TY  - JOUR
AU  - Popović, Dejana
AU  - Đorđević, Tea
AU  - Jakovljević, Đorđe
AU  - Ristić, Arsen
AU  - Lasica, Ratko
AU  - Arena, Ross
AU  - Guazzi, Marco
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3580
AB  - Ischemic heart disease leading to heart failure (HF) portends a high overall morbidity and mortality. A higher N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) at rest reflects HF severity and impaired cardiac output, most often secondary to reduced ejection fraction (EF). As an insufficient increase in cardiac output during exertion is common in all HF phenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratification index for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved EF (HFmrEF/HFpEF). 213 patients (123 HFrEF; 90 HFmrEF/HFpEF) underwent cardiopulmonary exercise testing (CPET). NT-pro-BNP was determined at rest and peak exercise. The distribution of HFrEF and HFmrEF/HFpEF etiology in subjects with and without oxygen consumption trajectory flattening during CPET was similar (p > 0.05). Patients with HFrEF had higher plasma levels of NT-pro-BNP at rest and peak exercise than those with HFmrEF/HFpEF (984 vs. 780; 1012 vs. 845 pg/mL, p < 0.01, respectively), whereas ΔNT-pro-BNPpeak/rest was similar (60 vs. 50 pg/mL, p > 0.05). During the tracking period (22.4 ± 20.3 months) 34 patients died, and there were 2 cardiac transplantations and 3 LVAD implantations. In a multivariate regression model only the NT-pro-BNPpeak and ΔNT-pro-BNPpeak/rest were retained in the regression for the prediction of adverse events (Chi-square:8.97, p = 0.003). ROC analysis demonstrated that NT-pro-BNPpeak ≥1506 pg/mL and ΔNT-pro-BNPpeak/rest ≥108 pg/mL were optimal for identifying patients with a risk (Sn = 76.9, 74.4 %; Sp = 84.7, 80.9 %, respectively). NT-pro-BNP changes during effort and absolute peak values reached provide novel insights emerging as new and strong predictors of adverse events in HF of any EF.
PB  - Elsevier
T2  - Peptides
T1  - N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction
VL  - 129
DO  - 10.1016/j.peptides.2020.170315
DO  - 10.1016/j.peptides.2020.170315
ER  - 

@article{
author = "Popović, Dejana and Đorđević, Tea and Jakovljević, Đorđe and Ristić, Arsen and Lasica, Ratko and Arena, Ross and Guazzi, Marco",
year = "2020",
abstract = "Ischemic heart disease leading to heart failure (HF) portends a high overall morbidity and mortality. A higher N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) at rest reflects HF severity and impaired cardiac output, most often secondary to reduced ejection fraction (EF). As an insufficient increase in cardiac output during exertion is common in all HF phenotypes, we examined the value of NT-pro-BNP during exercise testing as a risk stratification index for ischemic HF secondary to either reduced (HFrEF) or mid-ranged/preserved EF (HFmrEF/HFpEF). 213 patients (123 HFrEF; 90 HFmrEF/HFpEF) underwent cardiopulmonary exercise testing (CPET). NT-pro-BNP was determined at rest and peak exercise. The distribution of HFrEF and HFmrEF/HFpEF etiology in subjects with and without oxygen consumption trajectory flattening during CPET was similar (p > 0.05). Patients with HFrEF had higher plasma levels of NT-pro-BNP at rest and peak exercise than those with HFmrEF/HFpEF (984 vs. 780; 1012 vs. 845 pg/mL, p < 0.01, respectively), whereas ΔNT-pro-BNPpeak/rest was similar (60 vs. 50 pg/mL, p > 0.05). During the tracking period (22.4 ± 20.3 months) 34 patients died, and there were 2 cardiac transplantations and 3 LVAD implantations. In a multivariate regression model only the NT-pro-BNPpeak and ΔNT-pro-BNPpeak/rest were retained in the regression for the prediction of adverse events (Chi-square:8.97, p = 0.003). ROC analysis demonstrated that NT-pro-BNPpeak ≥1506 pg/mL and ΔNT-pro-BNPpeak/rest ≥108 pg/mL were optimal for identifying patients with a risk (Sn = 76.9, 74.4 %; Sp = 84.7, 80.9 %, respectively). NT-pro-BNP changes during effort and absolute peak values reached provide novel insights emerging as new and strong predictors of adverse events in HF of any EF.",
publisher = "Elsevier",
journal = "Peptides",
title = "N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction",
volume = "129",
doi = "10.1016/j.peptides.2020.170315, 10.1016/j.peptides.2020.170315"
}

