Gani Bajraktari | University of Prishtina (original) (raw)

Papers by Gani Bajraktari

Research paper thumbnail of P0841 Predictors of Mortality in Patients with Chronic Systolic Heart Failure

European Journal of Internal Medicine, 2009

Research paper thumbnail of Normal ranges of left ventricular strain in children: a meta-analysis

Cardiovascular Ultrasound, 2015

The definition of normal values of two-dimensional speckle-tracking echocardiography derived left... more The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures. A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used. Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient's follow up.

Research paper thumbnail of Total isovolumic time, a marker of left ventricular global dyssynchrony, is prolonged with age

Cardiologia Croatica, 2013

Research paper thumbnail of Management and comorbidities of atrial fibrillation in patients admitted in cardiology service in Kosovo-a single-center study

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2010

in patients admitted in cardiology service in Kosovo-a single-center study Kosovo'da kardiyoloji ... more in patients admitted in cardiology service in Kosovo-a single-center study Kosovo'da kardiyoloji servisine başvuran hastalarda atriyal fibrilasyonun komorbiditeleri ve takibi-Tek merkezli çalışma 36 ÖZET Amaç: Atriyal fibrilasyon (AF) iskemik inmenin en önemli risk faktörüdür. Antikoagülasyon tedavisi atriyal fibrilasyonlu hastalarda inme riskini büyük oranda azaltabilir. Bizim çalışmamızın amacı, taburcu olan AF'li hastaların takibi ve hastaların komorbiditesini araştırmak idi. Yöntemler: Ocak 2005 ve Mart 2008 tarihleri arasında kurumumuza başvuran 5382 ardışık hastadan, bu retrospektif çalışmaya dahil edilen 525'i (ortalama yaş 66.4±11.4 yaş, %53.3 erkek) taburcu edilirken atriyal fibrilasyonlu idi. Hastalar taburcu olurken antikoagülasyon tedavi reçetesine göre iki gruba ayrıldı. Eşleştirilmemiş Student t testi kullanılarak sürekli veriler gruplar arasında karşılaştırıldı. Uygunluklarına göre kategorik değişkenler, Ki-kare testi ya da Fisher'in kesin olasılık testi kullanılarak karşılaştırıldı. Oral antikoagülasyon tedavisinin reçetelenmesinin bağımsız klinik ve ekokardiyografik belirleyicilerini tanımlamak için lojistik regresyon analizi kullanıldı. Bulgular: Hastalarımızda atriyal fibrilasyonla ilgili komorbiditeler: İskemik kalp hastalığı (%21.4), hipertansif kalp hastalığı (%27.4), valvüler kalp hastalığı (%17.4), kongestif kalp yetersizliği (%47), kronik obstrüktif pulmoner hastalık (%6.7) ve diyabettir (%14.3). Hastların %76'sı betablokerlerle, %67 anjiyotensin dönüştürücü enzim inhibitörlerle, %23 digoksinle, %16 kalsiyum antagonistleri ile %67 diüretik ilaçlarla, ve %72 aspirinle ve 27% oral antikoagülasyon tedavisi (OAK) ile taburcu edildi, %11 ise her iki antitrombotiği alıyordu.

Research paper thumbnail of Predictors of exercise capacity in patients with chronic heart failure

