Aim. To identify risk factors for in-hospital mortality among patients with hyponatremia in a cardiology hospital.

Material and Methods. This single-center retrospective study included 119 patients (mean age 71.2 (12.7) years) admitted to a cardiology center from June 2024 to March 2025, who had at least one recorded instance of hypotonic hyponatremia (sodium level < 135 mmol/L). Patients with acute coronary syndrome and myocardial infarction were excluded. Statistical analysis was performed using logistic regression and ROC analysis.

Results. The prevalence of hyponatremia among the examined patients was 4.1%. In-hospital mortality reached 16.0% (19 deaths). Hypervolemic hyponatremia, typical for patients with chronic heart failure, was the most common type (48.7%). Compared to survivors, deceased patients more frequently had a history of myocardial infarction (52.6% vs. 21.2%), coronary artery stenting (36.8% vs. 8.2%), stage II chronic heart failure (21.1% vs. 4.0%), chronic kidney disease (73.7% vs. 29.3%), and cholelithiasis (31.6% vs. 12.1%). They also presented with a higher number of non-cardiac comorbidities: 4.0 [2.5; 5.0] vs. 2.0 [1.0; 4.0]. Deceased patients more often reported dyspnea (94.7% vs. 63.0%), had a higher respiratory rate (20.0 [16.5; 20.5] vs. 17.0 [16.0; 19.0]), lower oxygen saturation (96.0 [91.5; 97.0]% vs. 97.0 [96.0; 98.0]%), higher levels of creatinine (205.5 [160.6; 293.4] µmol/L vs. 116.8 [83.2; 165.2] µmol/L), potassium (5.0 (1.5) mmol/L vs. 4.4 (1.0) mmol/L), and troponin (2872.0 [186.0; 5456.0] ng/L vs. 30.4 [13.9; 1237.5] ng/L). They also exhibited lower sodium levels (128.0 [124.0; 132.0] mmol/L vs. 131.0 [129.0; 133.0] mmol/L), lower glomerular filtration rate (24.7 [15.8; 29.7] vs. 42.2 [32.6; 72.9] mL/min/1.73 m^2), larger left ventricular end-diastolic and left atrial dimensions, and lower left ventricular ejection fraction (35.5 [27.9; 54.3]% vs. 54.0 [40.0; 62.0]%). Multivariable regression analysis identified the following independent predictors of mortality: minimum sodium level (AOR 0.840; p=0.004), glomerular filtration rate (AOR 0.957; p=0.023), and left ventricular ejection fraction (AOR 0.947; p=0.022). The resulting predictive model demonstrated high discriminative power: AUC = 0.840 with a sensitivity of 71.4% and specificity of 88.2%.

Conclusion. Minimum serum sodium level is an independent risk factor for in-hospital mortality, particularly in patients with reduced glomerular filtration rate and left ventricular ejection fraction. Optimization of diagnostic protocols and implementation of more proactive methods for correcting electrolyte imbalances are necessary to reduce mortality rates.

Aim. To characterise the clinical-laboratory profile of adults with type 1 diabetes (T1D) hospitalised for diabetic ketoacidosis (DKA) and to assess echocardiographic parameters according to DKA severity and the presence of acute myocardial injury.

Material and methods. The single-center cross-sectional study included 160 patients aged 18 years and older with T1DM presenting with DKA. Based on DKA severity, patients were classified into mild (n=31), moderate (n=94), and severe (n=35) groups; additionally, patients were stratified by the presence or absence of AMI into AMI «positive» (n=90) and AMI «negative» (n=70) groups. Within the first 24 hours of hospitalisation, clinical evaluation, assessment of SOFA, APACHE II, and Glasgow Coma Scale scores, laboratory tests (glucose, HbA1c, high-sensitivity troponin I, N-terminal pro-brain natriuretic peptide, creatinine, urea, C-reactive protein, acid-base status parameters, lactate), as well as standard and speckle-tracking echocardiography were performed.

Results. In 72.0% of patients, DKA developed in previously diagnosed type 1 diabetes with poor treatment adherence, whereas in 28.0% it occurred at disease onset. Severe DKA was associated with longer diabetes duration (p=0.015), hemodynamic instability, higher APACHE II scores, lower Glasgow Coma Scale scores, and myocardial injury in all patients of this subgroup (p<0.001). Compared with injury-negative patients, the injury-positive group had longer diabetes duration (p=0.038), lower blood pressure, higher heart rate, more severe acidosis, and higher troponin I, NT-proBNP, creatinine, urea, glucose, and lactate levels (all p<0.001). Echocardiography showed higher left ventricular ejection fraction (p<0.001), larger indexed left atrial volume (p=0.007), less negative global longitudinal strain and right ventricular strain (both p<0.001), and lower global work efficiency (p<0.001), TAPSE (p=0.048), and peak atrial contraction strain (p=0.005). In the multivariable model, admission glucose (OR 1.08; 95% CI 1.00-1.16; p=0.04) and anion gap (OR 1.31; 95% CI 1.16-1.48; p<0.001) remained independently associated with myocardial injury.

Conclusion. Progression of DKA severity in adult patients with T1DM is accompanied by worsening metabolic and hemodynamic disturbances and an increased incidence of AMI. The presence of AMI is associated with alterations in myocardial deformation parameters and right heart function, despite preserved or increased left ventricular ejection fraction.

The aim of this review is to systematize current data on the mechanisms of action of pasteurized Akkermansia muciniphila in obesity and metabolic syndrome and to evaluate its clinical potential. Obesity and metabolic syndrome are leading risk factors for cardiovascular disease. In recent years, compelling evidence has accumulated on the important role of intestinal microbiota dysbiosis in the pathogenesis of these conditions, opening up prospects for the development of new therapeutic strategies aimed at its correction. Pasteurized A. muciniphila is of interest as a potentially promising postbiotic capable of preserving the effects of live bacteria while simultaneously enhancing its safety profile. Pasteurized A. muciniphila has been shown to exert a multicomponent effect, including reduction of intestinal barrier permeability, metabolic endotoxemia, and chronic low-grade inflammation, modulation of intestinal glucose transport, interaction with the gut-brain axis, and regulation of energy metabolism. Currently, efficacy data remain limited and are based primarily on preclinical studies. A. muciniphila has been shown to reduce body weight and fat mass, improve glycemic control, increase insulin sensitivity, and reduce inflammatory and fibrotic changes in the liver and adipose tissue. However, there remains a need to standardize postbiotic formulations, including pasteurization and dosing regimens, and to conduct large, long-term randomized trials to determine clinical efficacy and safety.