Aortic stenosis is the most common cause of valve replacement in Europe and North America with prevalence increasing with age. Transcatheter valve replacement (TAVR) represents an alternative for surgical valve replacement of severely stenotic valves. Despite lower risk of acute kidney injury compared to that associated with surgery, this complication remains prevalent in patients undergoing TAVR. There is a paucity of data confirming the relation of acute kidney injury with high morbidity and mortality, especially when superimposed on chronic kidney disease, which is a frequent comorbidity in the elderly with severe aortic stenosis. As there is no consensus on the prevention of acute kidney injury in patients undergoing TAVR, identification and limitation of risk factors are crucial. In this review, we aim to discuss the key aspects of acute kidney injury diagnosis, risk assessment, and outcomes in TAVR patients, and to point out gaps in current knowledge.

These are the first in man data demonstrating relation between changes in cognition and β2M. The phenomenon was reversible which indicates its therapeutic potential.

Heart failure (HF) is a common disease that causes significant limitations on the organism’s capacity and, in extreme cases, leads to death. Clinically, iron deficiency (ID) plays an essential role in heart failure by deteriorating the patient’s condition and is a prognostic marker indicating poor clinical outcomes. Therefore, in HF patients, supplementation of iron is recommended. However, iron treatment may cause adverse effects by increasing iron-related apoptosis and the production of oxygen radicals, which may cause additional heart damage. Furthermore, many knowledge gaps exist regarding the complex interplay between iron deficiency and heart failure. Here, we describe the current, comprehensive knowledge about the role of the proteins involved in iron metabolism. We will focus on the molecular and clinical aspects of iron deficiency in HF. We believe that summarizing the new advances in the translational and clinical research regarding iron deficiency in heart failure should broaden clinicians’ awareness of this comorbidity.

Introduction The data about use of venoarterial ECMO as a temporary circulatory support system in cardiogenic shock (CS) for Central Europe are scarce. Objectives The aim was to disclose the indications, in-hospital and long-term (1 year) mortality along with risk factors. Patients and methods The study is a retrospective investigation of patients who underwent VA ECMO support for the CS in the cardiac and cardiosurgical tertiary centre, from January 2013 to June 2018. We tested a broad spectrum of pre– and post-implantation factors along with their impact on mortality using univariate logistic regression analysis. Results 198 patients met the inclusion criteria. The median duration of support was 207 (IQR 91–339) hours, with no significant disparity in the length of support among hospital survivors and nonsurvivors (p=0.09). 40,4% of all patients deceased during ECMO support, while the joined in-hospital and six-month mortality progressed to 65,2% and one-year mortality to 67,2%. 9% underwent subsequent heart transplantation. The most frequent adverse events were bleeding (76%), infection (56%), neurologic injury (15%) and limb ischemia (15%). Multi-organ failure was identified as the most decisive risk factor of in-hospital mortality (OR 4,45, p<0,001). Patients with postcardiotomy cardiogenic shock had a significantly lower out-of-hospital survival rate than those with decompensated heart failure (32,3% vs 45%, log-rank p=0,037). The learning curve of our centre is noted with the lowest survival in the first two years of ECMO employment in comparison to the following 6-year period. Conclusion The outcomes of the study reinforce the clear survival benefit, despite frequent complications. The protocol focusing on proper candidate selection and timing can positively impact patients survival. The additional risk reduction can be achieved with the further increase of the team experience with ECMO. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National Institute of Cardiology in Warsaw, Poland - research grant. Figure 1 Figure 2

Background Heart failure (HF) is the leading cause of death and hospitalization in developed countries. Most of the information about HF is based on selected cohorts, the real epidemiology of HF is scarce. Purpose To assess trends in the real world incidence, prevalence and mortality of all in-and outpatients with HF who presented in public health system in 2009–2018 in Poland. Methods It is a retrospective analysis of 1,990,162 patients who presented with HF in Poland in years 2009–2018. It is a part of nationwide Polish Ministry of Health registry that collects detailed information for the entire Polish population (38,495,659 in 2013) since 2009. Detailed data within the registry were collected since 2013. HF was recorded if HF diagnosis was coded (ICD-10). Results The incidence of HF in Poland fell down from 2013 to reach 127,036 newly diagnosed cases (330 per 100,000 population) in 2018 that equals to 43.6% drop. This decrease was mainly driven by marked reduction in females (p<0.001; Fig. 1A) and HF of ischaemic etiology (HF-IE vs HF-nonIE, Fig. 1B. p<0.001). The HF incidence per 100,000 population decreased across all age groups with the greatest drop in the youngest (Table 1). The prevalence rose by 11.6% to reach 1,242,129 (3233 per 100,000 population) in 2018 with significantly greater increase in females and HF-IE (both p<0.0001, Fig. 1C and D, respectively). The HF prevalence per 100,000 population increased across all age groups except for the 70–79 years old. (Table 1). Mortality increased by 28.5% to reach 142,379 cases (370 per 100,000 population) in 2018. The rise was more pronounced among females (p=0.015, Fig. 1E) and in HF-IE (p<0.001, Fig. 1F). The HF mortality per 100 000 population increased across all age groups, except for the 50–59 subgroup (Table 1). Conclusions Heart failure incidence plummeted in years 2013–2018 in Poland due to drop in newly diagnosed HF-IE. Despite that fact, the prevalence and mortality increased with rising trends in HF-IE. Figure 1. Incidence, prevalence, mortality trends Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): The project is co-financed by the European Union from the European Social Fund under the Operational Programme Knowledge Education Development and it is being carried out by the Analyses and Strategies Department of the Polish Ministry of Health