Journal of Cardiovascular Medicine, 2011

Heart failure is a major and growing societal problem characterized by high mortality, frequent h... more Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. The six-minute walking test (6-MWT) may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to cardiopulmonary exercise testing (CPET). The CPET and 6-MWT are the most broadly used for assessing functional limitation in patients with heart failure. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population. This study included 132 consecutive patients (61 ± 10 years, 45% women) with stable heart failure. All patients underwent 6-MWT and Doppler echocardiographic examination on the same day. Clinical, biochemical and echocardiographic predictors were analyzed to assess predictors of exercise capacity. Patients were divided into two groups based on the 6-MWT distance. The first group comprised patients with limited exercise performance (≤ 300 m), and the second group, patients with good exercise performance (>300 m). In univariate analysis, patients' age [0.931 (0.895-0.968), P < 0.001], arterial hypertension [0.481 (0.239-0.967), P = 0.040], blood urea level [0.860 (0.759-0.975), P = 0.019], New York Heart Association (NYHA) class [0.441 (0.245-0.795), P = 0.006], early diastolic E wave [1.014 (1.000-1.029), P = 0.047], total isovolumic time (t-IVT) [0.868 (0.796-0.947), P = 0.001], Tei index [0.112 (0.028-0.450), P = 0.002], and E' of left-ventricular (LV) lateral wall [1.188 (1.099-1.400), P = 0.039] independently predicted poor 6-MWT performance (<300 m). In multivariate analysis, only patients' age [0.948 (0.902-0.996), P = 0.034], arterial hypertension [0.351 (0.133-0.922), P = 0.034], and t-IVT [0.828 (0.725-0.946), P = 0.005] independently predicted poor 6-MWT performance (<300 m). In chronic stable heart failure patients, in addition to age, systemic hypertension as well as LV asynchrony, as reflected by prolonged t-IVT, are independent predictors of poor exercise capacity.

Research paper thumbnail of P0840 MRSA ENDOCARDITIS OF BOVINE CONTEGRA VALVED CONDUIT, FOUR YEARS AFTER RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION AND ATRIAL SEPTAL DEFECT CORRECTION, ASSOCIATED WITH ACUTE GLOMERULONEPHRITIS, RENAL FAILURE AND SEVERE ANEMIA

European Journal of Internal Medicine, 2009

Research paper thumbnail of Total isovolumic time predict limited exercise capacity in male patients with heart failure, but not in female

Cardiologia Croatica, 2013

Research paper thumbnail of MRSA endocarditis of bovine Contegra valved conduit: a case report

Cases Journal, 2009

Background: Different techniques are used for the right ventricular outflow tract reconstruction,... more Background: Different techniques are used for the right ventricular outflow tract reconstruction, including homo-or porcine xenografts, which have several limitations. Contegra, a bovine jugular vein graft, is an interesting alternative to overcome these limitations. It consists of a bovine jugular vein with a naturally integrated valve in it. Isolated pulmonary valve endocarditis is extremely rare.

Research paper thumbnail of Predictors of exercise capacity in patients with chronic heart failure

Journal of Cardiovascular Medicine, 2011

Heart failure is a major and growing societal problem characterized by high mortality, frequent h... more Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. The six-minute walking test (6-MWT) may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to cardiopulmonary exercise testing (CPET). The CPET and 6-MWT are the most broadly used for assessing functional limitation in patients with heart failure. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population. This study included 132 consecutive patients (61 ± 10 years, 45% women) with stable heart failure. All patients underwent 6-MWT and Doppler echocardiographic examination on the same day. Clinical, biochemical and echocardiographic predictors were analyzed to assess predictors of exercise capacity. Patients were divided into two groups based on the 6-MWT distance. The first group comprised patients with limited exercise performance (≤ 300 m), and the second group, patients with good exercise performance (>300 m). In univariate analysis, patients' age [0.931 (0.895-0.968), P < 0.001], arterial hypertension [0.481 (0.239-0.967), P = 0.040], blood urea level [0.860 (0.759-0.975), P = 0.019], New York Heart Association (NYHA) class [0.441 (0.245-0.795), P = 0.006], early diastolic E wave [1.014 (1.000-1.029), P = 0.047], total isovolumic time (t-IVT) [0.868 (0.796-0.947), P = 0.001], Tei index [0.112 (0.028-0.450), P = 0.002], and E' of left-ventricular (LV) lateral wall [1.188 (1.099-1.400), P = 0.039] independently predicted poor 6-MWT performance (<300 m). In multivariate analysis, only patients' age [0.948 (0.902-0.996), P = 0.034], arterial hypertension [0.351 (0.133-0.922), P = 0.034], and t-IVT [0.828 (0.725-0.946), P = 0.005] independently predicted poor 6-MWT performance (<300 m). In chronic stable heart failure patients, in addition to age, systemic hypertension as well as LV asynchrony, as reflected by prolonged t-IVT, are independent predictors of poor exercise capacity.

