Cor et Vasa, 2011 (vol. 53), issue 12

Original research articles

Prognostic value of coronary artery calcium score in combination with cardiac stress sigle-photon emission tomography imaging in an asymptomatic population

Miroslava Budíková, Milan Kamínek, Eliška Sovová, Markéta Kaletová, Iva Metelková, Lenka Henzlová, Eva Buriánková, Radim Formánek

Cor Vasa 2011, 53(12):698-702 | DOI: 10.33678/cor.2011.173

Aim: The aim of this study was to investigate the prognostic value of coronary artery calcium (CAC) score in combination with cardiac stress sigle-photon emission tomography (SPECT) imaging in an asymptomatic population.Methods: One hundred twenty-eight consecutive asymptomatic patients (79 men, mean age 54±10 years, 25 with diabetes) underwent stress cardiac gated SPECT imaging and CT assessment of CAC score. Perfusion summed stress and difference score (SSS and SDS, resp.), the left ventricular ejection fraction (LVEF) and end-diastolic/end-systolic volumes (EDV/ESV) were automatically calculated using 4D-MSPECT. Cardiac event was defined...

Screening for congenital heart defects in the Moravian-Silesian Region: past and present

Jan Pavlíček, Tomáš Gruszka

Cor Vasa 2011, 53(12):703-711 | DOI: 10.33678/cor.2011.174

Aim: To evaluate the incidence of major congenital heart defects (CHD) in the Moravian-Silesian (MS) Region in a long-term prospective study. To describe the system of prenatal care and its effectiveness concerning detection of individual types of defects.Methods: Ultrasound examination of the fetal heart (fetal echocardiography) carried out as a part of prenatal screening, mostly in the 2nd trimester of pregnancy. If a heart defect is suspected, general examination of the fetus and the pregnancy follows. The study is based on its authors' own series supplemented by data from regional pediatric cardiology clinics and from regional gynecologists-obstetricians....

Concentration of Lp-PLA2 in stable patients in secondary prevention after STEMI and dose-effect of statins on its values

Ilona Pařenicová, Krystýna Prymusová, Miroslava Beňovská, Lucie Babušíková, Jiří Jarkovský, Ludmila Dostálová, Lenka Kubková, Petr Lokaj, Petr Kala, Martin Poloczek, Ondřej Toman, Jindřich Špinar, Jiří Pařenica

Cor Vasa 2011, 53(12):712-716 | DOI: 10.33678/cor.2011.175

Background and aim: Phospholipase A2 associated with lipoprotein (Lp-PLA2) is a biomarker specific for a vascular inflammation. Lp-PLA2 hydrolyzes oxidized phosphatidylcholine and produces an effective pro-inflammatory mediators that facilitate formation of atherosclerotic plaque instability. Previous works demonstrated that elevated Lp-PLA2>200-235 μg/L is an independent predictor of increased cardiovascular risk even after adjustment for traditional risk factors. The goal of our work was to determine levels of Lp-PLA2 in a group of stable patients after STEMI and to assess the effect of increased doses of statins on levels of Lp-PLA2 in a part...

Review articles

Early repolarization - a marker of ventricular fibrillation?

Jiří Procházka, Peter Wohlfahrt, Věra Adámková

Cor Vasa 2011, 53(12):676-682 | DOI: 10.33678/cor.2011.170

Elevation of the junction between the QRS complex and the ST segment on the ECG, also known as "early repolarization", has been considered for many years a physiologic variant of the norm seen mainly in young and physically active individuals. Recently, we have seen a growing number of studies demonstrating a relationship between this phenomenon and an increased cardiovascular risk. Studies with patients suffering from idiopathic ventricular fibrillation (IVF) have confirmed a higher risk of malignant ventricular arrhythmias in people with early repolarization. Elevation of the J point in inferior leads is associated with higher risk of arrhythmic...

