Orgánové podpory v akutní kardiologii

Jan Bělohlávek

Cor Vasa 2010, 52(3):115  

Resynchronization therapy in patients with chronic heart failure - hemodynamic changes

Eva Ozábalová, Miroslav Novák, Jan Krejčí, Petr Hude, Jolana Lipoldová, Jaroslav Meluzín, Pavel Vank, Jiří Vítovec

Cor Vasa 2010, 52(3):176-182 | DOI: 10.33678/cor.2010.045  

Aim: The aim of this study was to assess the early (at 3 months) and late (at 12 months) therapeutic effect of biventricular pacing in symptomatic patients with chronic heart failure despite adequate pharmacotherapy, with special emphasis on modulation of hemo-dynamic parameters.Patients and methods: A total of 118 patients with chronic heart failure (NYHA functional class II-IV, left ventricular ejection fraction [LVEF] 20.5±5.3%, mean age, 62.17±5.68 years) had biventricular devices implantation in the 2000-2006 period. Left bundle branch block and prolonged QRS complex (duration, 160.28±25.05 ms) on ECG were present.Changes...

The effects of losartan on central and peripheral blood pressure

Jiří Widimský jr., Ondřej Petrák, Branislav Štrauch, Alice Vranková, Tomáš Zelinka, Jana Dvořáková, Robert Holaj

Cor Vasa 2010, 52(3):183-186 | DOI: 10.33678/cor.2010.046  

We evaluated the antihypertensive effects of 100 mg losartan administered once daily for six months in patients with mild essential hypertension. The antihypertensive effects were assessed by measuring office and 24-hour blood pressure (BP), the latter using ambulatory blood pressure monitoring (ABPM). Additionally, central BP and aortic stiffness were measured by means of a Sfygmocor device.Losartan treatment resulted in a significant decrease in office systolic and diastolic BP (134 ± 15 vs. 143 ± 13 mmHg; p < 0.05 and 78 ± 6 vs. 82 ± 8 mmHg; p < 0.04). Ambulatory BP monitoring demonstrated a marked losartan-induced...

How are patients faring 30 years after radical tetralogy of Fallot repair?

Jana Popelová, Marie Voříšková, Bohumil Hučín, Štěpán Černý, Roman Gebauer, Petr Pavel, Václav Chaloupecký, Jan Škovránek, Milan Šamánek

Cor Vasa 2010, 52(3):154-161 | DOI: 10.33678/cor.2010.042  

Out of 283 patients with tetralogy of Fallot (TOF) undergoing its radical repair in a Prague-based Pediatric Heart Center between 1978 and 1988, then with a mean age of 7 years and 7 months, we were successful of getting information about 161, i.e., two thirds of those alive. There are 80 patients lost to follow-up (28% of those operated). A total of 42 patients (14.8%) died during follow-up, with early postoperative mortality being 7.4% (21 patients) and 21 late deaths. Long-term survival rates at 26 years after radical TOF repair were 85% for all patients and 92% for pediatric patients discharged to receive home care after the procedure.Overall,...

The role of exercise echocardiography in the diagnosis of heart failure with preserved left ventricular ejection fraction (primary diastolic heart failure)

Jaroslav Meluzin

Cor Vasa 2010, 52(3):162-167 | DOI: 10.33678/cor.2010.043  

The purpose of this review article is to provide data on the role of exercise echocardiography in the diagnosis of heart failure with preserved left ventricular ejection fraction (primary diastolic heart failure). Diastolic heart failure (DHF) accounts for 30%-50% of all cases of heart failure and has a poor prognosis. The main abnormality in DHF is an increase in left ventricular filling pressure (LVFP) as a consequence of increased LV stiffness. Current guidelines defining DHF based only on resting hemodynamic values do not allow diagnosing DHF in patients whose signs (dyspnea most often) and pathological values are confined to exercise only. Recently,...

