245 results on '"Orlic, D."'
Search Results
52. An Electron Microscopic Study of Erythropoiesis in Fetal and Neonatal Rabbits.
- Author
-
Hertzberg, C. and Orlic, D.
- Published
- 1981
- Full Text
- View/download PDF
53. Cutaneous fibrinolytic activity in primary hypertrophic osteoarthropathy.
- Author
-
Matucci-Cerinic, M., Lotti, T., Jajic, I., Di Lollo, S., Brunetti, L., and Orlic, D.
- Published
- 1987
- Full Text
- View/download PDF
54. Outcome Comparison of 600- and 300-mg Loading Doses of Clopidogrel in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Results From the ARMYDA-6 MI (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Myocardial Infarction) Randomized Study
- Author
-
Patti, G, Barczi, G, Orlic, D, Mangiacapra, F, Colonna, G, Pasceri, V, Barbato, E, Merkely, B, Edes, I, Ostojic, M, Wijns, W, and Di Sciascio, G
- Subjects
clopidogrel ,percutaneous coronary intervention ,outcome ,acute myocardial infarction ,infarct size ,cardiovascular diseases - Abstract
ObjectivesThe purpose of this study was to compare 600- and 300-mg clopidogrel loading doses in patients with ST-segment elevation myocardial infarction (STEMI).BackgroundGiven the high thrombotic risk of patients with STEMI, greater platelet inhibition may improve outcome in those patients receiving percutaneous coronary intervention (PCI). Although observational data suggest that pretreatment with a 600-mg clopidogrel loading dose may be more effective than the 300-mg regimen in primary PCI, this hypothesis has never been tested in a randomized study.MethodsA total of 201 patients undergoing primary PCI for STEMI randomly received a 600-mg (n = 103) or 300-mg (n = 98) clopidogrel loading dose before the procedure. The primary endpoint was the evaluation of the infarct size, defined as the area under the curve of cardiac markers.ResultsInfarct size was significantly lower in the high-dose regimen: median creatine kinase-myocardial band 2,070 ng/ml (interquartile range [IQR]: 815 to 2,847 ng/ml) versus 3,049 ng/ml (IQR: 1,050 to 7,031 ng/ml) in the 300-mg group, p = 0.0001; troponin-I 255 ng/ml (IQR: 130 to 461 ng/ml) versus 380 ng/ml (IQR: 134 to 1,406 ng/ml), p < 0.0001. In the 600-mg arm, Thrombolysis In Myocardial Infarction flow grade
- Full Text
- View/download PDF
55. Granulocyte colony-stimulating factor mobilized peripheral blood stem cells enter into G1 of the cell cycle and express higher levels of amphotropic retrovirus receptor mRNA - evidence for a pre-CFU-S cell?
- Author
-
Horwitz, M.E., Malech, H.L., Anderson, S.M., Girard, L.J., Bodine, D.M., and Orlic, D.
- Published
- 1999
- Full Text
- View/download PDF
56. Lymphocyte Infiltration of Gut Epithelium in Fetal and Neonatal Rabbits
- Author
-
Orlic, D., Gray, B.A., Carmichael, R.D., and Baron, P.
- Abstract
Lymphocytes infiltrate the epithelium of small intestinal villi of fetal rabbits as early as day 28 of gestation. They appear within the lateral spaces between the columnar absorptive cells. At this time, the epithelial cells transport compounds, such as injected horseradish peroxidase, through these intercellular spaces to the subjacent lamina propria. The possibility for in utero interaction between intraepithelial lymphocytes and antigen in swallowed amniotic fluid is discussed. There is an increase in the number of intraepithelial lymphocytes from 1 per 500 epithelial cells on day 1 to 16 per 500 epithelial cells on day 21 of postnatal life. Each segment, duodenum, jejunum and ileum, shows an increase in the number of lymphocytes during this period.
- Published
- 1981
- Full Text
- View/download PDF
57. Treatment of multivessel coronary artery disease with sirolimus-eluting stent implantation: immediate and mid-term results
- Author
-
Orlic, D, Bonizzoni, E, and Stankovic, G
- Published
- 2004
- Full Text
- View/download PDF
58. Stress-induced myocardial ischemia in patients with myocardial bridging: correlations with fractional flow reserve and quantitative coronary angiography measurements during dobutamine infusion
- Author
-
Aleksandric, S., Djordjevic-Dikic, A., Stepanovic, J., Dobric, M., Giga, V., Goran Stankovic, Vukcevic, V., Tomasevic, M., Stojkovic, S., Orlic, D., Saponjski, M., Nedeljovic, M., Juricic, S., Petrovic, M. T., and Beleslin, B.
59. Comparison of conventional and diastolic fractional flow reserve after adenosine and dobutamine infusions for hemodynamic assessment of myocardial bridging
- Author
-
Srdjan Aleksandric, Dobric, M., Teofilovski-Parapid, G., Tomasevic, M., Vukcevic, V., Stojkovic, S., Stankovic, G., Saponjski, J., Orlic, D., and Beleslin, B.
60. Retrograde approach for chronic total occlusions: Demystifying with experience ans proctorship
- Author
-
Stojkovic, S., Beleslin, B., Nedeljkovic, M., Vukcevic, V., Stankovic, G., Orlic, D., Tomasevic, M., Kostic, J., Dikic, M., Srdjan Aleksandric, Stepanovc, J., Djordjevic, A. D., and Ostojic, M.
61. Relations between biomechanical parameters and static power of arms in children with disturbed posture
- Author
-
Andrasic, S., Milic, Z., Marko Cvetkovic, Ujsasi, D., and Orlic, D.
- Subjects
lcsh:Sports ,lcsh:GV557-1198.995 ,children ,static power ,biomechanical parameters ,disturbed posture - Abstract
This study is aimed at determining the parameters and biomechanical analysis of their impact on the static arm strength in children with impaired posture as poor kyphotic posture, lordotic poor posture and children with flat feet. A transversal study included a sample of 67 children on the territory of the municipality of Subotica. The structure of the sample is as follows: 22 subjects with impaired kyphotic posture, 18 patients with impaired lordotic posture, and 27 subjects with flat feet. Measuring the level of static arm strength was done by the standardized "folding endurance" test. Observing the morphological development of children with kyphotic, lordotic poor posture and flat feet determined statistically significant differences in biomechanical variables.
62. The modified T stenting technique with crushing for bifurcation lesions: Immediate results and 6-month clinical outcomes
- Author
-
Airoldi, F., Stankovic, G., Orlic, D., Briguori, C., Spanos, V., Carlino, M., Montorfano, M., Michev, I., Rogacka, R., Tavano, D., Chieffo, A., Di Mario, C., and antonio colombo
63. An Electron Microscopic Study of Erythropoiesis in Fetal and Neonatal Rabbits
- Author
-
Hertzberg, C., primary and Orlic, D., additional
- Published
- 1981
- Full Text
- View/download PDF
64. Lymphocyte Infiltration of Gut Epithelium in Fetal and Neonatal Rabbits
- Author
-
Orlic, D., primary, Gray, B.A., additional, Carmichael, R.D., additional, and Baron, P., additional
- Published
- 1981
- Full Text
- View/download PDF
65. Effect of erythropoietin on proliferating stem cells in erythropoietically depressed mouse spleens
- Author
-
Orlic, D., primary and Gordon, A.S., additional
- Published
- 1972
- Full Text
- View/download PDF
66. Poster session 3
- Author
-
Winter, R, Lindqvist, P, Sheehan, F, Fazlinezhad, A, Vojdanparast, M, Nezafati, P, Martins Fernandes, S, Teixeira, R, Pellegrino, M, Generati, G, Bandera, F, Labate, V, Alfonzetti, E, Guazzi, M, Iriart, X, Dinet, ML, Jalal, Z, Cochet, H, Thambo, JB, Moustafa, S, Ho, TH, Shah, P, Murphy, K, Nelluri, BK, Lee, H, Wilansky, S, Mookadam, F, Stolfo, D, Tonet, E, Merlo, M, Barbati, G, Gigli, M, Pinamonti, B, Ramani, F, Zecchin, M, Sinagra, G, Bieseviciene, M, Vaskelyte, JJ, Mizariene, V, Lesauskaite, V, Verseckaite, R, Karaliute, R, Jonkaitiene, R, Patel, S, Li, L, Craft, M, Danford, D, Kutty, S, Vriz, O, Pellegrinet, M, Zito, C, Carerj, S, Di Bello, V, Cittadini, A, Bossone, E, Antonini-Canterin, F, Sarvari, S I, Rodriguez, M, Sitges, M, Sepulveda-Martinez, A, Gratacos, E, Bijnens, B, Crispi, F, Santos, M, Leite, L, Martins, R, Baptista, R, Barbosa, A, Ribeiro, N, Oliveira, A, Castro, G, Pego, M, Berezin, A, Samura, T, Kremzer, A, Stoebe, S, Tarr, A, Pfeiffer, D, Hagendorff, A, Benyounes Iglesias, N, Van Der Vynckt, C, Gout, O, Devys, JM, Cohen, A, De Chiara, B, Musca, F, D'angelo, L, Cipriani, MG, Parolini, M, Rossi, A, Santambrogio, GM, Russo, C, Giannattasio, C, Moreo, A, Soliman, A, Moharram, M, Gamal, A, Reda, A, Oni, O, Adebiyi, A, Aje, A, Ricci, F, Aquilani, R, Dipace, G, Bucciarelli, V, Bianco, F, Miniero, E, Scipioni, G, De Caterina, R, Gallina, S, Tumasyan, LR, Adamyan, KG, Chilingaryan, AL, Tunyan, LG, Kim, KH, Cho, JY, Yoon, HJ, Ahn, Y, Jeong, MH, Cho, JG, Park, JC, Popa, B A, Popa, A, Cerin, G, Ecocardiografico, Campagna Provinciale di Screening, Yiangou, K, Azina, CH, Yiangou, A, Georgiou, C, Zitti, M, Ioannides, M, Chimonides, S, Olsen, R H, Pedersen, LR, Snoer, M, Christensen, TE, Ghotbi, AA, Hasbak, P, Kjaer, A, Haugaard, SB, Prescott, E, Cacicedo, A, Velasco Del Castillo, S, Gomez Sanchez, V, Anton Ladislao, A, Onaindia Gandarias, J, Rodriguez Sanchez, I, Jimenez Melo, O, Garcia Cuenca, E, Zugazabeitia Irazabal, G, Romero Pereiro, A, Monti, L, Nardi, B, Di Giovine, G, Malanchini, G, Scardino, C, Balzarini, L, Presbitero, P, Gasparini, GL, Holte, E, Orlic, D, Tesic, M, Zamaklar-Trifunovic, D, Vujisic-Tesic, B, Borovic, M, Milasinovic, D, Zivkovic, M, Kostic, J, Belelsin, B, Ostojic, M, investigators, PATA STEMI, Trifunovic, D, Krljanac, G, Savic, L, Asanin, M, Aleksandric, S, Petrovic, M, Zlatic, N, Lasica, R, Mrdovic, I, Nucifora, G, Muser, D, Zanuttini, D, Tioni, C, Bernardi, G, Spedicato, L, Proclemer, A, Casalta, AC, Galli, E, Szymanski, C, Salaun, E, Lavoute, C, Haentjens, J, Tribouilloy, C, Mancini, J, Donal, E, Habib, G, Cavalcante, JL, Delgado-Montero, A, Dahou, A, Caballero, L, Rijal, S, Gorcsan, J, Monin, JL, Pibarot, P, Lancellotti, P, Keramida, K, Kouris, N, Kostopoulos, V, Giannaris, V, Trifou, E, Markos, L, Mihalopoulos, A, Mprempos, G, Olympios, CD, Calin, A, Mateescu, AD, Rosca, M, Beladan, CC, Enache, R, Gurzun, MM, Varga, P, Calin, C, Ginghina, C, Popescu, BA, Almeida Morais, L, Galrinho, A, Branco, L, Gomes, V, Timoteo, A