Institut klinické a experimentální medicíny na prahu páté dekády úspěšné existence

Jan Malý

Cor Vasa 2011, 53(1-2):4-5  

Origins of cardiology in the Krč-based hospital complex

Jiří Widimský

Cor Vasa 2011, 53(1-2):6-13  

The Institute for Cardiovascular Disease Research (Ústav pro choroby oběhu krevního, ÚCHOK in Czech) was the first institute specializing in cardiology in what was formerly Czechoslovakia, and the third such in the world (after the National Institute of Cardiology based in Mexico City and National Institute for Cardiovascular Disease in Bethesda, USA). The facility was in fact a predecessor to what later became the Second Research Department of Internal Medicine, Institute for Clinical and Experimental Medicine (IKEM in Czech) and, subsequently, Department of Cardiology, IKEM.The original institute was founded by Prof. Klement Weber and Prof. Jan...

Historie Kliniky kardiologie IKEM

Vladimír Staněk

Cor Vasa 2011, 53(1-2):14-15  

Catheter ablation of ventricular arrhythmias

Josef Kautzner, Petr Peichl, Markéta Koželuhová, Dan Wichterle, Robert Čihák

Cor Vasa 2011, 53(1-2):16-24  

Catheter ablation has become the treatment of choice in the majority of symptomatic idiopathic ventricular tachycardias (VTs) or ventricular ectopic beats. The advent of electroanatomical mapping and technology of the irrigated tip catheter have significantly increased success rate of catheter ablation of VT in the presence of structural heart disease. Epicardial mapping has enabled successful ablation even in patients with an epicardial location of the arrhythmogenic substrate. The concept of catheter ablation of the triggering focus has allowed successful management of electrical storms caused by polymorphic VT or ventricular fibrillation. Novel...

Current status and results of catheter-based therapy for aortic stenosis and mitral regurgitation

Michael Želízko, Bronislav Janek, Jiří Malý, Ivan Netuka, Josef Kautzner

Cor Vasa 2011, 53(1-2):25-32  

This is an overview article of current catheter-based valve therapies for aortic stenosis and mitral regurgitation. Indications, mid-term results of the PATRNER trial and possible complications of transcatheter aortic valve implantation are described. The second part deals with catheter-based techniques in patients with mitral regurgitation and results of the EVEREST II study.

Three-dimensional echocardiography in current practice

Petr Lupínek, Tomáš Marek

Cor Vasa 2011, 53(1-2):34-38  

The article deals briefly with the history and development of three-dimensional echocardiography (3DE), explains its principal advantages and benefits, modes of image acquisition, and technical limitations. Current clinical applications are reviewed. In some indications such as left ventricular volumetry, planimetry of the stenotic mitral orifice, identification of the mechanisms of mitral regurgitatiton, and description of mitral valve morphology, depiction of paraprosthetic dehiscences, and atrial septal defects, 3DE outperforms two-dimensional echocardiography or adds new information to it. Other clinical applications are being studied and developed.In...

Advances in differential diagnosis of cardiomyopathies

Miloš Kubánek, Marek Šramko, Jana Vrbská, Dana Kautznerová

Cor Vasa 2011, 53(1-2):39-43  

Development of the classification of cardiomyopathies evolves from a descriptive approach to identification of the causes of the disease. Advances in the fields of molecular genetics, imaging techniques, and evaluation of endomyocardial biopsy specimens have provided new insights into the etiology of individual types of cardiomyopathy. The paper seeks to assess the value of the above specialties and tools in current clinical practice.

Role of the specialist outpatient unit in the care of patients with advanced heart failure

Markéta Hegarová, Zora Dorazilová, Lenka Hošková, Miloš Kubánek, Mariana Podzimková, Ivan Netuka, Ivan Málek

Cor Vasa 2011, 53(1-2):44-47  

The incidence of chronic heart failure (CHF) in the general population is on the rise. Current pharmacological and non-pharmacological therapy procedures are able to reverse the grim prognosis of CHF patients to an extent. A precondition sine qua non is well-organized care making proper use of therapeutic algorithms based on the cause and stage of the disease. Our paper presents the system of care of CHF patients in a specialist outpatient unit of the Heart Center of the Institute for Clinical and Experimental Medicine. The outpatient unit is linked to wards and has access to all diagnostic and therapeutic modalities available at the Heart Center....

