The changes of secondary prevention practice in Czech post-stroke patients between 2007 and 2012/13

Jiří Vaněk, Otto Mayer jr., Peter Wohlfahrt, Lenka Kielbergerová, Alena Krajčoviechová, Jan Bruthans, Renata Cífková

Cor Vasa 2016, 58(4):e367-e373 | DOI: 10.1016/j.crvasa.2015.11.007  

It is evident that post-stroke patients benefit from appropriate secondary prevention; however, in clinical reality these patients are often overlooked in these terms. We aimed to evaluate the changes in adherence to treatment targets (defined by current guidelines) since 2007 in Czech patients after first ischemic stroke.Two independent descriptive surveys were undertaken in 2007 and 2012/2013. Consecutive patients less than 81 years of age suffering from verified first ischemic stroke were identified and examined at least 6 months afterwards.The study population included 2 series of 341 and 424 patients, aged 69.0 (±SD 9.1) and 66.8...

Reducing cardiac after-load by lowering blood viscosity in patients with familial hypercholesterolemia - A pilot study. Possible mechanism for occurrence of anemia in chronic heart failure patients?

Gheorghe A. M. Pop, Menko-Jan de Boer, Anton F. Stalenhoef

Cor Vasa 2016, 58(4):e374-e378 | DOI: 10.1016/j.crvasa.2015.10.001  

Anemia is present in more than 40% of the patients with chronic heart failure (CHF), especially in those with reduced ejection fraction. The etiology is not yet understood. Hematocrit is a major determinant of whole blood viscosity, which is an important factor of the total peripheral resistance for the heart. Therefore, lowering blood viscosity may reduce after-load for the failing heart. Patients with homozygous familial hypercholesterolemia (HFH) are characterized by markedly elevated low-density lipoprotein (LDL) cholesterol levels and premature ischemic heart disease. Selective LDL-cholesterol apheresis in HFH patients to remove LDL from the circulation...

Tricuspid annuloplasty using De Vega modified technique - Short-term and medium-term results

Monika Kunová, Radim Frána, František Toušek, Aleš Mokráček, Ladislav Pešl

Cor Vasa 2016, 58(4):e379-e383 | DOI: 10.1016/j.crvasa.2015.11.006  

Background: Tricuspid regurgitation is very often present in patients undergoing combined cardiosurgery operation. Tricuspid annuloplasty using modified De Vega technique is one of the possible approaches during the operation.Aim: To evaluate short-term and medium-term results of tricuspid valve annuloplasty by De Vega modified technique.Methods and results: From 1 April 2000 to 31 December 2013, there were total of 529 tricuspid valve repairs performed, out of which 43 patients had De Vega modified annuloplasty, in the Cardiocentre of České Budějovice Hospital. The cohort was composed of 17 males and 26 females with mean age (± SD)...

The impact of cardiac rehabilitation program on anxiety and depression levels after coronary artery bypass graft surgery

Leili Pourafkari, Samad Ghaffari, Arezou Tajlil, Jafar Shahamfar, Solmaz Hedayati, Nader D. Nader

Cor Vasa 2016, 58(4):e384-e390 | DOI: 10.1016/j.crvasa.2016.01.001  

Purpose: To investigate the role of cardiac rehabilitation program in depression and anxiety levels after coronary artery bypass graft surgery. Depression and anxiety are associated with worse outcome after coronary artery bypass graft surgery.Methods: We enrolled 40 consecutive patients who underwent coronary artery bypass graft surgery. They participated in an eight-week cardiac rehabilitation program (REH). Patients were personally interviewed for assessment of depression and anxiety. A research team member completed Beck's Depression Inventory-II (BDI-II) and Beck's Anxiety Inventory (BAI) for all patients before and after the rehabilitation...

Right bundle branch block and heart failure: Can a bifocal right ventricular pacing be an alternative to biventricular pacing?

Eraldo Occhetta, Gabriele Dell'Era, Chiara Sartori, Anna Degiovanni, Elisa Maggi, Paolo Marino

Cor Vasa 2016, 58(4):e391-e395 | DOI: 10.1016/j.crvasa.2016.01.016  

Patients with right bundle branch block (RBBB) and heart failure (HF) are not well represented in large randomized clinical trials evaluating the efficacy of cardiac resynchronization therapy (CRT), which included mainly left bundle branch block morphology. According to a recent meta-analysis, in our series we have 14 patients with RBBB and HF treated with conventional CRT (biventricular pacing), all of them turned out to be "non-responders".Bifocal pacing, a particular modality of simultaneous pacing with two leads implanted in the right ventricle, is a current option in case of unsuccessful biventricular pacing. In accordance with the results...

