<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Heart failure (HF) is a major public health problem characterised by a high rate of hospitalisation and death. The risk is maximal for patients admitted with acute heart failure (AHF). New therapies with solid proof of mortality reduction in both groups of patients with reduced and preserved ejection fraction (EF) are now available (valsartan/sacubitril and SGLT<sub>2</sub> inhibitors).</p>
<p>The purpose of this article is to review the main data available and to clarify the role of these new therapies in AHF. The precise moment of initiating these therapies is still a matter of debate. This paper presents the recommended criteria for clinical stability that the clinician could use in deciding to initiate therapy. There is a growing amount of evidence that initiating these therapies sooner provides more benefits to patients.</p>
</abstract>

“Carol Davila” Medicine and Pharmacy University

Earlier is Better. New Options for Acute Heart Failure: When, Who, How Much?

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Isometric handgrip (IHG) exercise causes changes in heart rate variability (HRV) and hemodynamic responses with individual differences. We test the hypothesis that baseline measurements affect post-exercise outcomes.</p>
</sec>
<sec><h3>Methods</h3>
<p>In this cross-sectional study, 45 males aged 17 to 22 were enrolled from SMS Medical College, Jaipur, India. Hemodynamic and HRV data were collected at baseline, during, and after 5 minutes of IHG exercise. Nonparametric tests compared the absolute and relative responses before, during, and after the exercise. The relationship of baseline measurements with outcomes was evaluated using Pearson's correlation.</p>
</sec>
<sec><h3>Results</h3>
<p>The study showed a significant increase in the absolute values of hemodynamic parameters and LF/HF ratio during and after 5 minutes of IHG exercise compared to the baseline. However, a significant decrease and increase occurred in all the relative hemodynamic parameters and most HRV parameters, respectively, after rather than during the 5 minutes of IHG exercise. Hemodynamic parameters significantly correlated with baseline during and after 5 minutes of IHG exercise. Similarly, baseline affects all the HRV parameters during IHG exercise, but not after 5 minutes of IHG exercise.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>The present study concludes that initial baseline status should be considered while evaluating the post-IHG exercise responses.</p>
</sec>
</abstract>

Effect of Baseline Status on Cardiovascular Responses Post-isometric Handgrip Exercise

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Objective</h3><p>Serum lactate, a marker of tissue hypoxia, is an important prognostic factor in sepsis, trauma, and cardiogenic shock. Data on the direct correlation of serum lactate and in-hospital mortality in normotensive acute pulmonary thromboembolism (APE) patients, however, remains scarce.</p></sec>
<sec><h3>Material and methods</h3><p>We analyzed normotensive APE patients admitted to our clinic from January 1, 2014, to December 31, 2021. Serum lactate was collected from arterial blood at admission.</p></sec>
<sec><h3>Results</h3><p>The study sample included 161 patients with an average age of 68.61 ± 11.54 years. 54.94% were female. In-hospital mortality was 19.88%.</p>
<p>In ROC analysis, serum lactate was a predictor of in-hospital mortality with an AUC of 0.662 (95%CI 0.584 – 0.735, p = 0.005). The cut-off level identified by the Youden index-associated criterion was > 38 mg/dL (34.38% sensitivity, 94.57% specificity).</p>
<p>In multivariable analysis for in-hospital mortality alongside the biomarkers proposed by the 2019 ESC guidelines for severity assessment, lactate > 38 mg/dL was an independent predictor of mortality (OR 10.92, 95%CI 3.04 – 39.29, p &lt; 0.001).</p>
<p>The prediction model including PESI score, right ventricular dysfunction, troponin I, and lactate > 38 mg/dL had the best predictive performance for in-hospital mortality (AUC 0.807, p &lt; 0.001).</p></sec>
<sec><h3>Conclusions</h3><p>Elevated serum lactate is an independent predictor of all-cause in-hospital mortality of normotensive APE patients, with the optimal cut-off > 38 mg/dL. Adding the lactate level for mortality prediction outperformed the 2019 ESC guidelines algorithm for severity assessment of normotensive APE patients.</p></sec>
</abstract>