T, Daniel, P, Rodrigues, I, Rosa, S, Fragata, J, Ferreira, R, Bandera, F, Generati, G, Pellegrino, M, Carbone, F, Labate, V, Alfonzetti, E, Guazzi, M, Galli, E, Leclercq, C, Samset, E, Donal, E, Kamal, H M, Oraby, MA, Eleraky, A Z, Yossuef, M A, Leite, L, Baptista, R, Teixeira, R, Ribeiro, N, Oliveira, AP, Barbosa, A, Castro, G, Martins, R, Elvas, L, Pego, M, Polte, CL, Gao, SA, Lagerstrand, KM, Johnsson, AA, Bech-Hanssen, O, Martinez Santos, P, Vilacosta, I, Batlle Lopez, E, Sanchez Sauce, B, Jimenez Valtierra, J, Espana Barrio, E, Campuzano Ruiz, R, De La Rosa Riestra, A, Alonso Bello, J, Perez Gonzalez, F, Jin, CN, Wan, S, Sun, JP, Lee, AP, Generati, G, Bandera, F, Pellegrino, M, Carbone, F, Labate, V, Alfonzetti, E, Guazzi, M, Reali, M, Cimino, S, Salatino, T, Silvetti, E, Mancone, M, Pennacchi, M, Giordano, A, Sardella, G, Agati, L, Kalcik, M, Yesin, M, Gunduz, S, Gursoy, MO, Astarcioglu, MA, Karakoyun, S, Bayam, E, Cersit, S, Ozkan, M, Cacicedo, A, Velasco Del Castillo, S, Gomez Sanchez, V, Anton Ladislao, A, Onaindia Gandarias, J, Rodriguez Sanchez, I, Jimenez Melo, O, Quintana Razcka, O, Romero Pereiro, A, Zugazabeitia Irazabal, G, Nascimento, H, Braga, M, Flores, L, Ribeiro, V, Melao, F, Dias, P, Maciel, MJ, Bettencourt, P, Ferreiro Quero, C, Mesa Rubio, M D, Ruiz Ortiz, M, Delgado Ortega, M, Sanchez Fernandez, J, Duran Jimenez, E, Morenate Navio, C, Romero, M, Pan, M, Suarez De Lezo, J, Kazum, S, Vaturi, M, Weisenberg, D, Monakier, D, Valdman, A, Vaknin- Assa, H, Assali, A, Kornowski, R, Sagie, A, Shapira, Y, Madeira, S, Ribeiras, R, Abecasis, J, Teles, R, Castro, M, Tralhao, A, Horta, E, Brito, J, Andrade, M, Mendes, M, Villagra, JM, Avegliano, G, Ronderos, R, Matta, MG, Camporrotondo, M, Castro, F, Albina, G, Aranda, A, Navia, D, Muraru, D, Siciliano, M, Migliore, F, Cavedon, S, Folino, F, Pedrizzetti, G, Bertaglia, M, Corrado, D, Iliceto, S, Badano, LP, Gobbo, M, Merlo, M, Stolfo, D, Losurdo, P, Ramani, F, Barbati, G, Pivetta, A, Pinamonti, B, Sinagra, GF, Di Lenarda, A, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Carbone, F, Alfonzetti, E, Guazzi, M, D'andrea, A, Di Palma, E, Baldini, L, Verrengia, M, Vastarella, R, Limongelli, G, Bossone, E, Calabro', R, Russo, MG, Pacileo, G, Azevedo, O, Cruz, I, Correia, E, Bento, D, Teles, L, Lourenco, C, Faria, R, Domingues, K, Picarra, B, Marques, N, Group, SUNSHINE, Nucifora, G, Muser, D, Gianfagna, P, Morocutti, G, Proclemer, A, Cruz, I, Gomes, AC, Lopes, LR, Stuart, B, Caldeira, D, Morgado, G, Almeida, AR, Canedo, P, Bagulho, C, Pereira, H, Lozano Granero, VC, Pardo Sanz, A, Marco Del Castillo, A, Monteagudo Ruiz, JM, Rincon Diaz, LM, Ruiz Rejon, F, Casas, E, Hinojar, R, Fernandez-Golfin, C, Zamorano Gomez, JL, Stampfli, S F, Erhart, L, Staehli, BE, Kaufmann, BA, Tanner, FC, Marketou, M, Kontaraki, J, Parthenakis, F, Maragkoudakis, S, Zacharis, E, Patrianakos, A, Vardas, P, Bento, D, Domingues, K, Correia, E, Lopes, L, Teles, L, Picarra, B, Magalhaes, P, Faria, R, Lourenco, C, Azevedo, O, Group, SUNSHINE, Mohty, D, Boulogne, C, Magne, J, Damy, T, Martin, S, Boncoeur, MP, Aboyans, V, Jaccard, A, Hernandez Jimenez, V, Saavedra Falero, J, Alberca Vela, MT, Molina Blazquez, L, Mata Caballero, R, Serrano Rosado, JA, Elviro, R, Gascuena, R, Di Gioia, C, Fernandez Rozas, I, Manzano, MC, Martinez Sanchez, JI, Molina, M, Palma, J, Ingvarsson, A, Werther Evaldsson, A, Radegran, G, Stagmo, M, Waktare, J, Roijer, A, Meurling, CJ, Cameli, M, Righini, FM, Sparla, S, Di Tommaso, C, Focardi, M, D'ascenzi, F, Tacchini, D, Maccherini, M, Henein, M, Mondillo, S, Werther Evaldsson, A, Ingvarsson, A, Waktare, J, Thilen, U, Stagmo, M, Roijer, A, Radegran, G, Meurling, C, Greiner, S, Jud, A, Aurich, M, Katus, HA, Mereles, D, Michelsen, MM, Faber, R, Pena, A, Mygind, ND, Suhrs, HE, Zander, M, Prescott, E, El Eraky, AZZA, Handoka, NESRIN, Ghali, MONA, Eldahshan, NAHED, Ibrahim, AHMED, Kamal, H M, Al-Eraky, A Z, El Attar, M A, Omar, A S, D'ascenzi, F, Pelliccia, A, Alvino, F, Solari, M, Cameli, M, Focardi, M, Bonifazi, M, Mondillo, S, Spinelli, L, Giudice, C A, Assante Di Panzillo, E, Castaldo, D, Riccio, E, Pisani, A, Trimarco, B, Stojanovic, S, Deljanin Ilic, M, Ilic, S, Mincu, RI, Magda, LS, Florescu, M, Velcea, A, Mihalcea, D, Chiru, A, Popescu, BO, Tiu, C, Vinereanu, D, Vindis, D, Hutyra, M, Cechakova, E, Littnerova, S, Taborsky, M, Mantovani, F, Lugli, R, Bursi, F, Fabbri, M, Modena, MG, Stefanelli, G, Mussini, C, Barbieri, A, Yi, JE, Youn, HJ, O, JH, Yoon, HJ, Jung, HO, Shin, GJ, Styczynski, G, Rdzanek, A, Pietrasik, A, Kochman, J, Huczek, Z, Milewska, A, Marczewska, M, Szmigielski, C A, Battah, AHMED, Abd Eldayem, SOHA, El Magd El Bohy, ABO, O'driscoll, J, Slee, A, Peresso, V, Nazir, S, Sharma, R, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Carbone, F, Alfonzetti, E, Guazzi, M, Velasco Del Castillo, S, Anton Ladislao, A, Gomez Sanchez, V, Cacidedo Fernandez Bobadilla, A, Onaindia Gandarias, JJ, Rodriguez Sanchez, I, Romero Pereira, A, Quintana Rackza, O, Jimenez Melo, O, Zugazabeitia Irazabal, G, Voilliot, D, Huttin, O, Venner, C, Deballon, R, Manenti, V, Villemin, T, Olivier, A, Sadoul, N, Juilliere, Y, Selton-Suty, C, Scali, MC, Simioniuc, A, Mandoli, GE, Dini, FL, Marzilli, M, Picano, E, Garcia Campos, A, Martin-Fernandez, M, De La Hera Galarza, JM, Corros-Vicente, C, Leon-Aguero, V, Velasco-Alonso, E, Colunga-Blanco, S, Fidalgo-Arguelles, A, Rozado-Castano, J, Moris De La Tassa, C, Opitz, B, Stelzmueller, ME, Wisser, W, Reichenfelser, W, Mohl, W, Herold, IHF, Saporito, S, Mischi, M, Bouwman, RA, Van Assen, HC, Van Den Bosch, HCM, De Lepper, A, Korsten, HHM, Houthuizen, P, Veiga, CESAR, I, JAVIER. Randulfe Juanjo Andina Jose Fanina Francisco Calvo Emilio Paredes-Galan Pablo Pazos Andres, Ageing, Diseases, Cardiovascular, Santos Furtado, M, Rodrigues, A, Leal, G, Silvestre, O, Andrade, J, Khan, UM, Hjertaas, JJ, Greve, G, Matre, K, Leite, L, Teixeira, R, Baptista, R, Barbosa, A, Ribeiro, N, Castro, G, Martins, R, Cardim, N, Goncalves, L, Pego, M, Leite, L, Teixeira, R, Baptista, R, Barbosa, A, Ribeiro, N, Castro, G, Martins, R, Cardim, N, Goncalves, L, Pego, M, Leite, L, Teixeira, R, Baptista, R, Barbosa, A, Oliveira, AP, Castro, G, Martins, R, Cardim, N, Goncalves, L, Pego, M, Keramida, K, Kouris, N, Kostopoulos, V, Markos, L, Olympios, CD, Molnar, AA, Kovacs, A, Tarnoki, AD, Tarnoki, DL, Kolossvary, M, Apor, A, Maurovich-Horvat, P, Jermendy, G, Sengupta, P, Merkely, B, Rio, P, Viveiros Monteiro, A, Galrinho, A, Pereira-Da-Silva, T, Moura Branco, L, Timoteo, A, Abreu, J, Leal, A, Varela, F, Cruz Ferreira, R, Huang, MS, Yang, LT, Tsai, WC, Papadopoulos, C, Mpaltoumas, K, Fotoglidis, A, Triantafyllou, K, Pagourelias, E, Kassimatis, E, Tzikas, S, Kotsiouros, G, Mantzogeorgou, E, Vassilikos, V, Venneri, L, Calicchio, F, Manivarmane, R, Pareek, N, Baksi, J, Rosen, S, Senior, R, Lyon, AR, Khattar, RS, Onut, R, Marinescu, C, Onciul, S, Zamfir, D, Tautu, O, Dorobantu, M, Casas Rojo, E, Carbonell San Roman, A, Rincon Diez, LM, Gonzalez Gomez, A, Fernandez Santos, S, Lazaro Rivera, C, Moreno Vinues, C, Sanmartin Fernandez, M, Fernandez-Golfin, C, Zamorano Gomez, JL, Bayat, F, Alirezaei, T, Karimi, AS, hospital, cardiovascular research center of shahid beheshti, Aggeli, C, Kakiouzi, V, Felekos, I, Panagopoulou, V, Latsios, G, Karabela, M, Petras, D, Tousoulis, D, Ben Kahla, S, Abid, L, Abid, D, Kammoun, S, Abid, L, Ben Kahla, S, Choi, JH, Lee, JW, Barreiro Perez, M, Martin Fernandez, M, Costilla Garcia, SM, Diaz Pelaez, E, and Moris De La Tassa, C
- Abstract
Purpose: We developed a transthoracic echo simulator that can measure psychomotor skill in echo to assist in training as well as for certification of competence. The simulator displays cine loops on a computer in response to the user scanning a mannequin with a mock transducer. The skill metric is the deviation angle between the image acquired by the user and the anatomically correct plane for the specified view. We sought to determine whether the simulator-based test could distinguish levels of expertise. Methods: Attendees at an echo course or at the annual meeting of the Swedish Heart Association were invited to take a 15 min test on the simulator. On the test, the user scanned the mannequin and acquired 4 views: parasternal long axis (pLAX) in patient 1, apical 4 chamber (a4c) and aLAX in patient 2, and pLAX in patient 3. Scan time was limited to 15 min. Attendees were asked regarding current work status, position, and experience with echo assessed from duration in years and procedure volume in the past 12 months. Results: Of the 61 participants there were 22 sonographers, 2 nurses, and 37 doctors who were all in practice except 1 doctor who was a resident. The data of nurses was combined with that of sonographers because their procedure volume was nearer to that of sonographers (850 ± 599 tests/yr) than doctors (312 ± 393, p < 0.001). Doctors and non-doctors had similar duration of experience (9 ± 8 vs. 12 ± 11 yrs, p=NS). The test was not completed by 12 participants (18%) but unfamiliarity with the simulator may have contributed because the deviation angle for pLAX dropped between the first and third patients (23 ± 11 to 18 ± 10 degrees, p<0.020). The average deviation angle over the 4 views was slightly lower for sonographers than for doctors (26 ± 11 vs. 30 ± 14 degrees, p=NS). The deviation angle for pLAX (55 ± 37 degrees) was higher than for a4C (17 ± 22 degrees) or either pLAX view (p<0.00001). pLAX was the only view whose deviation angle correlated significantly with experience and only with procedure volume (r=-0.302, p=0.025). Conclusions: The results of this study demonstrate that the skill metric employed, angle of deviation between the plane of an acquired view and the plane of the anatomically correct image for that view, can distinguish the relative experience of sonographers and doctors in practice. Simulation-based testing provides objective and quantitative assessment of the psychomotor skill of image acquisition and may be of value in certification of trainees and in maintenance of certification examination of practicing sonographers and doctors.
