The decline in cardiac contractility due to damage or loss of cardiomyocytes is intensified by changes in the extracellular matrix leading to heart remodeling. An excessive matrix response in the ischemic cardiomyopathy may contribute to the elevated fibrotic compartment and diastolic dysfunction. Fibroproliferation is a defense response aimed at quickly closing the damaged area and maintaining tissue integrity. Balance in this process is of paramount importance, as the reduced post-infarction response causes scar thinning and more pronounced left ventricular remodeling, while excessive fibrosis leads to impairment of heart function. Under normal conditions, migration of progenitor cells to the lesion site occurs. These cells have the potential to differentiate into myocytes in vitro, but the changed micro-environment in the heart after infarction does not allow such differentiation. Stem cell transplantation affects the extracellular matrix remodeling and thus may facilitate the improvement of left ventricular function. Studies show that mesenchymal stem cell therapy after infarct reduces fibrosis. However, the authors did not specify whether they meant the reduction of scarring as a result of regeneration or changes in the matrix. Research is also necessary to rule out long-term negative effects of post-acute infarct stem cell therapy.

Introduction: Sudden cardiac arrest is one of the most common causes of death. In cases of shock-resistant ventricular fibrillation, immediate transport of patients to the hospital is essential and made possible with use of devices for mechanical chest compression. Objectives: The efficacy of AutoPulse in patients with shock-resistant ventricular fibrillation was studied. Methods: This is a multicentre observational study on a population of 480,000, with 192 reported cases of out-of-hospital cardiac arrest. The study included patients with shock-resistant ventricular fibrillation defined as cardiac arrest secondary to ventricular fibrillation requiring ≥3 consecutive shocks. Eventually, 18 patients met the study criteria. Results: The mean duration of resuscitation was 48.4±43 min, 55% of patients were handed over to the laboratory while still in cardiac arrest, 83.3% of them underwent angiography and, in 93.3% of them, infarction was confirmed. Coronary intervention was continued during mechanical resuscitation in 50.0% of patients, 60% of patients survived the procedure, and 27.8% of the patients survived. Conclusions: Resistant ventricular fibrillation suggests high likelihood of a coronary component to the cardiac arrest. AutoPulse is helpful in conducting resuscitation, allowing the time to arrival at hospital to be reduced.

Background: Pulmonary hypertension (PH) is an independent risk factor of increased morbidity and mortality in cardiac surgery patients (CS). The most common cause underlying PH is left ventricular (LV) diastolic dysfunction. This study aimed to evaluate the echocardiographic probability of PH in patients undergoing CS and its correlation with postoperative respiratory adverse events (RAE). Methods: The echocardiographic probability of PH and its correlation with LV diastolic dysfunction was assessed in 56 consecutive adult patients who were qualified for coronary artery bypass grafting (CABG). Later, the postoperative RAE (such as pneumonia, pulmonary congestion, or hypoxemia), the length of intensive care unit (ICU) treatment and mortality in groups with moderate or high (PH-m/h) and low (PH-l) probability of pulmonary hypertension were examined. Results: PH-m/h was observed in 29 patients, of whom 65.5 % had LV diastolic dysfunction stage II or III. A significantly higher occurrence of RAE was observed in the PH-m/h group as compared to the PH-l group. There were no differences between the PH-m/h and PH-l patient groups regarding the in-hospital length of stay or mortality. Conclusions: High or intermediate probability of PH is common in cardiac surgical patients with left ventricular diastolic dysfunction and correlates with respiratory adverse events.

Borreliosis (Lyme borreliosis; Lyme disease) is a zoonotic disease caused by spirochetes from the genus Borrelia. In humans, the accidental host of ticks, the infection is transmitted by the bite of the tick - the spirochetes are present in the salivary glands of the tick. Any of the three forms of tick: larva, nymph and adult can be responsible for infection. The most common threats to humans are Borrelia burgdorferii sensu stricto, Borrelia garinii and Borrelia afzelii occurring mainly in Europe. Lyme disease is a complex, multi-stage disease and progresses in 3 stages. The targeted treatment of Lyme disease is based on the administration of antibiotics. The introduction of antibiotics in the early stages of Lyme borreliosis offers a good chance of a complete cure. Lyme disease is a major epidemiological problem in the world. In Europe, the average number of cases per year remains at 65,400. In Poland, the number of infections annually reaches several tens of thousands. According to the National Institute of Hygiene of Poland, which keeps statistics of epidemiological reports, a total of 83,495 people fell sick with Lyme disease in Poland between 2016 and 2019. Whereas in 2020, the number of cases of Lyme disease decreased to 12933. The reason for this is undoubtedly the COVID-19 pandemic, which has dominated health care and focused all the attention of medical workers. This review shows that Lyme borreliosis is a dangerous disease with a high risk of complications. A quick diagnosis is crucial in the therapeutic process. An algorithm should be developed in order to distinguish other diseases from Lyme disease and thus enable an early reaction and treatment.