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Particular evolution in a 72-year-old diabetic patient with acute coronary syndrome

Journal of Geriatric Cardiology 2018年第7期15卷 523-526页

作者： gabriela s gheorghe Ana Clobanu Ioan T Nanea Andreea s serban Mihaela R Mititelu Department of Internal Medicine and Cardiology "Theodor Burghele" Clinical Hospital "Carol Davila " University of Medicine and Pharmacy Bucharest Romania Nuclear Medicine Department "Dr. Carol Davila " Central Emergency Military Clinical Hospital Bucharest Romania

Diabetes mellitus is an important risk factor for coronary atherosclerosis and many patients present extensive coronary stenosis at coronarography. However, in patients with diabetes, endothelial and microvascular dysfunction also participate in chronic and acute myocardial ischemia. Although the majority of diabetic patients with myocardial infarction have angiographic evidence of significant coronary artery disease.

关键词： Diabetes Elderly Myocardial infarction

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Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

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Journal of Geriatric Cardiology 2017年第12期14卷 717-724页

作者： Ana Ciobanu Gary Tse Tong Liu Maria V Deaconu gabriela s gheorghe Adriana M Iliesiu Ioan T Nanea Department of Internal Medicine and Cardiology Theodor Burghele Clinical Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka shing Institute of Health sci- ences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease Department of Cardiology Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University Tianjin China

Objective To examine the relationship between Tpeak- Tend interval （Tpe） and Tpe/QT ratio with occurrence of ventricular premature beats （VPBs） and left ventricular remodeling in hypertension. Methods A total of 52 patients with mild to moderate essential hypertension were included, undergoing echocardiography and 24-hours Holter monitoring. Ventricular remodeling was assessed by left ventricular mass index （LVMI） using the Devereux formula and diastolic fimction by transmitral E and A wave velocities and E/A ratio. Tpe was measured in the precordial leads. The end of the T wave was set by the method of the tangent to the steepest descending slope of the T wave. Results Tpe and Tpe/QT in leads V2 （r = 0.33, P = 0.01; r = 0.27, P = 0.04 respectively） and V3 （r = 0.40, P = 0.002; r = 0.40, P = 0.003, respectively） correlated significantly with LVMI. A significant inverse relationship was observed between E/A ratio and QT （r = -0.33, P = 0.01）, Tpe in V3 （r = -0.39, P = 0.003） and Tpe/QT in V3 （r = -0.31, P = 0.02）. Tpe in V3, V5, mean Tpe and maximum Tpe with cut-offvalues of 60 ms, 59 ms, 62 ms and 71 ms, respectively, associated with the occurrence of ventricular premature beats. Conclusions The repolarization parameters Tpe interval and Tpe/QT ratio correlate with LVMI and indices of left ventricular diastolic function and show better predictive values than traditional parameters such as QT interval and QT dispersion. Lead V3 is the best lead for measuring Tpe and Tpe/QT. These ECG indices can therefore be used in clinical practice to monitor LV remodeling and predict occurrence of VPBs.

关键词： Hypertension Repolarization Tpeak-Tend Ventricular remodeling

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Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

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Journal of Geriatric Cardiology 2017年第12期 717-724页

作者： Ana Ciobanu Gary Tse Tong Liu Maria V Deaconu gabriela s gheorghe Adriana M Iliesiu Ioan T Nanea Department of Internal Medicine and Cardiology Theodor Burghele Clinical HospitalCarol Davila University of Medicine and Pharmacy Department of Medicine and Therapeutics Faculty of MedicineChinese University of Hong Kong Li Ka shing Institute of Health sciences Faculty of MedicineChinese University of Hong Kong Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical University

