1
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Borovac JA, Miric D, Lozo M, Zanchi J, Slujo AB. The electrocardiographic and angiographic discrepancy in determining culprit coronary artery lesion: anterior ST-T segment changes within the context of inferior wall acute myocardial infarction. Postepy Kardiol Interwencyjnej 2023; 19:296-297. [PMID: 37854957 PMCID: PMC10580838 DOI: 10.5114/aic.2023.131487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Josip Andelo Borovac
- Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Dino Miric
- Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Mislav Lozo
- Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Jaksa Zanchi
- Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Anteo Bradaric Slujo
- Division of Interventional Cardiology, Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
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2
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Miric D, Bakovic D, Zanchi J, Bradaric Slujo A, Lozo M, Borovac JA. Myocardial work in patients with heart failure and ischemic cardiomyopathy according to the mode of coronary revascularization. Hellenic J Cardiol 2023:S1109-9666(23)00142-2. [PMID: 37586481 DOI: 10.1016/j.hjc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/10/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The association of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) on myocardial function, as reflected in myocardial work (MyW) parameters, in patients with ischemic cardiomyopathy and heart failure (HF) is unknown. METHODS We analyzed data from 68 patients who were hospitalized with chronic HF due to ischemic cardiomyopathy and stratified them according to the mode of revascularization. All patients underwent a 2D speckle tracking echocardiography exam performed by the same expert sonographer and had complete MyW data including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). RESULTS The mean age of patients was 70 ± 10 years and 86.8% were men. The mean left ventricular ejection fraction (LVEF) in overall cohort was 31.6 ± 9.5%. Both subgroups did not significantly differ in terms of baseline LVEF, comorbidities, and pharmacotherapy. Compared with those who received PCI, patients revascularized with CABG had significantly greater GWI (821 vs. 555 mmHg%, p = 0.002), GCW (1101 vs. 794 mmHg%, p = 0.001), GWE (78 vs. 72.6%, p = 0.025), and global longitudinal strain (-8.7 vs. -6.7%, p = 0.004). Both patient subgroups did not significantly differ with respect to GWW (273 vs. 245 mmHg%, p = 0.410 for CABG and PCI, respectively) and survival during the median follow-up of 18 months (log-rank p = 0.813). CONCLUSION Patients with HF and ischemic cardiomyopathy revascularized with CABG had greater myocardial work performance when compared with those revascularized with PCI. This might suggest a higher degree of functional myocardial revascularization associated with the CABG procedure.
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Affiliation(s)
- Dino Miric
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Darija Bakovic
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia; Department of Physiology, University of Split School of Medicine, Split, Croatia
| | - Jaksa Zanchi
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Anteo Bradaric Slujo
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia; Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Mislav Lozo
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia
| | - Josip A Borovac
- Cardiovascular Diseases Department, University Hospital of Split, Split, Croatia; Department of Pathophysiology, University of Split School of Medicine, Split, Croatia.
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Borovac JA, Lozo M, Giunio L, Miric D, Bakovic D, Bulat C, Batinic T, Bradaric A, Zanchi J. Left ventricular aneurysm formation in patients with takotsubo syndrome: A peculiar phenomenon with subtle implications. Author's reply. Kardiol Pol 2023; 81:1036-1037. [PMID: 37537924 DOI: 10.33963/kp.a2023.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Affiliation(s)
- Josip A Borovac
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia.
- University of Split School of Medicine, Split, Croatia.
| | - Mislav Lozo
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Lovel Giunio
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Dino Miric
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Darija Bakovic
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Cristijan Bulat
- Department of Cardiac Surgery, University Hospital of Split, Split, Croatia
| | - Tonci Batinic
- Department of Radiology, University Hospital of Split, Split, Croatia
| | - Anteo Bradaric
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Jaksa Zanchi
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
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Lozo M, Giunio L, Miric D, Bakovic D, Bulat C, Batinic T, Bradaric A, Zanchi J, Borovac JA. Giant apical pseudoaneurysm in the left ventricle as a late complication of takotsubo syndrome: Not a benign course of the disease. Kardiol Pol 2023; 81:924-925. [PMID: 37331023 DOI: 10.33963/kp.a2023.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 06/11/2023] [Indexed: 10/06/2023]
Affiliation(s)
- Mislav Lozo
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Lovel Giunio
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Dino Miric
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Darija Bakovic
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Cristijan Bulat
- Department of Cardiac Surgery, University Hospital of Split, Split, Croatia
| | - Tonci Batinic
- Department of Radiology, University Hospital of Split, Split, Croatia
| | - Anteo Bradaric
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Jaksa Zanchi
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Josip A Borovac
- Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia.
