Georgievska-Ismail, Ljubica

Preferred name
Georgievska-Ismail, Ljubica
Official Name
Georgievska-Ismail, Ljubica
Alternative Name
Georgievska-Ismail Lj
Georgievska-Ismail L
Georgievska Lj
Georgievska L
Lj Georgievska-Ismail
Georgievska Ismail Lj
Georgievska Ismail L
Main Affiliation
Email
lgismail@medf.ukim.edu.mk
lgismail@gmail.com

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    Cardiac memory (t-wave memory) after ablation of posteroseptal accessory pathway
    (2008-07)
    Trajkov, I
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    Kovacevic, D
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    Dobrkovic, L
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    Cardiac memory is a phenomenon characterized by transient T-wave abnormalities occurring during normal sinus rhythm, after a period of altered ventricular depolarization, where the T-wave vector has the same direction as the vector of the previously altered QRS complex (T-wave inversion). It is a form of electrical remodelling of the ventricular, where the T-wave follows ("remembers") a previously altered QRS vector.
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    Effect of nephrology referral on the initiation of haemodyalisis and mortality in ESRD patients
    (Macedonian Academy of Sciences and Arts, 2007-12)
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    Polenakovic, M
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    Gelev, S
    Late nephrology referral of patients with chronic kidney disease (CKD) has been suggested as increasing mortality after the initiation of dialysis. The aim of this study was to assess the impact of nephrology referral on the initiation of haemodyalisis (HD) and mortality during HD treatment in end-stage renal disease (ESRD) patients who have died in our institution over a five-year period. We studied data from all 117 patients on HD treatment in our institution who died (after 90 days of HD treatment) in the period between 01.01. 2002 and 31.12. 2006. Early (ER) and late referral (LR) were defined by the time of follow-up by a nephrologist greater than or less than 6 months, respectively, before the initiation of haemodialysis. Out of a total of 117 patients, 37.6% (44 patients) started HD in the ER group and 62.4% (73 patients) in the LR group. At the start of HD, LR patients were older, had a higher proportion of temporary catheters and had a significantly lower levels of haemoglobin and diuresis. Creatinine clearance was less in the LR (7.67 +/- 3.86 ml/min/1.73 m2) vs. the ER group (8.70 +/- 3.62 ml/min/1.73 m2), but not significantly different. Cardiovascular disease (CVD), defined by a history of myocardial infarction, cerebral vascular disease, peripheral arteriopathy, and/or heart failure, was also significantly more common among LR patients compared to ER (56%; 27%, p = 0.002). During the haemodyalisis treatment, the LR group had significantly lower levels of haemoglobin and haematocrit. CVD accounted for about 64% of deaths observed in the LR group. According to echocardiography data, there were no significant differences in the left ventricular mass index (LVMI) between the LR and ER groups at the time of dialysis initiation, but during haemodialysis treatment the LR group had significantly greater LVMI than the ER group (232,96 +/- 92,48 g/m2 vs.184,09 +/- 51,74 g/m2; p = 0,031). The time until death in months during dialysis treatment was significantly different between the LR and ER group, (69.51 +/- 64.03 vs.113.27 +/- 89.03, p = 0.0025). LR patients experienced a greater degree of anaemia and a high prevalence of CVD at the time of dialysis initiation. Our data suggest that the anaemia, CV damage and progression of left ventricular hypertrophy (LVH) in the LR patients during haemodialysis treatment are associated with poor survival on haemodialysis.
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    Association of Left Ventricular Global Longitudinal Strain with Exercise Capacity in Heart Failure with Preserved Ejection Fraction
    (Official Publication of Rajaie Cardiovascular Medical and Research Center / Wolters Kluwer, 2017-10)
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    Zarko Hristovski
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    Planinka Zafirovska
    Background: Left ventricular global longitudinal strain (GLS) analysis using two-dimensional (2D) speckle-tracking echocardiography (STE) is a method for detecting subclinical systolic dysfunction. We hypothesized that exercise capacity (EC) is more closely related to systolic than diastolic dysfunction, especially to GLS in patients with heart failure and preserved ejection fraction (HFpEF). Methods: We assessed LV systolic and diastolic function in 172 patients with HFpEF using 2D echocardiography and STE. EC measured in units of metabolic equivalents (METs) was assessed using Bruce protocol treadmill stress testing. We defined reduced EC as <7 METs. Results: Out of 172 patients, 54 (31.4%) had EC of <7 METs. Patients with reduced EC of <7 METs versus those with ≥7 METs were significantly older (P = 0.0001), female (P = 0.001) with higher body mass index (BMI) (P = 0.001) and waist circumference for both man and women (P = 0.040, P = 0.001, respectively) as well as with higher resting heart rate (HR) (P = 0.009). Logistic regression analysis of EC as the dependent variable revealed that conventional risk factors (age, female gender, higher waist circumference, increased resting HR, and increased diastolic resting blood pressure) appeared as independent predictors of <7 METs. When age, gender, and hypertension were omitted from the analysis the results demonstrated that increased resting HR (odds ratio [OR] 1.025, P = 0.059, 95% confidence interval [CI] 0.997–1.192), higher BMI (OR 1.148, P = 0.003, 95% CI 1.047–1.258) along with elevated E/E’ average ratio (OR 1.090, P = 0.059, 95% CI 0.997–1.192) appeared as independent predictors of <7 METs. In addition, when we included only echocardiographic variables into the logistic model, the results showed that only lower GLS% (more positive) appeared as an independent predictor of <7 METs (OR 1.111, P = 0.044, 95% CI 1.003–1.231). Conclusion: Greater impairment of GLS in patients with HFpEF appeared as a significant independent predictor of reduced EC by METs achieved.
