Ljubica Georgievska-Ismail

University Clinic of Cardiology, Skopje, R.Macedonia · Echocardiography

Background and Objectives: The role of coronary artery bypass grafting (CABG) on postoperative left ventricular (LV) function in patients with preoperatively preserved left ventricular ejection fraction (LVEF) is still being discussed and only a few studies address this question. This study aimed to assess LV function after CABG in patients with pr...

Background : Current guidelines recommend indexing left atrial volume (LAV) by body surface area (BSA). However, in overweight and obese individuals this may result in the underestimation of left atrial enlargement (LAE). The aim of our study was to assess whether alternative LAV indexing to height and/or height-squared better identifies individual...

Obesity-related atrial cardiomyopathy is a clinical entity characterized by a variety of functional and structural abnormalities in the atria's myocardium. This study aimed to investigate the morphological and functional alterations of the left atrium (LA) in overweight and obese subjects. The study included 56 subjects aged 47+9.6 years, categoriz...

Background Aortic stenosis (AS) is the most prevalent valvular disease in the developed countries. The disease progression is long and It is of greatest importance to choose the optimal intervention timing and to secure best long term prognosis. Purpose To establish left ventricular strain as independent predictor for left ventricular function imp...

Introduction: The left ventricular ejection fraction (LVEF) is commonly used as a marker of aortic stenosis (AS) disease severity and to indicate surgical intervention. However, an LVEF <50% identifies mainly advanced disease. Hence, earlier detection of subclinical LV systolic dysfunction may improve clinical decision-making. The global longitudi...

Funding Acknowledgements Type of funding sources: None. Introduction Paradoxical aortic stenosis (AS) is low-flow (SVi ≤ 35ml/m2) , low- gradient (Mean PG ≤ 40mmHg) severe aortic stenosis (AVA < 1cm2) in patients with preserved ejection fraction (EF ≥ 50%) usually associated with female gender, advanced age, small body size and history of hyperten...

Right coronary artery (RCA) emerged as infarct related artery (IRA) in patients with right ventricular myocardial infarction (RVMI), which is followed by some degree of RV dysfunction. The aim of our study was to identify significant predictors of IRA among angiographic and/or echocardiographic data of RV dimension and/or function in patients with...

Abstract BACKGROUND: Electrocardiogram (ECG) signs on admission can serve as a prognostic marker in patients treated for myocardial infarction (MI). AIM: The aim of the study was to determine the predictive role of modified Anderson–Wilkins (MAW) ECG score of acuteness on the extent of myocardial injury, left ventricular (LV) remodeling, and clinic...

It was confirmed that coronary artery plaque [CAP] and its larger burden may influence myocardial perfusion independent of presence of significant coronary artery stenosis. The aim of our study was to examine the role of CAP as predictor of coronary artery disease [CAD] presence using pharmacological stress echocardiography [SE]. We prospectively a...

Decreased right ventricular (RV) function is a frequently observed phenomenon after coronary artery bypass grafting (CABG) that often implicated poor long term prognosis. The aim of this study was to assess the existence of RV dysfunction 4 to 6 months after CABG using echocardiographic Assessment of tricuspid annular plane systolic motion (TAPSE)...

Introduction: Spontaneous echo contrast(SEC) is usually detected in heart chambers as a result of reduced flow velocity in the cavity. The clinical importance of SEC lies in its association with embolic events. The aim of our study was to determine the frequency of SEC in left heart chambers in sinus rhythm patients with dilated cardiomyopathy and...

Background The impact of serum uric acid (UA) on morbidity and mortality in hemodialysis (HD) patients is quite controversial in relation to the general population. The aim of this study was to evaluate the association of serum UA with both mortality and left ventricular hypertrophy (LVH) in HD patients. Methods This longitudinal study enrolled 22...

Aim: This prospective study was designed to evaluate the changes in left ventricular (LV) systolic function after coronary artery bypass grafting (CABG) in patients with both normal and abnormal pre-operative systolic function. Methods: During the period from October 2017 to October 2018, forty-seven consecutive patients undergoing CABG were enr...

Introduction: Reactive oxygen species (ROS) are responsible for generalized oxidation which results in cell dysfunction, necrosis or apoptosis. Assessment of oxidative stress markers could modify course of treatment of patients with coronary artery disease (CAD). The aim of this study was to evaluate association of markers of oxidative stress, stre...

BackgroundStress echocardiography (SE) has become a routine technique for detection and outcome prediction of coronary artery disease (CAD). Objectives:We sought to define the frequency of clinical, ECG changes and abnormal BP and HR responses during SE and their relevance to myocardial ischemia and/or angiographically proven CAD. Methods We prospe...

