Plisienė, Jurgita
Item type:Publication, conference output[2026][T2][M001][1]; ; ; ; ; ; Įgimtosios širdies ydos: Daugiadalykės komandos priežiūra visą gyvenimą : 2026/04/24 : Abstraktų knyga, 2026-04-24, p. 4-4Background. Improved survival in congenital heart disease (CHD) has increased the number of adults at risk of acquired cardiovascular disease (CVD). In patients with pulmonary hypertension (PH), diagnosing coronary artery disease (CAD) is challenging due to atypical symptoms and baseline abnormalities. The aim of this case is to highlight the diagnostic complexity and clinical importance of CAD in CHD with PH. Case Report. A 58-year-old man with Eisenmenger syndrome from an unrepaired aortopulmonary window and severe PH was followed at a specialized PH center. His history included arterial hypertension, heart failure, dyslipidemia, hyperuricemia, and prior pulmonary embolism (PE). In 2023, he presented with progressive dyspnea without chest pain. ECG showed right ventricular (RV) hypertrophy and overload, while echocardiography confirmed severe PH, RV dysfunction, and preserved left ventricular function. Suspected acute PE was excluded by computed tomography. Coronary angiography, initially performed to assess possible compression of the left coronary ostium by a dilated pulmonary trunk, revealed significant two-vessel CAD. Elevated troponin I confirmed non-ST elevation myocardial infarction (MI). Percutaneous coronary intervention (PCI) was successfully performed. Despite optimized therapy and a normal lipid profile, the patient experienced two recurrent MI requiring PCI, along with progressive right heart failure. Evaluation for heart–lung transplantation is ongoing. Conclusions. Adults with CHD and PH are at increased risk of CAD, often presenting atypically. Baseline abnormalities on ECG, echocardiography may delay diagnosis of acute coronary syndromes. This case underscores the need for high clinical suspicion, timely evaluation, and multidisciplinary management to improve outcomes in ACHD population.
4 Item type:Publication, research article[2026][S1][M001][13]; ; ; ; ; ; ; ; ; ; ; ; ; Medicina, 2026-03-20, vol. 62, no. 3, p. 1-13Background and Objectives: Transcatheter aortic valve replacement (TAVR) in large aortic annuli poses challenges due to limited valve-size options and increased complication risks. The aim is to evaluate the safety and performance of XL sizes (30.5 mm and 32 mm) of the Myval transcatheter heart valve (THV) for treating patients with severe aortic stenosis and large aortic annuli. Material and Methods: This retrospective observational study included consecutive patients undergoing TAVR with XL sizes of the Myval THV between December 2023 and December 2024 at a single centre. During this period, 146 TAVI procedures were performed, of which 15 patients (10.3%) with large aortic annuli (mean systolic annular area 786.5 ± 48.2 mm2) received XL valves and were included in the present analysis. Patients were followed up at discharge, 3–6 months, and 1 year. Patient evaluation included echocardiography and clinical assessments following the Valve Academic Research Consortium-3 criteria. Results: All patients were male, with a mean age of 79.1 ± 5.9 years. Technical success was achieved in 100% of cases. At discharge, none of the patients had moderate or greater paravalvular leakage (PVL); 11 patients had no PVL, while 1 had trace and 3 had mild PVL. The mean effective orifice area (EOA) improved from 0.75 ± 0.15 cm2 at baseline to 2.31 ± 0.21 cm2 at discharge (p < 0.0001). At the 12-month follow-up, the mean EOA was 2.4 ± 0.3 cm2, and no moderate or severe PVL or major adverse clinical outcomes were observed. One patient required a permanent pacemaker implantation due to an atrioventricular block. Conclusions: The XL sizes of Myval THV showed both safety and efficacy in patients with large aortic annuli, demonstrating acceptable hemodynamic performance and low complication rates. However, large-scale studies with longer follow-ups are needed to validate these findings in diverse populations.
