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Mitic S, Stojanovic B, Tosic S, Pavlovic A, Kostic D, Mitic M. Comparative Study on Minerals in Peel and Pulp of Peach (Prunus persica L.) Fruit. REVISTA DE CHIMIE 2019. [DOI: 10.37358/rc.19.6.7323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this study, variations of minerals contents between peel and pulp parts of six different peach varieties originated from Serbia were investigated by using inductively coupled plasma optical emission spectrophotometry and one-way analysis of variance (ANOVA) with Tukey�s post-hoc test. The content of fifteen elements was determined and content of K was highest among macroelements and Fe among microelements in both parts of the peach fruit. Also, peach peel had higher levels of all minerals with the exception of K. Greater differences between the peel and the pulp and the same parts of different types of peaches are observed in the case of macroelements than the microelements. Hg and Cd are not detected while the contents of Pb and As are below prescribed values.
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Miller RJH, Heidary S, Pavlovic A, Schlachter A, Dash R, Fleischmann D, Ashley EA, Wheeler MT, Yang PC. Defining genotype-phenotype relationships in patients with hypertrophic cardiomyopathy using cardiovascular magnetic resonance imaging. PLoS One 2019; 14:e0217612. [PMID: 31199839 PMCID: PMC6568393 DOI: 10.1371/journal.pone.0217612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/16/2019] [Indexed: 01/28/2023] Open
Abstract
PURPOSE HCM is the most common inherited cardiomyopathy. Historically, there has been poor correlation between genotype and phenotype. However, CMR has the potential to more accurately assess disease phenotype. We characterized phenotype with CMR in a cohort of patients with confirmed HCM and high prevalence of genetic testing. METHODS Patients with a diagnosis of HCM, who had undergone contrast-enhanced CMR were identified. Left ventricular mass index (LVMI) and volumes were measured from steady-state free precession sequences. Late gadolinium enhancement (LGE) was quantified using the full width, half maximum method. All patients were prospectively followed for the development of septal reduction therapy, arrhythmia or death. RESULTS We included 273 patients, mean age 51.2 ± 15.5, 62.9% male. Of those patients 202 (74.0%) underwent genetic testing with 90 pathogenic, likely pathogenic, or rare variants and 13 variants of uncertain significance identified. Median follow-up was 1138 days. Mean LVMI was 82.7 ± 30.6 and 145 patients had late gadolinium enhancement (LGE). Patients with beta-myosin heavy chain (MYH7) mutations had higher LV ejection fraction (68.8 vs 59.1, p<0.001) than those with cardiac myosin binding protein C (MYBPC3) mutations. Patients with MYBPC3 mutations were more likely to have LVEF < 55% (29.7% vs 4.9%, p = 0.005) or receive a defibrillator than those with MYH7 mutations (54.1% vs 26.8%, p = 0.020). CONCLUSIONS We found that patients with MYBPC3 mutations were more likely to have impaired ventricular function and may be more prone to arrhythmic events. Larger studies using CMR phenotyping may be capable of identifying additional characteristics associated with less frequent genetic causes of HCM.
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McConnell MV, Shcherbina A, Pavlovic A, Homburger JR, Goldfeder RL, Waggot D, Cho MK, Rosenberger ME, Haskell WL, Myers J, Champagne MA, Mignot E, Landray M, Tarassenko L, Harrington RA, Yeung AC, Ashley EA. Feasibility of Obtaining Measures of Lifestyle From a Smartphone App: The MyHeart Counts Cardiovascular Health Study. JAMA Cardiol 2019; 2:67-76. [PMID: 27973671 DOI: 10.1001/jamacardio.2016.4395] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Studies have established the importance of physical activity and fitness, yet limited data exist on the associations between objective, real-world physical activity patterns, fitness, sleep, and cardiovascular health. Objectives To assess the feasibility of obtaining measures of physical activity, fitness, and sleep from smartphones and to gain insights into activity patterns associated with life satisfaction and self-reported disease. Design, Setting, and Participants The MyHeart Counts smartphone app was made available in March 2015, and prospective participants downloaded the free app between March and October 2015. In this smartphone-based study of cardiovascular health, participants recorded physical activity, filled out health questionnaires, and completed a 6-minute walk test. The app was available to download within the United States. Main Outcomes and Measures The feasibility of consent and data collection entirely on a smartphone, the use of machine learning to cluster participants, and the associations between activity patterns, life satisfaction, and self-reported disease. Results From the launch to the time of the data freeze for this study (March to October 2015), the number of individuals (self-selected) who consented to participate was 48 968, representing all 50 states and the District of Columbia. Their median age was 36 years (interquartile range, 27-50 years), and 82.2% (30 338 male, 6556 female, 10 other, and 3115 unknown) were male. In total, 40 017 (81.7% of those who consented) uploaded data. Among those who consented, 20 345 individuals (41.5%) completed 4 of the 7 days of motion data collection, and 4552 individuals (9.3%) completed all 7 days. Among those who consented, 40 017 (81.7%) filled out some portion of the questionnaires, and 4990 (10.2%) completed the 6-minute walk test, made available only at the end of 7 days. The Heart Age Questionnaire, also