BACKGROUND: Triad of childhood vesicoureteral reflux (VUR), urinary infection (UTI) and renal scarring might initiate potentially serious consequences that lead to renal dysfunction manifested at the second or third decade of life. AIM: To identify the risk factors predictive for renal dysfunction in adults with primary VUR after long-term follow-...

BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in patients with diabetes (DM). AIM: Тhe aim of our study was to analyse the ability of pharmacological SE to risk stratify patients with DM using qualitative and quantitative assessment of LV function. METHODS: We prospectively assessed 105 consecutive pati...

Objective: Treatment of subclinical hypothyroidism (ScH), especially the mild form of ScH, is controversial because thyroid hormones influence cardiac function. We investigate left ventricular systolic and diastolic function in ScH and evaluate the effect of 5-month levothyroxine treatment. Subjects and methods: Fifty-four patients with newly di...

Introduction: Spontaneous echo contrast (SEC) is "smoke-like" echo detected in heart chambers and is highly associated with embolic events. Purpose: We aimed to determine predictors of left heart chamber SEC presence in sinus rhythm patients with dilated cardiomyopathy of mild to moderate systolic dysfunction. Material and Methods: This was a prosp...

Introduction: Left ventricle (LV) volumes and ejection fraction (EF) determined with two-dimensional echocardiography (2DE) and three-dimensional echocardiography (3DE) show significant differences.The aim of this study is to determine the agreement of the measurements of LV volumes and EF with 2DE and 3DE in the general adult population, with pres...

INTRODUCTION: Although strict selection criteria are used to select patients for cardiac resynchronisation therapy, up to 30% of patients do not have a positive clinical response. PATIENTS: A total of 102 consecutive patients who had biventricular pacemaker/defibrillator (CRT-P or CRT-D) implanted were enrolled in this prospective observational st...

Background: Left ventricular global longitudinal strain (GLS) analysis using two-dimensional (2D) speckle-tracking echocardiography (STE) is a method for detecting subclinical systolic dysfunction. We hypothesized that exercise capacity (EC) is more closely related to systolic than diastolic dysfunction, especially to GLS in patients with heart fai...

Degenerative aortic stenosis is the most common valvular disease for which treatment of choice is stil surgery. Without the presence of symptoms, evaluation of systolic function of the left ventricle (LV) is crucial in surgical treatment decision making. Global longitudinal strain (GLS) is a valuable marker for subclinical systolic dysfunction deli...

The aim of the study was to assess the effect of body mass index (BMI) on myocardial function and mechanics among patients with severe aortic stenosis (AS) admitted for surgical aortic valve replacement (SAVR). The dramatic increase in the prevalence of obesity and its strong association with cardiovascular disease have resulted in growing interest...

Introduction: Left ventricle (LV) volumes and ejection fraction (EF) determined with two-dimensional echocardiography (2DE) and three-dimensional echocardiography (3DE) show significant differences.The aim of this study is to determine the agreement of the measurements of LV volumes and EF with 2DE and 3DE in the general adult population, with pre...

BACKGROUND: The use of a 12-lead electrocardiogram (ECG) in the screening of young athletes still has some controversies regarding the cost-benefit of the procedure. AIM: We wanted to identify types and frequency of ECG changes in athletes in the Republic of Macedonia as well as its relation to age, gender, duration, frequency and type of sports....

BACKGROUND: Elderly population (≥ 65) are more prone to develop acute kidney injury (AKI) compared to younger, also elderly with AKI have an increased requirement for dialysis treatment and an elevated risk of short-term and long-term mortality. AIM: The objectives of this study were to examine the effect of treatment of short-term outcomes and mo...

Introduction: The aim of this prospective study was to evaluate the association between serum magnesium (Mg) and mortality, in particular the cause-specific mortality of Mg and other risk factors in hemodialysis (HD) patients. Methods: We studied a cohort of 185 HD patients receiving thrice-weekly HD treatment, on a dialysate Mg concentration of...

Obesity is independently related to more pronounced subclinical LV systolic dysfunction expressed as reduced GLS in patients with HFpEF; thus may implicated increased risk and/or worse prognosis.

Background: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine. Aim: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed P...

Background/Aims The source of thrombi in patients with dilated cardiomyopathy is not necessarily from the dilated left ventricle. Left atrium (LA) and left atrial appendage (LAA) might be in charge for relatively high rate of systemic embolizations in these patients. The main aim of our study was to identify epidemiological predictors in sinus rhyt...

