mm Hg; aortic valve area and its index, 1.0 cm2 and 0.5 cm2/m2) and numerous comorbidities (including recently diagnosed lung cancer in the initial phase) was scheduled by the heart team for balloon aortic valvuloplasty (BAV) and Impella-supported complex PCI of the left main (LM) and the left anterior descending artery (LAD) (Figure 1 A) – the dominant right coronary artery was chronically occluded without the viability of the corresponding myocardium. Due to the abdominal aortic aneurysm with intraluminal thrombus, the procedure could only be performed via upper limb access, and the following interventional images demonstrate how to do it fully percutaneously without general anesthesia.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ultra-low contrast coronary angiography and zero-contrast percutaneous coronary intervention for prevention of contrast-induced nephropathy

Jerzy Sacha / Marek Gierlotka / Piotr Feusette / Dariusz Dudek

Advances in Interventional Cardiology, Vol 15, Iss 2, Pp 127-

step-by-step approach and review

2019 Volume 136

Abstract: Contrast-induced nephropathy is a serious complication after intravascular administration of iodinated contrast media and is associated with numerous adverse outcomes. Its prevalence is particularly high in patients with multiple comorbidities who ... ...

Abstract	Contrast-induced nephropathy is a serious complication after intravascular administration of iodinated contrast media and is associated with numerous adverse outcomes. Its prevalence is particularly high in patients with multiple comorbidities who undergo coronary angiography and percutaneous coronary intervention (PCI). Currently, the only effective method to prevent contrast-induced kidney injury is adequate hydration and a reduction of contrast volume during the intervention. Recently, new approaches aiming to minimize contrast usage have been proposed, i.e., ultra-low contrast angiography and zero-contrast PCI. However, neither tutorials for these techniques nor reviews of their outcomes exist in the literature, and therefore dissemination of these approaches among the interventional community may be limited. This article presents a step-by-step description on how to perform ultra-low coronary angiography and zero-contrast PCI, which should help invasive cardiologists to adopt these techniques in daily practice. A review of clinical studies, case series and single case reports regarding these methods is also provided. Despite the promising results, such procedures still require some improvements and confirmation of their effectiveness as well as safety in large clinical studies. This article aims to spread these new techniques throughout the interventional community, which is paramount for their further development and wider utilization.
Keywords	renal insufficiency ; chronic kidney disease ; contrast-induced nephropathy ; acute kidney injury ; zero-contrast percutaneous coronary intervention ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cusp overlap technique for transcatheter self-expanding aortic valve implantation

Jerzy Sacha / Krzysztof Krawczyk / Witold Gwóźdź / Jarosław Bugajski / Mariusz Darmetko / Marek Gierlotka

Advances in Interventional Cardiology, Vol 17, Iss 2, Pp 230-

2021 Volume 231

Abstract: Transcatheter aortic valve implantation (TAVI) may cause atrioventricular conduction disturbances and, consequently, the necessity for permanent pacemaker implantation (PPI). This is because the His bundle surfaces at the basal part of the membranous ... ...

Abstract	Transcatheter aortic valve implantation (TAVI) may cause atrioventricular conduction disturbances and, consequently, the necessity for permanent pacemaker implantation (PPI). This is because the His bundle surfaces at the basal part of the membranous septum (in the neighbourhood of the non-coronary cusp) and implant depth greater than the length of the membranous septum may interfere with the conduction system [1]. To mitigate this risk, the valve should be implanted at a high position to minimize the contact of the valve frame with the base of membranous septum. During TAVI, the valve is usually positioned in a coplanar fluoroscopic projection with 3 cusps view, but for a self-expanding valve, like the Evolut R (Medtronic, Minneapolis, Minnesota), such a view does not ensure a high implantation. However, a recently proposed technique based on a cusp overlap allows valve implantation at a very high position and significantly reduces the risk of PPI [2, 3].
Keywords	Medicine ; R
Subject code	621
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: In-Hospital and One-Year Outcomes of Patients after Early and Late Resuscitated Cardiac Arrest Complicating Acute Myocardial Infarction—Data from a Nationwide Database

Robert Kowalik / Marek Gierlotka / Krzysztof Ozierański / Przemysław Trzeciak / Anna Fojt / Piotr Feusette / Agnieszka Tycińska / Grzegorz Opolski / Marcin Grabowski / Mariusz Gąsior

Journal of Clinical Medicine, Vol 11, Iss 609, p

2022 Volume 609

Abstract: The prognostic role of early (less than 48 h) resuscitated cardiac arrest (ErCA) complicating acute myocardial infarction (AMI) is still controversial. The present study aimed to analyse the short-term and one-year outcomes of patients after ErCA and ... ...

