Potential drug-drug interactions between oral anticoagulants for high-risk patients with atrial fibrillation in Latvia

Ketija Apsite, Katrina Pukite, Andris Tupahins, Natalija Nikrus, Baiba Lurina, Irina Pupkevica, Aivars Lejnieks, Oskars Kalejs

Cor Vasa 2019, 61(3):e266-e271 | DOI: 10.33678/cor.2019.023  

Introduction: Atrial fibrillation (AFib) is a disease that affects many people, especially elderly ones. All of these persons have an increased risk of thromboembolic event. For lowering the risk these patients use anticoagulation therapy. There are two types of oral anticoagulants - vitamin K antagonist warfarin and new, known also as direct oral anticoagulants, dabigatran and rivaroxaban. Due to several comorbidities and other complications, e.g. the risk of bleeding and thromboembolism, AFib patients are using different medication simultaneously, therefore increasing the risk of drug-drug interactions because of one metabolism path through P-glycoprotein...

Role of serum microRNA-499 as a diagnostic marker in acute myocardial infarction

Kuzhandai Velu Vengatapathy, Ramasamy Ramesh, Medha Rajappa, Shweta Kulkarni, Mohammad Hanifa

Cor Vasa 2019, 61(3):e272-e276 | DOI: 10.1016/j.crvasa.2018.03.008  

Acute myocardial infarction is one of the leading causes of morbidity and mortality in developing countries such as India and even worldwide. Its etiology is complicated because of several confounding factors involved in its pathogenesis. Recently, MicroRNA has been recognized to play an important role in predicting the diagnosis and prognosis of myocardial infarction. MiR-499 plays a pivotal role in the recovery of cardiac cell, following injury. Since several studies have profiled several miRs in cardiovascular diseases and of which miR-499 is mainly expressed in the myocardium. Our study is primarily designed to explore the diagnostic role of miR-499...

Current status of secondary prevention in Czech coronary patients in the EUROASPIRE V Study

Jan Bruthans, Otto Mayer jr., Pavel Šulc, Kristina Hašplová, Martina Cvíčela, Július Gelžinský, Markéta Hronová, Jan Filipovský, Renata Cífková

Cor Vasa 2019, 61(3):e277-e283 | DOI: 10.33678/cor.2019.007  

Introduction: Secondary prevention after myocardial infarction is at least as important as treatment of the acute phase. Improved cardiovascular (CV) prevention can decisively contribute to the continuation of positive trends of CV morbidity and mortality seen in the Czech Republic in last three decades. Objectives: To determine, in patients with coronary heart disease (CHD), how the treatment goals as defined by the current European guidelines on CV secondary prevention (2012) are implemented in clinical practice. Methods: Patients ≤ 80 years when hospitalized for acute coronary syndrome, and/or CABG or PCI were identified from hospital records...

(Tryton - an alternative to established bifurcation techniques?)

Jiří Widimský, David Horák, Vladimír Hraboš, Zdeněk Šembera, Lukáš Jaworski, Jan Horák

Cor Vasa 2019, 61(3):e285-e289 | DOI: 10.33678/cor.2019.012  

Bifurcation lesions make up 15-20% of all treated coronary lesions. Despite impressive advances in interventional cardiology, their treatment has been associated with technical challenges and rather poor clinical efficacy. The main recommended strategy in the treatment of these lesions is "provisional stenting", with a double-stent technique to be possibly considered as an alternative. In our registry, we decided to assess the safety, technical and clinical success rates in the treatment of these lesions using the dedicated Tryton Side Branch bifurcation stent. The registry included 201 patients of an unselected population considered for treatment...

Cyanoacrylate glue in treatment of varicose veins

Karel Novotný, Vilém Rohn

Cor Vasa 2019, 61(3):e290-e293 | DOI: 10.33678/cor.2019.029  

Treatment of the great and small saphenous veins with modified cyanoacrylate is one of the most recent techniques. The article discusses the current findings related to cyanoacrylate treatment of varices, the mechanism of cyanoacrylate polymerization and degradation, cyanoacrylate properties, application-related risks, results of available studies, cyanoacrylate toxicity, and its histocompatibility, or findings related to vessel wall reactions to cyanoacrylate.

(Energetic metabolism of endothelial cell)

Adéla Prokopcová

Cor Vasa 2019, 61(3):e294-e298 | DOI: 10.33678/cor.2019.027  

Endothelial cells form an active lining of vascular system. They have a very active metabolism and so they have high demand for energy. The main source of energy is glucose that is utilized by anaerobic glycolysis. Other sources are used to produce metabolic intermediates needed for the maintenance of cell structure and for signalization in resting state, and for vascular proliferation in active state. Resting endothelial cells are not very sensitive to hypoxia. A lack of glucose and coincident hypoxia lead after some time (if their supply is not restored in time) to energetic collapse and cellular necrosis.

Depression, cardiovascular disease, and related pathophysiologic mechanisms in women

Tea Gegenava, Maka Gegenava

Cor Vasa 2019, 61(3):e300-e304 | DOI: 10.33678/cor.2019.028  

Background: Although depression is already elevated to the status of a risk factor for CVD in AHA and EACPR guidelines and recommendations, there is lack of gender specific information. Studies have proven that depression can be more prevalent in women at specific age and more significantly predisposes cardiovascular mortality compared to men. Purpose: The goal of our manuscript was to review current evidences suggesting prevalence of cardiovascular disease and depression in women, to find out the link between depression and cardiovascular disease in this particular population and determine plausible biological mechanism to account for this relationship....

