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Sopek Merkaš I, Lakušić N, Paar MH. Quadricuspid aortic valve and right ventricular type of myocardial bridging in an asymptomatic middle-aged woman: A case report. World J Clin Cases 2022; 10:8954-8961. [PMID: 36157661 PMCID: PMC9477056 DOI: 10.12998/wjcc.v10.i25.8954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/19/2022] [Accepted: 07/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Quadricuspid aortic valve (QAV) is a very rare congenital cardiac defect with the incidence of 0.0125%-0.033% (< 0.05%) predominantly causing aortic regurgitation. A certain number of patients (nearly one-half) have abnormal function and often require surgery, commonly in their fifth or sixth decade. QAV usually appears as an isolated anomaly but may also be associated with other cardiac congenital defects. Echocardiography is considered the main diagnostic method although more and more importance is given to computed tomography (CT) and magnetic resonance imaging (MRI) as complementary methods.
CASE SUMMARY A 60-year-old female patient was referred for transthoracic ultrasound of the heart as part of a routine examination in the treatment of arterial hypertension. She did not have any significant symptoms. QAV was confirmed and there were no elements of valve stenosis with moderate aortic regurgitation. At first, it seemed that in the projection of the presumed left coronary cusp, there were two smaller and equally large cusps along with two larger and normally developed cusps. Cardiac CT imaging was performed to obtain an even more precise valve morphology and it showed that the location of the supernumerary cusp is between the right and left coronary cusp, with visible central malcoaptation of the cusps. Also, coronary computed angiography confirmed the right-type of myocardial bridging at the distal segment of the left anterior descending coronary artery. Significant valve dysfunction often occurs in middle-aged patients and results in surgical treatment, therefore, a 1-year transthoracic echocardiogram control examination and follow-up was recommended to our patient.
CONCLUSION This case highlights the importance of diagnosing QAV since it leads to progressive valve dysfunction and can be associated with other congenital heart defects which is important to detect, emphasizing the role of cardiac CT and MRI.
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Sopek-Merkaš I, Lakušić N, Fučkar K, Cerovec D, Bešić KM. ANTIPLATELET THERAPY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY - UNEVENNESS OF DAILY CLINICAL PRACTICE. Acta Clin Croat 2022; 60:540-543. [PMID: 35282474 PMCID: PMC8907948 DOI: 10.20471/acc.2021.60.03.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/30/2019] [Indexed: 12/02/2022] Open
Abstract
Antiplatelet therapy is an integral part of optimal medicamentous therapy in patients with coronary artery disease. The strategy of antiplatelet/anticoagulant therapy is adjusted (combination of drugs, dosing and duration of therapy) depending on the stage of the disease (acute coronary syndrome with percutaneous coronary intervention, chronic coronary syndrome, or coronary surgical revascularization) and comorbidity of each patient (e.g., atrial fibrillation, left ventricular thrombus, etc.). Guidelines and clinical practice in particular are not uniform and specific regarding dual antiplatelet therapy in patients undergoing coronary artery bypass grafting, especially in the setting of chronic coronary syndrome.
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Sopek Merkaš I, Slišković AM, Lakušić N. Current concept in the diagnosis, treatment and rehabilitation of patients with congestive heart failure. World J Cardiol 2021; 13:183-203. [PMID: 34367503 PMCID: PMC8326153 DOI: 10.4330/wjc.v13.i7.183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023] Open
Abstract
Heart failure (HF) is a major public health problem with a prevalence of 1%-2% in developed countries. The underlying pathophysiology of HF is complex and as a clinical syndrome is characterized by various symptoms and signs. HF is classified according to left ventricular ejection fraction (LVEF) and falls into three groups: LVEF ≥ 50% - HF with preserved ejection fraction (HFpEF), LVEF < 40% - HF with reduced ejection fraction (HFrEF), LVEF 40%-49% - HF with mid-range ejection fraction. Diagnosing HF is primarily a clinical approach and it is based on anamnesis, physical examination, echocardiogram, radiological findings of the heart and lungs and laboratory tests, including a specific markers of HF - brain natriuretic peptide or N-terminal pro-B-type natriuretic peptide as well as other diagnostic tests in order to elucidate possible etiologies. Updated diagnostic algorithms for HFpEF have been recommended (H2FPEF, HFA-PEFF). New therapeutic options improve clinical outcomes as well as functional status in patients with HFrEF (e.g., sodium-glucose cotransporter-2 - SGLT2 inhibitors) and such progress in treatment of HFrEF patients resulted in new working definition of the term “HF with recovered left ventricular ejection fraction”. In line with rapid development of HF treatment, cardiac rehabilitation becomes an increasingly important part of overall approach to patients with chronic HF for it has been proven that exercise training can relieve symptoms, improve exercise capacity and quality of life as well as reduce disability and hospitalization rates. We gave an overview of latest insights in HF diagnosis and treatment with special emphasize on the important role of cardiac rehabilitation in such patients.