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    Hypomagnesemia and cause-specific mortality in hemodialysis patients: 5-year follow-up analysis
    (SAGE Publications, 2017-10-13)
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    Tozija, Liljana
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    The aim of this prospective study was to evaluate the association between serum magnesium (Mg) and mortality, in particular the cause-specific mortality of Mg and other risk factors in hemodialysis (HD) patients.
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    Chlamydia pneumoniae and helicobacter pylori serology - importance in patients with coronary heart disease
    (Academy of Medical Sciences of Bosnia and Herzegovina, 2012)
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    Zafirovska, Planinka
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    Jaglikovski, Branko
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    Chronic infections in CHD are due to one or both of the organisms Chlamydia pneumoniae and Helicobacter pylori.
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    The Effect of Treatment on Short-Term Outcomes in Elderly Patients with Acute Kidney Injury
    (Scientific Foundation SPIROSKI, 2017-08-15)
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    Elderly population (≥ 65) are more prone to develop acute kidney injury (AKI) compared to younger, also elderly with AKI have an increased requirement for dialysis treatment and an elevated risk of short-term and long-term mortality.
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    Predictors of in-hospital morbidity and mortality in patients with coronary artery disease treated with coronary artery bypass surgery
    (Macedonian Academy of Science and Art (MANU), 2006-12-27)
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    Borozanov, V
    Aim of the study: The aim of our study was to identify markers that can predict early morbidity and mortality in patients with coronary artery disease who underwent coronary artery bypass surgery (CABG) for myocardial revascularization. Material and methods: 749 patients (pts) were enrolled in the study at mean age 55 +/- 8 years, 639 male and 119 female. We analyzed pre-operative demographic, clinical, left ventricular morphologic and functional and angiographic variables, per-operative characteristics, and we registered occurrence of hospital complications including cardiac death during the first 30 days after the operation. Results: Hospital complications were registered in 173 (23.1%) patients, including cardiac death registered in two (3%) patients during the first 30 days after the operation. The most common complications were: pericardial effusion (8.4%), supraventricular arrhythmias (6.3%) and pleural effusion (5.6%), followed by more serious complications like infections, acute renal failure and stroke. Advanced age (>or=65 years), coexisting morbidities and risk factors: cerebrovascular disease (CVD), peripheral vascular disease (PVD), chronic obstructive pulmonary disease (COPD), hypertension (HTA), previous myocardial infarction (MI), heart failure before the operation, extensive coronary artery disease (CAD) (angiographicly identified), low left ventricular ejection fraction (LVEF), and high WMSS index were identified as predictors of in-hospital morbidity. Advanced age, Mod Gensini score (as marker of angiographic severity of CAD) and WMSS index were found to be independent predictors of in-hospital morbidity, while advanced age, heart failure before CABG and in-hospital complications were found to be independent predictors of in-hospital mortality. Conclusion: In patients with coronary artery disease who underwent CABG surgery, preoperative variables and operative technique can predict occurrence of in-hospital morbidity, while early complications can strongly predict in-hospital mortality.
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    Factors influencing graft potency in patients who underwent CABG for treatment of CAD
    (2006)
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    Borozanov, V
    Objectives: To identify factors that influence graft disease and native coronary arteries progression disease and prognostic implication of this process. Background: Unsolved problem in CABG patients is progression of the disease in bypass grafts and native coronary arteries. Methods: Data from 102 patients with CABG, who underwent re-coronarography, were analyzed: - Pre and post-operative variables: risk factors, clinical status, functional capacity, left ventricular parameters and angiographic status (before and after CABG). Proportional hazard regression model, was used, p<0.05 was considered statistically significant. Results: Cardiac death, myocardial infarction and heart failure were more frequent in patients with graft occlusion, non-stable angina pectoris in non-occlusive graft disease, which together with acute myocardial infarction was more often in patients with native coronary arteries progression disease. PCI was significantly more often performed on native coronary arteries. Conclusion: Graft disease and native coronary artery progression disease is a continuous process which can be slowed by aggressive risk factors reduction, medications, and PCI procedures. In contrary, it leads to unfavorable clinical outcome (Tab. 8, Fig. 6, Ref 19).
