Magdalena Balwierz

Background/Objectives: SGLT2 inhibitors (SGLT2i) became a cornerstone of heart failure with preserved ejection fraction (HFpEF) pharmacotherapy in the recent years However, their actual influence on pulmonary veins isolation (PVI) efficacy in this population remains unclear. The aim of the study was to evaluate an impact of SGLT2i on one-year first-time PVI efficacy and clinical course of patients with HFpEF and atrial fibrillation (AF). Methods: This is a single-center retrospective study including 105 HFpEF and AF individuals, who underwent the first-time PVI (51 (48.6%) males; mean age at PVI: 65.2 ± 9.5 years). 53 patients treated with SGLT2i (hospitalized for PVI since 2023) and 52 patients without such a treatment (2020-mid-2023) were assessed according to the clinical presentation and hard endpoints. The primary endpoint was arrhythmia recurrence rate. The secondary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCE). Results: SGLT2i therapy was associated with greater symptom reduction after PVI (90.6% vs. 62.7%; p < 0.001). There was a statistical trend toward reduced all-cause mortality in SGLT2i (0% vs. 5.8%; p = 0.076). Although overall AF recurrence rates were similar between subgroups, Kaplan–Meier analysis showed a non-significant trend toward lower recurrence in the SGLT2i group (p = 0.096). The analysis did not reveal significant differences in terms of cardiovascular hospitalizations, stroke/transient ischemic attack (TIA) and MACCE incidence between the subgroups. Non-vitamin K antagonist oral anticoagulants (NOACs) administration was associated with a lower risk of AF recurrence (OR 0.27; 95% CI 0.096 to 0.77; p = 0.014). MACCE occurrence was predicted by higher CHA₂DS₂-VA (Congestive heart failure, Hypertension, Age ≥ 75, Diabetes, Stroke, Vascular disease, Age 65–74) (OR 5.63; 95% CI 1.57–20.12; p = 0.008), lower left ventricular ejection fraction (LVEF) (OR 0.74; 95% CI 0.57–0.99; p = 0.028) and (vitamin K antagonists) VKA use (OR 97.44; 95% CI 3.2–2962.57; p = 0.009). Conclusions: SGLT2i pharmacotherapy in the study population was linked to higher efficacy in symptom reduction, with a probability of AF recurrence and all-cause mortality reduction, which may suggest a potential beneficial role of SGLT2i in this cohort.

Background and Objectives: The fact that men are at a higher risk of cardiovascular disease (CVD) compared to women, regardless of concomitant risk factors, draws attention to the potential role of sex hormones in cardiovascular health. Hormonal therapies undoubtedly play a crucial role in reproductive and endocrine health; however, their cardiovascular implications remain complex and incompletely understood. This review aims at providing an updated overview of recent studies on this topic, highlighting the practical clinical aspects and knowledge gaps. Materials and Methods: This review synthesizes recent clinical studies regarding the cardiovascular impact of female hormone replacement therapy (HRT) and testosterone replacement therapy (TRT). Results: It seems that both hormonal deficiency and excess can exert detrimental effects on the cardiovascular system. While HRT and TRT offer benefits to specific patient populations, their broad biological actions can lead to adverse effects. This creates a sophisticated and delicate relationship between hormonal balance and heart health, complicating the determination of universal safety profiles and use indications. Conclusions: The risk–benefit ratio of hormonal therapies remains a critical concern in clinical practice. Because cardiovascular effects vary significantly based on individual patient profiles, a nuanced approach to prescribing is necessary. Further research is required to bridge knowledge gaps and refine safety guidelines for the use of sex hormones in cardiovascular prevention and treatment.