available after 7 days, required entering lipid values and age 40 to 79 years (among 17 245 individuals, 43.1% of participants). Consequently, 1334 (2.7%) of those who consented completed all fields needed to compute heart age and a 10-year risk score. Physical activity was detected for a mean (SD) of 14.5% (8.0%) of individuals' total recorded time. Physical activity patterns were identified by cluster analysis. A pattern of lower overall activity but more frequent transitions between active and inactive states was associated with equivalent self-reported cardiovascular disease as a pattern of higher overall activity with fewer transitions. Individuals' perception of their activity and risk bore little relation to sensor-estimated activity or calculated cardiovascular risk. Conclusions and Relevance A smartphone-based study of cardiovascular health is feasible, and improvements in participant diversity and engagement will maximize yield from consented participants. Large-scale, real-world assessment of physical activity, fitness, and sleep using mobile devices may be a useful addition to future population health studies.
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Hershman SG, Bot BM, Shcherbina A, Doerr M, Moayedi Y, Pavlovic A, Waggott D, Cho MK, Rosenberger ME, Haskell WL, Myers J, Champagne MA, Mignot E, Salvi D, Landray M, Tarassenko L, Harrington RA, Yeung AC, McConnell MV, Ashley EA. Physical activity, sleep and cardiovascular health data for 50,000 individuals from the MyHeart Counts Study. Sci Data 2019; 6:24. [PMID: 30975992 PMCID: PMC6472350 DOI: 10.1038/s41597-019-0016-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/04/2019] [Indexed: 01/21/2023] Open
Abstract
Studies have established the importance of physical activity and fitness for long-term cardiovascular health, yet limited data exist on the association between objective, real-world large-scale physical activity patterns, fitness, sleep, and cardiovascular health primarily due to difficulties in collecting such datasets. We present data from the MyHeart Counts Cardiovascular Health Study, wherein participants contributed data via an iPhone application built using Apple's ResearchKit framework and consented to make this data available freely for further research applications. In this smartphone-based study of cardiovascular health, participants recorded daily physical activity, completed health questionnaires, and performed a 6-minute walk fitness test. Data from English-speaking participants aged 18 years or older with a US-registered iPhone who agreed to share their data broadly and who enrolled between the study's launch and the time of the data freeze for this data release (March 10 2015-October 28 2015) are now available for further research. It is anticipated that releasing this large-scale collection of real-world physical activity, fitness, sleep, and cardiovascular health data will enable the research community to work collaboratively towards improving our understanding of the relationship between cardiovascular indicators, lifestyle, and overall health, as well as inform mobile health research best practices.
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Kolarevic A, Pavlovic A, Djordjevic A, Lazarevic J, Savic S, Kocic G, Anderluh M, Smelcerovic A. Rutin as Deoxyribonuclease I Inhibitor. Chem Biodivers 2019; 16:e1900069. [DOI: 10.1002/cbdv.201900069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/18/2019] [Indexed: 12/22/2022]
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Sandset EC, de Sousa DA, Christensen H, Cordonnier C, Fischer U, Katan M, Kremer C, Pavlovic A, Sprigg N, Bart van der Worp H, Zedde M, Caso V. Women in the European Stroke Organisation: One, two, many… - A Top Down and Bottom Up approach. Eur Stroke J 2019; 4:247-253. [PMID: 31984232 DOI: 10.1177/2396987319841979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/10/2019] [Indexed: 11/15/2022] Open
Abstract
Background An increasing proportion of physicians are women, yet they still face challenges with career advancement. In 2014, the European Stroke Organisation established the goal of increasing the number and participation of women within the society using a Top Down and Bottom Up approach. The 'Women's Initiative for Stroke in Europe' was created the same year by a group of women active within the organisation. We aimed to assess the current status of women in European Stroke Organisation, and to explore the change in sex differences after the introduction of focused approaches to address disparities in 2014. Methods Using organisational records, we collected data on sex differences in core activities from 2008 up to 2017 including membership, participation in conferences, courses and in the official journal of the society, and positions of seniority and leadership. We estimated sex distribution differences in each of the activities from 2014 to date. Results In 2017, the proportion of female members was 40%, while 24% of fellows, 22% of the executive board and 19% of the editorial board in the official journal of the society were women. From 2014 to 2017, there was a significant increase in the proportion of female members (p = 0.0002) and in women participating in the annual conference as faculty (p = 0.001). There was no significant change in the sex distribution among the faculty members in junior educational activities (≤27%) or fellows. Interpretation In 2017, the proportion of women holding positions of seniority and leadership is still significantly lower to the proportion of women attending educational activities. Transparent data on sex distribution will assist implementing tailored programmes to achieve progress against sex-based barriers.
