Current knowledge of pulmonary arterial hypertension (PAH) epidemiology is based mainly on data from Western populations, and therefore we aimed to characterize a large group of Caucasian PAH adults of Central-Eastern European origin. We analyzed data of incident and prevalent PAH adults enrolled in a prospective national registry involving all Polish PAH centers. The estimated prevalence and annual incidence of PAH were 30.8/mln adults and 5.2/mln adults, respectively and they were the highest in females ≥65 years old. The most frequent type of PAH was idiopathic (n = 444; 46%) followed by PAH associated with congenital heart diseases (CHD-PAH, n = 356; 36.7%), and PAH associated with connective tissue disease (CTD-PAH, n = 132; 13.6%). At enrollment, most incident cases (71.9%) were at intermediate mortality risk and the prevalent cases had most of their risk factors in the intermediate or high risk range. The use of triple combination therapy was rare (4.7%). A high prevalence of PAH among older population confirms the changing demographics of PAH found in the Western countries. In contrast, we found: a female predominance across all age groups, a high proportion of patients with CHD-PAH as compared to patients with CTD-PAH and a low use of triple combination therapy.

The possibility of using a smartwatch as a rehabilitation tool to monitor patients’ heart rates during exercise has gained the attention of many researchers. This study aimed to evaluate the accuracy and precision of the HR measurement performed by two wrist monitors: the Fitbit Charge 4 and the Xiaomi Mi Band 5. Thirty-one healthy volunteers were asked to perform a stress test on a treadmill. Their heart rates were recorded simultaneously by the wristbands and an electrocardiogram (ECG) at 1 min intervals. The mean absolute error percentage (MAPE), Lin’s concordance correlation coefficient (LCCC), and Bland–Altman analysis were calculated to compare the precision and accuracy of heart rate measurements. The estimated validation criteria were MAPE < 10% and LCCC < 0.8. The overall MAPE and LCCC of the Fitbit were 10.19% (±11.79%) and 0.753 (95% CI: 0.717–0.785), respectively. The MAPE and LCCC of the Xiaomi were 6.89% (±9.75) and 0.903 (0.886–0.917), respectively. The precision and accuracy of both devices decreased with the increased exercise intensity. The accuracy of wearable wrist-worn heart rate monitors varies and depends on the intensity of training. Therefore, the decision to use such a device as a heart rate monitor during in-home rehabilitation should be made with caution.

Chronic thromboembolic pulmonary hypertension (CTEPH) may be treated with pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapy (MT). Assessment in a multidisciplinary team of experts (CTEPH team) is currently recommended for treatment decision making. The aim of the present study was to report the effects of such an interdisciplinary concept. A total of 160 patients were consulted by the CTEPH team between December 2015 and September 2018. Patient baseline characteristics, CTEPH team decisions and implementation rates of diagnostic and therapeutic procedures were analysed. Change in World Health Organization (WHO) functional class and survival rates were evaluated by treatment strategy. A total of 51 (32%) patients were assessed as operable and 109 (68%) were deemed inoperable. Thirty-one (61% of operable patients) underwent PEA. Patients treated with PEA, BPA(+MT) and MT alone were 50.9 ± 14.7, 62.9 ± 15.1 and 68.9 ± 12.7 years old, respectively. At the follow-up, PEA patients had the highest WHO functional class improvement. Patients treated with BPA(+MT) had significantly better survival than PEA (p = 0.04) and MT patients (p = 0.04; 2-year survival of 92%, 79% and 79%, respectively). The CTEPH team ensures that necessary diagnostic procedures are performed. A relatively low proportion of patients was assessed by the CTEPH team as operable and underwent surgery, which in survivors resulted in the best functional improvement. Although patients undergoing BPA(+MT) were older than patients treated with PEA, their survival was better than patients subjected to PEA or MT alone. The reviews of this paper are available via the supplemental material section.

Conduction disturbances, aortic incompetence, and myocardial fibrosis are known complications in adult patients with ankylosing spondylitis (AS). Its incidence has been reported to be 10% to 30%; however, less attention has been paid to all cardiac arrhythmias. The aim of this study was to evaluate arrhythmias and conduction disturbances in patients with AS using electrocardiograms and Holter monitoring (including heart rate variability analysis) and to estimate its relationships with age, gender, clinical features, and duration of AS. Thirty-one patients with AS (20 to 69 years old, mean 50 ± 14) and 22 healthy volunteers (26 to 69 years old, mean 49 ± 13) underwent rheumatologic and cardiologic evaluations. Ventricular extrasystoles were present in 55% of AS patients and in 28% of controls. Supraventricular extrasystoles were present in 94% of AS patients and 100% of controls. The frequency of ventricular extrasystoles was found to be higher in the AS patients than in the control subjects. Significant differences were found in heart rate variability analyses: ultra low-frequency power and root mean square recessive difference (r-MSSD) were lower in the AS group. When the AS group was divided into subgroups (stages 3 and 4), significant differences were found between control subjects and stage 3 patients in PR interval, heart rate (HR), T-wave duration, ultra low frequency, and r-MSSD and between controls and stage 4 patients in HR, T-wave duration, and r-MSSD. QTc and QTd were not significantly different in groups and subgroups and were not correlated with any other clinical or electrocardiographic parameter. Cardiac arrhythmias were more frequent in patients with AS than in the healthy population. Simple electrocardiograms and Holter parameters do not correlate with the incidence of VESs, age, gender, clinical features, and duration of AS.

Background: Abdominal obesity, together with atherogenic dyslipidemia, increased blood pressure and impaired glucose tolerance, was included in the components of metabolic syndrome identifying patients at high risk of cardiovascular diseases. Subcutaneous adipose tissue is a buffer for dietary fatty acids (FAs). It was reported that the fatty acid composition of adipose tissue reflects the dietary intake of FAs in the previous 6 to 9 months. Therefore, we decided to evaluate the early and long-term metabolic effects of lipocavitation and/or thermolipolysis on abdominal fat reduction. Material and Methods: The study population comprised 60 women. Subjects were randomly allocated into one of three subgroups, 20 women per subgroup, and each subgroup received 10 treatments with ultrasound (U group), radiofrequency (RF group), or combined radiofrequency and ultrasound (RF/U group) for the abdominal region. Treatments were provided three times a week using the multifunctional device (Professional Beauty Equipment, HEBE, Warsaw, Poland). Each treatment to reduce adipose tissue, regardless of the method used, involved 20 min of massage with the dedicated applicator head on a rectangular 20 cm × 10 cm area of the abdominal region. Fatty acid composition and biochemical and anthropometric parameters were measured before the first, after 10 treatments and 6 months after the last treatment. Results and discussion: The series of 10 treatments to reduce abdominal adipose tissue using ultrasound, radiofrequency or both methods resulted in a cosmetic effect which was reflected in weight loss and BMI reduction. Reduced waist circumference was also found in patients who received radiofrequency or two types of intervention (RF + U) but not ultrasound treatments. The long-term cosmetic effect (lasting for at least 6 months) was achieved only with RF treatment and was reflected in reduced body weight, BMI and waist circumference. None of the treatments had a direct, short or long-term effect on the lipid profile, insulin resistance markers, inflammation markers, or blood pressure. Consequently, did not modify the risk of cardiovascular diseases.