Acute Cardiac Care – an Interdisciplinary Approach

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> The predictive role of serum bilirubin levels on the alteration of total ischemic burden expressed via frontal QRS-T angle change has never been studied in patients with acute coronary syndrome (ACS). In this study, we aimed to investigate the relationship between serum bilirubin levels and frontal QRS-T angle change after percutaneous coronary intervention (PCI) in ACS patients.<bold>Methods:</bold> Frontal QRS-T angle change was accepted as positive or negative according to whether the value of the baseline frontal QRS-T angle minus the post PCI frontal QRS-T angle is positive or negative. A total of 314 consecutive patients with ACS who underwent PCI were divided into two groups based on their negative frontal QRS-T angle change (n = 152 patients) and positive frontal QRS-T angle change (n = 162 patients).<bold>Results:</bold> Multivariate logistic regression analysis showed that the C-reactive protein (CRP) to albumin ratio (CAR) (Odds ratio [OR]: 0.519, 95% CI: 0.373–0.724, p &lt;0.001), total bilirubin (OR: 3.687, 95% CI: 1.151–8.095, p = 0.03), and low-density lipoprotein (LDL) (OR: 0.985, 95% CI: 0.970–1.000, p = 0.04) were independent predictors of positive QRS-T angle change. In receiver operating characteristics curve analysis, a cut-off value of 0.59 total bilirubin had a 69% sensitivity and a 65% specificity (area under curve: 0.739, p &lt;0.001) for the prediction of positive QRS-T angle change.<bold>Conclusion:</bold> In ACS patients, serum total bilirubin has been found to be a useful decision-making tool to predict positive frontal QRS-T angle change as a sign of reduced total ischemic burden, to assess early invasive strategy independently from other study parameters.</abstract>

Serum Bilirubin Level Predicts Frontal QRS-T Angle Change in Patients with Acute Coronary Syndrome

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background:</bold> In this study, we aimed to compare echocardiography, electrocardiography (ECG) abnormalities, Doppler ultrasonography (USG), and computed tomography pulmonary angiography (CTPA) results in predicting 3-month mortality in patients with acute pulmonary embolism (PE).<bold>Methods:</bold> This retrospective cohort study included 124 patients (72 females, 52 males) with acute PE. Demographics, symptoms, clinical signs, comorbidities, history of surgery, arterial blood gas, liver-renal functions, complete blood count, echocardiography, ECG, Doppler USG, and CTPA results, as well as 3-month mortality were recorded.<bold>Results:</bold> pH (z = –2.623; p &lt;0.01), hemoglobin (z = –3.112; p &lt;0.01), and oxygen saturation (z = –2.165; p &lt;0. 01) were significantly higher in survivors. White blood cell (z = –2.703; p &lt;0.01), blood urea nitrogen (z = –3.840; p &lt;0.01), creatinine (z = –3.200; p &lt;0.01), respiratory rate (z = –2.759; p &lt;0.01), and heart rate (z = –2.313; p &lt;0.01) were significantly higher in non-survivors. Nonspecific ST changes (AUC 0.52, 95% CI 0.43–0.61), p pulmonale (AUC 0.52, 95% CI 0.43–0.61), normal axis (AUC 0.61), right axis deviation (AUC 0.56), right ventricle strain pattern (AUC 0.59), and right pulmonary artery embolism (AUC 0.54) on CTPA showed the highest mortality prediction.<bold>Conclusions:</bold> Nonspecific ST changes, p pulmonale, normal axis and right axis deviation in ECG, RV strain in echocardiography, and right pulmonary artery embolism on CTPA are associated with a higher mortality in patients with PE.</abstract>

Prediction of Mortality Associated with Cardiac and Radiological Findings in Patients with Pulmonary Embolism

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background:</bold> ST-segment elevation myocardial infarction (STEMI) is a clinical syndrome with high mortality. The main purpose of STEMI treatment is to achieve optimal revascularization for tissue perfusion. Besides the innovations in revascularization strategies, developments in antithrombotic therapy resulted in a significant reduction in STEMI-related mortality. Reperfusion can be demonstrated by resolution of ST-segment elevation (STR), TIMI frame count (TFC), and myocardial blush grade (MBG). Aim of the study: In our study, we investigated the effects of P2Y12 inhibitors clopidogrel, prasugrel, and ticagrelor on reperfusion parameters such as TFC, MBG, and STR, after primary percutaneous coronary intervention (pPCI) in STEMI.<bold>Material and Methods:</bold> The study was a retrospective analysis of STEMI patients who underwent successful pPCI. A total of 120 patients were included in the study as 3 equal groups according to the type of P2Y12 inhibitor administered in loading dose in the acute phase, and reperfusion parameters were compared between the groups.<bold>Results:</bold> There was no statistically significant difference between the groups in terms of baseline demographic, clinical, and angiographic parameters. Evaluation of reperfusion parameters indicated that STR, MBG, angina relief after pPCI and corrected TFC (cTFC) were significantly different between the groups (p &lt;0.05). In post-hoc analysis, the percentage of change in STR, MBG, angina relief after pPCI, and cTFC was significantly higher in the prasugrel group (p &lt;0.017).<bold>Conclusion:</bold> In STEMI patients undergoing pPCI, the analysis of tissue level reperfusion parameters indicates a superior effect of prasugrel compared with other P2Y12 inhibitors used to achieve reperfusion.</abstract>

