Introduction: Congenital structural anomalies of the pulmonary artery in children, encompassing defects such as pulmonary atresia (PA), pulmonary stenosis (PS), pulmonary artery hypoplasia, and tetralogy of Fallot (ToF), pose significant challenges in pediatric cardiac surgery due to impaired blood flow in pulmonary circulation. Traditional options for conventional repair-including autologous materials such as the native pericardium and synthetic materials such as artificial patches-have limitations including a lack of growth potential and vulnerability to restenosis over time. ProxiCor® patches, based on the extracellular matrix (ECM), have emerged as biologically compatible substitutes capable of fostering tissue regeneration. The primary outcomes of this study were the safety (absence of patch-related complications such as restenosis, dilation, aneurysm, infection, or thrombosis) and feasibility (intraoperative handling and surgical success) of ProxiCor® for pulmonary artery and right ventricular outflow tract (RVOT) reconstruction in a single-center pediatric cohort. Secondary outcomes included mortality, postoperative complications (prolonged mechanical ventilation > 72 h, need for continuous renal replacement therapy (CRRT), and intensive care unit (ICU) and hospital stay), and qualitative echocardiographic assessment of vessel patency during follow-up. Patients and methods: A retrospective analysis was conducted in 25 consecutive pediatric patients who underwent pulmonary artery or RVOT reconstruction with ProxiCor® at the Department of Pediatric Cardiac Surgery in Poznań (Poland) between the years 2023 and 2024. Surgical techniques, clinical outcomes, and follow-up data were assessed using transthoracic echocardiography (TTE). Results: The median age was 224 (Q1-Q3: 124-362) days, and median weight was 4.2 (Q1-Q3: 2.8-8.5) kg. Procedures targeted repairs of the main pulmonary artery (MPA), right pulmonary artery (RPA), left pulmonary artery (LPA), and RVOT. Diagnoses included tetralogy of Fallot (ToF), pulmonary artery stenosis (PS), pulmonary atresia (PA), pulmonary artery hypoplasia, and anomalous left coronary artery from the pulmonary artery (ALCAPA). The mortality rate stood at 8% (2/25), stemming from multiorgan failure and hemorrhagic stroke, unrelated to the patch. Over a median observation period of 483 (Q1-Q3: 363-584) days, no patch-related complications (e.g., restenosis or dilation) arose. The median hospitalization time was 22 (Q1-Q3: 8.5-38.5) days. Conclusions: ProxiCor® ECM patches appear to be safe and feasible for use in pulmonary artery and RVOT reconstruction, with favorable early outcomes. However, the small cohort size, lack of a control group, and limited mid- to long-term echocardiographic data preclude definitive conclusions about long-term outcomes or comparative effectiveness.

Background: Ambient air pollution is an established cardiovascular risk factor; however, its impact on long-term outcomes after coronary artery bypass grafting (CABG) remains insufficiently defined. We aimed to evaluate whether chronic exposure to air pollutants may influence long-term mortality following surgical revascularization. Methods: In this multicenter retrospective cohort study, 1033 consecutive patients undergoing CABG with BIMA (bilateral internal mammary arteries) grafting were analyzed with a median follow-up of 8.1 years. Individual exposure to nitrogen dioxide (NO2), particulate matter ≤10 μm (PM10), and ≤2.5 μm (PM2.5) was estimated based on residential data. Multivariable Cox proportional hazards models were used to assess associations with long-term mortality. Model performance was evaluated using receiver operating characteristic (ROC) analysis, while incremental prognostic value was quantified using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Kaplan–Meier analyses were performed using data-driven thresholds and model-based risk stratification. Results: During follow-up, 220 deaths (21.1%) occurred. In multivariable analysis, both NO2 and PM10 were associated with increased mortality (NO2: HR 2.70 per 10 μg/m3, 95% CI 2.03–3.59; PM10: HR 2.73 per 10 μg/m3, 95% CI 1.94–3.83; both p < 0.001), whereas PM2.5 was not significant. The clinical model demonstrated moderate discrimination (AUC 0.73), which improved significantly after inclusion of pollution variables (AUC 0.84; ΔAUC 0.11). Reclassification analysis showed substantial improvement (NRI 0.42, p < 0.001; IDI 0.11, p < 0.001). Kaplan–Meier analysis confirmed enhanced risk stratification, with a hazard ratio of 2.70 for the clinical model and 7.02 for the combined clinical and pollution model (both p < 0.001). Conclusions: In this retrospective cohort of patients undergoing CABG with BIMA grafting, higher long-term residential exposure to NO2 and PM10 was associated with greater all-cause mortality after adjustment for measured clinical and procedural factors. These findings support further investigation of environmental exposure as a prognostic marker in surgically treated coronary disease, pending external validation and more granular control for contextual confounding. These findings suggest that environmental exposure may represent a relevant component of long-term risk stratification, although confirmation in large-volume cohorts is required.

