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Exercise intolerance de novo is one of the most common reported symptoms in patients recovering from the Coronavirus Disease 2019 (COVID-19). The present study determines etiological and pathophysiological factors influencing the mechanism of impaired exercise tolerance in patients during Long-COVID. Consequently, the factors affecting the percentage predicted oxygen uptake at peak exercise (%VO2pred) in patients after COVID-19 with a normal left ventricular ejection fraction (LVEF) were assessment. A total of 120 patients recovering from COVID-19 at three to six months after confirmed diagnosis were included. The clinical examinations, laboratory test results, echocardiography, non-invasive body mass analysis, and spiroergometry were evaluated. The subjects were divided into the following groups: study patients' group with worsen oxygen uptake (%VO2pred < 80%; n = 47) and control group presenting%VO2pred ≥ 80% (n = 73). ClinicalTrials.gov Identifier: NCT04828629. The male gender and the percent of total body water content (TBW%) were significantly higher in the study group compared to the control group (53 vs. 29%, p = 0.007 and 52.67 (±6.41) vs. 49.89 (±4.59), p = 0.02; respectively). Patients with %VO2pred < 80% presented significantly lower global peak systolic strain (GLPS), tricuspid annular plane systolic excursion (TAPSE), and late diastolic filling (A) velocity (19.34 (±1.72)% vs. 20.10 (±1.35)%, p = 0.03; 21.86 (±4.53) vs. 24.08 (±3.20) mm, p = 0.002 and median 59.5 (IQR: 50.0–71.0) vs. 70.5 (IQR: 62.0–80.0) cm/s, p = 0.004; respectively) compared to the controls. The results of the multiple logistic regression model show that (A) velocity (OR 0.40, 95%CI: 0.17–0.95; p = 0.03) and male gender (OR 2.52, 95%CI: 1.07–5.91; p = 0.03) were independently associated with %VO2pred. Conclusions: Men have over twice the risk of persistent limited exercise tolerance in Long-COVID than women. The decreased (A) velocity, TAPSE, GLPS, and hydration status are connected with limited exercise tolerance after COVID-19 in patients with normal LVEF. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH) is a genetic autosomal co-dominant metabolic disorder leading to elevated circulating concentrations of low-density lipoprotein cholesterol (LDL-C). Early development of atherosclerotic cardiovascular disease (ASCVD) is common in affected patients. We aimed to evaluate the characteristics and differences in the diagnosis and therapy of FH children and adults. Methods: All consecutive patients who were diagnosed with FH, both phenotypically and with genetic tests, were included in this analysis. All patients are a part of the European Atherosclerosis Society FH-Study Collaboration (FHSC) regional center for rare diseases at the Polish Mother's Memorial Hospital Research Institute (PMMHRI) in Lodz, Poland. Results: Of 103 patients with FH, there were 16 children (15.5%) at mean age of 9 ± 3 years and 87 adults aged 41 ± 16; 59% were female. Children presented higher mean levels of total cholesterol, LDL-C, and high-density lipoprotein cholesterol (HDL-C) measured at the baseline visit (TC 313 vs. 259 mg/dL (8.0 vs. 6.6 mmol/L), p = 0.04; LDL 247 vs. 192 mg/dL (6.3 vs. 4.9 mmol/L), p = 0.02, HDL 53 vs. 48 mg/dL (1.3 vs. 1.2 mmol/L), p = 0.009). Overall, 70% of adult patients and 56% of children were prescribed statins (rosuvastatin or atorvastatin) on admission. Combination therapy (dual or triple) was administered for 24% of adult patients. Furthermore, 13.6% of adult patients and 19% of children reported side effects of statin therapy; most of them complained of muscle pain. Only 50% of adult patients on combination therapy achieved their treatment goals. None of children achieved the treatment goal. Conclusions: Despite a younger age of FH diagnosis, children presented with higher mean levels of LDL-C than adults. There are still urgent unmet needs concerning effective lipid-lowering therapy in FH patients, especially the need for greater use of combination therapy, which may allow LDL-C targets to be met in most of the patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors influencing maximal oxygen uptake (VO2max) and early identification of the profile of hypertensive women in the perimenopausal period at risk of heart failure. This study included 185 female patients. Regression analyses determined predictors of the lowest VO2max (quartile 1: VO2max < 17 mL/kg/min). Females with the lowest oxygen consumption had a significantly higher level of high sensitive cardiac Troponin T (hs-cTnT) (p = 0.001), higher values of the left