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Mehmedbegovic Z, Milasinovic D, Jelic D, Zaharijev S, Zobenica V, Pavlovic A, Dedovic V, Vukcevic V, Stankovic S, Asanin M, Stankovic G. P6362Comparison of the predictive value of contemporary risk scores for CIN development in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mehmedbegovic Z, Milasinovic D, Jelic D, Zaharijev S, Zobenica V, Pavlovic A, Dedovic V, Radomirovic M, Milosevic A, Vukcevic V, Stankovic S, Asanin M, Stankovic G. 4060The effect of optimal medical therapy on hospital discharge on 3-year mortality after acute myocardial infarction in patients undergoing primary percutaneous intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zobenica V, Milasinovic D, Mehmedbegovic Z, Zaharijev S, Jelic D, Pavlovic A, Dedovic V, Vukcevic V, Stankovic S, Asanin M, Stankovic G. P6198Association of heart failure and contrast-induced acute kidney injury on short- and long-term mortality in patients with STEMI undergoing primary PCI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jelic D, Milasinovic D, Mehmedbegovic Z, Zaharijev S, Zobenica V, Pavlovic A, Dedovic V, Vukcevic V, Asanin M, Stankovic G. P4397Effect of mild renal failure on admission on short- and long-term outcomes in patients with STEMI undergoing primary PCI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mehmedbegovic Z, Milasinovic D, Jelic D, Zaharijev S, Zobenica V, Pavlovic A, Dedovic V, Radomirovic M, Milosevic A, Stankovic S, Vukcevic V, Asanin M, Stankovic G. P778Gender stratified predictive capability of three well-validated risk scores in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zaharijev S, Milasinovic D, Mehmedbegovic Z, Jelic D, Zobenica V, Pavlovic A, Dedovic V, Vukcevic V, Asanin M, Stankovic G. P5556Association of admission anemia and heart failure on short- and long-term outcomes in patients with STEMI undergoing primary PCI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dedovic V, Milasinovic D, Jelic D, Vasilev V, Zivkovic M, Marinkovic M, Zaharijev S, Zobenica V, Pavlovic A, Mehmedbegovic Z, Tesic M, Stojkovic S, Vukcevic V, Asanin M, Stankovic G. P577Differential impact of gender on the relationship between body mass index and mortality in STEMI patients undergoing primary PCI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Knowles JW, Zarafshar S, Pavlovic A, Goldstein BA, Tsai S, Li J, McConnell MV, Absher D, Ashley EA, Kiernan M, Ioannidis JPA, Assimes TL. Impact of a Genetic Risk Score for Coronary Artery Disease on Reducing Cardiovascular Risk: A Pilot Randomized Controlled Study. Front Cardiovasc Med 2017; 4:53. [PMID: 28856136 PMCID: PMC5558259 DOI: 10.3389/fcvm.2017.00053] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/31/2017] [Indexed: 01/29/2023] Open
Abstract
Purpose We tested whether providing a genetic risk score (GRS) for coronary artery disease (CAD) would serve as a motivator to improve adherence to risk-reducing strategies. Methods We randomized 94 participants with at least moderate risk of CAD to receive standard-of-care with (N = 49) or without (N = 45) their GRS at a subsequent 3-month follow-up visit. Our primary outcome was change in low density lipoprotein cholesterol (LDL-C) between the 3- and 6-month follow-up visits (ΔLDL-C). Secondary outcomes included other CAD risk factors, weight loss, diet, physical activity, risk perceptions, and psychological outcomes. In pre-specified analyses, we examined whether there was a greater motivational effect in participants with a higher GRS. Results Sixty-five participants completed the protocol including 30 participants in the GRS arm. We found no change in the primary outcome between participants receiving their GRS and standard-of-care participants (ΔLDL-C: −13 vs. −9 mg/dl). Among participants with a higher GRS, we observed modest effects on weight loss and physical activity. All other secondary outcomes were not significantly different, including anxiety and worry. Conclusion Adding GRS to standard-of-care did not change lipids, adherence, or psychological outcomes. Potential modest benefits in weight loss and physical activity for participants with high GRS need to be validated in larger trials.
