Pub Date : 2022-12-30DOI: 10.3897/bgcardio.28.e97285
K. Genova, D. Kostova-Lefterova
Cardiac magnetic resonance tomography is widely used method in the diagnosis of cardiovascular diseases. In the last decade, new techniques have been developed to obtain quantitative parameters of myocardial changes. T1 and T2 mapping are part of the routine CMRT protocol and allow direct quantification of T1 and T2 relaxation times in the myocardium as well as the calculation of extracellular volume. These are important biomarkers both for the diagnosis of various myocardial diseases and for monitoring treatment follow-up and determining prognosis. The purpose of this article is to provide a brief overview of the basic principles of the T1 and T2 mapping techniques, as well as their main applications in different types of cardiomyopathies.
{"title":"T1 and T2 mapping – basic principles and clinical application","authors":"K. Genova, D. Kostova-Lefterova","doi":"10.3897/bgcardio.28.e97285","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97285","url":null,"abstract":"Cardiac magnetic resonance tomography is widely used method in the diagnosis of cardiovascular diseases. In the last decade, new techniques have been developed to obtain quantitative parameters of myocardial changes. T1 and T2 mapping are part of the routine CMRT protocol and allow direct quantification of T1 and T2 relaxation times in the myocardium as well as the calculation of extracellular volume. These are important biomarkers both for the diagnosis of various myocardial diseases and for monitoring treatment follow-up and determining prognosis. The purpose of this article is to provide a brief overview of the basic principles of the T1 and T2 mapping techniques, as well as their main applications in different types of cardiomyopathies.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43977533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-30DOI: 10.3897/bgcardio.28.e97466
M. Nedevska, V. Grudeva, A. Partenova
Ischemic heart disease, its sequelae and complications contribute substantially to morbidity and mortality worldwide. Significant technological progress in recent years has significantly expanded the application of non-invasive imaging modalities in the systematic and complex evaluation of patients with ischemic heart disease in the preclinical and clinically developed stages of the disease. Cardiac magnetic resonance imaging includes a complex morphological and functional assessment. Regional and global myocardial kinetics and function, morphological changes in myocardial tissue in the form of edema, hemorrhage, and scarring determine various manifestations of myocardial ischemia in its acute and chronic form. Currently established clinical protocols have already demonstrated their diagnostic and prognostic value. Under the influence of unceasing clinical interest, cardiac magnetic resonance imaging is constantly developing and improving with emerging imaging technologies that provide additional information based on advanced quantification of imaging biomarkers and improved diagnostic accuracy, therefore potentially allowing reduction or avoidance of contrast and/or stressor agents.
{"title":"Cardiac magnetic resonance imaging in acute and chronic myocardial ischemia: current clinical application and future directions","authors":"M. Nedevska, V. Grudeva, A. Partenova","doi":"10.3897/bgcardio.28.e97466","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97466","url":null,"abstract":"Ischemic heart disease, its sequelae and complications contribute substantially to morbidity and mortality worldwide. Significant technological progress in recent years has significantly expanded the application of non-invasive imaging modalities in the systematic and complex evaluation of patients with ischemic heart disease in the preclinical and clinically developed stages of the disease. Cardiac magnetic resonance imaging includes a complex morphological and functional assessment. Regional and global myocardial kinetics and function, morphological changes in myocardial tissue in the form of edema, hemorrhage, and scarring determine various manifestations of myocardial ischemia in its acute and chronic form. Currently established clinical protocols have already demonstrated their diagnostic and prognostic value. Under the influence of unceasing clinical interest, cardiac magnetic resonance imaging is constantly developing and improving with emerging imaging technologies that provide additional information based on advanced quantification of imaging biomarkers and improved diagnostic accuracy, therefore potentially allowing reduction or avoidance of contrast and/or stressor agents.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45402842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-30DOI: 10.3897/bgcardio.28.e97065
D. Kostova-Lefterova, A. Partenova
Cardiac magnetic resonance tomography (CMRT) is a method of high diagnostic value in the assessment of cardiac vitality through the application of various perfusion techniques, as well as in the evaluation and diagnosis of early myocardial ischemic changes. The aim of this article is to review the different technical aspects of CMRT. A major problem in CMRT studies is the deterioration of image quality due to the presence of motion artefacts. This necessitates the development of ECG-gated and respiratory triggered or breath-holding techniques and their implementation in practice. In contrast to most other applications of MRT, the planes used in CMRT are defined with respect to the orientation of the heart so that they are parallel and orthogonal to the cardiac axes. Two main groups of sequences are used in CMRT: 1) to determine morphology, function, and blood flow and 2) to provide good tissue contrast of the heart. Technological development of the method has not stopped, and techniques and pulse sequences continue to be developed to improve the diagnostic capabilities of CMRT. Through proper planning, a thorough understanding of the cardiac planes, and appropriate selection of technical parameters for the respective sequences depending on the clinical finding being addressed, a successful performance of each CMRT study is achieved.
