Biomedical subjects

Cătălina Arsenescu

Publications and source records attributed to Cătălina Arsenescu.

7 recordsLinked to original sources

PubMedDate not supplied

[Permanent cardiac pacing for chronic symptomatic atrioventricular block in uremic hemodialysed patients. A prospective study].

Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, reports concerning advanced A-V block, requiring permanent cardiac pacing in end-stage renal disease (ESRD) hemodialysed (HD) patients are very few. This is the first long term prospective study reporting on systematic permanent pacemaker implantation, in a cohort of ESRD patients from a single HD unit. Between 01/06/1997 and 30/12/2001, 396 pacemakers were inserted for advanced, symptomatic A-V block in our institution, including 5 in ESRD, HD patients (M/F--4/1, age 47-73, M +/- SD--61 +/- 12 years) from a single dialysis center, treating 137 patients during the study period. Thus, the incidence and prevalence of A-V defects treated by permanent pacing in uremic patients was 0.81% and 3.65% respectively. Conversely, the incidence and prevalence of ESRD treated by hemodialysis, among patients with advanced A-V conduction disturbances, requiring permanent pacing were 0.28% and 1.26%. Mitral valve calcifications were present in all patients; 3 subjects also had extensive aortic valve calcifications. Left ventricular hypertrophy (echocardiographic Framingham criteria) was present in 4 patients, but the systolic function (ejection fraction and fractional shortening index) was normal in all cases, although a clinical picture of chronic heart failure was seen in 3 subjects preoperatively. A-V conduction defects were attributed to extensive metastatic calcifications, involving the cardiac squeleton, consecutive to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. No technical difficulties, short or long-term complications related to pacemaker implantation (4 VVI and 1 VVD devices) were encountered. Acute threshold and sensing values were similar with those of non-uremic patients. During follow-up, one patients died from a non cardiac death. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted as a prompt life-saving method in all dialysis patients with chronic symptomatic advanced A-V blocks.

Aged↗

PubMedDate not supplied

Cardiac leiomyosarcoma. Case report.

A case of primary cardiac leiomyosarcoma diagnosed at Iaşi Cardiology Center is presented. The study was made on the surgical biopsy specimen, and the diagnosis by routine morphological techniques. The gross examination revealed a large intracavitary left atrial tumor attached by a small sessile base to the left posterior atrial wall, having a smooth, white-gray surface, and a dense consistency. On the cut surface, the tumor had a whirled white appearance, with focal brown areas. The microscopic examination revealed the presence of a spindle cell tumor, forming fascicles orientated at right angles. The study revealed the morphological aspect characteristic to leiomyosarcoma.

Biopsy↗

PubMedDate not supplied

Cardiac consequences of the systemic lupus erythematosus therapy with corticosteroids morphological study.

It is presented the case of a fifty years old women, diagnosed 3 years ago with systemic lupus erythematosus, under therapy with prednisone and cyclophosphamid therapy. She was admitted in our hospital for right decompensated heart disease and the presence of an apical right ventricular mass occluding part of the right ventricular cavity. The endomyocardial biopsy was made to clearify the nature of this mass. After processing the specimen, the histological study evidenciated an organizing apical thrombotic mass formed in a large right ventricular cavity in conditions of pulmonary hypertention. There are presented data concerning the adverse effects of the systemic lupus erythematosus drug therapy, as well. In these circumstances, we demonstrated histologically, that both conditions could alter the heart morphology.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Two cases of Marfan syndrome.

The early identification of the Marfan Syndrome should be essential for the prevention of the aortic dilatation and dissection, but the wide phenotypic expression of the disorder makes the clinical diagnosis very difficult. The aim of this study is to emphasise the necessity of a widely applicable method of morpho-clinical diagnosis. The diagnosis was confirmed on surgical biopsies from ascending aortic wall and aortic cusps, using routine morphological techniques. The macroscopical examination revealed a thin ascending aortic wall, presenting a transversal intimal tear, without secondary dissecting hematoma, and an aortic dilated annulus, producing aortic regurgitation. Microscopically, the diagnosis was supported by the identification of cystic medical necrosis, a specific degenerative lesion in the Marfan Syndrome, in patients with or without family history of aortic aneurysms. This study defines the morpho-clinical changes of the disease, emphasising the necessity of a permanent monitorization of the patient after surgery, due to the risk of late complications.

