Julia Haponiuk-Skwarlińska

Background: Ventricular septal defect (VSD) has a good prognosis after surgical treatment. Three-dimensional (3D) strain echocardiography is a novel method adapting AI for assessing ventricular function; however, its utility remains to be tested. The aim of the study was to assess accuracy of 3D strain echocardiography based on a specific population of patients. Methods: The study enrolled children after successful surgical VSD treatment. In all patients, 3D echocardiography was performed to assess left ventricular ejection fraction (LVEF) and global and segmental longitudinal (LS), circumferential (CS), and radial strain (RS) values. The results were compared with those of healthy individuals matched for age and sex. Results: The study group consisted of 20 children (12 males) aged 3–17 years (mean 7.0 ± 4.3 years), with normal ventricular function on routine 2D echocardiography. The global strain values in all patients were within the standard range in the literature for sex and age. Statistically significant differences between study and control groups were observed in terms of LVEF (55.6 ± 6.9% vs. 59.3 ± 4.8%, p = 0.046), global LS (−21.4 ± 4.3 vs. −24.8 ± 3.5, p = 0.010), and RS (38.7 ± 6.1% vs. 43.6 ± 5.0%, p = 0.010). Segmental strain values showed dysfunction limited to the patched septal area. Conclusions: 3D strain echocardiography is able to detect regional subclinical cardiac function impairment in children after successful surgical treatment of VSD.

Background: Ventricular septal defect (VSD) has a good prognosis after surgical treatment. Three-dimensional (3D) strain echocardiography is a novel and sensitive method adapting AI for assessing ventricular function; however, its utility remains to be tested. The aim of the study was to assess accuracy of 3D strain echocardiography based on specific population of patients. Methods: The study enrolled children after successful surgical VSD treatment. In all patients, 3D-echocardiography was performed to assess left ventricular ejection fraction (LVEF) and global and segmental longitudinal (LS), circumferential (CS), and radial strain (RS) values. The results were compared with those of healthy individuals matched for age and sex. Results: The study group consisted of 20 children (12 males) aged 3-17 years (mean 7.0±4.3 years), with normal ventricular function in routine 2D echocardiography. The global strain values in all patients were within literature norms for sex and age. Statistically significant differences between study and control group were observed in terms of LVEF (55.6±6.9% vs 59.3±4.8%, p=0.046), global LS (-21.4±4.3 vs -24.8±3.5, p=0.010), and RS (38.7±6.1% vs 43.6±5.0%, p=0.010). Segmental strain values showed dysfunction limited to the patched septal area. Conclusions: 3D strain echocardiography is a sensitive AI tool for the detection of regional subclinical cardiac function impairment in children after successful surgical treatment of VSD. 3D strain’s accuracy may be further used in pediatric cardiology.

Background/Objectives: Acute lymphoblastic leukemia (ALL) treatment is effective but involves the use of cardiotoxic anthracyclines. Data on three-dimensional (3D) strain echocardiography utility in the monitoring of acute and early-onset cardiotoxicity in children with ALL are scarce. The aim was to assess the left ventricular function in 3D strain echocardiography in children with ALL treated with anthracyclines in reference to a healthy cohort and to assess risk factors of possible subclinical cardiotoxicity. Methods: For this study, medical records from between May 2023 and December 2024 were retrospectively analyzed, and the echocardiographic data were reassessed. The study group consisted of children diagnosed and treated for ALL for at least 6 months with the use of daunorubicin and doxorubicin (or only with daunorubicin) who underwent routine cardiological evaluation with 3D echocardiography in >6 months and 2. Statistically significant differences between study and control groups were observed in terms of LVEF 3D (53.9 ± 4.4% vs. 59.1 ± 5.8%, p < 0.001), GLS 3D (−21.8 ± 4.2% vs. −25.2 ± 3.6%, p < 0.001), GCS 3D (−22.3 ± 3.8% vs. −27.3 ± 4.7%, p < 0.001) and GRS 3D (37.1 ± 5.0% vs. 44.6 ± 5.7%, p < 0.001). None of the previously described cardiotoxicity risk factors—age at the diagnosis, sex, age at treatment initiation, body surface area (BSA) at treatment initiation, time since treatment initiation, ALL subtype, total anthracycline dose and doxorubicin treatment—were statistically significant in the GLS or GCS models. Conclusions: GLS 3D, GCS 3D and GRS 3D of the left ventricle may be sensitive indicators of myocardial dysfunction in children with ALL treated with anthracyclines. The relation of the previously described cardiotoxicity risk factors to the 3D strain values and myocardial dysfunction is inconclusive; further studies are warranted.

