The optimal timing for aortic valve replacement (AVR) in aortic stenosis (AS) is still controvers... more The optimal timing for aortic valve replacement (AVR) in aortic stenosis (AS) is still controversial and may be guided by markers of adverse left ventricular (LV) remodeling. We aim to assess electrocardiographic (ECG) strain in relation to LV remodeling and myocardial fibrosis. 83 severe AS patients underwent surgical AVR, with preoperative 12-lead ECG, cardiovascular magnetic resonance with T1 mapping and echocardiography with global longitudinal strain analysis. Collagen volume fraction (CVF) was measured in myocardial biopsies sampled during AVR. Patients with ECG strain had more severe AS, more advanced LV remodeling and evidence of heart failure. Patients with ECG strain had more diffuse fibrosis, as evident by higher mean native T1 values (974.8 ± 34 ms vs. 946.5 ± 28 ms, p < 0.001). ECG strain was the only predictor of increased LV mass index on multivariate regression analysis (OR = 7.10, 95% CI 1.46–34.48, p = 0.02). Patients with persistent ECG strain at 1 year followi...
Value of scar imaging and inotropic reserve combination for the prediction of segmental and globa... more Value of scar imaging and inotropic reserve combination for the prediction of segmental and global left ventricular functional recovery after revascularisation
BACKGROUND Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains an unres... more BACKGROUND Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains an unresolved challenge. Many different diagnostic approaches are often required to diagnose, confirm, and evaluate MINOCA. The prevalence can be as high as 13 % of all acute MI patients indicating that this condition is not rare. At this time, there have been no completed randomized clinical trials involving MINOCA patients, and a better understanding of the mechanisms and management of these patients is important. This exploratory analysis seeks to find possible etiologic factors, the value of novel biomarkers, and the effect of different treatment strategies in patients with MINOCA. METHODS This prospective randomized pilot trial will include 150 patients with MINOCA. A thorough clinical, laboratory and imaging evaluation will be performed including novel biomarkers and modern imaging techniques (heart magnetic resonance imaging and noninvasive testing). The duration of the enrollment is 18 months, duration of the follow up is 12 months from the enrollment of the first patient. RESULTS The trial is registered under www.clinicaltrials.gov: NCT04538924. The study is currently recruiting participants. CONCLUSIONS Since MINOCA is not a benign disease, the results of the current investigation could inform future diagnostic and therapeutic strategies and enhance the understanding of MINOCA patients.
Background. Therapeutic hypothermia is recommended to reduce the risk of hypoxic brain damage and... more Background. Therapeutic hypothermia is recommended to reduce the risk of hypoxic brain damage and improve short-term survival after cardiac arrest. It also temporarily affects the cardiac conduction system. The aim of this study was to evaluate electrocardiographic changes during therapeutic hypothermia and their impact on the outcome. Materials and methods. This retrospective analysis involved 26 patients who underwent therapeutic hypothermia after cardiac arrest in Vilnius University Hospital Santaros Klinikos from 2011 to 2015. Results. During cooling, a significant reduction in the heart rate (p = 0.013), shortening of QRS complex duration (p = 0.041), and prolongation of the QTc interval (p < 0.001) were observed. During the cooling period, five patients had subtle Osborn waves, which disappeared after rewarming. The association between electrocardiographic changes during cooling and unfavourable neurological outcome or in-hospital mortality was non-significant. Conclusions....
Miokardo infarktas – pagrindinė mirties priežastis daugelyje pasaulio šalių. Į klinikinę praktiką... more Miokardo infarktas – pagrindinė mirties priežastis daugelyje pasaulio šalių. Į klinikinę praktiką įvedus laboratorinį troponinų tyrimą, pagerėjo miokardo išemijos, įvykusios ne dėl vainikinių kraujagyslių stenozės, diagnostika. 2007 m. universalaus miokardo infarkto apibrėžimo tarptautinio susitarimo dokumente buvo išskirti 5 miokardo infarkto tipai. I ir II tipo išskyrimas sukėlė nemažai painiavos, trūksta duomenų apie I ir II miokardo infarkto tipų dažnio, simptomatikos ir baigčių skirtumus. Tyrimo tikslas – įvertinti miokardo infarkto eigos, pasireiškimo, gydymo ir baigčių skirtumus pacientams, sergantiems I ir II tipų miokardo infarktu. Tyrimo metodika – atliktas retrospektyvinis tyrimas. Į tyrimą įtraukti 1583 tiriamieji, kurie dėl I arba II tipo miokardo infarkto 2011 – 2015 metais buvo hospitalizuoti Vilniaus universiteto ligoninėje Santaros klinikose ir įtraukti į ūmių koronarinių sindromų duomenų bazę. Lyginti pacientų su I ir II tipo miokardo infarktu demografiniai duomeny...