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    Хемодинамички детерминанти на постдијализниот повратен скок на уреата
    (Македонско лекарско друштво = Macedonian medical association, 2003)
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    Grozdanovski, Risto
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    Dzikova, Sonja
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    The effect of certain clinical characteristics and dialysis parameters of the hemodialysis patients upon the appearance of postdialysis urea rebound (PDUR) are not clearly defined. The aim of the study was to found the hemodynamic determinants of PDUR and their participating in the prescribed dose of hemodialysis. We measured PDUR 30 minutes after dialysis in 64 chronic hemodialysis patients. We analyzed the arterial-hemodynamic parameters: predialysis and postdialysis blood pressure (Systolic blood pressure: SBP1 and SBP2, Diastolic blood pressure: DBP1 and DBP2, Mean blood pressure: MBP1 and MBP2), cardiac output (CO), cardiac index (CI), total peripheral resistances (PREZ), access blood flow-Qbac above, Qbac below , Qb a.rad , Qb a.brach. The patient clearance time (tp) was calculated from the Tattersall equation where spKt/V and eKt/V are calculated by using 30 sec and 30 min. postdialysis urea concentrations. CO and access blood flow, were measured by Doppler after the dialysis session. The mean PDUR was 23.34 ± 12.82 % and correlated negatively with predialysis and postdialysis blood pressure, especially with MBP2 – mean postdialysis blood pressure (r = -0.3235, p=0.0093 ), with CO (r = -0.3102, p=0.0225), with Q.a. brach. (r = -0.3274, p=0.0281). SpKt/V was 1.39 ± 0.25 and eKt/V was 1.16 ± 0.20, while tp expressed in the minutes was 50.24 ± 24.06 and strongly correlated with PDUR, r = 0.944, p= 0.00. The patients with MBP2 < 100 mmHg (MBP2 83.44 ± 12.06 ) and the patients with CO <5.6 l/min (CO 4.29 ± 0.89) had statistically significant higher PDUR than the patients with MBP2 ≥ 100 and the patients with CO > 5.6 l/min. We can conclude from the study that hemodialysis patients with lower blood pressure and lower cardiac output have higher PDUR. These patients should have longer prescription time regarding their long clearance time.
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    Relationship of Mitral Annular Plane Systolic Excursion (MAPSE) to Left Ventricular Thrombus Formation
    (2014-10)
    Bakalli, A
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    Zahiti, B
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    Hocinaj, D
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    Gecaj-Gashi, A
    Background: Dilated cardiomyopathy is associated by radial and longitudinal contractile cardiac dysfunction. Left ventricular (LV) thrombus is a frequent finding in patients with dilated cardiomyopathy. The main purpose of our study was to evaluate the role of mitral annular plane systolic excursion (MAPSE) in LV thrombus formation in patients with dilated cardiomyopathy by assessing their correlation. Our additional objective was to compare the relationship of average MAPSE to relations of other LV features [LV size, LV ejection fraction (EF), wall motion score index (WMSI), sphericity index-width to length ratio (w/l) of the LV] and LV thrombus developmentMaterial and Methods: This was a prospective cross-sectional study conducted from October 2009 until January 2012 in 100 sinus rhythm patients with dilated cardiomyopathy without anticoagulation therapy. We excluded patients with: swallowing problems, acute myocardial infarction, atrial fibrillation/flutter, severe systolic dysfunction, severe arterial hypertension, valvular disease, and/or mechanical valves. Results: Mean patient age was 58.1±12.7 years and 69% were men. Mean LV EF was 39.1±6.4%, while mean value of average MAPSE was 9.3±2.2mm. LV thrombus was detected in 14% of patients and its presence correlated well with: average MAPSE (r=-0.22, p=0.01), MAPSE of sepatal wall (r=-0.23, p=0.01), MAPSE of lateral wall (r=-0.2, p=0.02), MAPSE of inferior wall (r=-0.22, p=0.01), LV EF (r=-0.21, p=0.02), LV end diastolic diameter (r=0.24, p=0.008), LV end systolic diameter (r=0.31, p=0.0008), WMSI (r=0.22, p=0.01) and w/l (r=0.19, p=0.03). Conclusions: Longitudinal LV dysfunction is associated with LV thrombus formation, as average MAPSE demonstrates a negative correlation with LV thrombus, and its role is similar to LV size, LV EF, sphericity index and WMSI.