Objective: To evaluate additional role of left atrial two-dimensional speckle tracking echocardiography in patients with diabetes mellitus type 2, 218 patients with heart failure with preserved left ventricular ejection fraction divided according to the presence of diabetes mellitus (108 with and 110 without) were enrolled in the study. Methods:...

P1138 Predictive value of left ventricular global longitudinal strain on exercise capacity in heart failure patients with preserved ejection fraction The Former Yugoslav Republic of Background: Echocardiographic left ventricular (LV) global longitudinal strain (GLS) analysis using two-dimensional speckle-tracking (2D-STE) is an accurate contemporar...

Introduction: In patients with an implanted pacemaker, asymptomatic atrial fibrillation (AF) is associated with an increased risk of thrombo-embolic complications. There is still no consensus which duration of episodes of atrial fibrillation should be taken as an indicator for inclusion of oral anticoagulation therapy (OAC). Material and methods:...

(Full text is available at http://www.manu.edu.mk/prilozi). Exercise intolerance in patients with heart failure with preserved ejection fraction (HFpEF) is most often attributed to diastolic dysfunction (DD); however, chronotropic incompetence (CI) could also play an important role. We intended to examine whether there are predictive echocardiograp...

Aim: Assess the significance of the echocardiographic, exercise test (ET) parameters as predictors of occurrence of symptoms and/or death, and relation of the Nt – proBNP value to the echo and ET parameters in asymptomatic ptc with severe AS (ASAS). Material: 58 ASAS ptc with normal left ventricle function EF>50%., monitored for 02-36 months with m...

Background: The risk stratification of chronic heart failure (CHF) patients can be performed using echocardiographic markers of left ventricle (LV) dysfunction, such as the ejection fraction (EF). LV global longitudinal strain (GLS) showed to be a sensitive measure of myocardium deformation. However, its role as prognostic marker in CHF patients wi...

Aim: To evaluate left atrial (LA) function as assessed by strain derived from 2D speckle tracking echocardiography (SD-STE) and its association with markers of left ventricular diastolic dysfunction (LVDD) in patients with diabetes (DM) and preserved left ventricular ejection fraction (PLVEF). Methods: A total of 113 age- and gender-matched pts wit...

Background A consensus about the optimal timing of dialysis initiation is still controversial. Thus, the goal of this analysis was to compare outcomes in patients with early and late referral with early and late initiation of hemodialysis (HD). Methods We studied 190 patients (mean age 52.03 ± 14.22) who were initiated on HD between 1994 and 200...

Background: Dilated cardiomyopathy is associated by radial and longitudinal contractile cardiac dysfunction. Left ventricular (LV) thrombus is a frequent finding in patients with dilated cardiomyopathy. The main purpose of our study was to evaluate the role of mitral annular plane systolic excursion (MAPSE) in LV thrombus formation in patients with...

Purpose: It is a well recognized fact that thromboembolic events are frequent in patients with congestive heart failure. Left atrial appendage (LAA) may be a crucial source of thromboembolism in patients with dilated cardiomyopathy. The purpose of this study was to identify clinical and echocardiographic predictors of LAA thrombus in sinus rhythm (...

The right atrium (RA) has many roles in the cardiac cycle and yet, it stays the least studied cavity in the heart. We came to an idea to evaluate the RA longitudinal strain in patients presenting with acute coronary syndrome with ST segment elevation (STE-ACS) in correlation with other echocardiographic parameters for right heart function. In thirt...

Background: Evaluation of right ventricular (RV) contractility and systolic function in patients with Right ventricular myocardial infarction (RVMI) is an essential component of clinical menagement. The aim of this study was to assess RV systolic function by in- fluence on rate of ventricular pressure change during the isovolumic contraction period...

Background: The aim of this study was to establish differences of dimensions of left and right heart cavities, and dimensions of the right ventricular wall in patients with ST segment elevation myocardial infarction with or without right ventricular myocardial infarction (RVMI). Methods: In 122 hospitalized patients with acute myocardial infarction...

Apical hypertrophic cardiomyopathy (AHCM) represents a rare condition in non- Japanese population with a relatively benign course. It is characterized by hypertrophy of the myocardium particularly in the left ventricular apex. The condition may present with chest pain mimicking acute coronary syndrome, atrial fibrillation, embolic events and ventri...