38 Item type:Publication, conference output[2026][T1e][M001][2]; ; 10th International Health Sciences Conference IHSC : March 5th-6th, 2026 : Abstract book / Edited by Beatrice Ziulyte, Karina Zerr, Gabija Varkuleviciute & Ignas Jusis, 2026-03-05, p. 45-46Introduction Cardiovascular diseases account for over half of all deaths in Lithuania, representing one of the highest proportions in the European Union [1]. Acute coronary syndrome (ACS) is associated with a high risk of recurrent cardiovascular events [2]. Although European guidelines strongly emphasize lifestyle modification and pharmacological therapy for secondary prevention, realworld adherence—particularly to lifestyle recommendations—remains suboptimal and represents a major barrier to effective risk reduction [3]. Aim To evaluate adherence to lifestyle and pharmacological recommendations after ACS and to assess whether physician advice was associated with patients’ subsequent efforts to modify lifestyle behaviours. Methods This cross-sectional study included 160 patients (mean age 62.7±9.0 years) assessed 6–12 months after ACS within a EUROASPIRE-based framework. Physical activity was assessed using weekly metabolic equivalent minutes (MET-min/week); adequate activity was defined as ≥600 MET-min/week. Lifestyle adherence analyses were limited to patients who reported receiving relevant recommendations. Smoking analyses included patients who smoked at the index event. Weight loss analyses were limited to patients with body mass index (BMI) ≥25 kg/m², with additional stratification by BMI 25–30 and ≥30 kg/m². Pharmacological therapy at discharge and current use were recorded. Chi-square or Fisher’s exact tests were applied (p85% for most drug classes), lifestyle modification remained limited after ACS. Among advised patients, only 26.3% of insufficiently active individuals improved physical activity and 40.9% of smokers achieved cessation at follow-up. These findings suggest that physician advice alone may be insufficient to achieve sustained behavioural change and underscore the need for structured, long-term strategies to improve secondary prevention outcomes.
17 Item type:Publication, research article[2026][S1][M001][10]; ; ; ; ; Stress echocardiography (SE) is widely used for assessing coronary artery disease, but volumetric chamber analysis during SE is limited by time-consuming manual tracings and operator-dependent variability. Automated evaluation may overcome these barriers and enhance efficiency.
50WOS© Citations 2 Item type:Publication, book[2025][K1a][M001][574]; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Kaunas : Medicininės informacijos centras, 2025-12-31Nutukimas - viena aktualiausių dabartinės visuomenės problemų, neigiamai veikianti daugelį organizmo sistemų ir trikdanti sergančiojo šia liga gyvenimo kokybę, darbingumą bei trumpinanti gyvenimą. Tai - metaboliškai aktyvi ir recidyvuojanti liga, kurios metu kūno masė didėja riebalinio audinio sąskaita. Nutukimą kaip ligą Amerikos medicinos asociacija oficialiai pripažino 2013 metais. Nutukimas pastaruoju metu yra labiausiai aptarinėjama tema tiek medicinos, tiek plačiojoje visuomenėje. Kalbant apie nutukimą, dažnai ši būklė siejama su asmeniniu kaltės priskyrimu: „reikia tik noro“, „reikia suimti save į rankas“ ir t. t. Įvairiais istoriniais laikotarpiais požiūris į žmogaus kūno formas keitėsi nuo Rubenso tipo moterų iki anoreksinių mados manekenių formų. Menamų kūno formų standartų neatitinkantis žmogus gali būti pavadintas putliu, stambiu, apkūniu, didelio dydžio ar net storuliu ar apsileidusiu. Medicinos bendruomenėje vyrauja terminai: antsvoris, hipotalaminis, pilvinis, centrinio tipo, kušingoidinis, morbidinis nutukimas ir kt. Nutukimas turi kompleksines pasekmes - skatina lėtines ligas, galinčias sutrumpinti žmogaus amžių 10-15 metų. Per pastaruosius 5 dešimtmečius nutukimo paplitimas pasaulyje padidėjo daugiau nei 3 kartus, ir dabar tai įvardijama kaip nutukimo pandemija. Klinikinėje praktikoje nustatomos įvairiausios nutukimo priežastys - nuo genetinių (Prader-Willi sindromas, Aistrom sindromas, LEPR (leptino receptoriaus) ar LEP (leptino) geno mutacijos ir kt.), endokrininių (hipotirozė, hiperkorticizmas, hipogonadizmas ir kt.) iki valgymo priklausomybių. Skirtingos yra ir nutukusių kūno formos bei kūno kompozicija. Todėl kūno masės indeksas (KMI) klinikiniu požiūriu jau nebetenka prasmės. KMI tikslinga naudoti populiaciniams, palyginamiesiems tyrimams. Statistiniais duomenimis (HIS Lietuva, Eurostat, 2019-2022 m.), pagal KMI nutukusių suaugusių Lietuvoje buvo 21-23 proc. Skaičiuojama, kad apie 60 proc. suaugusiųjų Lietuvoje turi antsvorio ar yra nutukę. Tai - tik statistika, neatspindinti konkrečios individo būklės. 2025 m. pasaulio 58 ekspertų grupė, atstovaujanti įvairioms medicinos specialybėms ir šalims, išanalizavo turimus įrodymus ir, pritarus 75 medikų ir pacientų organizacijoms, rekomendavo klasifikaciją, kurioje išskiriamas ikiklinikinis ir klinikinis nutukimas. Pagal epidemiologinius ir klinikinius duomenis, nutukimas susijęs su daugiau nei 200 skirtingų ligų ir sveikatos sutrikimų. [...]