BARI 2D - where has it taken us to and what the future has in store for us

Lenka Pavlíčková, Petr Neužil

Cor Vasa 2010, 52(3):168-175 | DOI: 10.33678/cor.2010.044  

Background: Optimal therapy for diabetics with stable coronary artery disease and mild symptoms has not yet been established. The BARI 2D study is the successor to the BARI study where diabetics (especially those on insulin) had a worse long-term outcome after revascularization compared with other populations. The multicenter clinical BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) Study took place from 2001-2008. It compared early revascularization (ER - either PCI or CABG) with medical therapy (MT), together with intensive pharmacotherapy and lifestyle intervention in both groups. At the same time, two diabetes drug treatment...

Amyloidosis as a rare cause of dyspnea

Eva Kociánová, Jan Václavík, Miloš Táborský, Marián Fedorco, Pavel Folwarczny, Tomáš Pika, Yvona Hrčková

Cor Vasa 2010, 52(3):188-192 | DOI: 10.33678/cor.2010.047  

We report the case of a 44-year-old man examined for dyspnea lasting several months with manifestations of heart failure. The patient developed the dyspnea after a protracted febrile condition. An electrocardiogram showing a scar on the anterior wall and left ventricular dysfunction with a 40% left ventricular ejection fraction (LVEF) and mild pericardial exudates led initially to suspected coronary heart disease ruled out by a negative coronary angiogram. Marked left ventricular hypertrophy on follow-up echocardiography and the finding of nephritic proteinuria made us consider a systemic disease. Heart magnetic resonance imaging excluded previous...

Pavel Jerie: Pro koho je medicína? Světem za lepšími léky

Doc. MUDr. Jiří Jirka, DrSc.

Cor Vasa 2010, 52(3):199  

Andrew T. Raftery, Eric Lim: Diferenciální diagnóza. Do kapsy

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2010, 52(3):200  

Jaroslav Hořejší: Na pomoc dětským srdcím. Hovory s Milanem Šamánkem

lip

Cor Vasa 2010, 52(3):201  

Hypertrofická obstrukční kardiomyopatie postihující obě srdeční komory

Lucia Martinkovičová, David Zemánek, Pavol Tomašov, Stanislava Homolová, Josef Veselka

Cor Vasa 2010, 52(3):193-194 | DOI: 10.33678/cor.2010.048  

Pooperační péče o pacienty po plicní endarterektomii

Jana Rousková, Klára Drábková, Lenka Pantoková

Cor Vasa 2010, 52(3):197-198  

Multiple organ dysfunction syndrome: update 2010

Jiří Chvojka, Martin Matějovič

Cor Vasa 2010, 52(3):116-120 | DOI: 10.33678/cor.2010.035  

Multiple organ dysfunction syndrome (MODS) is the leading cause of death in intensive care units. Critically ill patients may develop MODS during the course of severe infections, shock, multiple trauma, massive hemorrhage or a combination of the above. Although the exact pathophysiology of MODS remains unknown, it involves widespread molecular, cellular, and systemic alterations characterized by deregulated inflammatory processes, activation of coagulation, neuroendocrine and metabolic responses. Early and aggressive treatment of the underlying disease remains the cornerstone of MODS prevention, while the treatment of MODS itself remains primarily...

Acute renal failure requiring use of continuous renal replacement therapy methods in the coronary care unit of a cardiac center

Jan Bělohlávek, Vladimír Dytrych, Tomáš Kovárník, Ondřej Šmíd, Aleš Linhart

Cor Vasa 2010, 52(3):121-126 | DOI: 10.33678/cor.2010.036  

Introduction: Acute renal failure (ARF) requiring the use of renal replacement therapy methods is associated with a fairly poor prognosis of the critically ill, high mortality rates, and occurs in approximately 1-6% surgical and cardiac surgical patients. The incidence and relevance of ARF requiring the use of continuous renal replacement therapy methods has not been well characterized to date.Aim: To determine the incidence of ARF requiring the use of continuous renal replacement therapy methods in the general population of the critically ill in the coronary care unit of a cardiac center and to define the short-term mortality rates of these patients.Methods:...

