Grigore Tinica

Universitatea de Medicina si Farmacie Grigore T. Popa Iasi, Socola, Iaşi, Romania

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Publications (12)20.01 Total impact

  • The American Journal of Cardiology 03/2015; 115:S68-S69. DOI:10.1016/j.amjcard.2015.01.307 · 3.43 Impact Factor
  • Oana Bartos, Grigore Tinica, Cristina Grigorescu
    The American Journal of Cardiology 03/2015; 115:S119. DOI:10.1016/j.amjcard.2015.01.404 · 3.43 Impact Factor
  • Mariana Floria, Grigore Tinica, Mihaela Grecu
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    ABSTRACT: Cardiomyopathies classification is based on morphological and functional phenotypes and subcategories of familial/genetic and non-familial/non-genetic disease. The non-compaction cardiomyopathy is a rare disorder which is considered to be an unclassified cardiomyopathy according to the ESC Working Group on Myocardial and Pericardial Diseases and the World Health Organization or a primary genetically-determined cardiomyopathy according to the American Heart Association. The diagnosis of non-compaction is challenging and its nosology is debated since this morphological trait can be shared by different cardiomyopathies and non-cardiomyopathy conditions. Myocardial structure has a spectrum from normal variants to the pathological phenotype of non-compaction cardiomyopathy, which reflects the embryonic structure of the human heart due to an arrest in the compaction process during the first trimester. However, when a definite diagnosis of non-compaction is made, the diagnostic process should orient towards a genetic disease with a relatively high probability of sarcomere mutations. Non-compaction cardiomyopathy is a diagnostically challenging entity. Nowadays there are some controversies associated with this cardiomyopathy, that it worth to be discussed.
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    ABSTRACT: Atrial fibrillation is still the most common arrhythmia that occurs in heart surgery. However, there is few literature data on the manner in which preoperative atrial fibrillation may influence the postoperative outcome of various heart surgery procedures. The purpose of our research is to assess the effects of preoperative atrial fibrillation on patients having undergone different heart surgery procedures. The results of our research are a review of clinical data which were collected prospectively, over a 10-year period, from all the patients who had undergone heart surgery in our Institute. The study group included 1119 heart surgery patients, who were divided as follows: the preoperative AFib group (n = 226, 20.19%) and the sinus rhythm group (n = 893, 79.80%). Major postoperative complications and hospital mortality rates were analyzed. According to our statistical analysis, preoperative atrial fibrillation significantly increased the mortality risk (P = 0.001), the patients' mechanical ventilation needs (P = 0.022), the rate of occurrence of infectious complications (P < 0.5), the rate of occurrence of complications such as acute kidney failure (P = 0.012), and the time spent by the patients in the intensive care ward (P < 0.01). In conclusion, preoperative atrial fibrillation in heart surgery patients increases the mortality and major complication risk further to heart surgery.
    BioMed Research International 07/2014; 2014:584918. DOI:10.1155/2014/584918 · 2.71 Impact Factor
  • The American Journal of Cardiology 04/2014; 113(7):S60-S61. DOI:10.1016/j.amjcard.2014.01.165 · 3.43 Impact Factor
  • Mihaela Grecu, Mariana Floria, Grigore Tinica
    Europace 12/2013; 16(4). DOI:10.1093/europace/eut371 · 3.05 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P68. DOI:10.1186/1749-8090-8-S1-P68 · 3.05 Impact Factor
  • 08/2013; 15(2). DOI:10.1093/ehjci/jet147
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    ABSTRACT: Pulmonary hypertension (PH) is a frequent occurrence and a negative prognostic indicator in patients with mitral regurgitation. Preoperative PH causes higher early and late mortality rates after heart surgery, adverse cardiac events, and postoperative systolic dysfunction in the left ventricle (LV). The research consisted of a retrospective study of a group of 171 consecutive patients with mitral regurgitation and preoperative PH who had undergone mitral valve surgery between January 2008 and October 2011. The PH diagnosis was based on echocardiographic evidence (systolic pulmonary artery pressure [sPAP] >35 mm Hg). The echocardiographic examination included assessment of the following: LV volume, LV ejection fraction (LVEF), sPAP, right ventricular end-diastolic diameter, right atrium area indexed to the body surface area, the ratio of the pulmonary acceleration time to the pulmonary ejection time (PAT/PET), tricuspid annular plane systolic excursion (TAPSE), determination of the severity of the associated tricuspid regurgitation, and presence of pericardial fluid. Surgical procedures consisted of mitral valve repair in 55% of the cases and mitral valve replacement in the remaining 45%. Concomitant coronary artery bypass grafting (CABG) surgery was carried out in 52 patients (30.41%), and De Vega tricuspid annuloplasty was performed in 29 patients (16.95%). The primary end point was perioperative mortality. The secondary end points included