“Carol Davila” University of Medicine and Pharmacy

Serum Lactate, an Independent Prognostic Marker in Normotensive Patients With Acute Pulmonary Thromboembolism

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>We set out to assess whether the preoperative prediction of patient-prosthesis mismatch by an algorithm popularised by Pibarot et al. is accurate compared to PPMM defined as AVA &lt;0.85 cm<sup>2</sup>/m<sup>2</sup> (‘any PPMM’) or as AVA &lt;0.65cm<sup>2</sup>/m<sup>2</sup> (‘severe’ PPMM).</p>
<p>We studied 37 patients (16 female), with mean age 72.3 +/− 8.4 years, who had unplanned SAVR during 2019. By echo, 17 (19.7%) patients had severe PPMM (mean AVA (SD) = 0.55 (0.04) cm<sup>2</sup>). For the 0.85cm<sup>2</sup>/m<sup>2</sup> cut-off, 14/37 patients (37%) had PPMM (mean AVA (SD) 0.70 (0.15) cm<sup>2</sup>. By the Pibarot algorithm, 21 (56.7%) patients were predicted to have any PPMM and 10 (27%) severe PPMM.</p>
<p>The preoperative algorithm for the avoidance of patient prosthetic mismatch does not accurately identify patients who have postoperative PPMM as defined by echocardiography. Further refinements of the algorithm seem necessary before it can be used widely in clinical practice.</p>
</abstract>

Patient Prosthesis Mismatch in SAVR: How Avoidable is It in the ‘Real World’?

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>This article provides data on the workload of the interventional cardiology centers in Romania during 2021. Members from all interventional cardiology centers in Romania were requested to fill out a standard form about the total number of various procedures they performed during 2021. The report highlights the total number of coronary interventions, peripheral interventions, and interventions for structural heart diseases that were performed in 2021 in Romania. A comparison of the workload of the interventional cardiology centers from Romania between 2014 to 2021 was completed.</p>
</abstract>

The Workload of the Interventional Cardiology Centers from Romania: a 2021 Overview and 2014–2021 Trends

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Wellens syndrome is a clinical, biological, and electrocardiographic complex that identifies a subgroup of patients with unstable angina who have an impending risk of myocardial infarction and death, representing an equivalent of ST segment elevation myocardial infarction.</p>
</sec>
<sec><h3>Methods</h3>
<p>We conducted a prospective analysis of 64 consecutive patients, recruited over 2 years, with Wellens syndrome who underwent coronary angiography and we compared them with an age- and sex-matched group of patients with non-ST segment elevation acute coronary syndrome who underwent coronary angiography. The primary endpoints of our study were the rate of cardiovascular rehospitalizations, the rate of ischaemic reccurences, the rate of subsequent or recurrent revascularization, and the rate of mortality at six months from the index event.</p>
</sec>
<sec><h3>Results</h3>
<p>At 6 months, the patients in the control group had a higher rate of cardiovascular rehospitalizations (41.9% vs. 21.9%, p = 0.016). The rate of ischaemic recurrences and the rate of global mortality were similar across the two groups.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Physiopathologically and angiographically, Wellens syndrome is an abortive form of ST segment elevation myocardial infarction, but electrocardiographically and prognostically, it evolves similarly to a non-ST segment elevation acute coronary syndrome.</p>
</sec>
</abstract>

University of Medicine and Pharmacy „Carol Davila”

