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Hypoxia is a recognized inducer of oxidative stress during prolonged physical activity. Nevertheless, previous studies have not systematically examined the effects of normoxia and hypoxia during acute physical exercise. The study is aimed at evaluating the relationship between enzymatic and nonenzymatic antioxidant barrier, total antioxidant/oxidant status, oxidative and nitrosative damage, inflammation, and lysosomal function in different acute exercise protocols under normoxia and hypoxia. Fifteen competitive athletes were recruited for the study. They were subjected to two types of acute cycling exercise with different intensities and durations: graded exercise until exhaustion (GE) and simulated 30 km individual time trial (TT). Both exercise protocols were performed under normoxic and hypoxic ( Fi O 2 = 16.5 % ) conditions. The number of subjects was determined based on our previous experiment, assuming the test power = 0.8 and α = 0.05 . We demonstrated enhanced enzymatic antioxidant systems during hypoxic exercise (GE: ↑ catalase (CAT), ↑ superoxide dismutase; TT: ↑ CAT) with a concomitant decrease in plasma reduced glutathione. In athletes exercising in hypoxia, redox status was shifted in favor of oxidation reactions (GE: ↑ total oxidant status, ↓ redox ratio), leading to increased oxidation/nitration of proteins (GE: ↑ advanced oxidation protein products (AOPP), ↑ ischemia-modified albumin, ↑ 3-nitrotyrosine, ↑ S-nitrosothiols; TT: ↑ AOPP) and lipids (GE: ↑ malondialdehyde). Concentrations of nitric oxide and its metabolites (peroxynitrite) were significantly higher in the plasma of hypoxic exercisers with an associated increase in inflammatory mediators (GE: ↑ myeloperoxidase, ↑ tumor necrosis factor-alpha) and lysosomal exoglycosidase activity (GE: ↑ N-acetyl-β-hexosaminidase, ↑ β-glucuronidase). Our study indicates that even a single intensive exercise session disrupts the antioxidant barrier and leads to increased oxidative and nitrosative damage at the systemic level. High-intensity exercise until exhaustion (GE) alters redox homeostasis more than the less intense exercise (TT, near the anaerobic threshold) of longer duration ( 20.2 ± 1.9 min vs. 61.1 ± 5.4 min—normoxia; 18.0 ± 1.9 min vs. 63.7 ± 3.0 min—hypoxia), while hypoxia significantly exacerbates oxidative stress, inflammation, and lysosomal dysfunction in athletic subjects.

Introduction. This study sought to determine differences in the quarterly age distribution of young Polish volleyball players from the Sports School of the Polish Volleyball Federation (SS PVF), to investigate quarterly differences in anthropometric characteristics and jump test results. Material and Methods. RAE of young players from SS PVF (n = 232) born between 1989 and 2002 was identified in the course of the research. Furthermore, the study included anthropometric characteristics and jump test results (attack jump – AJ). Results. The chi-square test (χ2) revealed the overrepresentation of volleyball players born in quarters 1 and 2, both in the case of graduates (χ2 = 27.32, p < 0.0001) and students who did not finish school (χ2 = 17.95, p < 0.0005). Two-way ANOVA for unbalanced data for the Group factor showed significant differences in the value of estimated marginal means in the case of AJ (F(1,214) = 5.907, p < 0.016) and body mass (BM) (F(1,214) = 5.348, p < 0.022). Conclusions. These results point to the need for better understanding of RAE in order to avoid dropping out or the loss of potential talent, which will contribute to even greater development of volleyball in Poland.

Objectives The COMMENCE trial was conducted to evaluate the safety and effectiveness of an aortic bioprosthesis with novel RESILIA tissue (Edwards Lifesciences, Irvine, Calif). Reports of early noncalcific valve failure resulting from thrombosis or leaflet tears in other valves warrant careful evaluation of early valve performance. Methods Patients underwent clinically indicated surgical aortic valve replacement with the Edwards Pericardial Aortic Bioprosthesis, Model 11000A (Edwards Lifesciences) in a prospective, multinational, multicenter (n = 27), single-arm, Food and Drug Administration Investigational Device Exemption trial. Events were adjudicated by an independent clinical events committee; echocardiograms were analyzed by an independent core laboratory. Results Between January 2013 and March 2016, 689 patients received the study valve. Mean age was 67.0 ± 11.6 years. Mean Society of Thoracic Surgeons predicted risk of mortality was 2.0% ± 1.8%. Follow-up duration was 3.7 ± 1.2 years, with a total of 2533 patient years of follow-up and a median follow-up of 4 years. Early all-cause mortality was 1.2%, thromboembolism 2.3%, all bleeding 1.0%, and major paravalvular leak 0.1%. One- and 4-year actuarial freedom from all-cause mortality was 97.7% (95% confidence interval, 96.5%-98.8%) and 91.9% (95% confidence interval, 89.7%-94.1%), respectively. At 4 years, New York Heart Association functional class improved compared with baseline in 63.0%, effective orifice area was 1.5 ± 0.5 cm2, and mean gradient was 11.0 ± 5.6 mm Hg. Freedom from moderate or greater transvalvular insufficiency was 99.7%. There were no events of structural valve deterioration. Conclusions Safety and hemodynamic performance of this aortic bioprosthesis with RESILIA tissue at 4 years are favorable. This novel tissue does not appear to result in unexpected early thrombosis events or noncalcific structural valve deterioration.