- Published
- 2015
- Full Text
- View/download PDF
67. Rapid Fire Abstract session: multimodality imaging of ischaemic heart disease
- Author
-
Faber, L, Lindner, O, Bogunovic, N, Hering, D, Burchert, W, Horstkotte, D, Nel, K T, Senior, R, Anstey, CM, Begley, J, Byrne, CD, Kaski, J, Bull, R, Boos, CJ, Greaves, K, Trifunovic, D, Stankovic, S, Stepanovic, J, Orlic, D, Banovic, M, Tesic, M, Petrovic, O, Petrovic, M, Djordjevic-Dikic, A, Vujisic-Tesic, B, Rodero, S, Mutuberria, M, Rodriguez-Palomares, J, Terricabras, M, Gutierrez, L, Teixido, G, Galian, L, Gonzalez-Alujas, T, Evangelista, A, Garcia-Dorado, D, Rodero, S, Mutuberria, M, Rodriguez-Palomares, J, Terricabras, M, Gutierrez, L, Teixido, G, Galian, L, Gonzalez-Alujas, T, Evangelista, A, Garcia-Dorado, D, Hammache, N, Voilliot, D, Brembilla-Perrot, B, Odille, F, Felblinger, J, Mandry, D, Marie, PY, Sadoul, N, Huttin, O, De Chillou, C, Olsen, F J, Jensen, JS, Pedersen, SH, Nochioka, K, and Biering-Sorensen, T
- Abstract
Purpose: Low-intensity shock wave (SW) therapy (SWT) has been shown to improve symptoms and exercise tolerance in patients (pts.) with coronary artery disease (CAD). Methods47 pts. with severe stable angina in advanced CAD (mean age 67 ± 10 years) not suitable for surgical or catheter-based revascularization underwent a series of 9 echocardiography-targeted SW applications (3 applications/week in week 1, 5, and 9). The antero-septal wall (LAD territory) was targeted in 20, the lateral wall (RCX territory) in 20, and the inferior wall (RCA territory) in 7 pts. A series of 300-500 shocks was applied per session. Anti-anginal drugs therapy was kept unchanged. Regional myocardial blood flow (MBF) to the targeted region was measured by NH3-PET, and longitudinal regional strain was assessed by speckle tracking echocardiography at baseline and 4-6 weeks after SWT. Results: Complications of SWT did not occur. At follow-up, 34 pts. (72%) reported improvement of angina to a tolerable level. CCS angina class decreased from 3.1 ± 0.6 to 2.5 ± 0.6 (p<0.001). MBF in the target region improved from 117 ± 41 mL/min/100g to 128 ± 46 mL/min/100g (p=0.037), while there was no change in the opposite wall not treated with SWT (135 ± 51 vs. 136 ± 51 ml/min/100g; p=0.9). Longitudinal strain of the midventricular segment in the region targeted by SWT improved from -14 ± 5 to -17 ± 6 %; p=0.04. Conclusions: SWT improved symptoms in a sizeable number of pts. with chronic refractory angina. Regional MBF improvement in the region targeted by SWT was documented by PET imaging, and functional improvement by speckle tracking echocardiography. Additional studies are warranted to clarify the role of SWT in the armamentarium for this challenging patient group.
- Published
- 2015
- Full Text
- View/download PDF
68. P520 Percutaneous coronary intervention for chronic total occlusions of coronary arteries: procedural characteristics and long-term clinical outcomes.
- Author
-
Jeremic, V, Stojkovic, S, Dobric, M, Vukcevic, V, Orlic, D, Cvorovic, I, and Vasiljevic-Pokrajcic, Z
- Subjects
ANGIOPLASTY ,ARTERIAL occlusions ,ANGINA pectoris ,CHEST pain ,HEALTH outcome assessment ,MEDICAL statistics - Abstract
Purpose: Despite the fact that techniques for recanalization of chronic total occlusions (CTO) are improved, the benefit of successful recanalization of the artery remains unclear. The aim of our study is to determine the success rate of percutaneous procedures and to evaluate the event free long-term survival in patients with CTO who underwent percutaneous coronary intervention (PCI).Methods: Our study included 283 consecutive patients with chronic total occlusions who underwent percutaneous coronary intervention on CTO at Clinic for Cardiology, between Jan 1st 2009 and Dec 31st 2010. Data were obtained retrospectively from Cath lab database at Clinic for Cardiology. Follow up data were obtained by direct phone contact.Results: Overall procedural success was achieved in 62.3% interventions. Independent predictors for procedural failure were presence of vessel tortuosity (P=0.007), vessel wall calcifications (P=0.000), blunt stump (P=0.000) and unstable angina pectoris as negative predictor (P=0.009). Overall MACE rates were similar in the procedural success and procedural failure groups (10% vs. 12.8%, p=0.455). There was no significant difference in the event free survival rate between success and failure group (89.8% vs. 87.2%, Log-Rank =0.468, p=0.494).Conclusions: Our study demonstrated that success rate of PCI in patients with CTO is acceptable and safe. Nevertheless, successful recanalization of CTO was not associated with an improved event free survival. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
69. Septic Sacroiliitis: An Analysis of 14 Patients
- Author
-
Jajic, I., Furst, Z., Kralj, K., Ograjsek, A., Orlic, D., and Pecina, M.
- Abstract
In most joints arthritis is easily diagnosed. This, however, is not the case with infectious sacroiliitis because of the inaccessibility of the sacroiliac joint, due to the anatomic and topographic relations.Fourteen patients with septic sacroiliitis in whom the diagnosis was established between 10 and 90 days after the onset of the disease are reported for a 5-year period. All patients had scintigraphic high uptake and three patients did not show any radiographic changes.
- Published
- 1983
- Full Text
- View/download PDF
70. Unexpected Potential of Adult Stem Cells
- Author
-
Yuehua Jiang, Robert E. Schwartz, Catherine M. Verfaillie, Morayma Reyes, Orlic, D, Brummendorf, TH, Fibbe, W, Sharkis, S, and Kanz, L
- Subjects
Stem Cells ,General Neuroscience ,Cellular differentiation ,Cell Differentiation ,Amniotic stem cells ,Biology ,General Biochemistry, Genetics and Molecular Biology ,Rats ,Cell biology ,Endothelial stem cell ,Mice ,History and Philosophy of Science ,Organ Specificity ,Animals ,Humans ,Cell Lineage ,Progenitor cell ,Stem cell ,Cell potency ,Stem Cell Transplantation ,Adult stem cell ,Stem cell transplantation for articular cartilage repair - Abstract
We have identified a population of primitive cells in normal human (h) as well as murine (m) and rat (r), postnatal bone marrow (BM) that have, at the single cell level, multipotent differentiation and extensive proliferation potential, which we named Multipotent Adult Progenitor Cell or MAPC. MAPC differentiate in vitro into most mesodermal cell types (cells with characteristics of osteoblasts, chondroblasts, fibroblasts, adipocytes, skeletal, smooth and cardiac myoblasts, endothelial cells), as well as cells with neuroectodermal and with endodermal features. Using retroviral marking we have shown that multi-lineage differentiation is derived from single MAPC. MAPC express active telomerase and can undergo 100+ cell doublings without telomere shortening, suggesting that they do not senesce. MAPC express oct-4 mRNA. MAPC engraft in vivo and persist for 6+ months, differentiate into hematopoietic and epithelial cells in response to local “cues”, and contribute to all somatic cell types when injected in the blastocyst. The finding that stem cells exist in post-natal tissues with previously unknown proliferation and differentiation potential opens up the possibility of using autologous stem cells to treat a host of degenerative, traumatic or congenital diseases.
- Published
- 2003
71. Antiplatelet effect of 600- and 300-mg loading doses of clopidogrel in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: an analysis of the ARMYDA-6 MI (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Myocardial Infarction) Study
- Author
-
Emanuele Barbato, Fabio Mangiacapra, Dejan Orlic, Germano Di Sciascio, William Wijns, Miodrag Ostojic, Giuseppe Patti, Andrea D'Ambrosio, Aaron Peace, Mangiacapra, F, Patti, G, Barbato, Emanuele, Orlic, D, Peace, Aj, D'Ambrosio, A, Ostojic, M, Wijns, W, and Di Sciascio, G.