{"title":"Тechnical aspects of cardiac magnetic resonance tomography","authors":"D. Kostova-Lefterova, A. Partenova","doi":"10.3897/bgcardio.28.e97065","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97065","url":null,"abstract":"Cardiac magnetic resonance tomography (CMRT) is a method of high diagnostic value in the assessment of cardiac vitality through the application of various perfusion techniques, as well as in the evaluation and diagnosis of early myocardial ischemic changes. The aim of this article is to review the different technical aspects of CMRT. A major problem in CMRT studies is the deterioration of image quality due to the presence of motion artefacts. This necessitates the development of ECG-gated and respiratory triggered or breath-holding techniques and their implementation in practice. In contrast to most other applications of MRT, the planes used in CMRT are defined with respect to the orientation of the heart so that they are parallel and orthogonal to the cardiac axes. Two main groups of sequences are used in CMRT: 1) to determine morphology, function, and blood flow and 2) to provide good tissue contrast of the heart. Technological development of the method has not stopped, and techniques and pulse sequences continue to be developed to improve the diagnostic capabilities of CMRT. Through proper planning, a thorough understanding of the cardiac planes, and appropriate selection of technical parameters for the respective sequences depending on the clinical finding being addressed, a successful performance of each CMRT study is achieved.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41499984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-30DOI: 10.3897/bgcardio.28.e97523
R. Petkov, K. Genova
The purpose of this review article is to inform practicing cardiologists about the manifestations of cardiotoxicity in patients on or after antitumor therapy and about the potential of cardiac magnetic resonance imaging (CMR) in the diagnosis and follow-up of these patients. The definitions and classification of cardiotoxicity associated with antitumor treatment, the mechanisms of cardiac and vascular damage of some of the important groups of antitumor drugs, and the potential CMR findings are reviewed. The main clinical situations related to manifestations of cardiotoxicity in which CMR has or is expected to have a leading role are outlined.
{"title":"Cardiotoxicity during and after oncological treatment − role of cardio-magnetic resonance","authors":"R. Petkov, K. Genova","doi":"10.3897/bgcardio.28.e97523","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97523","url":null,"abstract":"The purpose of this review article is to inform practicing cardiologists about the manifestations of cardiotoxicity in patients on or after antitumor therapy and about the potential of cardiac magnetic resonance imaging (CMR) in the diagnosis and follow-up of these patients. The definitions and classification of cardiotoxicity associated with antitumor treatment, the mechanisms of cardiac and vascular damage of some of the important groups of antitumor drugs, and the potential CMR findings are reviewed. The main clinical situations related to manifestations of cardiotoxicity in which CMR has or is expected to have a leading role are outlined.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43367066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e79418
Zheyna V. Cherneva, R. Cherneva
Recent data has revealed the cardiovascular complications of COVID-19 infection. The mechanism of cardiovascular impairments involves binding of severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) to the protein angiotensin-converting enzyme 2 (ACE2), thus penetrating into the cells. There are other mechanisms, most of which are under research and will be explained. Cardiovascular complications of COVID-19 infection are heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism. This article aims to collect scientific evidence by exploring PubMed, Scopus, and Pedro databases to show the cardiovascular complications of COVID-19 infection and the benefit of physiotherapy treatment for these patients. Exercise training is a powerful element in physiotherapy and an important part of cardiac rehabilitation. It contributes to significant changes of the cardiovascular system - recovery of endothelial dysfunction and prevention of thromboembolic complications. In conclusion, due to the wide variety of programs of exercise training, as well as patient monitoring, physical activity is appropriate strategy for the treatment of cardiovascular complications of various degrees in post-COVID patients.