The high-voltage LiNi0.5Mn1.5O4 (LNMO) spinel cathode material offers high energy density storage capabilities without the use of costly Co that is prevalent in other Li ion battery chemistries (e.g., LiNixMnyCozO2 (NMC)). Unfortunately, LNMO-containing batteries suffer from poor cycling performance due the intrinsically coupled processes of electrolyte oxidation and transition metal dissolution that occurs at high voltage. In this work, we use operando electron paramagnetic resonance (EPR) spectroscopy and nuclear magnetic resonance (NMR) spectroscopy to demonstrate that transition metal dissolution in LNMO is tightly coupled to HF formation (and thus, electrolyte oxidation reactions as detected with operando and in situ solution NMR), indicative of an acid-driven disproportionation reaction that occurs during delithiation (i.e., battery charging). X-ray photoelectron emission microscopy (XPEEM) provided surface sensitive and localized X-ray absorption spectroscopy (XAS) measurements that indicate that disproportionation is enabled by surface reconstruction that occurs upon charging that leads to surface Mn3+ sites on the LNMO particle surface that can disproportionate into Mn2+(dissolved) and Mn4+(s). During discharge of the battery, we observe high quantities of metal fluorides (particularly rich in MnF2) deposit in the CEI layer on the LNMO particles as well as the conductive carbon additives on the composite surface. Electronic conductivity measurements indicate that the MnF2 decreases film conductivity by 3-fold compared to LiF, suggesting that this CEI may impede both the ionic and electronic properties of the cathode. Our data indicate that in order to prevent transition metal dissolution and the associated side reactions in spinel-type cathodes (particularly those that operate at high voltage like LNMO), the use of electrolytes that offer improved anodic stability and prevent acid byproducts will be necessary.

Research related to motor skill learning has provided an important insight into which instructional methods are effective. Recent research has shown that the combination of autonomy and external focus of attention may benefit learning outcomes; however, there is not enough strong evidence in this respect. The study sought to examine effects of attentional focus instructions and combined effects of autonomy (choice) and external focus of attention on the learning of a standing korfball shot. One hundred and seven postgraduate students of physical education (40 females and 67 males, age = 22.57) took part in the study. They were randomly assigned to one of four practice groups: external focus (E), internal focus (I), self-regulated (S) and self-regulated external (SE). During the acquisition phase, all participants completed a total of 150 trials, with 50 trials (5 sets x 10 repetitions) completed during each session. The results of the between-group comparison for shooting accuracy demonstrated no significant differences. The present findings suggest that external focus of attention benefits motor learning and performance. We did not reveal additive advantages for motor learning when comparing combined effects of external focus and autonomy support with each of these conditions administered separately.

A great number of studies focusing on the effects of dry-land resistance training interventions on swimming performance remain inconclusive. It is suggested that transferability of dry-land strength gains to swimming performance appear when dry-land resistance training programs are swim-specific. The main aim of this study was to compare the effects of specific dry-land resistance training on an ergometer with traditional dry-land exercises, and to determine how much of the resistance training effects were transferred to specific swimming conditions. The study included a group of 26 youth competitive male swimmers (age 15.7 ± 0.5 years, height 174.6 ± 6.6 cm, weight 68.4 ± 8.2 kg, training experience 5.8±0.7 years) of regional level. They were randomly allocated to one of two groups: experimental (E) and control (T). Both groups were involved in a 12-week dry-land resistance training concentrated on increasing muscular strength and power output of the upper limbs. Group E used a specialized ergometer (JBA – Zbigniew Staniak), while group T performed traditional resistance exercises. The program consisted of 10 sets of 30 s of exercise with 30 s rest intervals between each set. A two-way repeated measures ANOVA with Tukey HSD post hoc comparisons was used to determine if any significant differences existed between training groups across pretest and posttest conditions. The significance level was set at p ≤ 0.05. Dry-land resistance training modalities were the only differences in training between both groups. Our findings show that rates of transfer are much higher in group E than in group T, which resulted in a significant increase in swimming velocity (by 4.32%, p

The purpose of this study was to determine the effect of training of one side of the body on the muscle torques and power output on the trained and untrained side. Seventeen female and twenty-two male students were subject to a four-week knee joint power training regimen on a specially designed stand. The subjects were divided into two groups: a training group (female – N = 11 and male – N = 16) and a control group (female – N = 6 and male – N = 6). Effectiveness of power training on the stand described previously was estimated based on bilateral knee torque and power under static and isokinetic conditions. The experiment lasted for 39 days and was preceded by preliminary studies (pre-training). Control measurements in training groups were made after four weeks of training (post-training) and after the next two weeks (de-training). Power training caused an insignificant increase in force and power in both groups for the untrained leg and a significant increase in RMS EMG. Therefore, the study confirmed the hypothesis that resistance training performed in dynamic conditions can affect the contralateral limb and may also trigger delayed adaptations to training conditions during the detraining phase. Sex differences in adaptation to power training are not clear; however, the differences in gains in contralateral effects between men and women were not confirmed.