- Subjects
medicine.medical_specialty ,Internationality ,Ticlopidine ,medicine.medical_treatment ,Myocardial Infarction ,Infarction ,Percutaneous Coronary Intervention ,Postoperative Complications ,Internal medicine ,Angioplasty ,medicine ,Humans ,ST segment ,In patient ,Prospective Studies ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Dose-Response Relationship, Drug ,business.industry ,Medical school ,Percutaneous coronary intervention ,medicine.disease ,Clopidogrel ,humanities ,Treatment Outcome ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: an analysis of the ARMYDA-6 MI (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Myocardial Infarction) Study Fabio Mangiacapra ⁎, Giuseppe Patti , Emanuele Barbato , Dejan Orlic , Aaron J. Peace , Andrea D'Ambrosio , Miodrag Ostojic , William Wijns , Germano Di Sciascio a,⁎,1 a Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy b Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium c Department of Diagnostics and Catheterization Laboratories, Division of Cardiology, Clinical Center of Serbia, Medical School of Belgrade, Belgrade, Serbia
- Published
- 2012
72. THE USE OF $sup 55$Fe IN HIGH-RESOLUTION RADIOAUTOGRAPHY OF DEVELOPING RED CELLS.
- Author
-
Orlic, D
- Published
- 1968
- Full Text
- View/download PDF
73. Characterization of multipotent adult progenitor cells, a subpopulation of mesenchymal stem cells
- Author
-
Morayma Reyes, Catherine M. Verfaillie, Orlic, D, Brummendorf, TH, Sharkis, SJ, and Kanz, L
- Subjects
Cellular differentiation ,Becaplermin ,Bone Marrow Cells ,Cell Separation ,Biology ,General Biochemistry, Genetics and Molecular Biology ,Mesoderm ,Mice ,History and Philosophy of Science ,Animals ,Humans ,Cell Lineage ,Progenitor cell ,Cells, Cultured ,Progenitor ,Stem cell transplantation for articular cartilage repair ,Bone Marrow Transplantation ,Platelet-Derived Growth Factor ,Epidermal Growth Factor ,General Neuroscience ,Stem Cells ,Mesenchymal stem cell ,Age Factors ,Cell Differentiation ,Proto-Oncogene Proteins c-sis ,Telomere ,Cell biology ,Endothelial stem cell ,Phenotype ,Stem cell ,Adult stem cell ,Stem Cell Transplantation - Abstract
Mesenchymal stem cells were isolated and a subpopulation of cells--multipotent adult progenitor cells--were identified that have the potential for multilineage differentiation. Their ability to engraft and differentiate in vivo is under investigation. ispartof: pages:231-235 ispartof: Annals of the New York Academy of Sciences vol:938 pages:231-235 ispartof: 3rd International Conference on Hematopoietic Stem Cells: Genetics and Medicine location:GERMANY, TUBINGEN date:14 Sep - 16 Sep 2000 status: published
- Published
- 2001
74. Editorial: Challenges in the contemporary assessment of coronary physiology.
- Author
-
Aleksandric S, Tesic M, and Orlic D
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
75. Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention.
- Author
-
Antonijevic N, Mitrovic P, Gosnjic N, Orlic D, Kadija S, Ilic Mostic T, Savic N, Birovljev L, Lekovic Z, and Matic D
- Abstract
Caesarean section is a challenging intervention in patients treated with dual antiplatelet therapy. We present a case of a 32-year-old pregnant woman experiencing large acute myocardial infarction (MI) of the anterolateral wall, complicated by cardiogenic shock in the 38th week of pregnancy, and treated with drug-eluting stent implantation and dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor. Less than 24 h after the MI delivery started, an urgent Caesarean section was indicated. As multiplate aggregometry testing showed a relatively insufficient level of ticagrelor platelet inhibition and a moderate level of aspirin platelet inhibition, a Caesarean section was performed without discontinuation of ticagrelor, which was decided due to the need for emergency surgery. Local hemostatic measures including administration of tranexamic acid were applied. The patient did not experience excessive bleeding. A healthy male baby was born. To the best of our knowledge, this is the first reported case of surgery in pregnant women treated with DAPT without ticagrelor discontinuation.
- Published
- 2023
- Full Text
- View/download PDF
76. Case report: Acute toxic myocardial damage caused by 5-fluorouracil-from enigma to success.
- Author
-
Lasica R, Spasic J, Djukanovic L, Trifunovic-Zamaklar D, Orlic D, Nedeljkovic-Arsenovic O, and Asanin M
- Abstract
Considering the pandemic of both cardiovascular diseases and oncological diseases, there is an increasing need for the use of chemotherapy, which through various pathophysiological mechanisms leads to damage to heart function. Cardio toxicity of chemotherapy drugs can manifest itself in a variety of clinical manifestations, which is why establishing a valid diagnosis is a real mystery for clinicians. Acute systolic heart failure (AHF) due to the use of 5-fluorouracil (5-FU) is a rare occurrence if it is not associated with myocardial infarction, myocarditis or Takotsubo cardiomyopathy. Therefore, we decided to present a case of an 52-year-old male who was diagnosed with stage IV RAS wild-type adenocarcinoma of the rectum and in whom the direct toxic effect 5-FU is the main reason for the appearance of toxic cardiomyopathy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lasica, Spasic, Djukanovic, Trifunovic-Zamaklar, Orlic, Nedeljkovic-Arsenovic and Asanin.)
- Published
- 2022
- Full Text
- View/download PDF
77. Prognostic Value of Transthoracic Doppler Echocardiography Coronary Flow Velocity Reserve in Patients With Asymmetric Hypertrophic Cardiomyopathy.
- Author
-
Tesic M, Beleslin B, Giga V, Jovanovic I, Marinkovic J, Trifunovic D, Petrovic O, Dobric M, Aleksandric S, Juricic S, Boskovic N, Tomasevic M, Ristic A, Orlic D, Stojkovic S, Vukcevic V, Stankovic G, Ostojic M, and Djordjevic Dikic A
- Subjects
- Adult, Blood Flow Velocity, Female, Humans, Male, Middle Aged, Prognosis, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic physiopathology, Echocardiography, Doppler
- Abstract
Background Microvascular dysfunction might be a major determinant of clinical deterioration and outcome in patients with hypertrophic cardiomyopathy (HCM). However, long-term prognostic value of transthoracic Doppler echocardiography (TDE) coronary flow velocity reserve (CFVR) on clinical outcome is uncertain in HCM patients. Therefore, the aim of our study was to assess long-term prognostic value of CFVR on clinical outcome in HCM population. Methods and Results We prospectively included 150 HCM patients (82 women; mean age 48±15 years). Patients' clinical characteristics, echocardiographic and CFVR findings (both for left anterior descending [LAD] and posterior descending artery [PD]), were assessed in all patients. The primary outcome was a composite of: HCM related death, heart failure requiring hospitalization, sustained ventricular tachycardia and ischemic stroke. Patients were stratified into 2 subgroups depending on CFVR LAD value: Group 1 (CFVR LAD>2, [n=87]) and Group 2 (CFVR LAD≤2, [n=63]). During a median follow-up of 88 months, 41/150 (27.3%) patients had adverse cardiac events. In Group 1, there were 8/87 (9.2%), whereas in Group 2 there were 33/63 (52.4%, P <0.001 vs. Group 1) adverse cardiac events. By Kaplan-Meier analysis, patients with preserved CFVR LAD had significantly higher cumulative event-free survival rate compared to patients with impaired CFVR LAD (96.4% and 90.9% versus 66.9% and 40.0%, at 5 and 8 years, respectively: log-rank 37.2, P <0.001). Multivariable analysis identified only CFVR LAD≤2 as an independent predictor for adverse cardiac outcome (HR 6.54; 95% CI 2.83-16.30, P <0.001), while CFVR PD was not significantly associated with outcome. Conclusions In patients with HCM, impaired CFVR LAD (≤2) is a strong, independent predictor of adverse cardiac outcome. When the aim of testing is HCM risk stratification and CFVR LAD data are available, the evaluation of CFVR PD is redundant.
- Published
- 2021
- Full Text
- View/download PDF
78. Prompt and consistent improvement of coronary flow velocity reserve following successful recanalization of the coronary chronic total occlusion in patients with viable myocardium.
- Author
-
Dobric M, Beleslin B, Tesic M, Djordjevic Dikic A, Stojkovic S, Giga V, Tomasevic M, Jovanovic I, Petrovic O, Rakocevic J, Boskovic N, Sobic Saranovic D, Stankovic G, Vukcevic V, Orlic D, Simic D, Nedeljkovic MA, Aleksandric S, Juricic S, and Ostojic M
- Subjects
- Chronic Disease, Coronary Occlusion diagnosis, Coronary Occlusion physiopathology, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Echocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Time Factors, Coronary Occlusion surgery, Coronary Vessels physiopathology, Fractional Flow Reserve, Myocardial physiology, Myocardial Contraction physiology, Percutaneous Coronary Intervention
- Abstract
Background: Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO., Methods: Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO., Results: Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS)., Conclusions: In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months., Trial Registration: ClinicalTrials.gov (Number NCT04060615 ).
- Published
- 2020
- Full Text
- View/download PDF
79. Impairment of coronary flow velocity reserve and global longitudinal strain in women with cardiac syndrome X and slow coronary flow.
- Author
-
Jovanovic I, Tesic M, Giga V, Dobric M, Boskovic N, Vratonjic J, Orlic D, Gudelj O, Tomasevic M, Dikic M, Nedeljkovic I, Trifunovic D, Nedeljkovic MA, Dedic S, Beleslin B, and Djordjevic-Dikic A
- Subjects
- Aged, Blood Flow Velocity, Coronary Circulation, Coronary Vessels physiopathology, Female, Humans, Middle Aged, Ventricular Function, Left, Microvascular Angina physiopathology
- Abstract
Background: Microvascular dysfunction (MVD) is associated with adverse prognosis and may account for abnormal stress tests and angina symptoms in women with cardiac syndrome X (CSX). The aim of our study was to assess MVD by coronary flow velocity reserve (CFVR) and left ventricular (LV) contractile function by LV global longitudinal strain (LVGLS) in CSX patients with respect to presence of slow coronary flow (SCF). It was of additional importance to evaluate clinical status of CSX patients using Seattle Angina Questionnaire., Methods and Results: Study population included 70 women with CSX (mean age 61 ± 7 years) and 34 age-matched controls. CSX group was stratified into two subgroups depending on SCF presence: CSX-Thrombolysis In Myocardial Infarction (TIMI) 3- normal flow subgroup (n = 38) and CSX-TIMI 2- SCF subgroup (n = 32) as defined by coronary angiography. LVGLS measurements and CFVR of left anterior descending (LAD) and posterior descending (PD) artery were performed. CFVR-LAD and PD were markedly impaired in CSX group compared to controls (2.34 ± 0.25 vs 3.05 ± 0.21, p < 0.001; 2.32 ± 0.24 vs 3.01 ± 0.13, p < 0.001), and furthermore decreased in CSX-TIMI 2 patients. Resting, peak, and ΔLVGLS were all significantly impaired in CSX group compared to controls (for all p < 0.001), and furthermore reduced in CSX-TIMI 2 subgroup. Strongest correlation was found between peak LVGLS and CFVR LAD (r = -0.784, p < 0.001) and PD (r = -0.772, p < 0.001). CSX-TIMI 2 subgroup had more frequent angina symptoms and more impaired quality of life., Conclusions: MVD in CSX patients is demonstrated by reduction in CFVR and LVGLS values. SCF implies more profound impairment of microvascular and LV systolic function along with worse clinical presentation., (Copyright © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
80. Prognostic Value of Transthoracic Doppler Echocardiography Coronary Flow Velocity Reserve in Patients with Nonculprit Stenosis of Intermediate Severity Early after Primary Percutaneous Coronary Intervention.
