Background: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction (HfrEF). Etiology may influence the outcome of patients undergoing CRT. Objective: to evaluate whether etiology (ischemic vs non-ischemic) influences the response to CRT and overall outcome. Methods: Our study included HFrEF patients undergoing CRT between January 2017-November 2019. We assessed right ventricle (RV) and left ventricle (LV) function using transthoracic echocardiography at baseline and one year after CRT. The response to CRT was defined by a decrease of more than 15% of left ventricle systolic volume. Patients were divided in two groups: ischemic and non-ischemic based on personal history. Adverse events (HF related hospitalizations and deaths) were tracked for 33± 12.8 months. Results: 52 patients undergoing CRT were included (64±13.5 years, 55.7% male, 70% non-ischemic etiology) The two groups were similar considering LV systolic baseline parameters and volumes. Ischemic etiology was associated with non-LBBB morphology on ECG (p=0.03), a more severe LV diastolic dysfunction using E/e ratio (p<0.05), and a more severe RV dysfunction using TAPSE (p=0.008) and RV fractional area change (FAC) (p<0.05). There was no significant difference in CRT response between ischemic and non-ischemic etiology. 14 (26.9%) patients had events (10 hospitalizations and 4 deaths) with a higher prevalence in the ischemic group (58.33% vs 25%, p=0.01). Univariate Cox regression analysis reported a higher risk of cardiovascular events for ischemic etiology (HR 2.4, 95% CI [0.8-8.1], p <0.05). In our cohort there was no significant difference in use of an implantable cardioverter-defibrillator in addition to CRT between ischemic and non-ischemic group (64.2% respectively 63.3%, p =0.3). Conclusion: Our study shows that ischemic and non-ischemic HF patients had similar response to CRT. However, ischemic etiology was associated with a higher risk of adverse cardiovascular events and a worse RV systolic dysfunction at baseline.

Backround: Optimal antithrombotic therapy in patients with AF who undergo coronary stenting for an ACS has been a subject of constant change, with the addition of numerous trials in recent years. Objectives: The aim of our study was to assess current antithrombotic treatment in patients with AF and ACS treated with PCI. Material and methods: We performed a observational retrospective study on patients with nonvalvular AF, ACS and PCI between January 2017 and May 2019. We assessed both ischemic risk (IR) and haemorrhagic risk (HR) according to the 2018 ESC guidelines strategies. Results: 184 patients with nonvalvular AF and ACS treated with PCI were eligible for inclusion. In the whole cohort the HR was significantly higher than the IR (3.66+/-1.15 respectively 2.84+/- 1.15, p < 0.001). NSTEMI carries both the highest IR and HR (p<0.05). The majority of patients (88.04%) received triple antithrombotic therapy mostly for one month (39%). Main drug combination used was Aspirin, lopidogrel, antivitamin K (48.48%). Conclusions: In our registry of AF patients with ACS treated with PCI, triple antithrombotic therapy is still the strategy of choice with an initial duration of one month. In our cohort, HR is higher than IR, NSTEMI carrying the highest risks out of all the ACS.

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]. [...]

Despite the advanced technologies, the 12 leads electrocardiogram (ECG) remains an important investigation modality for providing a fast diagnostic of acute coronary syndromes (ACS). This method offers data concerning the presence, extension and severity characterizing the ischemic process (1). The ECG interpretation is still essential during the initial evaluation of patients admitted for ischemia suggestive symptoms (2).
Moreover, being a cheap, non-invasive and accessible technique, ECG continues to represent the gold-standard alternative for the differential diagnostic, for determining the appropriate treatment approach, for selecting patients susceptible of benefiting from reperfusion as well as regarding risk stratification (1).

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)

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.