Browsing by Author "Stankovic, I. (57197589922)"

Aims The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey on radiation exposure in interventional echocardiography. The survey aimed to collect data on local practices for radioprotection in interventional echocardiography and to assess the awareness of echocardiography operators about radiation-related risks. Methods and results A total of 258 interventional echocardiographers from 52 different countries (48% European) responded to the survey. One hundred twenty-two (47%) participants were women. Two-thirds (76%) of interventional echocardiographers worked in tertiary care/university hospitals. Interventional echocardiography was the main clinical activity for 34% of the survey participants. The median time spent in the cath-lab for the echocardiographic monitoring of structural heart procedures was 10 (5–20) hours/month. Despite this, only 28% of interventional echocardiographers received periodic training and certification in radioprotection and 72% of them did not know their annual radiation dose. The main adopted personal protection devices were lead aprons and thyroid collars (95% and 92% of use, respectively). Dedicated architectural protective shielding was not available for 33% of interventional echocardiographers. Nearly two-thirds of responders thought that the radiation exposure of interventional echocardiographers was higher than that of interventional cardiologists and 72% claimed for an improvement in the radioprotection measures. Conclusion Radioprotection measures for interventional echocardiographers are widely variable across centres. Radioprotection devices are often underused by interventional echocardiographers, portending an increased radiation-related risk. International scientific societies working in the field should collaborate to endorse radioprotection training, promote reliable radiation dose assessment, and support the adoption of radioprotection shielding dedicated to interventional echocardiographers. © The Author(s) 2024.

Background: There is a common assumption that patients with coronary slow flow (CSF) have an excellent prognosis in the absence of coronary artery stenoses. Little is known about whether a history of previous coronary events affects the long-term survival in this population. In this retrospective, observational study, we assessed the possible association of a previous coronary event and long-term prognosis in patients with CSF but without significant coronary artery stenoses. Methods: A total of 141 patients (70 male; median age: 59 years, range: 33–78 years) with CSF and normal coronary angiograms were included in the study. Patients were followed up for all-cause mortality during a period of 47 ± 22 months. Results: Previous myocardial infarction (MI) was reported by 16 (11%) patients who had similar left ventricular ejection fraction (LVEF) as those without previous MI (51 ± 16 vs. 53 ± 16%, p = 0.595). Patients with previous MI more often had an abnormal resting electrocardiogram (69 vs. 40%, p = 0.03), while there were no significant differences in other baseline clinical characteristics (p > 0.05 for age, gender, risk factors, pharmacological treatment). In univariate Cox analysis, only previous MI was associated with unfavorable long-term survival (log-rank p = 0.012), while an abnormal electrocardiogram, LVEF, and other clinical variables were not (log-rank p > 0.05, for all). Kaplan–Meier analysis revealed unfavorable long-term survival in patients with CSF and a history of previous MI. Conclusion: In patients with CSF and an otherwise normal coronary angiogram, a history of a previous MI is associated with unfavorable long-term outcomes. © 2019, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Objective. The goal of the current work was to assess the possible relationship between upright T wave in precordial lead V1 (TV1) and the occurrence of coronary artery disease (CAD) in patients undergoing coronary angiography with an otherwise unremarkable resting electrocardiogram (ECG).Methods. Twelve-lead resting ECGs of 2,468 patients who underwent coronary angiography were analyzed by independent reviewers blinded to the patients' clinical data. Patients with any condition known to affect cardiac repolarization were not eligible for inclusion.Results. Of 126 patients included in the study, 76 (60%) had at least one significant coronary artery stenosis. Significant CAD was more frequently found in patients with upright TV1 as compared to those with negative TV1 (74 vs. 43%, p = 0.001). Left circumflex (LCx) and left anterior descending (LAD) coronary artery lesions were more frequently observed in patients with upright TV1 than in those with inverted TV1. In univariate analysis, patients with upright TV1 were approx 4 times more likely to have significant CAD than those with inverted TV1 (odds ratio (OR) 3.7, 95% confidence interval (CI) 1.744-7.897). In addition, in the multivariate logistic regression model, upright TV1 was an independent predictor of significant CAD (OR 4.249, 95% CI 1.594-11.328), along with previous myocardial infarction (OR 17.533, 95% CI 3.338-92.091), male gender (OR 3.020; 95% CI 1.214-7.510), and age (OR 1.061; 95% CI 1.003-1.122).Conclusion. It might be worthwhile to routinely evaluate the polarity of the T wave in lead V1 in patients with suspected CAD, since it appears to have additional risk stratification potential. © 2012 Urban & Vogel.