Popović, D., Đorđević, T., Jakovljević, Đ., Ristić, A., Lasica, R., Arena, R.,& Guazzi, M.. (2020). N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction. in Peptides
Elsevier., 129.
https://doi.org/10.1016/j.peptides.2020.170315

Popović D, Đorđević T, Jakovljević Đ, Ristić A, Lasica R, Arena R, Guazzi M. N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction. in Peptides. 2020;129.
doi:10.1016/j.peptides.2020.170315 .

Popović, Dejana, Đorđević, Tea, Jakovljević, Đorđe, Ristić, Arsen, Lasica, Ratko, Arena, Ross, Guazzi, Marco, "N-Terminal-pro-Brain natriuretic peptide dynamics during effort phenotypes ischemic heart failure and determines prognosis regardless of ejection fraction" in Peptides, 129 (2020),
https://doi.org/10.1016/j.peptides.2020.170315 . .

TY  - JOUR
AU  - Popović, Dejana
AU  - Guazzi, Marco
AU  - Jakovljević, Đorđe G.
AU  - Lasica, Ratko
AU  - Banović, Marko
AU  - Ostojić, Miodrag
AU  - Arena, Ross
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3316
AB  - Background: This study examined the accuracy of cardiopulmonary exercise testing (CPET) on a treadmill (TM) and recumbent ergometry (RE) in the predicting coronary artery disease (CAD) severity and prognosis. Methods: Forty Caucasian subjects, mean age 63.5 +/- 7.6, with significant coronary artery lesions (>= 50%) were included. Within two months of coronary angiography, TM and RE CPET were performed on two visits 2-4 days apart and subsequently followed up to 32 +/- 10 months. Results: Mean left ventricular ejection fraction was 56.7 +/- 9.6%. TM CPET exhibited a higher occurrence of ST segment depression >= 1 mm (71.05% vs 28.95%, p = 0.04). Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a better CPET response compared to those with 3-SCA. ROC analysis revealed a high predictive value for the ventilation/carbon dioxide production (VE/VCO2) slope obtained on TM (area 0.84, p = 0.003, Sn 88.9%, Sp 72%) in distinguishing between 1 and 2-SCA and 3-SCA. Among all CPET parameters, work efficiency (Delta VO2/Delta WR) during RE predicted cumulative cardiac events (p  lt  0.01). Conclusions: CPET parameters hold predictive value for CAD severity and prognosis. CPET on a TM appears to be more reliable in the quantification of CAD compared to RE.
PB  - Elsevier Ireland Ltd, Clare
T2  - International Journal of Cardiology
T1  - Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing
VL  - 285
SP  - 11
EP  - 13
DO  - 10.1016/j.ijcard.2019.03.012
ER  - 

@article{
author = "Popović, Dejana and Guazzi, Marco and Jakovljević, Đorđe G. and Lasica, Ratko and Banović, Marko and Ostojić, Miodrag and Arena, Ross",
year = "2019",
abstract = "Background: This study examined the accuracy of cardiopulmonary exercise testing (CPET) on a treadmill (TM) and recumbent ergometry (RE) in the predicting coronary artery disease (CAD) severity and prognosis. Methods: Forty Caucasian subjects, mean age 63.5 +/- 7.6, with significant coronary artery lesions (>= 50%) were included. Within two months of coronary angiography, TM and RE CPET were performed on two visits 2-4 days apart and subsequently followed up to 32 +/- 10 months. Results: Mean left ventricular ejection fraction was 56.7 +/- 9.6%. TM CPET exhibited a higher occurrence of ST segment depression >= 1 mm (71.05% vs 28.95%, p = 0.04). Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a better CPET response compared to those with 3-SCA. ROC analysis revealed a high predictive value for the ventilation/carbon dioxide production (VE/VCO2) slope obtained on TM (area 0.84, p = 0.003, Sn 88.9%, Sp 72%) in distinguishing between 1 and 2-SCA and 3-SCA. Among all CPET parameters, work efficiency (Delta VO2/Delta WR) during RE predicted cumulative cardiac events (p  lt  0.01). Conclusions: CPET parameters hold predictive value for CAD severity and prognosis. CPET on a TM appears to be more reliable in the quantification of CAD compared to RE.",
publisher = "Elsevier Ireland Ltd, Clare",
journal = "International Journal of Cardiology",
title = "Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing",
volume = "285",
pages = "11-13",
doi = "10.1016/j.ijcard.2019.03.012"
}

