Projects / Programmes
Emergencies in internal medicine
July 1, 2004
- December 31, 2008
| Code |
Science |
Field |
Subfield |
| 3.06.00 |
Medical sciences |
Cardiovascular system |
|
| Code |
Science |
Field |
| B530 |
Biomedical sciences |
Cardiovascular system |
acute myocardial infarction, primary percutaneous coronary angioplasty, echocardiography, systolic and diastolic function of the left ventricle, atrial fibrillation, biphasic cardioversion, obstructive shock, pulmonary embolism, right heart thromby.
Researchers (22)
Organisations (1)
Abstract
1.1) ROLE OF PRIMARY PTCA FOR TREATMENT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. Immediate, complete and sustained reperfusion of infarct related artery (IRA) is the most important intervention in ST elevation acute myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) ismore effective than trombolysis and results in reduced rates of death, reinfarction and stroke. Primary PCI became routine reperfusion strategy at University Medical Center in the year 2000. Patients with STEMI are reffered either from our emergency department, from regional hospitals without PCI facilites or directly from the field. The purpose of our study is to compare these three clinical pathways in terms of prehospital treatment, delays to PCI and outcome including in-hospital mortality, reinfarction, need for urgent target revascularization and stroke.
1.2) EFFECT OF INTRAAORTIC BALLOON PUMP ON SYSTOLIC AND DYASTOLIC FUNCTION OF THE LEFT VENTRICLE IN PATIENTS WITH ACUTE CORONARY SYNDROME. Ischemia impaires relaxation and contractility of the ischemic part of the left ventricla. In patients with acute coronary syndrome due to severe stenosis of left main or left anterior descending coronary artery and in those with stenosis fo a single patent coronary artery, a sudden left ventricular pump failure may ensue from any additional ischemia. These patients are treated with intraaortic balloon pump, which increases coronary perfusion and ischemia. The aim of our study is to evaluate non-invasively, with Doppler echocardiography, the changes of left ventricular systolic and diastolic function that may result from better perfusion.
2) ROLE OF NEUROHORMONAL MARKERS AND HIGH SENSITIVITY CRP FOR PREDICTION OF CARDIOVERSION SUCCESS OF PAROXYSMAL ATRIAL FIBRILLATION. Chronic atrial fibrillation is associated with increased risk of intraatrial thrombus formation and systemic thrombembolism. Similary increased risk for thrombembolisms was documented for patients with paroxysmal atrial fibrillation with frequent paroxysms. Thrombembolisms are prevented by anticoagulant medications. In order to differentiate patients with high recurrence rate of atrial fibrillation following cardioversion and those with persistent sinus rhythm, several predictive factors have been proposed. Lately, new biochemical markers with potential for prediction of cardioversion success and persistence of sinus rhythm following successful conversion, have emerged. Most promising predictors of cardioversion success in patients with chronic atrial fibrillation are atrial (ANP) and brain natriuretic peptides (BNP), and high sensitivity CRP. Potential role of these markers for prediction of cardioversion success and persistence of sinus rhythm in patients with paroxysmal atrial fibrillation is not known. Aim of our study is to determine potential applicability of ANP, BNP and hrCRP as predictors of sinus rhythm persistence in patients following successful cardioversion of paroxysmal atrial fibrillation.
3) ROLE OF RIGHT HEART FREE FLOATING THROMBI IN PATIENTS WITH PULMONARY EMBOLISM. A free-floating right heart thrombus is observed in a minority of patients with acute pulmonary embolism. A right heart thrombus may cause either recurrent embolism, or a paradoxical embolism, particularly if it is attached to foramen ovale. Additionally, a free-floating thrombus might be a sign of a severe embolism. The aim of our study is to determine, whether a free-floating right heart thrombus is a sign of a severe embolism, and if it is associated with a reduced survival of patients with pulmonary embolism. We would also like to establish from our and other published data the best treatment modality of patients with pulmonary embolism and a right heart thrombus.
Significance for science
With fast approach to STEMI patients and with emergancy coronary interventions we have decreased mortality of these patients. We are close, on the second place, to the Chech Republic, which has leading position in in EU and in the world. With induced hypothermia after cardiac arest and emergancy coronary interventions we are one of the leading nations.
Significance for the country
With our research program we have improved the quality of our health care system especailly in the filed of emergancy and intensive care. We developed the system for emergancy evaluation, transportation and care about patients with suspected acute coronary syndrom. We have promoted to primary percutaneous coronary intervention centers in Slovenia (University clinical center Ljubljana and Maribor). With the introduction of fast track system the mortality has dropped for around 10 % (from 16% to 6%). Our further planes are to improve care after cardiac arrest to improve survival and quality of life after primary cardiac arrest.
Most important scientific results
Final report,
complete report on dLib.si
Most important socioeconomically and culturally relevant results
Final report,
complete report on dLib.si
