9 results on '"Agata Zdanowicz"'
Search Results
2. Image Quality Improvement in Deep Learning Image Reconstruction of Head Computed Tomography Examination
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Michal Pula, Emilia Kucharczyk, Agata Zdanowicz, and Maciej Guzinski
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deep learning reconstruction ,deep neural network ,head CT ,image quality improvement ,true fidelity ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
In this study, we assess image quality in computed tomography scans reconstructed via DLIR (Deep Learning Image Reconstruction) and compare it with iterative reconstruction ASIR-V (Adaptive Statistical Iterative Reconstruction) in CT (computed tomography) scans of the head. The CT scans of 109 patients were subjected to both objective and subjective evaluation of image quality. The objective evaluation was based on the SNR (signal-to-noise ratio) and CNR (contrast-to-noise ratio) of the brain’s gray and white matter. The regions of interest for our study were set in the BGA (basal ganglia area) and PCF (posterior cranial fossa). Simultaneously, a subjective assessment of image quality, based on brain structure visibility, was conducted by experienced radiologists. In the assessed scans, we obtained up to a 54% increase in SNR for gray matter and a 60% increase for white matter using DLIR in comparison to ASIR-V. Moreover, we achieved a CNR increment of 58% in the BGA structures and 50% in the PCF. In the subjective assessment of the obtained images, DLIR had a mean rating score of 2.8, compared to the mean score of 2.6 for ASIR-V images. In conclusion, DLIR shows improved image quality compared to the standard iterative reconstruction of CT images of the head.
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- 2023
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3. Clinical determinants and prognostic significance of hypocapnia in acute heart failure
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Mateusz Garus, Agata Zdanowicz, Marat Fudim, Robert Zymliński, Piotr Niewiński, Bartłomiej Paleczny, Marta Rosiek-Biegus, Gracjan Iwanek, Piotr Ponikowski, and Jan Biegus
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Medicine ,Science - Abstract
Abstract The aim of this research was to examine the prevalence of hyperventilation (defined by pCO2 value) among acute heart failure (AHF) patients and to link it with potential triggers and prognosis. All patients underwent dyspnea severity assessment and capillary blood examination on hospital admission and during hospitalization. Out of 241 AHF patients, 57(24%) were assigned to low pCO2 group (pCO2 ≤ 30 mmHg) and 184 (76%) to normal pCO2 group (pCO2 > 30 mmHg). Low pCO2 group had significantly lower HCO3 - (22.3 ± 3.4 vs 24.7 ± 2.9 mmol/L, p
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- 2022
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4. Serum Osmolarity and Vasopressin Concentration in Acute Heart Failure—Influence on Clinical Course and Outcome
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Mateusz Guzik, Mateusz Sokolski, Magdalena Hurkacz, Agata Zdanowicz, Gracjan Iwanek, Dominik Marciniak, Robert Zymliński, Piotr Ponikowski, and Jan Biegus
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acute heart failure ,osmolarity ,vasopressin ,outcomes ,Biology (General) ,QH301-705.5 - Abstract
Neurohormone activation plays an important role in Acute Heart Failure (AHF) pathophysiology. Serum osmolarity can affect this activation causing vasopressin excretion. The role of serum osmolarity and vasopressin concentration and its interaction remain still unexplored in AHF. The objective of our study was to evaluate the relationship of serum osmolarity with clinical parameters, vasopressin concentration, in-hospital course, and outcomes in AHF patients. The study group consisted of 338 AHF patients (male (76.3%), mean age of 68 ± 13 years) with serum osmolarity calculated by the equation: 1.86 × sodium [mmol/L] + (glucose [mg/dL]/18) + (urea [mg/dL]/2.8) + 9 and divided into osmolarity quartiles marked as: low: 304 mOsm/L. There was an increasing age gradient in the groups and patients differed in the occurrence of comorbidities and baseline clinical and laboratory parameters. Importantly, analysis revealed that vasopressin presented a linear correlation with osmolarity (r = −0.221, p = 0.003) and its concentration decreased with quartiles (61.6 [44.0–81.0] vs. 57.8 [50.0–77.3] vs. 52.7 [43.1–69.2] vs. 45.0 [30.7–60.7] pg/mL, respectively, p = 0.034). This association across quartiles was observed among de novo AHF (63.6 [55.3–94.5] vs. 58.0 [50.7–78.6] vs. 52.0 [46.0–58.0] vs. 38.0 [27.0–57.0] pg/mL, respectively, p = 0.022) and was not statistically significant in patients with acute decompensated heart failure (ADHF) (59.5 [37.4–80.0] vs. 52.0 [38.0–74.5] vs. 57.0 [38.0–79.0] vs. 50.0 [33.0–84.0] pg/mL, respectively, p = 0.849). The worsening of renal function episodes were more frequent in quartiles