Polskie Archiwum Medycyny Wewnetrznej[JOURNAL]

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Pulmonary embolism complicated by systemic arterial embolism due to high-risk patent foramen ovale.

Sławek-Szmyt S, Krasiński Z, Mularek-Kubzdela T … +3 more , Grygier M, Lesiak M, Araszkiewicz A

Pol Arch Intern Med · 2026 May · PMID 42003346 · Publisher ↗

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When ventricular tachycardia meets left ventricular thrombus: catheter ablation guided by intracardiac echocardiography with cerebral protection.

Ciechański E, Krzowski B, Rymuza B … +3 more , Szczasny M, Balsam P, Peller M

Pol Arch Intern Med · 2026 May · PMID 42003330 · Publisher ↗

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Giant aneurysm of the right coronary artery with a fistula to the coronary sinus and right atrium: long-term observation ended with a successful unconventional operation.

Wojtkowska A, Styczeń A, Zapolski T … +3 more , Widenka K, Czekajska-Chehab E, Tomaszewski A

Pol Arch Intern Med · 2026 May · PMID 41979890 · Publisher ↗

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Does rheumatoid arthritis affect the course of chronic hepatitis C and outcomes of antiviral treatment?

Brzdęk K, Zarębska-Michaluk D, Lorenc B … +9 more , Berak H, Brzdęk M, Janocha-Litwin J, Klapaczyński J, Stażyk K, Mazur W, Tudrujek-Zdunek M, Parfieniuk-Kowerda A, Flisiak R

Pol Arch Intern Med · 2026 May · PMID 41979570 · Publisher ↗

INTRODUCTION: Chronic hepatitis C virus (HCV) infection is a systemic disease often associated with extrahepatic autoimmune conditions, including rheumatoid arthritis (RA). Immune dysregulation and immunomodulatory thera... INTRODUCTION: Chronic hepatitis C virus (HCV) infection is a systemic disease often associated with extrahepatic autoimmune conditions, including rheumatoid arthritis (RA). Immune dysregulation and immunomodulatory therapy may raise concerns about the effectiveness and safety of direct‑acting antivirals (DAAs), but real‑world data on RA patients are lacking. OBJECTIVES: We aimed to assess whether the presence of RA influences the severity of liver disease and outcomes of DAA therapy in HCV‑infected patients. PATIENTS AND METHODS: This retrospective multicenter study compared adult HCV‑infected patients with RA and those without autoimmune disease (non‑AID). All patients were treated with DAAs in Polish centers between 2015 and 2024. RESULTS: Of the 20 645 patients included in the analysis, 206 (1%) had RA. They were older, predominantly female, had lower body mass index, and less advanced liver fibrosis, as compared with the non‑AID group. The sustained virologic response rates were high and comparable between the RA and non‑AID populations (98.4% vs 97.7%). RA was not associated with treatment failure. Independent predictors of virologic failure included male sex, genotype 3 infection, prior antiviral treatment, advanced liver disease, and Child-Pugh class B/C. Mild adverse events were more frequent in the RA patients, while the rates of serious adverse events, death, and treatment discontinuation were comparable. CONCLUSIONS: RA does not contribute to increased severity or progression of HCV‑related liver disease and does not negatively affect the effectiveness or safety of DAA therapy. Liver disease stage and hepatic dysfunction, rather than the presence of RA, are the key determinants of treatment outcomes in patients with chronic HCV infection.

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Endurance capacity and muscle strength as a composite indicator of physical reserve in men with systolic heart failure.

Żołyński MS, Barecka K, Krauze T … +4 more , Piskorski J, Wykrętowicz A, O'Driscoll J, Guzik P