Background: Acute cellular rejection (ACR) after heart transplantation remains incompletely explained despite standardized immunosuppression. Environmental exposures may contribute to residual immune activation; however, prior studies have focused primarily on air pollution rather than residential land-use composition. Objectives: To determine whether buffer-specific residential environmental composition is associated with rejection risk and whether these associations are scale-dependent and domain-specific. Methods: In this retrospective single-center cohort study, 30 heart transplant recipients contributed 267 biopsy-linked observations. Residential land-use composition was quantified within 300 m, 500 m, 700 m, and 1000 m buffers and aggregated into five domains: trees, other green surroundings, roads, water, and industrial land. Associations with ACR were evaluated using clustered logistic regression models adjusted for time since transplantation. Results: The strongest and only statistically robust associations after FDR correction were observed within the 300 m buffer. Tree-dominant (OR 1.42, 95% CI 1.22-1.65, q = 0.010) and industrial land exposure (OR 1.50, 95% CI 1.28-1.76, q = 0.010) were independently associated with increased odds of ACR. At 500 m, the association with trees persisted nominally (OR 1.39, 95% CI 1.03-1.88, p = 0.034), but did not remain significant after FDR correction, whereas water exposure showed a non-significant trend (OR 1.28, p = 0.057), which did not reach statistical significance. No associations were observed beyond 700 m across all models. Conclusions: Residential environmental composition may be associated with acute cellular rejection after heart transplantation in a scale-dependent manner, with signals confined to the immediate residential environment. Tree-dominant exposure within 300 m showed an association in clustered models; however, this finding was attenuated in mixed-effects sensitivity analyses. These results should be considered exploratory and hypothesis-generating study.

Postoperative wound complications remain a major cause of morbidity, prolonged hospitalization, increased healthcare costs, and reduced quality of life. While traditional wound dressings functioned primarily as passive barriers against contamination and exudate, advances in wound biology have transformed surgical wound management. Tissue repair is now recognized as a dynamic immunometabolic process involving coordinated interactions among immune cells, stromal populations, extracellular matrix remodeling, mechanotransduction, mitochondrial function, redox balance, microbial ecology, and bioelectrical signaling. Consequently, modern wound dressings are increasingly designed as bioactive systems capable of actively modulating the wound microenvironment. Recent developments in biomaterials science, immunoengineering, nanotechnology, extracellular vesicle biology, bioelectronics, and artificial intelligence have enabled the creation of advanced wound platforms, including stimuli-responsive hydrogels, immunomodulatory biomaterials, nanozyme-based dressings, conductive scaffolds, oxygen-generating matrices, extracellular vesicle-loaded systems, and biosensor-integrated interfaces. Therapeutic strategies are progressively shifting from antimicrobial-focused approaches toward immune-regenerative modulation targeting chronic inflammation, mitochondrial dysfunction, ferroptosis, cellular senescence, and impaired mechanobiological signaling. This review examines emerging surgical wound dressings from mechanistic, translational, and biomaterial perspectives, highlighting current innovations, translational challenges, and future directions. Collectively, these technologies may enable intelligent therapeutic systems capable of sensing and directing tissue regeneration in real time.