- Author
-
Tesic M, Djordjevic-Dikic A, Giga V, Stepanovic J, Dobric M, Jovanovic I, Petrovic M, Mehmedbegovic Z, Milasinovic D, Dedovic V, Zivkovic M, Juricic S, Orlic D, Stojkovic S, Vukcevic V, Stankovic G, Nedeljkovic M, Ostojic M, and Beleslin B
- Subjects
- Coronary Stenosis mortality, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, ST Elevation Myocardial Infarction mortality, Severity of Illness Index, Survival Rate, Coronary Stenosis diagnostic imaging, Coronary Stenosis surgery, Echocardiography, Doppler, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction surgery
- Abstract
Background: Treatment of nonculprit coronary stenosis during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction may be beneficial, but the mode and timing of the intervention are still controversial. The aim of this study was to examine the significance and prognostic value of preserved coronary flow velocity reserve (CFVR) in patients with nonculprit intermediate stenosis early after primary percutaneous coronary intervention., Methods: Two hundred thirty patients with remaining intermediate (50%-70%) stenosis of non-infarct-related arteries, in whom CFVR was performed within 7 days after primary percutaneous coronary intervention, were prospectively enrolled. Twenty patients with reduced CFVR and positive results on stress echocardiography or impaired fractional flow reserve underwent revascularization and were not included in further analysis. The final study population of 210 patients (mean age, 58 ± 10 years; 162 men) was divided into two groups on the basis of CFVR: group 1, CFVR > 2 (n = 174), and group 2, CFVR ≤ 2 (n = 36). Cardiac death, nonfatal myocardial infarction, and revascularization of the evaluated vessel were considered adverse events., Results: Mean follow-up duration was 47 ± 16 months. Mean CFVR for the whole group was 2.36 ± 0.40. There were six adverse events (3.4%) related to the nonculprit coronary artery in group 1, including one cardiac death, one ST-segment elevation myocardial infarction, and four revascularizations. In group 2, there were 30 adverse events (83.3%, P < .001 vs group 1), including two cardiac deaths, two ST-segment elevation myocardial infarctions, and 26 revascularizations., Conclusions: In patients with CFVR > 2 of the intermediate nonculprit coronary lesion, deferral of revascularization is safe and associated with excellent long-term clinical outcomes., (Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
81. Improved Propensity-Score Matched Long-Term Clinical Outcomes in Patients with Successful Percutaneous Coronary Interventions of Coronary Chronic Total Occlusion.
- Author
-
Stojkovic S, Juricic S, Dobric M, Nedeljkovic MA, Vukcevic V, Orlic D, Stankovic G, Tomasevic M, Aleksandric S, Dikic M, Tesic M, Mehmedbegovic Z, Boskovic N, Zivkovic M, Dedovic V, Milasinovic D, Ostojic M, and Beleslin B
- Subjects
- Aged, Female, Humans, Incidence, Male, Middle Aged, Patient Outcome Assessment, Percutaneous Coronary Intervention methods, Propensity Score, Registries, Risk Factors, Serbia epidemiology, Coronary Occlusion diagnosis, Coronary Occlusion mortality, Coronary Occlusion surgery, Long Term Adverse Effects diagnosis, Long Term Adverse Effects epidemiology, Long Term Adverse Effects etiology, Percutaneous Coronary Intervention adverse effects
- Abstract
The objective of the study was to evaluate major adverse cardiovascular events (MACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO).Limited data are available on long-term clinical follow-up in the treatment of chronic total occlusion (CTO).Between January 2009 and December 2010 PCI-CTO was attempted in 283 consecutive patients with 289 CTO lesions. Procedural success was 62.3% and clinical follow-up covered 83% (235/283) of the study population with a median follow-up of 66 months (range, 59-74).The total incidence of MACE was 57/235 (24.3%), and was significantly higher in the procedural failure group than in the procedural success group (33/87 (37.9%) versus 24/148 (16.2%), P < 0.001). All-cause mortality was significantly lower in patients with successful PCI-CTO compared to failed PCI-CTO (10.8% versus 20.7%, P < 0.05). Also, the rate of cardiovascular death in the procedural failure group (14.9%) was slightly higher than that in the procedural success group (7.4%, P = 0.066). The rate of TVR was statistically higher in the procedural failure group (P < 0.009). Propensity score-adjusted Cox regression showed that procedural success remained a significant predictor of MACE (adjusted HR 0.402; 95% CI 0.196-0.824; P = 0.013).Our study emphasizes the importance of CTO recanalization in improving long-term outcome including all-cause mortality with a borderline effect on cardiovascular mortality.
- Published
- 2018
- Full Text
- View/download PDF
82. Endothelial cell markers from clinician's perspective.
- Author
-
Rakocevic J, Orlic D, Mitrovic-Ajtic O, Tomasevic M, Dobric M, Zlatic N, Milasinovic D, Stankovic G, Ostojić M, and Labudovic-Borovic M
- Subjects
- Antigens, CD34 genetics, Antigens, CD34 metabolism, Cardiovascular Diseases diagnosis, Endoglin genetics, Endoglin metabolism, Humans, Neovascularization, Pathologic genetics, Neovascularization, Pathologic metabolism, Platelet Endothelial Cell Adhesion Molecule-1 genetics, Platelet Endothelial Cell Adhesion Molecule-1 metabolism, Randomized Controlled Trials as Topic, Receptors, Vascular Endothelial Growth Factor genetics, Receptors, Vascular Endothelial Growth Factor metabolism, Vascular Endothelial Growth Factor A genetics, Vascular Endothelial Growth Factor A metabolism, Vascular Endothelial Growth Factor Receptor-3 genetics, Vascular Endothelial Growth Factor Receptor-3 metabolism, von Willebrand Factor genetics, von Willebrand Factor metabolism, Biomarkers, Cardiovascular Diseases genetics, Endothelial Cells metabolism
- Abstract
Endothelial cell markers are membrane-bound or cytoplasmic molecules expressed by endothelial cells, which help their easier identification and discrimination from other cell types. During vasculogenesis, endothelial cells differentiate from hemangioblasts to form new blood vessels. With the discovery of endothelial progenitor cells (EPC) and their ability to form new blood vessels, the term vasculogenesis is not only reserved for the embryonic development. Possibility of de novo blood vessel formation from EPC is now widely explored in different ischemic conditions, especially in cardiovascular medicine. Numerous clinical trials have tested enhancing tissue vascularization by delivering hematopoietic cells that expressed endothelial markers. This therapeutic approach proved to be challenging and promising, particularly for patients who have exhausted all conventional therapeutic modalities. Angiogenesis, which refers to the formation of new blood vessels from existing vasculature, is indispensable process during tumor progression and metastasis. Blockage of tumor angiogenesis by targeting and inhibiting endothelial cell has emerged as novel safe and efficacious method to control many advanced malignant diseases. Numerous clinical studies are currently testing new antiangiogenic drugs which target and inhibit endothelial cell markers, receptors or molecules which transmit receptor-mediated signals, therefore inhibiting endothelial cell proliferation, migration and vascular tube formation. Many of these drugs are now widely used in clinical settings as first- or second-line chemotherapy in advanced malignant conditions. So far, these therapeutic approaches gave modest, yet encouraging clinical improvements, prolonging survival and improving functional capacity and quality of life for many terminally ill patients. Here we present the most commonly used endothelial cell markers along with their applicability in contemporary clinical practice., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
83. Co-expression of vascular and lymphatic endothelial cell markers on early endothelial cells present in aspirated coronary thrombi from patients with ST-elevation myocardial infarction.
- Author
-
Rakocevic J, Kojic S, Orlic D, Stankovic G, Ostojic M, Petrovic O, Zaletel I, Puskas N, Todorovic V, and Labudovic-Borovic M
- Subjects
- Biomarkers analysis, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors blood, Myocardial Infarction pathology, Neovascularization, Pathologic metabolism, Thrombosis metabolism, Antigens, CD34 metabolism, Endothelial Cells metabolism, Myocardial Infarction metabolism, Platelet Endothelial Cell Adhesion Molecule-1 metabolism, Vascular Endothelial Growth Factor Receptor-3 metabolism, Vesicular Transport Proteins metabolism
- Abstract
Introduction: Angiogenesis is the growth of both new vascular and lymphatic blood vessels from the existing vasculature. During this process, blood endothelial cells (BECs) and lymphatic endothelial cells (LECs) express specific markers, which help their discrimination and easier identification. Since the coronary thrombi material aspirated from patients with ST-elevation myocardial infarction (STEMI) proved as good angiogenesis model, we investigated the expression of CD34 and CD31 as BECs markers, and D2-40, LYVE-1 and VEGFR3 as LEC markers in this material., Materials and Methods: Aspirated thrombi were stained immunohistochemically for CD34, CD31, D2-40, LYVE-1 and VEGFR3. Organizational patterns of immunopositive cells were graded as single cells, clusters or microvessels. Double immunofluorescence for CD31, D2-40, LYVE-1 and VEGRF3 was done. Thrombi were also graded as fresh (<1day old), lytic (1-5days old) and organized (>5days old)., Results: Serial sections of aspirated thrombi showed concordant BEC and LEC markers immunopositivity. Double immunoflorescence proved co-expression of CD31 and LEC markers on the same cells. Cells expressing LEC markers organized in clusters and microvessels were mainly present in lytic and organized thrombi., Conclusion: Co-expression of BEC and LEC markers on the same non-tumorous cell during thrombus neovascularization indicates existing in vivo plasticity of endothelial cells under non-tumorous pathological conditions. It also points that CD34 and CD31 on one hand, and D2-40, LYVE-1 and VEGFR3 immunostaining on the other hand, cannot solely be a reliable indicators whether vessel is lymphatic or not., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
84. B-type Natriuretic Peptide and RISK-PCI Score in the Risk Assessment in Patients with STEMI Treated by Primary Percutaneous Coronary Intervention.
- Author
-
Asanin M, Mrdovic I, Savic L, Matic D, Krljanac G, Vukcevic V, Orlic D, Stankovic G, Marinkovic J, and Stankovic S
- Subjects
- Adult, Aged, Electrocardiography, Female, Humans, Male, Middle Aged, Myocardial Infarction therapy, ROC Curve, Myocardial Infarction mortality, Natriuretic Peptide, Brain blood, Percutaneous Coronary Intervention, Risk Assessment
- Abstract
Background: RISK-PCI score is a novel score for risk stratification of patients with ST elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI). The aim of this study was to evaluate the role of B-type natriuretic peptide (BNP) and the RISK-PCI score for early risk assessment in patients with STEMI treated by pPCI., Methods: In 120 patients with STEMI treated by pPCI, BNP was measured on admission before pPCI. The primary end point was 30-day mortality., Results: The ROC curve analysis revealed that the most powerful predictive factors of 30-day mortality were the plasma level of BNP ≥ 206.6 pg/mL with the sensitivity of 75% and specificity of 87.5% and the RISK-PCI score ≥ 5.25 with the sensitivity of 75% and specificity of 85.7%. Thirty-day mortality was 6.7%. After multivariate adjustment, admission BNP (≥ 206.6 pg/mL) (OR 2.952, 95% CI 1.072 - 8.133, p = 0.036) and the RISK-PCI score (≥ 5.25) (OR 2.284, 95% CI 1.140-4.578, p = 0.020) were independent predictors of 30-day mortality. The area under the ROC curve using the RISK-PCI score and BNP to detect mortality was 0.828 (p = 0.002) and 0.903 (p < 0.001), respectively. Addition of BNP to RISK-PCI score increased the area under the ROC to 0.949 (p < 0.001), but this increase measured by the c-statistic was not significant (p = 0.107). Furthermore, the significant improvement in risk reclassification (p < 0.001) and the integrated discrimination index (p = 0.042) were observed with the addition of BNP to RISK-PCI score for 30-day mortality., Conclusions: BNP on admission and the RISK-PCI score were the independent predictors of 30-day mortality in patients with the STEMI treated by pPCI. BNP in combination with the RISK-PCI score showed the way to more accurate risk assessment in patients with STEMI treated by pPCI.
