Srbinovska kostovska, Elizabeta
Preferred name
Srbinovska kostovska, Elizabeta
Official Name
Srbinovska kostovska, Elizabeta
Main Affiliation
Email
elizabeta.srbinovska.kostovska@medf.ukim.edu.mk
37 results
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Item type:Publication, Role of Echocardiography in Diagnosis and Treatment of Patients with Infective Endocarditis(Македонско лекарско друштво = Macedonian Medical Association, 2014-08-01); ; <jats:title>Abstract</jats:title> <jats:p>Infective endocarditis is an endovascular microbial infection of cardiovascular structures, localized on valves, large intrathoracic vessels, ventricular and atrial endocardium and prosthetic materials. IE may present as an acute, subacute and chronic disease. The incidence of IE ranges from one country to another within 3-10 episodes/100.000 persons per years. The classification of IE according to the localization of the infection is: left-sided native valve IE, left-sided prosthetic valve IE (PVE), right-sided IE and device-related IE.</jats:p> <jats:p>Echocardiography plays a key role in each of the steps of assessment of IE: the diagnosis, risk stratification and follow-up of patients with infective endocarditis. The major echocardiographic criteria for IE are discovering vegetations, abscess, new valvular regurgitation and prosthesis dehiscence. According to the recent ESC recommendation for diagnosis and assessment of patients with IE, in all patients with clinical suspicion of IE, transthoracic echocardiography (TTE) is the first step of assessment. If we speak about patients with prosthetic endocarditis, then transoesophageal echocardiography (TEE) is recommended in case of poor quality of TTE and in majority of patients with positive TTE. If TTE examination is negative with low suspicion of IE, further follow-up has to be stopped. If TTE is negative but there is a high suspicion of IE, TEE has to be repeated in 7-10 days. Anatomical features on IE echocardiography have specific characteristics: vegetation, destructive valve lesion (perforation, prolapse of the valve) and abscess formation (more frequent in <jats:italic>Ao valve and in prosthetic valve</jats:italic>), which can be complicated with pseudoaneurysm and fistulization). Other cardiac imaging modalities (multislice computed tomogramphy (CT), magnetic resonance, 18F-fluorodesoxyglucose PET-CT, and single photon emission computed tomography (SPECT) /CT sometimes can be used in discovering complications in IE.</jats:p> <jats:p><jats:bold>Conclusion:</jats:bold> Echocardiography is useful in diagnosis of endocarditis, assessment of the severity of the disease, prediction of short-term and long-term prognosis, prediction of embolic risk, management of its complications, as well as deciding whether to operate or not and in choosing optimal time for surgery and follow-up.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P1495ECG parameters as predictors of response to cardiac resynchronization therapy(Oxford University Press (OUP), 2017-06); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IMPORTANCE OF ADDITIONAL ECHOCARDIOGRAPHIC PARAMETERS IN SELECTING A CRT RESPONDER PATIENT(Wiley, 2013-05); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Single-Photon Emission Computed Tomography Myocardial Ischemia Detection in High-Risk Asymptomatic Patients: Correlation with Coronary Calcium Score and High-Sensitivity C-Reactive Protein(2019); ; ; Apostolopoulos, VassoThe association between myocardial ischemia in high-risk patients with coronary calcium score (CCS) and high-sensitivity C-reactive protein (hs-CRP) is not well established. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial(Lippincott Williams & Wilkins for the American Heart Association, 2024-12) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, First Macedonian Registry on Atrial Fibrillation(Hrvatsko kardiološko društvo, 2013-09-23); ; ; Objectives: More than a half of the patients with atrial fibrillation (AF) are not adequately anti-coagulated, even though there is strong evidence in favor of the oral anticoagulant (OAC) therapy used in prevention of ischemic stroke in this patient-population. Most frequent factors causing this problem are: non-adherence to the Guidelines as well as the limitations like: difficulties in the maintenance of INR within therapeutic range, the necessity of monitoring and numerous interactions with food and other medications. Aim: Concerning non-adherence to the Guidelines all over the world in the treatment of the patients with AF, the aim of this Registry is to find the weak points in the treatment of these patients, and equilibrate the treatment all over the Country. Patients and Methods: More than 1,000 consecutive patients with AF in their electrocardiogram, diagnosed in the last year will be included in this Registry in the first year, from all over the country. All parameters concerning underlying cardiovascular disease will be listed and analyzed, also all co-morbidities. All diagnostic and interventional procedures, medications during this period will be analyzed, with special concern on anticoagulation therapy, type of anticoagulation, monitoring, and reason why, if not anti-coagulated. Analyses will be done in the way of treatment of the patient regarding the place of consultation: outpatient department, hospital, university clinic. Outcome points were defined as: cardiovascular death, death from other reason, ischaemic stroke, hemorrhagic stroke, transitory ischaemic attack, other major hemorrhage or thrombo-embolic complication. Results: Will be available at the end of the study; preliminary results will be due July 2013. Conclusion: General risk profile of patients with AF, frequency of anticoagulation, frequency of effective treatment and risks of bleeding will be evaluated. All outcome points will be analyzed, their independent predictors will be determined and the follow up will continue in the next 5 years. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Left ventricular function in patients with advanced stages of chronic obstructive pulmonary disease in correlation with GOLD classification system(2024); ; ; ; Background: Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease, with irreversible airflow obstruction, disease with high morbidity and early mortality rate. COPD is not just a disorder limited to the lungs. As the disease progresses, extra pulmonary co morbidities occur, where cardiovascular diseases are the most common. They mostly affect the right side of the heart, but sometimes changes also occur on the left side of the heart, as a result of long-term strain from the right ventricle (RV) and pulmonary hypertension which follows COPD. Material and methods: The design of our study was prospective-clinical cross-sectional study with 2 years follow up. In the study were included 94 patients with previously confirmed chronic obstructive pulmonary disease with spirometry and classified by Tiffeneau index in four gold classes. We have analyzed the values of some echocardiographic parameters that were selected as indicators of left heart function, and also we have analyzed them in relation to the progression of COPD from milder to more severe Golden classes, such as: left ventricular diastolic dimension (LvdD - mm), left ventricular ejection fraction (EF %), myocardial performance index (MPI) of the left ventricle, global longitudinal strain (Gl strain - %) of LV, diastolic function (E/e'). Echo analysis was done by Vivid 7 echo machine with a special feature to left heart chamber characteristics and function. Results: All echocardiographic parameters analyzed in our study, underline their significance in disease progression in patients with COPD and increasing Gold classes. A varies of statistical methods and parameters were used to evaluate: left ventricular diastolic dimension(mm), Ejection fraction of left ventricle (%), MPI of the left ventricle obtain by Tissue Doppler, GL strain of left ventricle (%) and E/e' in correlation of disease progression and GOLD class. Echo-parameters MPI of the left ventricle and Global longitudinal strain LV (%), progressively grow with the rise of the gold class (form I to IV). On the contrary the values of the parameters LvdD and EF% gradually decrease with the progression of the disease and gold class. Echocardiographic parameter GL strain LV % has the highest value and statistically by decreasing the values of this parameter the risk of disease progression from gold stage I/II to Gold stage III/IV is 1.570 times higher, with high statistical significance(p<0,01). The calculated value of the parameter EF% is lower than 0,75, which indicates that the model of prediction is not the best one but it's acceptable. Conclusion: COPD is a progressive disease that affects the dimensions of the right and left heart chambers, as well as the function of both chambers and the development of pulmonary hypertension. Monitoring echocardiographic parameters intended for assessment cardiac dimension and function can help tо predict disease progression for timely inclusion of specific therapeutic strategies. We suggest screening of all COPD patients for cardiac assessment using echocardiography as a non-invasive and repeatable method for their follow-up. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prognostic Significance of Echocardiographic Parameters for Right Heart Assessment and Risk of Developing Advanced Gold Classes in Patients with Chronic Obstructive Pulmonary Disease (COPD)(2023); ; ; Background: Chronic obstructive pulmonary disease (COPD) аaccording to World Health Organization is the third leading cause for early death and disability in 2022. COPD is characterized by persistent airflow limitation that is typically progressive and associated with an enhanced chronic inflammatory response in the airways and lung tissue. As the disease progresses more cardiovascular complication appear such as right ventricular hypertrophy with preserved systolic function, pulmonary artery pressure (which is slightly to moderately increased), and moderate tricuspid regurgitation. Material and methods: The design of our study was a prospective-clinical cross-sectional study. We analyzed 94 patients with COPD. All patients were divided in groups according to degree of obstruction and classified by GOLD classification system into four groups from GOLD 1-GOLD4. In our study all patients during admission and hospital stay were thoroughly examined with anamnesis, physical examination and electrocardiogram (ECG), as well as with basic and advanced echocardiographic assessment.13teen echo parameters were evaluated applying advanced echocardiographic analysis especially in terms of right heart features. Results: All echocardiographic parameters were analyzed to understand their significance in disease progression in patients with COPD and increasing Gold classes. Twelve of 13-teen echo-parameters evaluated in our study have quantitative values, while collapsibility of vena cava >50% is a qualitative parameter. Quantitative values of the same echo-parameters (DA, S TDV DV, TAPSE, FAC, AT a.pulmonalis, SPAP, v.max, MPI DV, Stain DV, DA area, PVR and collapsibility of vena cava > 50 %) were compared in terms of Gold classes by multivariate linear regression analysis. With multivariate linear regression analysis, there is a statistically significant correlation (with the following three echocardiographic parameters: S’ TDV DV, DV basal and Global strain DV according to GOLD classes. In further analyses, binary categorization of GOLD classes into two binary categories was additionally used: lower GOLD classes (1 and 2), and more advanced GOLD classes (3 and 4) by applying logistic regression model. The parameter basal dimension of the right ventricle (RV basal) has the highest values statistically, the parameters SPAP, AT a.pulm, Gl strain of DV and TAPSE have somewhat lower values. Conclusion: Prevalence of pulmonary hypertension has a linear relationship with severity of COPD and severe pulmonary hypertension is almost every time associated with development of right heart failure. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions. We suggest screening of all COPD patients for cardiac complications using echocardiography as a non-invasive and repeatable for their follow-up - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Myocardial gated SPECT imaging in asymptomatic diabetic patients: clinical decision and optimal therapeutic approach(Medical Publishing, d.o.o., 2013-05-14); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial(Ovid Technologies (Wolters Kluwer Health), 2024-06)