Current data indicate that heart failure (HF) is associated with inflammation and microvascular dysfunction and remodeling. These mechanisms could be involved in HF development and progression, especially in HF with preserved ejection fraction (HFpEF). We aimed to compare structural changes in retinal arterioles and carotid arteries between HF patients and patients without heart failure. This preliminary, retrospective, case-control study included 28 participants (14 patients with HFpEF and 14 age- and sex-matched healthy controls). Carotid intima-media thickness to lumen ratio (cIMTLR) was assessed using B-mode ultrasonography. Retinal arterioles wall- to-lumen ratio (rWLR) was assessed by adaptive optics camera rtx1. The HF patients had higher IMTLR (Dmedian [HFpEF–control group] 0.07, p = 0.01) and eWLR (Dmedian 0.03, p = 0.001) in comparison to patients without HF. In the whole study group, rWLR correlated significantly with IMTLR (r = 0.739, p = 0.001). Prevalence of arterial hypertension was similar in both groups, however, patients with HF had a significantly lower office, central and 24-hour ambulatory blood pressure (systolic Dmedian −21 to −18 mmHg; diastolic Dmedian −23 to −10 mmHg). Our data suggests gradual and simultaneous progression of vascular remodeling in both retinal arterioles and carotid arteries in HFpEF patients. This process could be a marker of HF development. Significantly lower blood pressure values in HF group may indicate that vascular remodeling could be independent of BP control. Nevertheless, further and larger prospective studies allowing to reduce the impact of confounding and address temporality are warranted.

Obesity and hypertension are one of the most important cardiovascular risk factors. It is predicted that by 2030 almost two-thirds of the global population will struggle with being overweight or obese. Ambulatory Blood Pressure Measurement (ABPM) is a tool for a detailed analysis of mean blood pressure values and assessing the blood pressure profile during the night with the daily values and optimal treatment determination.The study aimed to assess the frequency of hypertension in patients with pathological obesity.The study consisted of two groups depending on their Body Mass Index (BMI): Group 1 BMI > 25 kg/m 2 ; < 40 kg/m 2 ; Group 2 (243 overweight and obese patients): BMI ≥ 40 kg/m 2 . Each patient was carefully interviewed, considering their use of the antihypertensive drugs. Each patient was subject to the ABPM assessment. Arterial hypertension (HT) was diagnosed at arterial blood pressure (BP) values > 135/85 mmHg based on the European Society of Hypertension (ESH) test bench. Depending on the patient's history, ABPM, and in-office BP measurements, patients were diagnosed with HT treated, newly diagnosed, or without HT. Based on the in-office BP and ABPM measurements taken, the diagnosis of white-coat uncontrolled hypertension (WUCH) and masked uncontrolled hypertension (MUCH) was diagnosed.The analysis of parameters revealed that all BP values were significantly higher in group 2. More than half of the patients in both groups had been previously treated for HT. Based on ABPM, newly diagnosed HT was identified significantly more often in patients with higher BMI. The younger individuals were significantly more likely to have WUCH.

Background: The identification of parameters that would serve as predictors of prognosis in COVID-19 patients is very important. In this study, we assessed independent factors of in-hospital mortality of COVID-19 patients during the second wave of the pandemic. Material and methods: The study group consisted of patients admitted to two hospitals and diagnosed with COVID-19 between October 2020 and May 2021. Clinical and demographic features, the presence of comorbidities, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with in-hospital mortality was evaluated. Results: A total of 1040 COVID-19 patients (553 men and 487 women) qualified for the study. The in-hospital mortality rate was 26% across all patients. In multiple logistic regression analysis, age ≥ 70 years with OR = 7.8 (95% CI 3.17–19.32), p < 0.001, saturation at admission without oxygen ≤ 87% with OR = 3.6 (95% CI 1.49–8.64), p = 0.004, the presence of typical COVID-19-related lung abnormalities visualized in chest computed tomography ≥40% with OR = 2.5 (95% CI 1.05–6.23), p = 0.037, and a concomitant diagnosis of coronary artery disease with OR = 3.5 (95% CI 1.38–9.10), p = 0.009 were evaluated as independent risk factors for in-hospital mortality. Conclusion: The relationship between clinical and laboratory markers, as well as the advancement of lung involvement by typical COVID-19-related abnormalities in computed tomography of the chest, and mortality is very important for the prognosis of these patients and the determination of treatment strategies during the COVID-19 pandemic.

IntroductionThe most common complications of COVID-19 infection are: pneumonia, acute respiratory distress syndrome, pulmonary fibrosis, pulmonary embolism, pneumothorax and pneumomediastinum.AimWe would like to highlight the rarity of pneumomediastinum and subcutaneous emphysema in nonventilated COVID-19 patient.Case studyA 50-year-old man was addmitted to the COVID-19 Department with SARS-CoV-2 pneumonia. The patient wasn’t vaccinated against COVID- 19. Upon admission the general condition was quite good with mild dyspnea.Results and discussionUpon admission a CT scan was performed in which there were bilateral infiltrates consistent with COVID-19 infection, covering approximately 50% of the lungs. On the 5th day of hospitalization the general condition deteriorated and a drop in saturation was observed. A follow-up CT scan revealed progression of lung inflammatory changes that spanned approximately 60%–70% of lung parenchyma; there was pneumomediastinum and subcutaneous emphysema in the neck, left subclavian, and axillary area. High flow nasal oxygen therapy (60 L/min) was administered. On the 13th day the general condition of the patient further deteriorated and blood saturation continued to drop which prompted the decision to escalate treatment. Initially, noninvasive ventilation was used, however, shortly after the patient was intubated. Immediately after intubation the patient went into cardiac arrest that ultimately led to his death.ConclusionsThe development of spontaneus pneumomediastinum in the patient can be mainly attributed to the intense cough and rapidly developing acute respiratory distress syndrome in the course of SARS-CoV-2 infection despite aggressive treatment with steroids, tolicizumab, and antibiotics for staphylococcal pneumonia.