Research paper thumbnail of Investigation of relation between periodontal disease and coronary heart disease

Journal Of Clinical Periodontology

Research paper thumbnail of Relationship between periodontal disease, hyperlipidemia and coronary heart disease

Research paper thumbnail of Left atrial emptying fraction predicts long-term outcome in HFpEF patients

Background and aim: Although many prognostic variables have been reported, the risk stratificatio... more Background and aim: Although many prognostic variables have been reported, the risk stratification of patients with heart failure and preserved ejection fraction (HFpEF) is still controversial. We investigated the prognostic value of various conventional Doppler echocardiographic parameters on the clinical outcomes of a sample of such patients. Methods: This study included 139 consecutive patients (62±10 years) with congestive HFpEF. The primary outcomes were cardiac events (CE = mortality or need for hospitalization) due to acute HF signs and/or symptoms. LV end-diastolic and end-systolic dimensions, ejection fraction (EF), mitral and tricuspid annulus peak systolic excursion (MAPSE and TAPSE), myocardial velocities (s', e' and a'), left atrial (LA) dimensions, LA volume and LA emptying fraction were all measured. Mean follow-up was 20±5 months. Results: During the follow-up period, 53 patients (38%) had CE. The hemoglobin level was lower (P=0.02), LV mass index was hig...

Research paper thumbnail of Aortic valve replacement normalizes the exaggerated twist in patients with aortic stenosis and preserved ejection fraction

Background and Aim. Long-standing aortic stenosis (AS) causes various degrees of left ventricular... more Background and Aim. Long-standing aortic stenosis (AS) causes various degrees of left ventricular (LV) function disturbances including exaggerated apical twist. The aim of this study was to assess the effect of aortic valve replacement (AVR) on the LV twist and torsion function in AS. Methods: We studied 28 consecutive patients (age 64±10 years, 10 male) with severe AS, normal LV ejection fraction (EF) and no obstructive coronary artery disease before, and six months after AVR. LV long axis function was studied using M-mode (amplitude) and tissue Doppler (myocardial velocities). Two-dimensional speckle tracking echocardoigraphy (STE) was also used to assess LV twist and torsion. Results were compared with those from 28 age and gender matched controls. Results: Long axis motion was decreased in patients with AS before surgery compared to controls (septal, 1.2±0.1 vs.1.5±0.3 cm, p<0.05 for M-mode and 5.7±1.1 vs. 7.0±1.2 cm/s, p<0.001 for TDI data) but normalized after AVR (p<...

Research paper thumbnail of Right ventricular function correlates with six minute walk distance in heart failure

Background and Aim: In heart failure (HF) patients the 6-min walking (6-MWT) test may serve as a ... more Background and Aim: In heart failure (HF) patients the 6-min walking (6-MWT) test may serve as a simple clinical tool for assessing patient’s functional capacity. The right ventricular function was shown as an important predictor in these patients. The aim of this prospective study was to investigate the right ventricular (RV) echocardiographic correlates of exercise capacity assessed by 6-MWT in patients with HF. Methods. A 6-MWT was performed in 186 consecutive patients (mean age 61±11 years, 55% male) with a mean LV ejection fraction 41±13% and signs of congestive heart failure (NYHA: 2.5±0.6). An echo-Doppler study was performed in the same day and the following measurements were obtained: LV end-diastolic (EDD) and end-systolic (ESD) dimensions, fractional shortening (FS), ejection fraction (EF), E:A ratio, LV and RV long axis function studied by M-mode (amplitude) at the base of lateralseptal LV wall and RV wall. The LV and RV myocardial diastolic (E’ and A’) and systolic (S’)...

Research paper thumbnail of Predictors of poor six minute walk performance in heart failure patients

Background and Aim: Six minute walking (6-MWT) is an important and useful test for assessing exer... more Background and Aim: Six minute walking (6-MWT) is an important and useful test for assessing exercise capacity in heart failure (HF) patients. We aimed in this study to assess predictors of poor 6-MWT performance in patients with stable HF. Methods: This study included 132 consecutive patients (61±10 years, 45% female) with stable HF who underwent 6-MWT and Doppler echoardiographic examination in the same day. LV end-diastolic (EDD) and end-systolic (ESD) dimensions, fractional shortening (FS), ejection fraction (EF), myocardial diastolic (E’, A’) and systolic (S’) velocities, and LV long axis excursion were measured. E:A ratio, E:E’ ratio, t-IVT [in s/min; calculated as: 60 – (total ejection time – total filling time)], and Tei index (t-IVT/ejection time) were also calculated. Patients were divided into two groups based on the 6-MWT distance (Group I: ≤300m, and Group II: >300m). Results. In univariate analysis, patient’s age [0.931 (0.895-0.968), p<0.001], arterial hypertens...