with higher osmolarity (4 vs. 2 vs. 13 vs. 11%, respectively, p = 0.018) and patients that belonged to the quartiles with low and high osmolarity were characterized more often by incidence of worsening heart failure (20 vs. 9 vs. 10 vs. 22%, respectively, p = 0.032). There was also a U-shape distribution in relation to one-year mortality (31 vs. 19 vs. 23 vs. 37%, respectively, p = 0.022). In conclusion, there was an association of serum osmolarity with clinical status and both in-hospital and out-of-hospital outcomes. Moreover, the linear dependence between vasopressin concentration and serum osmolarity in the AHF population was identified and was driven mainly by patients with de novo AHF which suggests different pathophysiological paths in ADHF and AHF de novo.
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- 2022
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5. Novel Phenotyping for Acute Heart Failure—Unsupervised Machine Learning-Based Approach
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Szymon Urban, Mikołaj Błaziak, Maksym Jura, Gracjan Iwanek, Agata Zdanowicz, Mateusz Guzik, Artur Borkowski, Piotr Gajewski, Jan Biegus, Agnieszka Siennicka, Maciej Pondel, Petr Berka, Piotr Ponikowski, and Robert Zymliński
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acute heart failure ,machine learning ,clustering ,Biology (General) ,QH301-705.5 - Abstract
Acute heart failure (AHF) is a life-threatening, heterogeneous disease requiring urgent diagnosis and treatment. The clinical severity and medical procedures differ according to a complex interplay between the deterioration cause, underlying cardiac substrate, and comorbidities. This study aimed to analyze the natural phenotypic heterogeneity of the AHF population and evaluate the possibilities offered by clustering (unsupervised machine-learning technique) in a medical data assessment. We evaluated data from 381 AHF patients. Sixty-three clinical and biochemical features were assessed at the admission of the patients and were included in the analysis after the preprocessing. The K-medoids algorithm was implemented to create the clusters, and optimization, based on the Davies-Bouldin index, was used. The clustering was performed while blinded to the outcome. The outcome associations were evaluated using the Kaplan-Meier curves and Cox proportional-hazards regressions. The algorithm distinguished six clusters that differed significantly in 58 variables concerning i.e., etiology, clinical status, comorbidities, laboratory parameters and lifestyle factors. The clusters differed in terms of the one-year mortality (p = 0.002). Using the clustering techniques, we extracted six phenotypes from AHF patients with distinct clinical characteristics and outcomes. Our results can be valuable for future trial constructions and customized treatment.
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- 2022
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6. Relationship of Vascular Endothelial Growth Factor C, a Lymphangiogenesis Modulator, with Edema Formation, Congestion and Outcomes in Acute Heart Failure
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Gracjan Iwanek, Barbara Ponikowska, Agata Zdanowicz, Marat Fudim, Magdalena Hurkacz, Robert Zymlinski, Piotr Ponikowski, and Jan Biegus
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Cardiology and Cardiovascular Medicine - Published
- 2023
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7. Novel Biomarkers of Renal Dysfunction and Congestion in Heart Failure
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Agata Zdanowicz, Szymon Urban, Barbara Ponikowska, Gracjan Iwanek, Robert Zymliński, Piotr Ponikowski, and Jan Biegus
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Medicine (miscellaneous) - Abstract
Heart failure is a major public health problem and, despite the constantly emerging, new, effective treatments, it remains a leading cause of morbidity and mortality. Reliable tools for early diagnosis and risk stratification are crucial in the management of HF. This explains a growing interest in the development of new biomarkers related to various pathophysiological mechanisms of HF. In the course of this review, we focused on the markers of congestion and renal dysfunction in terms of their interference with cardiovascular homeostasis. Congestion is a hallmark feature of heart failure, contributing to symptoms, morbidity, and hospitalizations of patients with HF and has, therefore, become a therapeutic target in AHF. On the other hand, impaired renal function by altering the volume status contributes to the development and progression of HF and serves as a marker of an adverse clinical outcome. Early detection of congestion and an adequate assessment of renal status are essential for the prompt administration of patient-tailored therapy. This review provides an insight into recent advances in the field of HF biomarkers that could be potentially implemented in diagnosis and risk stratification of patients with HF.
