Transition from angiotensin-converting enzyme inhibitor/angiotensin-II-receptor-blocker to sacubitril/valsartan in chronic heart failure patients: Initial experiences in clinical practice

Kateřina Hlavatá, Lenka Hošková, Janka Franeková, Antonín Jabor, Josef Kautzner, Vojtěch Melenovský, Jan Beneš

Cor Vasa 2018, 60(3):e209-e214 | DOI: 10.1016/j.crvasa.2017.10.009  

Background: Sacubitril/valsartan (S/V) therapy has been demonstrated to improve prognosis of patients with systolic heart failure (HF) when compared to standard therapy with ACEi. The purpose of this investigation was to document the safety and consequences of transition from ACEi/angiotensin-II receptor blocker (ARB) to S/V in chronic stable HF patients.Methods: A group of 12 stable HF outpatients (11 males, 1 female) was enrolled (NYHA 2.7 ± 0.7, 42% with coronary artery disease (CAD), average left-ventricle ejection fraction (LVEF) 26.5%. Patients were converted from ACEi/ARB to S/V. Laboratory evaluation, Minnesota Living with Heart...

Increased dose of diuretics correlates with severity of heart failure and renal dysfunction and does not lead to reduction of mortality and rehospitalizations due to acute decompensation of heart failure; data from AHEAD registry

Marie Pavlušová, Roman Miklík, Radim Špaček, Klára Benešová, Kamil Zeman, Alain Cohen-Solal, Alexandre Mebazaa, Simona Littnerová, Marián Felšöci, Ludmila Pohludková, Ladislav Dušek, Lenka Špinarová, Jiří Vítovec, Jindřich Špinar, Jiří Jarkovský, Jiří Pařenica

Cor Vasa 2018, 60(3):e215-e223 | DOI: 10.1016/j.crvasa.2017.09.007  

Background: Diuretics are being used to reduce symptoms of congestion and fluid retention in heart failure patients but their effect has not been studied in randomized clinical trials. The data about positive or negative effect of loop diuretics depending on their dose is conflicting and controversial. The aim of this analysis is to evaluate whether the relatively small increase in the dose of furosemide can reduce the incidence of readmissions for acute heart failure decompensation and/or total mortality.Methods and results: We evaluated a total of 1119 patients admitted for ADHF who were discharged from the hospital back home in a stable condition....

Chronic heart failure - Impact of the condition on patients and the healthcare system in the Czech Republic: A retrospective cost-of-illness analysis

Marie Pavlušová, Jiří Klimeš, Jindřich Špinar, Kamil Zeman, Jiří Jarkovský, Klára Benešová, Roman Miklík, Ludmila Pohludková, Marián Felšöci, Věra Veselá, Michaela Blahovcová, Filip Dostál, Richard Vonka, Jiří Pařenica

Cor Vasa 2018, 60(3):e224-e233 | DOI: 10.1016/j.crvasa.2018.03.002  

Background: The number of patients with heart failure is steadily increasing, as are the costs of their treatment. Nearly 70% of the costs associated with the treatment of heart failure are direct medical costs, and 70-80% of these are spent on hospitalizations. The aim of our study is to describe the all-cause hospitalization costs of patients with chronic heart failure (chronic HF) from the perspective of the healthcare system in the Czech Republic.Methods: In total, 1274 consecutively collected patients discharged in a stable condition from hospitalization for acute heart failure (= index hospitalization) from 2006 to 2012 were followed-up for...

Cardiac arrest center - One-year experience of the Regional Hospital Liberec

Jiří Seiner, Rostislav Polášek, Jan Lejsek, Matej Strýček, Jiří Karásek

Cor Vasa 2018, 60(3):e234-e238 | DOI: 10.1016/j.crvasa.2017.08.002  

Introduction: Out-of-hospital cardiac arrest (OHCA) is one of the most common causes of death in the adult population in developed countries. Centralization of post-resuscitation care may improve the patients' prognosis. Expert statement of the Czech Society of Cardiology recommends the establishment of cardiac arrest centers using the infrastructure of existing tertiary cardiac centers. The introduction of this system in the region of Liberec started in April 2016. The aim of our work is to present the one-year results compared to the results from previous years.Methods: All patients treated in the Department of Cardiology of Regional Hospital...

