KJaeva, Sasha
Preferred name
KJaeva, Sasha
Official Name
KJaeva, Sasha
Translated Name
Ќаева, Саша
Alternative Name
Sasha Kjaeva
Kjaeva Anastasova, Sasha
Саша Ќаева
Саша Ќаева Анастасова
Ќаева Анастасова, Саша
Kjaeva, S
Kjaeva Anastasova S
Ќаева Анастасова, С
Ќаева, С
Sasha Kjaeva Anastasova
Main Affiliation
Email
skaeva@gmail.com
20 results
Now showing 1 - 10 of 20
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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, Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia(International Scientific Invention Journals, 2019-02-13); ; ; Introduction: Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with gestational hypertension/preeclampsia. Aim: The aim of the study is to show that some of the heart changes in pregnancies complicated with gestational hypertension and preeclampsia are abnormal and further follow up of these patients is needed. Methods: A total of 81 patients were enrolled in the study. The patients were further divided in two groups. Pregnant women with gestational hypertension or preeclampsia (51) and a control group of normotensive pregnancies (30). A total of 3 echocardiograph exam were made, the first upon entry in the study (28 -34 g.w), the second 2 weeks after delivery and the last 6 months after delivery. Results and discussion: We found several statistically significant results that involve the IVS, PWLV, LKM, left chamber hypertrophy and diastolic function. Diastolic dysfunction usually shows up before systolic dysfunction in the evolution of ischemic/hypertensive cardiovascular disease and is of prognostic value in predicting long term cardiovascular morbidity. The changes seen 6 months after delivery on our last control mean that those changes are permanent and need further prevention strategies. Conclusion: From the noninvasive methods echocardiography is the most favorable method in identifying structural changes and functional changes in pregnancies with hypertension. Echocardiography allows fast, reproducible information and is both safe for mother and fetus. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Bilateral Serous Retinal Detachment in Preeclampsia: Case Report(Македонско лекарско друштво / Walter de Gruyter GmbH, 2017-06-01); ; ; Introduction. Preeclampsia presents a medical condition in pregnancy that is manifested with increased blood pressure and protein urine. Ocular involvement is rare. Retinal detachment in preeclampsia is a rare complication; it only occurs in 1-2% of severe preeclampsia but in 10% of those with eclamptic seizures. Case report. A pregnant patient G1P0 visited the outpatient clinic of the University Clinic for Ophthalmology complaining on visual disturbances. The chief complaint was blurred vision and headaches. She was in 31 week of gestation and complained that she had increased blood pressure over the last month. After initial assessment she was suspected of central serous retinal ablation (CSCR). Ocular ultrasound and posterior segment OCT (optical coherence tomography) confirmed the diagnosis.Treatment and outcome. Obstetric examination confirmed high blood (TA180/130) pressure with dipstick urine showing(+++). Unfortunately, the ultrasound showed an eutrophic pregnancy in 31 g.w. with fetus mortus inutero. The patient was administered to the intensive care unit. She had an ophthalmologic check-upat 2 weeks and one month post-partum that showed regression and visual acuity was getting better. The final check-up after 6 months revealed that retina was in place with no subretinal substantial fluid and no macular edema. Conclusion. Serous retinal detachment is a rare complication of preeclampsia. In most case it resolves spontaneously few weeks post delivery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Prevalence of Diabetes Mellitus in COPD Patients with Severe and Very Severe Stage of Disease(Scientific Foundation SPIROSKI, Skopje, 2016-05-22); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between detected respiratory pathogens and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease(Македонско лекарско друштво = Macedonian medical association, 2021); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The role of NT-proBNP as a diagnostic marker in patients with COPD(Македонско лекарско друштво = Macedonian medical association, 2020); ; ; ; Debreslioska, Angela - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of echocardiographic parameters for right heart function and pulmonary hypertension in the