Elena Kinova

• Professor at University Hospital "Tsaritsa Yoanna – ISUL"

Background: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. Purpose: This study explored the prevalence and characteristics of sleep apnea in patients with...

Introduction: Trimethylamine-N-oxide (TMAO) is a metabolite produced by intestinal microbiota. It is well recognized as an independent risk marker for cardiovascular and renal diseases and mortality. Aim: The aim of the present study was to investigate the effect of Lactobacillus plantarum GLP3 supplementation on TMAO levels in 30 patients with a h...

Introduction: Patients with diverse demographic and clinical characteristics and comorbidities are included in the category of atrial cardiomyopathy (ACM). Aim: Our study aims to evaluate the demographic, clinical, laboratory, and echocardiographic parameters of patients with ACM and to assess their impact on prognosis. Materials and methods: Only...

Background Atrial cardiomyopathy (ACM) is a new clinical entity with significant importance, because of its potential to be a determinant of heart failure, atrial fibrillation and thromboembolic complications¹. Defining different atrial phenotypes is challenging, because of the lack of consensus for the diagnosis of ACM²'³. Menopausal transition is...

Background Atrial cardiomyopathy (ACM) includes patients with heterogenous demographic characteristics and comorbidities. Defining phenotype groups with similar clinical characteristics is important for the effective treatment of these patients, and for their prognosis and prevention of ACM. Purpose To conduct a cluster analysis that could help us...

Background: Acute decompensated heart failure (ADHF) is a condition with a high frequency of hospitalizations and mortality, and obstructive sleep apnea (OSA) is a common comorbidity. Continuous positive airway pressure (CPAP) therapy at home can be a good adjunctive non-drug therapy for these patients. Methods: We conducted a single-center, prospe...

Introduction: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a severe progressive disease, more common than previously expected. The main objectives were to evaluate hereditary and wild type ATTR-CM frequency and clinical manifestations. Material and methods: One hundred seventy-eight patients at mean age 68 ± 13 years (129 males), referred by c...

Background: Congenital absence of pericardium is a rare cardiac disorder with a reported incidence of less than 1 in 10,000. Although most of the cases are of little clinical significance, some of them are associated with serious complications, including risk of herniation and strangulation or coronary artery compression. Detailed Case Description:...

Background: Trimethylamine N-oxide (TMAO) is synthesized by the intestinal microbiota and is an independent predictor of cardiovascular disease (CVD). However, its underlying mechanisms remain unclear. We investigated TMAO levels across different CVD-risk patient groups, and evaluated associations between TMAO and vascular alterations (e.g., arteri...

Background Exacerbated heart failure is a condition with a high frequency of hospitalizations and mortality, especially in overweight patients. Screening and treatment for sleep apnea can be helpful in these patients. Purpose To determine the frequency and the phenotypic characteristics and of sleep apnea in patients with overweight and exacerbate...

Background The main factor responsible for atrial cardiomyopathy (ACM) is atrial fibrillation (AF). It is known that AF causes remodeling of the left atrium but its effects on the right heart chambers and mortality are not well studied. Purpose To assess the echocardiographic characteristics of patients with atrial cardiomyopathy with long-standin...

Funding Acknowledgements Type of funding sources: None. Background Left ventricular (LV) ejection fraction (LVEF) is most commonly used validated echocardiographic parameter of systolic function estimation, but left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LVEF is normal....

Funding Acknowledgements Type of funding sources: None. Background Obesity and atrial fibrillation (AF) are emerging health problem, associated with significant morbidity and mortality. There is a significant relation between body mass index (BMI) on one hand and the amount of visceral fat and epicardial adipose tissue (EAT) on the other (1,2). EA...

Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is a progressive disease and can initiates and maintains in the absence of left atrial (LA) enlargement¹´². Echocardiographic parameters of LA mechanics had been proposed for best dealing with patients in AF³ . Combining different laboratory biomarkers with...

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Medical University - Sofia Background Often accompanying comorbidity in patients with acute heart failure and overweight is sleep disorders. Searching and treatment of sleep apnea will be helpful in these patients. CPAP therapy may improve the prognosis....

Unlabelled: Chest pain and dyspnoea are among the most common complaints seen in the emergency room and each symptom calls for a broad differential diagnosis. Large hiatal hernias are infrequent, but they can lead to atypical symptoms mimicking different cardiovascular, pulmonary and neoplastic diseases. We present two cases of older patients with...

