Papestiev, Vasil

Preferred name

Papestiev, Vasil

Official Name

Papestiev, Vasil

Translated Name

Васил Папестиев

Alternative Name

Papestiev, V

V. Papestiev

Васил Папестиев

Папестиев, В

Vasil Papestiev

В. Папестиев

Main Affiliation

papestiev@gmail.com

Now showing 1 - 10 of 19

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Capecitabine-induced Cardiotoxicity Complicated with Acute Coronary Syndrome and Acute Heart Failure: A Case Report and Review of Scientific Data
(Medicinska Naklada d.o.o., 2025-04)
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Grueva Nastevska, Elena
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Shehu, Enes
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Petkovski, Dushan
Capecitabine cardiotoxicity is relatively common and may lead to serios cardiovascular complications. The aim of this case report is to emphasize the importance of considering potential toxic effects, rapid therapy discontinuation, and prompt treatment of all complications. We present a case of a 46-yearold male patient who was admitted to our clinic with chest pain and ST segment elevation in the anterior and lateral leads as a sign of acute ST-segment elevation myocardial infarction. Urgent coronary angiography was performed with the finding of a thrombus in the left anterior descendent coronary artery, and percutaneous coronary intervention was subsequently performed. Two months before admission, the patient had undergone surgery for rectal cancer. The above symptoms started three days after the introduction of treatment with capecitabine, which was discontinued on admission. The patient clinically deteriorated during the procedure, with development of cardiogenic shock. An echocardiography exam performed after the procedure showed severe reduction of left ventricular (LV) function (ejection fraction (EF) 21%). Due to further deterioration and cardiogenic shock refractory to optimal inotropic and vasopressor support, veno-arterial extracorporeal membrane oxygenation support was applied and the patient was placed on mechanical ventilation. After all these treatment measures, the patient clinically stabilized. He was extubated after 2 days and hemodynamically stabilized with gradually improvement of LV function. Control echocardiography after 9 days from admission showed an EF of 58%. Our case is an example of successful treatment of the potential serious cardiotoxic complications of capecitabine therapy in a young patient. The case also emphasizes the necessity of multidisciplinary collaboration in similar clinical scenarios.
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Predicting Post-operative Atrial Fibrillation in Cardiac Surgery – The Added Value of Echocardiography
(Scientific Foundation Spiroski (publications), 2021-12-30)
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INTRODUCTION: Post-operative atrial fibrillation (POAF) is a frequent rhythmic complication in cardiac surgery with the potential to cause sudden hemodynamic instability and catastrophic thromboembolic complications. Despite vast scientific research, it is still hard to predict and prevents its occurrence. AIM: The aim of this study was to determine whether selected pre-operative and intraoperative echocardiographic variables would be of added value in POAF prediction. МАTERIAL AND METHODS: This prospective observational follow-up study included 178 cardiac surgery patients undergoing coronary artery bypass graft intervention. Demographic as well as echocardiographic variables of interest were examined to detect significant independent predictors for POAF. RESULTS: POAF was detected in 90 (50.56%) patients versus 88 (49.44%) patients without POAF. Patients who developed POAF were significantly older and burdened with multiple comorbidities. In multiple regression analysis pre-operative echocardiographic variables-diastolic dysfunctions, enlarged left atrial (LA) volume indexed for body surface area, mitral annular calcification, and secondary mitral regurgitation were predictive of POAF. LA appendage flow velocity obtained by intraoperative transesophageal echocardiography was also a significant intraoperative predictor for POAF. CONCLUSION: The results of this study confirmed that two-dimensional echocardiography is a valuable diagnostic and prognostic tool in relation to POAF. The addition of the aforementioned echocardiographic independent predictors to traditional demographic variables could be a solid foundation of a new predictive model for POAF.
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Therapeutic Resistance In Synchronous Endometrioid Carcinomas: A Case Report With A Pathogenic Germline Mutation In PMS2
(Elsevier BV, 2025-02)
