Heart failure

Jiří Vítovec

Cor Vasa 2013, 55(4):e285 | DOI: 10.1016/j.crvasa.2013.07.001  

Heart failure in AL amyloidosis-Are we still helpless?

Jan Krejčí

Cor Vasa 2013, 55(4):e330-e332 | DOI: 10.1016/j.crvasa.2013.01.004  

Inflammatory cardiomyopathy: Still many questions await answers

Tomáš Paleček

Cor Vasa 2013, 55(4):e341-e344 | DOI: 10.1016/j.crvasa.2013.03.014  

The importance of admission and discharge BNP assessment in patients hospitalized for acutely decompensated chronic systolic heart failure

Ondřej Ludka, Roman Štípal, Marta Šenkyříková, Viktor Musil, Jan Trna, Zbyněk Pozdíšek, Jiří Jarkovský, Ladislav Dušek, Jindřich Špinar

Cor Vasa 2013, 55(4):e286-e292 | DOI: 10.1016/j.crvasa.2013.03.007  

Introduction: The assessment of B-type natriuretic peptide (BNP) plasma levels is not only useful for the differential diagnosis of acute dyspnea, but also for the prognostic stratification of patients with heart failure. However, available studies that have addressed monitoring of hospitalized patients are burdened with significant limitations: 1) measurement of plasma BNP levels only at admission or at discharge, 2) lack of details regarding the cause of heart failure, 3) small sample size. Therefore, we conducted a prospective study of all patients presenting to our hospital with acutely decompensated chronic systolic heart failure.Aim: To determine...

Optimization of cardiac resynchronization therapy in non-responders

Milan Sepši, Lubomír Křivan, Milan Kozák, Marek Šebo, Martin Poloczek, Jiří Jarkovský, Lukáš Rybka, Lenka Kubková, Jitka Vlašínová, Jindřich Špinar

Cor Vasa 2013, 55(4):e293-e300 | DOI: 10.1016/j.crvasa.2013.07.002  

Background: Cardiac resynchronization therapy plays important role in treatment of heart failure patients with low left ventricular ejection fraction. However, a significant number of patients do not improve after implantation. Optimization of atrioventricular and interventricular delay could improve clinical status of these patients.Objectives: The purpose of this study was to compare optimization of atrioventricular (AV) and interventricular (VV) delays with aortic velocity-time integral (VTI) and with maximal value of the first derivative of a left ventricular pressure signal (LVdP/dtmax).Methods: Fifteen non-responders were optimized with...

Prevalence of donor-transmitted atherosclerosis-Clinical utility of intracoronary ultrasound early after heart transplantation. A single-center study

Helena Bedáňová, Marek Orban, Martin Třetina, Aleš Tomášek, Petr Malík, Petr Fila, Vladimír Horváth, Jiří Ondrášek, Radka Štěpánová, Petr Němec

Cor Vasa 2013, 55(4):e309-e314 | DOI: 10.1016/j.crvasa.2013.03.012  

Introduction: Coronary allograft vasculopathy (CAV) is one of the main factors limiting long-term survival following orthotopic heart transplantation (HTx). Whether or not and, if so, how donor-transmitted atherosclerosis (DCA) affects the post-transplant course of the allograft recipient is still unclear. Conventional coronary angiography is a moderately accurate technique for DCA detection as it will reveal only the more gross morphological lesions. By contrast, intravascular ultrasound (IVUS) has been shown to be a much more sensitive technique for CAV and DCA detection. In our study we sought to determine the prevalence of DCA in our HTx patient...