Sleep disorders are a common concomitant comorbidity in patients with heart failure. The aims of our study are to determine the incidence and phenotypic characteristics of sleep apnea in overweight patients with exacerbated heart failure and to assess the degree of involvement of systolic and diastolic function impairment in the individual group. F...

ESC 2022 Cardio-Oncology Guidelines

Objective: Increased arterial stiffness is an early predictor of cardiovascular changes. However the association between arterial stiffness with LV myocardial changes is poorly understoodThe aim of this study was to examine the relationship between arterial stiffness and LV function in well - controlled hypertensive patients.Methods: A total 100 c...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION Arterial stiffness is an independent risk factor in arterial hypertension, but little is known about the association between left –heart side remodeling and arterial stiffness in middle – aged hypertensive patients. AIM The aim of our study was to assess the independence between...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University - Sofia University Hospital "Tsaritsa Yoanna – ISUL” Background Often accompanying comorbidity in patients with heart failure and overweight is sleep disorders. Detection and treatment of sleep apnea will be helpful in these patients...

Objective Arterial stiffness is an independent risk factor in arterial hypertension, but little is known about the association between left atrial remodeling and arterial stiffness in middle – aged hypertensive patients. AIM To investigate the early changes in left atrial (LA) mechanical function and parameters of arterial stiffness in a populatio...

Funding Acknowledgements Type of funding sources: None. BACKGROUND Arterial hypertension (HTN) is the most prevalent risk factor for Atrial fibrillation (AF) through structural and functional changes of the left atrium. Paroxysmal AF is mainly asymptomatic and silent forms in patients with HTN are associated with thromboembolic complications. Howe...

Heart failure is often accompanied by sleep disorders. CPAP therapy has proven in the treatment of obstructive sleep apnea, but the benefits associated with comorbid patients and patients with heart failure is still under research. On the other hand, central sleep apnea is also with high frequency in these patients and more difficult to treat. The...

Background Non-invasive measurements of 24 h ambulatory central aortic systolic pressure (24hCASP) is now feasible method than single measurement of CASP. There is growing interest in CASP as cardiovascular risk marker beyond conventional brachial blood pressure (BP). Pulse wave velocity estimates arterial stiffness, whereas CASP is representative...

Background Left atrial volume index (LAVi) has been established as a surrogate marker for chronically elevated left ventricular (LV) filling pressure. Moreover it is a powerful predictor of atrial fibrillation (AF) in different pathologies. However, there is limited data for additional and sensitive echocardiographic predictors of AF in patients wi...

Cardiomyopathy is a frequent complication of pheochromocytoma and echocardiography is the most accessible method for its evaluation. The objective of this study was to assess the clinical significance of classical and novel echocardiographic parameters of cardiac function in 24 patients with pheochromocytomas (PPGL) compared to 24 subjects with ess...

Topic(s): Risk Factors and Prevention-Cardiovascular Risk Assessment Citation: Background: The 24hour central aortic pressure is an early predictor of cardiovascular complications in hypertension. However, the association between arterial stiffness and left ventricular dysfunction is poorly understood.

Background Left ventricular (LV) global longitudinal strain (GLS) is a more sensitive parameter than ejection fraction in the assessment of LV function. It has been established as a predictor of cardiac death and adverse events. In patients with dilated cardiomyopathy (DCM) LV deformation and twist mechanics are reduced in varying degrees. Purpose...

BACKGROUND Vascular stiffness and left atrial volume index (LAVI) are predictors of cardiovascular complications in hypertensive patients. The correlation of left atrium (LA) with left ventricle (LV) – arterial functional changes has not been well established. PURPOSE To investigate the relationship between LA remodeling and ventriculoarterial fun...

Introduction: In dilated cardiomyopathy (DCM) left ventricular (LV) strain and twist are significantly decreased. However, the rate of attenuation has not been investigated well in patients with varying degrees of systolic dysfunction. Aim: The present study aimed to investigate the relationship between LV deformational and rotational mechanics...