Cardioprotective effects of inhalational and intravenous anesthetics

Hynek Říha, Tomáš Kotulák, Aleš Březina, Ladislav Hess, Bohuslav Ošťádal, Jan Pirk

Cor Vasa 2011, 53(12):683-692 | DOI: 10.33678/cor.2011.171

Surgical procedures are invariably accompanied by the use of inhalational and intravenous anesthetics. Anesthetics have direct cardioprotective effects by positive influence on the myocardial oxygen supply/demand ratio, and indirect by the influence on cardiomyocyte function at the level of cell membranes, ion channels and regulatory enzymes. Anesthetics also interact with subcellular mechanisms of ischemic preconditioning and postconditioning. The results of clinical studies confirmed the fact that anesthetics influence also postoperative course. Detailed knowledge of cardioprotective effects of anesthetics, together with clarification of effectiveness...

Benefit of echocardiography for hemodynamic monitoring and identification of volume therapy responders in intensive care

Pavel Folwarczny, Martin Hutyra, David Vindiš, Karel Axmann, Miloš Táborský

Cor Vasa 2011, 53(12):693-697 | DOI: 10.33678/cor.2011.172

Echocardiographic methods may help the intensivist to determine the need for fluid infusion in patients with hemodynamic failure. Very low static parameters are usually associated with fluid responsiveness. But these static parameters fail to predict a positive response in patients with suspected hypovolemia. Dynamic parameters should, therefore, be preferred. The intensivist may use respiratory variation of the inferior vena cava, aortic blood flow, or stroke volume determined by echocardiography and changes in stroke volume or aortic velocity time integral following the provocation maneuver (passive leg-raising or volume challenge test) to identify...

Case reports

Development of tako-tsubo cardiomyopathy in a patient with hormonally active adrenal tumor - feochromocytome

Ivana Havlová, Antonín Novák, Jiří Herman, Marian Bystroň, Pavel Červinka, Tomáš Zelinka

Cor Vasa 2011, 53(12):717-721 | DOI: 10.33678/cor.2011.176

Tako-tsubo cardiomyopathy is characterized by transient left ventricular dysfunction connected with chest pain, ECG changes imitating acute myocardial infarction with cardiac markers elevation, without obstructive coronary artery disease, in consequence of stress situation. Exact cause of tako-tsubo cardiomyopathy remains unknown, although several patophysiological mechanisms have been proposed. Probable reason is a high level of catecholamines which causes a myocardial dysfunction. In our case report we describe a case of a 47-year-old female with tako-tsubo cardiomyopathy which was induced by catecholamine overproduction in association with pheochromocytoma...

Right atrial angiosarcoma

Lukáš Handl, Milan Hromádka, Tomáš Hájek, Jan Bulka, Petr Mukenšnábl, Jan Filipovský

Cor Vasa 2011, 53(12):722-725 | DOI: 10.33678/cor.2011.177

Heart tumors represent a relatively rare but serious group of cardiovascular disorders with late development of a wide scale of symptoms, the correct and timely diagnosis of which is still challenging. Malignant heart tumors are usually located in right-sided heart cavities but their incidence is very low. We describe a case of right atrial angiosarcoma, manifesting initially with a dyspnea and syncope during cardiac tamponade. After an emergent surgical procedure and favorable postoperative development, the patient underwent adjuvant chemotherapy. He has been clinically stabilized and symptom-free for 8 months, followed by disease recurrence with...

Unusual cause of stroke - papillary fibroelastoma - and its surgical management

Anton Bereš, Adrian Kolesár, Ján Luczy, Jana Jevčáková, František Sabol

Cor Vasa 2011, 53(12):726-728 | DOI: 10.33678/cor.2011.178

A papillary fibroelastoma (so called a Lambl excrescence, after Vilém Dušan Lambl) is a primary tumor of heart that typically involves one of the heart valves. Although the prevalence of primary cardiac tumors ranges from 0.0017-0.28%, the papillary fibroelastomas (PFE) are the second most common benign neoplasm of the cardiac valves after myxomas. Currently, with the advent of higher-resolution imaging technology, such cases are diagnosed more frequently. A papillary fibroelastoma is generally considered benign, however, in can be associated with syncope, chest pain, heart attack, stroke and even sudden death. In this case we report on surgical management...