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Lakusic N, Sopek Merkas I, Lucinger D, Mahovic D. Heterophile antibodies, false-positive troponin, and acute coronary syndrome: a case report indicating a pitfall in clinical practice. Eur Heart J Case Rep 2021; 5:ytab018. [PMID: 33569533 PMCID: PMC7859590 DOI: 10.1093/ehjcr/ytab018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Heterophile antibodies are one of the most common causes of false-positive troponin. CASE SUMMARY We report a case of a 53-year-old woman with false-positive troponin elevation and a clinical presentation understood and treated as non-ST-elevation acute coronary syndrome. Because of chronic basal elevation of troponin (at a 'plateau' level) and chest pain, the patient underwent several invasive coronary angiograms until false-positive increase of troponin due to heterophile antibodies was suspected. Borderline stenosis of a left circumflex coronary artery found on first coronary angiogram was a coincidental finding and heterophile antibodies in the patient's serum were confirmed. DISCUSSION This interesting case report aims to remind the clinicians about the possibility of false-positive troponin level due to laboratory analytical interference caused by heterophile antibodies. In this case, it is important to suspect false-positive troponin elevation, even when coronary artery disease is found. This rare and less mentioned and/or recognized cause of troponin elevation may lead to unnecessary invasive diagnostics and aggressive treatment of patients.
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Sopek Merkaš I, Lakušić N. Persistently Elevated Troponin Level Caused by Heterophile Antibodies: Challenge in Everyday Clinical Practice. JACC Case Rep 2020; 2:1654. [PMID: 34317026 PMCID: PMC8302170 DOI: 10.1016/j.jaccas.2020.05.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
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Lakušić N, Slivnjak V, Ciglenečki N, Cerovec D. TORSADES DE POINTES IN ELDERLY PATIENT WITH PAROXYSMAL ATRIAL FIBRILLATION TREATED BY SHORT-TERM PARENTERAL AMIODARONE THERAPY. Acta Clin Croat 2019; 58:751-756. [PMID: 32665746 PMCID: PMC7356489 DOI: 10.20471/acc.2019.58.04.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
One of the drugs that are widely used in the treatment of atrial fibrillation is amiodarone. Despite considerable prolongation of the corrected QT interval and a substantial degree of bradycardia, amiodarone exhibits a remarkably low frequency of pro-arrhythmic events and <1.0% incidence of torsades de pointes, mostly after long-term usage. We present a case of an 80-year-old female with paroxysmal atrial fibrillation accompanied by acute heart failure treated by short-term parenteral amiodarone therapy and development of torsades de pointes.
