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Author: search.filters.author.Kocinaj, DSubject: search.filters.subject.dilated cardiomyopathy

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    Lower Body Weight in Men, an Epidemiological Predictor of Enlarged Left Atrium in Sinus Rhythm Patients with Dilated Heart
    (Wolters Kluwer - Medknow, 2016-07)
    Bakalli, A
    ;
    ;
    Musliu, N
    ;
    Kocinaj, D
    Background/Aims: The source of thrombi in patients with dilated cardiomyopathy is not necessarily from the dilated left ventricle. Left atrium (LA) and left atrial appendage (LAA) might be in charge for relatively high rate of systemic embolizations in these patients. The main aim of our study was to identify epidemiological predictors in sinus rhythm patients with dilated heart for LA and LAA dilation and/or dysfunction. Patients and Methods: This was a prospective cross-sectional study conducted from 2009 to 2014 in 101 sinus rhythm patients with dilated heart. We excluded patients with swallowing problems, acute myocardial infarction, atrial fibrillation/flutter, severe systolic dysfunction, mechanical valves, oral anticoagulation therapy, and/or patients with a history of stroke/systemic thromboembolic event. Results: Mean patient age was 58.13 ± 12.66 years and 69.3% were men. Hypertension was encountered in 51% of our patients, 56% of them had a history of coronary artery disease, 30% had diabetes, 25% had dyslipidemia, 30% were smokers, whereas 10% were alcoholics. Mean LA dimensions resulted higher than reference values, whereas 86% of our patients had LAA dysfunction. Male gender was an independent predictor for LA diameter dilation (95% confidence interval [CI]: 1.765–9.078, P = 0.005), while lower body weight was a predictor for enlargement of LA area (95% CI: 0.044–0.351, P = 0.014) and LA volume (95% CI: 0.160–2.067, P = 0.024). Conclusion: Male patients with dilated cardiomyopathy at sinus rhythm with lower body weight tend to have larger LA and consequently might be at higher risk of developing atrial thrombus and its subsequent consequences.
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    Left ventricular and left atrial thrombi in sinus rhythm patients with dilated ischemic cardiomyopathy
    (Academy of Medical Sciences of Bosnia and Herzegovina, 2012-06)
    Bakalli, A
    ;
    ;
    Kocinaj, D
    ;
    Musliu, N
    ;
    Zahiti, B
    Introduction: Ischemic dilated cardiomyopathy offers a favorable terrain for left ventricular (LV) thrombus formation; however, left artial appendage (LAA) may be an additional source of thrombi in patients with dilated heart. The main objectives of this study were to determine the prevalence of LV and LAA thrombi in patients with chronic ischemic dilated cardiomyopathy in sinus rhythm, as well as to reveal echocardiographic predictors for thrombus formation. Methods: The study included 57 patients with chronic dilated ischemic cardiomyopathy in sinus rhythm, who were not under oral anticoagulation therapy. Exclusion criteria included patients with: swallowing problems, acute myocardial infarction, idiopathic and/or non-ischemic dilated cardiomyopathy, atrial fibrillation/flatter, severe systolic dysfunction. Transthoracic echocardiography and transesophageal echocardiography were obtained for each patient. Results: Mean patient age was 62 ± 10.5 years, mean LV end diastolic diameter was 67.2 ± 5.8 mm, whereas mean LV ejection fraction (EF) was 37.1 ± 4.3 %. LV thrombus was detected in 11 (19.3%) patients; while 23 (40.3%) patients had LAA thrombus. In a multiple regression analysis LV size (p=0.05) and lack of aspirin therapy (p=0.02) showed to be independent LV thrombus predictors, whereas lower LV EF (p=0.02) and larger LAA maximal area (p=0.004) demonstrated to be independent predictors of LAA thrombus. Conclusions: We consider that our study sheds light to the high possibility of LAA thrombi formation in addition to LV thrombi in patients with chronic dilated ischemic cardiomyopathy in sinus rhythm. LV size, LV EF, LAA maximal area and lack of aspirin therapy are shown to be independent predictors of left heart chamber thrombi in this patient category.