Browsing by Author "Kanjuh, V. (57213201627)"

Diabetic cardiomyopathy is a controversial clinical entity that in its initial state is usually characterized by left ventricular diastolic dysfunction in patients with diabetes mellitus that cannot be explained by coronary artery disease, hypertension, or any other known cardiac disease. It was reported in up to 52-60% of well-controlled type-II diabetic subjects, but more recent studies, using standardized tissue Doppler criteria and more strict patient selection, revealed a much lower prevalence. The pathological substrate is myocardial damage, left ventricular hypertrophy, interstitial fibrosis, structural and functional changes of the small coronary vessels, metabolic disturbance, and autonomic cardiac neuropathy. Hyperglycemia causes myocardial necrosis and fibrosis, as well as the increase of myocardial free radicals and oxidants, which decrease nitric oxide levels, worsen the endothelial function, and induce myocardial inflammation. Insulin resistance with hyperinsulinemia and decreased insulin sensitivity may also contribute to the left ventricular hypertrophy. Clinical manifestations of diabetic cardiomyopathy may include dyspnea, arrhythmias, atypical chest pain, and dizziness. Currently, there is no specific treatment of diabetic cardiomyopathy that targets its pathophysiological substrate, but various therapeutic options are discussed that include improving diabetic control with both diet and drugs (metformin and thiazolidinediones), the use of ACE inhibitors, beta blockers, and calcium channel blockers. Daily physical activity and a reduction in body mass index may improve glucose homeostasis by reducing the glucose/insulin ratio and the increase of both insulin sensitivity and glucose oxidation by the skeletal and cardiac muscles. © 2012 Urban & Vogel.

Percutaneous endomyocardial biopsy was performed for the diagnosis of various heart disorders in 160 consecutive patients in Belgrade, Yugoslavia. Tissue specimens were taken from the left ventricle in 150 patients and from the right ventricle in 10. To determine the clinical merit of endomyocardial biopsy, patients were divided into six groups based upon the existing clinical findings, including cardiomyopathy, myocarditis, specific heart muscle disease, alcohol-induced heart disease, major dysrhythmias, and other diagnoses. The clinical value of endomyocardial biopsy was gauged by the number of diagnoses that were histologically confirmed by the procedure. We combined the percentages of histologically suspected clinical diagnoses with those of completely changed clinical diagnoses and found that endomyocardial biopsy provided useful information in 70.6% of cases. Nonspecific histological findings were found in 25.6% of cases. The biopsy proved to be of no clinical value in only 3.8% of the cases. Although some investigators still object to the overall clinical usefulness of diagnostic endomyocardial biopsy, our findings help to underscore the value of this procedure for making an accurate diagnosis.

Background: Anthropologic, artistic and medical significance of heart inspired us to undertake this multidisciplinary study. Materials and methods: Amongst the 24 obtained echocardiograms and phonograms, 1 was used for a Photoshop processing. In addition, over 20,000 artwork reproductions were examined in this study. Results: Artistic and symbolic presentation of heart started some 15,000 years ago. First heart models were made by the Egyptian and Olmec civilisations. Ancient cultures regarded heart as the seat of the soul, spirit and intelligence. First anatomical and artistic images of heart were created by Leonardo da Vinci in the 15th century, and first wax models by the Italian anatomists in the 17th century. Mediaeval religious symbolism of heart was replaced in the Renaissance and later on mainly by its role in the romantic love. Anatomical heart art continued in the 18th and 19th centuries through the works of Sénac, Cloquet, Hirschfeld and Bourgery. Some modern artists, such as Dalí, Kahlo, Rivera, Warhol, Ivanjicki, Vital, Kober and Mastrlova, created the anatomical heart images or sculptures, whereas some others, such as Duchamp, Klee, Miró, Matisse and Dine, presented heart symbol in their artworks. New radiologic technologies produce fine images of heart, some of which are similar to the works of modern artists. Conclusions: Heart biology and symbolism have had a tremendous influence on our culture, including art and medical sciences. New radiologic techniques and computer technology have produced such images of heart, which substantially improved diagnosis, but also enhanced the heart aesthetics. Copyright © 2014 Via Medica.