Introduction and Purpose Migraine is a chronic neurological disorder characterized by recurring headaches and associated symptoms, such as nausea, sensitivity to light and sound. Migraine significantly impacts the daily functioning of individuals affected by the condition. This article explores the relationship between physical activity and migraines, focusing on how regular exercise may influence the frequency, intensity, and overall management of migraine attacks. Through a review of existing studies, the article aims to uncover the underlying mechanisms, assess the effectiveness of physical activity as both a preventive and therapeutic tool and provide practical guidance for healthcare professionals and patients. The goal is to highlight the potential of exercise as a non-pharmacological approach to improving migraine treatment outcomes. Materials and Methods A detailed literature review was conducted covering the years 1993-2023, using databases such as PubMed, ScienceDirect, and Google Scholar. Relevant studies were identified using keywords such as "migraine," "physical exercise," "physical activity," "migraine therapy," and "non-pharmacological treatment." Special attention was given to peer-reviewed articles, including primary research studies and systematic reviews, to ensure a comprehensive understanding of the topic. Summary The literature review highlights the growing recognition of physical activity as a valuable non-pharmacological intervention in the treatment of migraines. Regular exercise appears not only to reduce the frequency and intensity of migraine attacks but also to improve overall well-being by mitigating associated factors such as stress and sleep disturbances. These findings emphasize the importance of integrating physical activity into a holistic approach to migraine treatment, offering a promising pathway for both patients and healthcare professionals.

Introduction and purpose This article investigates the role of physical activity in Alzheimer's disease. It reviews existing research to explore how exercise affects cognitive decline, identifies mechanisms through which physical activity may slow disease progression, and evaluates practical recommendations for integrating exercise into Alzheimer's management. The goal is to provide valuable insights for individuals and healthcare professionals on using physical activity as a non-pharmacological approach to managing Alzheimer's disease. State of knowledge The article examines the current literature on Alzheimer's disease, with a focus on the effects of physical activity on cognitive function. By understanding the relationship between exercise and brain health, targeted interventions can be developed to slow cognitive decline. The impact of physical activity on overall Alzheimer's disease progression is also highlighted. Material and MethodsA review of literature from 2009 to 2024 was conducted using databases such as PubMed, ScienceDirect, and Google Scholar. Keywords included "Alzheimer's disease," "physical activity," "cognitive decline," and "exercise." The review focused on English-language primary research articles from peer-reviewed journals. SummaryThe review underscores the positive effects of physical activity in managing Alzheimer's disease. Evidence suggests that regular exercise helps improve cognitive function, slow disease progression, and enhance overall quality of life. This highlights the effectiveness of physical activity as a valuable, non-pharmacological approach to managing Alzheimer's.

Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically conditioned disease, characterized by gradual fibro-fatty replacement of myocardium and tendency to ventricular arrhythmias and heart failure. ARVC is included in a group of inherited similar clinical entities characterized by similar remodeling changes, named in general arrhythmogenic cardiomyopathies (ACM). The new guidelines of European Society of Cardiology (ESC) for the management of cardiomyopathies (2023) redefine arrhythmogenic left ventricular cardiomyopathy (ALVC), left dominant ARVC, or arrhythmogenic dilated cardiomyopathy (DCM) as non-dilated left ventricular cardiomyopathy (NDLVC). The diagnostic process is based on Padua Criteria (2020) according to ESC guidelines and includes: right ventricle dysfunction evidence, endomyocardial biopsy results, defects of repolarization and conduction, arrhythmias and family history. However, in 2024 European Task Force consensus with modified guidelines was proposed. The treatment focuses on arrhythmias and heart failure management, prevention of sudden cardia death and family screening. Multidisciplinary approach is required to the proper management of the patients. Aim of the study: The aim of the study is to review the current knowledge of ARVC, especially, novelties since 2023 ESC guidelines for the management of cardiomyopathies. Material and methods: This article presents the current knowledge of the diagnosis of ARVC, especially on the basis of the guidelines of European Society of Cardiology and more recent experts’ consensus. Literature analysis, which contain recent report in ARVC diagnosis were analyzed using the PubMed platform. The search included the keywords: “arrhythmogenic right ventricle cardiomyopathy”, ,‚arrhythmogenic cardiomyopathy”, “Task Force criteria for ARVC diagnosis”, “ventricular arrhythmias”.