47 Item type:Publication, conference output[2025][T1e][M001][2]; ; ; ; Revista Portuguesa de Clínica Geral e Familiar : 25th WONCA World Conference – Abstract Book : 17 – 21 September 2025, Lisbon, Portugal, 2025-11-26, vol. 41, no. Suppl. 15, p. 21-22Introduction: Cardiovascular diseases (CVD) are the leading cau- se of death globally, responsible for over 20.5 million deaths an- nually. In 2023, 52.1% of all deaths in Lithuania were due to cir- culatory system diseases. Treating dyslipidemia is crucial for re- ducing CVD morbidity and mortality. This study aims to analyze trends in dyslipidemia treatment in Lithuania over the past five years. Methods: Health data from the “e.sveikata” system (2019–2023) was analyzed, including 978,290 patients aged 40 or older with LDL-Ch measurements. LDL-Ch levels were assessed using 1.4, 1.8, and 3 mmol/L thresholds based on 2019 European Society of Cardiology (ESC) guidelines, comparing primary and secondary CVD prevention groups, diabetes patients, and stroke (S), perip- heral artery disease (PAD), high-risk (HR), and CVD subgroups within secondary prevention. Results: Median LDL-Ch levels decreased annually in all groups. From 2019 to 2023, ESC recommended LDL-Ch targets were achieved by 37% of primary prevention patients, 5.2% of secon- dary prevention patients, and 12% of diabetes patients. In se- condary CVD prevention subgroups, target LDL-Ch was reached by 2.9% of PAD, 3.6% of stroke, 5.2% of CVD, and 7.5% of HR patients. Overall, 33% of patients reached target LDL-Ch levels. Discussion: While more Lithuanians are reaching lower LDL-Ch levels, the results remain suboptimal. Focus should be on secon- dary prevention and diabetes patients, where few reach target LDL-Ch levels. Conclusion: Median LDL-Ch levels decreased annually. The hig- hest percentage of patients achieving target LDL-Ch levels were in primary prevention, while the lowest were in secondary pre- vention.
5 Item type:Publication, research article[2025][S1][M001][11]; ; ; ; ; ; Clinical Medicine Insights: Cardiology, 2025-09-16, vol. 19, p. 1-11Background: Non-ischemic dilated cardiomyopathy (NIDCM) remains a significant part of heart failure (HF) origin, requiring more detailed investigation of the whole heart. This study aimed to examine the commonly used biomarkers in clinical practice and their relationship with early alterations in whole-heart myocardial mechanics and morphometry in patients with NIDCM. Methods: In this prospective single-center study, 98 patients (mean age 49.5 ± 10.1 years; 69.4% male) were included in the final sample during the first phase, when the diagnosis of NIDCM was made. After 1 year, 42 patients were evaluated during the second follow-up phase. The cardiac magnetic resonance was used to analyze whole-heart myocardial mechanics and morphometry. Biomarkers (troponin I, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), brain natriuretic peptide, suppression of tumorigenicity 2, and neutrophil to lymphocyte were assessed at the time of the diagnosis. Results: The strongest correlations were observed between hs-CRP levels and left atrial (LA) global longitudinal strain (GLS) changes after 1year (r=−.659, P<.001). It was revealed that the cut-off value of 3.6mg/l of hs-CRP can prognosticate to find a reduced LA GLS with a sensitivity of 100% and specificity of 87% (AUC, 0.833; 95% CI, 0.65–1.008; P<.001).Other biomarkers had weaker associations with myocardial mechanics and morphometry; relationships were established only with left heart parameters. Conclusion: In NIDCM patients, the main biomarkers of HF are related to early changes in left-heart myocardial mechanics and morphometrics. The strongest relationship was between the initial levels of hs-CRP and early changes in LA GLS.