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Zivkovic I, Milasinovic D, Dobras J, Zaharijev S, Mehmedbegovic Z, Pavlovic A, Radomirovic M, Stevanovic M, Matic D, Tesic M, Ristic A, Seferovic P, Vukcevic V, Asanin M, Stankovic G. P4665Impact of the combined anemia and impaired left ventricular function on long-term outcome in STEMI patients undergoing primary PC. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Milasinovic D, Dobras J, Zaharijev S, Mehmedbegovic Z, Pavlovic A, Dedovic V, Stankovic S, Asanin M, Vukcevic V, Stankovic G. P6083Impact of beta-blocker therapy at discharge on long-term mortality in patients with or without impaired left ventricular function undergoing primary PCI for STEMI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Milosevic A, Milasinovic D, Dobras J, Zaharijev S, Stevanovic M, Radomirovic M, Pavlovic A, Mehmedbegovic Z, Dedovic V, Asanin M, Stankovic S, Vukcevic V, Stankovic G. P5590Association of older age with 30-day and 3-year mortality in patients undergoing primary PCI for STEMI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zivkovic I, Milasinovic D, Dobras J, Zaharijev S, Mehmedbegovic Z, Pavlovic A, Radomirovic M, Stevanovic M, Matic D, Dedovic V, Ristic A, Seferovic P, Vukcevic V, Asanin M, Stankovic G. P3266Differential impact of impaired renal function and acute heart failure on short- and long-term mortality in patients undergoing primary PCI for STEMI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zaharijev S, Milasinovic D, Dobras J, Mehmedbegovic Z, Pavlovic A, Zivkovic I, Radomirovic M, Stevanovic M, Stankovic S, Asanin M, Vukcevic V, Stankovic G. P5586Association of admission anemia and renal failure on short- and long-term outcomes in patients undergoing primary percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Milasinovic D, Zaharijev S, Dobras J, Pavlovic A, Mehmedbegovic Z, Dedovic V, Radomirovic M, Stevanovic M, Stankovic S, Asanin M, Vukcevic V, Stankovic G. P2291Impact of chronic total occlusion in non-culprit coronary artery on short- and long-term mortality in STEMI patients treated with primary PCI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mehmedbegovic Z, Milasinovic D, Zaharijev S, Dobras J, Stevanovic M, Radomirovic M, Pavlovic A, Zivkovic M, Dedovic V, Tesic M, Stankovic S, Vukcevic V, Asanin M, Stankovic G. P2746Can we identify with validated risk scores a low-to-intermediate risk patients that could benefit from early discharge after primary PCI? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mehmedbegovic Z, Milasinovic D, Zaharijev S, Dobras J, Radomirovic S, Stevanovic M, Zivkovic I, Pavlovic A, Dedovic V, Zivkovic M, Stankovic S, Vukcevic V, Asanin M, Stankovic G. P6076Impact of circumflex as a culprit artery on periprocedural and long-term clinical outcome in patients with acute myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dobras J, Milasinovic D, Mehmedbegovic Z, Zaharijev S, Pavlovic A, Zivkovic I, Zivkovic M, Stankovic S, Stevanovic M, Asanin M, Vukcevic V, Stankovic G. P1401Impact of contrast-induced acute kidney injury on short and long-term mortality in patients with renal failure undergoing primary PCI for STEMI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pavlovic A, Milasinovic D, Mehmedbegovic Z, Dobras J, Zaharijev S, Stevanovic M, Radomirovic M, Zivkovic I, Ristic A, Vukcevic V, Stankovic S, Asanin M, Stankovic G. P5124Impact of admission hyperglycemia on 3-year mortality in diabetic versus non-diabetic patients undergoing primary PCI for STEMI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Malojcic B, Giannakopoulos P, Sorond FA, Azevedo E, Diomedi M, Oblak JP, Carraro N, Boban M, Olah L, Schreiber SJ, Pavlovic A, Garami Z, Bornstein NM, Rosengarten B. Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. BMC Med 2017; 15:27. [PMID: 28178960 PMCID: PMC5299782 DOI: 10.1186/s12916-017-0799-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/21/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. METHODS At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. RESULTS Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. CONCLUSIONS US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.
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