Research paper thumbnail of Total isovolumic time correlates with limited exercise capacity in HFpEF – its shortening with stress suggests significant rise of filling pressure

Research paper thumbnail of Left ventricular global dyssynchrony is exaggerated with age

International Cardiovascular Forum Journal, 2015

total isovolumic time (t-IVt) and tei index both reflect global left ventricular (LV) dyssynchron... more total isovolumic time (t-IVt) and tei index both reflect global left ventricular (LV) dyssynchrony. they have been shown to be sensitive in responding to myocardial revascularization and in predicting clinical outcome in heart failure patients. since most these patients are senior, determining the exact effect of age on such parameters remains mandatory. the aim of this study was to investigate the effect of age on LV t-IVt and tei index compared with conventional systolic and diastolic parameters in normal individuals.

Research paper thumbnail of Hemorrhagic fever with acute renal failure: a report from Kosova

Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

Acute renal failure (ARF) is a well-known complication of hemorrhagic fever (HF). We studied pati... more Acute renal failure (ARF) is a well-known complication of hemorrhagic fever (HF). We studied patients with HF and ARF who were treated in our department for two years between March 2005 and the end of December 2006. The age of the patients ranged from 17 to 71 years. The incidence of complications in the study patients was acceptable and similar to that reported in the literature of Balkan region. Our study shows that the efficacy of the overall results in the treatment of these patients in our center is comparable to the published data in the country from the Balkan region.

Research paper thumbnail of Left ventricular dyssynchrony predicts limited exercise capacity in heart failure irrespective of ejection fraction

Research paper thumbnail of The prognostic significance of the presence and severity of mitral regurgitation for survival in patients with chronic heart failure

Research paper thumbnail of P0841 Predictors of Mortality in Patients with Chronic Systolic Heart Failure

European Journal of Internal Medicine, 2009

Research paper thumbnail of Normal ranges of left ventricular strain in children: a meta-analysis

Cardiovascular Ultrasound, 2015

The definition of normal values of two-dimensional speckle-tracking echocardiography derived left... more The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures. A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used. Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s follow up.

Research paper thumbnail of Total isovolumic time, a marker of left ventricular global dyssynchrony, is prolonged with age

Cardiologia Croatica, 2013

Research paper thumbnail of Management and comorbidities of atrial fibrillation in patients admitted in cardiology service in Kosovo-a single-center study

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2010

in patients admitted in cardiology service in Kosovo-a single-center study Kosovo'da kardiyoloji ... more in patients admitted in cardiology service in Kosovo-a single-center study Kosovo'da kardiyoloji servisine başvuran hastalarda atriyal fibrilasyonun komorbiditeleri ve takibi-Tek merkezli çalışma 36 ÖZET Amaç: Atriyal fibrilasyon (AF) iskemik inmenin en önemli risk faktörüdür. Antikoagülasyon tedavisi atriyal fibrilasyonlu hastalarda inme riskini büyük oranda azaltabilir. Bizim çalışmamızın amacı, taburcu olan AF'li hastaların takibi ve hastaların komorbiditesini araştırmak idi. Yöntemler: Ocak 2005 ve Mart 2008 tarihleri arasında kurumumuza başvuran 5382 ardışık hastadan, bu retrospektif çalışmaya dahil edilen 525'i (ortalama yaş 66.4±11.4 yaş, %53.3 erkek) taburcu edilirken atriyal fibrilasyonlu idi. Hastalar taburcu olurken antikoagülasyon tedavi reçetesine göre iki gruba ayrıldı. Eşleştirilmemiş Student t testi kullanılarak sürekli veriler gruplar arasında karşılaştırıldı. Uygunluklarına göre kategorik değişkenler, Ki-kare testi ya da Fisher'in kesin olasılık testi kullanılarak karşılaştırıldı. Oral antikoagülasyon tedavisinin reçetelenmesinin bağımsız klinik ve ekokardiyografik belirleyicilerini tanımlamak için lojistik regresyon analizi kullanıldı. Bulgular: Hastalarımızda atriyal fibrilasyonla ilgili komorbiditeler: İskemik kalp hastalığı (%21.4), hipertansif kalp hastalığı (%27.4), valvüler kalp hastalığı (%17.4), kongestif kalp yetersizliği (%47), kronik obstrüktif pulmoner hastalık (%6.7) ve diyabettir (%14.3). Hastların %76'sı betablokerlerle, %67 anjiyotensin dönüştürücü enzim inhibitörlerle, %23 digoksinle, %16 kalsiyum antagonistleri ile %67 diüretik ilaçlarla, ve %72 aspirinle ve 27% oral antikoagülasyon tedavisi (OAK) ile taburcu edildi, %11 ise her iki antitrombotiği alıyordu.