Popović, D., Guazzi, M., Jakovljević, Đ. G., Lasica, R., Banović, M., Ostojić, M.,& Arena, R.. (2019). Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing. in International Journal of Cardiology
Elsevier Ireland Ltd, Clare., 285, 11-13.
https://doi.org/10.1016/j.ijcard.2019.03.012

Popović D, Guazzi M, Jakovljević ĐG, Lasica R, Banović M, Ostojić M, Arena R. Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing. in International Journal of Cardiology. 2019;285:11-13.
doi:10.1016/j.ijcard.2019.03.012 .

Popović, Dejana, Guazzi, Marco, Jakovljević, Đorđe G., Lasica, Ratko, Banović, Marko, Ostojić, Miodrag, Arena, Ross, "Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing" in International Journal of Cardiology, 285 (2019):11-13,
https://doi.org/10.1016/j.ijcard.2019.03.012 . .

TY  - JOUR
AU  - Popović, Dejana
AU  - Damjanović, Svetozar S.
AU  - Đorđević, Tea
AU  - Martić, Dejana
AU  - Ignjatović, Svetlana
AU  - Milinković, Neda
AU  - Banović, Marko
AU  - Lasica, Ratko
AU  - Petrović, Milan
AU  - Guazzi, Marco
AU  - Arena, Ross
PY  - 2017
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2861
AB  - Objectives: Despite considerable knowledge regarding the importance of stress in coronary artery disease (CAD) pathogenesis, its underestimation persists in routine clinical practice, in part attributable to lack of a standardized, objective assessment. The current study examined the ability of stress hormones to predict CAD severity and prognosis at basal conditions as well as during and following an exertional stimulus.Materials and methods: Forty Caucasian subjects with significant coronary artery lesions (50%) were included. Within 2 months of coronary angiography, cardiopulmonary exercise testing (CPET) on a recumbent ergometer was performed in conjunction with stress echocardiography (SE). At rest, peak and after 3min of recovery following CPET, plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and NT-pro-brain natriuretic peptide (NT-pro-BNP) were measured by immunoassay sandwich technique, radioimmunoassay, and radioimmunometric technique, respectively. Subjects were subsequently followed a mean of 3210months.Results and discussion: Mean ejection fraction was 56.7 +/- 9.6%. Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a significantly lower plasma cortisol levels during CPET compared to those with 3-SCA (p lt .05), whereas ACTH and NT-pro-BNP were not significantly different (p>.05). Among CPET, SE, and hormonal parameters, cortisol at rest and during CPET recovery demonstrated the best predictive value in distinguishing between 1-, 2-, and 3-SCA [area under ROC curve 0.75 and 0.77 (SE=0.11, 0.10; p=.043, .04) for rest and recovery, respectively]. Cortisol peak/rest predicted cumulative cardiac events (area under ROC curve 0.75, SE=0.10, p=.049).Conclusions: Cortisol at rest and following an exercise test holds predictive value for CAD severity and prognosis, further demonstrating a link between stress and unwanted cardiac events.
PB  - Taylor & Francis Ltd, Abingdon
T2  - Supportive Care in Cancer
T1  - Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome
VL  - 20
IS  - 5
SP  - 523
EP  - 531
DO  - 10.1080/10253890.2017.1368488
ER  - 