BACKGROUND:Heart failure affects over 1.2 million Polish citizens. Although the current implantation rate of 3.3 left ventricular assist devices (LVADs) per million population remains below the European average, if the upward trend is maintained, Poland may soon reach the level of mid-range European countries (4-6 LVADs per million). AIMS:The national registry aimed to provide systematic oversight of the Polish LVAD population along with treatment outcomes. METHODS:A prospective multicenter observational registry of all consecutive LVAD patients undergoing LVAD implantation between January 1, 2022, and December 31, 2024. Data were compared to the Society of Thoracic Surgeons (STS) registry. RESULTS:From January 2022 to December 2024, 266 adult patients received LVAD in Poland. There has been a year-to-year increase in LVAD utilization of approximately 40%. The cohort consisted predominantly of men (96.1%) with a median age of 57.76 (49.80-64.53) years. In contrast, in the STS-Intermacs registry, women represented 21.9%. Ischemic cardiomyopathy was markedly more common (60.8%) in the POL-LVAD registry, contrary to non-ischemic cardiomyopathy in the STS registry (54.2%). Polish recipients presented with a significantly lower clinical acuity, with Intermacs profiles 1-3 accounting only for 55%-68% of implants, compared with nearly 90% in the STS cohort. Moreover, unlike the STS registry - in which destination therapy accounted for over 80% of implants - the Polish cohort was dominated by use of a bridge-to-transplantation strategy (72%). During a median follow-up of 471 days (interquartile range 283-729) 69 patients died and 26 underwent heart transplantation, which translates into an actual probability of survival of 81%, 71%, and 64% at 1, 2, and 3 years, respectively, and is comparable to the STS-Intermacs registry. Age was the main survival discriminator in the Polish cohort. CONCLUSIONS:This is the first report of the Polish National Mechanical Circulatory Support Registry. The POL-LVAD registry shows a dynamic growth of LVAD therapy in Poland, with survival outcomes comparable to the STS registry.

Introduction:Deep sternal wound infection (DSWI) remains a serious complication of coronary artery bypass grafting (CABG), particularly when bilateral internal thoracic arteries (BITA) are used. Concerns regarding DSWI often limit the adoption of multiple arterial grafting. Aim:To evaluate the effect of topical vancomycin paste on the incidence of DSWI in patients undergoing primary isolated CABG with BITA. Material and methods:This multicenter, retrospective study analyzed 1,694 patients who underwent BITA grafting between 2006 and 2024. Patients were stratified based on whether topical vancomycin paste was applied to the sternal edges (n = 455) or not (n = 1,239). Propensity score matching was used to account for baseline differences, generating 368 matched pairs. Odds ratios (ORs) were estimated using multivariable and conditional logistic regression. Results:Multivariable logistic regression demonstrated that the use of topical vancomycin paste was independently associated with a 63% reduction in DSWI (OR = 0.37; 95% CI: 0.14-0.97; p = 0.045). Other independent predictors of increased DSWI risk included age ≥ 60 years, obesity, chronic lung disease, insulin therapy, female sex, and heart failure symptoms. After propensity score matching, 368 well-balanced pairs were obtained. In this matched cohort, topical vancomycin paste was associated with a substantial reduction in DSWI (OR = 0.17; 95% CI: 0.05-0.60; p = 0.001). Conclusions:Topical application of vancomycin paste significantly reduces the risk of DSWI in patients undergoing CABG with BITA. This simple and effective prophylactic measure may help enable safer and broader adoption of multiple arterial grafting strategies.

