Andreea Calin - Academia.edu (original) (raw)

Papers by Andreea Calin

Contact address: Maria-Magdalena Gurzun University of Medicine and Pharmacy “Carol Davila”, Euroe... more Contact address: Maria-Magdalena Gurzun University of Medicine and Pharmacy “Carol Davila”, Euroecolab, Emergency Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Sos. Fundeni 258, sector 2, 022328, Bucharest, Romania. E-mail: magdalenagurzun@gmail.com 1 University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania 2 Emergency Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania 3 Elias Emergency Hospital, Bucharest, Romania INTRODUCTION Mitral valve repair is the surgical method of choice for patients with severe mitral regurgitation due to myxomatous mitral valve disease whenever the valve is deemed reparable by detailed imaging assessment and the required surgical expertise is available. Therefore, precise knowledge of mitral valve morpho logy and function is mandatory for proper patient management. Echocardiography is the main method for the diagnosis and detailed mitral valve anatomy description in patients with mitral regur...

Myxomatous mitral valve disease (MVD) is a common disorder in which the entire mitral valve appar... more Myxomatous mitral valve disease (MVD) is a common disorder in which the entire mitral valve apparatus seems to be involved. Mitral valve repair is nowadays the method of choice for the correction of mitral regurgitation but the optimal shape and flexibility of the annuloplasty ring remain controversial. Considering that myxomatous MVD covers a wide spectrum from limited fi bro-elastic deficiency to extensive Barlow disease, we presume that the mitral annulus morphological and functional changes are likely different in different types of myxomatous MVD. We analyze the 3-dimensional geometry and the dynamics of the mitral annulus in 110 patients with significant mitral regurgitation due to different types of myxomatous mitral valve disease and 40 normal subjects using 3D transesophageal echocardiography. The mitral annulus differs in patients with limited MVD, extensive MVD and in normal controls in terms of size, shape, and dynamics. Patients with limited MVD have larger, flatter, dy...

Contact address: Carmen Ginghină, “CC Iliescu” Emergency Institute for Cardiovascular Diseases, B... more Contact address: Carmen Ginghină, “CC Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania Fundeni Street, no. 258, sector 2, 022328, Bucharest, Romania. Email: carmenginghina2010@gmail.com 1 “Prof. Dr. C. C. Iliescu” Emergency Institute of Cardiovascular Diseases, Bucharest, Romania 2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania Abstract & aims: Although mortality is the most important clinical endpoint in heart failure (HF) clinical trials, it is now recognized that preventing HF hospitalization is important for patients and healthcare systems. In the Digitalis Investigation Group (DIG) trial, digoxin reduced hospitalization due to heart failure (HF) and improved outcomes in high-risk subgroups of HF patients. In our study, we investigated the contemporary use of digoxin in clinical practice based on current knowledge. Methods and results – We retrospectively studied the medical fi les of 300 patients (58% men, 65±12 years) admitte...

European Heart Journal, 2018

Congenital heart disease diagnostic aspects 315 vanced hemodynamic parameter. The previous study ... more Congenital heart disease diagnostic aspects 315 vanced hemodynamic parameter. The previous study demonstrated greater ventricular kinetic energy is necessary to generate flow in the pulmonary circulations in patients with repaired tetralogy of Fallot (rTOF). However, there is no clear mechanism regarding the energy transfer between myocardium and intraventricular flow. Purpose: The purpose of this study is to assess the MRI derived kinetic energy transfer in the right ventricle (RV) of rTOF patients. Methods: The study consisted of 26 rTOF patients (age: 22.2±3.2 y/o; male/female: 17/9) and 15 age-matched normal subjects (age: 22.0±1.2 y/o; male/female: 8/7) without known cardiovascular disease. They all underwent MRI with tissue phase mapping (TPM) and 4D flow. TPM was performed in longitudinal (z), radial (r), and circumferential (Ø) directions. Kinetic energy (KE) derived from 4D flow was computed. MRI derived parameters were compared between two groups. Results: rTOF group presented higher PR fraction, higher RV stroke volume index, and increased RV end-systolic and end-diastolic volume index than normal group (all p<0.001). There was no statistically difference of RV ejection fraction (p>0.05) in both groups. In systolic phase of RV, rTOF group exhibited significantly higher KEr (1.7±0.7 mJ vs 1.3±0.5 mJ, p<0.05), lower KEØ (0.4±0.2 mJ vs 1.3±0.6 mJ, p<0.001), and KEz (1.5±1.0 mJ vs 5.0±2.7 mJ, p<0.001) than normal group. In diastolic phase of RV, TOF group presented higher KEr (2.3±1.1 mJ vs. 1.2±0.4 mJ, p<0.001) and lower KEz (1.6±1.3 mJ vs. 5.8±2.2 mJ, p<0.001) than normal group. rTOF group demonstrated lower summation of KE than normal group during both systole (p<0.001) and diastole (p<0.001) of RV myocardium. As for RV intraventricular flow, only higher summation of diastolic KE were observed in rTOF group than in normal group (p<0.001). rTOF group had shorter basal time to peak of KE gradient than normal subjects (p<0.01). Conclusions: Our study quantified the difference of RV myocardial and intraventricular flow KE in rTOF patients with preserved RV function. Further studies are required to elucidate the effect of the different kinetic energy transfer on the cardiac function in rTOF patients.