{"title":"Physical activity and cardiac rehabilitation in COVID-19 patients with cardiovascular complications","authors":"Zheyna V. Cherneva, R. Cherneva","doi":"10.3897/bgcardio.28.e79418","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e79418","url":null,"abstract":"Recent data has revealed the cardiovascular complications of COVID-19 infection. The mechanism of cardiovascular impairments involves binding of severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) to the protein angiotensin-converting enzyme 2 (ACE2), thus penetrating into the cells. There are other mechanisms, most of which are under research and will be explained. Cardiovascular complications of COVID-19 infection are heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism. This article aims to collect scientific evidence by exploring PubMed, Scopus, and Pedro databases to show the cardiovascular complications of COVID-19 infection and the benefit of physiotherapy treatment for these patients. Exercise training is a powerful element in physiotherapy and an important part of cardiac rehabilitation. It contributes to significant changes of the cardiovascular system - recovery of endothelial dysfunction and prevention of thromboembolic complications. In conclusion, due to the wide variety of programs of exercise training, as well as patient monitoring, physical activity is appropriate strategy for the treatment of cardiovascular complications of various degrees in post-COVID patients. ","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45872096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e89568
Z. Stankov, I. Petrov, D. Boychev
During the period from March 2014 to May 2018, endovascular treatment of aortic dissection type A and type B was carried out in a total of 70 patients. Patients were divided into two groups, aortic dissection type A (14 patients) and type B (56 patients), a group-by-group descriptive analysis was conducted, and then a comparison was done between the two patient groups. The aim of the study was to establish the effective use of endovascular treatment in type A and type B aorta dissection. As a result of the survey, data on the demographic characteristics and risk profile of these patients are accumulated for the first time in Bulgaria. Endovascular treatment options for the treatment of aortic dissection type A and type B, as well as malperfusion syndrome, are examined, demonstrating their effectiveness and safety. As a result of the study, it is proven that endovascular treatment in aortic dissection type A and type B leads to a significant increase in the size of the true lumen and reduction of the false lumen, which leads to an improvement in perfusion and reduces the risk of developing an aneurysm and rupture. The presence of endoleak and persistent communication between the false and the real lumen are the most common causes of re-intervention, such as endovascular options are most often the first line for their dealing and are proven to be effective and safe. Treatment of dissection of the aorta type A and B is not a one-time act, but requires periodic diagnostic control and, if necessary, surfery and/or endovascular corrections of the complications that have arisen.
