Introduction: Heart transplantation affects all spheres of the patients’ functioning - their physical well-being and coping with everyday situations, as well as their identity and social functioning. Its long-term effects depend on the effective cooperation with the transplant team. Post-transplant patients are expected to be committed to adherence to recommendations. Patients’ subjective characteristics could increase the risk of difficulties during treatment or might have a protective effect. The major aim of the study was to evaluate the level of engagement in health behavior in heart transplant recipients in relation to their personal resources, such as personality traits, and their health status.Material and Method: The observational ex post facto model was proposed. Participants completed a set of psychological questionnaires. In the study, there were used questionnaires regarding health behavior (HBI), personality traits (NEO-FFI), health locus of control (MHLC), self-efficacy (GSES) and health status (GHQ-28). The group included in the analyses consisted of 107 heart transplant patients. They ranged in age from 19 to 75 years; 10.3% of them were women.Results: According to norms, 71% patients reported high level of engagement in health behavior. There were significant differences in the level of dietary habits and other types of health behaviors. The best predictors of overall health behavior were conscientiousness (β = 0.20, p < 0.05) and health locus of control (Powerful Others) (β = 0.25, p < 0.05). The prophylaxis behavior was related significantly to the level of conscientiousness (p < 0.05) and health locus of control (Internal and Powerful Others) (p < 0.05; p < 0.01). The level of positive mental attitude was related significantly to agreeableness (p < 0.05), health locus of control (Powerful Others) (p < 0.01), and self-efficacy (p < 0.01). Everyday healthy practices were related significantly to openness to experience (p < 0.01) and health locus of control (all categories: Internal, Powerful Others and Chance) (p < 0.05; p < 0.01; p < 0.05, respectively).Conclusion: Majority of heart transplant patients is engaged in high level of health behavior. Among the various forms of health-relevant habits, heart transplant patients adhere significantly less frequently to a healthy diet. Among examined resources, the best predictors of caring about health are generalized self-efficacy and age at the time of HTx.

Introduction: Balance and coordination disorders are factors provoking falls in the elderly. Their fast and precise identification is therefore of vital importance. The aim of study was to assess the risk of falls and the influence of early hospital rehabilitation on the balance and coordination parameters in patients after cardiac surgery. Material and methods: The study was conducted on 207 patients: 44 women and 163 men (mean age 60.2 ± 14.0), who participated in cardiac rehabilitation following cardiac surgery. The risk of falls was tested twice with the use of the FallSkip device: after the initial mobilization and before the discharge. Results: After rehabilitation, improvement was noted in the whole group in all analysed functional parameters and in the reduction of the risk of falls (p < 0.0001). A significantly higher risk of falls was observed in women in comparison with men, in indywiduals aged >70 in comparison with patients aged <70 (p < 0.001). After rehabilitation the risk of falls decreased significantly in men (p < 0.001) and in individuals aged <70, (p < 0.001), as well as in patients with the body mass index <30 (p < 0.012). There was a tendency for better results in men in all tested parameters. Conclusions: It was observed that even a short, limited mobility of the patient after surgery (approx. 48 hours), increases the risk of fall. Rehabilitation after cardiac surgery significantly improved the effectiveness of gait, time of reaction in response to audio stimuli, increased muscular strength of lower limbs and significantly reduced the risk of falls. The FallSkip equipment is useful in the assessment of the risk of falls in patients after cardiac surgery.

Treatment of patients with advanced heart failure (HF) with the use of left ventricular assist devices (LVADs) improves the quality of life and the length of survival. Despite the undeniable benefits associated with improved physical performance, as a result of the decrease of the underlying...

Ocena stanu psychicznego chorego z niewydolnością serca, kwalifikowanego do mechanicznego wspomagania krążenia, jest integralnym elementem ogólnej oceny medycznej. Jest ona kompleksowa, obejmuje szereg zagadnień psychospołecznych i jako taka dostarcza informacji pomocnych w wyborze odpowiedniego kandydata do leczenia, czasami identyfikuje też przeciwwskazania do niego. Pozwala upewnić się, czy pacjent spełnia oczekiwania dotyczące stabilności zdrowia psychicznego i przestrzegania zaleceń medycznych. Pozwala też na wczesną identyfikację problemów psychicznych i wdrożenie adekwatnego do nich leczenia. Ze względu na brak ujednoliconych wytycznych bywa ona dokonywana w sposób subiektywny, zwłaszcza, jeśli ma miejsce poza ośrodkami transplantacyjnymi. Artykuł przedstawia zasady oceny stanu psychicznego i postępowania w przypadku stwierdzenia zaburzeń psychicznych u kandydatów do transplantacji serca lub mechanicznego wspomagania krążenia oraz czynniki zwiększające ryzyko złego rokowania w tej grupie chorych. Celem artykułu jest podzielenie się z psychiatrami i psychologami doświadczeniem klinicznym i wiedzą na temat uniwersalnych zaleceń w zakresie psychospołecznych kryteriów kwalifikacji do mechanicznego wspomagania krążenia i transplantacji serca.

Hypertrophic cardiomyopathy (HCM) is the most common congenital disease increasing the risk of sudden cardiac death. For many years, HCM patients were excluded from exercise training. However, there are data showing that patients with HCM undergoing supervised exercise training could improve physical performance without serious adverse events. A project was designed as a randomized clinical trial to assess the effectiveness and safety of hybrid cardiac rehabilitation (HCR)—a combination of hospital-based cardiac rehabilitation (1 month) with a new form of home-based telemonitored cardiac rehabilitation (2 months) in HCM patients without left ventricular (LV) outflow tract obstruction and preserved systolic function. Sixty patients who fulfil the inclusion criteria have been randomly assigned (1:1) to either HCR plus usual care (training group) or usual care only (control group). The primary endpoint is a functional capacity evaluated by peak oxygen uptake (pVO₂). Secondary endpoints include workload time during the cardiopulmonary exercise testing, a six-minute walk test distance, NT-pro BNP level, echocardiographic parameters of the left ventricular diastolic function (E/A, E/e’, myocardial strain rate), right ventricular systolic pressure, a gradient in the LV outflow tract, and quality of life. The tertiary analysis includes safety, acceptance and adherence to the HCR program. Our research will provide innovative data on the effectiveness and safety of hybrid cardiac rehabilitation in HCM patients without LV outflow tract obstruction and preserved systolic function. Clinical trials registry: ClinicalTrials.gov Identifier NCT03178357.