European Heart Journal - Cardiovascular Imaging, 2019

Aims The present study sought to evaluate the correlation between indices of non-invasive myocard... more Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). Methods and results A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained....

JACC: Cardiovascular Imaging, 2017

This study sought to show the degree to which experience and training affect the precision and va... more This study sought to show the degree to which experience and training affect the precision and validity of global longitudinal strain (GLS) measurement and to evaluate the variability of strain measurement after feedback. BACKGROUND The application of GLS for the detection of subclinical dysfunction has been recommended in an expert consensus document and is being used with increasing frequency. The role of experience in the precision and validity of GLS measurement is unknown, as is the efficacy of training. METHODS Fifty-eight readers, divided into 4 groups on the basis of their experience with GLS, calculated GLS from speckle strain analysis of 9 cases with various degrees of image quality. Intraclass correlation coefficients (ICCs), mean difference, standard deviation (SD), and coefficient of variation (CV) were compared against the measurements of a reference group that had experience with >1,000 cases of strain measurement. Individualized feedback was distributed, and repeat measurements were performed by 40 readers. Comparisons with the baseline variation provided information about whether feedback was effective. RESULTS The ICC for GLS was significantly greater than that for ejection fraction regardless of image quality. Experience with strain measurement affected the concordance in strain values among the readers; the group with the highest level of experience showed significantly better ICC than those with no experience, although the ICC of the inexperienced readers was still very good (0.996 vs. 0.975, p ¼ 0.0002). As experience increased, the mean difference, SD, and CV became significantly smaller. The CV of segmental strain analysis showed significant improvement after training, regardless of experience. CONCLUSIONS The favorable interobserver agreement of GLS makes it more attractive than ejection fraction for follow-up of left ventricular function by multiple observers. Although experience is important, the precision of GLS was high for all groups. Training appears to be of most value for the assessment of segmental strain.

Journal of medicine and life

Atherosclerosis represents a systemic disease that affects all major vascular territories. Despit... more Atherosclerosis represents a systemic disease that affects all major vascular territories. Despite advances in medical therapies to prevent atherosclerosis and better manage patients with established peripheral arterial disease (PAD), the incidence of PAD continues to increase, and associated morbidity remains high, especially as the population ages. Over the past decade, percutaneous revascularization therapies for the treatment of patients with PAD have tremendously evolved, and a great number of patients can be offered treatment options that are less invasive than traditional surgical ones. Here we are presenting the case of a 67-year-old diabetic woman with multiple cardiovascular risk factors and oligosymptomatic atherosclerotic involvement in several important territories (severe internal carotid stenosis, severe proximal left subclavian artery stenosis, critical serial stenosis in the mid-segment of the left anterior descending artery). Bilateral staged carotid artery plus le...

European Heart Journal, 2013

P4133-Table 1. Comparisons of echocardiographic characteristics among the groups Variables Contro... more P4133-Table 1. Comparisons of echocardiographic characteristics among the groups Variables Control (n=39) Normal geometry (n=27) Concentric remodelling (n=33) Concentric hypertrophy (n=87) Eccentric hypertrophy (n=34) P LVMI (g/m 2) 94.5±13.

European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2011

In aortic stenosis (AS), both reduced systemic arterial compliance and increased valvular load ha... more In aortic stenosis (AS), both reduced systemic arterial compliance and increased valvular load have been shown to contribute to impaired left ventricular (LV) function. However, the relationship between LV function and aortic stiffness has not yet been investigated. We aimed to assess the relationship between aortic stiffness and LV global longitudinal strain (GLS), LV filling pressures (E/E') and B-type natriuretic peptide (BNP) in AS. A comprehensive echocardiogram was performed in 48 consecutive patients with severe AS (<0.6 cm(2)/m(2)) and preserved LV ejection fraction (≥50%). Aortic stiffness index (beta) was calculated based on aortic diameters measured by echocardiography and blood pressure. Systemic arterial compliance (SAC) and valvulo-arterial impedance (Z(va)) were also determined. Aortic beta index was significantly correlated with Z(va) (r = 0.30, P= 0.03) and SAC (r = -0.29, P = 0.04). GLS (r = 0.45, P = 0.001), E/E' (r = 0.48, P = 0.001) and BNP levels (r ...