The fatal heart failure - a natural course of cor triatriatum sinister V Rudiene1; D Zakarkaite1;... more The fatal heart failure - a natural course of cor triatriatum sinister V Rudiene1; D Zakarkaite1; S Glaveckaite1; L Latveniene1; L Gumbiene1 1University Hospital Santariskiu Klinikos, Centre of Cardiology and Angiology, Vilnius, Lithuania Introduction: Cor triatriatum sinister (CTS) is a rare cardiac anomaly with an incidence of 0.1-0.4% of all congenital heart defects. Clinical course and management of this pathology influenced by the degree of obstruction between the two left atrial chambers. Case report description: 20 years ago a 39 year-old man was consulted by the cardiologist because of 1 month history of palpitations, dyspnea and reduced exercise tolerance. He was followed by general practitioner from the age of 16 due to rheumatic heart disease. Physical examination revealed normal arterial blood pressure, irregular heart rate of about 110 bpm, and the diastolic heart murmur at the apex was heard, liver enlargement and mild peripheral edema. An electrocardiogram showed atri...
Key words: cardiovascular magnetic resonance; myocardial ischemia; coronary artery disease. Summa... more Key words: cardiovascular magnetic resonance; myocardial ischemia; coronary artery disease. Summary. This article presents the case of a 54-year-old male with evidence of myocardial is-chemia at rest. In our case, by means of cardiovascular magnetic resonance, myocardial ischemia at rest in theoretical left anterior descending artery territory was proved, myocardial scar was excluded, and need for revascularization was validated. Adresas susirašinėti: S. Glaveckaitė, VU MF Širdies ir kraujagys-lių ligų klinika, Introduction We present a case of resting myocardial ischemia and shortly discuss the value of cardiovascular mag-netic resonance (CMR) for the assessment of rest and stress ischemia especially in case when coronary artery stenosis is of unclear signifi cance.
The optimal timing for aortic valve replacement (AVR) in aortic stenosis (AS) is still controvers... more The optimal timing for aortic valve replacement (AVR) in aortic stenosis (AS) is still controversial and may be guided by markers of adverse left ventricular (LV) remodeling. We aim to assess electrocardiographic (ECG) strain in relation to LV remodeling and myocardial fibrosis. 83 severe AS patients underwent surgical AVR, with preoperative 12-lead ECG, cardiovascular magnetic resonance with T1 mapping and echocardiography with global longitudinal strain analysis. Collagen volume fraction (CVF) was measured in myocardial biopsies sampled during AVR. Patients with ECG strain had more severe AS, more advanced LV remodeling and evidence of heart failure. Patients with ECG strain had more diffuse fibrosis, as evident by higher mean native T1 values (974.8 ± 34 ms vs. 946.5 ± 28 ms, p < 0.001). ECG strain was the only predictor of increased LV mass index on multivariate regression analysis (OR = 7.10, 95% CI 1.46–34.48, p = 0.02). Patients with persistent ECG strain at 1 year followi...
Value of scar imaging and inotropic reserve combination for the prediction of segmental and globa... more Value of scar imaging and inotropic reserve combination for the prediction of segmental and global left ventricular functional recovery after revascularisation
BACKGROUND Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains an unres... more BACKGROUND Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains an unresolved challenge. Many different diagnostic approaches are often required to diagnose, confirm, and evaluate MINOCA. The prevalence can be as high as 13 % of all acute MI patients indicating that this condition is not rare. At this time, there have been no completed randomized clinical trials involving MINOCA patients, and a better understanding of the mechanisms and management of these patients is important. This exploratory analysis seeks to find possible etiologic factors, the value of novel biomarkers, and the effect of different treatment strategies in patients with MINOCA. METHODS This prospective randomized pilot trial will include 150 patients with MINOCA. A thorough clinical, laboratory and imaging evaluation will be performed including novel biomarkers and modern imaging techniques (heart magnetic resonance imaging and noninvasive testing). The duration of the enrollment is 18 months, duration of the follow up is 12 months from the enrollment of the first patient. RESULTS The trial is registered under www.clinicaltrials.gov: NCT04538924. The study is currently recruiting participants. CONCLUSIONS Since MINOCA is not a benign disease, the results of the current investigation could inform future diagnostic and therapeutic strategies and enhance the understanding of MINOCA patients.
