Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Language: search.filters.language.EnglishSubject: search.filters.subject.heart failure

Search Results

Now showing 1 - 5 of 5
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITORS IN HEART FAILURE
    (MIT University Skopje, 2023)
    ;
    Tonev, Jelena
    ;
    ;
    ;
    Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are antidiabetic drugs whose therapeutic action has gone beyond diabetes and extended to the cardiovascular and renal systems. They are class I evidence, guideline-directed medical therapy in heart failure irrespective of ejection fraction or diabetes mellitus. There are several assumptions about the mechanism of their action, but the exact mechanism has not yet been determined. Every doctor should be familiar with these new drugs for the implementation of their uses and better recognize and limit side effects.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Prognosticators of heart failure in patients after treatment because of acute coronary syndrome
    (2016-05)
    ;
    ;
    Bekim Pocesta
    ;
    Gorjan Krstevski
    ;
    Hajber Taravari
    Aim of the study was to identify frequency and predictors of heart failure in patients treated for acute coronary syndrome (ACS). Patients and methods: Patients with ACS treated medically or with PCI, were extracted from the hospital registry. Analyzed variables: age, gender, risk factors, SBP and HR at hospital admition, type of MI, location, CAD severity, LV function, type of treatment, in-hospital morbidity, pharmacologic treatment post discharge, time to event. Statistical analyze: descriptive and comparative analyze, uni and multivariate regression analyze, Caplan-Meier event free survival analyze. Results: 437 patients treated for ACS, at mean age 63,2±11,1 years, 294(67,3%) males and 143(32,7%) females, were followed up for mean 17,3±10,3 months. A total of 128(29,3%) patients had 136 cardiac events (CE), 32(25%) of whom heart failure (HF). Mean time to HF was 5,9±7,4 (SE), CI(3,3-8,6) (Figure 1). As univariate predictors of HF in ACS treated patients we identified: length of hospitalization (for ACS treatment) 3,9±2,2 vs 5±2,5 days (beta .169, p=0,009); diuretic utilization during ACS hospitalization (beta 1.992, p=0,001); EF (%) (beta -0.092, p=0,001); reduced EF (<40%) had OR for HF 3.282 (CI 1,129-9,542, p=0,011); receiving PPCI (beta -1.584, p=0,011, exp(B) 0.205); known DM (beta0.741, p=0,007, exp(B) 2,098); previous MI (beta 0.832, p=0,068, exp(B) 2,297); statin therapy prior ACS (beta-0.955, p=0,028, exp(B) 0,385); PCI performed (beta-0.990, p=0,043, exp(B) 0,372); in-hospital morbidity (beta 0.868, p=0.028, exp(B) 2,382). In multivariate analyze (binary logistic regression) four independent predictors were identified: known diabetes (p=0,004), PCI treatment for ACS (p=0,006), diuretic therapy during ACS hospitalization (p=0,004) and LV function (p=0,024). Conclusion: Predictors of HF development in pts. after ACS, seems to be preexisting DM, need for diuretic therapy during ACS event, and reduced LV systolic function as negative ones, but, receiving PCI (myocardial revascularization) is the most important positive predictor.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Functional outcome and quality of life after coronary artery bypass surgery in patients with severe heart failure and hibernated myocardium
    (Wolters Kluwer, 2008-03-29)
    Peovska, Irena
    ;
    Maksimovic, Jelena
    ;
    ;
    ;
    Background: Myocardial viability is an important parameter, predictive of improvement in left ventricular function after coronary artery bypass surgery (CABG). We wanted to define the relationship between the extent of hibernated myocardium and improvement in ejection fraction function and quality of life after CABG. Methods: Sixty-five consecutive patients with ischaemic cardiomyopathy (mean LVEF <40%) undergoing surgical revascularization were studied with (99m)Tc-sestamibi myocardial perfusion Gated SPECT imaging (MPI) to assess preoperative myocardial viability. Patients were divided into two groups, based on the extent of viable myocardium before CABG: group 1, 39 patients with more than four viable segments; and group 2, 26 patients with fewer than four viable segments. Regional and global ejection fraction function, heart failure symptoms and quality of life were measured before and 14+/-4 months after revascularization. We used bull's eye quantitative analysis of MPI scans and a 17-segment model of ejection fraction function and perfusion evaluation. Results: The number of viable segments per patient was directly related to the improvement in LVEF after revascularization (r=0.79, P<0.01). Patients with more than four viable segments representing 24% of the left ventricle yielded the sensitivity of 83% and specificity of 79%, respectively, for predicting improvement in LVEF. Furthermore, the presence of four or more viable segments predicted improvement in heart failure symptoms and quality of life after revascularization. Conclusion: The presence of more than four viable segments (24% of the left ventricle) on MPI in patients with ischaemic heart failure before CABG surgery is significantly correlated with the improvement in LVEF, heart failure symptoms and quality of life post-operatively.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Relationship between myocardial viability and improvement in left ventricular function and heart failure symptoms after coronary artery bypass surgery