- University of Split School of Medicine, Split, Croatia.
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Kumric M, Urlic H, Bozic J, Vilovic M, Ticinovic Kurir T, Glavas D, Miric D, Zanchi J, Bradaric-Slujo A, Lozo M, Borovac JA. Emerging Therapies for the Treatment of Atherosclerotic Cardiovascular Disease: From Bench to Bedside. Int J Mol Sci 2023; 24:8062. [PMID: 37175766 PMCID: PMC10178593 DOI: 10.3390/ijms24098062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Primarily a consequence of sedentary lifestyle, atherosclerosis has already reached pandemic proportions, and with every year the burden of it is only increasing. As low-density lipoprotein cholesterol (LDL-C) represents a crucial factor in atherosclerosis formation and progression, stringent lipid-lowering therapy could conceivably be the key to preventing the unfavorable outcomes that arise as a consequence of atherosclerosis. The use of statins in lipid-lowering is often burdened by adverse events or is insufficient to prevent cardiovascular events as a monotherapy. Therefore, in the present review, the authors aimed to discuss the underlying mechanisms of dyslipidemia and associated atherosclerotic cardiovascular disease (ASCVD) and preclinical and clinical trials of novel therapeutic approaches to its treatment, some of which are still in the early stages of development. Apart from novel therapies, a novel change in perspective is needed. Specifically, the critical objective in the future management of ASCVD is to embrace emerging evidence in the field of atherosclerosis, because clinicians are often burden by common practice and personal experience, both of which have so far been shown to be futile in the setting of atherosclerosis.
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Affiliation(s)
- Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.)
| | - Hrvoje Urlic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.)
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.)
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.)
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.)
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Split, 21000 Split, Croatia
| | - Duska Glavas
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
| | - Dino Miric
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
| | - Jaksa Zanchi
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
| | - Anteo Bradaric-Slujo
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
| | - Mislav Lozo
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
| | - Josip A. Borovac
- Cardiovascular Diseases Department, University Hospital of Split, 21000 Split, Croatia
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Borovac JA, Ferri-Certic J, Miric D, Zanchi J, Lozo M, Bradaric A, Schwarz K, Kwok CS. Revascularization with Coronary Artery Bypass Grafting in Non-ST-elevation Acute Coronary Syndromes: A Snapshot of Randomized Trials and Registries. Arq Bras Cardiol 2022; 120:e20220248. [PMID: 36629603 PMCID: PMC9833314 DOI: 10.36660/abc.20220248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Affiliation(s)
- Josip Andelo Borovac
- Cardiovascular Diseases DepartmentUniversity Hospital of SplitSplitCroáciaCardiovascular Diseases Department, University Hospital of Split, Split – Croácia
| | - Jerko Ferri-Certic
- Department of CardiologyDubrovnik General HospitalDubrovnikCroáciaDepartment of Cardiology, Dubrovnik General Hospital, Dubrovnik – Croácia
| | - Dino Miric
- Cardiovascular Diseases DepartmentUniversity Hospital of SplitSplitCroáciaCardiovascular Diseases Department, University Hospital of Split, Split – Croácia
| | - Jaksa Zanchi
- Cardiovascular Diseases DepartmentUniversity Hospital of SplitSplitCroáciaCardiovascular Diseases Department, University Hospital of Split, Split – Croácia
| | - Mislav Lozo
- Cardiovascular Diseases DepartmentUniversity Hospital of SplitSplitCroáciaCardiovascular Diseases Department, University Hospital of Split, Split – Croácia
| | - Anteo Bradaric
- Cardiovascular Diseases DepartmentUniversity Hospital of SplitSplitCroáciaCardiovascular Diseases Department, University Hospital of Split, Split – Croácia
| | - Konstantin Schwarz
- Department of Internal Medicine 3University Hospital St. PoltenKarl Landsteiner University of Health SciencesKremsÁustriaDepartment of Internal Medicine 3, University Hospital St. Polten, Karl Landsteiner University of Health Sciences, Krems – Áustria
| | - Chun Shing Kwok