{"title":"Endovascular treatment of type „A“ and type „B“ dissection of the aorta","authors":"Z. Stankov, I. Petrov, D. Boychev","doi":"10.3897/bgcardio.28.e89568","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e89568","url":null,"abstract":"During the period from March 2014 to May 2018, endovascular treatment of aortic dissection type A and type B was carried out in a total of 70 patients. Patients were divided into two groups, aortic dissection type A (14 patients) and type B (56 patients), a group-by-group descriptive analysis was conducted, and then a comparison was done between the two patient groups. The aim of the study was to establish the effective use of endovascular treatment in type A and type B aorta dissection. As a result of the survey, data on the demographic characteristics and risk profile of these patients are accumulated for the first time in Bulgaria. Endovascular treatment options for the treatment of aortic dissection type A and type B, as well as malperfusion syndrome, are examined, demonstrating their effectiveness and safety. As a result of the study, it is proven that endovascular treatment in aortic dissection type A and type B leads to a significant increase in the size of the true lumen and reduction of the false lumen, which leads to an improvement in perfusion and reduces the risk of developing an aneurysm and rupture. The presence of endoleak and persistent communication between the false and the real lumen are the most common causes of re-intervention, such as endovascular options are most often the first line for their dealing and are proven to be effective and safe. Treatment of dissection of the aorta type A and B is not a one-time act, but requires periodic diagnostic control and, if necessary, surfery and/or endovascular corrections of the complications that have arisen.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41637559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e89578
A. Zagorska, V. Gelev, I. Jeleva, N. Stoyanov, D. Ivanova
Introduction: Medical professionals performing fluoroscopy guided interventional procedures in cardiology are exposed to a risk of radiation induced cataract, especially if the eye lens dose exceeds the annual dose limit of 20 mSv. Aim: The aim of the current study is to measure the eye lens exposure in three interventional cardiology departments, to analyze the relationship between patient dose and eye lens dose and to study the effectiveness of lead goggles without side protection. Material and methods: Measurements were performed in three departments with participation of 4 interventional cardiologists and 6 nurses. The exposure of the eye lens was measured with EYE-DTM (Radcard) passive dosimeters. Results: For nurses the annual eye lens dose varied from 1.6 mSv to 4.3 mSv. For the interventional cardiologists the results were between 3.2 mSv and 31.4 mSv. The dose reduction factor of the studied safety goggles without side protection is 1 and 1.1. Conclusions: There is a risk of exceeding the annual exposure limit of 20 mSv among interventional cardiologists The eye lens exposure depends on the workload and the clinical complexity of the procedures, as well as on the use of radiation protection devices. Due to the specifics of the procedures, the use of goggles with side protection is recommended. The eye lens dose for nurses is lower than the annual limit, which can be explained with the larger distance between the patient and the nurses and partial shielding by the main operator. Lead glasses without side shielding are not recommended because the exposure occurs from the side.
{"title":"Eye lens dose assessment in interventional cardiology","authors":"A. Zagorska, V. Gelev, I. Jeleva, N. Stoyanov, D. Ivanova","doi":"10.3897/bgcardio.28.e89578","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e89578","url":null,"abstract":"Introduction: Medical professionals performing fluoroscopy guided interventional procedures in cardiology are exposed to a risk of radiation induced cataract, especially if the eye lens dose exceeds the annual dose limit of 20 mSv. Aim: The aim of the current study is to measure the eye lens exposure in three interventional cardiology departments, to analyze the relationship between patient dose and eye lens dose and to study the effectiveness of lead goggles without side protection. Material and methods: Measurements were performed in three departments with participation of 4 interventional cardiologists and 6 nurses. The exposure of the eye lens was measured with EYE-DTM (Radcard) passive dosimeters. Results: For nurses the annual eye lens dose varied from 1.6 mSv to 4.3 mSv. For the interventional cardiologists the results were between 3.2 mSv and 31.4 mSv. The dose reduction factor of the studied safety goggles without side protection is 1 and 1.1. Conclusions: There is a risk of exceeding the annual exposure limit of 20 mSv among interventional cardiologists The eye lens exposure depends on the workload and the clinical complexity of the procedures, as well as on the use of radiation protection devices. Due to the specifics of the procedures, the use of goggles with side protection is recommended. The eye lens dose for nurses is lower than the annual limit, which can be explained with the larger distance between the patient and the nurses and partial shielding by the main operator. Lead glasses without side shielding are not recommended because the exposure occurs from the side.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43044187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e89444
V. Dimitrova, I. Petrov, N. Zlatareva
A 27-years old female patient presented with a severe general condition of generalized edema and hypotension. Two months earlier computed tomography imaged thrombosis of the inferior vena cava and the three hepatic veins, or Budd-Chiari syndrome (BCS). Additional findings were thrombosis of the right common iliac vein and thrombosis of the renal veins bilaterally. Genetic testing proved congenital thrombophilia. Anticoagulation therapy did not affect thrombotic occlusions. In another cardiovascular center, an unsuccessful attempt for interventional treatment of the inferior vena cava with a jugular approach was made. The patient was admitted to our hospital for further evaluation and decision on treatment strategy. Laboratory and non-invasive imaging at admission rejected hepatic cirrhosis. An abdominal ultrasound scan demonstrated complete occlusion of the three hepatic veins and post hepatic portal hypertension. When thrombosis of all hepatic veins was detected transjugular intrahepatic portosystemic shunt (TIPS) was an option. An endovascular strategy for inferior vena cava was undertaken and complete revascularization was achieved with the right femoral approach as a bridge to TIPS shunt procedure, since the patient didn’t meet the criteria for liver transplantation. In diagnosing disease, the main contributors were the gastroenterologist, diagnostic imaging specialist, and hematologist, while the multidisciplinary team included also cardiologist, interventional cardiologist, and angiologist. In this case the multidisciplinary decisions played a major role in diagnosing and building an appropriate therapeutic strategy for systemic illnesses and conditions for which medical guidance does not yet have clear guidelines.