Research paper thumbnail of Predictors of exercise capacity in patients with chronic heart failure

Journal of Cardiovascular Medicine, 2011

Heart failure is a major and growing societal problem characterized by high mortality, frequent h... more Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. The six-minute walking test (6-MWT) may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to cardiopulmonary exercise testing (CPET). The CPET and 6-MWT are the most broadly used for assessing functional limitation in patients with heart failure. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population. This study included 132 consecutive patients (61 ± 10 years, 45% women) with stable heart failure. All patients underwent 6-MWT and Doppler echocardiographic examination on the same day. Clinical, biochemical and echocardiographic predictors were analyzed to assess predictors of exercise capacity. Patients were divided into two groups based on the 6-MWT distance. The first group comprised patients with limited exercise performance (≤ 300 m), and the second group, patients with good exercise performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 m). In univariate analysis, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age [0.931 (0.895-0.968), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001], arterial hypertension [0.481 (0.239-0.967), P = 0.040], blood urea level [0.860 (0.759-0.975), P = 0.019], New York Heart Association (NYHA) class [0.441 (0.245-0.795), P = 0.006], early diastolic E wave [1.014 (1.000-1.029), P = 0.047], total isovolumic time (t-IVT) [0.868 (0.796-0.947), P = 0.001], Tei index [0.112 (0.028-0.450), P = 0.002], and E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; of left-ventricular (LV) lateral wall [1.188 (1.099-1.400), P = 0.039] independently predicted poor 6-MWT performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;300 m). In multivariate analysis, only patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age [0.948 (0.902-0.996), P = 0.034], arterial hypertension [0.351 (0.133-0.922), P = 0.034], and t-IVT [0.828 (0.725-0.946), P = 0.005] independently predicted poor 6-MWT performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;300 m). In chronic stable heart failure patients, in addition to age, systemic hypertension as well as LV asynchrony, as reflected by prolonged t-IVT, are independent predictors of poor exercise capacity.

Research paper thumbnail of P0840 MRSA ENDOCARDITIS OF BOVINE CONTEGRA VALVED CONDUIT, FOUR YEARS AFTER RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION AND ATRIAL SEPTAL DEFECT CORRECTION, ASSOCIATED WITH ACUTE GLOMERULONEPHRITIS, RENAL FAILURE AND SEVERE ANEMIA

European Journal of Internal Medicine, 2009

Research paper thumbnail of Total isovolumic time predict limited exercise capacity in male patients with heart failure, but not in female

Cardiologia Croatica, 2013

Research paper thumbnail of MRSA endocarditis of bovine Contegra valved conduit: a case report

Cases Journal, 2009

Background: Different techniques are used for the right ventricular outflow tract reconstruction,... more Background: Different techniques are used for the right ventricular outflow tract reconstruction, including homo-or porcine xenografts, which have several limitations. Contegra, a bovine jugular vein graft, is an interesting alternative to overcome these limitations. It consists of a bovine jugular vein with a naturally integrated valve in it. Isolated pulmonary valve endocarditis is extremely rare.