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Lakusic N, Sopek Merkas I. Posttraumatic stress disorder after myocardial infarction; still a neglected entity in daily cardiology practice. PSYCHIATRIA DANUBINA 2019; 31:206-207. [PMID: 31291226 DOI: 10.24869/psyd.2019.206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mahovic D, Lakusic N, Ljubicic I, Zerjavic NL, Tudor KI, Pavlisa G. Recurrent Transitory Ischemic Attacks with Subsequent Development of the Ischemic Stroke as Initial Manifestation of Eosinophilic Granulomatosis with Polyangiitis in Depressed Patient. PSYCHIATRIA DANUBINA 2017; 29:510-513. [PMID: 29197212 DOI: 10.24869/psyd.2017.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Reactive cholecystitis as the leading sign of subacute perforation of the right ventricle with the electrode of an implantable cardioverter defibrillator. SIGNA VITAE 2017. [DOI: 10.22514/sv131.052017.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Compostella L, Lakusic N, Russo N, Setzu T, Compostella C, Vettore E, Isabella G, Tarantini G, Iliceto S, Bellotto F. Functional parameters but not heart rate variability correlate with long-term outcomes in St-elevation myocardial infarction patients treated by primary angioplasty. Int J Cardiol 2016; 224:473-481. [PMID: 27736721 DOI: 10.1016/j.ijcard.2016.09.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Depressed heart rate variability (HRV) is usually considered a negative long-term prognostic factor after acute myocardial infarction. Anyway, most of the supporting research was conducted before the era of immediate reperfusion by percutaneous coronary intervention (PCI). Main aim of this study was to evaluate if HRV still retains prognostic significance in our era of immediate PCI. METHODS AND RESULTS Two weeks after STEMI treated by primary PCI, time-domain HRV was assessed from 24-h Holter recordings in 186 patients: markedly depressed HRV (SDNN <70ms or <50ms) was present in 16% and in 5% of cases, respectively; patients with left ventricle ejection fraction (LVEF) <40% presented more often SDNN values in the lowest quartile. Physical performance was also assessed, by 6-minute walk tests (6MWT) and by cardiopulmonary exercise test (CPET). After >2years from infarction, occurrence of major clinical events (MCE) was investigated. Cases with or without MCE did not differ by initial HRV parameters; Kaplan-Meier events-free survival curves were similar between patients with lowest quartile SDNN and the remaining ones (χ2 0.981, p=0.322). By the contrary, events-free survival was worse if patients walked shorter distances at 6MWT (χ2 6.435, p=0.011), developed poorer ventilatory efficiency at CPET (χ2 10.060, p=0.002), or presented LVEF <40% (χ2 7.085, p=0.008). CONCLUSIONS In primary-PCI STEMI patients, markedly abnormal HRV was found in a small percentage of cases. HRV seems to have lost its prognostic significance, while parameters indicating LV function (LVEF and physical performance) could allow better prognostication in primary-PCI STEMI patients.
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The monitoring of antiaggregation effect of acetylsalicylic acid therapy by measuring serum thromboxane B2 in patients with coronary artery bypass grafting. Blood Coagul Fibrinolysis 2016; 27:370-3. [PMID: 26575493 DOI: 10.1097/mbc.0000000000000438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shatynska-Mytsyk I, Rodrigo L, Cioccocioppo R, Petrovic D, Lakusic N, Compostella L, Novak M, Kruzliak P. The impact of thyroid hormone replacement therapy on left ventricular diastolic function in patients with subclinical hypothyroidism. J Endocrinol Invest 2016; 39:709-13. [PMID: 25740068 DOI: 10.1007/s40618-015-0262-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 02/18/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Subclinical hypothyroidism (SH) is associated with a moderately elevated risk of heart failure events among older adults. The objective of our prospective study was to assess the impact of thyroid hormone replacement therapy (HRT) with low doses of L-thyroxine (6.25-25 µg/day) on left ventricular diastolic function in patients with SH. MATERIALS AND METHODS 33 patients with SH and 25 healthy controls were involved. All participants underwent standard echocardiography and Doppler imaging at baseline and, the patient group, also after a course of HRT. RESULTS At baseline, patients with SH showed significantly lower E (0.79 ± 0.22 vs. 0.93 ± 0.19, p < 0.001), E/A ratio (1.19 ± 0.29 vs. 1.31 ± 0.25, p < 0.003), and higher intraventricular septum thickness (IVST) (0.99 ± 0.14 vs. 0.89 ± 0.18, p < 0.001) in comparison with healthy controls. After 6 months of therapy, the E/A ratio underwent significant increase (1.28 ± 0.21 vs. 1.19 ± 0.29, p < 0.001), while the IVS displayed a robust reduction (0.92 ± 0.16 vs. 0.99 ± 0.14, p < 0.001). CONCLUSIONS HRT with low-dosed L-thyroxine may improve left ventricular diastolic function in patients with SH.
