Effects of cigarette smoke on Holter ECG recordings in patients with arterial hypertension — the heart rate

Wstęp Epidemia palenia tytoniu i nadciśnienia tętniczego (NT) stanowią jedne z najbardziej istotnych problemów zdrowotnych współczesnego świata. Celem przeprowadzonych badań była ocena wpływu dymu papierosowego na częstość akcji serca (HR) u chorych z rozpoznanym NT, czynnie lub biernie palących papierosy.Materiał i metody Do badań zakwalifikowano łącznie 223 kolejne osoby. W zasadniczym etapie badań w grupie chorych z NT, na podstawie kryterium palenia papierosów zostały wyodrębnione następujące grupy: grupa A (n = 42) — osoby czynnie palące papierosy; grupa B (n = 30) — osoby biernie palące papierosy; grupa C (n = 34) — osoby nienarażone na dym papierosowy; grupa D (n = 26) — osoby, które rzuciły nałóg palenia papierosów. U każdego chorego określono maksymalną, minimalną i średnią częstość serca w obserwacji 24-godzinnej metodą Holtera EKG (HR max, HR min i HR mean).Wyniki Grupy A, B i D charakteryzowały się znamiennie wyższymi średnimi wartościami HR maxi HR min w porównaniu z analogicznymi wartościami uzyskanymi w grupie C. Wykazano, że w grupie chorych z NT niezależne czynniki ryzyka zwiększonej HR mean stanowią dłuższy czas trwania NT i wyższe wartości rozkurczowego ciśnienia tętniczego. Ponadto wykazano, że w grupie D dłuższy czas upływający odrzucenia nałogu jest niezależnym czynnikiem chroniącym przed zwiększoną HR mean.Wnioski U chorych z NT zarówno czynne, jak i bierne palenie papierosów skutkuje zwiększoną HR. Rzucenie nałogu palenia może stanowić czynnik chroniący przed zwiększoną HR.Background The epidemic of smoking and arterial hypertension is one of the most important health problems of the world. The aim of this research was to evaluate the effects of cigarette smoke on the heart rate in patients with diagnosed arterial hypertension, who are active or passive smokers.Material and methods A total of 223 persons were qualified for the research. The group of persons suffering from arterial hypertension was divided, on the basis of the cigarette smoking criterion, into the following groups: group A (n = 42) — active smokers; group B (n = 30) — passive smokers; group C (n = 34) — persons who are not exposed to cigarette smoke; group D (n = 26) — persons who have given up smoking. The maximum, minimum and mean heart rates were determined for each patient during the24-hour Holter ECG (HR max, HR min and HR mean).Results A, B and D groups were characterized by a significantly higher average values of HR max and HR min, compared to the corresponding values obtained for the C group. It has been shown that longer duration of the arterial hypertension and higher diastolic blood pressure are independent risk factors increasing the HR mean in patients with arterial hypertension. It has also been shown that a longer period of staying away from smoking is an independent factor protecting against an increased HR mean in the D group.Conclusions In patients with arterial hypertension, both active and passive smoking results in an increased heart rate. Giving up smoking may be a protective factor again stan increased HR mean

Complicated Holter tracing with an incidence of inappropriate mode switch due to sensing abnormalities in a patient with dual-chamber pacemaker

24-hour Holter monitoring of a 59 year-old man with DDDR pacemaker (programmed mode: DDD) implanted for sick sinus syndrome with paroxysmal atrial fibrillation was performed one month after implantation, due to palpitations. Several episodes of rapid pacing of decreasing rate were detected. Intracardiac recording stored in the pacemaker memory had shown episodes of atrial lead oversensing, which led to the mode switch, resulting in DDIR mode. Signals which caused oversensing were not seen in Holter tracing. (Cardiol J 2011; 18, 1: 94-96

Selected factors influencing the risk of falls in the elderly

Introduction: Falls concern 1/3 of people aged >65 years and every second person aged >80, leading to seniors’ disability and dependence on other people’s care. The unmodifiable causes for falls are age, sex, marital status, and place of residence. The modifiable causes include involutional changes in all body systems, multimorbidity, polypharmacy, as well as living and environmental conditions. Aim: To determine the risk factors of falls in the elderly. Material and methods: The study involved 220 hospitalized patients aged >65 years who had experienced a fall. An anonymous questionnaire was applied that referred to the medications taken, diagnosed diseases, factors predisposing to falls, and the frequency of falls. The Mini-Mental State Examination was performed to qualify the subjects, and Tinetti test to assess gait and balance. Results: In the Tinetti scale, 48.2% of the subjects were characterized by a rise in the risk of fall 5-fold higher than average; the risk increase less frequently concerned people undertaking physical activity and those who were younger (65–70 years) (

