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Povzetek: Abstract Aims To evaluate general and disease-specific health literacy in patients with heart failure (HF) and to examine their association with behavioural, patient-reported and clinical outcomes. Methods and results This prospective observational study included 126 outpatients with HF (mean age 69 ± 11 years; 71% male) who were followed for six months. General health literacy was assessed using the Brief Health Literacy Screen (BHLS), and disease-specific health literacy using the Heart Failure-Specific Health Literacy Scale (HFsHLS). The two measures were moderately positively correlated (Spearman's ρ = 0.49, p < 0.001), indicating partial overlap. Limited general health literacy (BHLS ≤ 9) was identified in 22% of patients and was associated with lower educational level, more depressive symptoms, higher NT-proBNP levels, and a greater number of prescribed medications (all p < 0.05). In univariable analyses, both health literacy measures were associated with better HF-related knowledge (p = 0.004 and 0.049), higher health-related quality of life (p < 0.001 and 0.007), and better self-rated health (p < 0.001 for both), which was not sustained after multivariable adjustment. Additionally, disease-specific health literacy was associated with self-care behaviours (p = 0.033), also after multivariable adjustment (p = 0.026). Neither measure was independently associated with clinical outcomes (death, HF hospitalization, emergency department visit); however, patients with limited general health literacy showed numerically higher event rates and a tendency towards increased risk of clinical outcomes. Conclusion In patients with HF, limited general health literacy was observed in 22% of patients. General and disease-specific health literacy measures were not interchangeable, and only disease-specific health literacy showed an independent association with self-care behaviours. A tendency towards less favourable clinical outcomes was observed among patients with limited general health literacy.
Ključne besede: heart failure, health literacy
Objavljeno v DiRROS: 24.07.2026; Ogledov: 177; Prenosov: 96
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Ključne besede: atrial fibrillation, heart failure, interleukin-6, interleukin-6/interleukin-10 ratio, orosomucoid
Objavljeno v DiRROS: 12.06.2026; Ogledov: 175; Prenosov: 140
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Ključne besede: Adipose tissue mesenchymal stromal cells, allogeneic therapy, clinical trial, heart failure, stem cells
Objavljeno v DiRROS: 05.06.2026; Ogledov: 298; Prenosov: 281
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Povzetek: This review provides an in-depth analysis of argatroban as an alternative anticoagulant in cardiac surgery, with a focus on its use in patients with heparin-induced thrombocytopenia (HIT). We examine argatroban's pharmacokinetics and dosing regimens and the challenges associated with cosnventional monitoring methods-such as activated clotting time (ACT) and activated partial thromboplastin time (aPTT)-to evaluate its safety and effectiveness in high-risk surgical settings. Drawing on data from multiple case reports and series, our review highlights both the potential benefits and limitations of argatroban, including complications such as clot formation in extracorporeal circulation systems and prolonged postoperative coagulopathy. In addition to the literature review, we present a detailed clinical case of urgent HeartMate 3 left ventricular assist device implantation in a patient with advanced heart failure and active HIT. In this case, despite targeting an ACT above 400 s, intraoperative complications such as clot formation in the heart-lung machine and difficulty achieving hemostasis highlight the need for improved monitoring and dosing protocols. Our findings call for refined anticoagulation strategies and advanced monitoring techniques to optimize argatroban use in cardiac surgery, offering valuable insights for clinicians managing complex scenarios where conventional heparin therapy is contraindicated.
Ključne besede: heart failure, left ventricular assist device, heparin-induced thrombocytopenia, argatroban, anticoagulation, heart transplantation, cardiac surgery
Objavljeno v DiRROS: 22.04.2026; Ogledov: 240; Prenosov: 216
Celotno besedilo (2,73 MB)
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Povzetek: Background and Aims: Left bundle branch area pacing (LBBAP) promotes physiological synchronous activation of the left ventricle and may be particularly beneficial in patients with atrioventricular block (AVB), but its mortality benefit remains unclear. This study aims to compare long-term survival in AVB patients receiving either LBBAP or right ventricular pacing (RVP) and to analyse predictors of mortality during LBBAP. Methods: MELOS RELOADED, a multicentre European collaboration, was a registry-based study of pacemaker patients with AVB, left ventricular ejection fraction (LVEF) >40% and ventricular pacing >20%. The primary outcome was all-cause mortality based on national registries. A 1:1 propensity score matching was performed between the RVP and LBBAP groups. Kaplan–Meier curves and multivariable Cox proportional hazards models were used to estimate survival. Results: In total, 3382 patients receiving LBBAP or RVP were matched. At 4-year follow-up, the Kaplan–Meier curve showed an absolute difference in survival of 11.8% in favour of LBBAP (P < .001). LBBAP was a robust predictor of reduced mortality with a hazard ratio (HR) of 0.53 (95% confidence interval 0.42–0.65, P < .001). Within the LBBAP group, the following independent predictors of increased mortality were identified: lack of confirmed left bundle branch capture (HR 1.85, P < .001), lower percentage of ventricular pacing (HR 1.12), and age. Conclusions: This is the first large study demonstrating the long-term survival benefit of LBBAP. This strengthens the use of LBBAP in AVB patients with preserved/mildly reduced LVEF while awaiting the results of randomized trials. Confirmation of left bundle branch capture seems advisable to achieve optimal results with LBBAP.
Ključne besede: conduction system pacing, left bundle branch area pacing, atrioventricular block, mortality, heart failure
Objavljeno v DiRROS: 10.04.2026; Ogledov: 1120; Prenosov: 312
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