Discipline - Cardiology and Cardiovascular Surgery - Bucharest University Emergency Hospital

Professor Vinereanu Dragos, PhD tenured
Professor Cinteza Mircea, PhD tenured
Associate Professor Darabont Roxana Oana, PhD tenured
Associate Professor Siliste Calin, PhD tenured
Associate Professor Rimbas Roxana-Cristina, PhD tenured
Associate Professor Badiu Catalin Constantin, PhD tenured
Head of works Vintila Vlad-Damian, PhD tenured
Head of works Stoicescu Claudiu-Ionut, PhD tenured
Head of works Magda Lucia-Stefania, PhD tenured
Head of works Mihaila-Baldea Sorina, PhD tenured
Head of works Ciobanu Andrea-Olivia, PhD tenured
Head of works Mihalcea Janina-Diana, PhD tenured
Assistant Professor Suran Maria Claudia Berenice, PhD tenured
Assistant Professor Cotoban Alexandru George, PhD tenured
Assistant Professor Iacobescu Loredana Anamaria, PhD fixed term
Assistant Professor Danet Ruxandra, PhD fixed term
Assistant Professor Bratu Dan Vladimir, PhD fixed term
Assistant Professor Danet Andrei, PhD fixed term
Assistant Professor Balinisteanu Anca Elena, PhD fixed term
Assistant Professor Velcea Andreea Elena, PhD tenured
Assistant Professor Memis Hayat, PhD fixed term

The Cardiology Clinic of the University Hospital of Emergency, in which the medical activity of the Department takes place, includes:

  • 2 cardiology wards, with units dedicated to USTAC (acute coronorary therapy and monitoring) and Interventional Cardiology
  • Electrophysiology Laboratory
  • Laboratory of Interventional Cardiology (3 angiographies)
  • Laboratory of Echoocardiography (with european accreditation)

Medical services that are offered:

  • Monitoring and USTAC specific care
  • Electrocardiograms
  • ECG effort tests
  • Ambulatory monitoring/24 hours ECG and blood pressure
  • 2D and 4D transthoracic echocardiography and 2D and 3D transesophageal echocardiography, with the possibility of offline ecographic analysis through Echopac BT stations
  • Vascular ecography
  • Diagnostic and interventional coronary angiography (3 angiographies), including primary angioplasties in emergency guard system for STEMI (national program) 2 times/week

Methodological approach

Application in cardiology and internal medicine of our research team’s experience in the field of cardiac and vascular ecography, interventional cardiology and electrophysiology:

  • Transthoracic ecography (standard, tissue Doppler, Speckle Tracking,  3D)
  • 2D and 3D Transesophageal ecography
  • Vascular ecography (including e-tracking, wave intensity and flow-mediated dilatation)
  • Cardio-pulmonary effort test
  • Interventional treatment of acute coronary syndromes
  • Interventional treatment of cardiac arrhythmias
  • Interventional treatment of cardiac insufficiency (resynchronization therapy)
  • Identification of diagnostic, prognostic and predictive factors for cardiac dysfunction in systemic diseases etc.

Infrastructure

  • The echocardiography laboratory is one of the most prestigious in Romania (16 echocardiography specialists in the country and abroad, for complete evaluation for clinical and research purposes of cardiac and vascular function); European accreditation since 2011.
  • The laboratory of coronary angiography has has a high capacity of diagnosis of coronary pathology (intravascular ecography, optical coherence tomography, fractioned and coronary flow reserve estimation ) and interventional treatment of structural cardiac diseases.
  • The laboratory of electrophysiology and intra-cardiac devices: equipped with angiograph and conventional and electro-anatomic mapping system – in order to implant the cardiac anti-bradycardia pace-makers, cardiac resynchronization devices, internal defibrillators; as well as for simple and complex ablations.

The following equipment is available for research projects:

  • VIVID 7, VIVID 9 as well as portable VIVID I echocardiographs, GE Medical System (with 2D and 3D probes and transesophageal echography, equipped with software for 2D, spectral and color Doppler, TVI, Q analysis, 2D speckle tracking, 3D MultiPlan echography), Aloka α10  (with cardiac and vascular ultrasound probes, equipped with specific software of interpretation);
  • High-capacity server for storage and analysis of all ultrasound data;
  • Complior System for assessing wave pulse velocity;
  • Arteriograph System to determine central aortic pressure and pulse wave velocity;
  • GE/Cortex cardio-pulmonary effort test;
  • Ambulatory monitoring device for blood pulse and ECG;
  • Portable electrocardiograph;
  • Computer network with dedicated software for statistical analysis;
  • Siemens Angiography– hybrid room;
  • Siemens Angiography - Artis Zee;
  • Electro-anatomic system for electro-physiology NavX EnSite Velocity;
  • Electro-anatomic system for electro-physiology CARTO 3;
  • Electro-physiology system GE Prucka;

The completed grants with internal financing have aimed to develop a center specialized in the early diagnosis of subclinical cardiac dysfunction in populations at risk, to assess by using the echocardiograph the acute hypertensive pulmonary edema, to quantify the cardiac and vascular subclinical dysfunction in rheumatoid arthritis, to develop a modern research base for cardiac insufficiency and arrhythmia, to develop a national register of pharmacologically active stents, to compare the Indapamida SR 1.5 mg with Hidroclortiazidum 25mg, in combination with an angiotensin-converting enzyme inhibitor, in patients with mild-moderate hypertension and type II diabetes (AISHA study), to create a sleep laboratory specialized in assessing the cardiac diseases associated with sleep disorders.; evaluation of the extension of cardiac and vascular dysfunction in systemic diseases, such as liver cirrhosis, multiple sclerosis or scleroderma.

