Cor et Vasa, 2004 (vol. 45), issue 9
Original research articles
The risk profiles of smokers, ex-smokers, and non-smokers in a population random sample of the Czech Republic
Zdenka Škodová, Renata Cífková, Rudolf Poledne, Věra Lánská, Petr Stávek, Věra Adámková, Eva Novozámská, Marie Jozífová, Helena Pistulková, Markéta Plášková, Zdenka Petržilková, Ludmila Peterková, Daniel Palouš, Markéta Galovcová
Cor Vasa 2004, 45(9):409-417
Aim:One of the mechanisms of action of tobacco smoking on cardiovascular morbidity and mortality is an effect on lipid and carbohydrate metabolism and on some anthropometric parameters, which partly persists after smoking cessation. The aim of our study was to analyze and compare the lipid profiles of smokers, ex-smokers, and never-smokers in a population random sample of nine districts of the Czech Republic. Patients and method:A survey of risk factors was undertaken in the 2000-2001 in a 1% population random sample aged 25-64 years resident in Benešov, Cheb, Chrudim, Jindřichův Hradec, Kroměříž, Litoměřice, Pardubice, Plzeň-město,...
Surgical revascularization in patients with shortage of suitable vein grafts on the lower extremities
Petr Němec, Vilém Bruk, Marek Gwozdziewicz, Andrea Steriovský, Petr Vymětal, Roman Hájek
Cor Vasa 2004, 45(9):418-421
Aim:To assess the risk of revascularization with multiple arterial grafts in elderly patients with multiple risk factors. Patients and methods:A shortage of vein grafts on the lower extremities was found in 32 patients (aged 72.7 ± 5.5 years), who were listed for myocardial revascularization. The reasons for vein shortage were inferior quality in 21 patients (mostly because of varicose veins), absence of suitable vein grafts at all (9 patients had surgery for varicose veins) and fear of inappropriate wound healing (one patient suffered from leg ischemia and another one from the post-thrombotic syndrome). Results:The...
Review articles
Clinical applications of intracardiac echocardiography
Josef Kautzner, Robert Čihák, Michael Želízko, Tomáš Marek, Petr Frídl
Cor Vasa 2004, 45(9):423-427
Intracardiac echocardiography broadens the spectrum of echocardiographic techniques. Novel sector echocardiographic catheters allow (after their introduction into the right atrium) high-quality imaging of cardiac structures to a depth of 16 cm, including pulse and continuous wave Doppler and/or color Doppler. The main advantage of this method is that it allows to monitor complex cardiac interventions. These include predominantly catheter-based closures of atrial septal defects. Another area of interest is catheter ablation of complex arrhythmic substrates such as pulmonary vein isolation for treatment of atrial fibrillation or ablation of some ventricular...
Atherosclerosis and natural autoantibody. Part 1: Natural autoantibody and oxidized lipoproteins
Pavel Kuneš, Jan Krejsek
Cor Vasa 2004, 45(9):429-434
Natural IgM class antibody constitutes a protective factor offsetting the proatherogenic effects and cellular toxicity of oxidized low-density lipoproteins (LDL). The protective, antiatherogenic action of IgM class antibody takes place at two levels. The first, and the more important of both, is so called competitive inhibition. Binding of IgM class antibody to oxidized LDL results in reducing their phagocytosis by macrophages or vascular wall smooth muscle cells. The result is decreased formation of the foam cell as the basic substrate of the atherogenic process. Another, possibly only a complementary mechanism, is the formation of immune complexes...
Albumin cobalt binding capacity-a test for diagnosing myocardial ischemia. Potential clinical uses and practical experience
David Stejskal, Bořek Lačňák, Renata Juráková, Jitka Prošková, Sylva Adamovská, Gabriela Ožanová, Radka Ochmanová
Cor Vasa 2004, 45(9):435-438
The commonly used laboratory markers of coronary injury in individuals developing acute coronary syndrome (ACS) are not myocardial ischemia-specific and are not helpful unless irreversible myocardial injury has occurred. Recently, there has been debate on the need for a laboratory test capable of satisfactory identification of individuals with myocardial ischemia and symptoms typical of coronary heart disease (CHD) versus those free of CHD.Several papers have been published since 1994 addressing albumin cobalt binding (ACB) capacity, reporting unique diagnostic sensitivity and specificity of this test for estimating the presence of myocardial ischemia....
Case reports
Hyperhomocysteinemias caused by vitamin B12 deficiency and detected using selective screening in patients after Q-wave infarction, pulmonary embolism and deep vein thrombosis
Josef Hyánek, Jana Matoušková, Petr Kmoníček, Pavel Formánek, Petr Lepší, Karel Kopřiva, Ladislava Dubská, Jana Dvořáková, Hana Veselá, Karel Kupka, Bohumil Malec, Hedvika Pejznochová, Rudolf Hoffmann, Jozef Balasz, Věra Martiníková, Martina Vodičková, Josef Pola
Cor Vasa 2004, 45(9):440-445
The authors report three cases of high blood homocysteine levels; a patient after a Q-wave myocardial infarction (142.5 µmol/L), another patient with massive pulmonary artery embolism (72 µmol/L) and a female patient with deep vein thrombosis (98 µmol/L) while having a normal lipid spectrum. All three patients, after the acute event had resolved, were found to have low levels of vitamin B>sub>12, with hyperhomocysteinemia identified as the only potential trigger. Subsequent examinations demonstrated evolving pernicious anemia successfully treated by cobalamine administration. Two patients were shown to be heterozygous for a...
Short communication
VALUE for blood pressure. VALUE trial results have documented the key role of a blood pressure decrease
Jindřich Špinar, Jiří Vítovec
Cor Vasa 2004, 45(9):447-449
The VALUE trial was designed to compare valsartan (at a dose of 160 mg) with amlodipine (at a dose of 10 mg) in hypertensive patients at increased risk for cardiovascular complications. The study demonstrated more effective blood pressure control associated with amlodipine, as also reflected by the lower incidences of myocardial infarction (p = 0.02) and stroke (p = 0.08). Valsartan-treated patients showed a lower incidence of new-onset diabetes mellitus (p < 0.001). After adjustment to comparable blood pressure values, the incidence of cardiovascular complications was identical in both groups. Thus, the VALUE trial confirmed both the main outcome...
How to reach the target levels of LDL-cholesterol? The place of ezetimibe in current cholesterol-lowering therapy
Richard Češka
Cor Vasa 2004, 45(9):452-456
At present, there is an adequate body of evidence indicating that the benefit of lipid lowering is dependent primarily on the maximal lipid-modifying effects of therapy. As regards LDL lowering, the following hypothesis applies: "The lower, the better". Despite this evidence, treatment protocols have failed to reach target levels recommended by US as well as European guidelines. The paper reviews some possible explanations as well as solutions to this situation. Combination therapy constitutes a rational approach to maximizing LDL lowering. Recently, the first cholesterol intestinal absorbtion inhibitor, ezetimibe (trade mark EZETROL) has been approved...