Background/Objectives: Perioperative risk stratification in cardiac surgery is based mainly on static preoperative variables and therefore does not fully capture dynamic multiorgan responses to surgical stress. The Model for End-Stage Liver Disease (MELD) score, which integrates bilirubin, creatinine, and the international normalized ratio (INR), reflects hepatorenal function, but its perioperative dynamics remain insufficiently explored. This study aimed to characterize perioperative MELD trajectories in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and to assess the influence of sex and diabetes mellitus on these changes and their clinical relevance. Methods: This retrospective observational study included 111 patients undergoing elective OPCAB. MELD scores were assessed preoperatively (MELD0), on postoperative day 1 (MELD1), and on day 6 (MELD6). Dynamic indices of MELD change were calculated, including the early postoperative increase (ΔMELD01). The effects of sex and diabetes mellitus on MELD trajectories were analyzed using multivariable linear regression and generalized estimating equations. A high-surge phenotype was defined as the upper quartile of ΔMELD01. Results: MELD increased significantly on postoperative day 1 and partially recovered by day 6 (p < 0.001). Female sex was independently associated with lower postoperative MELD values (β = -2.54, p < 0.001) and a smaller ΔMELD01, whereas diabetes mellitus was associated with a reduced MELD rise (β = -1.07, p = 0.028). Patients with a high-surge MELD phenotype had significantly longer hospitalization than those with a lower MELD response (12.8 ± 2.1 vs. 9.2 ± 1.2 days, p < 0.001). Conclusions: Perioperative MELD trajectories reflect a dynamic hepatorenal stress response after OPCAB and may improve identification of clinically relevant physiological vulnerability.

Pulsatile blood flow is a fundamental characteristic of cardiovascular physiology that regulates endothelial function, vascular homeostasis, microcirculatory integrity, and organ adaptation through complex mechanobiological pathways. The widespread use of continuous-flow left ventricular assist devices (CF-LVADs) has created a unique clinical model of chronic pulsatility deprivation, whereas heart transplantation restores physiological pulsatile hemodynamics. This review examines the molecular, cellular, and systemic consequences of these contrasting circulatory states. Evidence from experimental and clinical studies indicates that reduced pulsatility during CF-LVAD support is associated with impaired endothelial mechanotransduction, glycocalyx disruption, oxidative stress, inflammatory activation, angiogenic dysregulation, acquired von Willebrand syndrome, and microvascular remodeling. These alterations contribute to bleeding, thrombosis, neurological events, and progressive end-organ dysfunction. In contrast, restoration of pulsatile flow following heart transplantation promotes recovery of endothelial signaling, nitric oxide bioavailability, vascular responsiveness, and tissue perfusion, although persistent immune-mediated injury may limit complete vascular normalization. Emerging concepts involving Piezo1 signaling, YAP/TAZ mechanotransduction, extracellular vesicles, immunometabolism, and multi-omics profiling further support the role of pulsatility as a biological regulator rather than a simple hemodynamic consequence of cardiac contraction. Understanding pulsatility-dependent cardiovascular remodeling may facilitate the development of next-generation circulatory support technologies and novel therapeutic strategies to preserve vascular health.

BACKGROUND:Acute kidney injury (AKI) is a frequent and prognostically important complication of cardiac surgery, yet early risk stratification remains challenging. The purpose of this prospective exploratory study was to determine whether preoperative vitamin levels differ in patients who develop cardiac surgery-associated AKI. METHODS:Consecutive patients scheduled for cardiac surgery due to coronary artery disease and/or severe aortic stenosis between October 2024 and July 2025 were included. Fourteen patients (16.1%) had preoperative eGFR below 60 mL/min. Preoperative serum levels of vitamin A (retinol), vitamin E (α-tocopherol), and vitamin D (25-hydroxyvitamin D3) were measured. RESULTS:A total of 87 patients (72 males (82.8%) with a median (Q1-Q3) age of 66 (61.5-71) years) were included in the study. Cardiac surgery-associated AKI occurred in 36 (41.4%), as a mild and transient impairment, with only two patients with a more severe stage requiring temporary renal replacement therapy. Patients who developed AKI had significantly higher preoperative retinol levels (p = 0.046). Retinol concentrations correlated positively with preoperative creatinine (Spearman's rho 0.321, p = 0.002), postoperative day 0 creatinine (Spearman's rho 0.333, p = 0.002), and postoperative day 1 creatinine (Spearman's rho 0.268, p = 0.012), and negatively with preoperative eGFR (Spearman's rho -0.288, p = 0.007). Tocopherol and 25(OH)D3 did not differ significantly between subgroups. No difference in vitamin levels was observed between patients with and without diabetes. CONCLUSIONS:Increased preoperative retinol levels were associated with cardiac surgery-associated AKI and correlated with perioperative renal dysfunction. Retinol may reflect impaired kidney handling of retinol and identify increased renal vulnerability in cardiac surgery patients. Retinol may represent a hypothesis-generating biomarker of cardiac surgery-associated AKI risk that warrants confirmation in larger cohorts.