Objective To examine the relationship between Tpeak-Tendinterval（Tpe） and Tpe/QT ratio with occurrence of ventricular premature beats（VPBs） and left ventricular remodeling in hypertension. Methods A total of 52 patients with mild to moderate essential hypertension were included, undergoing echocardiography and 24-hours Holter monitoring. Ventricular remodeling was assessed by left ventricular mass index（LVMI） using the Devereux formula and diastolic function by transmitral E and A wave velocities and E/A ratio. Tpe was measured in the precordial leads. The end of the T wave was set by the method of the tangent to the steepest descending slope of the T wave. Results Tpe and Tpe/QT in leads V2（r = 0.33, P = 0.01; r = 0.27, P = 0.04 respectively） and V3（r = 0.40, P = 0.002; r = 0.40, P = 0.003, respectively）correlated significantly with LVMI. A significant inverse relationship was observed between E/A ratio and QT（r =-0.33, P = 0.01）, Tpe in V3（r =-0.39,P=0.003） and Tpe/QT in V3（r =-0.31,P= 0.02）. Tpe in V3, V5, mean Tpe and maximum Tpe with cut-off values of 60 ms,59 ms, 62 ms and 71 ms, respectively, associated with the occurrence of ventricular premature beats. Conclusions The repolarization parameters Tpe interval and Tpe/QT ratio correlate with LVMI and indices of left ventricular diastolic function and show better predictive values than traditional parameters such as QT interval and QT dispersion. Lead V3is the best lead for measuring Tpe and Tpe/QT. These ECG indices can therefore be used in clinical practice to monitor LV remodeling and predict occurrence of VPBs.

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Medical management of symptomatic severe aortic stenosis in patients non-eligible for transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2020年第11期17卷 704-709页

作者： gabriela silvia gheorghe Andreea simona Hodorogea Andrei Cristian Dan gheorghe Ioan Tiberiu Nanea Ana Ciobanu University of Medicine and Pharmacy Carol Davila BucharestProf.Dr.Th.Burghele HospitalBucharestRomania

1 Transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? Aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The preferred treatment in symptomatic severe aortic stenosis(sAs) is surgical aortic valve replacement(sAVR), but in the elderly, the surgical risk can be greater than the benefit.([3]).

关键词： Angiotensin-converting enzyme inhibitors Beta-blockers Calcium channel blockers Diuretics symptomatic severe aortic stenosis Transcatheter aortic valve implantation

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split-dose or hybrid nonsteroidal anti-inflammatory drugs and Nacetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis

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World Journal of Clinical Cases 2019年第3期7卷 300-310页

作者： Laura Pavel gheorghe Gh Balan Alexandra Nicorescu Georgiana Emmanuela Gilca-Blanariu Catalin sfarti stefan Chiriac smaranda Diaconescu Vasile Liviu Drug gheorghe Balan gabriela stefanescu Gastroenterology "Grigore T.Popa" University of Medicine and Pharmacy Endocrinology "Grigore T. Popa" University of Medicine and Pharmacy Department of Mother and Child Medicine "Grigore T. Popa" University of Medicine and Pharmacy

BACKGROUND Despite significant technical and training improvements, the incidence of postendoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) has not significantly dropped. Although many studies have evaluated the efficacy of various agents, e.g. nonsteroidal anti-inflammatory drugs, octreotide,antioxidants, administered via various dosages, routes(oral, intrarectal or parenteral), and schedules(before or after the procedure), the results have been *** To evaluate efficacy of three pharmacologic prophylactic methods for prevention of *** In this prospective, single-center randomized trial, patients who underwent firsttime ERCP for choledocholithiasis were randomly assigned to three groups. The first group received 600 mg N-acetylcysteine 15 min prior to ERCP, and perrectum administration of 50 mg indomethacin both prior to and after completion of the ERCP. The second group was administered only the 50 mg indomethacin per-rectum both prior to and after the ERCP. The third group was administeredper-rectum 100 mg indomethacin only after the ERCP, representing the control group given the guideline-recommended regimen. The primary end-point was PEP *** Among the total 211 patients evaluated during the study, 186 fulfilled the inclusion criteria and completed the protocol. The percentages of patients who developed PEP in each of the three groups were not significantly different(χ2 =2.793, P = 0.247). Among the acute PEP cases, for all groups, 14 patients developed mild pancreatitis(77.77%) and 4 moderate. No severe cases of PEP occurred, and in all PEP cases the resolution was favorable. No adverse events related to the medications(digestive hemorrhage, rectal irritation, or allergies)*** The efficacies of split-dose indomethacin and combined administration(Nacetylcysteine with indomethacin) for preventing PEP were similar to that of the standard regimen.

关键词： Endoscopic retrograde cholangiopancreatography Prophylaxis Postendoscopic retrograde cholangiopancreatography pancreatitis Nonsteroidal antiinflammatory drugs N-acetylcysteine

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