Purpose Myocardial bridge is a congenital anomaly with a markedly variable reported incidence on autopsy (4.7%–86%), likely related to geographical regions. Our previous retrospective study showed a prevalence of 0.8%, which we doubted to be the true one in the examined sample of the Serbian population. To assess the importance of the phenomenon we conducted a 2-year prospective study at the same institution. Methods Ninety-six cadaver hearts from adult individuals of both genders (51 men, 45 women) who died from natural causes underwent special dissection. Tunneled coronary arteries and myocardium were examined using light microscopy. Results A total of 14 myocardial bridges were found in 13 (13.54%) hearts. This anomaly was insignificantly more common in men (13.72% vs. 13.33%, p > 0.05). In one heart we noted two myocardial bridges (the left anterior interventricular artery and left marginal artery were overbridged). None of the myocardial bridges had been diagnosed during life. The most common causes of death were cardiac related. Myocardial bridges were located in the following areas: left anterior interventricular (50%), left circumflex artery (28.6%), left marginal artery (14.3%), and right coronary artery (7.1%). In 92.3% of cases, the right coronary artery was dominant. The only heart with a balanced-type had two bridges. Most of the myocardial bridges were long and deep. All tunneled coronary arteries, and although surrounded by “coronary cushion,” were not protected from atherosclerosis. In 30.8% of hearts with myocardial bridges, we found additional coronary artery anomalies. Conclusion Myocardial bridges were not rare in the examined sample of the Serbian population and were often associated with other coronary artery anomalies, rendering the carriers at higher risk. © 2016 Elsevier GmbH

Purpose Myocardial bridge is a congenital anomaly with a markedly variable reported incidence on autopsy (4.7%–86%), likely related to geographical regions. Our previous retrospective study showed a prevalence of 0.8%, which we doubted to be the true one in the examined sample of the Serbian population. To assess the importance of the phenomenon we conducted a 2-year prospective study at the same institution. Methods Ninety-six cadaver hearts from adult individuals of both genders (51 men, 45 women) who died from natural causes underwent special dissection. Tunneled coronary arteries and myocardium were examined using light microscopy. Results A total of 14 myocardial bridges were found in 13 (13.54%) hearts. This anomaly was insignificantly more common in men (13.72% vs. 13.33%, p > 0.05). In one heart we noted two myocardial bridges (the left anterior interventricular artery and left marginal artery were overbridged). None of the myocardial bridges had been diagnosed during life. The most common causes of death were cardiac related. Myocardial bridges were located in the following areas: left anterior interventricular (50%), left circumflex artery (28.6%), left marginal artery (14.3%), and right coronary artery (7.1%). In 92.3% of cases, the right coronary artery was dominant. The only heart with a balanced-type had two bridges. Most of the myocardial bridges were long and deep. All tunneled coronary arteries, and although surrounded by “coronary cushion,” were not protected from atherosclerosis. In 30.8% of hearts with myocardial bridges, we found additional coronary artery anomalies. Conclusion Myocardial bridges were not rare in the examined sample of the Serbian population and were often associated with other coronary artery anomalies, rendering the carriers at higher risk. © 2016 Elsevier GmbH

To investigate whether the antivasoconstrictor effect of P1075, a potassium channel openers, could be partly due to modulation of neurotransmitter release from adrenergic nerve endings we analysed the presynaptic and postsynaptic effects of P1075 on the isolated human saphenous vein (HSV). The HSV rings were contracted by electrical field stimulation (EFS) or by exogenous noradrenaline (10 μM; NA). The repetitive transmural EFS was carried out at 20 Hz with square wave pulses of 0.3 ms duration and supramaximal voltage. The contraction of the HSV in response to transmural EFS recorded in our experiments are neurogenic in nature, as this effect was abolished by tetrodotoxin (1 μM). We have also found that phentolamine (1 μM) inhibited almost completly (90 ″ 2%) the HSV contractions to EFS suggesting that this response was mediated by NA release from perivascular sympathetic nerve endings activating postjuncional α adrenoceptors. P1075 (0.01-10 μM) induced a concentration-dependent inhibition of both neurogenic contractions, and contractions evoked by exogenous NA of the HSV with pEC 50 values of of 6.48 ″ 0.05 and 6.36″ 0.08. The difference between the pEC 50 values (r) was not statistically significant (P > 0.05). These results suggest that the antivasoconstrictor effect of P1075 on the HSV might be postsynaptic, and associated with opening of the smooth muscle potassium channels.