Publications by authors named "Niya Mileva"
Background: Aortic stiffening is a well-known cardiovascular risk factor. Computed tomography (CT) has proven to be a valuable tool in the assessment of aortic elastic properties. Drugs that inhibit the renin-angiotensin system (RAS) play a central role in cardioprotective therapy.
View Article and Find Full Text PDFCoronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. We highlight how the inflammatory processes inherent in vasculitis contribute to accelerated atherosclerosis and myocardial ischemia.
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- Coronary bifurcation lesions are common in heart procedures but involve significant challenges, leading to higher risks and poorer outcomes for patients.
- This review discusses the unique characteristics of these lesions and the difficulties faced during treatment, while also assessing different methodologies for managing them.
- A new combined approach for treating bifurcation lesions shows promise for improving procedures and long-term results, highlighting the need for ongoing refinement and evaluation of these techniques.
In public health, simulation modeling stands as an invaluable asset, enabling the evaluation of new systems without their physical implementation, experimentation with existing systems without operational adjustments, and testing system limits without real-world repercussions. In simulation modeling, the Monte Carlo method emerges as a powerful yet underutilized tool. Although the Monte Carlo method has not yet gained widespread prominence in healthcare, its technological capabilities hold promise for substantial cost reduction and risk mitigation.
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- * The study included 226 patients with a mean age of 70.9 years, finding that DOAC treatment correlated with significantly lower all-cause and cardiovascular mortality compared to VKA treatment over a median follow-up of about 55 months.
- * VKA therapy was identified as an independent predictor of cardiovascular death, highlighting the advantages of using DOACs in patients with AF and coronary bifurcation lesions.
Systemic necrotising vasculitides (SNVs) pose significant challenges due to their diverse clinical manifestations and variable outcomes. Therefore, identifying reliable biomarkers holds promise for improving precision medicine in SNVs. This review explores emerging biomarkers aiming to enhance diagnostic accuracy, prognostic assessment, and disease monitoring.
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- Side branch predilatation (SBPD) during coronary bifurcation interventions is discouraged by current guidelines, yet there is limited data on its long-term clinical outcomes.
- This study examined the long-term mortality outcomes for patients undergoing SBPD versus those who did not, using a large patient registry and careful statistical matching.
- Results showed that patients who underwent SBPD had higher all-cause and cardiovascular mortality rates compared to those who did not, indicating that while SBPD might improve angiographic results, it does not lead to better overall survival.
Background: To identify anatomical and morphological plaque features predictors of PCI and create a multiparametric score to increase the predictive yield. Moreover, we assessed the incremental predictive value of FFR (Fractional Flow Reserve derived from CCTA) trans-lesion gradient (ΔFFR) when integrated into the score.
Methods: Observational cohort study including patients undergoing CCTA for suspected coronary artery disease, with FFR available, referred to invasive coronary angiogram and assessment of fractional flow reserve.
: Multisystem inflammatory syndrome in children (MIS-C) poses challenges to the healthcare system, especially with frequent heart involvement. The current retrospective observational study aims to summarize the type and degree of cardiovascular involvement in children with MISC and to find possible associations between laboratory, inflammatory, and imaging abnormalities and the predominant clinical phenotype using a cluster analysis. We present a retrospective observational single-center study including 51 children meeting the MIS-C criteria.
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- The study aimed to compare two methods (continuous and bolus thermodilution) for measuring coronary flow reserve (CFR) and microvascular resistance reserve (MRR) in patients with chest pain and nonobstructive coronary artery disease.
- Results indicated that mean CFR and MRR values were significantly higher when measured using continuous thermodilution compared to bolus thermodilution, with continuous allowing for greater precision and lower variability in the results.
- The correlation between CFR and MRR values from both methods was significant but weak, suggesting that while both methods provide useful information, continuous thermodilution is generally more reliable for assessments.
Residence time in complex left main bifurcation disease after stenting.
Cardiovasc Revasc Med
April 2024
Article Synopsis
- The study examines the mean resident time (RT) after left main (LM) bifurcation stenting using patient-specific computational fluid dynamics (CFD) in 27 patients, highlighting the techniques used: provisional cross-over stenting, DK crush, and Nano-inverted T (NIT).