Background: Left atrial appendage (LAA) may be a source of thrombi in patients with dilated cardiomyopathy at sinus rhythm. The objectives of our study were to assess the prevalence of intracardiac left chamber thrombus and/or spontaneous echo contrast and to identify clinical and echocardiographic predictors for left ventricle (LV), left atrium (...

Chronic infections in CHD are due to one or both of the organisms Chlamydia pneumoniae and Helicobacter pylori. To examine the association between serum markers of Chlamydia pneumoniae and Helicobacter pylori infection and markers of myocardial damage. in patients with acute coronary syndrome (ACS), with chronic coronary artery disease (CAD) and in...

Ischemic dilated cardiomyopathy offers a favorable terrain for left ventricular (LV) thrombus formation; however, left artial appendage (LAA) may be an additional source of thrombi in patients with dilated heart. The main objectives of this study were to determine the prevalence of LV and LAA thrombi in patients with chronic ischemic dilated cardio...

Thromboembolic events are a frequent cause of mortality in patients with congestive heart failure. The aim of or study was to evaluate the relationship of left ventricular end diastolic diameter (LVEDD) to left atrial (LA) size and left atrial appendage (LAA) size in patients with dilated cardiomyopathy in sinus rhythm, as well as to determine the...

Objectives: Left atrial (LA) enlargement has been suggested as a marker of the severity and duration of diastolic dysfunction (DD). DD has been described as an early sign of diabetic cardiomyopathy. We wanted to determine if there is distinctive echocardiographic predictor of severity of DD in pts with diabetes mellitus (DM) irrespective of its dur...

Objective: Right ventricular (RV) myocardial infarction (MI) and associated severe RV dysfunction is the major cause of worse prognosis after acute MI of left ventricle (LV). The aim of the study was to assess usefulness of echocardiographic indexes of systolic RV function in pts with electrocardiographic signs of acute RVMI. Method: Out of 122 sel...

7th Balkan Congress of Microbiology, Belgrade, Srbia, 25-29 October, 2011

The ability of brain natriuretic peptide (BNP) together with other traditional and nontraditional risk factors to predict cardiovascular (CV) mortality in hemodialysis (HD) patients has not been well established. The aim of this prospective study was to determine the predictive cutoff values of baseline measurement of BNP along with the known CV di...

Interatrial septal anomalies, which include atrial septal defect, patent foramen ovale, and atrial septal aneurysm, are common disorders among adult patients. Early detection of interatrial septal anomalies is important in order to prevent haemodynamic consequences and/or thromboembolic events. Electrocardiogram offers some clues that should serve...

The purpose of the study was to assess the endothelial dysfunction (ED) in type 2 diabetic patients ultrasonographically and estimate the correlation of ED with glycemia and other cardio-metabolic risk factors. 171 patient (age 60.0 + 8.5 years) with diagnosed type 2 diabetes and coronary artery disease (CAD) were randomly included in a cross secti...

The risk factors that define the metabolic syndrome lead to an accelerated development of atherosclerosis, cardiovascular diseases in apparently healthy persons. The goal of the research is determining the prevalence of the metabolic syndrome as well as the participation of the risk factors that define this condition in apparently healthy persons....

Objective of our study was to estimate the metabolic syndrome (MSy)' components in type 2 diabetic subjects (T2D) with symptomatic coronary artery disease (CAD): arterial hypertension, waist circumference, triglyceridemia and plasma level of HDL, in order to define their clinical role in angina severity status. Second objective was to compare Adult...

(Full text is available at http://www.manu.edu.mk/prilozi). The study was aimed to define the risk factors for development of peripheral arterial (PAD) and carotid artery disease (CARD) among type 2 diabetic patients (T2D). The study population consisted of 30 patients diagnosed with type 2 diabetes and absent vascular disease. the mean age of the...

(Full text is available at http://www.manu.edu.mk/prilozi). The aim of the study was to establish the predictive role of maximal aortic-jet velocity, i.e. its annual rate of progression, in the decision in favour of aortic valve replacement (AVR), as well as in the event appearance and/or patients' survival with severe asymptomatic aortic stenosis....

Aim: to determine prognostic power of preoperative SPECT MPI in prediction of ICMP and HF in CAD patients treated with CABG. Methods:78 pts underwent ECG-GATED SPECT MPI before CABG. Divided in two groups: ICMP – 26, and non ICMP -52 pts. Results: clinical and angiographic variables show no significant differecenses, as oposite to MPI variables (T...

Aim. The aims of reaserch project were to determine the predictive role of diabetes type 2 as independent factor and/or in correlation with others in occurrence, extent and prognosis of CAD, as well as to evaluate the feasibility, safety and the effect of an aggressive control of risk factors, multifactoral medicament therapy and application of rev...