Uncommon etiology of right atrial tumour - extension of thyroid cancer

Enikő Havránková, Emőke Šteňová, Ingrid Olejárová

Cor Vasa 2011, 53(12):729-730 | DOI: 10.33678/cor.2011.179

Direct tumour extension into the right atrium in thyroid cancer is extremely uncommon. We report the case of an 80-year-old woman with echocardiography diagnosed in the right atrial mass. A large thyroid tumour with extension into the right jugular vein (JV), the superior vena cava (SVC) filling the right atrium was revealed by magnetic resonance imaging (MRI). Percutaneous fine-needle aspiration biopsy led to carcinoma being strongly suspected. The massive intravascular invasion and age of the patient contra-indicated surgical resection.

Unicuspid aortic valve in a patient with severe stenosis and dilatation of ascending aorta

Lukáš Krýže, Eva Koudelková, Josef Kautzner

Cor Vasa 2011, 53(12):731-733 | DOI: 10.33678/cor.2011.180

Unicuspid aortic valve is a rare congenital anomaly that is often associated with severe valvular stenosis, regurgitation or a combination of both. Other complications include dilatation of ascending aorta and increased risk of its dissection. We present a case of 53-year-old man with unicuspid aortic valve with severe stenosis and dilatation of ascending aorta. The patient underwent successful aortic valve replacement together with replacement of ascending aorta. The aim of this report is to review diagnostics and treatment of this anomaly.

Unrecognized infective endocarditis in a young woman

Jan Lhotský, Jitka Lhotská, Jiří Široký, Richard Rokyta

Cor Vasa 2011, 53(12):734-736 | DOI: 10.33678/cor.2011.181

We present a case report of infective endocarditis in a 30-year-old woman in whom the correct diagnosis was not made before almost 6 months after the onset of symptoms. The patient was referred to our cardiology department only at the point when she suffered from severe cardiac complications and general exhaustion. She had underwent, however, detailed diagnostic procedures 5 months earlier, following an ischemic stroke which was not explained satisfactorily then.

Traumatic dissection of LAD artery as a cause of large myocardial ischemia

Jakub Čech, Jan Pešek, Vratislav Pechman, Richard Rokyta

Cor Vasa 2011, 53(12):737-739 | DOI: 10.33678/cor.2011.182

Blunt chest trauma is an important cause of morbidity and mortality in developed countries. It may cause injury of chest wall or intrathoracic organs, for example, contusion of heart. Coronary artery dissection is a rare complication. Case of 64-year-old man without history of coronary artery disease who suffered large myocardial infarction with severe left ventricular dysfunction as a result of dissection of left anterior descending artery during traffic accident is described in our case report. The article refers to need of at least internal examination with a registration of ECG, eventually cardiological assessment with transthoracal echocardiography...

Acute lower extremity arterial occlusion as a first manifestation of myocardial infarction with ST-segment elevation

Michaela Červinková, Antonín Novák, Jiří Herman, Radim Špaček, Marian Bystroň, Martin Kvašňák, Milouš Derner, Věra Lažanská, Pavel Červinka

Cor Vasa 2011, 53(12):740-743 | DOI: 10.33678/cor.2011.183

Authors present unusual case of acute myocardial infarction with ST-segment elevation presenting as acute lower extremity occlusion due to left ventricle thrombus embolization in a patient with long-lasting insulin-dependent diabetes mellitus.

Large metastatic involvement of pericardium, myocardium and andocardium of both heart ventricles in pulmonary adenocarcinoma

Pavel Franc, Dalibor Kašík, Dana Matoušková, Anna Korcová, Martin Mašek, Tomáš Paleček

Cor Vasa 2011, 53(12):744-747 | DOI: 10.33678/cor.2011.184

This case report describes clinical course, results of imaging methods and autopsy findings in a patient with metastatic involvement of all cardiac structures as a first manifestation of pulmonary adenocarcinoma.

Reviews

Jiří Widimský, Jaroslav Malý a kolektiv Akutní plicní embolie a žilní trombóza. Patogeneze, diagnostika, léčba a prevence

Prof. MUDr. Pavel Gregor, DrSc.

Cor Vasa 2011, 53(12):756