Research paper thumbnail of Predictors of exercise capacity in patients with chronic heart failure

Journal of Cardiovascular Medicine, 2011

Heart failure is a major and growing societal problem characterized by high mortality, frequent h... more Heart failure is a major and growing societal problem characterized by high mortality, frequent hospitalization, reduced quality of life and a complex therapeutic regimen. The six-minute walking test (6-MWT) may serve as a useful and reproducible test for assessing exercise capacity in heart failure patients and has been suggested as a simple, well-tolerated and inexpensive alternative to cardiopulmonary exercise testing (CPET). The CPET and 6-MWT are the most broadly used for assessing functional limitation in patients with heart failure. Echocardiography is well qualified to meet the growing need for noninvasive imaging in the expanding heart failure population. This study included 132 consecutive patients (61 ± 10 years, 45% women) with stable heart failure. All patients underwent 6-MWT and Doppler echocardiographic examination on the same day. Clinical, biochemical and echocardiographic predictors were analyzed to assess predictors of exercise capacity. Patients were divided into two groups based on the 6-MWT distance. The first group comprised patients with limited exercise performance (≤ 300 m), and the second group, patients with good exercise performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 m). In univariate analysis, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age [0.931 (0.895-0.968), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001], arterial hypertension [0.481 (0.239-0.967), P = 0.040], blood urea level [0.860 (0.759-0.975), P = 0.019], New York Heart Association (NYHA) class [0.441 (0.245-0.795), P = 0.006], early diastolic E wave [1.014 (1.000-1.029), P = 0.047], total isovolumic time (t-IVT) [0.868 (0.796-0.947), P = 0.001], Tei index [0.112 (0.028-0.450), P = 0.002], and E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; of left-ventricular (LV) lateral wall [1.188 (1.099-1.400), P = 0.039] independently predicted poor 6-MWT performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;300 m). In multivariate analysis, only patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age [0.948 (0.902-0.996), P = 0.034], arterial hypertension [0.351 (0.133-0.922), P = 0.034], and t-IVT [0.828 (0.725-0.946), P = 0.005] independently predicted poor 6-MWT performance (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;300 m). In chronic stable heart failure patients, in addition to age, systemic hypertension as well as LV asynchrony, as reflected by prolonged t-IVT, are independent predictors of poor exercise capacity.

Research paper thumbnail of Investigation of relation between periodontal disease and coronary heart disease

Journal Of Clinical Periodontology

Research paper thumbnail of Relationship between periodontal disease, hyperlipidemia and coronary heart disease

Research paper thumbnail of Left atrial emptying fraction predicts long-term outcome in HFpEF patients

Background and aim: Although many prognostic variables have been reported, the risk stratificatio... more Background and aim: Although many prognostic variables have been reported, the risk stratification of patients with heart failure and preserved ejection fraction (HFpEF) is still controversial. We investigated the prognostic value of various conventional Doppler echocardiographic parameters on the clinical outcomes of a sample of such patients. Methods: This study included 139 consecutive patients (62±10 years) with congestive HFpEF. The primary outcomes were cardiac events (CE = mortality or need for hospitalization) due to acute HF signs and/or symptoms. LV end-diastolic and end-systolic dimensions, ejection fraction (EF), mitral and tricuspid annulus peak systolic excursion (MAPSE and TAPSE), myocardial velocities (s', e' and a'), left atrial (LA) dimensions, LA volume and LA emptying fraction were all measured. Mean follow-up was 20±5 months. Results: During the follow-up period, 53 patients (38%) had CE. The hemoglobin level was lower (P=0.02), LV mass index was hig...

Research paper thumbnail of Aortic valve replacement normalizes the exaggerated twist in patients with aortic stenosis and preserved ejection fraction

Background and Aim. Long-standing aortic stenosis (AS) causes various degrees of left ventricular... more Background and Aim. Long-standing aortic stenosis (AS) causes various degrees of left ventricular (LV) function disturbances including exaggerated apical twist. The aim of this study was to assess the effect of aortic valve replacement (AVR) on the LV twist and torsion function in AS. Methods: We studied 28 consecutive patients (age 64±10 years, 10 male) with severe AS, normal LV ejection fraction (EF) and no obstructive coronary artery disease before, and six months after AVR. LV long axis function was studied using M-mode (amplitude) and tissue Doppler (myocardial velocities). Two-dimensional speckle tracking echocardoigraphy (STE) was also used to assess LV twist and torsion. Results were compared with those from 28 age and gender matched controls. Results: Long axis motion was decreased in patients with AS before surgery compared to controls (septal, 1.2±0.1 vs.1.5±0.3 cm, p<0.05 for M-mode and 5.7±1.1 vs. 7.0±1.2 cm/s, p<0.001 for TDI data) but normalized after AVR (p<...