Pol Arch Intern Med · 2026 May · PMID 41979569 · Publisher ↗

INTRODUCTION: Reduced composite physical reserve (CPR) may coexist with systolic heart failure (HF). OBJECTIVES: We aimed to evaluate clinical differences among patients stratified by CPR in the 6‑minute walk test (6MWT)... INTRODUCTION: Reduced composite physical reserve (CPR) may coexist with systolic heart failure (HF). OBJECTIVES: We aimed to evaluate clinical differences among patients stratified by CPR in the 6‑minute walk test (6MWT) and maximal handgrip (MHG) strength, and to identify clinical correlates of reduced physical function. PATIENTS AND METHODS: This post hoc analysis included 332 men from a prospective cohort of outpatients with stable HF (left ventricular ejection fraction <50%) who completed both tests. The patients were stratified into 3 categories based on median splits of 6MWT (480 m) and MHG (40 kg) to define CPR: 1) both 6MWT and MHG values above the group medians; 2) either 6MWT or MHG at or below the median; or 3) both parameters at or below the median. Patient clinical characteristics were compared using analysis of covariance (estimated marginal means and SE) and logistic regression (odds ratios [ORs]), adjusted for age, diabetes, and smoking. RESULTS: The category 3 patients had higher mean (SD) resting heart rate (72.2 [0.96] vs 64.4 [1.1] bpm; P <0.001), serum creatinine level (1.27 [0.03] vs 1.16 [0.04] mg/dl; P <0.001), and N-terminal pro-B-type natriuretic peptide level (log10 3.09 [0.05] vs 2.76 [0.05] pg/ml; P <0.001) than the category 1 patients. Each 1‑category increase was associated with greater odds of New York Heart Association class III-IV (OR, 2.6; 95% CI, 1.78-3.8), resting heart rate above 75 bpm (OR, 2.44; 95% CI, 1.64-3.64), chronic atrial fibrillation (OR, 1.53; 95% CI, 1.06-2.2), and increased use of diuretics (OR, 1.53; 95% CI, 1.02-2.29) and digoxin (OR, 1.99; 95% CI, 1.17-3.39). CONCLUSIONS: Lower combined endurance and strength identify HF patients with a more severe clinical phenotype and greater treatment intensity. This functional performance-based categorization may offer a simple, promising tool for clinical phenotype stratification in systolic HF.

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Association between serum amino acid profiles and clinical severity in heart failure with reduced ejection fraction: an exploratory study.

Urbanowicz T, Plewa S, Pietkiewicz D … +3 more , Krasińska B, Matysiak J, Tykarski A

Pol Arch Intern Med · 2026 Apr · PMID 41961958 · Publisher ↗

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Secondary fungal coinfection(s) in influenza A-associated acute respiratory distress syndrome during venovenous extracorporeal membrane oxygenation: diagnostic challenges.

Górski WJ, Zuzda K, Prokop J … +3 more , Michałowski Ł, Jankowski M, Szułdrzyński K

Pol Arch Intern Med · 2026 Apr · PMID 41949023 · Publisher ↗

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Cervical Nabothian cyst mimicking metastatic disease on post-therapy iodine-131 single-photon emission computed tomography / computed tomography.

Domin R, Ziółkowska P, Stajgis P … +3 more , Gut P, Ruchała M, Czepczyński R

Pol Arch Intern Med · 2026 Apr · PMID 41948973 · Publisher ↗

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Use of a bioresorbable scaffold in a patient with chronic limb-threatening ischemia: the first successful implantation in Poland.

Maga M, Chernovol I

Pol Arch Intern Med · 2026 Apr · PMID 41948972 · Publisher ↗

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Crazy-paving pattern in both lungs and milky pulmonary effluent in a 47-year-old man.

Zhong J, Lai B

Pol Arch Intern Med · 2026 Apr · PMID 41879625 · Publisher ↗

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Mechanical thrombectomy as a bailout therapy for highly resistant coronary thrombus in a young patient with ST-segment elevation myocardial infarction.

Glanowski S, Czech A, Manikowska A … +3 more , Niewiara Ł, Legutko J, Kleczyński P

Pol Arch Intern Med · 2026 Apr · PMID 41879624 · Publisher ↗

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Fibrosis-4 index screening beyond hepatology: a signal of systemic vulnerability.

Åberg F, Männistö V

Pol Arch Intern Med · 2026 Mar · PMID 41873605 · Publisher ↗

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Sodium-glucose contransporter 2 inhibitors in atrial fibrillation: a signal for safer, broader risk reduction?

Fragakis N, Karakasis P

Pol Arch Intern Med · 2026 Mar · PMID 41873604 · Publisher ↗

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Improved survival despite fewer discharge prescriptions: implementation is the missing variable in contemporary heart failure care.

Szarpak L, Pruc M, Siudak Z

Pol Arch Intern Med · 2026 Mar · PMID 41873603 · Publisher ↗

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Improved survival despite fewer discharge prescriptions: implementation is the missing variable in contemporary heart failure care. Authors' reply.

Doryńska A, Drohomirecka A, Łazarczyk H … +1 more , Rywik TM

Pol Arch Intern Med · 2026 Mar · PMID 41873602 · Publisher ↗

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Three-dimensional catheter ablation of atypical atrial flutter in a lung transplant recipient.

Rusztyn P, Farkowski MM, Mruk B … +3 more , Kowalewski M, Korczyński P, Gil RJ

Pol Arch Intern Med · 2026 Apr · PMID 41859937 · Publisher ↗

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When rare matters: aortic valve destruction in myeloperoxidase antineutrophil cytoplasmic antibody-associated microscopic polyangiitis.

