Search Results

You are looking at 1 - 2 of 2 items for

  • Author: Ivan Nikčević x
Clear All Modify Search
Open access

Ivan Nikčević and Jovana Parlić

Abstract

Based on the interpretation of the European Court of Justice regarding the Treaty provisions, the EU Directive creates only a vertical direct effect. However, through judicial interpretation, the Directive achieves diverse and far-reaching effects. Interpretation of national laws by Member State’s courts, in accordance with the purpose and wording of the directive, can directly affect private individuals and lead to horizontal direct effect. The European Court of Justice’s interpretation of the case based on non- implementation of the directive has created one of the general principles of Community law, in order to mitigate disadvantages and limitations of the doctrine of horizontal direct effect. The interpretation of the directive is gradually expanding the scope of its effects.

Open access

Ivana Petrovic, Ivan Stankovic, Goran Milasinovic, Gabrijela Nikcevic, Bratislav Kircanski, Velibor Jovanovic, Srdjan Raspopovic, Nikola Radovanovic and Sinisa U. Pavlovic

Summary

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.