Peripheral artery disease of the lower limbs is, in fact, an arterial pathology, by which the blood flow is reduced, due to the obstruction caused by the deposit of atheroma plaques.(1) This deposition occurs slowly, which leads to a slow progression of the disease, and thus, at the onset of symptomatology. The objective of the study was to make a comparison between the invasive and noninvasive paraclinical investigations performed in patients with peripheral arterial disease of the lower limbs in the E.C.C.H. Sibiu. In conclusion, between the two investigations (computed tomography angiography and digital subtraction angiography) there are no noticeable differences in the terminal aorta and iliac arteries, but in reducing the arteries calibre, the use of digital subtraction angiography is preferred, according to our study, although it is more invasive and exposed to complications.
Cardiorenal syndrome (CRS) is a serious condition in which cardiac dysfunction leads to renal impairment and viceversa, with a high risk of mortality. This paper is a review of the most recent studies that investigated the role of Levosimendan on kidney function in case of patients with CRS. Compared with standard therapy (diuretics, other inotropes), Levosimendan has renoprotective effects associated with a lower mortality rate, it leads to an important improvement in NYHA class, a decrease in markers of congestion (BNP) and shortage of hospitalization stay. A study from 2018, in which Levosimendan was compared with Dobutamine, indicated that although both agents increase renal perfusion, only Levosimendan can improve GFR. In conclusion, Levosimendan – through its protective profile for both heart and kidneys, provides higher survival expectancy and seems to be the ideal alternative to the standard therapy in the management of hemodynamic CRS at present.
Peripheral arterial disease (PAD) is a partial or complete occlusion of one or more arteries leading to a suppression of blood flow and ischemia. In the process of stenosis, numerous processes are described, among which, the most common being atherosclerosis, affecting the arteries of the inferior and coronary limbs. In the 60 patients investigated angio-coronarographically in the Emergency County Clinical Hospital of Sibiu with PAD, the prevalence of high blood pressure (HBP) and smoking was observed, among the risk factors, and 73.3% had one or more coronary lesions. The association of diabetes mellitus (DM) with PAD has shown an increase in the number of coronary lesions. There was also a strong positive correlation between the presence of left anterior descending artery (LAD) injuries and the stage of PAD regardless of other risk factors.
Ischemic heart disease is the most common heart pathology in medical practice. Proper assessment of the size of myocardium injury and its consequences on the heart function is extremely important both for a correct drug therapy and for interventional approach. Most frequently the left ventricle is affected. The need for accurate evaluation of the impact of left ventricular myocardial damage has led to the development of new imaging techniques and improvement of the existing ones. At the moment the most commonly used imaging method for the assessment of left ventricular function is echocardiography. Cardiac Magnetic Resonance and nuclear tomography are precious imaging techniques as well. They are more expensive but bring valuable information when used in adequate situations.