(Midventricular obstruction in hypertrophic cardiomyopathy)

Tomáš Březák, Josef Veselka

Cor Vasa 2019, 61(3):e305-e308 | DOI: 10.1016/j.crvasa.2018.08.002  

In this series of case reports we present three patients with midventricular obstruction as a less usual complication of hypertrophic cardiomyopathy. We briefly analyse mechanisms leading to the development of midventricular obstruction, its consequences, therapeutic alternatives and especially diagnostic possibilities of echocardiography including the demonstration of typical findings. The aim of the article is to remind this less frequent variant of the disease that may be encountered in a cardiologist's practice.

Cardioembolic stroke as consequence of myocardial infarction: case report and concise review

Ondřej Černý, Tomáš Roubíček, Jindřich Kupec, Rostislav Polášek

Cor Vasa 2019, 61(3):e309-e313 | DOI: 10.1016/j.crvasa.2018.07.003  

Despite tremendous achievements in myocardial infarction therapy, thromboembolic complications remain very serious and its prognosis often fatal. Postinfarction cardioembolic stroke is the most frequent and has the highest mortality of all ischemic stroke subtypes. In this case report we describe cardioembolic stroke from postinfarction apical left ventricular aneurysm as a first symptom of myocardial infarction. In brief literature overview we discuss main risk factors and prognosis, diagnostic algorithm and anticoagulation strategy.

Ebstein's anomaly with significant dysplasia of the tricuspid valve presenting at 73 years of age. A case report

Lumír Koc, Jiří Ondrášek, Tomáš Zatočil, Anna Nečasová, Jindřich Špinar

Cor Vasa 2019, 61(3):e314-e317 | DOI: 10.1016/j.crvasa.2018.07.004  

Ebstein's anomaly (EA) is a rare congenital heart defect, characterized by an anomalous tricuspid valve displaced towards the apex of the right ventricle (RV); it is usually accompanied by regurgitation. While its severe forms with an extremely dilated functional RV and oppression of the left heart chambers result in the development of severe heart failure at a young age and, in some cases, even prenatally, patients with mild EA may live until old age with the condition unrecognized. We present the case of a patient with a milder form of EA and a contribution of dysplasia, with the disease undiagnosed until his eighties when he developed heart failure...

Iatrogenic epinephrine-induced Takotsubo cardiomyopathy in beta-blocker poisoning: case report

Abdelbaki Azouzi, Majdi Omri, Hajer Kraiem, Hanen Mbarek, Mehdi Slim, Mohamed Boussarsar

Cor Vasa 2019, 61(3):e319-e322 | DOI: 10.1016/j.crvasa.2018.06.004  

Background: Takotsubo cardiomyopathy is a transient left ventricular dysfunction with wall-motion abnormalities which mimics myocardial infarction without acute coronary disease. Physiopathology of this entity remains unclear and different hypotheses are given. We present a case of a multifactor induced takutsubo cardiomyopathy in a young 18-year-old man. Case presentation: A previously healthy 18-year-old North African male presented to the emergency department for beta-blocker poisoning (propranolol). Physical examination revealed signs of circulatory failure with cardiac conduction disturbances. The patient's hemodynamic status stabilized after...

The less common arrhythmias in the acute cardiac care unit

Predrag Stojadinović, Jiří Kettner, Josef Kautzner

Cor Vasa 2019, 61(3):e323-e326 | DOI: 10.1016/j.crvasa.2018.06.005  

Acute cardiac care (ACC) is being continuously delivered by healthcare professionals to the patients with a wide spectrum of acute cardiovascular diseases or conditions. The aim of this communication is to demonstrate the diagnosis and treatment strategies of less common arrhythmias in the ACC unit. Due to didactic reasons, these arrhythmias will be divided into supraventricular and ventricular. We present three real-life cases.

Obstructive sleep apnea syndrome as a cause of secondary arterial hypertension: a case report

Petr Štverka, Miroslav Homza, Vilém Novák

Cor Vasa 2019, 61(3):e327-e332 | DOI: 10.33678/cor.2019.021  

Sleep medicine is a young discipline that has experienced unprecedented development in the last ten years. It is a multidisciplinary field that necessitates cooperation with other medical disciplines. Sleep apnea is a condition in which sleep medicine impacts cardiology. The pathophysiology of obstructive sleep apnea includes, inter alia hyperactivation of the sympathetic nervous system (SNS) with a number of implications for the cardiovascular system. This case report reveals the importance of considering obstructive sleep apnea syndrome in relation to resistant hypertension.

Jan Petrášek: Vzpomínky aneb honem než to zapomenu

Petr Bartůněk

Cor Vasa 2019, 61(3):e348  

(Secondary prevention of coronary heart disease and peripheral artery disease combining antiaggregation and anticoagulation therapy. Expert consensus statement of the Czech Society of Cardiology, the Czech Society of Internal Medicine and the Czech Society of Angiology to the outcomes of COMPASS trial)

Petr Widimský, Debora Karetová, Richard Češka, Miloš Táborský, Hana Rosolová, Jean-Claude Lubanda, Aleš Linhart

Cor Vasa 2019, 61(3):e334-e340 | DOI: 10.33678/cor.2019.019  

(Towards better definition, quantification and treatment of fibrosis in heart failure.

Jana Petřková, Miloš Táborský

Cor Vasa 2019, 61(3):e341-e347 | DOI: 10.33678/cor.2019.022