Journal of Hypertension, 2011

toms of cerebral hypoperfusion during test (13/62 vs 24/37, p < 0,001), and carotid atheroscleros... more toms of cerebral hypoperfusion during test (13/62 vs 24/37, p < 0,001), and carotid atherosclerosis were more frequent in type II (97% vs 24% p < 0.001). Conclusions: The prolonged initial orthostatic depressor reactions are associated with higher frequency symptoms of cerebral hypoperfusion during test and carotid atherosclerosis in patients with essential hypertension.

$Research paper thumbnail of Impact of aortic stifness on left ventricular filling pressures and BNP levels in patients with severe aortic stenosis and preserved ejection fraction$

Journal of the American College of Cardiology

Heart

This review focuses on the available data regarding the utility of advanced left ventricular (LV)... more This review focuses on the available data regarding the utility of advanced left ventricular (LV) imaging in aortic stenosis (AS) and its potential impact for optimising the timing of aortic valve replacement. Ejection fraction is currently the only LV parameter recommended to guide intervention in AS. The cut-off value of 50%, recommended for decision-making in asymptomatic patients with AS, is currently under debate. Several imaging parameters have emerged as predictors of disease progression and clinical outcomes in this setting. Global longitudinal LV strain by speckle tracking echocardiography is useful for risk stratification of asymptomatic patients with severe AS and preserved LV ejection fraction. Its prognostic value was demonstrated in these patients, but further work is required to define the best thresholds to aid the decision-making process. The assessment of myocardial fibrosis is the most studied application of cardiac magnetic resonance in AS. The detection of repla...

JACC: Cardiovascular Imaging

JACC. Cardiovascular imaging, Jan 11, 2018

The goal of this study was to compare echocardiographic measurements of global longitudinal strai... more The goal of this study was to compare echocardiographic measurements of global longitudinal strain (GLS) (using 3 apical views) with single-view longitudinal strain (LS, 4- or 2-chamber [4CV_LS and 2CV_LS, respectively]) for detection of cancer-therapy related cardiotoxicity. GLS is useful for the detection of cardiotoxicity, but the need for repeated measurements poses a significant burden on busy echocardiography laboratories. A single-view LS measurement, possibly at point of care, could improve efficiency. Seventeen international centers prospectively recruited 108 patients (mean age 54 ± 13 years) at high risk for cardiotoxicity as part of the ongoing SUCCOUR (Strain Surveillance for Improving Cardiovascular Outcomes During Chemotherapy) randomized controlled trial. Echocardiography performed at baseline and follow-up were analyzed in a core laboratory setting blinded to clinical information. Peak systolic GLS and LS were measured from raw data. Cardiotoxicity was defined by re...

$Research paper thumbnail of Left atrial dysfunction as a determinant of pulmonary hypertension in patients with severe aortic stenosis and preserved left ventricular ejection fraction$

The international journal of cardiovascular imaging, Jan 15, 2017

In patients with severe aortic stenosis (AS), the presence of pulmonary hypertension (PH) has bee... more In patients with severe aortic stenosis (AS), the presence of pulmonary hypertension (PH) has been linked to a poor prognosis. We aimed to assess the main determinants of PH in patients with severe AS and preserved left ventricular ejection fraction (LVEF). We prospectively enrolled 108 consecutive patients with isolated severe AS (indexed aortic valve area <0.6 cm(2)/m(2)) and LVEF >50%, in sinus rhythm. Left atrial (LA) function was assessed using longitudinal deformation parameters (by speckle tracking echocardiography). PH (defined as systolic pulmonary artery pressure >40 mmHg) was present in 20 patients. Patients with severe AS and PH were older (p = 0.05), had higher BNP values (p = 0.05) and a greater degree of LV diastolic dysfunction: higher E/e' and E/A ratios and lower EDT values (p < 0.03 for all) compared to patients without PH. There were no differences between groups regarding AS severity and LV systolic function parameters. Patients with PH had a mor...

Nephrology Dialysis Transplantation, 2016