Analysis of time intervals related to STEMI management in 2008-2016

Lumír Francek, Ota Hlinomaz, Ladislav Groch, Silvie Bělašková

Cor Vasa 2018, 60(3):e239-e245 | DOI: 10.1016/j.crvasa.2017.07.007  

Introduction: A modern treatment of patients with ST segment elevation myocardial infarction (STEMI) is based on a rapid primary percutaneous coronary intervention with direct recanalization of the affected coronary artery (dPCI). The outcome of the treatment depends largely on the pre-hospital care management, which can reduce the total ischaemic time and subsequently improve patient's outlook.Aims: The principal aims of this retrospective study were to assess the development of time intervals related to the pre-hospital care and the effect of the mode of transportation to the cathlab (primary vs secondary) on these intervals in patients with...

Low cardiovascular event rate and high atrial fibrillation recurrence rate one year after electrical cardioversion

Evija Knoka, Irina Pupkevica, Baiba Lurina, Ginta Kamzola, Aldis Strelnieks, Oskars Kalejs, Aivars Lejnieks

Cor Vasa 2018, 60(3):e246-e250 | DOI: 10.1016/j.crvasa.2017.08.005  

Background: Electrical cardioversion is widely used to restore sinus rhythm in patients with atrial fibrillation. However, the long term clinical event and sinus rhythm maintenance rates following electrical cardioversion still remains unclear. This study evaluated one year incidence and risk factors for cardiovascular events and atrial fibrillation recurrence in a single center clinical practice.Methods: In a prospective study 188 patients with atrial fibrillation who underwent electrical cardioversion were enrolled. Patients and their primary care physicians were followed up one year after cardioversion and patient clinical and arrhythmic event...

Large vessel vasculitis

Lucie Zavadilová, Ladislav Gergely

Cor Vasa 2018, 60(3):e251-e262 | DOI: 10.1016/j.crvasa.2017.09.003  

Vasculitis represents a heterogeneous group of immunopathological diseases, characterized by the inflammation of blood vessels leading to destruction of the vascular wall, subsequent proliferation and constriction, or even blockage of the lumen. According to their range, inflammatory changes cause various severe systemic manifestations such as loss of appetite, weight loss, fever of unknown origin, and night sweats; locally causing ischemia of areas supplied by the affected artery. The aim of our paper is to highlight the fact that vasculitis pose significant danger for patients, who may encounter significant delays in getting the correct diagnosis...

Heart failure and inhibition of renin-angiotensin-aldosteron system

Jiří Vítovec, Jindřich Špinar, Lenka Špinarová

Cor Vasa 2018, 60(3):e263-e273 | DOI: 10.1016/j.crvasa.2018.02.003  

A historical survey is presented of mortality clinical trials focussed on the inhibition of the renin-angiotensin-aldosterone system on different levels in patients with chronic heart failure. The first study, CONSENSUS, was published in 1987 and showed that the ACE-inhibitor enalapril clearly reduced mortality in severe heart failure compared with placebo. This was followed by studies with beta blockers, angiotensin II type 1 receptor blockers, blockers of mineralocorticoid receptors, and direct renin inhibitors.A recent study, PARADIGM, comparing dual inhibitor of neprilysin and angiotensin II receptor (LCZ696) with enalapril, was terminated...

Obstructive sleep apnea in outpatient care - What to do with?

Monika Kamasová, Jan Václavík, Eva Kociánová, Miloš Táborský

Cor Vasa 2018, 60(3):e274-e280 | DOI: 10.1016/j.crvasa.2017.09.004  

Obstructive sleep apnea is a relatively common sleep disorder, which is on the increase in the last decades. It significantly contributes to morbidity and mortality in all countries worldwide. Obstructive sleep apnea is one of the most common causes of daytime sleepiness. Typical risk factors for obstructive sleep apnea in the normal adult population are male gender, obesity (preferentially central obesity), increased neck circumference, presence of manifest cardiovascular disease, diabetes mellitus, and anomalies in the upper respiratory tract. Early diagnosis and treatment improves not only the quality of life, but also significantly decreases patient...

