Pharmacoeconomic analysis of costs related to cardiac surgery in patients hospitalized for acute heart failure

Barbora Ondráčková, Jiří Pařenica, Roman Miklík, Marián Felšőci, Alexandra Šulcová, Petr Němec, Daniela Tomčíková, Petr Kala, Jindřich Špinar

Cor Vasa 2010, 52(11-12):684-689 | DOI: 10.33678/cor.2010.172  

Aim: To assess the direct costs of hospitalization in connection with management of patients undergoing cardiac surgery and initially hospitalized at a department of cardiology for acute heart failure (AHF) from the perspective of the health care payer; a detailed analysis of the proportion of comprehensive management of heart failure by cardiac surgery (including surgical revascularization, treatment of heart valve disease, and perioperative management of atrial fibrillation by cryoablation) in total costs incurred during hospitalization related to management of AHF.Methods: Out of a total of 1,357 patients hospitalized between 2005 and 2007 in...

Inflammatory biomarkers and coronary restenosis in patients with type-2 diabetes

Robert Náplava, Martin Gřiva, Čestmír Číhalík, Zdeněk Coufal, Milada Špendlíková, Ota Hlinomaz

Cor Vasa 2010, 52(11-12):690-694 | DOI: 10.33678/cor.2010.173  

Aim of study: To test the possibility of predicting development of restenosis in patients with type-2 diabetes mellitus using selected inflammatory markers.Method: The group comprised 27 patients with type-2 diabetes mellitus and stable coronary heart disease undergoing percutaneous coronary intervention (PCI) in 2007-2008. Prior to the procedure and at one and six months post-procedurally, the patients had clinical examination, laboratory investigations to measure common biochemical parameters, and blood sampling for high-sensitive CRP (hsCRP), soluble ligand CD40 (sCD40L), and monocyte chemoattractant protein-1 (MCP-1) determination. At six months,...

Role of a dynamic LVOT obstruction in the pathogenesis of takotsubo syndrome

Jan Pavlovič, Karel Hlaváček, Rudolf Feuereisl, Roman Surovčík, Petr Frídl, Ondřej Myslivec, František Paďour, Pavel Jebavý

Cor Vasa 2010, 52(11-12):695-699 | DOI: 10.33678/cor.2010.174  

Aims: To explore the possible causative relationship between a dynamic left ventricular outflow tract (LVOT) obstruction and takotsubo syndrome.Methods and results: We analyzed a group of eleven patients with takotsubo syndrome. In this article, we focus on one patient developing a less common variant of takotsubo (stress) syndrome after a situation creating a decreased preload, but without a preceding stressful event (either psychological or physical). Coincidently we found a dynamic obstruction of left ventricular outflouw tract and septal bulge mimicking the pattern of hypertrophic cardiomyopathy. After the contraction abnormalities had normalized,...

What are the optimal values of systolic blood pressure in patients with diabetes? The ACCORD Blood Pressure study completed

Jiří Widimský

Cor Vasa 2010, 52(11-12):700-705 | DOI: 10.33678/cor.2010.175  

The presence of hypertension dramatically increases the cardiovascular risk of patients with type-2 diabetes mellitus. The 2007 European guidelines for the management of arterial hypertension recommend to decrease systolic blood pressure (BP) to < 130 mmHg in hypertensive patients with diabetes. However, this recommendation is not based on data obtained from a randomized prospective study. Mean systolic BP levels of 135/74 mmHg were only reported in a group of patients with diabetes treated with a fixed perindopril/indapamid combination in the ADVANCE study.A retrospective analysis of ONTARGET showed a J-curve relation between systolic BP and...