Research paper thumbnail of Right ventricular function correlates with six minute walk distance in heart failure

Background and Aim: In heart failure (HF) patients the 6-min walking (6-MWT) test may serve as a ... more Background and Aim: In heart failure (HF) patients the 6-min walking (6-MWT) test may serve as a simple clinical tool for assessing patient’s functional capacity. The right ventricular function was shown as an important predictor in these patients. The aim of this prospective study was to investigate the right ventricular (RV) echocardiographic correlates of exercise capacity assessed by 6-MWT in patients with HF. Methods. A 6-MWT was performed in 186 consecutive patients (mean age 61±11 years, 55% male) with a mean LV ejection fraction 41±13% and signs of congestive heart failure (NYHA: 2.5±0.6). An echo-Doppler study was performed in the same day and the following measurements were obtained: LV end-diastolic (EDD) and end-systolic (ESD) dimensions, fractional shortening (FS), ejection fraction (EF), E:A ratio, LV and RV long axis function studied by M-mode (amplitude) at the base of lateralseptal LV wall and RV wall. The LV and RV myocardial diastolic (E’ and A’) and systolic (S’)...

Research paper thumbnail of Predictors of poor six minute walk performance in heart failure patients

Background and Aim: Six minute walking (6-MWT) is an important and useful test for assessing exer... more Background and Aim: Six minute walking (6-MWT) is an important and useful test for assessing exercise capacity in heart failure (HF) patients. We aimed in this study to assess predictors of poor 6-MWT performance in patients with stable HF. Methods: This study included 132 consecutive patients (61±10 years, 45% female) with stable HF who underwent 6-MWT and Doppler echoardiographic examination in the same day. LV end-diastolic (EDD) and end-systolic (ESD) dimensions, fractional shortening (FS), ejection fraction (EF), myocardial diastolic (E’, A’) and systolic (S’) velocities, and LV long axis excursion were measured. E:A ratio, E:E’ ratio, t-IVT [in s/min; calculated as: 60 – (total ejection time – total filling time)], and Tei index (t-IVT/ejection time) were also calculated. Patients were divided into two groups based on the 6-MWT distance (Group I: ≤300m, and Group II: >300m). Results. In univariate analysis, patient’s age [0.931 (0.895-0.968), p<0.001], arterial hypertens...

Research paper thumbnail of Total isovolumic time correlates with limited exercise capacity in HFpEF – its shortening with stress suggests significant rise of filling pressure

Research paper thumbnail of Left ventricular global dyssynchrony is exaggerated with age

International Cardiovascular Forum Journal, 2015

total isovolumic time (t-IVt) and tei index both reflect global left ventricular (LV) dyssynchron... more total isovolumic time (t-IVt) and tei index both reflect global left ventricular (LV) dyssynchrony. they have been shown to be sensitive in responding to myocardial revascularization and in predicting clinical outcome in heart failure patients. since most these patients are senior, determining the exact effect of age on such parameters remains mandatory. the aim of this study was to investigate the effect of age on LV t-IVt and tei index compared with conventional systolic and diastolic parameters in normal individuals.

Research paper thumbnail of Hemorrhagic fever with acute renal failure: a report from Kosova

Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

Acute renal failure (ARF) is a well-known complication of hemorrhagic fever (HF). We studied pati... more Acute renal failure (ARF) is a well-known complication of hemorrhagic fever (HF). We studied patients with HF and ARF who were treated in our department for two years between March 2005 and the end of December 2006. The age of the patients ranged from 17 to 71 years. The incidence of complications in the study patients was acceptable and similar to that reported in the literature of Balkan region. Our study shows that the efficacy of the overall results in the treatment of these patients in our center is comparable to the published data in the country from the Balkan region.

Research paper thumbnail of Left ventricular dyssynchrony predicts limited exercise capacity in heart failure irrespective of ejection fraction

Research paper thumbnail of The prognostic significance of the presence and severity of mitral regurgitation for survival in patients with chronic heart failure