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Changes in Heart Rate Variability after Coronary Artery Bypass Grafting and Clinical Importance of These Findings. BIOMED RESEARCH INTERNATIONAL 2015; 2015:680515. [PMID: 26078960 PMCID: PMC4452832 DOI: 10.1155/2015/680515] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/14/2014] [Indexed: 11/23/2022]
Abstract
Heart rate variability is a physiological feature indicating the influence of the autonomic nervous system on the heart rate. Association of the reduced heart rate variability due to myocardial infarction and the increased postinfarction mortality was first described more than thirty years ago. Many studies have unequivocally demonstrated that coronary artery bypass grafting surgery generally leads to significant reduction in heart rate variability, which is even more pronounced than after myocardial infarction. Pathophysiologically, however, the mechanisms of heart rate variability reduction associated with acute myocardial infarction and coronary artery bypass grafting are different. Generally, heart rate variability gradually recovers to the preoperative values within six months of the procedure. Unlike the reduced heart rate variability in patients having sustained myocardial infarction, a finding of reduced heart rate variability after coronary artery bypass surgery is not considered relevant in predicting mortality. Current knowledge about changes in heart rate variability in coronary patients and clinical relevance of such a finding in patients undergoing coronary artery bypass grafting are presented.
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Habek JC, Lakusic N, Kruzliak P, Sikic J, Mahovic D, Vrbanic L. Left ventricular diastolic function in diabetes mellitus type 2 patients: correlation with heart rate and its variability. Acta Diabetol 2014; 51:999-1005. [PMID: 25274395 DOI: 10.1007/s00592-014-0658-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 09/19/2014] [Indexed: 01/20/2023]
Abstract
AIMS To assess the prevalence of left ventricular diastolic dysfunction in a population of patients with type 2 diabetes mellitus; to determine correlation of diastolic dysfunction with heart rate and its variability. METHODS The study included 202 patients with type 2 diabetes mellitus. Echocardiography was performed with special reference to diastolic function, and heart rate variability was analysed using standard deviation of normal RR intervals, root mean square of successive differences and percentage of successive R-R intervals greater than 50 ms (pNN 50 %) in a 24-h electrocardiogram recording. RESULTS Diastolic dysfunction is present in 79 % of type 2 diabetes mellitus patients: grade 1 in 52 %, grade 2 in 26 % and grade 3 in 1 % of patients. The subjects with grade 1 diastolic dysfunction had a statistically significantly higher heart rate variability compared with those with grade 2 diastolic dysfunction (LSD, post hoc test, p = 0.001). In the group with diastolic dysfunction, grade 2 reduced heart rate variability was recorded in 83 % of patients (37 and 7 % for grade 1 and normal diastolic function). An increase in the severity of diastolic dysfunction was associated with decreased heart rate variability and increased heart rate. CONCLUSION Progression of diastolic dysfunction is associated with a significantly greater prevalence of reduced heart rate variability, which is accompanied by increased heart rate.
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The dynamics of soluble Fas/APO 1 apoptotic biochemical marker in acute ischemic stroke patients. Adv Med Sci 2014; 58:298-303. [PMID: 24277959 DOI: 10.2478/ams-2013-0014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Until recently, neuronal death in ischemic stroke infarction was ascribed exclusively to necrotic process. However, experimental animal models of cerebral ischemia suggest apoptosis to play a role in the pathogenesis of cerebral infarction. The aim of this study was to determine the level and monitor the dynamics of soluble Fas/APO 1 (sFas/APO 1) in serum and cerebrospinal fluid of acute ischemic stroke patients. MATERIAL AND METHODS This prospective study included 23 patients with first ever, computed tomography verified acute ischemic stroke and 20 control subjects with other functional neurologic disorders. Serum and cerebrospinal fluid sFas/APO 1 levels were determined on several occasions. Blood samples were obtained on day 1, 3 and 12, and lumbar puncture on day 3 and 12 of disease onset. Quantitative sandwich ELISA method was used on sFas/APO 1 determination. RESULTS On day 1 of disease onset, serum and cerebrospinal fluid sFas/APO 1 levels were significantly higher in stroke patients as compared to control subjects, and then gradually declined during the period of monitoring. CONCLUSION Study results confirmed the dynamic pattern of sFas/APO 1 in serum and cerebrospinal fluid of patients with acute ischemic stroke, suggesting the possible role of apoptosis in the pathogenesis of cerebral infarction.