Background: Traditional cardiovascular risk models focus on patient-related clinical variables, while the impact of long-term environmental exposure remains insufficiently characterized in post-revascularization populations. Objective: To evaluate the association between environmental exposure and long-term mortality after coronary artery bypass grafting (CABG), and to determine whether integrated environmental measures provide additional prognostic value beyond established clinical risk factors. Methods: This retrospective multicenter cohort study included 1042 consecutive patients undergoing CABG with a median follow-up of 8.1 years. Regional environmental data were linked to individual patients. Multivariable Cox regression models were constructed using a hierarchical approach. To address collinearity among environmental variables, principal component analysis (PCA) was applied. Mean winter temperature was analyzed as a clinically interpretable proxy of overall environmental exposure. Results: During follow-up, 220 deaths (21.1%) occurred. Established clinical predictors of mortality included age, diabetes mellitus, peripheral vascular disease, and dyslipidemia. Individual environmental variables showed unstable associations due to collinearity. PCA identified a dominant environmental component explaining 82.0% of variance; however, its association with mortality did not reach statistical significance after adjustment (HR 1.17 per SD, 95% CI 0.98-1.39; p = 0.083). In contrast, higher mean winter temperature was independently associated with increased mortality (HR 1.24 per SD, 95% CI 1.05-1.48; p = 0.013) per 1 °C increase, with evidence of non-linearity. Conclusions: Environmental exposure represents a relevant component of long-term risk after CABG. While individual environmental variables are highly correlated and unstable, clinically interpretable measures such as winter temperature may provide practical support for risk assessment.

Coronary artery disease (CAD) often coexists with severe aortic stenosis (AS) in patients undergoing transcatheter aortic valve implantation (TAVI), posing a complex diagnostic and therapeutic challenge. As TAVI is increasingly used for younger, lower-risk patients, managing CAD is becoming a personalized, long-term clinical concern. This narrative review summarizes the current evidence on coronary assessment and revascularization strategies in individuals with severe AS. Invasive coronary angiography remains the leading method for anatomical coronary imaging, but coronary computed tomography angiography is emerging as a reliable alternative that may reduce unnecessary invasive procedures in certain patients. The routine performance of PCI before TAVI is under increasing scrutiny, and available data support a more selective approach based on lesion significance, CAD complexity, procedural timing, and anticipated need for future coronary access. Significant uncertainties remain concerning the physiological evaluation of lesions, the timing and completeness of revascularization, and the treatment of left main or multivessel disease. Additional phenotype-specific and longitudinal studies are needed to improve management algorithms for this population.

Background: Decellularized extracellular matrix (ECM) patches have emerged as a potential alternative to synthetic and autologous materials in pediatric cardiac surgery; however, clinical data on their use in septal defect repair remain limited. Methods: This single-center retrospective study evaluated the applicability and early outcomes of ECM scaffolds for pediatric septal defect repair using data from the national cardiac surgery registry. Early postoperative outcomes and perioperative variables were analyzed. Results: The study included 72 procedures performed in 68 patients (35 males and 33 females), aged 10 days to 16 years (median age: 187 days; IQR: 105-327 days). Reoperations accounted for 6% of cases. Postoperative complications occurred in 1.4% of patients, and continuous renal replacement therapy was required in 6 (8.8%) patients. Overall mortality was 2.9% (2/68 patients). No statistically significant differences were observed between atrial and ventricular septal defect groups. Conclusions: ECM patches appeared to be a safe and effective option for septal defect repair in pediatric cardiac surgery, demonstrating low complication rates and satisfactory early outcomes across different types of congenital heart defects.