Department of Cardiology, Faculty of Medicine

Effectiveness of Different P2Y12 Inhibitors on Coronary Flow in Patients with ST-Elevation Myocardial Infarction

<abstract xmlns="http://www.w3.org/1999/xhtml">COVID-19 is a disease caused by the new coronavirus discovered in 2019, which may lead to a severe acute respiratory syndrome and has a major impact on public health worldwide, being declared a pandemic by World Health Organization. In Italy, and especially in the region of Lombardia, the healthcare system has faced a huge overload, which led to significant consequences on cardiology resources. The accessibility to cardiology care units has been drastically reduced, and scheduled interventions, such as elective primary percutaneous coronary interventions, have been significantly delayed. During this time, there was a global concern regarding the management of the SARS-CoV-2 pandemic, but also the management of main cardiovascular emergencies. Under usual circumstances, the differential diagnosis of myocardial injury does not confront many difficulties. Unfortunately, there are several limitations in the management of patients with SARS-CoV-2 infection in the current pandemic state. The aim of the present manuscript is to provide an overview on the main causes of myocardial injury during the COVID-19 pandemic.</abstract>

“George Emil Palade” University of Medicine, Pharmacy, Science and Technology

Differential Diagnosis of Myocardial Injury in the SARS-CoV-2 Era – Myocarditis Versus Acute Coronary Syndrome

<abstract xmlns="http://www.w3.org/1999/xhtml">Pulmonary arterial hypertension (PAH) is a rare but severe complication that should be investigated in patients diagnosed with transposition of the great arteries who have undergone neonatal arterial switch operation. Early diagnosis and aggressive combination therapy for PAH could help to improve survival in these patients. We report a favorable clinical response 6 months after the initiation of vasodilator therapy in a pediatric case with transposition of the great arteries, successfully repaired in the neonatal period, who developed pulmonary arterial hypertension at the age of 5 years.</abstract>

Critical Neonatal Congenital Heart Disease – a Rare Complication after Successful Surgical Correction

AHEAD OF PRINT

Volume 10 (2024): Issue 1 (March 2024)

Volume 9 (2023): Issue 4 (December 2023)

Volume 9 (2023): Issue 3 (September 2023)

Volume 9 (2023): Issue 2 (June 2023)

Volume 9 (2023): Issue 1 (March 2023)

Volume 8 (2022): Issue 4 (December 2022)

Volume 8 (2022): Issue 3 (September 2022)

Volume 8 (2022): Issue 2 (June 2022)

Volume 8 (2022): Issue 1 (March 2022)

Volume 7 (2021): Issue 4 (January 2021)

Volume 7 (2021): Issue 3 (September 2021)

Volume 7 (2021): Issue 2 (June 2021)

Volume 7 (2021): Issue 1 (March 2021)

Volume 6 (2020): Issue 4 (December 2020)

Volume 6 (2020): Issue 3 (September 2020)

Volume 6 (2020): Issue 2 (June 2020)

Volume 6 (2020): Issue 1 (March 2020)

Volume 5 (2019): Issue 4 (December 2019)

Volume 5 (2019): Issue 3 (September 2019)

Volume 5 (2019): Issue 2 (June 2019)

Volume 5 (2019): Issue 1 (March 2019)

Volume 4 (2018): Issue 4 (December 2018)

Volume 4 (2018): Issue 3 (September 2018)

Volume 4 (2018): Issue 2 (June 2018)

Volume 4 (2018): Issue 1 (March 2018)

Volume 3 (2017): Issue 4 (December 2017)

Volume 3 (2017): Issue 3 (September 2017)

Volume 3 (2017): Issue 2 (June 2017)

Volume 3 (2017): Issue 1 (March 2017)

Volume 2 (2016): Issue 4 (December 2016)

Volume 2 (2016): Issue 3 (September 2016)

Volume 2 (2016): Issue 2 (June 2016)

Volume 2 (2016): Issue 1 (March 2016)

Volume 1 (2015): Issue 2 (December 2015)

Volume 1 (2015): Issue 1 (July 2015)

Journal of Cardiovascular Emergencies

 The Journal of Cardiovascular Emergencies aims to publish top quality papers related to acute conditions in any cardiovascular pathology. The journal will mainly focus on recent advances in the field of diagnosis and treatment of the most common causes of cardiovascular emergencies, including acute coronary syndromes, acute heart failure, acute aortic diseases, pulmonary embolism, peripheral arterial diseases or cardiac arrhythmia. Interdisciplinary approaches will be extremely welcomed, presenting new advances in the approach of different other pathologies (i.e. stroke) from the cardiovascular perspective.  The Journal of Cardiovascular Emergencies will publish high-quality basic and clinical research related to these topics, in a common approach that will integrate the clinical studies with the pre-clinical work dedicated to discovery of new mechanisms involved in the development and progression of acute cardiovascular conditions.  Especially in the case of acute coronary syndromes, the journal will try to provide the entire cardiology community with the perspective of the regional cardiology networks in Central and Eastern European countries, reflecting the regional model of care in cardiovascular acute conditions.  The journal will primarily focus on publishing original research papers, but also other types of materials (such as review articles, case reports, state of the art papers, comments to editor, etc) will be extremely welcomed.  Rejection Rate   30%   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 