20 research outputs found
Arterial stiffness in patients with heart failure with preserved ejection fraction
No full textАдрес за кореспонденция:
Д-р Десислава Петрова Сомлева;
Клиника по кардиология;
УМБАЛ „Царица Йоанна – ИСУЛ”
ул. „Бяло море” № 8;
1527 София;
tel. 02 9432 297;
tel. 02 9432 126;
e-mail: [email protected] ***** Address for correspondence:
Desislava Petrova Somleva, M. D.;
Clinic of Cardiology;
UMHAT “Tsaritsa Yoanna – ISUL”;
8, Bialo more Str.;
Bg – 1527 Sofia Address for correspondence:
Desislava Petrova Somleva, M. D.
Clinic of Cardiology
UMHAT “Tsaritsa Yoanna – ISUL”
8, Bialo more Str.
Bg – 1527 Sofia;
tel.: +359 2 9432 297
tel.: +359 2 9432 126
e-mail: [email protected]При пациентите със сърдечна недостатъчност и запазена фракция на изтласкване (СНзФИ) е установена повишена артериалната ригидност. Целта е да се изследва връзката между артериалната ригидност и степента на диастолна дисфункция при пациенти със
СНзФИ. Изследвани са 40 пациенти със СНзФИ, 40 пациенти с артериална хипертония (АХ) и 21
здрави контроли. Артериалната ригидност е определена чрез каротидо-феморалната скорост
на пулсовата вълна (СПВ). Ехокардиографски са изчислени индексираните левокамерна (ЛК) маса и обем на ляво предсърдие (ЛП). Диастолната функция е оценена с конвенционална и тъканна Doppler ехокардиография. Пациентите със СНзФИ спрямо пациентите с АХ и здравите контроли се характеризират с по-високи СПВ (11.85 ± 2.64 m/s спрямо 10.02 ± 2.39 m/s и 7.51 ± 1.20 m/s, p < 0.0001), индекс на ЛК маса (p < 0.0001), индекс на ЛП обем (р < 0.0001), съотношение на ранната митрална скорост Е към ранната диастолна скорост на медиалния митрален анулус ЕmЕ/Еm и на митрална скорост Е към ранната диастолна скорост на латералния анулус El – E/El (p < 0.0001). При контролиране за възрастта се установи сигнификантна умерена корелация на СПВ с ЛК маса (r* = 0.46, p* < 0.0001) и Е/Еm (r* = 0.45, p* < 0.0001). Повишената артериална ригидност има роля в развитието на СНзФИ и е свързана с наличието на ЛК хипертрофия и повишени налягания на ЛК пълнене.
***** Summary. The arterial stiffness has been shown to be increased in patients with heart failure with preserved
ejection fraction (HFpEF). Purpose: To determine the relation between arterial stiffness and diastolic
dysfunction in patients with HFpEF. We examined 40 patients with HFpEF, 40 patients with arterial
hypertension (AH), 21 healthy controls. Arterial stiffness was assessed by pulse wave velocity (PWV). Left
ventricular mass index (LVMI) and left atrium volume index (LAVI) were measured by 2D-echocardiography.