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The occurrence of synchronous malignancies, particularly endometrial and ovarian cancers, presents a notable clinical challenge, with studies indicating that approximately 2-10% of women diagnosed with ovarian cancer also present with endometrial carcinoma. Mismatch repair (MMR) genes, including PMS2, play a crucial role in the pathogenesis of these cancers, as mutations in MMR genes are associated with increased susceptibility to various malignancies. Understanding these genetic factors is essential for effective treatment approaches.
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Myocardial Function after Coronary Artery Bypass Grafting in Patients with Preoperative Preserved Left Ventricular Ejection Fraction-The Role of the Left Ventricular Longitudinal Strain
(MDPI AG, 2023-05-12)
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Risteski, Petar
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Popov, Aron Frederik
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Shokarovski, Marjan
Background and Objectives: The role of coronary artery bypass grafting (CABG) on postoperative left ventricular (LV) function in patients with preoperatively preserved left ventricular ejection fraction (LVEF) is still being discussed and only a few studies address this question. This study aimed to assess LV function after CABG in patients with preoperatively preserved LVEF using left ventricular longitudinal strain assessed by 2D speckle tracking imaging (STI). Materials and Methods: Fifty-nine consecutive adult patients with coronary artery disease (CAD) referred for a first-time elective CABG surgery were enrolled in the final analysis of this prospective single-center clinical study. Transthoracic echocardiography (TTE), with conventional measures and STI measures, was performed within 1 week before CABG as well as 4 months after surgery. Patients were divided into groups based on their preoperative global longitudinal strain (GLS) value. Differences in systolic and diastolic parameters between groups were analyzed. Results: Preoperative GLS was reduced (GLS < -17%) in 39% of the patients. Parameters of systolic LV function were significantly reduced in this group of patients compared to the patient group with GLS% ≥ -17%. In both groups, 4 months after CABG there was a decline in LVEF but statistically significant only in the group with GLS% ≥ -17% (p = 0.035). In patients with reduced GLS, there was a statistically significant postoperative improvement (p = 0.004). In patients with preoperative normal GLS, there was not a significant change in any strain parameters after CABG. There was an improvement in diastolic function parameters measured by Tissue Doppler Imaging (TDI) in both groups. Conclusions: There is improvement in LV systolic and diastolic function after CABG in patients with preserved preoperative LVEF measured by STI and TDI. GLS might be more sensitive and effective than LVEF for monitoring improvements in myocardial function after CABG surgery in patients with preserved LVEF.
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Finding of a mass on the mitral valve in a patient on chronic dialysis
(Elsevier BV, 2025-04)
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Shokarovski, Marjan
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Lazovski, Nikola
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Mehmedovic, Nadica
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Myxomas are cardiac neoplasms that are most commonly located in the left atrium, usually arising from the vicinity of the fossa ovalis. However, there have been cases, although very rarely, of valvular myxoma. A cardiac mass found incidentally on echocardiography can present a challenge in particular if asymptomatic or found in an unusual location. We present the case of a 58-year-old male with kidney disease treated with chronic dialysis, referred to the cardiology clinic because of an incidental finding of a mitral valvular mass on routine transthoracic echocardiography. Although this lesion was initially misdiagnosed as native valvular endocarditis with vegetation, a series of clinical and radiological investigations led to the preoperative diagnosis of possible papillary fibroelastoma or calcified thrombotic mass. Given the increased risk of embolization due to the mass being mobile and greater than 1 cm in size, the patient was referred to cardiac surgery. Excision of the mass without mitral valve replacement was performed. Histopathological findings of the mass revealed the existence of a cardiac myxoma. In such cases of a mitral valve mass, multimodality imaging should have of high priority to achieve an accurate diagnosis. Although a definitive diagnosis can only be established after surgical excision of the mass and histopathological confirmation, it is very important to consider a differential diagnosis of mitral valve myxoma in any patient with an unexplained mitral valve mass.