The Impact of the COVID-19 Emergency on Life Activities and Delivery of Healthcare Services in the Elderly Population

Due to the prevailing pandemic of the coronavirus disease COVID-19, we are experiencing emotional and social isolation, which negatively affects mental and physical health, particularly among the elderly population. In this study, we performed a cross-sectional analysis based on computer-assisted telephone interviews of 500 Polish adults aged 60 years or older in order to determine the impact of the SARS-CoV-2 pandemic on the older population’s behavior, life activity, and delivery of healthcare services. According to our study, COVID-19 infection entailed a substantial change in older people’s behavior. Over 50%, nearly 80%, and more than 25% of the surveyed participants reduced their social, recreational, and professional activities, respectively. The most significant change in senior’s behavior due to the fear of COVID-19 infection was observed in patients (1) with cardiac and pulmonary problems, (2) being on multi-drug therapy, (3) vaccinated against influenza, and (4) with several mental difficulties including loneliness, social isolation, and depression. Furthermore, we demonstrated that 10% of participants canceled planned hospitalization due to the fear of COVID-19 infection. This was observed primarily in patients suffering from chronic heart and lung diseases, vaccinated against influenza, exhibiting the reluctance to carry out more complex daily activities, and with a higher level of anxiety, social loneliness, and malnutrition. Thus, these groups of seniors require more attention; hence, we propose telemedicine as a strategy directed to them that provides clinical healthcare and information regarding measurements, control, and protection against SARS-CoV-2 during the prevailing COVID-19 pandemic. We believe this strategy may improve treatment outcomes, reduce comorbidities-related complications and unnecessary hospitalizations

The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study

The prevailing COVID-19 pandemic has dramatically affected the mental health and well-being of individuals. This cross-sectional study aimed to assess the perceived fear of COVID-19 among older adults in Poland and identify subpopulations with the highest risk of potential mental health disorders. The study was conducted in November–December 2020 on 500 people aged ≥60 years (mean M = 67.9, standard deviation SD = 4.2). In order to collect information on participants’ characteristics and COVID-19-related information, they were asked to complete a questionnaire based on recorded telephone calls. Perceived fear of COVID-19 was measured using our generated and validated seven-item tool: “Scale of fear of COVID-19 infection”, which ranged from 7 to 35. Multiple linear regression was performed to identify factors associated with the perceived fear of COVID-19. Our results showed that the highest level of fear of COVID-19 infection was observed among women (p = 0.025) and patients taking anticoagulants (p = 0.004). Moreover, older adults with higher anxiety levels were more likely to be fearful of COVID-19 (according to the GAS-10 scale; p < 0.001). These findings may help policy makers and healthcare workers to adapt and implement better mental health strategies to help the elderly fight fear and anxiety during the prevailing pandemic

Zależność między czasem trwania cukrzycy typu 2 a nasileniem wybranych powikłań sercowo-naczyniowych u pacjentów chorujących na nadciśnienie tętnicze

Wstęp Celem obecnej pracy było określenie związku między czasem trwania cukrzycy typu 2 a występowaniem powikłań sercowo-naczyniowych: dysfunkcji rozkurczowej lewej komory (LVDD) i przerostu lewej komory (LVH) u pacjentów chorujących na nadciśnienie tętnicze. Materiał i metody Badaniami objęto 63 osoby chorujące na nadciśnienie tętnicze ze współistniejącą cukrzycą typu 2. Średnia wieku pacjentów włączonych do badania wynosiła 63,65 &#177; 12,04 roku. Średni czas trwania cukrzycy wynosił 9,76 &#177; 8,97 roku. Na podstawie kryterium mediany czasu trwania cukrzycy w badanej grupie wyodrębniono 2 podgrupy: I &#8212; osób chorujących na cukrzycę typu 2 krócej niż 7 lat (n = 32), II &#8212; osób chorujących na cukrzycę typu 2 dłużej niż 7 lat (n = 31). Wykonano badanie echokardiograficzne, oceniono funkcję rozkurczową lewej komory oraz geometrię lewej komory. Wyniki W grupie I znamiennie rzadziej rozpoznawano LVH i LVDD niż w grupie II (LVH &#8212; I: 40,6%, II: 61,3%, p < 0,05; LVDD &#8212; I: 21,9%, II: 32,3%, p < 0,05). W całej badanej grupie występowały istotne statystycznie korelacje liniowe między czasem trwania cukrzycy a wybranymi parametrami echokardiograficznymi: LVMI (r = 0,37, p < 0,05), RWT (r = 0,39, p < 0,05) oraz E/E&#8217; (r = 0,51, p < 0,05). Regresja logistyczna wykazała, że starszy wiek i dłuższy czas trwania cukrzycy stanowią niezależne czynniki ryzyka LVH, a wyższe BMI i dłuższy czas trwania cukrzycy niezależne czynniki ryzyka LVDD. Wnioski U osób z nadciśnieniem tętniczym dłużej chorujących na cukrzycę typu 2 powikłania sercowo- &#8211;naczyniowe zdają się bardziej wyrażone i zdają się występować z większą częstością niż u osób z nadciśnieniem tętniczym krócej chorujących na cukrzycę typu 2. Czas trwania cukrzycy typu 2 stanowi niezależny czynnik ryzyka LVDD oraz LVH