- Royal Stoke University HospitalStoke-on-TrentReino UnidoRoyal Stoke University Hospital, Stoke-on-Trent – Reino Unido
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7
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Miric D, Giunio L, Lozo M, Zanchi J, Bradaric AS, Borovac JA. When foe becomes a friend: Sequential balloon tamponade, coiling, and autologous fat particle embolization for the successful seal of a refractory distal coronary perforation during a percutaneous coronary intervention. Kardiol Pol 2022; 80:1058-1059. [DOI: 10.33963/kp.a2022.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/15/2022]
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8
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Zanchi J, Miric D, Giunio L, Bradaric Slujo A, Lozo M, Erceg D, Orsulic D, Borovac JA. Conservative Management of Spontaneous Left Main Coronary Artery Dissection (SCAD) Triggered by Emotional Stress in the Late Postpartum Period: Case Report and Pathophysiology. Pathophysiology 2022; 29:610-618. [PMID: 36412632 PMCID: PMC9680376 DOI: 10.3390/pathophysiology29040047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/05/2022] [Accepted: 10/22/2022] [Indexed: 12/14/2022] Open
Abstract
A spontaneous coronary artery dissection (SCAD) during the postpartum period is a serious medical emergency and the most important non-atherosclerotic cause of coronary artery disease (CAD) in this population. While conservative management is recommended in most SCAD scenarios, cases complicated by hemodynamic instability or cardiogenic shock are particularly challenging and might be amenable only with invasive percutaneous or cardiothoracic surgical management. Herein, we present a case of a 35-year-old otherwise healthy woman that suffered an intense emotional stress event and was subsequently admitted with crushing chest pain to the emergency department. The initial electrocardiogram showed dynamic changes suggesting anterolateral ST-elevation myocardial infarction. She gave birth to a healthy child 3 months before the current presentation. Diagnostic angiography found no occlusive CAD but instead an extensive intramural hematoma originating from the left main artery dissection and extending to the whole left coronary circulation was observed. Hemodynamic instability and hypotension soon followed, and the patient went into cardiogenic shock. The heart team opted for conservative and supportive intensive care management without surgical or percutaneous intervention. This decision ultimately led to the successful extubation of the patient and the achievement of hemodynamic stability. The patient was eventually safely discharged home without any permanent disability.
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Affiliation(s)
- Jaksa Zanchi
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Dino Miric
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Lovel Giunio
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Anteo Bradaric Slujo
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
| | - Mislav Lozo
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Duje Erceg
- Clinic for Anaesthesiology, Reanimatology and Intensive Care, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Duje Orsulic
- Department of Cardiac Surgery, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
| | - Josip A. Borovac
- Division of Interventional Cardiology, Clinic for Heart and Vascular Diseases, University Hospital of Split (KBC Split), Spinciceva 1, 21000 Split, Croatia
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
- Correspondence: ; Tel.: +385-92-172-13-14
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9
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Katić J, Runjić F, Giunio L, Bradarić A, Lozo M. LEFT LATERAL VIEW FOR PCI TREATMENT OF INFERIOR STEMI IN A PATIENT WITH DEXTROCARDIA. Acta Clin Croat 2022; 61:364-366. [PMID: 36818918 PMCID: PMC9934044 DOI: 10.20471/acc.2022.61.02.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/11/2021] [Indexed: 02/10/2023] Open
Abstract
Rapid recognition of ST-segment elevation myocardial infarction and electrocardiogram interpretation in patients with dextrocardia could be a challenging situation. This case report discusses presentation in a patient with dextrocardia and situs inversus who was found to have acute inferior myocardial infarction. Percutaneous coronary intervention in cases of dextrocardia can be technically challenging considering coronary origin and orientation, and difficulty in appropriate catheter selection.
