Maria Dorobantu

Maria Dorobantu

Two-Dimensional Speckle Tracking Echocardiography - a Useful Non-Invasive Method in Predicting Significant Coronary Artery...

Echocardiography is the first cardiac imaging technique used to evaluate patients presenting with acute coronary syndrome (ACS). However, in the absence of wall motion abnormalities, conventional echocardiography at rest provides little information. Patients presenting with low risk ACS usually have normal wall motion and left ventricle ejection fraction (LVEF) at rest.

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Blood Pressure Control and Quality of Life in Hypertensive Patients Treated with Amlodipine/Valsartan Fixed Dose Combination...

High blood pressure is the world’s most common cause of death, estimated to affect at 4 out of 10 Romanian adults [1-3]. Despite the availability of a wide range of antihyper-tensive drugs, about 70% of treatment hypertensive pa-tients fail to achieve the blood pressure target of less than 140/90 mmHg recommended by the current guidelines [4,5]. In Romania, less than one quarter of treated hypertensive adults have a controlled blood pressure (less than 140/90 mmHg) [1-3,6,7]. [...]

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The Role of Echocardiography in the Surgical Management of Secondary Mitral Regurgitation

Secondary mitral regurgitation (MR) also known as functional mitral regurgitation is more common, portends a worse prognosis than primary MR and its management is more difficult and less sustained by evidence. [1]The etiology of secondary MR may be ischemic or nonischemic such as in idiopathic dilative cardiomyopathy. The prognosis of patients with secondary MR is worse with increasing severity ofMR.[2] The mechanism of secondary MR is linked to the left ventricle (LV) geometrical remodeling with secondary tethering of the mitral leaflets, while the valve morphology is normal. [3][4] [...]

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Alternative Pathways of Delivering Cardiac Resynchronization Therapy: A Single Center 10 Year Experience on 400 Consecutive...

Heart failure (HF) can be either induced or aggravated by the existence of left ventricular (LV) intraventricular dyssynchrony (IVD). Cardiac resynchronization therapy (CRT) can potentially correct LV-IVD in well-characterized populations (see current Guidelines). CRT has demonstrated clear benefits in both soft (NYHA class, 6MWT, QoL) and hard (all cause mortality, 6 months hospitalizations) randomized control trial (RCT) endpoints. The standard approach is to deliver a unipolar (UP)/bipolar (BP) dedicated LV-lead via the coronary sinus (CS) into a postero-lateral (PL) tributary vein.
Suboptimal LV-lead positioning has been long recognized as an important cause of CRT non-response. Optimal, delay targeted LV-lead placement might sometimes only be possible with non-standard techniques due to various patient particularities. We decided to retrospectively evaluate the frequencies and types of techniques we used in over a decade of CRT experience in our centre. "Alternative CRT" is not yet a coined term. We defined unexpendable variations from the straightforward technique as alternative pathways of delivering CRT.

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The Additive Value of 2D Longitudinal Strain During Stress Echocardiography in Coronary Artery Disease Detection in Low Risk...

Approximately 20% of patients arriving in the crowded emergency departments (ED) present with acute chest pain (ACP) and 60% are admitted in order to rule out an acute coronary syndrome (ACS). In the latter category, the ACS is confirmed only in 15% of patients thus resulting in a huge number of unnecessary admissions and wasted resources. (1) Stratifying ACP as low, moderate or high risk ACS allows physicians to take immediate action, initiate treatment and transfer the patient to the appropriate location.

