Cosmin Cojocaru

• Bachelor of Medicine
• Carol Davila University of Medicine and Pharmacy

Catheter ablation-based management strategies for the drug-refractory electrical storm (ES) have been proven to abolish acute ventricular arrhythmic episodes and improve long-term outcomes. However, this effect is highly influenced by multiple independently acting factors, which, if identified and addressed, may allow a more tailored management to...

Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used da...

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hyper...

Objective Atrial fibrillation (AF) is increasingly prevalent in all European countries, particularly in those strongly associated with high cardiovascular risk. We sought to evaluate AF epidemiology in Romanian adults recruited in three consecutive editions of the SEPHAR national survey (Study for Evaluation of Prevalence of Hypertension and Cardio...

(1) Background: Acute ST-segment elevation myocardial infarction (STEMI) remains one of the main morbidity and mortality contributors worldwide. Its main treatment, primary percutaneous coronary intervention (pPCI), can only be performed with a high anticoagulation regimen, usually with heparin. There is still not enough evidence regarding the timi...

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data...

Introduction: Prognosis after electrical storm (ES) ablation remains severe, especially in patients with recurrent sustained monomorphic ventricular tachycardia (SMVT) or progressive heart failure (HF). However, single-factor-based prediction is suboptimal and may be refined by more complex algorithms. We sought to evaluate if a novel score MSA-VT...

Frequent premature ventricular complexes (PVCs) are associated with deleterious effects on left ventricular (LV) function in various clinical scenarios. Repaired tetralogy of Fallot (rTOF) is frequently affected by sustained ventricular arrhythmias dependent on complex post-surgical substrates. However, there is limited data regarding the potential...

Background and aims There is limited data concerning the effect of non-revascularized chronic total occlusions (NR-CTOs) after VT ablation. This study sought to evaluate the impact of NR-CTOs after ablation for electrical storm (ES). Methods Post-hoc retrospective analysis of data regarding 64 consecutive post-myocardial infarction patients (out o...

Funding Acknowledgements Type of funding sources: None. Background/Introduction Outcomes in post-myocardial infarction (MI) patients which are referred for catheter ablation (CA) for drug-refractory electrical storm (ES) are influenced both by patient characteristics and procedural results. Previous data has shown higher risk for the first inciden...

Objectives: This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania. Methods: A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.61 years, range 18-80 years, 59.9% women) was multimodally evaluated during two study visits. Hypertension was de...

Cardiac resynchronization therapy (CRT) restores ventricular dyssynchrony, improving left ventricle (LV) systolic function, symptoms, and outcome in patients with heart failure, systolic dysfunction, and prolonged QRS interval. The left atrium (LA) plays tremendous roles in maintaining cardiac function, being often inflicted in various cardiovascul...

Background Data regarding cardiac damage in Romanian hypertensive adults are scarce. Our aim was to assess hypertension-mediated subclinical and clinical cardiac damage using a post-hoc echocardiographic analysis of a national epidemiological survey. Methods A representative sample of 1477 subjects was included in the SEPHAR IV (Study for the Eval...

Subclinical alterations in myocardial structure and function occur early during the natural disease course. In contrast, clinically overt signs and symptoms occur during late phases, being associated with worse outcomes. Identification of such subclinical changes is critical for timely diagnosis and accurate management. Hence, implementing cost-eff...

Hypertrophic cardiomyopathy (HCM) is an inherited primary myocardial disease characterized by asymmetrical/symmetrical left ventricle (LV) hypertrophy, with or without LV outflow tract (LVOT) dynamic obstruction, and poor prognosis. Cardiac resynchronization therapy (CRT) has emerged as a minimally invasive tool for patients with heart failure (HF)...

Background Prediction of cardiac resynchronization therapy (CRT) response, particularly a super-response, is of great importance. Study Question The aim of our study was to assess the predictors for super-responders in CRT. Study Design We conducted a retrospective, observational study, which finally included 622 patients with heart failure treat...

Introduction: Cateter ablation (CA) for atrial fibrillation (AF) has been proven to be extremely effective in maintaining sinus rhythm but success rates still vary widely. Procedural costs are not negligible and a low, but nonetheless present, rate of potentially severe complications exists, therefore an accurate estimation of results is necessary...

Background While left atrial and left ventricular functional parameters are established prognostic markers in heart failure (HF), recent studies suggest that parameters assessing the atrio-ventricular interaction are better predictors. Left atrioventricular coupling index (LACI) assessed with cardiac magnetic resonance is an emerging outcome predic...