Left ventricular assist devices for treatment of severe pulmonary hypertension in orthotopic heart transplantation candidates at IKEM

Zora Dorazilová, Jiří Kettner, Ivan Netuka, Markéta Hegarová, Ivo Skalský, Hynek Říha, Hikmet Al-Hiti, Josef Kautzner, Jan Pirk

Cor Vasa 2011, 53(1-2):48-54  

Introduction: Until recently, severe pulmonary hypertension (PH) has been a contraindication for patients at risk of acute right ventricular failure of the donor graft and its possible loss in the immediate post-transplant period.Aim: The aim of our study was to assess the efficacy of the HeartMate II LVAD (left ventricular assist device) (Thoratec Corp., Pleasanton, CA, USA) in modulating PH thereby allowing to safely perform orthotopic heart transplantation.Patients and methods: From October 2008 through September 2010, 36 patients with end-stage chronic heart failure had HeartMate II LVAD implantation at the Institute for Clinical and Experimental...

The role of echocardiography in the care of patients with the HeartMate II left ventricular assist device

Tomáš Marek, Zora Dorazilová, František Straka, Ivan Netuka, Jan Pirk, Ivo Skalský

Cor Vasa 2011, 53(1-2):55-59  

Mechanical cardiac support devices are gradually becoming an integral part of care of patients with end-stage heart failure. Echocardio-graphy is the main imaging technique helpful in providing this type of care from the decision-making process to long-term follow-up after implantation. The authors of this overview report on their own experience with echocardiography in assessing more than 50 patients with HeartMate II device implantation over a period of five years.

Specific features of care for patients after heart transplantation

Lenka Hošková, Mariana Podzimková, Ivan Málek, Markéta Hegarová, Zora Dorazilová, Ivan Netuka, Josef Kautzner, Jan Pirk

Cor Vasa 2011, 53(1-2):60-67  

Heart transplantation is now an established modality of treatment reserved for patients with end-stage heart failure when other therapeutic options have failed. The clinical heart transplant program was launched at the Institute for Clinical and Experimental Medicine in 1984. Since then, 785 heart transplant procedures have been performed by the end of August 2010. Based on our own experience, improving outcomes depend not only on improved surgical techniques but also on advances in immunosuppressive therapy. Clinical follow-up of heart transplant recipients brings some specific problems, mainly graft rejection, opportunistic infections, malignancies,...

Treatment of pulmonary arterial hypertension

Martin Šurda, Hikmet Al-Hiti, Jiří Kettner, Josef Kautzner

Cor Vasa 2011, 53(1-2):68-71  

Pulmonary arterial hypertension is a rare orphan disease caused by impaired regulation of vasodilator and antiproliferative mechanisms in the pulmonary vascular bed, resulting in an increase in pulmonary vascular resistance and right ventricular dysfunction. If untreated, the disease leads to rapid progression and early death. This article provides an overview of contemporary pharmacological treatment options, followed by a short summary of experience from the Center for Diagnosis and Treatment of Pulmonary Hypertension at the Prague-based Institute for Clinical and Experimental Medicine (Institut klinické a experimentální medicíny, IKEM in Czech).

The development of ballistocardiography from 1877 to the present

Lucia Barčiaková, Jan Pirk, Petr Šeba, Jan Kříž

Cor Vasa 2011, 53(1-2):72-74  

Cardiology has witnessed major advances in the diagnosis and treatment of overt coronary heart disease (CHD) over the past 20 years; however, mortality rates for CHD continue to be unsatisfactory. This was also one of the reasons why current research has focused particularly on diagnosing pre-clinical CHD. Major predictors of cardiovascular risk include aortic pulse wave velocity (PWV), determined primarily by applanation tonometry. Our study has shown PWV can also be measured using computer-assisted ballistocardiography. This review article provides a look at the history of ballistocardiography and its potential uses in current medical practice.

Secondary prevention in the follow-up study of a group of patients undergoing surgery for coronary heart disease (12-year development)

Věra Adámková, Jan Pirk, Markéta Galovcová, Ludmila Peterková, Martina Vitásková, Zdenka Petržílková, Peter Wohlfahrt, Jiří Bělohoubek, Jiří Procházka, Jan Bruthans, Alena Krajčoviechová, Jelena Skibová

Cor Vasa 2011, 53(1-2):75-79  

Aim: To determine the value of secondary prevention in the follow-up study of a group of patients undergoing surgery for coronary heart disease 12 years ago.Method: A group of 336 persons was analyzed (249 males and 87 females, mean age: males 58.55±9.834 years, females 57.72±11.509 years; n.s.). Laboratory parameters (lipids, fasting glycemia) and left ventricular ejection fraction were also determined.Results: In 1998, fasting glycemia>6.1 mmol/l was found in 32% of patients, with the figure rising to 54% in 2010. While 26% of patients had total cholesterol