Geographic variation in the access to heart transplantation in the Czech Republic

Silvia Pasnišinová, Jan Beneš, Petr Němec, Helena Bedáňová, Jan Pirk, Ivan Málek, Josef Kautzner, Vojtěch Melenovský

Cor Vasa 2016, 58(4):e396-e402 | DOI: 10.1016/j.crvasa.2015.09.011  

Background: Heart transplantation (HTx) is the last resort therapeutic option in management of end-stage heart failure (HF). Geographic variation in incidence of HTx may disclose regional bias in the access to health care. The purpose of the study was to evaluate regional distribution of HTx in the Czech Republic.Methods: We retrospectively analyzed data from all patients who underwent HTx in the Czech Republic between 1. 1. 2008 and 30. 9. 2013 and determined the incidence of HTx in all counties ("okresy") and higher administrative regions ("kraje"). In addition, we determined whether such regional incidence of HTx was related to geographical,...

Elevated systolic pulmonary artery pressure for prediction of myocardial necrosis and right ventricular dysfunction in acute pulmonary embolism

Karsten Keller, Martin Geyer, Meike Coldewey, Johannes Beule, Jörn Oliver Balzer, Wolfgang Dippold

Cor Vasa 2016, 58(4):e403-e410 | DOI: 10.1016/j.crvasa.2015.12.001  

Background: Echocardiography is currently the mainstay examination for assessment of right ventricular dysfunction (RVD) in acute pulmonary embolism (PE). RVD is associated with poorer prognosis, but there is still no generally accepted definition. Systolic pulmonary artery pressure (sPAP) is mostly not included in these RVD-criteria. We aimed to investigate sPAP for prediction of myocardial necrosis and RVD in acute PE.Methods: Data of 182 patients with acute PE were analysed retrospectively. PE patients with sPAP ≤ 30 mmHg were compared to those with sPAP > 30 mmHg. Logistic regression models were calculated to investigate associations...

Platelet function testing after acute myocardial infarction: The correlation among various assays is insufficient

Radomír Nykl, Jiří Plášek, Tomáš Fürst, Jana Fürstová, Jaromír Gumulec, Karin Lichá, Miroslav Homza

Cor Vasa 2016, 58(4):e411-e418 | DOI: 10.1016/j.crvasa.2015.11.004  

Aim: High on-treatment platelet reactivity (HPR) after Acetylsalicylic acid (ASA) and/or Clopidogrel was identified by four different platelet function assays in high risk acute myocardial infarction patients. Correlation among the methods was examined and variability in the measurement of each platelet function assay was evaluated.Methods: Each of the 53 patients was sampled twice for LTA, PFA-100/200, Multiplate®, and VerifyNow® platelet function assays in the range of 3-5 days after a myocardial infarction. Non-parametric correlation and linear regression were used to assess the variability in the data.Results: All HPR platelet function...

Monocyte adhesion to the endothelium is an initial stage of atherosclerosis development

Soňa Čejková, Ivana Králová Lesná, Rudolf Poledne

Cor Vasa 2016, 58(4):e419-e425 | DOI: 10.1016/j.crvasa.2015.08.002  

The formation of atherosclerotic plaque is a long and very complex process. The first signs of development of atherosclerosis occur in areas where the blood vessels are strongly stressed. Although it clinically manifests from middle age, the first signs of plaque formation are detectable at a very early age [1]. Although the endothelium consists of only one layer of cells, it plays an important role in the development of atherosclerosis. The endothelium produces a wide range of factors that influence vascular tone, cellular adhesion, vessel wall injury, thromboresistance and smooth muscle cell proliferation. Adhesion and migration of monocytes occur...

Current look on postural tachycardia syndrome

Karel Vykoupil

Cor Vasa 2016, 58(4):e426-e430 | DOI: 10.1016/j.crvasa.2015.08.008  

Introduction: Postural tachycardia syndrome (POTS) is one of the common causes of orthostatic intolerance. It is a pathophysiologically heterogeneous disorder characterized by orthostatic intolerance and an increase of heart rate by 30 bpm in the first 10 min after standing up or during head-up tilt test (HUTT) without orthostatic hypotension.Clinical features: Symptoms accompanying this syndrome are those due to cerebral hypoperfusion and due to sympathetic hyperactivity and consist of orthostatic, nonorthostatic and diffuse associated symptoms.Classification: For this heterogeneous group of disorders, many different classifications have been...