- Published
- 2016
- Full Text
- View/download PDF
85. Epidemiology of musculoskeletal tumors in a national referral orthopedic department. A study of 3482 cases.
- Author
-
Bergovec M, Kubat O, Smerdelj M, Seiwerth S, Bonevski A, and Orlic D
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Incidence, Infant, Male, Middle Aged, Retrospective Studies, Sex Distribution, Young Adult, Bone Neoplasms epidemiology, Neoplasms, Connective and Soft Tissue epidemiology
- Abstract
Aim of the Study: Musculoskeletal tumors are relatively rare, and their geographic distribution varies greatly around the world. In this study, we present the incidence, age distribution and localization of musculoskeletal tumors diagnosed and/or treated at a tertiary referral orthopedic department, catering to an entire Southeastern European country., Methods: This was a retrospective study of prospectively collected data, in which all patients diagnosed and/or treated for musculoskeletal tumors at our Department in the period of 30 years (1981-2010) were included., Results: Data of a total of 3482 patients with musculoskeletal tumors were collected. Average age of patients was 33.5 years (range, 2 months-88 years), with even distribution according to sex. Malignant tumors were seen in 20.7% of patients, more often in men (56.9%). Most common malignant tumors were osteosarcoma (estimated incidence: 1.68/million/year), chondrosarcoma (0.79/million/year) and Ewing sarcoma (0.76/million/year). Benign tumors and tumor-like lesions were found in 79.3% of patients, with slight female predominance. Most common benign bone lesions were osteochondroma (5.81/million/year), simple bone cyst (2.13/million/year), and enchondroma (2.05/million/year)., Conclusion: This report represents a first of its kind in our region, and gives representative results to be compared to other middle and south European countries. Further nationwide studies are needed to improve strategies in bone tumor diagnosis and treatment., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
86. Time-dependent changes of plasma adiponectin concentration in relation to coronary microcirculatory function in patients with acute myocardial infarction treated by primary percutaneous coronary intervention.
- Author
-
Trifunovic D, Stankovic S, Marinkovic J, Beleslin B, Banovic M, Djukanovic N, Orlic D, Tesic M, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Stepanovic J, Djordjevic-Dikic A, Giga V, and Ostojic M
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Myocardial Infarction blood, Odds Ratio, Time Factors, Adiponectin blood, Coronary Circulation, Microcirculation, Myocardial Infarction therapy, Percutaneous Coronary Intervention adverse effects
- Abstract
Background and Purpose: To analyze plasma adiponectin kinetics in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI) and its association with coronary flow reserve (CFR), an index of coronary microcirculatory function., Methods: A total of 96 consecutive patients with the first anterior STEMI treated by pPCI without heart failure were included. CFR was assessed on the 7th day after pPCI. Plasma adiponectin was measured on admission before pPCI, and on the 2nd and 7th day after pPCI., Results: Adiponectin concentration was the highest on admission, declined to the lowest level on the 2nd day, and rose on the 7th day remaining below admission values. Impaired coronary microcirculatory function (CFR<2) was observed in 41% of the patients. Adiponectin concentrations significantly positively correlated with CFR, and the strongest correlation was with the 2nd day adiponectin (r=0.489, p<0.001). In multivariate models, adiponectin concentrations were independent predictors of impaired CFR [on admission: odds ratio (OR) 0.175, confidence interval (CI): 0.047-0.654, p=0.010; 2nd day: OR 0.146, 95% CI: 0.044-0.485, p=0.002; 7th day: OR 0.198, CI: 0.064-0.611, p=0.005]. The best power to predict impaired CFR was the 2nd day adiponectin. Delta values of adiponectin (differences between adiponectin concentrations) did not correlate with CFR., Conclusions: In patients with the first anterior STEMI treated by pPCI plasma adiponectin concentrations before and after pPCI are strongly associated with CFR. Our results support the hypothesis that low adiponectin, especially during the early post-pPCI period, carries the risk for impaired coronary microcirculatory function in STEMI patients., (Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
87. Reduced sirolimus systemic exposure and improved bioresorbable polymer properties: new allies for the treatment of patients with coronary artery disease.
- Author
-
Stojkovic S, Neskovic AN, Mehmedbegovic Z, Kafedzic S, Ostojic M, Nedeljkovic M, Orlic D, Ilisic B, Ilic I, Aleksic A, Cerovic M, Nikolajevic I, Vlahovic-Stipac A, Stajic Z, Putnikovic B, and Hamilos M
- Subjects
- Adult, Aged, Angioplasty, Balloon, Coronary methods, Coronary Angiography methods, Coronary Artery Disease blood, Drug-Eluting Stents adverse effects, Female, Humans, Male, Middle Aged, Polymers adverse effects, Prospective Studies, Sirolimus adverse effects, Sirolimus blood, Treatment Outcome, Coronary Artery Disease drug therapy, Polymers metabolism, Sirolimus pharmacokinetics
- Abstract
This prospective, first-in-man, open-label multicenter study sought to assess the pharmacokinetics of sirolimus after Ultimaster drug-eluting stent implantation (coated with sirolimus and bioabsorbable co-polymer) in patients with de novo coronary artery disease (the TCD-10023 PK study). The primary endpoint was sirolimus concentration in peripheral whole blood at 28 days after stent implantation. In addition, safety, tolerability, therapeutic outcome and vasomotor response after stent implantation were studied. Twenty patients were enrolled in the study. Blood samples for the measurements of sirolimus concentration were collected at eight time points during first 48 h, at 7 days and 28 days after stent implantation. Patients underwent 6-month angiographic and up to 12 months clinical follow-up. At 28 days, only two of 20 patients had sirolimus concentrations above lower limit of quantification (20.0 pg/mL). The highest sirolimus blood concentration was 105 pg/mL. The median maximum concentration was 36.8 pg/mL (range 22.9-41.5 pg/mL) for stent 3.0 × 15 mm and 87.2 pg/mL (range 60.0-105.0 pg/mL) for 3 × 28 mm stent. The median systemic exposure, as measured by the area under the time-concentration curve, was 8.3 ng h/mL (range 6.47-28.0 ng h/mL). At 6 months, endothelial function was well preserved, and up to 12 months, there were no signs of sirolimus toxicity nor any other safety concerns. Our results demonstrate that implantation of Ultimaster stent resulted in almost nondetectable sirolimus in blood after 28 days. These findings were translated into exceptional safety profile, without any sign of systemic toxicity., (© 2014 Société Française de Pharmacologie et de Thérapeutique.)
- Published
- 2015
- Full Text
- View/download PDF
88. Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size.
- Author
-
Trifunovic D, Sobic-Saranovic D, Beleslin B, Stankovic S, Marinkovic J, Orlic D, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Banovic M, Djukanovic N, Petrovic O, Petrovic M, Stepanovic J, Djordjevic-Dikic A, Tesic M, and Ostojic M
- Subjects
- Adenosine, Aged, Biomarkers blood, Blood Flow Velocity, Coronary Vessels physiopathology, Creatine Kinase, MB Form blood, Feasibility Studies, Female, Humans, Male, Microcirculation, Middle Aged, Multivariate Analysis, Myocardial Infarction blood, Myocardial Infarction diagnostic imaging, Myocardial Infarction physiopathology, Myocardial Perfusion Imaging methods, Predictive Value of Tests, Prospective Studies, Serbia, Time Factors, Tomography, Emission-Computed, Single-Photon, Treatment Outcome, Vasodilator Agents, Coronary Vessels diagnostic imaging, Echocardiography, Doppler, Fractional Flow Reserve, Myocardial, Myocardial Infarction therapy, Percutaneous Coronary Intervention
- Abstract
Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = -0.686, p < 0.01), DDT (r = -0.727, p < 0.01), and DDT adeno (r = -0.780, p < 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion.
- Published
- 2014
- Full Text
- View/download PDF
89. The randomized physiologic assessment of thrombus aspiration in patients with acute ST-segment elevation myocardial infarction trial (PATA STEMI): study rationale and design.
- Author
-
Orlic D, Ostojic M, Beleslin B, Milasinovic D, Tesic M, Borovic M, Vukcevic V, Stojkovic S, Nedeljkovic M, and Stankovic G
- Subjects
- Coronary Circulation, Coronary Thrombosis complications, Humans, Microcirculation, Myocardial Infarction etiology, Percutaneous Coronary Intervention, Prospective Studies, Vascular Resistance, Coronary Thrombosis therapy, Myocardial Infarction therapy, Thrombectomy
- Abstract
Introduction: Routine thrombus aspiration is proposed to be superior to conventional primary percutaneous coronary intervention (PCI) in terms of improved myocardial perfusion, in patients with ST-segment elevation acute myocardial infarction (STEMI). However, myocardial perfusion after thrombus aspiration has not been evaluated by a quantitative, invasive method. We intend to determine whether manual thrombus aspiration in the infarct-related coronary artery increases myocardial perfusion assessed by index of microcirculatory resistance (IMR) compared with conventional primary PCI., Study Design: PATA STEMI is a single-center, prospective, randomized trial with a planned inclusion of 128 patients with the first STEMI. Prior to coronary angiography, patients are randomly assigned to thrombus aspiration using the Eliminate aspiration catheter (Terumo Medical Supply, Japan) or to conventional primary PCI. After completion of primary PCI, IMR is determined both in infarct-related artery and in noninfarct-related arteries without critical stenoses. The primary end-point is a group mean value of IMR after thrombus aspiration compared with conventional primary PCI. Secondary end-points are myocardial perfusion grade, resolution of ST-segment elevation, enzymatic estimation of infarct size, left ventricular remodeling assessed by echocardiographic indices, and major adverse cardiac events rate at 1, 6, and 12 months., Conclusion: If manual thrombus aspiration significantly reduces microcirculatory resistance, thereby improving myocardial perfusion, it may become the routine strategy in primary PCI., (© 2014, Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
90. Coronary vasomotion one year after drug-eluting stent implantation: comparison of everolimus-eluting and paclitaxel-eluting coronary stents.
- Author
-
Hamilos M, Ribichini F, Ostojic MC, Ferrero V, Orlic D, Vassanelli C, Karanovic N, Sarno G, Cuisset T, Vardas PE, and Wijns W
- Subjects
- Aged, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Coronary Vessels diagnostic imaging, Coronary Vessels physiopathology, Endothelium, Vascular diagnostic imaging, Endothelium, Vascular physiopathology, Europe, Everolimus, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Prospective Studies, Prosthesis Design, Sirolimus administration & dosage, Time Factors, Treatment Outcome, Cardiovascular Agents administration & dosage, Coronary Artery Disease therapy, Coronary Vessels drug effects, Drug-Eluting Stents, Endothelium, Vascular drug effects, Hemodynamics drug effects, Paclitaxel administration & dosage, Percutaneous Coronary Intervention instrumentation, Sirolimus analogs & derivatives
- Abstract
First-generation drug-eluting stents (DES) have been associated with impaired localized coronary vasomotion and delayed endothelialization. We aimed to compare coronary vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative coronary angiography was performed offline. Endothelium independent vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs -4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs -4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent vasomotion at adjacent stent segments is relatively preserved after EES implantation while vasoconstriction was observed after PES implantation.