    (Macedonian Academy of Science and Art (MANU), 2007-07-28)
    Peovska, I
    ;
    Maksimovic, J
    ;
    ;
    Davceva, J
    ;
    Background: The evaluation of myocardial viability is an important preoperative parameter, predictive of improvement in regional and global left ventricular (LV) function after coronary artery bypass surgery (CABG). However, whether the presence of viability is also associated with relief of heart failure symptoms after revascularization is not always certain. The aims of the study were to define the relationship between extent of viable myocardium and improvement in LV function after CABG and to determine whether preoperative viability testing can predict improvement in heart failure symptoms. Methods: Eighty-five consecutive patients with ischemic cardiomyopathy (mean LVEF 35%) undergoing surgical revascularization were studied with a Tc-99m sestamibi one-day rest/nitrate enhanced myocardial perfusion SPECT imaging (MPI) to assess viability. Regional and global function were measured before and 16 -/+ 6 months after revascularization. We have used the Bull's eye quantitative analysis of MPI scans and 17 segment model of LV function and perfusion evaluation. Heart failure symptoms were graded according to the New York Heart Association (NYHA) criteria, before and 16 -/+ 6 months after revascularization. Results: The number of viable segments per patient was directly related to the improvement in LVEF after revascularization (r 0.79, P < 0.01). Patients with > 4 viable segments representing 24% of the left ventricle yielded the sensitivity of 83% and specificity of 79% respectively for predicting improvement in LVEF. Furthermore, the presence of four or more viable segments predicted improvement in heart failure symptoms after revascularization, with positive and negative predictive values of 79% and 74%, respectively. Conclusion: The presence of substantial viability (four or more viable segments, 24% of the left ventricle) on myocardial perfusion gated SPECT imaging in patients with ischemic heart failure before CABG surgery has significant correlation with the improvement in LVEF and heart failure symptoms postoperatively.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    In-hospital outcome of patients with peripartum cardiomyopathy – a single center study
    (Medical Publishing, d.o.o., 2014-10-29)
    ;
    Arnaudova-Dezulovic, Frosina
    ;
    ;
    ;
    Palasheva, Lidija
    Peripartum cardiomyopathy (PPCMP) is a disorder of unknown cause in which initial left ventricular systolic dysfunction and symptoms of heart failure (HF) occur between the last month of pregnancy and the first 5 months postpartum. The causes and pathogenesis are poorly understood and PPCMP remains a diagnosis of exclusion. Clinical presentation includes usual signs and symptoms of heart failure, and unusual presentations relating to thromboembolism. Effective HF treatment reduces mortality rates and increases the number of women who fully recover left ventricular (LV) systolic function. PPCMP is common in some countries and rare in others. During 6 years period (2008-2014) 22 patents (pts) were admitted to our hospital with diagnosis of PPCMP. 16(73%) pts were admitted to our hospital immediately post-partum, because of acute HF which needed immediate and aggressive HF treatment. Six (27%) pts presented congestive HF symptoms during the first three months after delivery. At the admission all the pts had documented LV systolic dysfunction with echocardiography (EF <45%). Five of them (23%) had severely impaired LV systolic function (EF=25-30%), seven (32%) pts had EF of 30-40%, and 10 (45%) pts had mild LV systolic dysfunction. During the hospitalization, clinical and functional improvement and stabilization was achieved in all patients. Complete recovery of LV systolic function was observed in 12 (55%) pts with PPCMP. In 10 pts (45%) there was persistence of LV systolic dysfunction determined with echocardiography. Peripartum cardiomyopathy is rare, but a serious disease associated with significant cardiac functional deterioration. Early diagnosis and appropriate medical treatment allows good functional recovery in majority of these patients and favorable prognosis. Reliable population-based information about incidence and prevalence of PPCMP is essential to the development of health policies for prevention and control of this condition.