Asymptomatic damage of central nervous system defined by excess level of protein S-100B in patients undergoing the radiofrequency ablation of ventricular tachycardia

Eva Šušková, Otakar Jiravský, Radek Neuwirth, Jan Chovančík, Marian Branny

Cor Vasa 2018, 60(3):e281-e286 | DOI: 10.1016/j.crvasa.2017.09.002  

Aim: Evaluation of the effect of radiofrequency catheter ablation of ventricular arrhythmias on asymptomatic central nervous system evaluation with the help S-100B protein. Furthermore, identification of factors predicting elevation of S-100B protein level after ablation.Methods: Consecutive patients undergoing RFA for ventricular arrhythmias between 11/2015 and 8/2016. Protein S-100B was evaluated before the procedure, immediately after the procedure, in 8 and 24 h after the procedure. In the case of the excess values of the S-100B protein within 24 h after computed tomography (CT) of CNS supplementation and neurological examination.Set of...

Echocardiography in patients with chronic kidney diseases

Jan Malík, Vilém Danzig, Vladimíra Bednářová, Zdenka Hrušková

Cor Vasa 2018, 60(3):e287-e295 | DOI: 10.1016/j.crvasa.2017.07.008  

Vast majority of chronic kidney disease patients die from cardiovascular complications. Echocardiography is a fundamental method, which reveals many of them. They include especially dilatation and systolic dysfunction of the left ventricle and atrium, left ventricular hypertrophy, diastolic dysfunction of the left ventricle, heart calcification, which could lead up to the development of stenotic valvular disease, right ventricular dysfunction and pulmonary hypertension. Patients with chronic kidney failure differ from the general population by cyclic changes of hydration and by the presence of a low resistant arteriovenous shunt (hemodialysis access)....

Sexual activity and cardiovascular disease, erectile dysfunction as a predictor of ischemic heart disease

Štěpán Hudec, Miloslav Špaček, Martin Hutyra, Ondřej Moravec, Miloš Táborský

Cor Vasa 2018, 60(3):e296-e305 | DOI: 10.1016/j.crvasa.2017.08.006  

Sexual activity affects the quality of life of patients with cardiovascular disease (CVD). The purpose of this document is to highlight the fact that sexual activity of patients with stable forms of CVD and moderate exercise tolerance is safe. Delaying resumption of sexual activity is not justified and could have a negative impact on the patient's mental status and the quality of partners' life. Vasculogenic erectile dysfunction is considered an independent risk factor for coronary heart disease.

Use of ultrasound guidance in vascular cannulation and effusion punctures at the cardiology department

Radim Špaček, Otakar Jiravský, Radek Neuwirth, Bronislav Holek, Libor Škňouřil, Jan Hečko, Marian Branny

Cor Vasa 2018, 60(3):e306-e313 | DOI: 10.1016/j.crvasa.2017.08.001  

The use of ultrasound in cardiology for the guidance of vessel cannulations and effusion punctures is getting more and more frequent every day. Ultrasound in this setting provides the operator with many advantages and after a certain learning curve, one is then able to cannulate vessels, that are small or normally inaccessible with the standard anatomical landmarks approach. Since many randomized studies confirmed the benefits of using ultrasound in these procedures, it has become a standard of care for many physicians and hospitals.

Recommendations to organize care for adults with congenital heart disease in the Czech Republic

Tomáš Zatočil, Petra Antonová, Jana Rubáčková Popelová, Daniela Žáková, Olga Pokorná, Václav Chaloupecký, Vilém Rohn, Ivo Skalský, Hana Jičínská, Miloš Táborský, Josef Kautzner, Jan Janoušek

Cor Vasa 2018, 60(3):e331-e334 | DOI: 10.1016/j.crvasa.2018.03.009  

Listerial myocarditis as a complication of Listerial meningoencephalitis

Matěj Strnadel, Tomáš Hnátek, Roman Havlíček, Eva Krčová, Martin Malý, Miroslav Zavoral