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Affiliation(s)
- Josip Katić
- Department of Cardiology, Split University Hospital Center, Split, Croatia
| | - Frane Runjić
- Department of Cardiology, Split University Hospital Center, Split, Croatia
| | - Lovel Giunio
- Department of Cardiology, Split University Hospital Center, Split, Croatia
| | - Anteo Bradarić
- Department of Cardiology, Split University Hospital Center, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, Split University Hospital Center, Split, Croatia
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10
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Katić J, Katić A, Katić K, Duplančić D, Lozo M. CONCURRENT DEEP VEIN THROMBOSIS AND PULMONARY EMBOLISM ASSOCIATED WITH HYPERTHYROIDISM: A CASE REPORT. Acta Clin Croat 2021; 60:314-316. [PMID: 34744284 PMCID: PMC8564842 DOI: 10.20471/acc.2021.60.02.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
Numerous disorders of coagulation and fibrinolysis have been reported in patients with thyroid diseases, especially with hyperthyroidism. Most articles are focused on deep vein thrombosis risk, however, few of them describe association between hyperthyroidism and pulmonary embolism. We report a case of a 43-year-old woman with long-term uncontrolled hyperthyroidism complicated by venous thromboembolism. The potential mechanisms could be endothelial dysfunction, decreased fibrinolytic activity, and increased levels of coagulation factors. Thyroid evaluation should be recommended in patients with unprovoked venous thromboembolic events.
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Affiliation(s)
| | - Ana Katić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Karla Katić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Darko Duplančić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Mislav Lozo
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
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11
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Lozo Vukovac E, Miše K, Gudelj I, Perić I, Duplančić D, Vuković I, Vučinović Z, Lozo M. Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease. J Int Med Res 2018; 47:791-802. [PMID: 30488761 PMCID: PMC6381468 DOI: 10.1177/0300060518811560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods We performed an observational, analytical case–control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing. Results The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels. Conclusions AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.
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Affiliation(s)
- Emilija Lozo Vukovac
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Kornelija Miše
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Ivan Gudelj
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Irena Perić
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Darko Duplančić
- 2 University of Split School of Medicine, Split, Croatia.,3 Department of Cardiology, University Hospital Center Split, Split, Croatia
| | - Ivica Vuković
- 2 University of Split School of Medicine, Split, Croatia.,3 Department of Cardiology, University Hospital Center Split, Split, Croatia
| | - Zoran Vučinović
- 4 Department of Endocrinology, University Hospital Center Split, Split, Croatia
| | - Mislav Lozo
- 3 Department of Cardiology, University Hospital Center Split, Split, Croatia
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12
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Sušilović Grabovac Z, Baković D, Lozo M, Pintarić I, Dujić Ž. Early Changes in Platelet Size and Number in Patients with Acute Coronary Syndrome. Int J Angiol 2017; 26:249-252. [PMID: 29142492 DOI: 10.1055/s-0037-1607048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
A strong relationship exists between acute coronary syndrome (ACS) and platelets (PLTs) volume. Mean platelet volume (MPV) is a parameter of PLT functions and a marker for increased PLT activation. The aim of this study was to determine early changes in number of total PLT and MPV in different manifestation of ACS and to find out predictive value of MPV in the spectrum of ACS. This was a prospective study. One hundred thirty-four ACS patients were enrolled, 76 of them finished the study. PLT and MPV in patients with unstable angina, non-ST elevation, and ST elevation myocardial infarctions were determined on arrival and 1, 3, 72 hours, and 7 days after the admission to hospital. There was decrease in PLT and MPV in all three groups after 3 hours of arrival in hospital in comparison with admission values. In the later time period (72 hours and 7 days), there was an increase in PLT and MPV only in patients with acute myocardial infarction (AMI). We have revealed completely new dynamics in early changes in MPV and PLT count in patients with AMI. Biphasic changes were found in early phase after admission to the hospital. Fast response in these parameters raises new questions about their origin.