@article{
author = "Popović, Dejana and Damjanović, Svetozar S. and Đorđević, Tea and Martić, Dejana and Ignjatović, Svetlana and Milinković, Neda and Banović, Marko and Lasica, Ratko and Petrović, Milan and Guazzi, Marco and Arena, Ross",
year = "2017",
abstract = "Objectives: Despite considerable knowledge regarding the importance of stress in coronary artery disease (CAD) pathogenesis, its underestimation persists in routine clinical practice, in part attributable to lack of a standardized, objective assessment. The current study examined the ability of stress hormones to predict CAD severity and prognosis at basal conditions as well as during and following an exertional stimulus.Materials and methods: Forty Caucasian subjects with significant coronary artery lesions (50%) were included. Within 2 months of coronary angiography, cardiopulmonary exercise testing (CPET) on a recumbent ergometer was performed in conjunction with stress echocardiography (SE). At rest, peak and after 3min of recovery following CPET, plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and NT-pro-brain natriuretic peptide (NT-pro-BNP) were measured by immunoassay sandwich technique, radioimmunoassay, and radioimmunometric technique, respectively. Subjects were subsequently followed a mean of 3210months.Results and discussion: Mean ejection fraction was 56.7 +/- 9.6%. Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a significantly lower plasma cortisol levels during CPET compared to those with 3-SCA (p lt .05), whereas ACTH and NT-pro-BNP were not significantly different (p>.05). Among CPET, SE, and hormonal parameters, cortisol at rest and during CPET recovery demonstrated the best predictive value in distinguishing between 1-, 2-, and 3-SCA [area under ROC curve 0.75 and 0.77 (SE=0.11, 0.10; p=.043, .04) for rest and recovery, respectively]. Cortisol peak/rest predicted cumulative cardiac events (area under ROC curve 0.75, SE=0.10, p=.049).Conclusions: Cortisol at rest and following an exercise test holds predictive value for CAD severity and prognosis, further demonstrating a link between stress and unwanted cardiac events.",
publisher = "Taylor & Francis Ltd, Abingdon",
journal = "Supportive Care in Cancer",
title = "Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome",
volume = "20",
number = "5",
pages = "523-531",
doi = "10.1080/10253890.2017.1368488"
}

Popović, D., Damjanović, S. S., Đorđević, T., Martić, D., Ignjatović, S., Milinković, N., Banović, M., Lasica, R., Petrović, M., Guazzi, M.,& Arena, R.. (2017). Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome. in Supportive Care in Cancer
Taylor & Francis Ltd, Abingdon., 20(5), 523-531.
https://doi.org/10.1080/10253890.2017.1368488

Popović D, Damjanović SS, Đorđević T, Martić D, Ignjatović S, Milinković N, Banović M, Lasica R, Petrović M, Guazzi M, Arena R. Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome. in Supportive Care in Cancer. 2017;20(5):523-531.
doi:10.1080/10253890.2017.1368488 .

Popović, Dejana, Damjanović, Svetozar S., Đorđević, Tea, Martić, Dejana, Ignjatović, Svetlana, Milinković, Neda, Banović, Marko, Lasica, Ratko, Petrović, Milan, Guazzi, Marco, Arena, Ross, "Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome" in Supportive Care in Cancer, 20, no. 5 (2017):523-531,
https://doi.org/10.1080/10253890.2017.1368488 . .

TY  - JOUR
AU  - Popović, Dejana
AU  - Martić, Dejana
AU  - Đorđević, Tea
AU  - Pešić, Vesna
AU  - Guazzi, Marco
AU  - Myers, Jonathan
AU  - Mohebi, Reza
AU  - Arena, Ross
PY  - 2017
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2877
AB  - Background: Revascularization appears to be beneficial only in patients with high levels of ischemia. This study examined the utility of gas analysis during the recovery phase of cardiopulmonary exercise testing (CPET) in predicting coronary artery disease (CAD) severity and prognosis. Methods: 40 Caucasian patients (21.2% females), mean age 63.5 +/- 7.6 with significant coronary artery lesions (>= 50%) were studied. Within two months of coronary angiography, CPET on a treadmill (TM) and recumbent ergometer (RE) were performed on two visits 2-4 days apart; subjects were subsequently followed 32 +/- 10 months. Myocardial wall motion was recorded by echocardiography at rest and peak exercise. Ischemia was quantified by the wall motion score index (WMSI). Results: Mean ejection fraction was 56.7 +/- 9.6%. Patients with 1-2 stenotic coronary arteries (SCA) showed a poorer CPET response during the recovery phase than patients with 3-SCA. ROC analysis revealed the change of carbon-dioxide output (Delta VCO2) recovery/peak (area under ROC curve 0.77, p = 0.02, Sn = 87.5%, Sp = 70.4%) and oxygen uptake (Delta VO2) recovery/peak during TM CPET (area under ROC curve 0.76, p = 0.03, Sn 75.0%, Sp 77.8%) were significant in distinguishing between 1-2-SCA and 3-SCA. The same variables predicted.WMSI peak/rest on univariate analysis (p  lt  0.05). Multivariate Cox analysis revealed a high predictive value of Delta VO2 recovery/peak obtained during TM CPET for composite endpoint of cumulative cardiac events (HR = 1.27, CI = 1.07-1.51, p = 0.008). Conclusions: The current study suggests CPET parameters in recovery hold predictive value for CAD severity and prognosis. TM testing seems to be a better approach in the assessment of CAD severity and prognosis.
PB  - Elsevier Ireland Ltd, Clare
T2  - International Journal of Cardiology
T1  - Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome
VL  - 248
SP  - 39
EP  - 45
DO  - 10.1016/j.ijcard.2017.06.107
ER  - 

