Browsing by Author "Mladenović, Zorica (57219652992)"

Introduction/Objective The purpose of the Echocardiographic Society of Serbia (ECHOS) national survey was to assess current echocardiography practice in Serbia, the availability of different echocardiographic techniques and self-perceived need for improvement at personal and institutional level. Methods A survey comprising 20 questions about demographics, numbers and distribution of echo-cardiographic equipment and techniques, image acquisition and reporting standards as well as future educational preferences was sent to all ECHOS members via email. Results A total of 106 members (42%) answered the survey. Echocardiographic examinations are most frequently performed by cardiologists and internal medicine specialists. Transesophageal echocar-diography (TOE), stress echocardiography (SECHO) and speckle tracking echocardiography (SpTE) are available in approximately 20% of centers, three-dimensional echocardiography in 11%, while contrast echocardiography is practiced in only two centers. Less than a third of respondents always attach elec-trocardiographic electrodes and archive examinations. Almost all respondents (96%), always evaluate both systolic and diastolic function of the left ventricle (LV), although systolic LV function is frequently assessed (55%) using non-standard methods. The newer echocardiographic machines are more often available at university than non-university centers (87 versus 44%, p < 0.01). SECHO was perceived as the most needed technique at the institutional level, while SpTE and TOE were most often reported personal aspirations of the respondents. Conclusion Advanced techniques, SECHO and TOE are needed but rarely performed outside the university hospitals in Serbia. In order to achieve a better adherence to standards of practice in echocardiography, the development of national guidelines and personal and laboratory accreditation seem warranted. © 2020, Serbia Medical Society. All rights reserved.

Introduction/Objective The purpose of the current Echocardiographic Society of Serbia (ECHOS) survey was to assess echocardiography practice in Serbia during the Coronavirus disease 2019 (COVID-19) pandemic. Methods An online survey consisting of 12 questions about the usa of echocardiography, the availability of portable ultrasound devices and personal protective equipment (PPE) was sent to all ECHOS members. Results Overall, 126 ECHOS members (43%) answered the survey. One-third of respondents (36%) were physicians from specialized COVID-19 centers. During the pandemic, indications for echocardiographic examination were restricted in both COVID-19 and non-COVID-19 centers. In COVID-19 centers, 41% of respondents performed lung ultrasound to each patient versus 26% in non-COVID-19 centers. Transesophageal echocardiography was not performed in suspected or confirmed COVID-19 cases in any center. Portable ultrasound devices were available to 66% of respondents from COVID-19 versus 44% of respondents from non-COVID-19 centers (p = 0.018). The respondents reported regular use of PPE, regardless of the patient’s COVID-19 status and found their personal knowledge about protective measures and use of PPE satisfactory. Conclusion During the COVID-19 pandemic in Serbia, indications for echocardiography were restricted to clinical scenarios in which the results of examination were expected to alter patient management. In both COVID-19 and non-COVID-19 centers, the use of PPE was in line with national and international recommendations. A wider availability of portable ultrasound devices and application of lung ultrasound could improve patient management in similar situations in the future. © 2020, Serbia Medical Society. All rights reserved.

Background/Aim. Previous studies have confirmed a positive correlation between homocysteine levels and a greater risk for acute coronary syndrome and stroke, but there are no available data to support an association between homocysteine and inflammatory markers and the severity of coronary artery disease according to the clinical SYNTAX score in patients with stable angina. The aim was to determine the association between homocysteine and inflammatory biomarker levels: interleukin (IL)-6, high sensitive C-reactive protein (hs-CRP), fibrinogen, erythrocyte sedimentation rate (ESR) and the severity of coronary artery disease according to clinical SYNTAX score. Methods. Eighty-two patients with stable angina pectoris (average age 65 ± 8 years, 28.9% females) underwent coronary angiography and were divided into three groups according to the clinical SYNTAX score: the group I < 22 (39 patients), the group II 23–32 (16 patients), the group III > 33 (27 patients). The severity and complexity of coronary artery disease were calculated by clinical SYNTAX score, multiplying the SYNTAX score with the modified ACEF score, based on the patients’ left ventricular ejection fraction, age and creatinine clearance (derived with Cockcroft–Gault equation). Results. Homocysteine levels were significantly higher in patients with high clinical SYNTAX score [the group I: median (interquartile range – IQR): 10.20 (3.97), the group II: 10.45 (5.77), the group III: 14.70 (7.50), p = 0.005]. Patients in the group III had significantly higher homocysteine levels compared to the group I (p = 0.001). We also found a positive association between inflammatory biomarkers (IL-6, hsCRP, fibrinogen, ESR) and the severity of coronary artery disease according to the clinical SYNTAX score (p = 0.017, 0.001, 0.032, 0.049 respectively). We detected significantly lower plasma levels of vitamin B12 in the group III and group II in comparison with the group I (the group I: median (IQR): 238 (160), the group II: 171 (160), the group III: 172 (102), p = 0.022), which indicates its important role in homocysteine metabolism. Conclusion. The elevated plasma levels of homocysteine, IL-6, hsCRP, fibrinogen, ESR were detected in patients with high clinical SYNTAX score (> 33). Our results showed that hyperhomocysteinemia and some inflammatory biomarkers can predict more severe and extensive coronary artery disease in stable angina patients. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction. Left ventricular noncompaction (LVNC) is a congenital disorder characterised by prominent trabeculations in the left ventricular myocardium. This heart condition very often goes completely undetected, or is mistaken for hyper-trophic cardiomyopathy or coronary disease. Case report. A middle-aged female with a positive family history of coronary disease was admitted with chest pain, electrocardiography (ECG) changes in the area of the inferolateral wall and elevation in cardiac specific enzymes. Initially, she was suspected of having acute coronary syndrome. However, in the left ventricular apex, especially alongside the lateral and inferior walls, cardiac ultrasound visualised hypertrabeculation with multiple trabeculae projecting inside the left ventricular cavity. A short-axis view of the heart above the papillary muscles revealed the presence of two layers of the myocardium: a compacted homogeneous layer adjacent to the epicardium and a spongy layer with trabeculae and sinusoids under the endocardium. The thickness ratio between the two layers was 2.2:1. The same abnormalities were corroborated by multislice computed tomography (MSCT) of the heart. Conclusion. Left ventricular noncompaction is a rare, usually hereditary cardiomyopathy, which should be considered as a possibility in patients with myocardial hypertrophy. It is very often mistaken for coronary disease owing to ECG changes and elevated cardiac specific enzymes associated with myocardial hypertrophy and heart failure. © 2018, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

[No abstract available]

Echocardiography is an indispensable diagnostic tool of cardi-ologists and other specialties involved in proving care to cardiovascular patients. In this paper, Echocardiographic Society of Serbia provides its viewpoint regarding the organization of basic education in transthoracic echocardiography, aiming at homogeneity of education and improving the quality of echo-cardiographic training in Serbia. © 2021, Serbia Medical Society. All rights reserved.

[No abstract available]