the following: pericardial, pleural, hepatic, or renal complications; the need for a new surgical procedure; postoperative mechanical ventilation >24 hours; length of stay in the intensive care unit; duration of postoperative inotropic support; need for an intra-aortic balloon pump; and need for pulmonary vasodilator drugs. The mortality rate was 2.34%. In the univariate analysis, the clinical and echocardiographic parameters associated with mortality were preoperative New York Heart Association (NYHA) class IV, the PAT/PET ratio, TAPSE, the indexed area of the right atrium, and concomitant CABG surgery. In the multivariate analysis, the indexed area of the right atrium and concomitant CABG surgery remained statistically significant. The multivariate analysis also showed the indexed area of the right atrium, LVEF, presence of pericardial fluid, preoperative NYHA class, and concomitant CABG surgery as statistically significant for the secondary end point. The receiver operating characteristic (ROC) curves identified an sPAP value >65 mm Hg to have the highest specificity and sensitivity for the risk of perioperative death in mitral regurgitation patients (area under the ROC curve [AUC], 0.782; P < .001) and identified an sPAP value of 60 mm Hg as the secondary end point (AUC, 0.82; P < .001). Severe PH (sPAP >60 mm Hg) is associated with a significant increase in the mortality rate; a longer stay in the intensive care unit; a mechanical ventilation duration >24 hours; lengthy inotropic support; renal, hepatic, and pericardial complications; and a need for endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and/or prostanoids, both in the general group and in patients with preserved systolic functioning of the left ventricle. PH is a strong short-term negative prognostic factor for patients with mitral regurgitation. The surgical procedure should be performed in the early stages of PH. Echocardiographic examination has useful, simple, and reproducible tools for classifying operative risks. An ischemic etiology and a need for concomitant CABG surgery are additional risk factors for patients with mitral regurgitation and PH.
    Heart Surgery Forum 06/2012; 15(3):E127-32. DOI:10.1532/HSF98.20121008
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    Grigore Tinica, Oana Bartos
    01/2012; 7(1):96.
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    ABSTRACT: The incidence of cardiac sarcoidosis is more then 5% from the patients with chronic sarcoidosis and the survival is between 2 and 5 years. The diagnosis must be precocious and the treatment aggressive for increasing life expectancy. We describe the case of a 72 years old male with pulmonary and lymph node sarcoidosis which required surgical intervention. The histological examination revealed non caseous granulomatous inflammation in the mediastinal nodes and epithelioid cardiac granulomas without myocyte necrosis. Six month later the patient developed progressive heart failure and after one year the cardiac examination revealed multiple cardiac lesions. The diagnosis of cardiac sarcoidosis is often difficult to confirm when the cardiac dysfunction is the only sign because of the lack of specific diagnosis tests. A diagnosis guide that includes histological and clinic criteria. The diagnosis must be sustained by invasive and non-invasive methods. Cardiac sarcoidosis remains a challenge by the unforeseeable evolution to death. Sudden death is common in cardiac sarcoidosis, often noiseless clinically.
    Romanian Journal of Legal Medicine 03/2010; 18(1):13-16. DOI:10.4323/rjlm.2010.13 · 0.15 Impact Factor
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    ABSTRACT: OBJECTIVE: We report an extremely rare case of germ-cell tumor localized at the level of the anterior mediastinum. Clinical presentation: A 36-year-old man who presented with left subclavial vein thrombosis was admitted to our hospital for specific cure. Computed tomographic scan of the chest showed a large anterior mediastinal mass. Surgical intervention revealed an infiltrative mediastinal tumor involving the left subclavial vein, which was biopsied for morphological examination. Histologically, the tumoral mass proved to be a carcinoma, with papillary and tubular growth patterns. Immunohistochemical stains for alpha-fetoprotein were positive in the tumor cells while stains for carcinoembryonic antigen and placental like alkaline phosphatase were negative. The serum level of alpha-fetoprotein of this patient was elevated, as well. This supported the diagnosis of Yolk sac tumor, a rare primary tumor within the mediastinum. Postsurgery, the patient received a combination chemotherapy consisting of cisplatin, vepesid and bleomycin every 3 weeks for a total of 4 cycles. During the treatment, the alpha-fetoprotein level, was decreasing. Conclusion: Primary mediastinal Yolk sac neoplasm is a rare tumor. The diagnosis should be made not only by morphological studies but also the patient's age and the elevation of serum alpha-fetoprotein. In spite of modern chemotherapy, the prognosis of mediastinal yolk sac tumor remains poor. The single most important prognostic indicator is whether the tumor mass can be completely excised before or after chemotherapy.
    Chirurgia (Bucharest, Romania: 1990) 105(6):831-4. · 0.78 Impact Factor