The purpose of the study was to analyze the variability of performance and kinematics of different shot put techniques in elite athletes (group A: 5 athletes using the rotational technique and 3 athletes using the glide technique) and sub-elite athletes (group B: 3 athletes using the rotational technique and 3 athletes using the glide technique). Each athlete performed 6 trials. Only 34 trials in group A and 27 trials in group B were analyzed. Two high-speed digital cameras were positioned 8 m from the center of the shot put throwing circle. All throws performed during international and national competitions were analyzed using the Ariel Performance Analysis System. To estimate variability of kinematic parameters, the value of relative error was calculated. The average relative error generally showed low variability for the analyzed indicators. In only 4 analyzed cases, variability was high (>20%). Statistical analysis was used to find indicators which have a significant influence on the distance of the throw (according to the sports level and technique). Significant inverse correlations (at p < 0.05) between the distance and the average relative error of the selected indicators were mainly obtained, which meant that the distance was longer when the value of variability (average relative error) was low. The research results show that greater repeatability of the technique (lower RE) has a significant impact on the length of the shot put.

The aim of this study was to identify biomechanical factors affecting successful and unsuccessful snatch attempts in elite female weightlifters during the 2013 World Weightlifting Championships. Fourteen female competitors took part in this study. Their successful and unsuccessful snatch lifts with the same load were recorded with 2 camcorders (50 Hz), and selected points were digitized manually on to the body and the barbell using the Ariel Performance Analysis System. The kinetic and kinematic barbell movement as well as the athlete’s body movement variables during the liftoff phase were examined. The results of this study show statistical differences (p ≤ 0.05) between successful and unsuccessful attempts in relation to the angle values in the knee and hip joints in preparation for the aerial phase position. Similarly, the center of gravity velocity was significantly higher in successful attempts during the catch phase. Thus, coaches should pay particular attention to the accuracy of the execution in preparation for the aerial phase position and to the velocity of the center of gravity of the competitors during the catch phase.

The aim of the study was to evaluate whether the most common polymorphisms in the IL-6 and HSP70 genes affect the circulating heat shock protein 70 (HSP70), as well as inflammatory and prooxidant-antioxidant parameters in healthy men undergoing chronic endurance training. The subjects were randomly assigned to a 12-week swimming training (ST group) or control group (CON). Fasting blood samples were collected pre- and post-study period to assessment: superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, serum levels of lipid hydroperoxides (LHs), tumor necrosis factor α (TNFα), and HSP70. Subjects were genotyped for IL-6-174G/C, HSPA1A + 190 G/C and HSPA1B + 1538 A/G single nucleotide polymorphisms (SNPs) by real-time PCR. After a 12-week study period, a decrease in TNFα, HSP70, and GPx was observed in the ST group, but not the CON group. IL-6 SNP affected serum TNFα levels (main effect of genotype). Higher TNFα levels (pre- and post-study period) was observed in CC CON than in other IL-6 genotypes of CON and ST groups. However, a post-training decrease in TNFα was observed in both GG and CC IL-6 genotypes of ST group. In turn, only GG IL-6 genotype of the ST group was related to a post-training decrease in HSP70 (main time and genotype interaction). Moreover, pre- and post-training LHs were lower in GG than GC/CC HSPA1A genotypes of the ST group (main genotype effect). In conclusion, polymorphisms within the IL-6 and HSPA1A genes seem to affect baseline levels of some inflammatory parameters and prooxidant-antioxidant status and/or their changes after chronic swimming training. However, the results should be confirmed in a study with a larger sample size, one that includes individuals with sedentary lifestyles.

Aims. A major clinical concern is the continuous increase in the number of patients diagnosed with advanced coronary artery disease, ischemic heart failure, and refractory angina, and one of the most promising treatment options for these conditions is stem cell-based therapy. The aim of this study was to assess the functional improvement following intramyocardial injection of adipose-derived stromal cells, using cardiac magnetic resonance. Methods and Results. Thirteen patients with ischemic heart failure, reduced left ventricular ejection fraction, refractory angina, and who have been disqualified from any form of direct revascularization were enrolled in the study with transthoracic autologous adipose-derived stromal cell implantation. All patients underwent cardiac magnetic resonance prior to the procedure and after 12 months of follow-up. A significant increase in stroke volume ( 83.1 ± 8.5 mL vs 93.8 ± 13.8 mL , p = 0.025 ) and stroke volume index ( 43.3 ± 7.6 mL / m 2 vs 48.7 ± 9.1 mL / m 2 , p = 0.019 ), a statistical trend toward an increase in left ventricle ejection fraction ( 36.7 ± 13.2 vs 39.7 ± 14.9 , p = 0.052 ), and cardiac output improvement ( 5.0 ± 0.7 vs 5.5 ± 0.9 , p = 0.073 ) was observed in the patient postprocedure. Enhanced relative regional thickening was noted in the segments with adipose-derived stromal cell implantation. Conclusions. Intramyocardial adipose-derived stromal cell implantation is a promising therapeutic option for selected, symptomatic patients with ischemic heart failure, who have preserved myocardial viability despite being unsuitable for direct revascularization.