progression of Chronic Obstructive Pulmonary Disease(2022); ; ; Risteski, DejanINTRODUCTION Chronic opstructive pulmonary disease (COPD) is one of the diseases with highest mortality rate, high morbidity and early mortality. Right ventricular hypertrophy with preserved systolic function is most common finding in patients with COPD.COPD patients not so rarely have increased pulmonary vascular resistance (PVR), moderate to severe form of pulmonary hypertension, ‘’cor pulmonale” and right heart failure. Our study investigated the echocardiographic parameters used to assess right ventricular function and pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) according to their specificity and sensitivity and disease progression. MATERIAL AND METHODS We have analysed 94 patients with COPD (Gold class I-IV). The 13 echo-cardiography parameters important for assessment of right ventricular function and pulmonary hypertension due to their sensitivity and specificity and progression of the disease were evaluated: basal dimension of the right ventricle(DV bazal), right atrium(DA), right atrial area(DA area), S‘wave of the right ventricle of TDI, TAPSE, functional area change (FAC %), (SPAP), Vmax of tricuspid regurgitation , acceleration time of pulmonary artery (AT), pulmonary vascular resistance (PVR), myocardial performance index of the right venricle (MPI), global strain of the right ventricle(GL strain), collаpsibility of vena.cava inferior >/<50 %. RESULTS AND DISCUSSION Predictors of disease progression with high specifity ans sensitivity are the parameters: MPI DV TDI, Global strain of DV and collabsibility of v.cava inferior less then 50%. Predictors of disease progression with high specifity and low sensitivity are : DV bazal, DA, DA area, S TDI, TAPSE, FAC, SPAP, V max TR. Predictors of disease progression with low specifity and high sensistivity are parameters: shortened acceleration time of the pulse Dopler of the pulmonary valve and the development of pulmonary vascular resistаnce. CONCLUSION Echocardiography is a non invasive and useful method for evaluation and follow up the patients with COPD. All this indicates that the values of certain echocardiographic parameters can help us detect disease progression, with high sensitivity, high specificity or both. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HEART DAMAGE IN PREGNANCIES COMPLICATED WITH PREECLAMPSIA: CASE REPORT(Macedonian Medical Association/ Walter de Gruyter GmbH, 2016); ; ; ; Introduction. Heart function in pregnancy is a subject of many debates and studies. A large number of epidemiologic studies have found association between preeclampsia and cardiovascular morbidity/mortality. About 5-8% of deliveries are complicated with preeclampsia. Until recently, heart damage associated with preeclampsia has not been studied. A number of heart difficulties only appear long after the reproduction period has en-ded. Preeclampsia increases the risk for B stage (asymptomatic) of heart failure. Case report. A 37-year-old pregnant patient, G2P1 27 weeks of gestation, paid her first visit to the Gynecology Outpatient Clinic. She complained on heavy breathing, difficulty with movement and hypertension. She was referred for further evaluation to the Cardiology Outpatient Clinic with a suspicion of gestational hypertension and heart abnormalities. The pregnancy was evaluated several times at the Out-patient Clinics of Gynecology and Cardiology with the diagnosis of gestational hypertension. Echocardiography showed abnormal heart remodeling. In the 36 g.w laboratory findings showed urine dip stick ++,ТА160/110. The diagnosis was changed to preeclampsia. The patient was delivered with a re-caesarean section because of previous S.C and preeclampsia. Postpartum echocardio-graphy confirmed left chamber hypertrophy with per-sistent hypertension. Results. Clinical cardiovascular complications in preec-lampsia continue long after the pregnancy has ended. Studies show that pregnancies with both early and late preeclampsia have an increased risk for asymptomatic left chamber dysfunction/hypertrophy and essential hypertension in the next 2 years after delivery. If the damages are caught early prevention can be started sooner rather than later before patients become symptomatic (C stage of heart failure). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between echocardiographic parameters and the severity of stage in patients with COPD(Macedonian Association of Anatomists and Morphologists, 2020-03); ; ;