Topic(s): Risk Factors and Prevention-Cardiovascular Risk Assessment Citation: BACKGROUND: The concept of "ventriculoarterial coupling" could be a key determinant for the prediction of cardiovascular events. The interaction between left atrium (LA) and ventriculoarterial coupling for evaluation of functional abnormalities remains unclear.

https://pdfs.journals.lww.com/jhypertension/2019/07001/ASSOCIATION_BETWEEN_CENTRAL_AORTIC_PRESSURE_AND.884.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1599214647093;payload|mY8D3u1TCCsNvP5E421JYK6N6XICDamxByyYpaNzk7FKjTaa1Yz22MivkHZqjGP4kdS2v0J76WGAnHACH69s21Csk0OpQi3YbjEMdSoz2UhVybFqQxA7lKwSUlA502zQZr96TQRwhVlocEp/sJ586aVbcBFlltKNKo+tbuMfL...

Galectin 3, reccurent Atrial fibrillation

Aim: The aim was to investigate twist alterations depending on the degree of functional mitral regurgitation (MR) by speckle-tracking echocardiography. Methods: Sixty-three patients with symptomatic dilated cardiomyopathy (DCM) were included. Patients were divided according to MR vena contracta width (VCW): group 1 with VCW <7 mm (mild/moderate...

Background: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K ant...

Около една трета от пациентите, на които им предстои оперативна интервенция, имат сърдечни заболявания или главни рискови фактори за исхемична болест на сърцето. Голямата несърдечна хирургия е свързана с периоперативна смъртност от 0,5 до 1,5% и сърдечно-съдови усложнения, като нефатален сърдечен арест, нефатален миокарден инфаркт, сърдечна недоста...

Imbalance of activation and inhibition of matrix metalloproteinases (MMPs) lead to an increase in their activity and the occurrence of pathological changes in the vascular wall. The purpose of this paper is to determine the role of MMP-2 and MMP-9 in vascular and ventricular remodelling in patients with heart failure with preserved ejection fractio...

Implementation of new biochemical markers of acute coronary syndrome (ACS) could be helpful in early diagnosis, monitoring and risk stratification in addition to standard risk models. The purpose of our study is to determine the role of high sensitivity C-reactive protein (hsCRP), soluble CD40 Ligand (sCD40L) and endothelial dysfunction in patients...

Подготовката и провеждането на несърдечна хирургична интервенция при пациенти на антикоагулантна и антиагрегантна терапия представлява дилема за клиницистите. Препоръките за оценка на периоперативния риск и поведението при тези пациенти са представени в Европейското ръководство и още по-подробно в 9-ото издание на ръководството на Американското дру...

Cardiovascular disease continues to be the leading cause of premature death and disability in the world. While the role of statins for secondary prevention of cardiovascular events is well established, their role in primary prevention is less clinically approved. Recent studies and meta-analyses showed convincing results. Statin use was associated...

We reported a case of large right atrial thrombus which migrated from the inferior vena cava after acute left ventricular dysfunction due to 5-Fluorouracil cardiotoxicity. The patient had recurrent episodes of chest pain and dyspnea suggestive of pulmonary thromboembolism and several days later control echocardiography showed that the right atrial...

Degenerative aortic valve stenosis (DAS) is the most common degenerative valvular lesion in the elderly people. DAS and atherosclerosis share common risk factors and pathogenetic mechanisms. Markers such as oxidized low-density lipoproteins (oxLDL) and antibodies against oxLDL (Ab oxLDL) are supposed to play a role in their pathogenesis and are cur...

Anthracycline cardiotoxicity is cumulative and can cause congestive heart failure. The cardiotoxicity caused by 5-fluorouracil (5-FU) is acute and is usually observed during the first cycle of chemotherapy. We present the case of a female patient operated on for colorectal cancer and receiving her first postoperative chemotherapy cycle. Three hours...

Introduction: Combined assessment of mitral filling pattern and colour M-mode flow propagation velocity (Vp) allows separation of the effects of compliance and relaxation on left ventricular filling, thereby allowing identification of pseudonormal filling, which may be valuable after myocardial infarction. We sought to investigate prognostic implic...

Even in the modern era of antibiotic therapy and advanced diagnostic imaging, infective endocarditis continues to be a disease with a persistently high mortality and morbidity. We report a serious complication of infective endocarditis of bicuspid aortic valve with aortic root abscess ruptured into the right atrium with fatal outcome, registered by...