Cardiac cachexia - Up-to-date 2015

Martin Gřiva

Cor Vasa 2016, 58(4):e431-e438 | DOI: 10.1016/j.crvasa.2015.08.003  

Cachexia is defined as unintended loss of 5% of the original body weight of a patient with edema within 3-12 months in combination with typical symptoms of a chronic disease. Prevalence of cardiac cachexia (CC) in chronic heart failure (CHF) is 5-15%, with an annual mortality rate of 20-30%. The condition involves loss of lean body mass (skeletal muscle), body fat, and, to a lesser extent, also bone tissue. In pathophysiological terms, cachexia is associated with complex alterations in neurohormonal and immunological status, catabolism prevailing over anabolism, and activation of pro-inflammatory cytokines, with the key role played by TNF-α....

When is it too late for a correction of an atrial septal defect secundum type in an adult patient?

Stefan Naydenov Naydenov, Nikolay Margaritov Runev, Emil Ivanov Manov, Rabhat Ahmet Shabani, Temenuga Ivanova Donova, Pencho Doychev Kratunkov

Cor Vasa 2016, 58(4):e439-e443 | DOI: 10.1016/j.crvasa.2015.06.004  

Atrial septal defects (ASD) are among the most commonly recognized congenital cardiac anomalies presenting in adulthood, characterized by a defect in the interatrial septum allowing blood from the left atrium to pass to the right atrium. In this article we present a clinical case of a 39-year-old female patient with uncorrected ASD secundum type, diagnosed in adulthood after cardiac morphologic and functional changes, have been developed. At the time of presentation, clinical symptoms required exclusion of life-threatening complications such as infective endocarditis, located at the interatrial defect. After careful evaluation, surgical approach was...

A case of dynamic segmental saphenous vein graft compression during diastole

Andreas Y. Andreou

Cor Vasa 2016, 58(4):e444-e447 | DOI: 10.1016/j.crvasa.2015.07.002  

We present the case of a patient in whom coronary angiography performed for non-ST-segment elevation myocardial infarction five months after coronary artery bypass graft surgery disclosed a tight stenosis with superimposed diastolic compression in the proximal segment of a saphenous vein graft (SVG) to a diagonal artery. Furthermore, the SVG segment immediately distal to the stenosis exhibited obstructive dynamic compression during diastole. Stent implantation across the proximal stenosis was undertaken successfully with a consequent resolution of the dynamic downstream stenosis. This is the third case of diastolic segmental SVG compression not related...

Acute myocardial infarction due to coronary dissection in early postpartum

Hakan Altay, Didem Oguz, Ersin Doganozu, Seckin Pehlivanoglu

Cor Vasa 2016, 58(4):e448-e450 | DOI: 10.1016/j.crvasa.2015.06.003  

Spontaneous coronary artery dissection (SCAD) is a rare but well known cause of myocardial ischemia. The majority of the victims are young who have a few cardiac risk factors. SCAD typically causes large myocardial infarction and presents significant challenges to diagnosis and management. SCAD is the most common cause of myocardial ischemia during peripartum and postpartum period in woman of childbearing age.We present a case of acute anterior myocardial infarction (MI) in a breastfeeding woman, 13 days after delivery. The presumed cause was flow limiting left anterior descending (LAD) artery dissection, in the particular context of peripartum....

Rare case of a patient with recurrent thrombosis of a mechanical valve during pregnancy

Kateřina Vrkočová, Jiří Plášek, Tomáš Veiser, Miroslav Homza

Cor Vasa 2016, 58(4):e451-e456 | DOI: 10.1016/j.crvasa.2015.06.002  

There is always a risk during the pregnancy of a patient with a prosthetic valve. Thrombosis of a prosthetic valve is one of the most severe complications that may be life-threatening to both the mother and the foetus. Thrombosis of a prosthetic valve may be treated either with thrombolysis or surgically, which both may be accompanied by severe complications. Our case report presents the case of a pregnant patient who underwent treatment step by step with both of the methods mentioned above. At the time the first mechanical mitral valve thrombosis occurred, she underwent thrombolysis which was successful despite the transient neurologic deficit. Upon...

Čestná členství a ceny České kardiologické společnosti 2016

Prof. MUDr. Miloš Táborský, CSc., FESC, FACC, MBA

Cor Vasa 2016, 58(4):507  

18. symposium Pracovní skupiny chlopenní a vrozené srdeční vady v dospělosti

Cor Vasa 2016, 58(4):512-516  

Jiří Kettner, Josef Kautzner et al.: Akutní kardiologie

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2016, 58(4):508  

Zemřel prof. MUDr. Bořivoj Semrád, CSc. (7. 11. 1938-19. 6. 2016)

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

Cor Vasa 2016, 58(4):506  

Editorial Board

Editorial board

Cor Vasa 2016, 58(4):i | DOI: 10.1016/S0010-8650(16)30087-X  

Závěrečná zpráva ke grantovému projektu České kardiologické společnosti

Cor Vasa 2016, 58(4):509-511