Introduction Infective endocarditis (IE) is a severe condition of endocardium, which can manifest through a wide spectrum of unspecific symptoms related to various organ systems. The diagnosis is made on the basis of the presence of bacteraemia and imaging findings confirming IE visualized in echocardiography, computer tomography and nuclear imaging. Anatomical changes or foci of altered metabolism can be located on the valves, in the perivalvular area or in the area of foreign material (e. g. valves prosthesis or implantable device). Not only the diagnostic process can be challenging, but also the treatment, which consists of antibiotic therapy and cardiac surgery. The indications for surgical treatment depend on patients’ clinical condition, which can change dynamically. Multidisciplinary approach is required to the proper care of the patients. Aim of the study The aim of the study is to review the current knowledge of infective endocarditis and the timing indications of cardiac surgery treatment. Material and methods This article presents the current knowledge of the diagnosis and treatment in infective endocarditis, especially on the basis of the guidelines of European Society of Cardiology. Literature analysis, especially papers, which contain recent report in infective endocarditis treatment were analysed using the PubMed platform. The search included the keywords: “infective endocarditis”, ,‚surgery treatment of infective endocarditis”, “endocarditis team”, “CIED- related infective endocarditis”.

Neurodegenerative and psychiatric diseases remain a therapeutic challenge. Mental illnesses such as depression and bipolar affective disorder lead to disruption of the diurnal rhythm of melatonin secretion and disruption of the sleep-wake axis. The use of new melatonergic drugs has received special attention in recent years. Selective melatoninergic M1 and M2 receptor agonists (tasimelteon, ramelteon) show a more favorable metabolic profile, better regulation of circadian rhythms, and effects on total sleep time and sleep quality compared to the already well-studied melatonin. In addition, these drugs show no addictive potential. Agomelatine, through its action on M1 and M2 receptors, as well as serotonergic 5-HT2C and 5-HT2B receptors, exhibits antidepressant, normothymic, and neuroprotective effects, providing primary therapy or adjunctive treatment.

Amyloidoza jest rzadką chorobą charakteryzującą się nieprawidłowym gromadzeniem się białka amyloidowego w tkankach. Amyloidozę można podzielić na dwa główne podtypy: amyloidozę transtyretynową (ATTR-CA) i amyloidozę łańcuchów lekkich immunoglobulin (AL-CA). Nagromadzenie białka amyloidu w mięśniu sercowym może doprowadzić do zaburzeń przewodzenia, kardiomiopatii restrykcyjnej i w konsekwencji niewydolności serca. Objawy mogą obejmować spadek tolerancji wysiłku, duszność, obrzęki oraz omdlenia. Rozpoznanie opiera się na badaniach laboratoryjnych, obrazowych oraz biopsji. Leczenie koncentruje się głównie na spowolnieniu postępu choroby oraz leczeniu objawowym.

Sarkoidoza serca (cardiac sarcoidosis – CS) jest rzadkim i trudnym do zdiagnozowania schorzeniem prowadzącym do zaburzeń przewodzenia, rytmu i nagłej śmierci sercowej. Rozpoznanie CS jest niezwykle trudne, ponieważ we wczesnych stadiach może nie dawać objawów i często imituje inne stany. Narzędziami diagnostycznymi wykorzystywanymi w diagnostyce CS są: echokardiografia, rezonans magnetyczny, pozytonowa tomografia emisyjna oraz biopsja zmienionej tkanki. Leczenie polega na zastosowaniu leków hamujących układ odpornościowy. Niektóre zaburzenia rytmu serca i przewodzenia związane z CS mogą mieć charakter odwracalny, jednak częściej wymagają one zabezpieczenia urządzeniami takimi jak rozruszniki serca czy defibrylatory. Konieczne są dalsze badania w celu opracowania skuteczniejszych strategii diagnostycznych dla poprawy wykrywania i leczenia tego stanu.