Wellens Syndrome: Single Centre Study and Literature Review

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>We present the case of a patient with heart failure with reduced left ventricular (LV) ejection fraction, diagnosed in the first instance by echocardiography and further on by more accurate cardiac magnetic resonance imaging with LV non-compaction (LVNC). Blood tests showed high erythrocyte and hematocrit levels, inappropriate in this setting, whilst Janus Kinase 2V617F mutation was absent, erythropoietin level was slightly increased, and arterial O2 pressure level was normal. At the time of diagnosis, the patient had mild renal impairment, and abdominal echography revealed bilateral polycystic kidney disease (PKD). The patient had one son who fulfilled the echocardiographic criteria for LVNC and had bilateral renal cysts revealed by abdominal ultrasound. The genes responsible for autosomal dominant PKD (ADPKD) development are PKD1, on chromosome 16, coding for polycystin 1 and PKD2, on chromosome 4, coding for polycystin 2. There are some experimental data which suggest that polycystins might play an important role in cardiac development and hence PKD1 and PKD2 mutations may be involved in primary cardiomyopathies. These data could explain this particular association between LVNC and ADPKD. To date, there are only a few isolated cases reported, and only one shows this association in more than one member of the same family. Further genetic testing in the few reported cases would presumably elucidate whether this finding is the result of complex genetic synergy or just a simple coincidence.</p>
</abstract>

Carol Davila University of Medicine and Pharmacy

Department of Internal Medicine and Cardiology, Theodor Burghele Clinical Hospital

Left Ventricular Non-compaction Cardiomyopathy and Polycystic Kidney Disease Revealed by Inappropriate Polycythemia: A Fortuitous Association? Case Report

AHEAD OF PRINT

Volume 34 (2024): Issue 1 (March 2024)

Volume 33 (2023): Issue 4 (December 2023)

Volume 33 (2023): Issue 3 (September 2023)

Volume 33 (2023): Issue 2 (June 2023)

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Volume 32 (2022): Issue 4 (December 2022)

Volume 32 (2022): Issue 3 (September 2022)

Volume 32 (2022): Issue 2 (June 2022)

Volume 32 (2022): Issue 1 (March 2022)

Volume 31 (2021): Issue 4 (December 2021)

Volume 31 (2021): Issue 3 (September 2021)

Volume 31 (2021): Issue 2 (June 2021)

Volume 31 (2021): Issue 1 (March 2021)

Romanian Journal of Cardiology

The Romanian Journal of Cardiology (RJC) is the official journal of the Romanian Society of Cardiology (Societatea Romana de Cardiologie) and is published quarterly.   The aim of the Romanian Journal of Cardiology was stated from the moment of its foundation in 1991: to provide an open forum for exchange of ideas and a strong connection between basic and clinical cardiology. The journal serves the interest of both practicing clinicians and researchers.   The Romanian Journal of Cardiology is an international, English language, peer-reviewed journal publishing original scientific articles in a wide range of basic, clinical, and experimental research areas. It covers all aspects of cardiology and its related specialties. The Journal publishes articles relevant to adult and pediatric cardiologists, cardiac surgeons, internists, and professionals from other areas of medicine interested in cardiovascular diseases.   The Romanian Journal of Cardiology publishes a diverse and high-quality selection of review articles, clinical trials, case reports, short communications, points of view, letters to the editor, editorials and Images in Cardiology. A letter of transmittal must accompany the submission of a manuscript, indicating that all the authors have contributed to the paper and that they have reviewed and agree with the content of the article.   The journal is based on independent and unbiased blind peer-reviewed principles. The Journal accepts for submission only unpublished papers that are not under review for publication elsewhere.   There is no charge for authors to submit articles to the Romanian Journal of Cardiology, which is an Open Access Journal. This allows the interested reader to search, access, download, or print the full-text articles and use them for any other lawful purpose.   All statements and opinions are solely the responsibility of the authors.  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. 

Romanian Journal of Cardiology

Volume 32 (2022): Issue 4 (December 2022)

Review

Earlier is Better. New Options for Acute Heart Failure: When, Who, How Much?

Original Article

Effect of Baseline Status on Cardiovascular Responses Post-isometric Handgrip Exercise

Serum Lactate, an Independent Prognostic Marker in Normotensive Patients With Acute Pulmonary Thromboembolism

Patient Prosthesis Mismatch in SAVR: How Avoidable is It in the ‘Real World’?

The Workload of the Interventional Cardiology Centers from Romania: a 2021 Overview and 2014–2021 Trends

Wellens Syndrome: Single Centre Study and Literature Review

Case Report

Left Ventricular Non-compaction Cardiomyopathy and Polycystic Kidney Disease Revealed by Inappropriate Polycythemia: A Fortuitous Association? Case Report

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