- Results show that the NIT technique yielded the lowest mean RT (0.33 seconds), while provisional stenting had the highest, revealing a significant difference in wall shear stress (WSS) across the techniques.
- The findings suggest that double-stenting approaches, particularly the NIT technique, result in better hemodynamic outcomes compared to provisional stenting in patients with complex LM bifurcation disease.
Article Synopsis
- Despite the proven safety and effectiveness of COVID-19 vaccines, concerns persist among high-risk groups, particularly those with a history of blood clotting or bleeding issues.
- The review examines various genetic and acquired blood disorders, their potential interactions with the immune response to vaccination, and the available safety data related to these vaccines.
- It concludes that while there are rare instances of bleeding and thrombotic events, these do not demonstrate a direct cause-and-effect relationship with the COVID-19 vaccines, reinforcing the need for vaccination as a priority over minimal risks.
Article Synopsis
- The study aimed to evaluate the accuracy of a virtual stenting tool, the FFR Planner, which uses coronary CT angiography (CCTA) data to predict fractional flow reserve (FFR) after percutaneous coronary interventions (PCI) in patients with chronic coronary syndromes.
- It found that the FFR Planner showed good agreement with invasively measured post-PCI FFR across varying levels of CCTA image quality, with a mean difference of only 0.02 FFR units among different image quality scores.
- The findings suggest that the FFR Planner's accuracy is influenced by a higher nitrate dose, and its reliability across various image qualities may enhance clinical decision-making in coronary interventions.
Objective: To assess aortic regurgitation (AR) prevalence, its hemodynamic effect, and long-term prognostic implications in patients admitted with de novo or worsened heart failure with preserved ejection fraction (HFpEF).
Methods: Consecutive patients hospitalized with de novo or worsened HFpEF between 2014 and 2020 were enrolled. Patients with more than moderate aortic and/or mitral valve disease were excluded.
Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal-fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc.
View Article and Find Full Text PDFAims: To analyze the association between chronic SGLT2-I treatment and development of contrast-induced acute kidney injury (CI-AKI) in diabetic patients with acute myocardial infarction (AMI) undergoing PCI.
Methods: Multicenter international registry of consecutive patients with type 2 diabetes mellitus (T2DM) and AMI undergoing PCI between 2018 and 2021. The study population was stratified by the presence of chronic kidney disease (CKD) and anti-diabetic therapy at admission (SGLT2-I versus non-SGLT2-I users).
Article Synopsis
- The study examines the link between vessel volume, myocardial mass, and fractional flow reserve (FFR) after percutaneous coronary intervention (PCI) in patients with significant coronary lesions.
- Results show that lower post-PCI FFR values are associated with higher myocardial mass and a lower ratio of coronary volume to mass (V/M).
- The findings suggest that measuring myocardial mass and V/M ratio can help in predicting post-PCI outcomes and may guide treatment decisions.
Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is common in current clinical practice. Cardiac magnetic resonance (CMR) plays an important role in its management and is increasingly recommended by all the current guidelines. However, the prognostic value of CMR in patients with MINOCA is still undetermined.
View Article and Find Full Text PDFBackground: A bolus thermodilution-derived index of microcirculatory resistance (IMR) has emerged as the standard for assessing coronary microvascular dysfunction (CMD). Continuous thermodilution has recently been introduced as a tool to quantify absolute coronary flow and microvascular resistance directly. Microvascular resistance reserve (MRR) derived from continuous thermodilution has been proposed as a novel metric of microvascular function, which is independent of epicardial stenoses and myocardial mass.
View Article and Find Full Text PDFAims: The leading reason for delayed discharge after pulmonary vein isolation (PVI) is vascular complications. This study aimed to evaluate feasibility, safety, and efficacy of the Perclose Proglide™ suture-mediated vascular closure in ambulatory PVI, report complications, patient satisfaction, and cost of this approach.
Methods And Results: Patients scheduled for PVI were enrolled prospectively in an observational design.