Background Left atrial stiffness index (LASI) derived from speckle-tracking echocardiography (STE) is a marker of pressure transfer to the pulmonary circulation and a predictor of symptoms in patients with heart failure (HF). However, the role of the right atrial stiffness index (RASI) in the setting of left-sided HF is incompletely understood. Pu...

Ischemic heart disease represent a heavy burden for the medical systems irrespective of the methods used for diagnosis and treatment of such patients in the daily medical routine. The present paper depicts the protocol of a study whose main aim is to develop, implement and test an artificial intelligence algorithm and cloud based platform for fully...

Frequent premature ventricular contractions (PVCs) associated left ventricular systolic dysfunction (LVSD) is a well-known clinical scenario and numerous predictors for cardiomyopathy (CMP) development have been already thoroughly described. It may present as a "pure" form of dissynchrony-induced cardiomyopathy or it may be an aggravating component...

Objectives: There are limited epidemiological data regarding atrial fibrillation (AF) in hypertensive (HT) Romanian adults. We sought to evaluate AF prevalence trends in the SEPHAR surveys (Study for Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) during a nine-year interval (2012-2016-2021). Me...

Background: Electrical storm (ES) is defined by clustering episodes of ventricular tachycardia (VT) and is associated with severe long-term outcomes. We sought to evaluate the prognostic impact of radiofrequency catheter ablation (RFCA) in ES as assessed by aggressive programmed ventricular stimulation (PVS). Methods: Single-center retrospective lo...

Background Catheter ablation of the ventricular substrate can reduce ventricular tachycardia (VT) recurrence and mortality in an electrical storm (ES). However, identification and specific treatment of plausible triggers is mandatory and may lead to the resolution of ES. Objective This case presentation seeks to exemplify how pulmonary vein isolat...

The coronavirus disease outbreak in 2019 (COVID-19) reached devastating pandemic proportions, still representing a challenge for all healthcare workers. Furthermore, the social environment underwent significant changes and healthcare facilities were overwhelmed by COVID-19 patients. The purpose of our study was to compare the prevalence, characteri...

Funding Acknowledgements Type of funding sources: None. Introduction Catheter ablation of accessory pathways (AP) located in the posterior pyramidal space are often challenging due to its anatomical complexity. Scarce of data are available about the ECG features that might indicate when an epicardial approach is required in the ablation of the pos...

Aims – Frequent premature ventricular complexes (PVCs) may induce/aggravate LV systolic dysfunction (LVD) by tachy(dyssynchrono)cardiomyopathy (tCMP) in patients with/without previous structural heart disease. High arrhythmic burden (i.e. >26%) is the main predictor of tCMP development in patients with previously normal LV function. However, its pr...

Pediatric inherited cardiomyopathies (CMPs) and channelopathies (CNPs) remain important causes of death in this population, therefore, there is a need for prompt diagnosis and tailored treatment. Conventional evaluation fails to establish the diagnosis of pediatric CMPs and CNPs in a significant proportion, prompting further, more complex testing t...

Background Left ventricular non-compaction (LVNC) is a structural cardiomyopathy (SC) with a high probability of LV systolic dysfunction. Left bundle branch block (LBBB) frequently occurs in SCs. Purpose We sought to analyse the evolution of LVNC-CRT (LC) patients in general and compare it with the non-LVNC-CRT group (nLC). Methods We analysed 40...

Background Right ventricular (RV) stimulation induces supplemental dyssynchrony in case of left bundle branch block (LBBB) patients. Isolated left ventricular (LV) pacing has been proven superior to biventricular pacing (BiV) in terms of acute hemodynamic response. Purpose We sought to determine whether an optimised isolated LV pacing algorithm ca...

Background Electric storm is a life threatening condition, that can complicate multiple cardiac pathologies and is associated with high mortality. Catheter ablation has been shown to reduce ventricular tachycardia (VT) burden in patients with electrical storm but the optimal procedural endpoint and the therapeutic particularities required by differ...

Background Left ventricular dilation and mild systolic dysfunction at rest in young endurance athletes may mandate differential diagnosis between adaptive physiology and various forms of incipient non-ischemic dilated cardiomyopathies, especially if family history is positive. Multimodal imaging (i.e. bidimensional echocardiography (TTE), speckle t...