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Cardiovascular Autonomic Dysfunction: A Possible Prognostic Marker in Patients with Arterial Pulmonary Hypertension

In the past two decades, the association between the cardiovascular autonomic dysfunction and the cardiovascular mortality has been well documented. This association indicates that individuals with abnormal autonomic function tests are candidates for close surveillance. In type 2 diabetes it is recommended that a baseline determination of cardiovascular autonomic function be performed upon diagnosis and within 5 years of diagnosis for those with type 1 diabetes, followed by a yearly repeat test.[1]
Out of the markers that objectify this relationship, heart rate variability (HRV) has proven to be the most reliable and the easiest to quantify. Although HRV has been the subject of numerous clinical studies whose purpose was linking heart rate changes to the gravity and the evolution of the disease, only in two clinical settings a consensus was reached. The drop in HRV can be used as a risk factor in the period following an acute myocardial infarction (AMI) and as a warning sign for cardiac autonomic neuropathy (CAN) in diabetic patients. HRV parameters and their possible prognostic significance have not been thoroughly evaluated in patients presenting pulmonary arterial hypertension.

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Acute Myocardial Infarction in Youngs: Presentation, Treatment and Outcome

Coronary Artery Disease (CAD), the world’s leading cause of death and morbidity, it is not anymore an attribute of old age (1). The increase prevalence of atherosclerotic risk factors among the young and very young population is responsible for more premature CAD cases (2). Prior studies highlighted that AMI in young’s is associated with different clinical features and has a better short-term outcome than in older population (3,4,5). However, long-term follow-up revealed a higher mortality and morbidity in young AMI survivors than in general population (6,7). Also, the conclusion of several studies and "real-world" registries was that patients with STEMI and NSTEMI, regardless of age and despite different management, have similar inhospital outcome and longterm survival (8,9).
In our country, RO-STEMI registry is providing the most extensive information on the profile, treatment and inhospital outcome of the STEMI Romanian patients (10) but only few reports about mid and long-term follow up of young Romanian patients with AMI, especially in case of NSTEMI, are available (11,12,13).

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Predictors of Increased Arterial Stiffness in Hypertensive Patients

In Romania, a high cardiovascular (CV) risk East European country, where prevalence of hypertension is still high and optimal blood pressure control still represents a doubtfull challange (1-5), adopting a treatment approach strategy based on total cardiovascular risk assessment can maximize the costeffectiveness of hypertensive patinets management, ensuring the best use of the limited resources of our health-care system, to prevent cardiovascular diseses and to decrease CV morbidity and mortality.
Recent research show that increased arterial stiffness represents an independent predictor of fatal and non-fatal CV events in hypertensive patients (6-10).

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Left Atrial Function in Patients with Reentrant Paroxysmal Supraventricular Tachycardia with Narrow QRS Complex - The Role of..

The reentrant paroxysmal supraventricular tachycardias with narrow QRS complex are in a large majority represented by atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT). From an electrophysiological (EP) point of view the difference between the two forms is made by the type of the reentry circuit. That means that the former requires an accessory pathway with retrograde conduction while the latter implies the existence of perinodal pathways.
The left atrium (LA) is a part of the circuit in both types of arrhythmias. In sinus rhythm the left atrium has several functions: it acts as a conduit during protodiastole, it has a contractile function raising the filling pressure during atrial systole but it also has a reservoir function during ventricular systole. (1)

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Arterial Hypertension Epidemiology: Romania among the Balkan Countries - Data from SEPHAR Surveys

Cardiovascular disease prevention showed its utility and efficiency in developed countries, where it lowered the cardiovascular morbidity and mortality. Instead, in Balkan countries, the mortality due to this pathology displayed an ascendant, worrying curve [1], diagnosis and control of arterial hypertension (HT) representing efficient methods for lowering cardiovascular mortality. Though recent studies didn’t show any significant differences between hypertension prevalence in developed versus developing countries [2], stroke mortality (the best surrogate marker of hypertension effects) was much higher in developing countries. Since modifying genetics was a target impossible to reach for the moment, the only solution was represented by the evaluation and correct treatment (pharmacological and non pharmacological) of arterial hypertension.
As international scientific organisations recom-mend, cardiovascular disease prevention must be implemented in an individualized way in each geo-graphical region, being inappropriate and impossible to apply the same prevention methods globally [3,9]. In this context, the Balkan Peninsula aggregates a number of countries with common geographical and social characteristics, many of them sharing economical transition.

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