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Affiliation(s)
| | - Darija Baković
- Department of Cardiology, University of Split Hospital Center, Split, Croatia.,Department of Physiology, School of Medicine, University of Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, University of Split Hospital Center, Split, Croatia
| | - Irena Pintarić
- Department of Neurology, University of Split Hospital Center, Split, Croatia
| | - Željko Dujić
- Department of Physiology, School of Medicine, University of Split, Split, Croatia
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13
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Giunio L, Boric T, Bulat C, Dragicevic D, Lozo M. Cardiac Tamponade after Right Ventricular Perforation Caused by Screw-in Lead. Int J Angiol 2016; 25:e177-e179. [PMID: 28031691 DOI: 10.1055/s-0036-1580700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
A 69-year-old man was admitted after syncope followed with chest pain and signs of cardiac tamponade. He had undergone permanent dual-chamber pacemaker implantation 3 weeks earlier. Transthoracic echocardiography (TTE) confirmed a pericardial effusion, and urgent pericardial drainage was performed. Right ventricular perforation caused by active-fixation (screw-in) lead was verified by multislice computed tomography. The lead was extracted under fluoroscopy and bedside TTE monitoring in the operating room with cardiothoracic surgery backup. In the same act, the new ventricular passive-fixation lead was implanted.
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Affiliation(s)
- Lovel Giunio
- Department of Cardiology, University Hospital Centre Split, Split, Croatia
| | - Teo Boric
- Division of Vascular Surgery, Department of Surgery, University Hospital Centre Split, Split, Croatia
| | - Cristijan Bulat
- Department of Cardiac Surgery, University Hospital Centre Split, Split, Croatia
| | - Dragan Dragicevic
- Department of Radiology, University Hospital Centre Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, University Hospital Centre Split, Split, Croatia
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14
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Lovering AT, Lozo M, Barak O, Davis JT, Lojpur M, Lozo P, Čaljkušić K, Dujić Ž. Resting arterial hypoxaemia in subjects with chronic heart failure, pulmonary hypertension and patent foramen ovale. Exp Physiol 2016; 101:657-70. [DOI: 10.1113/ep085657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/14/2016] [Indexed: 01/09/2023]
Affiliation(s)
| | - Mislav Lozo
- Department of Cardiology; University Hospital Centre Split; Split Croatia
| | - Otto Barak
- Department of Integrative Physiology; University of Split, School of Medicine; Split Croatia
- Department of Physiology; University of Novi Sad; Novi Sad Serbia
| | - James T. Davis
- Department of Human Physiology; University of Oregon; Eugene OR USA
| | - Mihajlo Lojpur
- Department of Anesthesiology; University Hospital Centre Split; Split Croatia
| | - Petar Lozo
- Department of Cardiology; University Hospital Centre Split; Split Croatia
| | - Krešimir Čaljkušić
- Department of Neurology; University Hospital Centre Split; Split Croatia
| | - Željko Dujić
- Department of Integrative Physiology; University of Split, School of Medicine; Split Croatia
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Perić I, Paladin I, Lozo Vukovac E, Vela Ljubić J, Gudelj I, Lozo M. Tracheomalatia, to stent or not to stent. Respir Med Case Rep 2015; 16:137-9. [PMID: 26744681 PMCID: PMC4682007 DOI: 10.1016/j.rmcr.2015.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 09/26/2015] [Accepted: 09/28/2015] [Indexed: 11/25/2022] Open
Abstract
Benign thyroid disorders such as goiter, especially retrosternal, can cause tracheostenosis by extrinsic tracheal compression, which is due to the lack of specific symptoms often misdiagnosed. Tracheomalatia develops as a result to long term tracheal compression and refers to weakness of the trachea characterized by softness of the tracheal cartilage arches and by loss of regular tracheal structure. Tracheomalatia is characterized by reduction of the endotracheal lumen and may affect the entire trachea or may be localized to one portion of it. We present the case of a 72-year old patient with distinct tracheostenosis and tracheomalatia, caused by long term pressure by the retrosternal goiter. We have been monitoring the patient for last 20 years after the second endotracheal stent had been placed. The first one was placed 34 years ago, in 1981. On both occasions granulation tissue and colonization of bacteria occurred. In the end the placed stents were rejected and migrated to the main carina. Despite the tracheal diameter narrower than 5 mm the patient has been living normally without the stent for 17 years, with the exception of no hard physical labor. He had a few short term antibiotic therapies and bronchial toilets during symptomatic deteriorations. Diagnosing retrosternal goiter and surgical treatment on time is of crucial importance in cases such as this one. Considering the complications caused by the stent, our opinion is that the majority of patients may require conservative treatment with closely monitoring during respiratory infections.
