Michał Tkaczyszyn

Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials.

The aim of this study was to assess the net clinical and prognostic effects of intravenous (i.v.) iron therapy in patients with systolic heart failure (HF) and iron deficiency (ID).

The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications.

Skeletal and respiratory myopathy not only constitutes an important pathophysiological feature of heart failure and chronic obstructive pulmonary disease, but also contributes to debilitating symptomatology and predicts worse outcomes in these patients. Accumulated evidence from laboratory experiments, animal models, and interventional studies in sports medicine suggests that undisturbed systemic iron homeostasis significantly contributes to the effective functioning of skeletal muscles. In this review, we discuss the role of iron status for the functioning of skeletal muscle tissue, and highlight iron deficiency as an emerging therapeutic target in chronic diseases accompanied by a marked muscle dysfunction.

Iron deficiency and red cell indices in patients with heart failure

To investigate the prevalence of iron deficiency (ID) in heart failure (HF) patients with normal vs. abnormal red cell indices (RCI), the associations between iron parameters and RCI, and prognostic consequences of ID independently of RCI.

The influence of the sounds of crying baby and the sounds of violence on haemodynamic parameters and autonomic status in young, healthy adults

INTRODUCTION There is evidence that various stimuli affect the balance in the autonomic nervous system (ANS) and the functioning of cardiovascular system. OBJECTIVE The aim of the study was to assess whether the sounds of crying baby and the sounds of violence affected haemodynamic parameters and ANS in young, healthy adults and to measure differences in these reactions between the genders and these 2 stimuli. METHODS Haemodynamic parameters (measured non-invasively by the NEXFIN device), heart rate and blood pressure variability (HRV and BPV, respectively) and baroreflex sensitivity (BRS) were analyzed in 65 adults (21 women, mean age: 23years) during a 15-minute rest followed by the emission of two 5-minute acoustic stimuli: sounds of crying baby and sounds of violence emitted randomly and separated by a 4-minute pause. RESULTS Resting systolic blood pressure was lower, whereas indices of HRV (RMSSD, NN50, pNN50, high frequency component of HRV - HRV HF) and BPV (high frequency component - BPV HF) as well as BRS were higher in women as compared to men. During the emission of the sounds of crying baby, a decrease in diastolic blood pressure (DBP), systemic vascular resistance index, HRV HF and BPV LF (low frequency component of BPV) and an increase in stroke volume index were observed in the whole examined group, whereas during the emission of the sounds of violence subjects presented a decrease in DBP, mean blood pressure, HRV HF and BPV LF. The reaction to the sounds of crying baby (expressed as a decrease in HRV HF) was greater in women as compared to men (-0.28±0.49 versus -0.04±0.38ms(2), p=0.04). The comparison of the reaction between 2 stimuli revealed no differences. CONCLUSIONS The stronger decrease in parasympathetic drive in women exposed to the sounds of crying baby may be related to a particular role of this stimulus, which signals the babys distress and compels the caregivers to react.

Late-onset hypogonadism in men with systolic heart failure: prevalence, clinical associates, and impact on long-term survival

Male ageing is characterized by diminished circulating androgens with several adverse psychosomatic consequences and can be aggravated by concomitant chronic diseases. According to the European Male Aging Study (EMAS) Group, late‐onset hypogonadism (LOH) refers to testosterone deficiency accompanied by sexual complaints.

Depleted iron stores are associated with inspiratory muscle weakness independently of skeletal muscle mass in men with systolic chronic heart failure: Iron deficiency and inspiratory muscle weakness in heart failure

Skeletal and respiratory muscle dysfunction constitutes an important pathophysiological feature of heart failure (HF). We assessed the relationships between respiratory muscle function, skeletal muscle mass, and physical fitness in men with HF with reduced left ventricular ejection fraction (HFrEF), and investigated the hypothesis of whether iron deficiency (ID) contributes to respiratory muscle dysfunction in these patients.

Iron deficiency and red cell indices in patients with heart failure: reply: Iron deficiency and red cell indices in heart failure: reply

We would like to thank Zeng for the interest in our study1 investigating iron deficiency (ID) and abnormalities regarding red cell indices (RCI) in patients with heart failure (HF) with either reduced or preserved ejection fraction. In the correspondence, the author raises concerns regarding the appropriateness of the definition of ID [based on ferritin and transferrin saturation (TSAT)] applied in the study. We fully agree with the author that serum ferritin levels can be affected by different confounding factors, such as chronic low-grade inflammation.2 However, we would like to emphasize that associations between iron parameters and inflammation in HF

Muscle Ergoreflex Activity and Autonomic Balance Assessed in the Vertical and Horizontal Body Positions in Young Healthy Men

We investigated whether indices of the reflex regulation of the cardiovascular system, i.e., muscle ergoreflex activity (ERGO) and characteristics of the autonomic balance, differ from each other while measured in the vertical vs. horizontal positions in healthy humans. Ten young healthy men (mean age 28 ± 1 years; BMI 23.6 ± 0.8 kg/m2) were examined. In each subject, the ERGO (ventilatory response to a control handgrip exercise, with repetitive isometric contractions at 50% of the maximal strength), baroreflex sensitivity (BRS, the sequence method), heart rate variability (HRV), and a few hemodynamic parameters were measured in two positions, horizontal and vertical. In the latter position, the heart rate, and diastolic and mean blood pressures (BP) were higher, while the stroke volume was smaller (all P < 0.05) with no differences in the systolic BP, cardiac output, and systemic vascular resistance (all P > 0.2). The HRV time domains, as well as BRS, decreased, whereas HRV-LF increased (all P < 0.05) in the vertical position as compared to the horizontal one. There were no differences between other HRV parameters (all P > 0.2) in the two examined positions. Minute ventilation during the exercise increased, while ERGO was reduced in the vertical position (all P < 0.05). Thus, the body position noticeably affects both reflex regulation of the cardiovascular system and autonomic balance. This observation has to be taken into account during physiological testing.

EFFECTS OF INTRAVENOUS IRON THERAPY IN IRON DEFICIENT PATIENTS WITH SYSTOLIC HEART FAILURE: META-ANALYSIS OF RANDOMIZED CONTROL TRIALS

Iron deficiency (ID) is an ominous co-morbidity commonly found in patients with systolic heart failure (HF), and iron therapy is presumed to bring clinical benefits. We performed a meta-analysis of all randomized control trials that compared the effects of intravenous iron therapy with either no