Cardiac memory is a phenomenon characterized by transient T-wave abnormalities occurring during normal sinus rhythm, after a period of altered ventricular depolarization, where the T-wave vector has the same direction as the vector of the previously altered QRS complex (T-wave inversion). It is a form of electrical remodelling of the ventricular, w...

The study was aimed to define the predictors for peripheral and carotid revascularization in type 2 diabetic population. In all, 279 patients with type 2 diabetes and peripheral arterial disease were enrolled in a cohort longitudinal study. Study population was followed up for 24 months for the need and performance of peripheral or carotid revascul...

77th Congress of the European Atherosclerosis Society, April 26-29, 2008 Istanbul, Turkay

77 EAS Congress, Istanbul, April 2008.

Late nephrology referral of patients with chronic kidney disease (CKD) has been suggested as increasing mortality after the initiation of dialysis. The aim of this study was to assess the impact of nephrology referral on the initiation of haemodyalisis (HD) and mortality during HD treatment in end-stage renal disease (ESRD) patients who have died i...

The aim of the study was to identify incremental values of carotid ultrasound measurements (carotid plaques and stenosis) on the prediction of future coronary revascularization among type 2 diabetic patients. The second objective was to determine the predictive value of the assessment of blood lipids, BMI, abdominal obesity and the ankle-brachial i...

The scope of our study was to assess the prevalence of metabolic syndrome (MSy) and its components in the type 2 diabetic population with symptomatic coronary artery disease in a sample of the Macedonian population. 327 pts with type 2 diabetes and manifested coronary artery disease were randomly included in a survey. MSy was defined according ATP...

Endothelial dysfunction, per se, in coronary arteries can stratify a risk in coronary artery disease patients. Selected studies evaluating endotheliopathy as predictor of events in patients with type 2 diabetes, but without coronary artery disease. We hypothesized that peripheral endothelial dysfunction could predict prognosis of type 2 diabetic pa...

Assessment of endothelial dysfunction (ED) in type 2 diabetic patients with coronary artery disease (CAD) and estimation of correlation of ED with metabolic parameters: low HDL, hypertriglyceridemia, obesity, systolic blood pressure and with inflammatory-hemostatic parameters: CRP and fibrinogen. 42 patients (age 60.0 +/- 8.5 years) with diagnosed...

The aim of the study was to evaluate the prevalence of carotid artery disease in type 2 diabetes patients with coronary artery disease, and to establish the influence of metabolic factors on its occurrence. In all, 145 patients (aged 59.85±8.43 years, diabetes duration 8.89±6.29 years) were randomly selected in a cross-sectional study. Carotid ultr...

To evaluate the incidence and prognostic power of arterial hypertension in patients with coronary artery disease treated with surgical myocardial revascularisation, before and after the operation. Arterial hypertension is one of the leading modifiable risk factors in CAD patients who underwent CABG surgery with the major impact on clinical outcome...

The aim of this study is to identify the risk factors for development of chronic critical limb ischemia (CLI) in diabetic and nondiabetic patients with peripheral arterial disease (PAD). 127 patients (pts) with PAD (63 with type 2 diabetes and 64 nondiabetic) were randomly included in a cross sectional study. Out of them 17 were with CLI. Populatio...

The aim of our study was to identify markers that can predict early morbidity and mortality in patients with coronary artery disease who underwent coronary artery bypass surgery (CABG) for myocardial revascularization. 749 patients (pts) were enrolled in the study at mean age 55 +/- 8 years, 639 male and 119 female. We analyzed pre-operative demogr...

To identify factors that influence graft disease and native coronary arteries progression disease and prognostic implication of this process. Unsolved problem in CABG patients is progression of the disease in bypass grafts and native coronary arteries. Data from 102 patients with CABG, who underwent re-coronarography, were analyzed: - Pre and post-...

In order to assess the predictive value of left ventricular (LV) function on prognosis during 16 years of follow-up we retrospectively/prospectively evaluated 320 patients (mean age 55.9 +/- 9.2 years; 44 women, 276 men) undergoing coronary artery bypass surgery. Patients were divided according to the assessed echocardiographically pre- and postope...

Republic of Macedonia officially became a part of the Bologna process for redesigning the curricula/ study programs for higher education in September 2003, when the Minister for education and science of Macedonia signed the Declaration adopted at the Bologna conference in 1999. Activities within the University "Ss. Cyril and Methodius" in Skopje fo...