Adolescent↗

PubMedDate not supplied

Morphological evaluation of the surgically removed aortic and mitral valves.

In 2001, of the 114 valves surgically excised at the Iaşi Center of Cardiology from 59 men and 54 women (mean age 51 years; age range: 25 to 78 years), half were aortic and the other half mitral valves. The 57 aortic valves, from 20 women and 37 men (mean age 51.1; age range 25 to 78 years), had been surgically replaced. Functionally, 57.63 percent (30) were stenotic, 21.05 percent (12) were incompetent, and 26.31 percent (15) were both stenotic and incompetent (aortic disease). Pure stenosis was related to calcification of degenerative (73.3 percent), bicuspid (3.33 percent), post-inflammatory (20 percent), and undetermined (3.33 percent) causes. Pure regurgitation was not related to calcification and causes included infective endocarditis (50 percent), bicuspid valve (16.66 percent), postinflammatory (16.66 percent), aortic root dilatation (8.33 percent), and undetermined (8.33 percent). Aortic disease was secondary to postinflammatory etiologies (40 percent), degenerative calcification (33.33 percent), bicuspid and undetermined (13.33 percent each) causes. The reminder of 57 mitral valves, from 35 women and 24 men (mean age 45.5 years; age range 28 to 71 years), were surgically replaced. Functionally, 40.35 percent (23) were purely stenotic, 19.29 percent (11) were purely regurgitant, and 40.35 percent (23) both stenotic and regurgitant (mitral disease). The causes of pure stenosis were postinflammatory (presumably rheumatic) disease in 91.3 percent (21 cases) and degenerative disease in 8.7 percent (3 cases). Pure regurgitation etiology involved floppy valves in 45.45 percent (5 cases), degenerative disease in 27.27 percent (3 cases), postinflammatory disease in 18.18 percent (2 cases) and infective endocarditis 9.1 percent (1 case).

Adult↗

PubMedDate not supplied

[Risk of sudden death in patients with chronic renal failure and hemodialysis].

Cardiovascular mortality in uremic patients treated by hemodialysis overrates ten times cardiovascular mortality in general population. Approximatively 40% of patients on iterative hemodialysis die from cardiac diseases, half of cases by sudden death. Several risk factors for sudden death are well known: QTc interval prolongation, decrease of RR interval <750 msec, decrease of heart rate variability, presence of late ventricular potentials (LVP), presence of high risk ventricular extrasystoles, decrease of ejection fraction (EF) <40 %, presence of left ventricular hypertrophy. Our study evaluated the above-mentioned risk factors for sudden death in patients with chronic renal failure on hemodialysis. We studied 37 patients, 22 males and 15 females, with mean age of 42 years old, without diabetes, heart failure and arrhythmias, without myocardial ischemia on ECG, being on hemodialysis (HD) programme for minimum 1 year (HD parameters are: 4 h x 3/week, qB = 300 ml/min, buffer = bicarbonate, Ca dialysate = 1.75 mmol/l, K dialysate = 2.1 mmol/l, conductivity = 135 mS). The patients were evaluated by echocardiography, standard and Holter ECG. Statistics evaluation was performed in SPSS v.9.0. Program. The results proved that 80% of patients on HD have risk factors for sudden death, which are closely related with age and hyperhydration. Statistics proved that presence of high-risk arrhythmias is connected with heart rate variability and prolongation of QTc interval (favored by HD). 50% of our patients have 2 to 4 risk factors for sudden death, which increase incidence of sudden death in patients on HD.

Adult↗

PubMedDate not supplied

[Cardiac amyloidosis. A case report].

The paper presents the morphoclinical picture in cardiac amyloidosis to a 50 years old man admitted at Iasi Cardiology Center with progressive chronic cardiac failure, the patient having recent history of restrictive cardiomyopathy. It was made a complete cardiovascular evaluation including the right cardiac catheterization for endomyocardial biopsy. The biopsy specimens were fixed in buffered 10 % formalin, followed by routine paraffin embedding, and were stained with haematoxylin-eosin, elastic Van Gieson and sulphated blue Alcian for amyloid evaluation. The amyloid deposits were evidentiated in the interstitium and into vascular walls of the biopsy, pointing the importance of the morphological exam for amyloidosis diagnosis.

Amyloidosis↗