Romejko K, Leśniak K, Hanke J … +3 more , Potapowicz-Krysztofiak M, Gawalski K, Niemczyk S

Pol Arch Intern Med · 2026 Apr · PMID 41859909 · Publisher ↗

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Fabry cardiomyopathy: a mixed pattern of ischemic and nonischemic myocardial injury.

Lucki M, Lesiak M, Smukowski T … +1 more , Lesiak M

Pol Arch Intern Med · 2026 Apr · PMID 41859868 · Publisher ↗

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Hemostasis assessment in patients suspected of venous thrombosis and pulmonary embolism in emergency setting: challenges for clinicians.

Lippi G, Mullier F, Favaloro EJ

Pol Arch Intern Med · 2026 Apr · PMID 41854416 · Publisher ↗

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality worldwide, and represents a time‑sensitive clinical condition where diagnostic delay i... Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality worldwide, and represents a time‑sensitive clinical condition where diagnostic delay increases unfavorable outcomes. Among the various laboratory biomarkers investigated to support the diagnosis of VTE, D‑dimer has emerged as the reference test for excluding acute thrombosis when interpreted within an appropriate clinical framework. D‑dimer is a fibrin degradation product generated during plasmin‑mediated breakdown of cross‑linked fibrin, reflecting concurrent activation of coagulation and fibrinolysis. Modern diagnostic strategies integrate D‑dimer testing with structured assessment of pretest probability using validated clinical decision tools, such as the Wells score, the Revised Geneva Score, and the Pulmonary Embolism Rule‑out Criteria. In patients with low or intermediate clinical probability, a negative D‑dimer result can safely exclude VTE and avoid unnecessary imaging, whereas elevated values or high clinical suspicion require confirmatory imaging. Recent developments, including age‑adjusted D‑dimer thresholds and probability‑adapted algorithms, such as the YEARS and Pulmonary Embolism Graduated D‑dimer, have improved diagnostic specificity and reduced reliance on imaging techniques without compromising patient safety. Nevertheless, the clinical reliability of D‑dimer testing is influenced by preanalytical variables, assay‑related differences, and presence of physiological or pathological conditions associated with elevated or low fibrin turnover. Accordingly, optimal use of D‑dimer testing requires strict laboratory supervision and integration with clinical probability assessment to ensure accurate and timely diagnosis of VTE.

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Impact of cardiovascular-kidney-metabolic conditions on clinical outcomes in patients with atrial fibrillation: results from a prospective cohort.

Mantovani M, Vitolo M, Bonini N … +8 more , Mei DA, Cherubini B, Trapanese P, Tartaglia E, Serafini K, Pretolani G, Imberti JF, Boriani G

Pol Arch Intern Med · 2026 May · PMID 41842911 · Publisher ↗

INTRODUCTION: Cardiovascular‑kidney‑metabolic (CKM) conditions are frequently encountered in clinical practice. OBJECTIVES: Our aim was to evaluate the epidemiology and impact of CKM conditions in patients with atrial fi... INTRODUCTION: Cardiovascular‑kidney‑metabolic (CKM) conditions are frequently encountered in clinical practice. OBJECTIVES: Our aim was to evaluate the epidemiology and impact of CKM conditions in patients with atrial fibrillation (AF), with a focus on their association with left atrial (LA) remodeling and clinical outcomes. PATIENTS AND METHODS: Patients with AF enrolled in this single‑center prospective study were stratified based on the presence of CKM comorbidities. We assessed the relationship between CKM status, LA remodeling, and adverse clinical outcomes. The primary outcome was a composite of all‑cause death, acute coronary syndrome, ischemic stroke and transient ischemic attack, and hospitalization for heart failure. RESULTS: A total of 1236 patients at a median (interquartile range) age of 75 (66-82) years (37.5% women) were included. Among them, 43.4% had no CKM conditions, 34.6% had 1 CKM condition, 16.7% had 2 CKM conditions, and 5.3% had 3 CKM conditions. LA remodeling was progressively more pronounced with increasing CKM burden. After median follow‑up of 524 (217-1297) days, 283 events of the primary outcome (27.5%) were reported. As compared with the patients with 0 CKM conditions, there was a progressively higher risk of adverse events in the patients with 1 CKM condition (adjusted hazard ratio [aHR], 1.56; 95% CI, 1.14-2.12), 2 CKM conditions (aHR, 1.98; 95% CI, 1.4-2.79), and 3 CKM conditions (aHR, 2.55; 95% CI, 1.61-4.02). The impact of the CKM status was consistent irrespective of sex, obesity, and AF type. CONCLUSIONS: CKM multimorbidity is highly prevalent in AF patients, where it is associated with progressive LA remodeling and a stepwise increase in the risk of adverse events.

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Polskie Archiwum Medycyny Wewnetrznej[JOURNAL]

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