- Published
- 2014
- Full Text
- View/download PDF
91. Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function.
- Author
-
Trifunovic D, Stankovic S, Sobic-Saranovic D, Marinkovic J, Petrovic M, Orlic D, Beleslin B, Banovic M, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Stepanovic J, Djordjevic-Dikic A, Tesic M, Djukanovic N, Petrovic O, Vasovic O, Nestorovic E, Kostic J, Ristic A, and Ostojic M
- Subjects
- Acute Disease, Aged, Female, Humans, Male, Middle Aged, Myocardial Infarction diagnosis, Prospective Studies, Coronary Circulation physiology, Insulin Resistance physiology, Microcirculation physiology, Myocardial Infarction physiopathology, Myocardial Infarction surgery, Percutaneous Coronary Intervention methods
- Abstract
Background: Insulin resistance (IR) assessed by the Homeostatic Model Assessment (HOMA) index in the acute phase of myocardial infarction in non-diabetic patients was recently established as an independent predictor of intrahospital mortality. In this study we postulated that acute IR is a dynamic phenomenon associated with the development of myocardial and microvascular injury and larger final infarct size in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI)., Methods: In 104 consecutive patients with the first anterior STEMI without diabetes, the HOMA index was determined on the 2nd and 7th day after pPCI. Worst-lead residual ST-segment elevation (ST-E) on postprocedural ECG, coronary flow reserve (CFR) determined by transthoracic Doppler echocardiography on the 2nd day after pPCI and fixed perfusion defect on single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) determined six weeks after pPCI were analyzed according to HOMA indices., Results: IR was present in 55 % and 58 % of patients on day 2 and day 7, respectively. Incomplete post-procedural ST-E resolution was more frequent in patients with IR compared to patients without IR, both on day 2 (p = 0.001) and day 7 (p < 0.001). The HOMA index on day 7 correlated with SPECT-MPI perfusion defect (r = 0.331), whereas both HOMA indices correlated well with CFR (r = -0.331 to -0.386) (p < 0.01 for all). In multivariable backward logistic regression analysis adjusted for significant univariate predictors and potential confounding variables, IR on day 2 was an independent predictor of residual ST-E ≥ 2 mm (OR 11.70, 95% CI 2.46-55.51, p = 0.002) and CFR < 2 (OR = 5.98, 95% CI 1.88-19.03, p = 0.002), whereas IR on day 7 was an independent predictor of SPECT-MPI perfusion defect > 20% (OR 11.37, 95% CI 1.34-96.21, p = 0.026)., Conclusion: IR assessed by the HOMA index during the acute phase of the first anterior STEMI in patients without diabetes treated by pPCI is independently associated with poorer myocardial reperfusion, impaired coronary microcirculatory function and potentially with larger final infarct size.
- Published
- 2014
- Full Text
- View/download PDF
92. Shear stress-induced mechanotransduction protein deregulation and vasculopathy in a mouse model of progeria.
- Author
-
Song M, San H, Anderson SA, Cannon RO 3rd, and Orlic D
- Subjects
- Animals, Disease Models, Animal, Gene Expression, Humans, Intermediate Filament Proteins metabolism, Lamin Type A, Mechanotransduction, Cellular, Mice, Muscle, Smooth, Vascular metabolism, Muscle, Smooth, Vascular pathology, Nuclear Proteins metabolism, Protein Precursors metabolism, Stress, Mechanical, Progeria metabolism, Progeria pathology, Vascular Diseases metabolism, Vascular Diseases pathology
- Abstract
Introduction: A mouse model of progeria derived by insertion of the human mutant LMNA gene (mLMNA), producing mutant lamin A, shows loss of smooth muscle cells in the media of the ascending aorta. We hypothesized that high shear stress, in the presence of mutant lamin A, induces this vasculopathy and tried to define the molecular and cellular basis for aortic vasculopathy., Methods: Ascending and descending aortas from wild type (WT) and mLMNA+ mice were compared using proteomics, Western blots, PCR and immunostaining. To determine whether high fluidic shear stress, known to occur in the ascending aorta, contributed to the vasculopathy, we exposed descending aortas of mLMNA+ mice, with no apparent vasculopathy, to 75 dynes/cm2 shear stress for 30 minutes using a microfluidic system., Results: When the mice were one year of age, expression of several mechanotransduction proteins in the ascending aorta, including vimentin, decreased in mLMNA+ mice but no decrease occurred in the descending aorta. High fluidic shear stress produced a significant reduction in vimentin of mLMNA+ mice but not in similarly treated WT mice., Conclusions: The occurrence of mutant lamin A and high shear stress correlate with a reduction in the level of mechanotransduction proteins in smooth muscle cells of the media. Reduction of these proteins may contribute over time to development of vasculopathy in the ascending aorta in progeria syndrome.
- Published
- 2014
- Full Text
- View/download PDF
93. Additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.
- Author
-
Brkovic V, Dobric M, Beleslin B, Giga V, Vukcevic V, Stojkovic S, Stankovic G, Nedeljkovic MA, Orlic D, Tomasevic M, Stepanovic J, and Ostojic M
- Subjects
- Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction mortality, Predictive Value of Tests, Proportional Hazards Models, Recurrence, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Coronary Angiography, Decision Support Techniques, Myocardial Infarction diagnostic imaging, Myocardial Infarction therapy, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality
- Abstract
This study evaluated additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). All six scores were calculated in 209 consecutive STEMI patients undergoing pPCI. Primary end-point was the major adverse cardiovascular event (MACE--composite of cardiovascular mortality, non-fatal myocardial infarction and stroke); secondary end point was cardiovascular mortality. Patients were stratified according to the SYNTAX score tertiles (≤12; between 12 and 19.5; >19.5). The median follow-up was 20 months. Rates of MACE and cardiovascular mortality were highest in the upper tertile of the SYNTAX score (p < 0.001 and p = 0.003, respectively). SYNTAX score was independent multivariable predictor of MACE and cardiovascular mortality when added to GRACE, TIMI, ZWOLLE, and PAMI risk scores. However, the SYNTAX score did not improve the Cox regression models of MACE and cardiovascular mortality when added to the CADILLAC score. The SYNTAX score has predictive value for MACE and cardiovascular mortality in patients with STEMI undergoing primary PCI. Furthermore, SYNTAX score improves prognostic performance of well-established GRACE, TIMI, ZWOLLE and PAMI clinical scores, but not the CADILLAC risk score. Therefore, long-term survival in patients after STEMI depends less on detailed angiographical characterization of coronary lesions, but more on clinical characteristics, myocardial function and basic angiographic findings as provided by the CADILLAC score.
- Published
- 2013
- Full Text
- View/download PDF
94. Efficiency, safety, and long-term follow-up of retrograde approach for CTO recanalization: initial (Belgrade) experience with international proctorship.
- Author
-
Stojkovic S, Sianos G, Katoh O, Galassi AR, Beleslin B, Vukcevic V, Nedeljkovic M, Stankovic G, Orlic D, Dobric M, Tomasevic M, and Ostojic M
- Subjects
- Angioplasty, Balloon, Coronary adverse effects, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Registries, Retrospective Studies, Angioplasty, Balloon, Coronary methods, Collateral Circulation, Coronary Occlusion therapy
- Abstract
Background: Retrograde approach increases the success rate for percutaneous recanalization of complex chronic total occlusion (CTO) of coronary arteries., Objectives: The purpose of this study was to describe our initial experience of retrograde percutaneous coronary intervention for CTO program, focusing on its safety and feasibility, and long-term clinical follow-up., Methods: The study was a single center retrospective registry which included a total of 40 patients, of 590 CTO treated patients (6.7%), between January 2008 and October 2011, who underwent retrograde approach for CTO recanalization., Results: Mean occlusion duration was 37.8 ± 40.3 months. Overall success recanalization rate was 87.5% (35/40). Septal collaterals were used to access the occlusion in all cases (100%). Retrograde guidewire crossing of collateral channels was successful in 36/40 (90.0%) patients with success rate of CTO recanalization in these patients of 97.2%. Retrograde approach as the primary strategy was applied in 23/40 (57.5%) patients, retrograde approach immediately after antegrade failure attempt was performed in 8/40 (20.0%) patients, and retrograde approach as elective procedure, after previously failed antegrade attempt, was performed in 9/40 (22.5%) patients. The success rate of these strategies was: 87.0% (20/23 patients) for primary, 87.5% (7/8 patients) for retrograde immediately after antegrade failure, and 88.9% (8/9 patients) for retrograde after previous failed antegrade attempt, respectively. Total in-hospital major adverse cardiac events (MACE) rate was 5.0% (2 non-Q-wave myocardial infarctions). The MACE free survival at median follow-up of 20 months was 89% (95% CI: 78-100%)., Conclusions: This study has demonstrated that adequate training and international proctorship for this complex and demanding technique is a necessity and prerequisite to achieve high overall success rates, with acceptable complication rates and excellent long-term survival rate., (©2012, Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
95. Antiplatelet effect of 600- and 300-mg loading doses of clopidogrel in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: an analysis of the ARMYDA-6 MI (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Myocardial Infarction) Study.
- Author
-
Mangiacapra F, Patti G, Barbato E, Orlic D, Peace AJ, D'Ambrosio A, Ostojic M, Wijns W, and Di Sciascio G
- Subjects
- Angioplasty, Balloon, Coronary adverse effects, Clopidogrel, Dose-Response Relationship, Drug, Humans, Internationality, Myocardial Infarction epidemiology, Postoperative Complications epidemiology, Prospective Studies, Ticlopidine administration & dosage, Treatment Outcome, Myocardial Infarction drug therapy, Percutaneous Coronary Intervention adverse effects, Platelet Aggregation Inhibitors administration & dosage, Postoperative Complications drug therapy, Ticlopidine analogs & derivatives
- Published
- 2012
- Full Text
- View/download PDF
96. Fractional flow reserve and myocardial viability as assessed by SPECT perfusion scintigraphy in patients with prior myocardial infarction.
- Author
-
Beleslin B, Dobric M, Sobic-Saranovic D, Giga V, Stepanovic J, Djordjevic-Dikic A, Nedeljkovic M, Stojkovic S, Vukcevic V, Stankovic G, Orlic D, Petrasinovic Z, Pavlovic S, Obradovic V, and Ostojic M
- Subjects
- Aged, Angioplasty, Balloon, Coronary, Female, Humans, Male, Middle Aged, Technetium Tc 99m Sestamibi, Coronary Circulation, Heart physiopathology, Myocardial Infarction diagnostic imaging, Myocardial Infarction physiopathology, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Background: In patients with previous myocardial infarction (MI), assessment of myocardial viability and physiological significance of coronary artery stenoses are essential for appropriate guidance of revascularization. The aim of the study was to evaluate the relation between fractional flow reserve (FFR) and myocardial viability as assessed by gated SPECT MIBI perfusion scintigraphy in patients with previous MI undergoing elective PCI., Methods: The study population consisted of 26 patients (mean age 55 ± 7 years; 21 male) with a previous MI and a significant coronary stenosis in a single infarct-related coronary vessel for which PCI was being performed. In all patients, FFR was evaluated before and immediately after PCI. SPECT imaging was done before and 3 ± 1 months after PCI. A region representing the MI was considered viable if MIBI uptake was ≥55% of the normal region. Improvement in perfusion after revascularization was considered achieved if perfusion abnormalities decreased by 5% or more and there was a decrease in segmental score of ≥1 in three segments in PCI-related vascular territory., Results: Extent of perfusion abnormalities decreased from 32 ± 16% to 27 ± 19% after PCI (P < .001). In patients with myocardial viability in comparison to patients with no viability, there was significant difference in FFR before PCI (.57 ± .14 vs .76 ± .12, P = .002), despite almost the same values of diameter stenosis of infarct-related artery (63 ± 8% vs 64 ± 3%, respectively, P = .572). In addition, FFR prior to PCI was related to improvement in perfusion abnormalities after revascularization (P = .047), as well as with peak activity of creatine-kinase measured during previous MI (r = .56, P = .005)., Conclusion: Lower values of FFR before angioplasty are associated with myocardial viability and functional improvement as assessed by SPECT perfusion scintigraphy.