64-multislice CT - one-year experience with the detection of early graft occlusion after coronary artery bypass surgery

Petr Kačer, Michal Smetana, Dana Kautznerová, David Hačkajlo, Jan Pirk

Cor Vasa 2011, 53(1-2):80-83  

Aim: To present one-year experience with the use of 64-multislice computed tomography (CT) to detect early postoperative graft occlusion in patients after coronary artery bypass grafting (CABG) showing early postoperative signs of transient myocardial ischemia.Method: Standard coronary artery bypass grafting was performed on 1222 patients in our center between November 2005 and March 2007. Of this number, 49 patients showed postoperative signs of transient myocardial ischemia and had 64-multislice CT coronary angiography using a Somatom Sensation 64 system.Results: In six of the 49 patients, 64-multislice CT revealed occlusion of a graft confirmed...

A periadventitial sirolimus-eluting system in the prevention of neointimal hyperplasia in autologous venous grafts

Ivo Skalský, Ondrej Szárszoi, Elena Filová, Martin Pařízek, Andriy Lytvynets, Jana Malušková, Alena Lodererová, Jana Olšovská, Zdeněk Kameník, Eduard Brynda, Zdeněk Plichta, Tomáš Riedel, Věra Lisá, Zuzana Burdíková, Martin Čapek, Ľubica Grausová, Tomáš Suchý, Jan Pirk, Lucie Bačáková

Cor Vasa 2011, 53(1-2):84-90  

Aim: Autologous venous grafts such as coronary artery bypass grafts often develop intimal hyperplasia resulting in stenoses and occlusions. The aim of our study was to prevent the development of intimal hyperplasia using a novel perivascular system allowing for long-term release of sirolimus.Method: The controlled-release system comprises a polyester mesh coated with a sirolimus-eluting copolymer of L lactic acid and ε-caprolactone system designed to be wrapped around an autologous venous graft during its implantation. In vitro sirolimus release and its effects on smooth muscle and endothelial cells were assessed. The sirolimus controlled-release...

Our 15-year experience with an outpatient thoracic aortic disease unit

Michael Jonák, Ladislav Těšínský, Jan Pirk

Cor Vasa 2011, 53(1-2):91-93  

Thoracic aortic surgery has a longstanding tradition at the Department of Cardiovascular and Transplant Surgery of the Prague-based Institute for Clinical and Experimental Medicine. A diagnostic, indication, and therapeutic algorithm of care for patients with thoracic aortic disease was developed there as early as the 1990s, resulting in a significant increase in the numbers of patients undergoing surgery. As thoracic aortic disease is invariably a most serious and high-risk condition, long-term follow-up of these patients simply had to be arranged. This explains why a specialist outpatient thoracic disease unit was set up in our department as early...

Intensive care of patients after mechanical support device implantation

Hynek Říha, Tomáš Kotulák, Ivan Netuka, Marian Pinďák, Petr Kramář, Petr Syrovátka, Pavel Kellovský, Leona Říhová, Jiří Malý, Ondrej Szárszoi, Daniel Turek, Jiří Kettner, Jan Pirk

Cor Vasa 2011, 53(1-2):94-98  

Mechanical circulatory support devices represent an important therapeutic option for patients with acute and chronic heart failure. The paper reviews specific aspects of intensive care - divided by individual organ systems - in patients with long-term ventricular assist devices (VAD) as reflected in the outcomes of the VAD program in Heart Centre at the Institute for Clinical and Experimental Medicine.

Zápis ze schůze výboru ČKS konané dne 8. 11. 2010 v Praze

I. Pavézková, Michael Aschermann

Cor Vasa 2011, 53(1-2):104  

13. symposium Pracovní skupiny chlopenní a vrozené srdeční vady v dospělosti České kardiologické společnosti

Cor Vasa 2011, 53(1-2):105-108  

Zamyšlení nad využitím experimentálních výsledků v klinické praxi

Prof. MUDr. Bohuslav Ošťádal, DrSc.

Cor Vasa 2011, 53(1-2):100-101  

Jubilant prof. MUDr. Jiří Vítovec, CSc., FESC

Cor Vasa 2011, 53(1-2):102-103