Cor Vasa 2018, 60(3):e314-e316 | DOI: 10.1016/j.crvasa.2017.02.004  

Here, we present a case report of a 53-year-old patient who was admitted for an acute ischaemic stroke. During the hospitalization period, the patient developed meningoencephalitis and acute myocarditis with recurrent episodes of ventricular fibrillation that required defibrillation repeatedly. Listeria monocytogenes was isolated from blood culture samples. The patient was treated with antibiotic therapy and showed a good clinical response. The diagnosis of myocarditis was based on the clinical and ECG presentation (ventricular arrhythmia) and elevation of troponin T level, echocardiography and MRI showed myocardial hypertrophy and pericardial effusion....

Composite venous allograft for femoro-pedal bypass grafting in critical limb ischaemia

Miroslav Špaček, Petr Mitas, Jan Hrubý, Rudolf Špunda, Pavel Měřička, Lukáš Lambert, Jaroslav Lindner

Cor Vasa 2018, 60(3):e317-e320 | DOI: 10.1016/j.crvasa.2017.03.003  

Background: We report a series of four patients with critical limb ischaemia and lack of autologous conduits, treated with composite (end-to-end anastomosis) allogenic fresh/or cryopreserved saphenous vein bypass grafting. This technique may be necessary in case of femoro-pedal artery bypass grafting, which is an extreme situation if there is shortage in length or inadequate quality of the venous allograft. Such a long reconstruction requires two donor saphenous veins.Case report: Four patients were indicated for "I-composite" fresh venous allograft for femoro-pedal bypass grafting. One composite graft occluded 4 months postoperatively, one 21...

Heterogeneous aetiology and clinical presentation of cardiac involvement in hypereosinophilic syndrome: A case series

Martin Kotrč, Miloš Kubánek, Pavlína Malíková, Dana Kautznerová, Jacqueline Maalouf, Tereza Jančušková, Petr Lupínek, Jana Vrbská, Vojtěch Melenovský, Josef Kautzner

Cor Vasa 2018, 60(3):e321-e326 | DOI: 10.1016/j.crvasa.2017.06.012  

Introduction: Hypereosinophilic syndrome (HES) is a heterogeneous group of diseases defined by marked hyperesonofilia (1.5× 109/l) that persists more than 6 months with organ infiltration and damage. Cardiac involvement in HES is common and is associated with significant morbidity and mortality. To illustrate contemporary diagnostic and therapeutic methods, we reviewed three cases of HES with cardiac involvement, recently diagnosed in our institution.Description of cases: We present a series of three cases of HES with cardiac involvement and clinical presentation in the form of intracardiac thrombosis. One of these cases was caused by FIP1L1-PDGFRA...

Takotsubo cardiomyopathy in a patient with essential thrombocythemia treated with anagrelide: Case report

Lenka Eremiášová, Josef Marek, Tomáš Paleček, Aleš Král, Michael Aschermann, Aleš Linhart, Vilém Danzig

Cor Vasa 2018, 60(3):e327-e330 | DOI: 10.1016/j.crvasa.2017.05.013  

Takotsubo cardiomyopathy is a rare syndrome. Most often imitates acute coronary syndrome. It is characterized by transient wall motion abnormalities, especially in the apical segments of the left ventricle. Less frequently it is possible to find transient akinesis or dyskinesis in the mid-ventricular segments of the left ventricle. Pathophysiological mechanisms are not completely clear. The main cause of stress cardiomyopathy is stress insult. But in rare cases takotsubo cardiomyopathy can be caused by other conditions. We reported a rare case of takotsubo cardiomyopathy caused by high dose anagrelide therapy. Anagrelide is most often used in patients...

Kam kráčíš, ty naše česká kardiorehabilitace?

Eliška Sovová

Cor Vasa 2018, 60(3):390-391  

Vladimír Tuka a kol. Preventivní kardiologie pro praxi

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2018, 60(3):392  

Editorial Board

Editorial board

Cor Vasa 2018, 60(3):i | DOI: 10.1016/S0010-8650(18)30062-6