{"title":"Thrombophilia in Budd-Chiari syndrome patient","authors":"V. Dimitrova, I. Petrov, N. Zlatareva","doi":"10.3897/bgcardio.28.e89444","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e89444","url":null,"abstract":"A 27-years old female patient presented with a severe general condition of generalized edema and hypotension. Two months earlier computed tomography imaged thrombosis of the inferior vena cava and the three hepatic veins, or Budd-Chiari syndrome (BCS). Additional findings were thrombosis of the right common iliac vein and thrombosis of the renal veins bilaterally. Genetic testing proved congenital thrombophilia. Anticoagulation therapy did not affect thrombotic occlusions. In another cardiovascular center, an unsuccessful attempt for interventional treatment of the inferior vena cava with a jugular approach was made. The patient was admitted to our hospital for further evaluation and decision on treatment strategy. Laboratory and non-invasive imaging at admission rejected hepatic cirrhosis. An abdominal ultrasound scan demonstrated complete occlusion of the three hepatic veins and post hepatic portal hypertension. When thrombosis of all hepatic veins was detected transjugular intrahepatic portosystemic shunt (TIPS) was an option. An endovascular strategy for inferior vena cava was undertaken and complete revascularization was achieved with the right femoral approach as a bridge to TIPS shunt procedure, since the patient didn’t meet the criteria for liver transplantation. In diagnosing disease, the main contributors were the gastroenterologist, diagnostic imaging specialist, and hematologist, while the multidisciplinary team included also cardiologist, interventional cardiologist, and angiologist. In this case the multidisciplinary decisions played a major role in diagnosing and building an appropriate therapeutic strategy for systemic illnesses and conditions for which medical guidance does not yet have clear guidelines.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49048207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e91048
S. Vasilev, I. Petrov, Z. Stankov, L. Janevska, G. Adam
Atherosclerosis is the major cause of cardiovascular diseases (CVD) in the world. It is a multifocal disease that leads to plaque formation and subsequent ischemia in the arteries of the body. Atherosclerotic obstructive peripheral artery disease causes disturbance of blood delivery to the tissues, which can be translated as temperature decrease on the skin surface, making surface temperature an important indicator of vascular health. Even though there are many classical diagnostic tools for assessing patients with peripheral vascular dysfunction, they have many limitations. On the other hand, infrared thermography imaging presents a noninvasive, relatively cheap, quick and reliable method that does not require direct doctor-to-patient contact. It provides a real time screening information of the tissue perfusion, based on the skin surface temperature. In this article, we present a case of a patient with type B aortic dissection, treated with an endovascular approach. A postprocedural closure device complication led to an acute left lower limb ischemia during the night, which was promptly diagnosed with the help of an onsite high-resolution infrared thermography optimized by specialized AI based software performed by the physician on duty followed by remote evaluation by the operator. The obstruction was treated immediately with successful endovascular recanalization and flow restoration and again evaluated with the thermographic camera confirming excellent tissue vascular result. Infrared thermography imaging can be a time-saving method for physicians, while being a very convenient method for the patient and that is why we advocate on the usage of specialized software supported high resolution thermography imaging as a supplementary diagnostic modality for patients with peripheral artery disease.