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Affiliation(s)
- Irena Perić
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Ivan Paladin
- The Croatian Institute of Emergency Medicine, Split, Croatia
| | - Emilija Lozo Vukovac
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Jadranka Vela Ljubić
- Department of Ear, Nose, Throat, Head and Neck Surgery, University Hospital Center Split, Split, Croatia
| | - Ivan Gudelj
- Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, University Hospital Center Split, Split, Croatia
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16
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Lozo M, Lojpur M, Madden D, Lozo P, Banic I, Dujic Z. The effects of nitroglycerin, norepinephrine and aminophylline on intrapulmonary arteriovenous anastomoses in healthy humans at rest. Respir Physiol Neurobiol 2014; 199:19-23. [DOI: 10.1016/j.resp.2014.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/22/2014] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
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17
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Lozo M, Madden D, Gunjaca G, Ljubkovic M, Marinovic J, Dujic Z. The impact of consecutive freshwater trimix dives at altitude on human cardiovascular function. Clin Physiol Funct Imaging 2014; 35:142-9. [DOI: 10.1111/cpf.12139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 01/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Mislav Lozo
- Department of Integrative Physiology; University of Split School of Medicine; Split Croatia
| | - Dennis Madden
- Department of Integrative Physiology; University of Split School of Medicine; Split Croatia
| | - Grgo Gunjaca
- Department of Pharmacology; University of Split School of Medicine; Split Croatia
| | - Marko Ljubkovic
- Department of Integrative Physiology; University of Split School of Medicine; Split Croatia
| | - Jasna Marinovic
- Department of Integrative Physiology; University of Split School of Medicine; Split Croatia
| | - Zeljko Dujic
- Department of Integrative Physiology; University of Split School of Medicine; Split Croatia
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18
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Lozo Vukovac E, Lozo M, Mise K, Gudelj I, Puljiz Ž, Jurcev-Savicevic A, Bradaric A, Kokeza J, Mise J. Bronchoalveolar pH and inflammatory biomarkers in newly diagnosed IPF and GERD patients: a case-control study. Med Sci Monit 2014; 20:255-61. [PMID: 24535066 PMCID: PMC3930643 DOI: 10.12659/msm.889800] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Several studies have suggested that idiopathic pulmonary fibrosis (IPF) may be related to repeated aspiration of gastric contents over long periods of time. We aimed to investigate differences between pH measured directly in the lung, and biomarkers of acute inflammation in patients with newly diagnosed IPF and in patients with newly diagnosed GERD. Material/Methods All subjects (N=61) underwent collection of medical history, physical examination, pulmonary function testing, bronchoscopy, endoscopy, arterial blood gas analyses, and biochemical testing. Results Previously diagnosed GERD was found in 56.7%, typical symptoms of reflux in 80%, and Helicobacter pylori in gastric biopsy specimens in 76.6% of the cases. pH in peripheral branches of bronchi in the cases was 5.32±0.44 and was 6.27±0.31 (p<0.001) in the control group. The average values of LDH, ALP, and CRP in bronchoalveolar aspirate and in serum, as well as TNF-α in bronchoalveolar aspirate, were significantly higher in IPF patients. Conclusions The more acidic environment in the bronchoalveolar aspirate of the IPF subjects could contribute to the development or progression of IPF, possibly via changes in local metabolism or by damaging local cells and tissue. However, further studies with larger numbers of patients are required to clarify the role of gastric fluid aspiration in IPF pathogenesis. Our preliminary work has identified inflammatory biomarkers LDH, ALP, and TNF-α as potentially important in the pathologic processes in IPF. Further research is needed to determine their importance in clinical intervention and patient care.