Pediatric heart transplantation: 17-year Brno experience

Marie Ošmerová, Petr Němec, Jan Černý

Cor Vasa 2013, 55(4):e315-e319 | DOI: 10.1016/j.crvasa.2013.05.008  

Aim: To summarize the follow-up of children who underwent orthotopic heart transplantation (HTx) in the Center of Cardiovascular and Transplantation Surgery in Brno during the past 17 years.Patients and methods: Between May 1995 and October 2012, 42 children aged 2 months-17.5 years were listed for HTx, of these 26 underwent HTx later.Results: Of 42 children listed for HTx, 12 died, 26 underwent HTx, 3 were excluded because of improved clinical status, and 1 is waiting for HTx. Five children died early after the transplantation, one patient died 6.5 years after HTx. The 1-year, 5-year and 10-year post-transplantation survival rates are 81%,...

Heart transplantation after short-term mechanical circulatory support

Vladimír Horváth, Petr Němec, Jiří Ondrášek, Jiří Slavík, Petr Pokorný, Helena Bedáňová, Marek Orban

Cor Vasa 2013, 55(4):e320-e323 | DOI: 10.1016/j.crvasa.2013.05.002  

Introduction: Short-term ventricular assist device (VAD) implantation is a life-saving procedure in patients with refractory cardiogenic shock. The present paper provides our experience with patients we were able to bridge from this critical condition directly to heart transplantation.Method: Our group comprises 11 patients implanted a Levitronix CentriMag short-term ventricular assist device from April 2009 to October 2012 as a bridge to heart transplantation. Six (55%) patients received a biventricular assist device while five (45%) had a left-ventricular assist device implanted. The mean age of patients was 41.2 years (20-63 years). Our group...

Impact of inflammatory infiltration and viral genome presence in myocardium on the changes of echocardiographic parameters

Jan Krejčí, Hana Poloczková, Petr Hude, Tomáš Freiberger, Eva Němcová, Víta Žampachová, Alžběta Sirotková, Radka Štěpánová, Lenka Špinarová, Petr Němec, Jiří Vítovec

Cor Vasa 2013, 55(4):e333-e340 | DOI: 10.1016/j.crvasa.2013.02.003  

Patients and methods: 70 patients with a recent occurrence of DCM with left ventricle ejection fraction (LVEF) < 40 % and with the history of symptoms less than 12 months were enrolled to observation. In EMB samples the average number of T-lymphocytes (CD3+ cells) and mononuclear leucocytes (LCA+ cells) in mm2 was determined. The presence of inflammation was evaluated as positive in case of findings > 7 CD3+ cells and/or > 14 LCA+ cells in mm². The detection of pathological agents in myocardium was performed by quantitative polymerase chain reaction (PCR).Results: According to immunohistological (IH) assessment findings were...

Relationship of cardiorenal biomarkers for prediction of renal dysfunction in patients after heart transplantation

Lenka Hošková, Janka Franeková, Ivan Málek, Peter Sečník Jr., Jan Pirk, Josef Kautzner, Ondřej Szárszoi, Antonín Jabor

Cor Vasa 2013, 55(4):e364-e369 | DOI: 10.1016/j.crvasa.2013.03.004  

Introduction: Renal dysfunction is a frequent complication after heart transplantation (HTx). It is mainly a result of ischaemic-reperfusion injury and/or the use of calcineurin inhibitors (CNIs). Serum creatinine and glomerular filtration rate (GFR) are widely used parameters for evaluation of renal function. However, serum creatinine is not accurate indicator, especially when kidney function changes. In our study, we focused on the assessment of microalbuminuria, cystatin C, lipocalin-2 (NGAL) and alpha-1-microglobulin (α-1M).Aim: To describe the association between the measured biomarkers and renal functions during 6 months of follow-up.Methods:...

Why to use propensity score in observational studies? Case study based on data from the Czech clinical database AHEAD 2006-09

Simona Littnerová, Jiří Jarkovský, Jiří Pařenica, Tomáš Pavlík, Jindřich Špinar, Ladislav Dušek

Cor Vasa 2013, 55(4):e383-e390 | DOI: 10.1016/j.crvasa.2013.04.001  

Randomized clinical trials represent the gold standard of the evidence based medicine research; nevertheless they may not always be feasible or ethical and the researchers have to rely on observational studies or research databases. However, obtaining reliable results from these studies requires the elimination of potential influence of confounding factors. Fortunately, several statistical methods capable of identifying and reducing the impact of confounding factors exist. One of them is the propensity score which has been frequently used in recent times to estimate relevant clinical effects adjusted for given confounders. This work aims to provide...