Danon disease - a disorder of autophagy as a cause of hypertrophic cardiomyopathy

Miloš Kubánek, Milan Elleder, Jakub Sikora, Marek Šramko, Jana Malušková, Lenka Dvořáková, Hana Vlášková, Martin Kotrč, Jana Vrbská, Petr Ridzoň, Michal Šnorek, František Toušek, Ivan Málek, Jan Pirk

Cor Vasa 2010, 52(11-12):706-712 | DOI: 10.33678/cor.2010.176  

Danon disease is an X-linked disorder caused by a mutation of lysosomal-associated membrane protein 2 (LAMP2). Clinically, the disorder manifests itself mainly as hypertrophic cardiomyopathy, skeletal muscle myopathy or, alternatively, as liver disease. In women, its presentation in organs and severity of the disorder are modified by X-inactivation. The aim of our study was to report the first case of a family with Danon disease diagnosed in the Czech Republic. The diagnosis was initially established in a 27-year-old man with end-stage heart failure secondary to hypetrophic cardiomyopathy and, subsequently, also in the patient's sister and nephew....

Antibody-mediated rejection after heart transplantation - an overview of current concepts

Tomáš Gazdič, Ivan Málek, Josef Kautzner

Cor Vasa 2010, 52(11-12):713-720 | DOI: 10.33678/cor.2010.177  

A factor shown to heavily impact the prognosis of heart transplant recipients is absence of rejection, i.e., the failure of the body to accept a transplanted tissue. Historically, a better characterized and more readily treatable type is cellular rejection which has been at the forefront of research and interest over the past 45 years. There has been an appreciable renewal of interest in antibody-mediated rejection after graft dysfunction up to graft failure in the early post-transplant period had been shown to be causally related to transplant coronary artery disease at a later time. This review article aims at keeping the reader up to date about...

Mild therapeutic hypothermia in pre-hospital care: 8 for versus 8 against?

Roman Škulec, Anatolij Truhlář, Jana Šeblová, Jiří Knor, Vladimír Černý

Cor Vasa 2010, 52(11-12):721-725 | DOI: 10.33678/cor.2010.178  

Mild therapeutic hypothermia (TH) has been considered one of the approaches demonstrably improving the prognosis of successfully resuscitated cardiac arrest patients. The European and the Czech guidelines emphasize the requirement to start cooling as soon as possible. Therefore, a procedure of pre-hospital initiation of cooling has been evolving both in the world and in our country recently. In their review, the authors evaluate state of the art in the field of pre-hospital TH and assume that when the medical, technical and logistic requirements are met, adoption of the method may be beneficial.

Hybrid myocardial revascularization in a patient with pectus excavatum

Vilém Rohn, Jiří Humhal, Jan Rulíšek

Cor Vasa 2010, 52(11-12):726-728 | DOI: 10.33678/cor.2010.179  

We report the case of a 78-year-old male patient with severe pectus excavatum and ischaemic heart disease. He had CCS Class III angina and a significant finding on coronary angiography. The patient was indicated for myocardial revascularization. Additionally, the patient suffered from rheumatoid arthritis treated by corticosteroids and methotrexate. Given the high risk of impaired healing of the sternotomy and subsequent infection, the patient was scheduled for so-called hybrid revascularization, involving coronary bypass using small anterior thoracotomy followed by percutaneous coronary intervention (PCI). This procedure is a valuable alternative...

Vascular skin lesions in a child with Klippel-Trénaunay syndrome

Vladimír Bartoš, Katarína Adamicová, Milada Kullová, Oľga Zacharová, Tatiana Bulejčíková, Martin Péč

Cor Vasa 2010, 52(11-12):729-733 | DOI: 10.33678/cor.2010.180  

Klippel-Trénaunay syndrome is a rare congenital vascular disorder in which one of the main diagnostic features are capillary skin malformations characterized by naevus flammeus present since birth. However, the clinical symptomatology of the disease is relatively variable with frequent incomplete forms whereby the most important diagnostic feature is its cutaneous manifestation. Beside the capillary anomalies there can be also present multiple hemangiomas, lymphangiomas, angiokeratomas with exceptionally reported malignant skin tumors. The authors present the case report of a 12-year-old boy with Klippel-Trénaunay syndrome focusing on dermatologic...