Introduction:Surgical revascularization, alongside percutaneous intervention, is a viable therapeutic option with satisfactory long-term results. Accumulating evidence indicates that biological sex modulates the predisposition to coronary artery disease and perioperative risk. Aim:The study aimed to identify potential long-term prognostic factors after surgical revascularization in patients undergoing off-pump coronary artery bypass (OPCAB) using bilateral mammary arteries. Material and methods:In total, 276 consecutive patients were operated on due to complex stable coronary disease with off-pump surgical revascularization using bilateral mammary arteries. The long-term survival rates, including the Kaplan-Meier survival curve, were compared based on all-cause mortality risk between the female and male populations. Results:Among the 276 analyzed participants, 64 (23%) were deceased, with a median follow-up time of 3,307 days (range: 1,703-5,414 days). The 5-, 10-, and 15-year survival rates in the male and female populations were 90.5% vs. 96.5%, 78.1% vs. 91.4%, and 62.9% vs. 81.3%, respectively. Conclusions:Female sex may be related to superior long-term survival in off-pump revascularization with bilateral mammary artery grafts. While early perioperative risks may be higher in women due to anatomical and referral delay factors, the long-term survival in women may surpass that of men once the immediate postoperative period is successfully navigated. Large-scale studies are required to confirm the suggested association.

Background: Continuous-flow left ventricular assist devices (LVADs) and heart transplantation (HTX) improve survival and quality of life in advanced heart failure. However, restoration of central hemodynamics does not consistently normalize exercise capacity, physical performance, or body composition. Persistent skeletal muscle dysfunction, endothelial abnormalities, metabolic disturbances, and adverse body composition changes frequently limit functional recovery. Methods: This narrative review examines determinants of rehabilitation outcomes across the transition from advanced heart failure to LVAD support and subsequent HTX. Particular emphasis is placed on restoration of pulsatile circulation, vascular and microcirculatory adaptation, immunosuppressive therapy, body composition remodeling, and emerging immunometabolic mechanisms. Results: Rehabilitation outcomes appear to be increasingly determined by peripheral rather than central cardiovascular factors. Continuous-flow LVAD support induces vascular, endothelial, autonomic, and microcirculatory adaptations that may persist after transplantation. Although HTX restores physiological pulsatile circulation and cardiac output, recovery is often limited by skeletal muscle dysfunction, impaired mitochondrial capacity, chronotropic abnormalities, and adverse body composition changes. Immunosuppressive therapies further influence muscle plasticity, adipose tissue distribution, insulin sensitivity, endothelial function, and exercise adaptation, contributing to phenotypes such as sarcopenia, myosteatosis, and sarcopenic obesity. Conclusions: Functional recovery after LVAD support and HTX is a multidimensional process extending beyond restoration of cardiac function. We propose a hemodynamic-immunometabolic framework in which vascular adaptation, skeletal muscle biology, body composition remodeling, and immunosuppressive therapy interact to determine rehabilitation success and may inform personalized rehabilitation strategies.

Introduction:Surgical site infections (SSIs) are one of the most serious complications in surgery and are associated with significant mortality and morbidity. Prophylactic systemic antibiotics are not completely effective in SSI prevention. Aim:The purpose of this study was to assess outcomes of routine application of a gentamicin-impregnated sponge. Material and methods:The study involved 363 consecutive patients with a mean age of 62.7 ±12.1 years who underwent cardiac surgical operations from complete or partial midline sternotomy. In group S (n = 196) a gentamicin-impregnated sponge was placed retrosternally. whereas in group C (n = 167) no local antibiotics were used. The other aspects of the perioperative prophylactic protocol were not changed during the study. Postoperative adverse events were assessed with special attention to SSI rate. Results:Patients of both groups were comparable in terms of the majority of pre- and intraoperative variables. The only exception was lower BMI in group S (28.3 ±4.2 kg/m2) than in group C (29.5 ±4.8 kg/m2; p = 0.013); however, prevalence of obese subjects was comparable between groups (36.7% vs. 41.6%, in group S and group C, respectively; ns). Any adverse events in the early postoperative period were more frequent in group C (22.3%) than in group S (19.8%) (p = 0.040), mainly due to SSI rate (4.1% vs. 10.7%) (p = 0.017). Routine application of a gentamicin-impregnated sponge led to a marked reduction in deep SSI rates from 5.4% to 1.5% (p = 0.040) but not in superficial SSI rates (5.4% vs. 2.6%; p = 0.162). Conclusions:Our study suggested that routine application of a gentamicin-impregnated sponge may be efficacious in prevention of deep wound infection following cardiac surgical procedures irrespective of risk profile.