Comparison of clinical guidelines for the diagnosis and treatment of chronic heart failure of ČKS and ESC 2012

Jindřich Špinar, Jiří Vítovec, Jaromír Hradec, Ivan Málek, Jaroslav Meluzín, Lenka Špinarová, Lenka Hošková, Markéta Hegarová, Ondřej Ludka, Miloš Táborský

Cor Vasa 2013, 55(4):e301-e308 | DOI: 10.1016/j.crvasa.2013.03.011  

In 2012, the Czech and European clinical guidelines for diagnosis and treatment of heart failure have been issued. The main difference between them is that the European guidelines include both acute and chronic heart failure while our national guidelines contain only chronic heart failure.They differ even in the definition of heart failure; the European guidelines do not include natriuretic peptides among the diagnostic criteria and response to treatment as an auxiliary criterion in cases of unclear diagnosis.Regarding signs and symptoms of heart failure, both guidelines are similar in this part, they only differ in their categorization. In...

Metabolic profile of patients after heart transplantation

Lenka Špinarová, Peter Lidinský, Petr Hude, Jan Krejčí, Hana Poloczková, Július Godava, Jiří Vítovec

Cor Vasa 2013, 55(4):e324-e329 | DOI: 10.1016/j.crvasa.2013.06.010  

Orthotopic heart transplantation improves life expectancy and quality of life in patients with severe heart failure. After transplantation, metabolic complications are frequent. They are caused particularly by immunosuppressive therapy. In our cohort of 315 patients, 52% had diabetes mellitus together with hyperlipoproteinemia, hyperlipoproteinemia without diabetes had 41% of patients, diabetes mellitus without hyperlipoproteinemia 3% of patients and none of these disorders only 4% of patients. Therapeutic options with respect to interactions with immunosuppressive therapy are discussed in this article.

New biomarkers and heart failure

Dagmar Vondráková, Filip Málek, Petr Ošťádal, Andreas Krüger, Petr Neužil

Cor Vasa 2013, 55(4):e345-e354 | DOI: 10.1016/j.crvasa.2013.04.003  

Heart failure is a major health problem with an increasing incidence and prevalence of the disease. The role of both established natriuretic peptides: B-type natriuretic peptide (BNP) and N-terminal prohormone pro-brain natriuretic peptide (NT-proBNP) in acute and chronic heart failure (HF) has been intensively studied. Its testing is routine in clinical practice for diagnosis and prognosis in HF. However, increased clarification and understanding of the interplay in the pathophysiology of HF revealed several new potential cardiac biomarkers. These novel biomarkers soluble ST2, galectin, copeptin and mid-regional fragment of pro-adrenomedullin (MR-proADM)...

Possibilities of influencing the myocardial remodeling

Markéta Hegarová, Ivan Málek

Cor Vasa 2013, 55(4):e355-e363 | DOI: 10.1016/j.crvasa.2013.06.003  

Current possibilities of chronic heart failure treatment with positive impact on patient prognosis interfere with the pathophysiological processes of myocardial remodeling. RAAS-inhibitors and beta-blockers are considered to be effective pharmacological therapeutics. Available non-pharmacological methods of intervention are: cardiac resynchronization therapy, valvular diseases corrections and mechanical cardiac support devices. The effect of pharmacological therapy is dose-dependent and the effect of all mentioned treatment methods is additive.