{"title":"Infrared thermography imaging as a diagnostic tool in the case of acute lower limb ischemia","authors":"S. Vasilev, I. Petrov, Z. Stankov, L. Janevska, G. Adam","doi":"10.3897/bgcardio.28.e91048","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e91048","url":null,"abstract":"Atherosclerosis is the major cause of cardiovascular diseases (CVD) in the world. It is a multifocal disease that leads to plaque formation and subsequent ischemia in the arteries of the body. Atherosclerotic obstructive peripheral artery disease causes disturbance of blood delivery to the tissues, which can be translated as temperature decrease on the skin surface, making surface temperature an important indicator of vascular health. Even though there are many classical diagnostic tools for assessing patients with peripheral vascular dysfunction, they have many limitations. On the other hand, infrared thermography imaging presents a noninvasive, relatively cheap, quick and reliable method that does not require direct doctor-to-patient contact. It provides a real time screening information of the tissue perfusion, based on the skin surface temperature. In this article, we present a case of a patient with type B aortic dissection, treated with an endovascular approach. A postprocedural closure device complication led to an acute left lower limb ischemia during the night, which was promptly diagnosed with the help of an onsite high-resolution infrared thermography optimized by specialized AI based software performed by the physician on duty followed by remote evaluation by the operator. The obstruction was treated immediately with successful endovascular recanalization and flow restoration and again evaluated with the thermographic camera confirming excellent tissue vascular result. Infrared thermography imaging can be a time-saving method for physicians, while being a very convenient method for the patient and that is why we advocate on the usage of specialized software supported high resolution thermography imaging as a supplementary diagnostic modality for patients with peripheral artery disease.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48642877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.3897/bgcardio.28.e93484
I. Petrov, Z. Stankov, J. Stoykova, S. Vasilev
Introduction: Arterial hypertension is the most common correctable risk factor for death worldwide. Achievement of therapeutic goal is hampered by multiple factors including non-adherence to drug therapy and individual physiological resistance. Objective: We aimed to determine the efficacy of renal denervation in lowering SBP and DBP at 1st and 6th month, in patients at high cardiovascular risk, in whom lowering BP would possibly also result in risk reduction and lower incidence of future cardiovascular events. Methods: The procedure was performed in 39 patients with resistant hypertension admitted to the University Hospital „Acibadem City Clinic – Cardiovascular Center“ (Sofia) for the period January 2017–June 2020. Access was via brachial artery and the Simplicity Spiral catheters were used, at an average of 19.5 ablation points per artery. The number of complications, as well as the mean systolic and diastolic BP values at 1st and 6th month were recorded. Baseline, risk profile and follow-up medical treatment of the study group was monitored. Results: In the study group, the predominant risk factors were dyslipidemia, age, diabetes mellitus, with 21 patients (53.84%) already having clinically significant atherosclerosis – a realized heart attack, stroke, peripheral or coronary revascularization. At follow-up, a significant reduction in both systolic and diastolic BP (blood pressure) values was observed. At the first month, the fall in SBP (systolic blood pressure) was –17.8 mm Hg, with a persistent reduction in the range of –14.5 mm Hg at 6th month. In terms of DBP (diastolic BP), the mean reduction at the first month was –8.9 mm Hg and at the 6th month it was –7.2 mm Hg. Regarding antihypertensive treatment, there was a mild reduction in the intake of antihypertensive drugs. Conclusion: Substantial proportion of people with hypertension have uncontrolled hypertension (both treatment resistant and due to non-adherence to treatment or due to additional pathophysiological mechanisms). Renal denervation has proven effective and safe in patients with uncontrolled hypertension and high cardiovascular risk profile
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