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- 2022
8. Biomarkers of Myocardial Injury and Remodeling in Heart Failure
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Barbara Ponikowska, Gracjan Iwanek, Agata Zdanowicz, Szymon Urban, Robert Zymliński, Piotr Ponikowski, and Jan Biegus
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Medicine (miscellaneous) - Abstract
With its complicated pathophysiology, high incidence and prevalence, heart failure remains a major public concern. In hopes of improving diagnosis, treatment and prognosis, the utility of many different biomarkers is researched vigorously around the world. In this review, biomarkers of myocardial remodeling and fibrosis (galectin-3, soluble isoform of suppression of tumorigenicity 2, matrix metalloproteinases, osteopontin, interleukin-6, syndecan-4, myostatin, procollagen type I C-terminal propeptide, procollagen type III N-terminal propeptide, vascular endothelial growth factor, nitric oxidase synthetase and asymmetric dimethylarginine), myocyte injury (heart-type fatty acid-binding protein, glutathione S-transferase P1 and heat shock protein 60), as well as iron metabolism (ferritin, transferrin saturation, soluble transferrin receptor and hepcidin), are considered in terms of possible clinical applicability and significance. Our short review consists of a summary of the aforementioned cardiovascular biomarkers’ clinical relevance and perspectives.
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- 2022
9. Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high-risk acute heart failure patients
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Piotr Ponikowski, Robert Zymliński, Waldemar Banasiak, Jeffrey M. Testani, Ewa A. Jankowska, Agata Zdanowicz, Jan Biegus, and Dominik Marciniak
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medicine.medical_specialty ,Sodium ,Population ,Urology ,Renal function ,chemistry.chemical_element ,030204 cardiovascular system & hematology ,Natriuresis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,education ,Heart Failure ,education.field_of_study ,business.industry ,Hazard ratio ,Odds ratio ,medicine.disease ,Hospitalization ,chemistry ,Heart failure ,Concomitant ,Acute Disease ,Cardiology and Cardiovascular Medicine ,business ,Glomerular Filtration Rate - Abstract
AIMS In acute heart failure (AHF), assessment of renal function comprises estimation of glomerular filtration rate (eGFR), which does not provide any information about renal sodium/water handling. We describe the interactions between urinary sodium concentration and eGFR to better characterize AHF patients. METHODS AND RESULTS In 219 patients with AHF, spot urine sodium (UNa+ ) and eGFR were assessed on admission, day 1 and day 2 of hospitalization. We found no correlation between UNa+ and eGFR (calculated on each consecutive day, as an average of all three values, and as changes from baseline; all P > 0.05). The population was subsequently divided into four profiles based on eGFR (preserved vs. impaired; cutoff of 60 mL/min/1.73 m2 ) and UNa+ (sodium excreter vs. non-excreter; cutoff of 60 mmol/L). At day 1, there were 70 (31.9%) patients classified as preserved eGFR/sodium excreter, 37 (16.8%) as impaired eGFR/sodium non-excreter, 72 (32.9%) as impaired eGFR/sodium excreter, and 40 (18%) as preserved eGFR/sodium non-excreter. Both sodium non-excreter profiles were associated with an increased risk of in-hospital heart failure worsening [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.3-6.4], inotrope use (OR 2.6, 95% CI 1.1-6.7) and rehospitalization due to AHF (OR 3.2, 95% CI 1.6-6.2; all P
- Published
- 2020
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