International multi-center studies include different types of modern treatment for acute coronary syndromes, cardiac insufficiency, arrhythmia, hypertension, as well as for primary and secondary prophylaxis in patients with ischemic cardiac disease.

The universitary activity includes:

  • Cardiology module for forth year students (7 weeks X 3 modules/year)
  • Respiratory module for forth year students (8 weeks X 1 module/year)
  • Emergency Medicine module (course and practical work) for sixth year students (16 weeks)
  • Coordination of degree works

Cardiology module

  • 1 week of Cardiovascular Surgery courses and practical works
  • 7 weeks of Cardiology courses and practical works:
  1. Normal electrocardiogram
  2. Pathological electrocardiogram
  3. Basic notions in echocardiography
  4. Basic concepts in cardiac catheterization
  5. Acute articular rheumatism
  6. Mitral valvulopathies
  7. Aortic valvulopathies
  8. Infective endocarditis
  9. Dilatative cardiomyopathy
  10. Hypertrophic cardiomyopathy
  11. Atherosclerosis
  12. Stable angina
  13. Acute coronary syndromes without ST-segment steep elevation
  14. Myocardial infarction with steep elevation of the ST-segment
  15. Primary and secondary systemic hypertension
  16. Rhythm and conduction disturbances (4 courses)
  17. Venous thromboembolic disease
  18. Cardiac insufficiency

Selective bibliography for Cardiology module

  • Cardiology Course for forth year medical students, ’Carol Davila’ Bucharest Medical Publishing House 2016
  • Small treaty of cardiology (red. Carmen Ginghina). The Romanian Academy Publishing House 2010
  • ESC Guidelines –Cardiovascular Medicine- compendium of shortened ESC guidelines – romanian language edition. Mediamed Publicis, 2011

Respiratory module

  • 1 week of Occupational Medicine courses and practical works
  • 1 week of Pneumoftiziology courses and practical works
  • 4 weeks of Respiratory diseases courses and practical works:
  1. Chronic obstructive bronchopneumopathy
  2. Bronchial asthma
  3. Pneumonias
  4. Pulmonary suppurations
  5. Diffuse interstitial pneumopathies
  6. Bronchial neoplasm
  7. Pleural syndrome
  8. Pulmonary hypertension
  9. Chronic pulmonary heart
  10. Respiratory insufficiency
  11. Functional respiratory exploration -

These courses are held from Monday to Thursday

On Friday there are practical applications of imaging and functional respiratory exploration and discussion of clinical cases.

Selective bibliography for Respiratory module

  • Pneumology – under the redaction of Miron Alexandru Bogdan, , ’Carol Davila’ Bucharest Medical Publishing House 2008
  • www.copd.org: Global Initiative for Chronic Obstructive Lung Dusease, Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Disease updated. 2016
  • www.ginasthma.org: Global Strategy for Asthma Management and Prevention updated 2016
  1. Course for certified competence in vascular ecography – coordinator Associate Professor Dr. Roxana Oana Darabont
  • 80 h course and 160 h practical work

Selective bibliography

  • Darabont Roxana Oana – Ultrasound evaluation of vascular system. In: Clinical Cardiology, Eduard Apetrei (ed). Callisto, 2015
  • Zwiebel W. J. - Introduction to vascular ultrasonography, 5th edition, ELSEVIER SOUNDERS
  • Thrush A., Hartshorne T. - Vascular ultrasound. How, why and when?, 3rd Edition, Churchill Livingstone, ELSEVIER
  • Zierler ER - Stradness's Duplex Scanning in Vascular Disorders, LWW, 2015
  • Myers K, Clough AM - Practical Vadcular Ultrasound: An Illustrated Guide, CRC Press, 2014
  1. Course for certified competence in special ecography (including transesophageal) - coordinator Senior Lecturer Dr Carmen Lucia Gherghinescu
  2. Course for certified competence in interventional cardiology - coordinator Prof. Dr. Dragos Vinereanu

Thematics for doctoral studies admision examination at the Cardiology Discipline

  1. Aortic and mitral valvulopathies
  2. Supraventricular rhythm disorders
  3. Ventricular rhythm disorders
  4. Atrio-ventricular blocks
  5. Dilatative and hypertrophic cardiomyopathies
  6. Stable angina
  7. Acute coronary syndromes without ST-segment steep elevation
  8. Acute coronary syndromes with ST-segment steep elevation
  9. Primary and secondary systemic arterial hypertension
  10. Congestive cardiac insufficiency