atrial (LA) volume, late diastolic mitral annulus velocity (A′), E/E′ (p = 0.0003, p = 0.02, p = 0.04; respectively), higher BMI and fat content (kg and %) (p < 0.0001), higher fat free mass (FFM) (kg) (p < 0.0001), total body water content (TBW) (p = 0.0002) as well as extracellular body water content (ECW) (p < 0.0001) and intracellular body water content (ICW) (p = 0.005), ECW/TBW × 100% (p < 0.0001) and metabolic age (p < 0.0001) and lower E′ (p = 0.001) compared to controls. In a multiple logistic regression model independently associated with VO2max were: ECW/TBW × 100% (OR 4.45, 95% CI: 1.77–11.21; p = 0.002), BMI (OR 7.11, 95% CI: 2.01–25.11; p = 0.002) and hs-cTnT level (OR 2.69, 95% CI: 1.23–5.91; p = 0.013). High-sensitivity cardiac troponin may serve as an early biomarker of heart failure in hypertensive women. Hydration status should be considered in overall hypertensive women care. There is an importance of body mass compartments analysis in the early identification of hypertensive females at risk of heart failure. Optimization and personalization of body structure may be a preventive method for this disease. ClinicalTrials.gov Identifier: NCT04802369. [ABSTRACT FROM AUTHOR]

Energy issues are sensitive for the four Visegrad countries as European Union (EU) member states; thus, this area's convergence might be problematic for these countries. There is a clear research gap concerning the processes of Europeanization of the energy policy in the Visegrad countries. This article aims to identify and evaluate the progress of four Visegrad countries (V4) in implementing the EU energy goals in the context of the Europeanization. The article uses three main methods: Hellwig's method, Kendall's rank concordance coefficient, and k-means clustering. These calculations will allow one to study the Europeanization processes, which means checking the gamma convergence. For calculations, we use the available statistical data from Eurostat for the years 2005–2018. Poland and other Central European countries, including Czechia, and Hungary, largely depend on coal for their energy needs. The empirical results have shown that there have been no significant changes in the classification of EU countries in terms of their fulfillment of the EU climate and energy targets in the analyzed period. This is the case in all EU member states, including the Visegrad Group countries, but except for Poland. This means that the level of Europeanization of the energy policy and its effectiveness is similar in all member states except for Poland, which is becoming a kind of the exception. Throughout the investigating period, the Czech Republic, Hungary, and Slovakia were close to meeting the set targets and could be rated high compared to the EU countries. Poland, especially since 2015, has been noticeably and increasingly distanced from the other V4 countries. It can be perceived as a gradual drift away from Europeanization of the EU climate and energy policy in Poland. [ABSTRACT FROM AUTHOR]

The aim of this article is to verify what the relations are between entrepreneurial orientation and knowledge utilization in the internationalization of Polish firms. The article distinguishes four types of knowledge: market knowledge, network knowledge, sociocultural knowledge, and entrepreneurial knowledge. The research uses quantitative design and is based on a survey conducted in 2015 on a sample of 355 businesses from Poland (the response rate was 10.7%), following which statistical techniques (t-tests and regression analyses) were applied to verify the hypotheses. An overview of prior studies enabled us to identify the research gap in the literature regarding the combination of three elements that link to form one picture of reality, namely, (i) entrepreneurial orientation and (ii) knowledge utilization in (iii) the internationalization process of firms. The case of Polish firms confirms that entrepreneurial orientation is substantial in the use of knowledge in the internationalization process. Firms characterized by higher entrepreneurial orientation use particular types of knowledge much more intensely at various stages of the internationalization process. Entrepreneurial orientation, and especially risk-taking, has significant positive effects on the scope of internationalization. Greater entrepreneurial orientation increases the number of foreign markets in which a given firm operates. Not only market knowledge in the traditional approach, but especially network and entrepreneurial knowledge have significant positive effects on the intensification of the internationalization scale. [ABSTRACT FROM AUTHOR]