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Affiliation(s)
- Emilija Lozo Vukovac
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, Split University Hospital, Split, Croatia
| | - Kornelija Mise
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Ivan Gudelj
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Željko Puljiz
- Department of Gastroenterology, Split University Hospital, Split, Croatia
| | - Anamarija Jurcev-Savicevic
- Depatrment of Epidemiology, Teaching Public Health Institute of Split and Dalmatia County and School of Medicine, University of Split, Split, Croatia
| | - Anteo Bradaric
- Department of Cardiology, Split University Hospital, Split, Croatia
| | - Josipa Kokeza
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Josko Mise
- School of Medicine, University of Zagreb, Zagreb, Croatia
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19
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Abstract
Arterialization of gas bubbles after decompression from scuba diving has traditionally been associated with pulmonary barotraumas or cardiac defects, such as the patent foramen ovale. Recent studies have demonstrated the right-to-left passage of bubbles through intrapulmonary arterial-venous anastamoses (IPAVA) that allow blood to bypass the pulmonary microcirculation. These passages open up during exercise, and the aim of this study is to see if exercise in a postdiving period increases the incidence of arterialization. After completing a dive to 18 m for 47 min, patent foramen ovale-negative subjects were monitored via transthoracic echocardiography, within 10 min after surfacing, for bubble score at rest. Subjects then completed an incremental cycle ergometry test to exhaustion under continuous transthoracic echocardiography observation. Exercise was suspended if arterialization was observed and resumed when the arterialization cleared. If arterialization was observed a second time, exercise was terminated, and oxygen was administered. Out of 23 subjects, 3 arterialized at rest, 12 arterialized with exercise, and 8 did not arterialize at all even during maximal exercise. The time for arterialization to clear with oxygen was significantly shorter than without. Exercise after diving increased the incidence of arterialization from 13% at rest to 52%. This study shows that individuals are capable of arterializing through IPAVA, and that the intensity at which these open varies by individual. Basic activities associated with SCUBA diving, such as surface swimming or walking with heavy equipment, may be enough to allow the passage of venous gas emboli through IPAVA.
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Affiliation(s)
- Dennis Madden
- Department of Physiology, University of Split School of Medicine, Split, Croatia
| | - Mislav Lozo
- Department of Physiology, University of Split School of Medicine, Split, Croatia
| | - Zeljko Dujic
- Department of Physiology, University of Split School of Medicine, Split, Croatia
| | - Marko Ljubkovic
- Department of Physiology, University of Split School of Medicine, Split, Croatia
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Thom SR, Milovanova TN, Bogush M, Yang M, Bhopale VM, Pollock NW, Ljubkovic M, Denoble P, Madden D, Lozo M, Dujic Z. Bubbles, microparticles, and neutrophil activation: changes with exercise level and breathing gas during open-water SCUBA diving. J Appl Physiol (1985) 2013; 114:1396-405. [PMID: 23493363 DOI: 10.1152/japplphysiol.00106.2013] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The study goal was to evaluate responses in humans following decompression from open-water SCUBA diving with the hypothesis that exertion underwater and use of a breathing mixture containing more oxygen and less nitrogen (enriched air nitrox) would alter annexin V-positive microparticle (MP) production and size changes and neutrophil activation, as well as their relationships to intravascular bubble formation. Twenty-four divers followed a uniform dive profile to 18 m of sea water breathing air or 22.5 m breathing 32% oxygen/68% nitrogen for 47 min, either swimming with moderately heavy exertion underwater or remaining stationary at depth. Blood was obtained pre- and at 15 and 120 min postdive. Intravascular bubbles were quantified by transthoracic echocardiography postdive at 20-min intervals for 2 h. There were no significant differences in maximum bubble scores among the dives. MP number increased 2.7-fold, on average, within 15 min after each dive; only the air-exertion dive resulted in a significant further increase to 5-fold over baseline at 2 h postdive. Neutrophil activation occurred after all dives. For the enriched air nitrox stationary at depth dive, but not for other conditions, the numbers of postdive annexin V-positive particles above 1 μm in diameter were correlated with intravascular bubble scores (correlation coefficients ∼0.9, P < 0.05). We conclude that postdecompression relationships among bubbles, MPs, platelet-neutrophil interactions, and neutrophil activation appear to exist, but more study is required to improve confidence in the associations.
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Affiliation(s)
- Stephen R Thom
- Institute for Environmental Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
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