General bibliography

  • Cardiology Course for forth year medical students, ’Carol Davila’ Bucharest Medical Publishing House 2016
  • Braunwald's Heart Disease: a textbook of Cardiovascular Medicine – Elsevier Saunders-Philadelphia, 10-th Edition 2015
  • Small treaty of cardiology (red. Carmen Ginghina). The Romanian Academy Publishing House 2010
  • ESC Guidelines –Cardiovascular Medicine- compendium of shortened ESC guidelines – romanian language edition. Mediamed Publicis, 2011

Themes of PhD (9 doctoral students active at the moment):

  • Post-cardiostimulation cardiac memory – clinical implications;
  • Management of national registers of acute coronary syndromes without ST-segment steep elevation and percutaneous coronary interventions;
  • Assesing and quantifying the subclinical cardiac dysfunction in patients with neoplastic diseases;
  • The role of reactive C Protein in determing the cardiovascular risk at patients with surgical interventions for hip prosthesis;
  • Predictive elements for the recurence of post-ablation atrial fibrillation;
  • Microalbuminuria as a pronostic factor at patients with chronic renal disease;
  • Changes of cardiovascular function in patients with thrombophilia and pregnancy complications
  • prediction of cardiac dysfunction in systemic diseases
  • interventional cardiology
  • special echocardiography
  1. 2012: Strain sUrveillance during Chemotherapy for improving Cardiovascular Outcomes (SUCOUR; Grant in collaboration with University of Tasmania, Australia).
  2. 2012: Normal Reference Ranges for Echocardiography Study (NORRE; Grant in collaboration with European Association of Cardiovascular Imaging).
  3. 2012: A clustered randomized trial to IMProve treatment adherence with AntiCoagulanTs in patients with Atrial Fibrillation (IMPACT-AF; Grant in collaboration with Duke University, SUA).
  4. 2015: Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS; Grant in collaboration with Populational Health Research Institute, Canada).
  5. 2015: Chronic Ischemic Cardiovascular Disease Long-Term Registry (CICD-LT; Grant in collaboration with EORP – European Society of Cardiology).
  1. Mihalcea DJ, Florescu M, Suran BM, Enescu OA, Mincu RI, Magda S, Patrascu N, Vinereanu D. Comparison of pulse wave velocity assessed by three different techniques: Arteriograph, Complior, and Echo-tracking. Heart Vessels 2015 [Epub ahead of print].
  2. Rimbaş RC, Mihăilă S, Vinereanu D. Sources of variation in assessing left atrial functions by 2D speckle-tracking echocardiography. Heart Vessels 2014 [Epub ahead of print].
  3. Vinereanu D, Dulgheru R, Magda S, Dragoi Galrinho R, Florescu M, Cinteza M, Granger C, Ciobanu AO. The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: results of a randomized trial. Am Heart J 2014; 168(4): 446-56.
  4. Florescu M, Magda LS, Enescu OA, Jinga D, Vinereanu D. Early detection of epirubicin-induced cardiotoxicity in patients with breast cancer. J Am Soc Echocardiogr 2014; 27(1): 83-92.
  5. Tatu-Chiţoiu G, Arafat R, Deleanu D, Vinereanu D, Udroiu C, Petris A. Impact of the Romanian national programme for interventional therapy in ST-elevation myocardial infarction. EuroIntervention 2012; 8 Suppl P:P126-32.
  6. Mǎrgulescu AD, Suran BM, Rimbaş RC, Dulgheru RE, Silişte C, Vinereanu D. Accuracy of fluoroscopic and electrocardiographic criteria for pacemaker lead implantation by comparison with three-dimensional echocardiography. J Am Soc Echocardiogr 2012; 25(7): 796-803.
  7. Mărgulescu AD, Rimbaş RC, Florescu M, Dulgheru RE, Cinteză M, Vinereanu D. Cardiac adaptation in acute hypertensive pulmonary edema. Am J Cardiol 2012; 109(10): 1472-81.
  8. Magda SL, Ciobanu AO, Florescu M, Vinereanu D. Comparative reproducibility of the noninvasive ultrasound methods for the assessment of vascular function. Heart Vessels 2013; 28(2): 143-50.
  9. Vinereanu D, Gherghinescu C, Ciobanu AO, Magda S, Niculescu N, Dulgheru R, Dragoi R, Lautaru A, Cinteza M, Fraser AG. Reversal of subclinical left ventricular dysfunction by antihypertensive treatment: a prospective trial of nebivolol against metoprolol. J Hypertens 2011; 29(4): 809-17.
  10. Florescu M, Stoicescu C, Magda S, Petcu I, Radu M, Palombo C, Cinteza M, Lichiardopol R, Vinereanu D. „Supranormal” cardiac function in athletes related to better arterial and endothelial function. Echocardiography 2010; 27(6): 659-67.
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