Intraaortic balloon counterpulsation in intensive cardiac care

Richard Rokyta jr., Jitka Tesařová, Jakub Čech, Vratislav Pechman, Denisa Polívková, Jan Pešek, Jiří Koza, Michal Šmíd, Ivo Bernat

Cor Vasa 2010, 52(3):127-133 | DOI: 10.33678/cor.2010.037  

Aim: To assess the use of intraaortic balloon counterpulsation (IABC) and its indications in an intensive cardiac care unit (ICCU), patients' characteristics, and clinical outcomes.Methods: Retrospective analysis of patients treated with IABC in an ICCU from January 1, 2005 through December 31, 2008.Results: Intraaortic balloon counterpulsation was used in 67 patients. The most frequent indications were cardiogenic shock in STEMI patients (61%), cardiogenic shock in non-STEMI patients (21%), and cardiogenic shock of another etiology (9%). In 9% of patients, IABC was used as a support measure before high-risk PCI. The mean IABC treatment duration...

Non-invasive ventilation in acute respiratory failure

Ondřej Šmíd, Jan Bělohlávek, Vladimír Dytrych, Aleš Linhart

Cor Vasa 2010, 52(3):134-140 | DOI: 10.33678/cor.2010.038  

Non-invasive ventilation (NIV) is a safe and effective technique of organ support in patients with acute respiratory failure of various etiology. Advantages of NIV include adequate ventilation while minimizing the risks associated with endotracheal intubation. Non-invasive ventilation improves the symptoms of a broad range of patients with acute dyspnea and makes therapy shorter while improving mortality in selected populations.

Prophylactic use of extracorporeal circulatory support with a membrane oxygenator in high-risk percutaneous coronary intervention

Andreas Krüger, Petr Ošťádal, Petr Kmoníček, David Doubek, Jan Marounek, Svatava Horáková, Marcela Škabradová, Petr Neužil, Miloš Táborský

Cor Vasa 2010, 52(3):141-144 | DOI: 10.33678/cor.2010.039  

Prophylactic use of mechanical circulatory support in high-risk percutaneous coronary intervention (PCI) is an approach designed to reduce the risk of periprocedural complications in patients with critical coronary lesions and co-existing severe left ventricular dysfunction, associated heart valve disease, hemodynamic or electrical instability, and severe non-cardiac comorbidity. However, the currently most-oft used support systems do not allow eliminating complete circulatory arrest or are too overcomplicated to set up.An alternative to the current common methods is the use of an extracorporeal circuit with an in-built extracorporeal membrane...

The Essen concept of surgical management of patients with acute aortic dissection

Jaroslav Benedík, Konstantinos Tsagakis, Markus Kamer, Adam Jarowit Piotrowski, Parwis Massoudy, Brigitte Osswald, Paschalis Tossios, Mathias Thielmann, Holger Egebrecht, Thomas Konorza, Raimund Erbel, Hainz Jakob

Cor Vasa 2010, 52(3):145-148 | DOI: 10.33678/cor.2010.040  

Aim of study: To present the concept of management of patients with acute aortic dissection, developed at the Department of Thoracic and Cardiovascular Surgery of University Hospital Essen, Germany.Methods: The concept is based on four main principles, i.e., minimization of time from diagnosis to actual surgery, optimal selection of arterial cannulation based on preoperative assessment performed right on the operating table of a hybrid operating room, termination of severe visceral malperfusion using fenestration or stenting in the abdominal aorta region, and use of intraoperative angioscopy to examine the aortic arch and descending aorta to determine...

Characteristics of patients on the waiting list for heart transplantation

Ivan Málek, Markéta Hegarová

Cor Vasa 2010, 52(3):149-153 | DOI: 10.33678/cor.2010.041  

Introduction: The waiting list for heart transplantation comprises patients with advanced heart failure in whom all other therapeutic options have failed and who meet the criteria for heart transplantation.Waiting list analysis: As of 22 June 2009, the waiting list for heart transplantation included 51 patients. Ninety percent of these were individuals with coronary heart disease or dilated cardiomyopathy. The median waiting time was 307 days for urgent patients, and 398 days for those listed as normal status candidates. Severe pulmonary hypertension was present in 22% of patients, median B-natriuretic peptide concentration was 517.9 nith high...

Zamyšlení metodologické

Prof. MUDr. Pavel Bravený, CSc.

Cor Vasa 2010, 52(3):196  

Důležité upozornění pro autory textů pro časopis Cor et Vasa

Michael Aschermann

Cor Vasa 2010, 52(3):114