Diastolic function was assessed by PW- Doppler and tissue Doppler imaging. The patients with HFpEF
compared to hypertensive and healthy subjects had higher PWV (11.85 ± 2.64 m/s vs 10.02 ± 2.39 m/s and
7.51 ± 1.20 m/s, p < 0.0001), LVMI (p < 0.0001), LAVI (p < 0.0001), ratio of early mitral flow velocity E and
early diastolic medial mitral annulus velocity EmE/Em ratio, and ratio of early mitral flow velocity E and
early diastolic lateral mitral annulus velocity ElE/El ratio (p < 0.0001). Moderate significant correlation of
PWV with LVMI (r* = 0.46, p* < 0.0001, adjusted for age) and Е/Еm ratio (r* = 0.45, p* < 0.0001, adjusted for
age) was found. Increased arterial stiffness may have a role in the development of heart failure with
preserved ejection fraction and is related to LV hypertrophy and increased LV filling pressure
Вентрикуло-съдово куплиране при пациенти със сърдечна недостатъчност и запазена фракция на изтласкване
No full textДисертационен труд за прицъждане на образователна и научна степен "Доктор" /CD/ / Десислава Петрова Сомлева . - София, 2012 . - 138 с. + Автореферат /CD/ Научна специалност: Кардиология; Шифър: 03.01.47 Научен ръководител: Проф. д-р Асен Гудев, дм
MANAGEMENT OF GRADUATE STUDENT’S THESIS WRITING THROUGH A SPECIALIZED SOFTWARE SYSTEM
No full textThe inclusion of Learning Management Systems (LMSs) in the Bulgarian academic institutions has augmented students’ learning experience. The paper presents a software system for managing and supporting the interaction between graduate students and their supervisors in the course of theses writing. The system allows to plan, manage and track the progress of students’ theses/graduation projects. The author makes a comprehensive critical examination of the specialized software systems’ impact on the process of teaching and learning. Further studies and practical implications are also discussed
Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
No full textBackground: 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 obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. Methods: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). Results: Among 81 patients with sleep apnea, 73% (n = 59) had obstructive sleep apnea (OSA) and 27% (n = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, p < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, p < 0.001). Significant correlations were noted between KCCQ and BDI scores (r = −0.849, p < 0.001) and central apnea events (r = −0.485, p < 0.001). Conclusions: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes
Sleep disorders in patients with acute and exacerbated chronic heart failure
No full textHeart failure is often accompanied by sleep disorders. Continuous Positive Airway Pressure (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 aim of the current publication is to make a brief review of acute and exacerbated chronic heart failure in patients with sleep disorders – frequency, severity, and types to treat
Sleep apnea in patients with exacerbated heart failure and overweight
No full textSleep 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. From 100 screened patients with heart failure in our department from 2015 to 2017, 61 met the inclusion criteria and participated in the study. 82% (n = 50) of the patients had obstructive sleep apnea (OSA), and 18% (n = 11) had central sleep apnea (CSA). The CSA group had a significantly lower left ventricular ejection fraction (LVEF) than the OSA group (EF% 49.6 ± 8.5 vs 41.8 ± 11.4; p = 0.013). A negative correlation was found between LVEF and the number of central apnea events (r = −0.52; p < 0.001). More frequent hospitalizations for heart failure (HF) and higher mortality rate were found in the CSA group. Screening for sleep apnea in patients with exacerbated heart failure and obesity is necessary for the complex treatment of these patients
Verbal and musical choral actions in theatrical productions. Methodological and music staging aspects
No full textThe text is based on two realized theatre events. „Medea†by Euripidies (producer Desislava Shpatova, Plovdiv, 2020) and „Oedipus The Tiran – choruses) acting studio „Sound, Text, Melos†based on fragments from Sophocles’ tragedy (NBU, The Red House, Sofia, 2017). In the text, the author presents new approaches to the interpretation of traditional choruses in ancient Greek theater. He examines not only his own compositional techniques for creating choral episodes, but also various aspects of the preparatory rehearsal process, as well as describing some of the difficulties that theatre actors and students face in meeting such choral practices. He shares his preparatory and musicalstaging methods for the achievement of theatrical-musical unity and integrity in the choral episodes in the considered productions
Equity Ownership Strategy in Greenfield Investments : Influences of Host Country Infrastructure and MNE Resources in Emerging Markets
No full textThis chapter addresses equity ownership strategy in greenfield investments by multinational enterprises (MNEs) in the emerging markets (EMs). It is one of the few studies to hypothesize and analyze influences of host EM physical infrastructure in relation to investment decisions of MNEs. We use resource dependence theory (RDT) as a theoretical basis and test the moderating effects of firm resources like size and host country investment experience. Moreover, the current study assumes a more nuanced approach to studying equity ownership by analyzing wholly owned subsidiaries versus joint ventures (JVs) and including majority versus minority JVs in the analysis as well. The empirical results based on greenfield investments undertaken by Nordic (Danish, Finnish, Norwegian, and Swedish) MNEs in EMs during 1990–2015 reveals the importance of host country physical infrastructure for high equity ownership strategy. Moreover, host country investment experience moderates the effect of physical infrastructure on equity ownership strategy. Finally, the analysis of a sub-sample of greenfield JVs reveals that determinants of equity ownership strategy differ somewhat between greenfield JV or greenfield wholly owned subsidiaries (WOS).© The Author(s) 2019.fi=vertaisarvioitu|en=peerReviewed