Prognostic value of pulmonary hemodynamic parameters in cardiac transplant candidates

Background: Pulmonary hypertension is a contradiction for heart transplantation (HTx). The aim of the study was to examine prognostic significance of pulmonary hemodynamic variables in patients with severe chronic heart failure (HF) considered for HTx.Methods: Patients with HF were qualified to HTx in Poland. We measured pulmonary artery systolic pressure (PASP), pulmonary capillary wedge pressure (PCWP), transpulmonary gradient (TPG), cardiac output (CO), pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR). We performed biochemical evaluation, 6-min walking test, VO2max. Death or emergency HTx were assumed as the endpoints in the follow-up. Death or any kind of HTx were considered an end of observation. Survival analysis was conducted using Kaplan-Meier curves (long rank test with strait defined by terciles of analyzed hemodynamic parameters).Results: Six hundred and fifty-eight patients were qualified to HTx between 2003 and 2007. The mean follow-up: 601 days. 87.8% male. Mean age was under 50, III and IV NYHA class. Mean PASP was 44.3 ± 16.9 mm Hg, TPG 10.0 ± 6.6 mm Hg and PVR 2.9 mm Hg, PCWP20.9 ± 9.3 mm Hg. PASP and PCWP had influence on survival or emergency HTx. There was a significant difference in survival between patients with PCWP &gt; 25 mm Hg and PCWP &lt; 25 mm Hg. The worst prognosis was with PASP higher than 50 mm Hg. One-, two-, and three-year survival was 75%, 58% and 48% compared to patients with PASP &lt; 35 mm Hg (80%, 70%, and 68%, respectively).Conclusions: In patients qualified to HTx, pathological values of pulmonary hemodynamic parameters have a significant influence on survival. The worst prognosis have patients with PASP &gt; 50 mm Hg, and PCWP &gt; 25 mm Hg. Pulmonary hemodynamic parameters are important during allocation process to HTx

Resting heart rate and its change induced by physical training in patients with ischemic heart disease at various ages treated with beta-blockers

Background: The present study was aimed at possible modifications of resting HR induced by systematic physical training in patients of different age populations with ischemic heart disease (IHD) subjected to chronic therapeutic beta-blockade. Methods: The goal was the assessment of initial resting heart rate (HR) and its change after 6 months of physical training in two groups of patients with IHD at various ages (A: 55.5 &plusmn; &plusmn; 4.6 years; B: 72.5 &plusmn; 4.37 years) treated with beta-blockers, the dosage of which was not modified during the observation. Results: Comparison between the groups A and B concerned the initial rHR (min-1): 79.3 &plusmn; &plusmn; 8.3 vs. 73.6 &plusmn; 8.3 (p < 0.01), the after-training rHR: 70.9 &plusmn; 7.9 vs. 67.7 &plusmn; 8.4 (NS), and the delta of rHR: -8.4 &plusmn; 4.8 vs. -5.9 &plusmn; 2.8 (p < 0.01). Statistically significant correlation coefficients both between the patients&#8217; ages and the initial rHR (r = -0.377) and the delta of rHR (r = 0.347) were noted. Conclusions: The reduction of rHR after 6-months of training was less in the older IHD patients because of their lower initial rHR compared with the younger patients, which was probably determined more by physiological vagotonia than therapeutic beta-blockade. (Cardiol J 2007; 14: 493-496

Recommendations for the prevention of Herpes zoster in solid organ transplant recipients in Poland

Herpes zoster (i.e. shingles) is a widespread and common infectious disease caused by reactivation of the varicella zoster virus. Although the cutaneous manifestation of the disease is the most common, shingles is also associated with numerous complications, such as neurological, including postherpetic neuralgia. It is estimated that one-third of general population will develop herpes zoster during their lifetime and the incidence in the solid organ recipients group is even higher. What is more the transplant recipients are more likely to suffer from severe complications of the disease. The most effective method of preventing herpes zoster is vaccination. The only available in Poland and recommended vaccine is the recombinant, adjuvanted zoster vaccine. Its safety and effectiveness was proven in both general, adult population and solid organ recipients. In this article, we present the position of experts in transplantation and infectious diseases on herpes zoster prevention in solid organ transplant recipients population. The group includes kidney, liver, lung and heart recipients