@article{
author = "Popović, Dejana and Martić, Dejana and Đorđević, Tea and Pešić, Vesna and Guazzi, Marco and Myers, Jonathan and Mohebi, Reza and Arena, Ross",
year = "2017",
abstract = "Background: Revascularization appears to be beneficial only in patients with high levels of ischemia. This study examined the utility of gas analysis during the recovery phase of cardiopulmonary exercise testing (CPET) in predicting coronary artery disease (CAD) severity and prognosis. Methods: 40 Caucasian patients (21.2% females), mean age 63.5 +/- 7.6 with significant coronary artery lesions (>= 50%) were studied. Within two months of coronary angiography, CPET on a treadmill (TM) and recumbent ergometer (RE) were performed on two visits 2-4 days apart; subjects were subsequently followed 32 +/- 10 months. Myocardial wall motion was recorded by echocardiography at rest and peak exercise. Ischemia was quantified by the wall motion score index (WMSI). Results: Mean ejection fraction was 56.7 +/- 9.6%. Patients with 1-2 stenotic coronary arteries (SCA) showed a poorer CPET response during the recovery phase than patients with 3-SCA. ROC analysis revealed the change of carbon-dioxide output (Delta VCO2) recovery/peak (area under ROC curve 0.77, p = 0.02, Sn = 87.5%, Sp = 70.4%) and oxygen uptake (Delta VO2) recovery/peak during TM CPET (area under ROC curve 0.76, p = 0.03, Sn 75.0%, Sp 77.8%) were significant in distinguishing between 1-2-SCA and 3-SCA. The same variables predicted.WMSI peak/rest on univariate analysis (p  lt  0.05). Multivariate Cox analysis revealed a high predictive value of Delta VO2 recovery/peak obtained during TM CPET for composite endpoint of cumulative cardiac events (HR = 1.27, CI = 1.07-1.51, p = 0.008). Conclusions: The current study suggests CPET parameters in recovery hold predictive value for CAD severity and prognosis. TM testing seems to be a better approach in the assessment of CAD severity and prognosis.",
publisher = "Elsevier Ireland Ltd, Clare",
journal = "International Journal of Cardiology",
title = "Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome",
volume = "248",
pages = "39-45",
doi = "10.1016/j.ijcard.2017.06.107"
}

Popović, D., Martić, D., Đorđević, T., Pešić, V., Guazzi, M., Myers, J., Mohebi, R.,& Arena, R.. (2017). Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome. in International Journal of Cardiology
Elsevier Ireland Ltd, Clare., 248, 39-45.
https://doi.org/10.1016/j.ijcard.2017.06.107

Popović D, Martić D, Đorđević T, Pešić V, Guazzi M, Myers J, Mohebi R, Arena R. Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome. in International Journal of Cardiology. 2017;248:39-45.
doi:10.1016/j.ijcard.2017.06.107 .

Popović, Dejana, Martić, Dejana, Đorđević, Tea, Pešić, Vesna, Guazzi, Marco, Myers, Jonathan, Mohebi, Reza, Arena, Ross, "Oxygen consumption and carbon-dioxide recovery kinetics in the prediction of coronary artery disease severity and outcome" in International Journal of Cardiology, 248 (2017):39-45,
https://doi.org/10.1016/j.ijcard.2017.06.107 . .