Natriuretic peptides in heart failure

Jan Krupička, Tomáš Janota, Jaromír Hradec

Cor Vasa 2013, 55(4):e370-e376 | DOI: 10.1016/j.crvasa.2013.03.010  

The worldwide incidence of heart failure is steadily increasing over the past several decades, partly due to population aging and improved survival of patients with cardiovascular diseases. Therefore the importance of biochemical substances raises which would uncover ongoing cardiac overload, enable the treatment monitoring and make care of the patients with heart failure more effective. According to the results of many clinical trials, this task is fulfilled at most by natriuretic peptides which become gradually a part of standard clinical practice. Both, brain natriuretic peptide and its N-terminal propeptide help to detect heart failure in patients...

Durable left ventricular assist devices - the minimum for referring cardiologists

Eva Goncalvesová

Cor Vasa 2013, 55(4):e377-e382 | DOI: 10.1016/j.crvasa.2013.06.004  

Growing population of advanced heart failure patients represents one of the major burdens for health care system. Heart transplantation is the gold standard for a severe HF but contraindications and lack of donors are ultimate hurdles for its widespread use. Heart replacement using durable mechanical circulatory support, e.g. continuous-flow left ventricular assist devices (LVAD), has grown fast in recent years. It is reasonable to assume that the number of LVAD implantations will continue to grow and will soon exceed the number of HTx. The review is intended to provide essential information on the results of clinical trials with continuous-flow left...

Heart failure in patients with liver cirrhosis

Radek Pudil, Radek Pelouch, Rudolf Praus, Martina Vašatová, Petr Hůlek

Cor Vasa 2013, 55(4):e391-e396 | DOI: 10.1016/j.crvasa.2013.06.002  

Liver cirrhosis is associated with severe hemodynamic changes which include hyperdynamic circulation with increased cardiac output, heart rate and reduced systemic vascular resistance. The term cirrhotic cardiomyopathy is defined as the presence of chronic cardiac dysfunction, characterized by blunted contractile responsiveness to stress and altered diastolic relaxation with electrophysiological abnormalities (QT interval prolongation), all occurring in the absence of any other cardiac disease. The key role in diagnosis is played by 2-dimensional echocardiography, electrocardiography and various serum markers (natriuretic peptides). The prognosis of...

Hypertension and chronic kidney diseases

Václav Monhart

Cor Vasa 2013, 55(4):e397-e402 | DOI: 10.1016/j.crvasa.2013.07.006  

Chronic kidney diseases - arising from inborn or acquired renal disorders - are one of the most common causes of secondary hypertension. Renal parenchymatous hypertension accompanying bilateral or unilateral kidney diseases is more prevalent than renovascular hypertension. The prevalence and severity of hypertension are influenced by age, weight, type of renal affliction, and depth of renal dysfunction. In multifactorial pathogenesis, sodium retention plays the crucial role together with dysbalance concerning effects of different vasoactive substances; however, unequivocal distinction between volume- and renin-type hypertension is difficult. The treatment...

Gerd Herold und Mitarbeiter: Innere Medizin

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2013, 55(4):509-510  

Milan Cholt: Cévní sonografie. Repetitorium ultrazvukové cévní diagnostiky a atlas nálezů na DVD

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2013, 55(4):510  

Zápis ze schůze výboru ČKS konané dne 4. 5. 2013 v Brně

P. Widimský, P. Riebauerová

Cor Vasa 2013, 55(4):511-512  

Intoxikace blokátory kalciových kanálů při kombinovaném pokusu o suicidium

Bc. Jitka Callerová

Cor Vasa 2013, 55(4):507-508  

K životnímu jubileu prof. MUDr. Romana Čerbáka, CSc.

Prof. MUDr. Jiří Vítovec, CSc., FESC, prof. MUDr. Jindřich Špinar, CSc., FESC

Cor Vasa 2013, 55(4):504-505  

Kardiolog mezi kardiochirurgy

Petr Němec

Cor Vasa 2013, 55(4):505  

Kulaté výročí prof. MUDr. Romana Čerbáka, CSc.

Jaromír Hradec

Cor Vasa 2013, 55(4):506  

Editorial Board

Editorial board

Cor Vasa 2013, 55(4):i | DOI: 10.1016/S0010-8650(13)00099-4