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The significance of nutritional status in postoperative management in cardiac surgery
(2024)
Kalinska, Sonja
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Zhivikj, Dushan
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Petreska Ivanovska, Tanja
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Zhivikj, Zoran
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THE SIGNIFICANCE OF THE ELECTROCARDIOGRAPHIC SCREENING USED IN PREVENTION AND DETECTION OF PATHOLOGICAL CHANGES IN HEARTS OF ATHLETES
(Faculty of Physical Education, Sport and Health, Skopje, Republic of Macedonia, 2022)
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Abstract Changes in the structure and function of the heart that occur as a result of engaging in professional amateur training can be detected in a timely manner by using 12-channel electrocardiography (ECG) as one of the non-invasive methods used for cardiovascular screening in athletes.. The aim of the study is to promptly detect and diagnose cardiovascular conditions that can cause sudden cardiac death in athletes. In this prospective cross-sectional study conducted during 2016/2017, 285 examinees-athletes aged 9-38 years of both sexes were included (62,1% men and 37,9% women). An ECG was performed on all of them and a personal, sports and family history was taken. According to the ECG changes and in accordance with international recommendations for its interpretation, the examinees were divided into 4 groups. The results showed that physiological changes in the ECG were found in 51,9% of examinees, borderline changes in the ECG in 21,4%, while abnormal in 7,7%. Due to the possibility of timely identification and detection of heart changes due to physical activity or congenital, and could cause sudden cardiac death, the use of 12-channel electrocardiography is necessary in the evaluation of athletes. Key words: electrocardiography, sudden cardiac death, screening for cardiovascular disease, athletes
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Diagnosis and Management of Acquired von Willebrand Disease in Heart Disease: A Review of the Literature
(Thieme, 2020-04)
Mate Petricevic
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Jadranka Knezevic
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Gordan Samoukovic
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Bozena Bradaric
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Ivica Safradin
The incidence of acquired von Willebrand syndrome (AvWS) in patients with heart disease is commonly perceived as rare. However, its occurrence is underestimated and underdiagnosed, potentially leading to inadequate treatment resulting in increased morbidity and mortality.In patients with cardiac disease, AvWS frequently occurs in patients with structural heart disease and in those undergoing mechanical circulatory support (MCS).The clinical manifestation of an AvWS is usually characterized by apparent or occult gastrointestinal (GI) or mucocutaneous hemorrhage frequently accompanied by signs of anemia and/or increased bleeding during surgical procedures. The primary change is loss of high-molecular weight von Willebrand factor multimers (HMWM). Whereas the loss of HMWM in patients with structural heart disease is caused by increased HMWM cleavage by von Willebrand factor (vWF)-cleaving protease, ADAMTS13, AvWS in MCS patients is predominantly a result of a high shear stress coupled with mechanical destruction of vWF itself.This manuscript provides a comprehensive review of the evidence regarding both diagnosis and contemporary management of AVWS in patients with heart disease.
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Changes in left ventricular function after coronary artery bypass grafting in patient with left ventricular dysfunction
(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2020)
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Sokarovski, Marjan
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Caseous Calcification of the Mitral Annulus: From Asymptomatic Lesion to Embolic Complication- Case Report
(ClinMed International Library, 2022-01-24)
Mitrovska, Slavica
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Mitashova, Vesna
Caseous calcification of the mitral annulus (CCMA) is a rare form of mitral annular calcification with a prevalence of 0.06% in the general population [1]. It is considered a benign condition, but in some cases it carries a risk for cardiovascular and cerebrovascular events. There is no consensus regarding treatment strategy and surgery is recommended for mitral valve dysfunction or thromboembolic events [2]. We present a case of surgical management of caseous mass of the posterior commissures of the mitral annulus with rapid dynamics from asymptomatic lesion to embolic complication.

Papestiev, Vasil

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