The purpose of the present study was to examine the effectiveness of learning a complex gymnastic routine with different frequencies of model demonstration controlled by the experimenter or self-controlled by learners. Fifty undergraduate physical education (PE) students were randomly assigned to 5 training groups: GF100 (100% frequency), GF20 (20% frequency), GFF (faded frequency), GSF (self-controlled frequency) and GYF (yoked group). All five groups followed the same experimental design, with one difference: groups GF100, GF20 and GFF observed model demonstration under externally controlled frequency, whereas group GSF self-controlled that condition. Participants were asked to perform a complex gymnastic routine (maximum vertical jump) with swinging the arms forwards and upwards, pulling the knees up to the chest while grabbing the shins followed by a half-squat landing with arms extended sidewards. During the acquisition phase, all the participants completed a total of 150 trials, with 15 trials completed in three blocks during each of the ten practice sessions. In the present study, we used expert ratings based on the FIG-COP to evaluate movement quality. For each trial, three gymnastic judges assessed the performance. To assess the differences between the five groups, a repeated measures ANOVA was conducted on the last factor for retention and transfer (Group x Test) and practice (Group x Practice). Partial eta squared (ηp2) effect sizes were calculated for multiple comparisons and Cohen’s d effect sizes were calculated for pairwise comparisons. Post-hoc Fisher’s LSD test was used for pairwise comparison. No significant Group x Test interaction or Group main effect was found, indicating that no group performed better than another in retention immediate, delayed and transfer tests. For each group, a significant improvement compared to baseline was observed in the retention and transfer tests (d > 0.8). The most important finding from the current study was that groups under self-controlled and experimenter-controlled frequency of model observing appeared similarly effective in learning a complex gymnastic routine. No significant differences were observed between the five groups in retention and transfer tests.

Introduction Transapical access (TA) transcatheter aortic valve implantation (TAVI) (TA-TAVI) represents one of the possible routes in patients with severe aortic stenosis (AS) who are not suitable for transfemoral access. Aim To assess early- and mid-term clinical outcomes after TA-TAVI. Material and methods Patients with severe symptomatic AS undergoing TA-TAVI from November 2008 to December 2019 were enrolled. Clinical and procedural characteristics as well as clinical outcomes including all-cause mortality during 12-month follow-up were assessed. Results Sixty-one consecutive patients underwent TA-TAVI for native AS. Patients were elderly with median age of 80.0 (76.0-84.0) years; 55.7% were males. Median baseline EuroSCORE I and STS scores were 18.2% (11.6-27.7) and 4.8% (3.3-8.2), respectively. The procedural success rate was 96.7%. In-hospital, 30-day and 12-month mortality rates were 9.8%; 18.0% and 24.6%, respectively. The main periprocedural and in-hospital complications were bleeding complications (14.8%). The following factors were associated with 12-month mortality: previous cerebrovascular event (CVE), glomerular filtration rate (GFR), aortic valve area (AVA), right ventricular systolic pressure (RVSP) and serum level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (RR for CVE 3.17, 95% confidence interval (CI): 1.15-8.76: p = 0.026; RR for AVA per 0.1 cm2 1.28, 95% CI: 1.03-1.55: p = 0.024; RR for GFR per 1 ml/min 0.96: 95% CI: 0.94-0.99: p = 0.007; RR for NT-proBNP per 1000 pg/ml 1.07: 95% CI: 1.01-1.17: p = 0.033; RR for RVSP per 1 mm Hg 1.07: 95% CI 1.02-1.16: p = 0.011). Conclusions Transapical TAVI in high-risk patients provides good hemodynamic results with acceptable outcomes.