Coronary artery disease remains an epidemiological challenge as global morbidity is not declining despite the fact that the risk factors are well known. Metabolomic derivatives of atherosclerosis formation have recently gained attention as a possible non-traditional risk factor. The aim of this study was to find potential differences in acetyl-carnitine chain serum concentrations between epicardial artery disease patients and a control group. There were 41 patients (25 men and 16 women), with a median (Q1–Q3) age of 69 (63–73) years, enrolled in the prospective metabolomic analysis. They were divided into two groups based on cine angiography results confirming epicardial artery disease (group 1, n = 25 (61%)) or showing characteristics corresponding to normal angiograms (group 2, n = 16 (39%)). The quantitation of metabolites was performed based on the coronary angiograms. Significant differences related to the plasma concentration of L-Acetyl-carnitine (7.49 (4.79–9.23) µM vs. 9.36 (8.57–10.23) µM (p = 0.009)), Decanoyl-carnitine (0.00 (0.00–0.37) µM vs. 0.36 (0.19–0.44) µM (p = 0.040)), C12:1-carnitine (0.17 (0.14–0.20) µM vs. 0.22 (0.18–0.24) µM (p = 0.008)), trans-2-Dodecenoyl-carnitine (0.10 (0.07–0.13) µM vs. 0.13 (0.10–0.15) µM (p = 0.002)), cis-5-Tetradecenoyl-carnitine (0.03 (0.02–0.04) µM vs. 0.04 (0.03–0.05) µM (p = 0.043)), and 3,5-Tetradecadien-carnitine (0.16 (0.14–0.18) µM vs. 0.18 (0.17–0.27) µM (p = 0.007)) in group 1 vs. group 2 were noted. Increased plasma levels of acetyl-carnitine may be characteristic of patients with normal coronary angiograms.

Background/Objectives: Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist and share similar pathophysiological pathways, including inflammation, lipid deposition, and extracellular matrix remodeling. Trace elements are involved in cellular and physiological processes, playing regulatory and signaling roles. Their concentrations may be altered in various pathological conditions. The aim of our study was to compare trace metal concentrations in patients with severe aortic stenosis with and without coexisting coronary artery disease. Methods: In 53 patients (25 male, 47.2%, median age of 78 (75-81) years) with severe aortic stenosis, CAD coexistence and progression were analyzed based on the most recent coronary angiography report and history of revascularization. Blood samples for trace element analysis were collected prior to the implantation of the prosthesis, from the peripheral artery and by the pigtail catheter at the aortic root. Results: Twenty-six patients presented any degree of CAD, and were further differentiated into more advanced disease stages. The analysis found that patients with CAD had lower median concentrations of aluminum and calcium in the peripheral blood, and manganese and selenium in the aorta. Furthermore, in most advanced CAD patients, the concentration of magnesium, calcium, nickel, and copper in peripheral blood, along with chromium and selenium in aortic blood, was found to be lower compared to non-CAD patients. Lower selenium in aortic blood samples was predictive of an advanced stage of CAD. Conclusions: Patients with severe aortic stenosis and coexisting CAD present significantly lower blood concentrations of trace elements compared to those with the isolated disease.

Cardiovascular morbidity is still an epidemiological problem, especially related to the risk of re-intervention. In addition to classical atherosclerosis risk factors, the influence of climate changes related to ambient temperature exposure has been recently taken into account. The individual approach is indicated as desirable and justified for clinical conclusion drawing. The possible relation between air temperature and coronary artery atherosclerosis progression was the subject of our study. Out of 224 patients, 146 (100 (68