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy with promising survival. ALL treatment involves the use of cardiotoxic anthracyclines. The data for children on new methods of echocardiographic detection of early-onset anthracycline-related left ventricle dysfunction is lacking. Methods: Consecutive children with ALL were prospectively enrolled. The echocardiography was performed after ALL diagnosis and before initiation of anthracyclines (first assessment) and after induction and intensification therapy completion (second assessment). The left ventricle echocardiographic assessment involved conventional two-dimensional (2D) echocardiography, 2D speckle tracing, and three-dimensional (3D) echocardiography with offline analysis for 3D speckle tracing. Results: The preliminary group of 32 children presented with mean time between the first and second assessment of 7.3 ± 1.5 months (min.5.3–max.11.4). All children were treated by the same treatment protocol and received doxorubicin and daunorubicin. The mean cumulative equivalent anthracycline dose was 165.6 ± 54.0 mg/m². Statistically significant differences between the first and the second echocardiography were observed in LV-GLS-2D −24.6 ± 3.3% vs. −21.0 ± 3.3%; p < 0.001, LVEF-3D 59.7 ± 7.3% vs. 55.1 ± 3.0%; p = 0.010, LV-GLS-3D −23.3 ± 5.3% vs. −20.4 ± 2.8%; p = 0.031 and LV-GCS-3D −26.3 ± 5.9% vs. −21.9 ± 3.2%; p = 0.017. The differences in LVEF-2D and LV-GRS-3D were not statistically significant. The decrease of >15% from the first assessment was observed in 9 (28%) in LV-GLS-2D, 8 (25%) in LV-GLS-3D, 11 (34%) in LV-GCS-3D and only in 4 (13%) patients in LV-GRS-3D. Conclusions: Two-dimensional and three-dimensional speckle tracing and 3D-LVEF may be sensitive indicators of subclinical left ventricular function impairment in children treated for ALL with anthracyclines. However, this is a preliminary analysis of the planned cohort; our results should be interpreted with caution.

Background/Objectives: Prehabilitation is a multimodal intervention introduced in preparation for various surgical procedures. The most effective treatment for obesity is bariatric surgery. Physiotherapy during prehabilitation for bariatric surgery may be an effective method of functional capacity improvement. We aimed to evaluate the impact of an individual outpatient 12-week, exercise-based physiotherapy program featuring prehabilitation on functional status, exercise tolerance, everyday mobility, and fatigue among patients qualified for bariatric surgery. Methods: The completion of an individual outpatient 12-week, exercise-based physiotherapy program during prehabilitation was an inclusion criterion for the study group. Participants included in the study and control groups were assessed twice, after enrollment into the prehabilitation program (the first assessment) and after prehabilitation but before surgery (the second assessment). Both assessments involved functional tests (a six-minute walking test [6MWT], a timed up and go test [TUG], a chest mobility test, anthropometric measures, a mobility index [Barthel], and a modified Borg scale). The collected anthropometric data and values from the 6MWT were used to create original linear models. This study followed STROBE recommendations. Results: The study group and control group did not differ statistically in terms of their anthropometric data. Statistically significant results were obtained between the first and second assessments in both groups in terms of body weight and waist circumference. However, only the study group showed improved results in the TUG test (p = 0.0001) and distance in the 6MWT (p = 0.0005). The study group presented with the normalization of blood pressure (BP) after exertion in the second assessment (systolic BP p = 0.0204; diastolic BP p = 0.0377), and the 6MWT results were close to the norms. According to the original linear model used to predict performance in the 6MWT, the primary modifiable determinant of exercise tolerance was the participant’s weight, while gender served as a non-modifiable determinant. Conclusions: Exercise-based physiotherapy in prehabilitation was associated with improved functional capacity in patients preparing for bariatric surgery, contributing to the improvement in 6MWT results in relation to the norms as well as exercise tolerance. Body weight may be an independent factor determining distance in the 6MWT for patients undergoing prehabilitation for bariatric surgery.

Objectives: To assess dietary supplements, functional foods and nutraceuticals use among the patients after myocardial infarction (MI). Material and Methods: The authors prospectively enrolled 100 consecutive patients hospitalized due to MI and remaining under coordinated outpatient care...

Heart failure is defined as a clinical syndrome consisting of key symptoms and is due to a structural and/or functional alteration of the heart that results in increased intracardiac pressures and/or inadequate cardiac output at rest and/or during exercise. One of the key mechanisms determining myocardial dysfunction in heart failure is oxidative stress. MicroRNAs (miRNAs, miRs) are short, endogenous, conserved, single-stranded non-coding RNAs of around 21–25 nucleotides in length that act as regulators of multiple processes. A systematic review following the PRISMA guidelines was performed on the evidence on the interplay between microRNA and oxidative stress in heart failure. A search of Pubmed, Embase, Scopus, and Scopus direct databases using the following search terms: ‘heart failure’ AND ‘oxidative stress’ AND ‘microRNA’ or ‘heart failure’ AND ‘oxidative stress’ AND ‘miRNA’ was conducted and resulted in 464 articles. Out of them, 15 full text articles were eligible for inclusion in the qualitative analysis. Multiple microRNAs are involved in the processes associated with oxidative stress leading to heart failure development including mitochondrial integrity and function, antioxidant defense, iron overload, ferroptosis, and survival pathways.