Browsing by Author "Pavlovic, Sinisa U. (7006514891)"

Heart rate (HR) asymmetry is a dynamic phenomenon related to the interplay of dominant regulatory mechanisms of cardiovascular system which operate over different scales of observation. The aim of this work is to examine asymmetry phenomenon in heart failure (HF) patients with sinus rhythm. We computed Guzik's index of heart rate asymmetry related to HR deceleration (C-{d}) from the Poincaré plot (Pp) analysis extended up to 20th order. In the control group asymmetry is maintained over all orders of the Pp. In HF patients with asymmetric properties, C-{d} is reduced in the range between 2ndand 5th order of the Pp analysis, compared the control subjects. More, this method revealed two clusters of HF patients. In conclusion, proposed new approach can be applied to reveal alterations in the behavior of the cardiovascular control mechanisms in pathological conditions. © 2020 IEEE.

Heart rate (HR) asymmetry is a dynamic phenomenon related to the interplay of dominant regulatory mechanisms of cardiovascular system which operate over different scales of observation. The aim of this work is to examine asymmetry phenomenon in heart failure (HF) patients with sinus rhythm. We computed Guzik's index of heart rate asymmetry related to HR deceleration (C-{d}) from the Poincaré plot (Pp) analysis extended up to 20th order. In the control group asymmetry is maintained over all orders of the Pp. In HF patients with asymmetric properties, C-{d} is reduced in the range between 2ndand 5th order of the Pp analysis, compared the control subjects. More, this method revealed two clusters of HF patients. In conclusion, proposed new approach can be applied to reveal alterations in the behavior of the cardiovascular control mechanisms in pathological conditions. © 2020 IEEE.

Background: In the majority of patients with a wide QRS complex and heart failure resistant to optimal medical therapy, cardiac resynchronization therapy (CRT) leads to rever se ventricular remodeling and possibly to changes in cardiac collagen synthesis and degradation. We investigated the relationship of biomarkers of myocardial collagen meta bolism and volumetric response to CRT. Methods: We prospectively studied 46 heart failure patients (mean age 61±9 years, 87% male) who underwent CRT im plantation. Plasma concentrations of amino-terminal pro peptide type I (PINP), a marker of collagen synthesis, and carboxy-terminal collagen telopeptide (CITP), a marker of collagen degradation, were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume at 6-month follow-up. Results: Baseline PINP levels showed a negative correlation with both left ventricular end-diastolic volume (r=-0.51; p=0.032), and end-systolic diameter (r=-0.47; p=0.049). After 6 months of device implantation, 28 patients (61%) responded to CRT. No significant differences in the base-line levels of PINP and CITP between responders and nonresponders were observed (p>0.05 for both). During follow-up, responders demonstrated a significant increase in serum PINP level from 31.37±18.40 to 39.2±19.19 μg/L (p=0.049), whereas in non-responders serum PINP levels did not significantly change (from 28.12±21.55 to 34.47±18.64 μg/L; p=0.125). There were no significant changes in CITP levels in both responders and non-responders (p>0.05). Conclusions: Left ventricular reverse remodeling induced by CRT is associated with an increased collagen synthesis in the first 6 months of CRT implantation.

Background: In the majority of patients with a wide QRS complex and heart failure resistant to optimal medical therapy, cardiac resynchronization therapy (CRT) leads to rever se ventricular remodeling and possibly to changes in cardiac collagen synthesis and degradation. We investigated the relationship of biomarkers of myocardial collagen meta bolism and volumetric response to CRT. Methods: We prospectively studied 46 heart failure patients (mean age 61±9 years, 87% male) who underwent CRT im plantation. Plasma concentrations of amino-terminal pro peptide type I (PINP), a marker of collagen synthesis, and carboxy-terminal collagen telopeptide (CITP), a marker of collagen degradation, were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume at 6-month follow-up. Results: Baseline PINP levels showed a negative correlation with both left ventricular end-diastolic volume (r=-0.51; p=0.032), and end-systolic diameter (r=-0.47; p=0.049). After 6 months of device implantation, 28 patients (61%) responded to CRT. No significant differences in the base-line levels of PINP and CITP between responders and nonresponders were observed (p>0.05 for both). During follow-up, responders demonstrated a significant increase in serum PINP level from 31.37±18.40 to 39.2±19.19 μg/L (p=0.049), whereas in non-responders serum PINP levels did not significantly change (from 28.12±21.55 to 34.47±18.64 μg/L; p=0.125). There were no significant changes in CITP levels in both responders and non-responders (p>0.05). Conclusions: Left ventricular reverse remodeling induced by CRT is associated with an increased collagen synthesis in the first 6 months of CRT implantation.

Background: The aim of this paper was to present single centre experience in the treatment of extra cranial carotid artery aneurysms (eCCa) and to analyze results discussing different treatment modalities. MeThods: The study analyzed 60 patients with 62 eCCa treated surgically at the Clinic for vascular and endovascular surgery, serbian Clinical Center (Belgrade) in the period between 1985 and 2013. Treatment strategy was individually selected and demographic, morphologic, intraoperative and postoperative data were collected. resulTs: Thirty-day operative mortality was 3.3% and completely stroke related. Besides two fatal strokes one additional was registered making total number of 3 (4.8%) postoperative strokes. only one (1.6%) early graft thrombosis has been found. The 30-day-patency rate was 98.4%. during the same period seven local complications were found: three (4.8%) hemorrhage and four (6.4%) cranial nerves injuries. in all cases of hemorrhage successful re-intervention was performed without any consequences. Cranial nerves injuries included transient contusions of hypoglossal (2) and superior laryngeal nerve (2). ConClusions: The etiology, location, and morphology of an eCCa are determining selection of appropriate therapy. large or tortuous aneurysms, as well as aneurysms involving common carotid or proximal internal carotid artery, are also absolutely indicated to open surgical therapy. Aneurysms which involve the distal internal carotid artery and false anastomotic aneurysms are best managed with endovascular techniques. The ligature is indicated for the treatment of external carotid aneurysms, mycotic aneurysms with local infection and in ruptured eCCa with uncontrolled bleeding. © 2016 Edizioni Minerva Medica.