Lucia Agoston-Coldea

By Lucia Agoston-Coldea, Teodora Mocan and Silvia Lupu

Part of the book: Coronary Angiography

By Lucia Agoston-Coldea and Silvia Lupu

Part of the book: Hot Topics in Echocardiography

By Lucia Agoston-Coldea, Carmen Cionca and Silvia Lupu

Coronary computed tomography angiography (CCTA) is used extensively nowadays as a non-invasive imaging method for the evaluation of patients suspected of coronary artery disease, providing data on calcium burden, the presence of coronary artery stenoses, but also, more recently, on coronary atherosclerotic plaque morphology and composition. Plaque morphology analysis by CCTA aims to accurately identify vulnerable plaques, in an attempt to reduce the number of ischemic events triggered by high-risk atherosclerotic lesions. Recent research provides CCTA descriptions of vulnerable plaques and a particular radiological sign shows promising perspectives. The napkin-ring sign refers to a rupture-prone plaque in a coronary artery, comprising a necrotic core covered by a thin cap fibro-atheroma. The napkin-ring sign is described on CCTA in cross-sectional images of coronary arteries as a central low-attenuation area surrounded by an open ring area of high attenuation, having a high specificity and positive predictive value for the presence of advanced lesions. These lesions have been designated as vulnerable plaques, indicating an increased probability of rupture, and were shown to correlate with a higher incidence of cardiovascular events. In acute coronary syndromes, the location of the napkin-ring sign was shown to correspond to the culprit lesions. The aim of the current paper is to provide an overview of the current literature on available methods for quantitative measurement of atherosclerotic plaque features from CCTA and to discuss the clinical implications of the napkin-ring sign as detected by CCTA.

Part of the book: Coronary Artery Disease

By Lucian Mocan, Ofelia Mosteanu, Teodora Pop, Lucia Agoston- Coldea, Cornel Iancu, Teodora Mocan and Furcea Luminita

There are about 500,000 new cases of cancer of the esophagus and 400,000 esophageal cancer-related deaths recorded annually around the world. The disease is three to four times more frequent in men than in women, being the sixth most common cancer and the fifth most frequent cancer-related death among men. The prognosis of esophageal cancer is quite poor, despite advances in surgical procedures (two-field and three-field lymph node dissection) and perioperative management, which is still controversial. The use of chemotherapy and radiotherapy in combination with surgery might be a new approach for future treatment. Progress in optical technology has led to the development of a new minimally invasive surgical approach for the treatment of esophageal cancer, namely esophagectomy.

Part of the book: Esophageal Abnormalities

By Alexandru Zlibut, Lucia Agoston-Coldea, Teodora Mocan, Ioana Corina Bocsan and Lucian Mocan

Nowadays, biomarkers are useful in the early detection and risk stratification of metabolic syndrome (MetS) patients. Studies confirmed the implication of adipokines, neuropeptides, inflammatory cytokines, prothrombotic factors, and others in MetS pathogenesis. Leptin:adiponectin ratio is useful in predicting insulin resistance and MetS severity; leptin is correlated with obesity and waist size and adiponectin is inversely related with MetS components. Ghrelin is inversely correlated with MetS components, and studies confirmed its role in MetS prediction. Regarding the pro-inflammatory cytokines, studies confirmed that interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha are positively correlated with hypertriglyceridemia, hypertension, fasting glucose levels, insulin resistance, and in postmenopausal women with central obesity. Oxidized low-density lipoprotein (LDL) levels could be implicated in insulin resistance. Recent studies also confirmed that novel biomarkers such as pentraxin-3 are positively correlated with MetS severity and the presence of vascular lesions, and it could bring new data on the MetS mechanism. Within this chapter, we review data on the contribution of biomarkers as well as on the stratification of MetS patients, discussing their key contribution for creating a risk assessment algorithm.

Part of the book: Ultimate Guide to Insulin