Agnieszka Sarnecka

Mechanism and prognostic role of qR in V1 in patients with pulmonary arterial hypertension

BACKGROUND The presence of qR pattern in lead V1 of the 12-lead surface ECG has been proposed as a risk marker of death in patients with pulmonary arterial hypertension (PAH). We aimed to validate these findings in the modern era of PAH treatment and additionally to assess the relation of qR in V1 to PAH severity. We also investigated the possible mechanisms underlying this ECG sign. METHODS Consecutive patients with PAH excluding patients with congenital heart defect were recruited between February 2008 and January 2016. A 12-lead standard ECG was acquired and analyzed for the presence of qR in V1 and other potential prognostic patterns. Cardiac magnetic resonance and echocardiography were used for structural (masses and volumes) and functional (ejection fraction, eccentricity index) characterization of left (LV) and right (RV) ventricles. Standard markers of PAH severity were also assessed. RESULTS We enrolled 66 patients (19 males), aged 50.0±15.7years with idiopathic PAH (n=52) and PAH associated with connective tissue disease (n=14). qR in V1 was present in 26(39.4%) patients and was associated with worse functional capacity, hemodynamics and RV function. The main structural determinants of qR in V1 were RV to LV volume ratio (OR: 3.99; 95% CI: 1.47-10.8, p=0.007) and diastolic eccentricity index (OR: 15.0; 95% CI: 1.29-175.5, p=0.03). During observation time of 30.5±19.4months, 20 (30.3%) patient died, 13 (50%) patients with qR and 7 (17.5%) patients without qR pattern. Electrocardiographic determinants of survival were qR (HR: 3.06, 95% CI: 1.21-7.4; p=0.02) and QRS duration (HR: 1.02, 95% CI: 1.01-1.04; p=0.01). CONCLUSIONS Presence of qR in V1 reflects RV dilation and diastolic interventricular septum flattening. It is a sign of advanced PAH and predicts the risk of death in this population.

Polish Forum for Prevention Guidelines on Diabetes: update 2017

1Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 21st Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland 3Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland 4Department of Haemodynamics and Angiocardiography, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland 5Chair of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland 6Department of Preventive Medicine and Medical Education, Medical University in Gdansk, Gdansk, Poland 71st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 8Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 9Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 10Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 11Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 122nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 13Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland

Wytyczne Polskiego Forum Profilaktyki Chorób Układu Krążenia dotyczące nadciśnienia tętniczego: aktualizacja 2017

11st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 2Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland 3Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland 4Department of Haemodynamics and Angiocardiography, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 5Department of Preventive Medicine and Medical Education, Medical University in Gdansk, Gdansk, Poland 6Department of Epidemiology, CVD Prevention, and Health Promotion, Institute of Cardiology, Warsaw, Poland 7Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 8Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 9Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 10Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 11Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 122nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 13Department of Allergy and Immunology, 2nd Chair of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland 14Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland 15Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland 16Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland

Polish Forum for Prevention Guidelines on Dyslipidaemia: update 2016

1National Institute of Food and Nutrition, Warsaw, Poland 21st Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland 3Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland 4Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland 5Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland 6Department of Haemodynamics and Angiocardiography, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 7Department of Hypertension and Diabetology, Medical University in Gdansk, Gdansk, Poland 81st Department of Cardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 9Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 10Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 11Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 122nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 13Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 142nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland 15Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 16Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 17Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland

Polish Forum for Prevention Guidelines on Cardiovascular Risk Assessment: update 2016

1Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland 21st Department of Cardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 3Department of Hypertension and Diabetology, Medical University in Gdansk, Gdansk, Poland 4Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland 5Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland 6Department of Haemodynamics and Angiocardiography, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 7Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 8Department of Biochemistry and Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 9Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 102nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 11Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 12Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 13Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 14Department of Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland

Wytyczne Polskiego Forum Profilaktyki Chorób Układu Krążenia dotyczące farmakoterapii prewencyjnej: aktualizacja 2017

1Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland 21st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland 3Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 4Chair of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland 5Centre for Family and Community Medicine, Faculty of Health Sciences, Medical University of Lodz, Lodz, Poland 6Department of Epidemiology, CVD Prevention, and Health Promotion, Institute of Cardiology, Warsaw, Poland 7Department of Preventive Medicine and Medical Education, Medical University in Gdansk, Gdansk, Poland 81st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 9Department of Haemodynamics and Angiocardiography, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 10Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 11Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 122nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 13Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 14Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 15Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 16Department of Internal Diseases and Rural Medicine, Jagiellonian University Medical College, Krakow, Poland

Polish Forum for Prevention Guidelines on Smoking: update 2017

11st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 2Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland 3Department of Haemodynamics and Angiocardiography, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 4Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland 5Department of Preventive Medicine and Medical Education, Medical University in Gdansk, Gdansk, Poland 6Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland 7Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland 82nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 9Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland 10Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland 11Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland 12Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland 13Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland