Vaškelytė, Jolanta Justina
Item type:Publication, conference paper[2026][P1f][M001][7]; Kardiologijos praktika : Kauno krašto kardiologų draugijos konferencija "Širdies vožtuvų patologija ir antitrombozinis gydymas kardiologijoje – skirtingos problemos ir jų bendrystė" : 2026 kovo 24 d. : Konferencijos pranešimų tezės/straipsniai, 2026-05-01, no. 2, p. 5-11Funkcinis mitralinio ar triburio vožtuvo nesandarumas yra dažnos širdies vožtuvų patologijos, atsirandančios dėl širdies ertmių remodeliacijos ir vožtuvų aparato geometrinių pokyčių, kai vožtuvų burės išlieka struktūriškai nepažeistos. Pastaraisiais metais vis daugiau dėmesio skiriama mitralinio ir triburio vožtuvų nesandarumo fenotipavimui. Echokardiografija išlieka pagrindiniu diagnostikos metodu, leidžiančiu įvertinti vožtuvų anatomiją, regurgitacijos mechanizmą, sunkumą bei širdies ertmių struktūrinius pokyčius. Svarbu anksti diagnozuoti šias patologijas, siekiant laiku parinkti tinkamą gydymo strategiją, kuri gali apimti medikamentinį gydymą, ritmo kontrolę esant prieširdžių virpėjimui bei chirurgines ar kateterines intervencijas. Išmanant funkcinio mitralinio ir triburio vožtuvų nesandarumo mechanizmus galima geriau įvertinti ligos progresavimą ir pagerinti pacientų prognozę.
20 Item type:Publication, journal article[2025][S1][M001][10]; ; ; ; Medicina, 2025-11-13, vol. 61, no. 11, p. 1-10Background and Objectives: Cardiac myxoma (CM) is the most common primary benign neoplasm of the heart. This study’s objective was to analyse diagnostic features of CM, surgical data and postoperative courses of patients over a 20-year period in a single institution. Materials and Methods: We conducted a retrospective analysis of patients with diagnosed and pathologically confirmed CM who underwent surgical resection in our hospital from 1 January 2004 to 1 January 2024. Data was assessed and analysed from medical records. Results: The study included 76 patients (mean age, 61.7 ± 12.6 years; 60.5% female). The majority of patients (93.7%) had symptoms, most commonly presenting with dyspnoea (64.5%), chest pain (39.5%) and arrhythmias (35.5%). Myxomas were found in the left atrium (89.5%), right atrium (9.2%) and left ventricle (1.3%). Isolated tumour extirpation surgery was performed in 50 patients (65.8%). During the early postoperative period, arrhythmias were the most common complication (n = 16, 21.1%). Early in-hospital mortality occurred in two patients due to cardiopulmonary failure. In the late postoperative period, 11 deaths (14.9%) were observed 4 to 17.5 years after surgery. No recurrence of CM was found in any patient during the follow-up period, yet tumours of other localisations were detected in nine patients. Conclusions: Surgery is the first-line treatment for CM, with a good prognosis. Although during the late postoperative period no cardiac tumour recurrence was observed in our study, 12.2% patients were newly diagnosed with non-cardiac neoplasms. Therefore, we suggest monitoring patients not only for cardiac disorders but also for the occurrence of extracardiac tumours.
28WOS© Citations 2 Item type:Publication, [Anotuoto mašininio mokymosi pritaikomumas plaučių auskultacinėje diagnostikoje, esant skirtingiems Gauso triukšmo lygiams]doctoral thesis[2025][R1][M001][197]; ; ; ; ; Lung auscultation has long been essential for pulmonary assessment, yet it still faces challenges due to ambient noise in clinical settings. While supervised machine learning (ML) shows diagnostic promise, most studies overlook noise effects and human-ML comparisons. As a result, there is a paucity of knowledge on how to safely integrate this technology as a diagnostic assistant in the clinical field. A prospective study was created to compare 45 medical students and 24 spectrogram-based vs. scalogram-based ML models' ability to correctly classify three lung sound classes under three Gaussian white noise (GWN) levels (no GWN added, SNR-40, SNR-20). A proprietary database of three classes of lung sounds: normal, continuous and discontinuous adventitious sounds was created from 108 patients and 250 recordings. The 250 lung sound recordings were used for training and assessment at an 80/20 split. GWN was added to assessment recordings used at SNR-40 (medium level) and SNR-20 (high level). Study group performances were compared via PR-AUC, ROC-AUC, Matthews correlation coefficient, sensitivity, and specificity. The results show that spectrogram ML outperformed scalogram (0.837 vs 0.735 ROC-AUC, P < 0.001). Spectrogram-based Histgradient ML was one of the best-performing models, surpassing students for discontinuous sounds identification in quiet conditions and medium (SNR-40) (P = 0.002). In contrast, students outperformed ML in high noise (SNR-20) (P = 0.009). Therefore, machine learning models can potentially aid healthcare workers as a clinical assistant.
31 6 Item type:Publication, research article[2025][S1][M001][8]; ; ; ; ; ; Perfusion, 2025-04-01, vol. 40, no. 3, p. 605-612Patients with primary mitral regurgitation (MR) usually remain asymptomatic for a long time due to compensatory mechanisms and an adequate treatment could be delayed. Stress echocardiography and speckle-tracking analysis could help to evaluate impaired left atrium (LA) function before the manifestation of clinically significant myocardial changes in asymptomatic patients with primary MR and preserved left ventricular (LV) ejection fraction (EF).
63 2 - book[2024][K2a1][M001][627]
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Kaunas : LSMU Akademinė leidyba, 2024-12-12Jūsų rankose - Lietuvos sveikatos mokslų universiteto vadovėlis „Kardiologijos pagrindai“. Tai platus ir svarus leidinys, apimantis sindrominę diagnostiką, paciento tyrimo metodiką, kardiologijoje naudojamų vaistų klinikinę farmakologiją, vaizdinius širdies ligų tyrimo metodus, genetinius širdies ligų tyrimus bei tam tikrų širdies ir kraujagyslių ligų profilaktiką, diagnostiką, gydymą ir reabilitaciją. Vadovėlį rengė LSMU Kardiologijos klinikos, Vidaus ligų klinikos, Širdies, krūtinės ir kraujagyslių chirurgijos klinikos, Reabilitacijos klinikos, Anesteziologijos klinikos, Genetikos ir molekulinės medicinos klinikos, Onkologijos ir hematologijos klinikos, Fiziologijos ir farmakologijos instituto bei Kardiologijos instituto darbuotojai, iš viso 68 autoriai, todėl kiekvieną skyrių rašė geriausi tos srities specialistai. Pastarasis dešimtmetis medicinoje išsiskyrė įrodymais grįstos medicinos įsigalėjimu, diagnostikai bei gydymui naudojamų technologijų sudėtingumu ir įvairove, labai greitu mokslo bei technikos naujovių įdiegimu į kasdieninę klinikinę praktiką. Todėl tikslinga atnaujinti kardiologijos vadovėlį, kuris taptų ne vien priemone studentams mokyti, bet ir kiekvieno gydytojo rezidento, vidaus ligų gydytojo, kardiologo parankine knyga. Laikas bėga labai greitai, todėl net rengiant šį vadovėlį keitėsi daugelio ligų diagnostikos bei gydymo rekomendacijos, nes greita mokslo pažanga ir nauji duomenys nuolat keičia mūsų požiūrį į daugelį dalykų, kurie atrodė aiškūs ir nusistovėję. Todėl siūlome skaitytojui priimti skaitomą medžiagą kaip geriausią šiuo metu turimą informaciją ir kardiologinės patologijos sampratą, tačiau kartu palikti protą atvirą naujovėms, kurios gali ateiti plečiantis mūsų žinioms visose medicinos srityse. Dėkojame visiems, prisidėjusiems prie vadovėlio „Kardiologijos pagrindai“ išleidimo: autoriams, recenzentams, kalbos redaktorei, leidėjams, o ypač rėmėjams, be kurių pagalbos šis leidinys nebūtų išvydęs dienos šviesos.
851 1 Item type:Publication, research article[2024][S1][M001][14]; ; ; ; ; ; ; ; ; ; ; ; ; Cancers, 2024-11-12, vol. 16, no. 22, p. 1-14Background: Hematopoietic stem cell transplantation (HSCT) is a potentially curative procedure that is used in various hematological malignancies. However, among an increasing number of HSCT, the amount of cancer therapy-related cardiac dysfunction (CTRCD) is increasing as well. This study aimed to determine the prevalence of subclinical CTRCD in HSCT patients 12 months after HSCT and to assess the impact of clinical factors on the development of CTRCD. Material and Methods: We included 55 patients who underwent autologous or allogeneic HSCT. The patients were assessed using an echocardiography method before and 12 months after a HSCT procedure. Results: Our study revealed that during the 12-month follow-up period, asymptomatic CTRCD was observed in 15 patients (27.3%), 6 experienced moderate CTRCD, and 9 experienced mild CTRCD. Patients with previous use of anthracyclines tended to have CTRCD more often: nine patients (60%) in the CTRCD group and nine patients (22.5%) in non-CTRCD group. Patients who received the BEAM regimen for conditioning also experienced CTRCD more often: five patients (33.3%) in CTRCD group vs. two patients (5%) in the non-CTRCD group. Conclusions: Our study showed that asymptomatic CTRCD was found in 27.3% of the patients 12 months after HSCT. The BEAM chemotherapy conditioning protocol following prior anthracycline use were identified as factors contributing to the development of CTRCD.
59WOS© Citations 1 Item type:Publication, research article[2024][S1][M001][15]; ; ; ; ; ; ; Diagnostics (Basel, Switzerland), 2024-11-10, vol. 14, no. 22, p. 1-15While tricuspid annuloplasty (TAP) is an effective treatment option for tricuspid regurgitation (TR), understanding the echocardiographic factors contributing to recurrent TR can help in developing more effective preventive measures to reduce the rate of recurrent TR after TAP.
41 Item type:Publication, conference paper[2024][T1a][M001][2]; ; ; ; ; European Heart Journal : ESC Congress 2024 30 August – 02 September London, UK : Abstract Supplement, 2024-10-28, vol. 45, no. Suppl. 1, p. 1-2INTRODUCTION The increasing worry revolves around the reappearance of tricuspid regurgitation (TR) following tricuspid annuloplasty (TA) among individuals dealing with functional tricuspid regurgitation (FTR). Despite TA's efficacy as a treatment, a complete understanding of the echocardiographic elements influencing the recurrence of TR is pivotal. This knowledge holds the potential to guide the development of more robust preventive strategies, aiming to ease the incidence of recurrent TR after TA.
AIM The aim of this study was to examine the prognostic value of tricuspid valve (TV) and echocardiographic parameters related to both right ventricular (RV) geometry and function. Specifically, our focus is on understanding these relationships in the context of recurrent TR following TA.
METHODS This prospective observational cohort study aimed to investigate determinants of recurrent TR post-surgical TV repair. The focus was on patients with moderate or severe functional TR related to left heart valvular disease, primarily severe mitral regurgitation, excluding those with ischemic heart disease. The study involved 66 participants, assessed preoperatively with 2D and 3D echocardiography, examining RV and right atrial (RA) geometry, functional, and TV parameters. TR severity followed ESC guidelines. Two groups were formed: effective TA group (50 patients) and recurrent TR group (16 patients), defined by mild to moderate TR and significant moderate-severe TR one year post-surgery, respectively. Statistical analysis employed SPSS software, with adjusted univariate logistic regression considering age and gender.
RESULTS Of the patients, 54% were male, with a mean age of 68±9 years. Echocardiography parameters in Table 1 showed no significant differences in gender, left ventricular, atrial geometrical, functional parameters, or preoperative effective regurgitant TV orifice area between groups (recurrent TR vs. effective TA: 38 [33] mm2 vs. 29 [15] mm2, p=0.117). Univariate logistic regression analysis highlighted RV and RA geometry, along with TV diameter, as predictors for recurrent TR. Notably, 3D TV geometrical parameters had prognostic significance, as confirmed by univariate adjusted logistic regression analysis. Functional RV parameters did not exhibit statistical significance in this analysis.
CONCLUSION In conclusion, the recurrence of moderate-severe functional tricuspid regurgitation following tricuspid annuloplasty is linked to the tricuspid annulus size, as well as the geometry of the right atrium and right ventricle before surgery. Notably, no correlation was identified between the recurrence of TR and alterations in RV function.
35 Item type:Publication, conference paper[2024][T1a][M001][1]; ; ; ; ; European Heart Journal : ESC Congress 2024 30 August – 02 September London, UK : Abstract Supplement, 2024-10-28, vol. 45, no. Suppl. 1, p. 1-1INTRODUCTION There is growing concern about the recurrence of tricuspid regurgitation (TR) after tricuspid annuloplasty (TA) in individuals with functional tricuspid regurgitation (FTR). While TA is effective in treating FTR, a comprehensive understanding of the echocardiographic factors influencing TR recurrence is crucial.
AIM This study aims to employ multivariate regression analysis to investigate the prognostic significance of tricuspid valve (TV) geometry and echocardiographic parameters associated with both RV geometry and function. The focus is on comprehending these relationships in the context of recurrent TR subsequent to TA.
METHODS This prospective observational cohort study aimed to explore factors contributing to recurrent tricuspid regurgitation (TR) after tricuspid annuloplasty (TA). The focus was on patients with moderate or severe functional TR due to left heart valvular disease, particularly severe mitral regurgitation, excluding those with ischemic heart disease. The cohort included 66 individuals undergoing preoperative assessments with 2D and 3D echocardiography, quantifying RV and right atrial (RA) geometry, functional, and tricuspid valve (TV) parameters. TR severity followed ESC guidelines. Patients were categorized into effective TA (50 patients) and recurrent TR (16 patients) groups, defined by mild-moderate TR and significant moderate-severe TR one year post-surgery, respectively. SPSS software facilitated statistical analysis, with adjusted logistic regression considering parameters such as age and gender.
RESULTS Among the patients (54% male, mean age 68±9 years), no significant differences were found in gender, left ventricular and atrial parameters, or preoperative TV orifice area between groups (recurrent TR vs. effective TA: 38 [33] mm2 vs. 29 [15] mm2, p=0.117). Univariate logistic regression analysis identified Septal-Lateral Systolic TA Diameter (OR 1.62), Septal-Lateral Diastolic TA Diameter (OR 1.99), and Major Axis Diastolic TA Diameter (OR 1.59) as key predictors. For diagnostic efficacy, ROC analysis revealed Major Axis Diastolic TA Diameter (AUC 0.848; cut-off 52.5 mm), TV Leaflet Tenting Volume (AUC 0.778; cut-off 5.1 ml), and RV Basal Diameter (AUC 0.763; cut-off 47.5 mm) as the most predictive parameters. The combined use of predefined RV basal diameter and Major Axis Diastolic TA Diameter showed the highest odds ratio for recurrent TR.
CONCLUSION Key predictors, including Septal-Lateral Systolic and Diastolic TA Diameters, and Major Axis Diastolic TA Diameter, were identified, emphasizing their significance in understanding TR recurrence after tricuspid annuloplasty. The combination of predefined RV basal diameter and Major Axis Diastolic TA Diameter showed the highest odds ratio for recurrent TR, offering valuable insights for clinical assessment and preventive strategies.
22 Item type:Publication, conference poster[2024][T1a][M001][2]; ; ; ; ; ; ; ; ; ; ; ; ; Bone Marrow Transplantation : The 50th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians – Poster Session (P001-P755), 2024-10-08, vol. 59, no. Suppl. 1, p. 568-569Background: Hematopoietic stem cell transplantation (HSCT) can cause cardiac toxicity of different grade. In this study we aimed to evaluate the impact of mobilization procedure for autologous HSCT process on left and right ventricle sizes and systolic function. Methods: Data of 35 patients undergoing autologous HSCT at the Department of Oncology and Hematology in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics from October 2021 till Feb 2023 were analyzed. Bioethics approvement for prospective study was obtained (No BE-2-96). HSCT was performed for various reasons – mostly multiple myeloma, also mantle cell lymphoma, Hodgkin lymphoma, diffuse large B cell lymphoma, Ewing sarcoma. All patients underwent hematopoietic stem cell mobilization with chemotherapy and filgrastim 10 µg/kg/d. Echocardiography was performed before enrolling to the transplantation process and after mobilization before the conditioning regimen. Left ventricular end diastolic diameter (LVEDD), LVEDD index according to body surface area (BSA) (LVEDDi), left ventricular ejection fraction (LV EF), left ventricular global longitudinal strain (GLS), right ventricle (RV) end diastolic diameter (RVEDD, tricuspid annular systolic velocity (S’) using tissue doppler and tricuspid annular plane systolic excursion (TAPSE) were measured before and after mobilization and compared. Statistical analysis was performed using SPSS statistics 20. Qualitative data is presented as an absolute value (N) and percentage (%), quantitative parameters are given as average (m ± standard deviation). We used paired- samples T test to compare quantitative parameters. Statistically significant difference was considered when p<0.05. Results: Out of 35 patients there were 18 men (51,4%) and 17 women (48,6%). Mean age was 57,4±13,15 years, ranging from 18 to 74. 26 (74,3%) patients had multiple myeloma, 4 (11,4%) mantle cell lymphoma, 2 (5,7%) Hodgkin ‘s lymphoma, 2 (5,7%) PCNS diffuse large B cell lymphoma, 1 (2,9%) Ewing sarcoma. Statistically significant difference was observed in the change of RV function. S‘ and TAPSE slightly decreased. Changes of echocardiographic parameters are presented in Table 1. Conclusions: Mobilization procedure in patients undergoing autologous HSCT is associated with reduced RV systolic function. S‘ and TAPSE might be used for early cardiotoxicity evaluation in HSCT patients.
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