Identification of success factors in wrestling as well as establishing their hierarchy are crucial from a cognitive and practical standpoint. It may provide a lot of practical recommendations related to wrestling-specific training. The aim of this study was to identify and establish the hierarchy of success factors in wrestling regardless of a fighting style and weight class. This study included 168 elite male freestyle and Greco-Roman wrestlers. They were divided into two groups: athletes who won medals (successful wrestlers) in high-rank competitions (Polish Championships or higher) and those who did not win any medals (less successful wrestlers) in those competitions. The following elements were assessed: anthropological measurements, body composition, dynamic strength, strength endurance, agility, special endurance, wrestling-specific fitness, response time, technical wrestling skills and anaerobic capacity. For initial data analysis, one-way ANOVA (α = 0.005) was used. Random Forests classifier was employed to identify success factors and to determine the importance of each of these factors in terms of sports performance. Seven key success factors were identified: anaerobic power, strength endurance, response time, special endurance, wrestling-specific fitness and technical wrestling skills performed in a horizontal position. Random Forests turned out to be an effective method of modelling success in wrestling (compared to SVM and KNN, which were also used in the study). These findings suggest that wrestling-specific training can be effectively monitored by controlling several vital indicators of athletes’ preparedness: anaerobic power, strength endurance, response time, special endurance, wrestling-specific fitness and technical wrestling skills (the performance of reverse waistlock from a standing position and trunk grip gut wrench assessed by experts).

BACKGROUND: In middle-aged patients undergoing aortic valve replacement (AVR), the selection of prosthesis type is a complex process. Current guidelines do not unequivocally indicate the type of prosthesis (bioprosthetic or mechanical) recommended for patients between 60–70 years of age. The aim of the study was to present the trends in AVR prosthesis selection in borderline patients over a 10-year period, based on real-life registry data. METHODS: The study population comprised of 9,616 consecutive patients aged between 60–70 years, who underwent isolated AVR between 2006 and 2016 in all cardiac surgery departments in Poland. Data were extracted from the Polish National Registry of Cardiac Surgery. RESULTS: Among 27,797 consecutive AVR procedures, patients aged 60–70 years represented 34.6% of the population operated on. From 2006 to 2016, bioprosthetic valves (BVs) were implanted in 53.9% cases, (and) mechanical valves (MVs) in 42.1%. The proportion of different valve types changed in time: from 77.5% of MVs vs. 22.5% of BVs in 2006 to 23.2% of MVs vs. 76.8% of BVs in 2016 (P

Patients with severe heart failure (HF), who are not eligible for cardiac transplantation and receive optimal medical management, based mainly on the use of pharmacological treatment and devices such as resynchronization therapy (implantable cardioverter-defibrillator), achieve poor clinical outcomes and constitute a group with extremely poor prognosis. Currently, the technology used in the latest generation left ventricular assist devices (LVADs), such as the HeartMate 3, makes it possible to achieve patient survival at the level obtained by patients after heart transplantation, and they can be used not only in patients eligible for heart transplantation as a bridge to transplant, but also in those with significantly worse prognosis, who are ineligible for heart transplantation as destination therapy. The objective of this publication is to present recommendations from experts in cardiology and cardiac surgery, supported by clinical trial results, on the use of LVADs as a destination therapy in HF patients who are not eligible for cardiac transplantation. The paper also presents the issue of cardiac transplantation and extracorporeal membrane oxygenation therapy in Poland, as well as current challenges faced by interventional cardiology and cardiac surgery in Poland.

Gierczuk, D, Bujak, Z, Cieślinski, I, Lyakh, V, and Sadowski, J. Response time and effectiveness in elite Greco-Roman wrestlers under simulated fight conditions. J Strength Cond Res 32(12): 3442-3449, 2018-The purpose of the study was to determine changes in response time and its correlations with tactical and technical actions performed by Greco-Roman wrestlers in a fight. Twenty wrestlers aged 19-25 (21.4 (Equation is included in full-text article.)1.8) years were divided into 2 groups, i.e., finalists of Polish Senior Championships (winners of 1st and 2nd places) and wrestlers who won 3rd-6th places in those competitions. The subjects from 1 group were individually paired with the wrestlers from the other group according to the same weight class. Response time before a fight and during the intervals between the 3 rounds was assessed. Batak Lite (test IV) was used in the study. The Polar M400 watch was used to register heart rate. Response time changed during a fight. The finalists showed significantly quicker reaction and performed a higher number of technical and tactical actions. The differences grew in the course of a fight, and the largest ones were observed during the third round. The strongest correlations were noted between response time and the number of technical and tactical actions performed during the third round (r = 0.77, p < 0.001). Response time is a significant determinant of wrestlers' results, which can be observed at submaximal intensity of the effort (176-195 b·min) during a fight.

Purpose: The objective of this study was to investigate the effects of chronic Rhodiola rosea (R. rosea) supplementation on mental and physical performance, as well as hormonal and oxidative stress biomarkers. Methods: Twenty-six healthy male students received either R. rosea extract (600 mg/day; RR) or placebo (PL) in a randomized double-blind trial. Prior to supplementation (Term I) and following 4 weeks of supplementation (Term II), the students underwent psychomotor tests for simple and choice reaction time, included in the Vienna Test System. Also, the subjects performed VO2peak test. Blood samples were obtained before and after the test to measure the hormonal profile (cortisol, testosterone, and growth hormone), as well as the biomarkers of oxidative stress (lipid hydroperoxides, total antioxidant capacity, and superoxide dismutase) and muscle damage (creatine kinase). Results: R. rosea ingestion shortened reaction time and total response time. Moreover, a greater relative increase in the number of correct responses was observed in RR group as compared to the PL group. No changes in endurance exercise capacity and hormonal profile were observed after R. rosea ingestion. R. rosea ingestion raised plasma total antioxidant capacity. It did not, however, affect other measured parameters. Conclusion: Chronic R. rosea ingestion does not affect physical performance, but can improve the results of some psychomotor tests (simple and choice reaction time) in young, healthy, and physically active men. The improvements in mental performance, however, at least in our study, seem not to be related to changes in cortisol release or antioxidant activity of R. rosea extract. Thus, the specific mechanisms responsible for these effects still need to be elucidated. Keywords: Cortisol, Endurance capacity, Incremental exercise, Men, Oxidative stress, Simple and choice reaction time, Testosterone

Introduction . The aim of the study was to determine the changes in the peak torque of the knee extensors and flexors of the dominant lower limb, the shoulder internal and external rotators of the dominant upper limb, and the shoulder extensors and flexors of the dominant upper limb as well as the changes in jump height in volleyball players during the annual training macrocycle. Material and methods . The study involved 13 volleyball players from a Polish second-league team. The measurements were performed five times: before the preparation period (T1), at the beginning of the competitive season (T2), in the middle (T3) and at the end of the first competition period (T4), and after the competitive season (T5). The torque of the knee muscles and shoulder rotators was measured in isokinetic conditions, and the torque of the shoulder extensors and flexors was assessed in isometric conditions. Jumping ability was tested using a piezoelectric platform. Results . We observed statistically significant differences (p < 0.05) in jump height and relative peak torque between the measurements, except for the torque of the shoulder external rotators and flexors. The results of multiple factor analysis based on 5 sets composed of 5 strength variables revealed differences between subjects and measurement sessions. Conclusions . The results obtained indicate that strength and jumping ability should be assessed regularly during the competitive season. The findings of the study suggest that it is necessary to modify the training methods used during the preparation period and individualize the training in the final phase of the competition period.

Background : Arterial hypertension is one of the most common chronic disease in the Western World, affecting more than 25% of adult population. Aim: The aim of this study was to assess changes in arterial blood pressure (BP) levels in hypertensive patients, after ablation of nerve terminals in renal arteries using radiofrequency energy during 24 months follow-up. Methods and Results: Thirty two patients with diagnosed resistant hypertension (20 men and 12 women) underwent percutaneous catheter-based renal denervation of nerve terminals in renal arteries wall. Mean blood pressure value before ablation was [mmHg]: systolic 174.92, diastolic 99.73 and pulse pressure 75.19. After procedure reduction value of blood pressure was reported [mmHg]: systolic 146.78; diastolic 87.14, pulse pressure 59.64 in 24 months follow-up (p

Background: The durability of bioprosthetic heart valves is limited by structural valve deterioration (SVD) due to long-term calcification. A novel bioprosthetic tissue (RESILIA TM ) has been developed which, in preclinical studies, has shown reduced calcification. The purpose of this study was to evaluate the intermediate-term clinical outcomes and hemodynamic performance of this tissue. Methods: A prospective, single-arm, observational trial was conducted in patients who required surgical aortic valve replacement (AVR). Between July 2011 and February 2013, 133 patients were implanted at two sites in Poland. Hemodynamic performance and clinical outcomes were assessed annually through 4 years of follow-up. All safety events were adjudicated by an independent Clinical Events Committee, and echocardiographic data were evaluated by a core laboratory. Results: Patients were 65.3±13.5 years old and 26% were ≤60 years old. The average follow-up was 3.8±1.1 (median: 4.1; IQR, 4.0–4.3) years. Early (≤30 day) and late (>30 day) all-cause mortality rates were 2.3% (n=3) and 3.2% late patient-years (n=16), respectively. There were no cases of early or late SVD. There was one early case of major paravalvular leak (0.8%), and no late cases. At 4 years, the mean gradient was 14.5± 7.4 mmHg and the effective orifice area was 1.6±0.4 cm 2 , both markedly improved from baseline. At 4 years, the New York Heart Association functional class had improved from baseline in 54.5% of patients. Conclusions: The aortic bioprosthesis with novel RESILIATM tissue demonstrated excellent hemodynamic performance and safety outcomes over 4 years. Longer follow-up will be important to confirm the durability of this bioprosthesis.

Background: Valve prosthesis selection in aortic valve replacement (AVR) is particularly difficult in middle‑aged patients (60–70 years old). Aims: We described changes in trends and outcomes of AVR in middle‑aged patients over the last 10 years, based on the real‑life single‑center data from the Polish National Registry. Methods: A total of 4912 consecutive adult patients who underwent any type of isolated aortic valve surgery between 2006 to 2016 were included. The main outcome measures were changes in the number of procedures, characteristics, surgical details, and in‑hospital mortality. Results: Out of all 4912 AVR procedures performed, 1531 patients (31.2%) were between 60 and 70 years of age. The share of aortic valve prosthesis in the overall number of replacements changed between 2006 and 2016 for mechanical valves (MV) from 98.3% to 15.2% and for biological valves (BV) from 0% to 81.8% (P < 0.001 for both comparisons). In the BV group, stented valves were implanted in 92.6%. The most common MV was the St. Jude Medical Mechanical Heart Valve (St. Jude Medical, Saint Paul, Minnesota, United States) and most common BV was the Carpentier‑Edwards Perimount Magna (Edwards Lifesciences, Irvine, California, United States). The most common prosthesis size was 23 mm. There were no significant differences in body mass index and comorbidities between the patients with MV and BV. The overall in‑hospital mortality was 3.46% (3.33% in the MV group and 3.69% in the BV group; P = 0.85). Conclusions: In the last 10 years, one‑third of aortic valve replacements were performed in patients between 60 and 70 years of age. We observed rapidly changing trends in the type of implanted valve prostheses.

Surgical ablation for atrial fibrillation (AF) performed at the time of other valvular- or nonvalvular cardiac procedure is a mainstay of therapy; yet the data regarding its influence on remote survival are sparse. We aimed to evaluate late survival in patients undergoing mitral valve (MV) surgery with concomitant surgical ablation for AF.Procedure-related data from the Polish National Registry of Cardiac Surgery Procedures (Krajowy Rejestr Operacji Kardiochirurgicznych) were retrospectively collected. A total of 11,381 patients with baseline AF (46.6% men; mean age 65.6 ± 9.0 years) undergoing MV surgery between 2006 and 2017 in 37 reference centers across Poland and included in the registry were analyzed. Median follow-up was 5 years (mean, 4.6 years; interquartile range, 1.9-7.9 years). Cox proportional hazards models were used for computations. Propensity score matching for the comparison of MV + ablation versus MV alone was performed.Of included patients, 2449 (21.5%) underwent surgical ablation for AF. Patients in this group were significantly younger (63.8 ± 8.7 years vs 66.1 ± 9.0 years; P .001) and were at lower baseline surgical risk (EuroSCORE, 2.86 vs 3.69; P .001). During the 12-year study period, there was a significant survival benefit (hazard ratio, 0.71; 95% confidence interval, 0.63-0.79; P .001) for MV + ablation compared with MV alone. After rigorous propensity matching (logit model, 1784 pairs) surgical ablation was associated with nearly 20% improved survival (hazard ratio, 0.82; 95% confidence interval, 0.70-0.96; P = .011). Benefit of surgical ablation was maintained in subgroup analyses, yet most benefit was appraised in low-risk patients such as those with EuroSCORE of 2 to 5 or age 50 years.Concomitant surgical ablation for AF in patients undergoing mitral valve procedures is safe, feasible, and significantly improves late survival.

Background Aortic valve replacement (AVR) is one of the most common surgeries performed in cardiac surgery operating rooms. We present actual, real life trends from the last 10 years for AVR interventions based on a multicentre National Registry of Cardiac Surgery Database. Methods The study population consisted of all 50,846 consecutive adult patients who underwent AVR between January 2006 and August 2016 in all cardiac surgery units in Poland. The main outcome measures were changes in the number of valves, characteristics of valves, operative details, and in-hospital mortality. Analysis consisted of all aortic valve (AV) procedures, including isolated AV surgery, combination procedures and patients who had a prior valve operation. Results In last 10 years, the number of procedures increased by 46%. Isolated surgical AVR was performed in 61.2%, AVR + coronary artery bypass grafting (CABG) in 23.9%, AVR + mitral valve replacement (MVR) in 7%, and transcatheter aortic valve implantation (TAVI) in 2.3% of patients. The mean patient age increased significantly from 61.4 years in 2006 to 66.1 years in 2016. Aortic stenosis was diagnosed in 73.4%, severe aortic insufficiency in 15.8% of cases. The most common valve pathology was calcification. Congenital valve dysfunction was diagnosed in 3.7% of cases. There was a 33.7% increase of bioprosthesis, and the most common implanted bioprosthesis was the Hancock II. The most common implanted mechanical prosthesis was the St. Jude Medical Mechanical Valve. In-hospital mortality decreased significantly over the 10-year period in all AV procedures from 10.9% in 2006 to 8.3% in 2016. Mean in-hospital mortality was: 4.0% in isolated surgical AVR, 5.4% in TAVI, 6.8% in AVR + CABG, 9.8% in AVR + MVR, 17.2% in AVR + MVR + CABG. Conclusions In the last ten years, the number of AV procedure has doubled. Mortality was significantly lower with all types of AV procedure despite very rapid aging of AVR patients. TAVI procedure rapidly grew in popularity. There is significant increase in the use of bioprosthesis.

