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Virgil Radu Enatescu,1,* Dragos Cozma,2,3,* Diana Tint,4,5 Ileana Enatescu,6 Mihaela Simu,1 Catalina Giurgi-Oncu,1 Mihai Andrei Lazar,2 Cristian Mornos2,3 1Department of Neuroscience, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 2Department of Cardiology 1, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 3Institute of Cardiovascular Diseases Timisoara, Timisoara, Romania; 4School of Medicine, Transylvania University, Brasov, Romania; 5Department of Cardiology, ICCO Clinics Brasov, Brasov, Romania; 6Department of Obstetrics and Gynecology-Discipline of Childcare and Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania*These authors contributed equally to this workCorrespondence: Ileana Enatescu Email enatescu.ileana@umft.roDiana Tint Email dianatint@gmail.comPurpose: The relationship between personality traits and cardiovascular disease has gathered sustained interest over the last years, type –D personality (TDP) being significantly associated with coronary artery disease (CAD). However, data regarding the connection between the TDP and the severity of CAD disease is scarce. The aim of our study was to assess the relationship between TDP and the complexity of CAD, and to compare it with other sociodemographic and clinical features.Patients and Methods: We conducted a cross-sectional case-control clinical-based study on 221 consecutive hospitalized patients with chest pain (60 ± 10.2 years; 131 men), referred for coronary angiography.Results: TDP was identified in 42 (19%) patients, using the DS 14 scale. Symptomatology profile was evaluated using the SCL-90 scale. Syntax score was greater in the subgroup of patients with TDP in comparison to non-TDP subgroup (26.21± 12.03 vs 15.49± 8.89, respectively, p< 0.001), and most of SCL-90 symptom dimension

Cristina Vacarescu,1 Dragos Cozma,1,2 Lucian Petrescu,1,2 Simona Dragan,1,2 Cristian Mornos,1,2 Simina Crisan,1,2 Horea Feier,1,2 Mihai-Andrei Lazar,1 Ramona Alina Cozlac,1,2 Constantin Tudor Luca1,21Cardiology Department, Victor BabeÈ™ University of Medicine and Pharmacy, TimiÈ™oara, Romania; 2Cardiology Department, Institute of Cardiovascular Diseases, TimiÈ™oara, RomaniaPurpose: Left ventricle (LV)-only pacing is non-inferior to biventricular pacing but permanent fusion pacing is needed to ensure cardiac resynchronization therapy (CRT) responsiveness. The role of systematic exercise testing (ET) in these patients has not been established. This study was designed to assess clinical and therapeutic implications (device programming/drugs) of systematic ET in patients requiring fusion-pacing CRT without an right ventricle (RV) lead.Methods: Consecutive patients with a right atrium/LV-only dual-chamber (DDD) pacing system were included. Prospective data were obtained: device interrogation, ET, and echocardiography at every 6-month follow-up visit. CRT assessment during ET included maximal heart rate, beat-to-beat echocardiography analysis of LV fusion pacing, LV loss of capture, and improvement in exercise capacity. If LV loss of capture or unsatisfactory LV fusion pacing occurred, reprogramming was individualized for each patient and ET redone.Results: A total of 55 patients (29 male) aged 62±11 years were included. During follow-up (39±18 months), a total of 235 ETs were performed, with mean exercise load 6.4±1.3 metabolic equivalents of task (118±35 W, maximal heart rate 119±17 beats/min). Twenty patients (36%) had inadequate pacing or loss of LV capture during ET, due to exceeding the maximum tracking rate (11%), chronotropic incompetence (7%), and LV pacing outside the fusion-pacing band (18%), caused by physiological shortening of the PR interval or exagerated LV preexcitation during maximum exercis

Simina Crişan,1,2 Lucian Petrescu,1,2 Mihai Andrei Lazăr,1,2 Cristina Văcărescu,1,2 Alina-Ramona Nicola,1 Dragoş Cozma,1,2 Cristian Mornoş,1,2 Constantin Tudor Luca1,2 1Cardiology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Institute of Cardiovascular Diseases, Timisoara, Romania Abstract: The evaluation of patients diagnosed with impaired systolic function heart failure represents a great challenge, in both the general and elderly population. We consider that elderly patients are the most severely affected by this disease that represents the final impact of cardiovascular disease continuum. Cardiovascular diseases are associated with serious morbidity and mortality, and considerable health care costs related to diagnosis and treatment. In this report we discuss some controversies regarding methods of heart failure evaluation as well as therapeutic steps and devices, including: reparatory therapeutic steps and initiation of therapy with loop diuretics, inconsistent dose titration for angiotensin-converting enzyme inhibitors/angiotensin receptor blocker and beta blockers, as well as novel therapies, such as angiotensin receptor neprilysin inhibitor and treatments that directly improve cardiomyocyte function. We conclude that, beyond technical progress, which is raising the cost of therapy for patients with heart failure, more careful monitoring of patient progress through clinical and paraclinical control visits, both at medical facilities and at home, would have greater impact and be more cost-effective. Physical therapy and promoting emotional and psychological wellbeing, to maintain a positive state of mind, contribute substantially to the quality of life and life expectancy, and are most important in elderly people who are most affected by dramatic reductions in wellbeing. Unfortunately, for many patients with severe impairment of left ventricular ejection fraction, these goals and therapeutic procedures are often lack

Diana Aurora Bordejevic,1,* Florina Caruntu,1,* Cristian Mornos,2 Ioan Olariu,2 Lucian Petrescu,2 Mirela Cleopatra Tomescu,1 Ioana Citu,1 Adelina Mavrea,1 Sorin Pescariu2 1Internal Medicine Department, 2Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania *These authors contributed equally to this work Background: The purpose of this retrospective study was to evaluate the prognostic impact of systolic blood pressure (SBP) and heart rate (HR) on in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) patients, after primary percutaneous intervention (PCI). Patients and methods: The study included 294 patients admitted for STEMI. They were divided into five groups according to the SBP at admission: group I, <105 mmHg; group II, 105–125 mmHg; group III, 126–140 mmHg; group IV, 141–158 mmHg; and group V, ≥159 mmHg. Increased HR was defined as ≥80 beats per minute (bpm). In-hospital death was defined as all-cause death during admission and classified into cardiac and noncardiac death. Results: Among the 294 patients admitted for STEMI, 218 (74%) were men. The mean age was 62±17 years. In-hospital mortality rate was 6% (n=18), with 11 (3.7%) deaths having cardiac causes. The highest mortality was registered in group I (n=9, 16%, P=0.018). Compared to the other groups, group I patients were older (P=0.033), more often smokers (P=0.026), and had a history of myocardial infarction (P=0.003), systemic hypertension (P=0.023), diabetes (P=0.041), or chronic kidney disease (P=0.0200). They more often had a HR ≥80 bpm (P=0.028) and a Killip class 3 or 4 at admission (P=0.020). The peak creatine phosphokinase-MB level was significantly higher in this group (P=0.005), while the angiographic findings more often identified as culprit lesions were the right coronary artery (P=0.005), the left main trunk (P=0.040)