Dilated cardiomyopathy and mild myopathic syndrome in a 40-year-old man

Edvard Ehler, Petr Vojtíšek, Jana Sedláčková, Lenka Fajkusová, Josef Zámečník

Cor Vasa 2010, 52(11-12):734-738 | DOI: 10.33678/cor.2010.181  

In muscular dystrophies, there are pathological changes in skeletal muscles and, in many cases, also in the myocardium. While cardiomyopathy may manifest itself at the same time as myopathic syndrome, it may develop even earlier. Becker muscular dystrophy (BMD) is most often associated with dilated cardiomyopathy. We present the case report of a 40-year-old man with fatigue and muscle weakness beginning in his school age. Progression of myopathic syndrome and the presence of dilated cardiomyopathy (with the latter diagnosed by a cardiologist) raised suspicion of BMD. The diagnostic work-up was not easy. DNA analysis revealed neither deletion nor duplication...

Novinky z výročního kongresu American Heart Association 2010

Prof. MUDr. Petr Widimský, DrSc., FESC

Cor Vasa 2010, 52(11-12):762-763 | DOI: 10.33678/cor.2010.189  

Nesiritide not verified

Prof. MUDr. Jindřich Špinar, CSc., FESC

Cor Vasa 2010, 52(11-12):764-765 | DOI: 10.33678/cor.2010.190  

Zpráva z kongresu - Heart Failure 2010

MUDr. Filip Málek, Ph.D.

Cor Vasa 2010, 52(11-12):766-767 | DOI: 10.33678/cor.2010.191  

Cardiac surgery at the Pediatric Cardiocentre in Motol, Prague

Bohumil Hučín

Cor Vasa 2010, 52(11-12):739-748  

The group of young cardiac surgeons, followers of Prof. Václav Kafka interested in palliative surgery of newborns and infants with critical congenital heart defects at the Clinic of Pediatric Surgery in Prague na Karlově Hospital since 1964 joined the Prague-based Pediatric Cardiocentre at Motol University Hospital in 1977. Once there, they gradually introduced total corrections of all types of congenital heart defects using time-proven protocols of and experience with open-heart procedures in prestigious cardiac centres of the world. Most techniques of operations performed for the first time at the Pediatric Cardiocentre in Motol University Hospital...

Medaile Za zásluhy pro profesora Milana Šamánka

Michael Aschermann

Cor Vasa 2010, 52(11-12):748  

Percutaneous aortic valve implantantion and the PARTNER trial

Petr Kala, Petr Němec

Cor Vasa 2010, 52(11-12):750-752  

Surgical aortic valve replacement is the most long-term effective treatment modality for patients with aortic stenosis. In patients with severe symptomatic aortic stenosis who are at very high operative risk, percutaneous (transcatheter) aortic valve implantation can be used as an effective and relatively safe treatment method. This is especially true in patients classified as inoperable where aortic valve implantation is the only treatment possibility significantly decreasing mortality and the need for further hospitalizations.

Zápis ze schůze výboru ČKS konané dne 21. září 2010 v Brně
Zpráva o činnosti Pracovní skupiny srdeční selhání 2010

Cor Vasa 2010, 52(11-12):768-769  

ECHODNY 2010
Kalendář odborných akcí

Cor Vasa 2010, 52(11-12):770-774  

Deep hypothermia in current cardiac surgery

František Mlejnský, Igor Vykydal, Jaroslav Lindner, Jan Táborský, Tomáš Grus

Cor Vasa 2010, 52(11-12):759-761  

The authors discuss the potential uses of hypothermia in current cardiac surgery. Based on their own experience, they evaluate its risks and potential for safe management of extracorporeal circulation in deep hypothermia as well as techniques of circulatory arrest. The paper includes a review of tools employed for optimal cooling and rewarming of the patient, and their use.

Ockhamova břitva

Prof. MUDr. Pavel Bravený, CSc.

Cor Vasa 2010, 52(11-12):757  

Bývalý prezident Evropské kardiologické společnosti prof. Franz Loogen zemřel

Prof. MUDr. Jiří Widimský, DrSc., FESC, FAHA

Cor Vasa 2010, 52(11-12):758  

Soutěž o nejlepší kasuistiku na téma Diferenciální diagnostika dušnosti

Cor Vasa 2010, 52(11-12):754  

Index of authors 2010

Cor Vasa 2010, 52(11-12):775-792