BACKGROUND Left atrial appendage closure (LAAC) with LARIAT has emerged as one of the alternatives to oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (AF). Our aim was to study long-term outcomes in patients undergoing LARIAT procedure. METHODS We analyzed patients screened for LARIAT device in four centers between December 2009 and June 2012. Out of these, patients who didn't undergo LAAC with the LARIAT device due to unfavorable LAA morphology and other preprocedural contraindications were included in control group. We analyzed thromboembolism, bleeding events, and mortality between LAA and control group. RESULTS About 153 patients were screened. Out of these, 108 (70.6%) patients underwent LARIAT placement (LAA arm) and 45 (29.4%) excluded patients were included in control arm. There were no differences in CHADS2 and CHA2 DS2 -VASc score. Mean HAS-BLED score was significantly higher in the LARIAT group (3.5 ± 1.06 vs 3.09 ± 1.22, P = .04). Mean follow-up time (in years) was 6.56 ± 0.84 in LAA and 6.5 ± 1.26 in control arm. During follow-up period, the LARIAT group was associated with significantly less thromboembolic events (1.9% vs 24%, P

Background: Patients after cardiac surgery are particularly at risk of infections. The oral cavity is a potential source of bacteria. Aim: To assess of influence of incomplete oral sanation on the probability of occurrence of infection in the postoperative period. Methods: The study subjects (n = 240) were patients undergoing cardiac surgery, with (n = 185) and without (n = 55) complete oral sanation. Complete oral sanation — patients had treated and eradicated all potential inflammatory foci in the oral cavity. Dental treatment: conservative dental treatment (70%), endodontic treatment (30%), and surgical dental treatment (85%), depending on treatment needs. Results: Patients with incomplete oral cavity sanation had more infections (7.27% vs. 1.62%, p = 0.062) in the postoperative period. The risk of infection was six times higher compared to the patients with complete sanation (p = 0.042), which correlated with higher level of leucocytosis in the early postoperative period (10.11 vs. 10.96 × 103/μL, p = 0.059). Conclusions: Incomplete oral sanation is associated with higher levels of leucocytosis and greater risk of infection in the early postoperative period.

Background and aim: The assessment of percutaneous renal sympathetic denervation (RDN) efficacy in patients with true-resistant hypertension (true-RH) in a newly established net of Polish centres (RDN-POL Registry). Methods and results: Forty-four patients with true-RH (23 men, mean age 52.3 years) with daytime systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) ≥ 135 mm Hg, on ≥ three antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up. Mean reductions of office SBP/diastolic blood pressure were –23.8/–10.0, –12.5/–4.6, and –12.6/–6.1 mm Hg at 3, 6, and 12 months, respectively (all significant except diastolic at 6 months). Diabetes was the only predictor of office SBP reduction at 6 months (OR 9.6, 95% CI 1.4–66.5, p < 0.05). Mean 24-h SBP change was –8.3 mm Hg at 6 months and –4.6 mm Hg at 12 months. Increased 2 h-glucose in oral glucose tolerance test was the only predictor of 24-h SBP reduction at 6 months (OR 1.24 for 10 mg/dL glucose increase, 95% CI 1.04–1.48, p < 0.05). At 12 months, 24-h SBP change predictors were: baseline office SBP (OR 4.93 for 10 mm Hg SBP increment, 95% CI 1.01–24.1, p < 0.05) and 2 h-glucose (OR 1.47, 95% CI 1.08–2.00, p < 0.05). In ABPM responders, significant reduction of 2 h glucose was found as compared to the non-responders (–45.8 vs. –7.7 mg/dL, p < 0.005). Conclusions: The RDN-POL Registry demonstrated moderate blood pressure decrease after RDN. The predictors of blood pressure reduction were diabetes, 2 h-glucose, and baseline office SBP. Analysis of ABPM responders indicates a probable positive impact of RDN on glycaemic control.

Introduction. Many studies have compared different backpack designs and their influence on the carrier; however, no data referring to school students aged 7-8 years are currently available. Therefore, the aim of the research was to assess the influence of backpack design on centre of pressure (COP) displacement and plantar force distribution in children during an upright stance. Material and methods. Nineteen school students (9 males and 10 females) volunteered for the study. Two Polish backpacks intended for school use were evaluated: backpack A, which had two main compartments, and backpack B, which had one main compartment. The backpack load was composed of books, binders, and regular school equipment. During the measurements, the subjects were asked to look ahead with the head straight and arms at the sides in a comfortable position and to stand barefoot on the F-Scan® sensors (Tekscan, F-Scan®) attached to the force platform (Kistler), carrying a load corresponding to 10% of their body mass. Results. The study found insignificant differences between the two backpack designs. Moreover, COP parameters increased significantly during an upright stance while carrying backpack B in comparison to the empty backpack condition. Additionally, we observed significantly higher values of plantar force distribution in the heel region for the condition without load and insignificantly higher ones for carrying backpack A. Conclusions. The results of the current study suggest that the differences between the two backpack designs are too marginal to be detected through COP displacement. Disturbances in plantar force distribution suggest a lack of posture control and a lower stability of the standing position with a backpack, but these disturbances were significant only when the backpack with one main compartment was used.