- Published
- 2010
- Full Text
- View/download PDF
97. Cardiomyogenesis in the adult human heart.
- Author
-
Kajstura J, Urbanek K, Perl S, Hosoda T, Zheng H, Ogórek B, Ferreira-Martins J, Goichberg P, Rondon-Clavo C, Sanada F, D'Amario D, Rota M, Del Monte F, Orlic D, Tisdale J, Leri A, and Anversa P
- Subjects
- Adult, Age Factors, Aged, Animals, Autopsy, Cell Death, Cell Fusion, Cell Nucleus pathology, DNA Repair, Endothelial Cells drug effects, Female, Fibroblasts drug effects, Flow Cytometry, Humans, Idoxuridine therapeutic use, Immunohistochemistry, Male, Microscopy, Confocal, Middle Aged, Myocytes, Cardiac drug effects, Neoplasms drug therapy, Phenotype, Polyploidy, Radiation-Sensitizing Agents therapeutic use, Rats, Rats, Inbred F344, Regeneration, Time Factors, Young Adult, Cell Proliferation drug effects, Endothelial Cells pathology, Fibroblasts pathology, Muscle Development drug effects, Myocardium pathology, Myocytes, Cardiac pathology, Neoplasms pathology
- Abstract
Rationale: The ability of the human heart to regenerate large quantities of myocytes remains controversial, and the extent of myocyte renewal claimed by different laboratories varies from none to nearly 20% per year., Objective: To address this issue, we examined the percentage of myocytes, endothelial cells, and fibroblasts labeled by iododeoxyuridine in postmortem samples obtained from cancer patients who received the thymidine analog for therapeutic purposes. Additionally, the potential contribution of DNA repair, polyploidy, and cell fusion to the measurement of myocyte regeneration was determined., Methods and Results: The fraction of myocytes labeled by iododeoxyuridine ranged from 2.5% to 46%, and similar values were found in fibroblasts and endothelial cells. An average 22%, 20%, and 13% new myocytes, fibroblasts, and endothelial cells were generated per year, suggesting that the lifespan of these cells was approximately 4.5, 5, and 8 years, respectively. The newly formed cardiac cells showed a fully differentiated adult phenotype and did not express the senescence-associated protein p16(INK4a). Moreover, measurements by confocal microscopy and flow cytometry documented that the human heart is composed predominantly of myocytes with 2n diploid DNA content and that tetraploid and octaploid nuclei constitute only a small fraction of the parenchymal cell pool. Importantly, DNA repair, ploidy formation, and cell fusion were not implicated in the assessment of myocyte regeneration., Conclusions: Our findings indicate that the human heart has a significant growth reserve and replaces its myocyte and nonmyocyte compartment several times during the course of life.
- Published
- 2010
- Full Text
- View/download PDF
98. Systemic rapamycin without loading dose for restenosis prevention after coronary bare metal stent implantation.
- Author
-
Stojkovic S, Ostojic M, Nedeljkovic M, Stankovic G, Beleslin B, Vukcevic V, Orlic D, Arandjelovic A, Kostic J, Dikic M, and Tomasevic M
- Subjects
- Administration, Oral, Aged, Coronary Angiography, Coronary Restenosis diagnostic imaging, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Prospective Studies, Secondary Prevention, Stents adverse effects, Blood Vessel Prosthesis Implantation adverse effects, Coronary Restenosis prevention & control, Immunosuppressive Agents administration & dosage, Sirolimus administration & dosage
- Abstract
Objectives: The aim of this study was to assess the role of short oral administration of rapamycin, without loading dose, in the reduction of restenosis rate after bare metal stent implantation., Background: Previous studies suggest that the administration of oral rapamycin reduces angiographic restenosis after bare metal stent implantation., Methods: This was prospective, open-label study of 80 patients randomized to either oral rapamycin (2 mg/day for 30 days, starting within 24 hr of stent implantation) or no therapy after implantation of a coronary bare metal stent. The primary study end point was incidence of angiographic binary restenosis and late loss at six months. The secondary end points were target lesion revascularization (TLR), target vessel revascularization (TVR), and incidence of major adverse cardiovascular events (MACE) at 6 months., Results: Angiographic follow up was completed in 72/80 (90%) of patients. In the rapamycin group, the drug was well tolerated (22.5% minor side effects) and was maintained in 100% of patients. At six months, the in-segment binary restenosis was 10.5% in rapamycin group vs. 51.4% in no-therapy group, P < 0.001) and the in-stent binary restenosis was 7.9% in rapamycin group vs. 48.7% in no-therapy group, P < 0.001. The in-segment late loss was also significantly reduced with oral therapy (0.29 + or - 0.39 vs. 0.86 + or - 0.64 mm, respectively, P < 0.001). Similarly, after six months, patients in the oral rapamycin group also showed a significantly lower incidence of TLR and TVR (7% vs. 22.7%, respectively, P = 0.039) and MACE (7% vs. 22.7%, respectively, P = 0.039)., Conclusions: This study showed that the administration of oral rapamycin (2 mg/day, without loading dose) during 30 days after stent implantation significantly reduces angiographic and clinical parameters of restenosis.
- Published
- 2010
- Full Text
- View/download PDF
99. Bone marrow-derived cells do not repair endothelium in a mouse model of chronic endothelial cell dysfunction.
- Author
-
Perry TE, Song M, Despres DJ, Kim SM, San H, Yu ZX, Raghavachari N, Schnermann J, Cannon RO 3rd, and Orlic D
- Subjects
- Animals, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Body Weight, Cell Movement, Cell Proliferation, Cells, Cultured, Chronic Disease, DNA metabolism, Disease Models, Animal, Endothelial Cells enzymology, Endothelial Cells pathology, Endothelium, Vascular enzymology, Endothelium, Vascular pathology, Green Fluorescent Proteins biosynthesis, Green Fluorescent Proteins genetics, Hypertension enzymology, Hypertension genetics, Hypertension pathology, Hypertension physiopathology, Mice, Mice, Inbred C57BL, Mice, Knockout, Mice, Transgenic, Microscopy, Confocal, Myocardium pathology, Nitric Oxide Synthase Type III deficiency, Nitric Oxide Synthase Type III genetics, RNA, Messenger metabolism, Telemetry, Time Factors, Transplantation Chimera, Bone Marrow Transplantation, Endothelial Cells transplantation, Endothelium, Vascular physiopathology, Hypertension prevention & control, Stem Cell Transplantation
- Abstract
Aims: Bone marrow (BM)-derived endothelial progenitor cells (EPCs) in the circulation replace damaged vascular endothelium. We assessed the hypothesis that a BM transplant from healthy animals would restore normal arterial endothelium and prevent hypertension in young endothelial nitric oxide synthase-deficient (eNOS(-/-)) mice., Methods and Results: Radiation or busulfan-induced BM ablation in eNOS(-/-) mice on day 6, day 14, or day 28 was followed by a BM transplant consisting of enhanced green fluorescent protein positive (EGFP(+)) cells from C57BL/6J mice. Peripheral blood cell chimerism was always greater than 85% at 4 months after BM transplant. Molecular assays of heart, kidney, and liver revealed low-level chimerism in all treatment groups, consistent with residual circulating EGFP(+) blood cells. When aorta, coronary, renal, hepatic, and splenic arteries in BM-transplanted eNOS(-/-) mice were examined by confocal microscopy, there were no EGFP- or eNOS-positive endothelial cells detected in these vessels in any of the treatment groups. Likewise, telemetry did not detect any reduction in blood pressure. Thus, no differences were observed in our measurements using several different treatment protocols., Conclusion: We found no evidence for BM-derived EPC renewal of endothelium in this eNOS-deficient mouse model of a chronic vascular disease or in wild-type mice during postnatal growth. Hence, renewal of chronic dysfunctional endothelium and endothelial homeostasis may be dependent on resident vascular progenitor cells.
- Published
- 2009
- Full Text
- View/download PDF
100. The pharmacokinetics of Biolimus A9 after elution from the Nobori stent in patients with coronary artery disease: the NOBORI PK study.
- Author
-
Ostojic M, Sagic D, Jung R, Zhang YL, Nedeljkovic M, Mangovski L, Stojkovic S, Debeljacki D, Colic M, Beleslin B, Milosavljevic B, Orlic D, Topic D, Karanovic N, Paunovic D, and Christians U
- Subjects
- Cardiovascular Agents administration & dosage, Cardiovascular Agents adverse effects, Cardiovascular Agents blood, Chromatography, Liquid, Colorado, Coronary Artery Disease drug therapy, Female, Humans, Male, Middle Aged, Prospective Studies, Prosthesis Design, Serbia, Sirolimus administration & dosage, Sirolimus adverse effects, Sirolimus blood, Sirolimus pharmacokinetics, Tandem Mass Spectrometry, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Cardiovascular Agents pharmacokinetics, Coronary Artery Disease therapy, Drug-Eluting Stents, Sirolimus analogs & derivatives
- Abstract
Objectives: The aim of this study was to assess the pharmacokinetics and tolerability of Biolimus A9 eluted from Nobori coronary stents., Background: : The release kinetics and pharmacokinetics of drugs delivered via coronary stents have been shown to play an essential role in the efficacy and safety of drug eluting stents., Methods: Twenty patients with coronary artery disease were treated with single 14-mm (10 patients) or 28-mm long stent (10 patients). Blood samples were drawn at 16 time points to determine the pharmacokinetics of Biolimus A9. At seven time points, complete laboratory and toxicology panels were assessed to screen for potential Biolimus A9 toxicity. The primary endpoint of the study was the systemic blood concentrations of Biolimus A9 after 28 days and 6 months as measured using highly specific and sensitive liquid chromatography- tandem mass spectrometry assay., Results: At 28 days, 6 patients (30%) had quantifiable Biolimus A9 concentrations in blood. The highest Biolimus A9 blood concentration measured in any sample was 32.2 pg/mL. The median time to maximum concentration was 2 hr, ranging from 0.05 hr to 3 months. Six months after stent implantation, only 1 of 20 patients had measurable Biolimus A9 concentrations at the lowest level of quantification, while at 9 months no sample had quantifiable Biolimus A9 concentrations. Laboratory and toxicology assessments did not indicate any impact of Biolimus A9 on the evaluated parameters., Conclusion: Results of this study suggest that systemic exposure to Biolimus A9 was very low and that Biolimus A9 was well tolerated., (Copyright 2008 Wiley-Liss, Inc.)
- Published
- 2008
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.