43 Item type:Publication, research article[2025][S1][M001][8]; ; ; ; ; ; ; Echocardiography (Mount Kisco, N.Y.), 2025-09-02, vol. 42, no. 9, p. 1-8This study sought to evaluate the feasibility, accuracy, and diagnostic performance of a fully automated deep learning model for assessing left ventricular diastolic function (LVDF) using 2D transthoracic echocardiography (TTE).
49WOS© Citations 1 Item type:Publication, research article[2025][S1][M001][12]; ; ; ; ; ; Medicina, 2025-08-19, vol. 61, no. 8, p. 1-12Background and Objectives: Low-density lipoprotein cholesterol (LDL-C) reduction is critical for cardiovascular disease (CVD) prevention. This study aimed to assess the proportion of patients achieving the LDL-C target in Lithuania and to identify factors associated with target achievement. Materials and Methods: This retrospective study used anonymized health data from the Electronic Health Services and Cooperation Infrastructure Information System (ESPBI IS) in Lithuania. Adults aged ≥40 years with at least one LDL-C measurement in 2023 and no documented cancer diagnosis were included. The primary outcome was the proportion of patients achieving LDL-C < 1.8 mmol/L, the target recommended by the European Society of Cardiology guidelines for high-risk individuals. Univariate logistic regression analysis was conducted to identify factors associated with achieving the LDL-C target. Results: The study included 396,835 patients (mean age, 66.9 years). The mean LDL-C concentration was 3.32 mmol/L, and only 8.1% of patients achieved LDL-C < 1.8 mmol/L. Target achievement was higher among patients in the secondary CVD prevention group compared to primary prevention (20.6% vs. 7.3%). Over half of patients (56.4%) received no lipid-lowering therapy (LLT). Statin monotherapy was the most prescribed LLT (31.3%), while only 2.7% of patients received statin and ezetimibe combination. In logistic regression analysis, secondary prevention status, more frequent cardiologist consultations, and higher LLT prescription frequency were associated with LDL-C target achievement. Compared to patients not receiving LLT, the odds of achieving LDL-C < 1.8 mmol/L were significantly higher in those receiving statin monotherapy (odds ratio [OR]: 3.153, 95% confidence interval [CI]: 3.069–3.240), statin and ezetimibe (OR: 7.631, 95% CI: 7.267–8.013), or statin and antihypertensive (OR: 3.945, 95% CI: 3.803–4.092). Conclusions: LDL-C target attainment remains low in Lithuania, with the underuse of LLT. Broader implementation of guideline-recommended lipid-lowering strategies is needed to improve LDL-C control.
26 - research article[2025][S1][M001][7]
; ; ; ; ; ; ; ; Vascular, 2025-02-02, vol. 33, no. 1, p. 205-211The incidence of stroke after on-pump cardiac surgery during the perioperative period can affect up to 2% of patients, and is frequently linked to carotid artery disease. Notably, in patients with significant unilateral carotid artery stenosis of 80%-99%, the risk of stroke reaches 4%. Among individuals undergoing coronary artery bypass grafting (CABG), 3% to 10% exhibit significant carotid artery stenosis. To mitigate the risk of stroke and mortality, patients can undergo either simultaneous or staged carotid endarterectomy and CABG. The aim of this study was to assess whether early postoperative complications, including stroke, following simultaneous CABG/CAE procedures, correlate with morphological attributes of carotid plaque, assessed via contrast-enhanced ultrasound.
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