Abstract	The prognostic role of early (less than 48 h) resuscitated cardiac arrest (ErCA) complicating acute myocardial infarction (AMI) is still controversial. The present study aimed to analyse the short-term and one-year outcomes of patients after ErCA and late resuscitated cardiac arrest (LrCA) compared to patients without cardiac arrest (CA) complicating AMI. Data from the prospective nationwide Polish Registry of Acute Coronary Syndromes (PL-ACS) were used to assess patients with resuscitated cardiac arrest (rCA) after AMI. Baseline clinical characteristics and the predictors of all-cause death were assessed. The all-cause mortality rate, complications, performed procedures, and re-hospitalisations were assessed for the in-hospital period, 30 days after discharge, and 6- and 12-month follow-ups. Among 167,621 cases of AMI, CA occurred in 3564 (2.1%) patients, that is, 3100 (87%) and 464 (13%) patients with ErCA and LrCA, respectively. The mortality rates in the ErCA vs. LrCA and CA vs. non-CA groups were as follows: in-hospital: 32.1% vs. 59.1% ( p < 0.0001) and 35.6% vs. 6.0% ( p < 0.0001); 30-day: 2.2% vs. 3.2% ( p = 0.42) and 9.9% vs. 5.2% ( p < 0.0001); 6-month: 9.2% vs. 17.9% ( p = 0.0001) and 12.3% vs. 21.1% ( p < 0.0001); and 12-month: 12.3% vs. 21.1% ( p = 0.001) and 13% vs. 7.7% ( p < 0.0001), respectively. ErCA (hazard ratio (HR): 1.54, confidence interval (CI):1.28–1.89; p < 0.0001) and LrCA (HR: 2.34, CI: 1.39–3.93; p = 0.001) increased the risk of 12-month mortality. During the 12-month follow-up, patients after LrCA more frequently required hospitalisation due to heart failure compared to patients after ErCA. ErCA was related to a higher hospitalisation rate due to coronary-related causes and a higher rate of percutaneous coronary intervention. An episode of LrCA was associated with higher in-hospital and long-term mortality compared to ErCA. ErCA and LrCA were independent risk factors for one-year mortality.
Keywords	acute coronary syndrome ; cardiac rehabilitation ; sudden cardiac death ; life-threatening ventricular arrhythmia ; early and late cardiac arrest ; secondary prevention of sudden cardiac death ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects

Jerzy Sacha / Marek Gierlotka / Przemysław Lipski / Piotr Feusette / Dariusz Dudek

Advances in Interventional Cardiology, Vol 15, Iss 2, Pp 137-

2019 Volume 142

Keywords	renal insufficiency ; contrast-induced nephropathy ; acute kidney injury ; zero-contrast percutaneous coronary intervention ; Medicine ; R
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Antiplatelets in acute coronary syndrome in Poland – from guidelines to clinical practice

Stanisław Tubek / Wiktor Kuliczkowski / Mariusz Gąsior / Marek Gierlotka / Jacek Kubica / Andrzej Budaj / Adam Witkowski / Krzysztof Reczuch / Piotr Ponikowski

Advances in Interventional Cardiology, Vol 17, Iss 2, Pp 141-

2021 Volume 154

Abstract: Acute coronary syndrome is a factor for poor prognosis and recurrent cardiovascular events. Adequate antiplatelet therapy is crucial in patients with the acute coronary syndrome for risk reduction. Such treatment is well described in four documents ... ...

Abstract	Acute coronary syndrome is a factor for poor prognosis and recurrent cardiovascular events. Adequate antiplatelet therapy is crucial in patients with the acute coronary syndrome for risk reduction. Such treatment is well described in four documents issued by the European Society of Cardiology, which precisely illustrate the use of antiplatelets in the settings of ST-elevated and non-ST elevated myocardial infarction. Despite its unquestioned role in the treatment of acute coronary syndrome, recent real-world-data from Polish registries reveal poor adherence to the guidelines-recommended antiplatelet treatment in Poland. Thus, we present here a comprehensive review of the use of antiplatelets in the settings of the acute coronary syndrome. Each phase of the treatment, i.e. pre-hospital, in-hospital and post-hospital, is discussed separately for a better understanding of the decision-making process at each step. We also present unpublished data from Polish registries (e.g. PL-ACS 2019, National Registry of Procedures of Invasive Cardiology, RECEPTOmetrPEX panel) regarding adherence to the guidelines-recommended treatment in Poland, thus highlighting the points of care which should be immediately improved. It has to be stressed here that careful assessment of ischaemic and bleeding risk has to be performed in each patient with acute coronary syndrome individually and repeated at successive phases of the treatment. Only such an approach allows for appropriate antiplatelet therapy tailoring.
Keywords	guidelines ; antiplatelet treatment ; st elevation myocardial infarction ; non-st elevation myocardial infarction ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Occlusion of the abdominal aorta during coronary angiography with fractional flow reserve due to migration of the left ventricle thrombus in a patient with thrombocytosis

Przemysław Lipski / Jarosław Bugajski / Magdalena Stachera / Marek Piskozub / Katarzyna Sznajder / Marek Gierlotka

Advances in Interventional Cardiology, Vol 15, Iss 2, Pp 260-

2019 Volume 261

Keywords	Medicine ; R
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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