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Lakusic N, Mahovic D, Sonicki Z, Slivnjak V, Baborski F. Outcome of patients with normal and decreased heart rate variability after coronary artery bypass grafting surgery. Int J Cardiol 2013; 166:516-8. [PMID: 22560918 DOI: 10.1016/j.ijcard.2012.04.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Revised: 03/10/2012] [Accepted: 04/08/2012] [Indexed: 11/25/2022]
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Slivnjak V, Vrljić D, Lakusić N. Arrhythmogenic effect of propafenone administered for a "wrong" clinical diagnosis. Acta Clin Croat 2012; 51:445-7. [PMID: 23330412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lakusić N, Klasić A, Dubroja RC, Halapir M, Cerovec D, Bernat R, Sipić T. [Clinical relevance of false-positive troponin level]. LIJECNICKI VJESNIK 2011; 133:292-3. [PMID: 22165199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lakusić N, Mahović D, Slivnjak V. Ashman phenomenon: an often unrecognized entity in daily clinical practice. Acta Clin Croat 2010; 49:99-100. [PMID: 20635592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Tako-Tsubo syndrome: A diagnostic challenge. Open Med (Wars) 2009. [DOI: 10.2478/s11536-009-0030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Fuckar K, Lakusić N, Cerovec D. Rare psychotropic adverse event of moxonidine. PSYCHIATRIA DANUBINA 2009; 21:518. [PMID: 19935487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Slivnjak V, Lakusic N, Richter D, Cerovec D. Stress cardiomyopathy with ST-segment elevation of the anterolateral location complicated by a secondary massive intracranial bleeding. Int J Cardiol 2009; 136:e63-5. [PMID: 18707779 DOI: 10.1016/j.ijcard.2008.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 05/03/2008] [Indexed: 10/21/2022]
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[Incidence of major adverse cardiovascular events after cardiac surgery procedures]. LIJECNICKI VJESNIK 2009; 131:54-7. [PMID: 19514249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of the study was to analyze the incidence of major adverse cardiovascular events after different cardiac surgery procedures. This study included 307 patients who underwent some of cardiac surgery procedures within a period of 6 months of arriving at stationary cardiac rehabilitation. There were 101 patients (33%) who had valve surgery and 206 patients (67%) who underwent coronary artery bypass grafting (CABG). Primary end-point was death caused by fatal myocardial infarction (MI) or sudden death, and secondary end-points were non-fatal MI or unstable angina pectoris, stroke, new cardiac surgery or percutaneous coronary intervention, heart failure or significant arrhythmia and non-cardiac death. The mean duration of follow-up period after leaving stationary cardiac rehabilitation was 35 +/- 21 months. During the follow up period, there was total of 61 primary and secondary end-points. In CABG group, there were 48 major adverse cardiovascular events compared to 13 in the group of patients with prosthetic valve (p=0.03). There was total of 19 fatal MI or sudden death (6%). The fatal outcome rates of cardiovascular origin were significantly higher in the group of patients after CABG than in the patients with prosthetic valve (16 vs. 3 death, NS). The results of this study suggest that the complications after cardiac surgery procedures occurs more often in CABG patients. However, mortality rate after cardiac surgery in the analyzed groups of patients is relatively low.
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Improvement in lipid profile of patients referred to a cardiac rehabilitation program: is the effect of regular exercise underestimated because of the antilipid drugs? EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION AND REHABILITATION : OFFICIAL JOURNAL OF THE EUROPEAN SOCIETY OF CARDIOLOGY, WORKING GROUPS ON EPIDEMIOLOGY & PREVENTION AND CARDIAC REHABILITATION AND EXERCISE PHYSIOLOGY 2009; 16:114-6. [PMID: 19238000 DOI: 10.1097/01.hjr.0b013e32830e1e75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Slivnjak V, Lakusić N, Cerovec D, Richter D. [Tako-Tsubo cardiomyopathy; reversible left ventricular dysfunction mimicking acute myocardial infarction with ST-elevation]. LIJECNICKI VJESNIK 2009; 131:14-7. [PMID: 19348350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Tako-Tsubo cardiomyopathy is still en entity of unknown etiology and pathophysiology which clinically manifests with sudden, severe chest pain and/or dyspnea. It is generally triggered by emotional or physical stress and most cases are reported in postmenopausal women. Electrocardiographic changes are similar to acute myocardial infarction with ST-elevation, laboratory markers of myocardial lesion are usually mild to moderately high, and coronary angiography shows no significant pathomorphological changes of epicardial coronary arteries. Ventriculography and echocardiography show reversible akinesis and ballooning of the left ventricular apex with reduced ejection fraction which is usually normalized within 2-4 weeks. Generally, Tako-Tsubo cardiomyopathy has a good prognosis, in-hospital mortality rate is about 1%. In this article, we present a review about todays knowledge on Tako-Tsubo cardiomyopathy.
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