Background. Therapeutic hypothermia is recommended to reduce the risk of hypoxic brain damage and... more Background. Therapeutic hypothermia is recommended to reduce the risk of hypoxic brain damage and improve short-term survival after cardiac arrest. It also temporarily affects the cardiac conduction system. The aim of this study was to evaluate electrocardiographic changes during therapeutic hypothermia and their impact on the outcome. Materials and methods. This retrospective analysis involved 26 patients who underwent therapeutic hypothermia after cardiac arrest in Vilnius University Hospital Santaros Klinikos from 2011 to 2015. Results. During cooling, a significant reduction in the heart rate (p = 0.013), shortening of QRS complex duration (p = 0.041), and prolongation of the QTc interval (p < 0.001) were observed. During the cooling period, five patients had subtle Osborn waves, which disappeared after rewarming. The association between electrocardiographic changes during cooling and unfavourable neurological outcome or in-hospital mortality was non-significant. Conclusions....
Miokardo infarktas – pagrindinė mirties priežastis daugelyje pasaulio šalių. Į klinikinę praktiką... more Miokardo infarktas – pagrindinė mirties priežastis daugelyje pasaulio šalių. Į klinikinę praktiką įvedus laboratorinį troponinų tyrimą, pagerėjo miokardo išemijos, įvykusios ne dėl vainikinių kraujagyslių stenozės, diagnostika. 2007 m. universalaus miokardo infarkto apibrėžimo tarptautinio susitarimo dokumente buvo išskirti 5 miokardo infarkto tipai. I ir II tipo išskyrimas sukėlė nemažai painiavos, trūksta duomenų apie I ir II miokardo infarkto tipų dažnio, simptomatikos ir baigčių skirtumus. Tyrimo tikslas – įvertinti miokardo infarkto eigos, pasireiškimo, gydymo ir baigčių skirtumus pacientams, sergantiems I ir II tipų miokardo infarktu. Tyrimo metodika – atliktas retrospektyvinis tyrimas. Į tyrimą įtraukti 1583 tiriamieji, kurie dėl I arba II tipo miokardo infarkto 2011 – 2015 metais buvo hospitalizuoti Vilniaus universiteto ligoninėje Santaros klinikose ir įtraukti į ūmių koronarinių sindromų duomenų bazę. Lyginti pacientų su I ir II tipo miokardo infarktu demografiniai duomeny...
The fatal heart failure - a natural course of cor triatriatum sinister V Rudiene1; D Zakarkaite1;... more The fatal heart failure - a natural course of cor triatriatum sinister V Rudiene1; D Zakarkaite1; S Glaveckaite1; L Latveniene1; L Gumbiene1 1University Hospital Santariskiu Klinikos, Centre of Cardiology and Angiology, Vilnius, Lithuania Introduction: Cor triatriatum sinister (CTS) is a rare cardiac anomaly with an incidence of 0.1-0.4% of all congenital heart defects. Clinical course and management of this pathology influenced by the degree of obstruction between the two left atrial chambers. Case report description: 20 years ago a 39 year-old man was consulted by the cardiologist because of 1 month history of palpitations, dyspnea and reduced exercise tolerance. He was followed by general practitioner from the age of 16 due to rheumatic heart disease. Physical examination revealed normal arterial blood pressure, irregular heart rate of about 110 bpm, and the diastolic heart murmur at the apex was heard, liver enlargement and mild peripheral edema. An electrocardiogram showed atri...
Key words: cardiovascular magnetic resonance; myocardial ischemia; coronary artery disease. Summa... more Key words: cardiovascular magnetic resonance; myocardial ischemia; coronary artery disease. Summary. This article presents the case of a 54-year-old male with evidence of myocardial is-chemia at rest. In our case, by means of cardiovascular magnetic resonance, myocardial ischemia at rest in theoretical left anterior descending artery territory was proved, myocardial scar was excluded, and need for revascularization was validated. Adresas susirašinėti: S. Glaveckaitė, VU MF Širdies ir kraujagys-lių ligų klinika, Introduction We present a case of resting myocardial ischemia and shortly discuss the value of cardiovascular mag-netic resonance (CMR) for the assessment of rest and stress ischemia especially in case when coronary artery stenosis is of unclear signifi cance.
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Papers by Sigita Glaveckaite