Heart rate variability evaluation in the assessment of cardiac autonomic neuropathy in patients with type 2 diabetes

Rudolf Metelka, Lubica Cibičková, Jaromíra Gajdová, Ondřej Krystyník

Cor Vasa 2018, 60(4):e335-e344 | DOI: 10.1016/j.crvasa.2017.05.001  

Introduction: Heart rate variability (HRV) is a respected measure used in the assessment of cardiac autonomic neuropathy (CAN) and it can serve as an independent prognostic indicator of sudden arrhythmic death risk. Despite the importance of early detection, the diagnosis of CAN is often made too late, especially in diabetics. Beside the long subclinical phase of CAN, reasons for this include great diversification of employed diagnostic methods and absence of universally accepted normal values; the latter applies mostly in HRV evaluated using short-term spectral analysis (SAHRV).Aim: The aim of this cross-sectional study involving patients with...

Residual SYNTAX score can predict short- and long-term outcomes in patients with STEMI

Altuğ Ösken, Ramazan Akdemir, Bariş Güngör, Ercan Aydin, Salih Şahinkuş, İbrahim Kocayiğit, Yusuf Can, Selçuk Yaylaci, Hüseyin Gündüz

Cor Vasa 2018, 60(4):e345-e351 | DOI: 10.1016/j.crvasa.2018.02.007  

Objectives: The prognostic value of residual SYNTAX score (rSS) has been observed in different patient groups. However, its prognostic value has not been compared in patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).Methods: A total of 208 patients meeting the eligibility criteria were included in the study. Complete revascularisation (CR) was defined as rSS = 0 and incomplete revascularisation (IR) was defined as rSS ≥ 1.Results: Among the sample, 78 patients (33.3%) were included in the CR group and 130 patients (67.7%) in the IR group. One patient (1.3%) in the...

Prognostic value of cystatin C in relation to other markers of renal function in early prediction of hospital mortality and major cardiac adverse events in patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention

Jan Přeček, Martin Hutyra, Martin Sněhota, Jiří Jarkovský, Tomáš Adam, Miloslav Špaček, Štěpán Hudec, Miloš Táborský

Cor Vasa 2018, 60(4):e352-e360 | DOI: 10.1016/j.crvasa.2017.11.005  

Introduction: Cystatin C has been implicated as a prognostic marker in cardiovascular diseases. The aim of prospective study was to evaluate the benefits of measuring cystatin C for prognostic stratification to predict hospital mortality and the rates of major cardiac adverse events (MACE) in ST elevation myocardial infarction (STEMI) patients and to compare cystatin C to other markers of renal function and Global Registry of Acute Coronary Events (GRACE) score.Methods: A total of 659 consecutive patients (479 men, mean age 65 years) from a prospective study on acute STEMI treated by primary percutaneous coronary intervention (PCI) were evaluated....

The long-term effects of individual cardiac rehabilitation in patients with coronary artery disease

Vladimír Kincl, Roman Panovský, Jan Máchal, Jiří Jančík, Pavel Kukla, Petr Dobšák

Cor Vasa 2018, 60(4):e361-e366 | DOI: 10.1016/j.crvasa.2018.03.005  

Background: The positive effects of cardiac rehabilitation have been repeatedly described and are well-known over the short- and middle-term periods. However, there is less knowledge about long-term outcomes in patients with chronic stable coronary artery disease.Aim: The aim of this study was to evaluate the long-term outcome of individual cardiac rehabilitation in patients with coronary artery disease.Methods: One hundred fifty-two patients with stable coronary artery disease were retrospectively divided into two groups according to their adherence to individual physical activity recommendations, regardless of their participation in guided...

Cardiac resynchronization therapy - A comparison of VV delay optimization by 3D echocardiography using systolic dyssynchrony index and QRS width assessment at 6 months after CRT implantation

Jiří Vondrák, Dan Marek, Jan Večeřa, Klára Benešová, Petr Vojtíšek

Cor Vasa 2018, 60(4):e367-e376 | DOI: 10.1016/j.crvasa.2017.11.006  

Aim: The aim of this study was to compare the setting of interventricular (VV) delay by 3D echocardiography (3DE) using systolic dyssynchrony index (SDI) versus QRS width measurement in new cardiac resynchronization therapy (CRT) recipients. We observed the impact on the reduction of left ventricle volumes and increase in volumetric responders (defined as a ≥15% reduction in left ventricular end-systolic volume (LVESv) at the 6-month follow-up.Methods: We included 63 patients with recently implanted CRT in this open-label, randomized trial. Patients were randomized into two groups. VV delay was set by the QRS width in the group 1 (n = 31) to...

Impact of radial and femoral access on radiation dose and fluorography time in patients with acute coronary syndrome

Jakub Rychlík, Ivan Horňáček, Miloslav Tejc, Erik Petrikovits, Zdeněk Klimsa

Cor Vasa 2018, 60(4):e377-e380 | DOI: 10.1016/j.crvasa.2017.11.004  

Background: Current guidelines favor radial over femoral access in patients with acute coronary syndromes for safety according to the results of recent trials. However, influence of access site on radiation dose and fluorography time is still unclear.Methods: We retrospectively analyzed 390 patients who underwent percutaneous coronary intervention for acute coronary syndrome in Kardiocentrum Vysočina. We compared the access site with the number of stents implanted, the average fluorography time in minutes, the average radiation dose and mean effective dose that each patient received in Gy/cm2 or mSv respectively.Results: Use of femoral access...

Impact of the radial versus femoral access for primary percutaneous intervention on smoking cessation rates: A paradoxus between the health related quality of life and smoking quitting?

Bulent Deveci, Ozcan Ozeke, Murat Gul, B. Acar, E. Hande Ozcan Cetin, Cengiz Burak, Serkan Cay, Serkan Topaloglu, Dursun Aras, Erdogan Ilkay

Cor Vasa 2018, 60(4):e381-e386 | DOI: 10.1016/j.crvasa.2018.03.006  

Background: Smoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI.Objective: To assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial ( RA) versus femoral approach (FA).Methods:...

Cost effectiveness analysis of out-patient and remote monitoring of patients after pacemaker replacement from the perspective of the health care payer

Karol Čurila, Jan Šmída, Ondřej Lešetický, Dalibor Heřman, Petr Štros, Pavel Osmančík, Jana Žďárská, Radka Procházková, Petr Widimský

Cor Vasa 2018, 60(4):e387-e392 | DOI: 10.1016/j.crvasa.2018.02.006  

Objectives: To determine the cost effectiveness of remote vs. outpatient monitoring of patients with pacemaker after device replacement due to battery depletion.Background: Despite the fact that modern pacemakers can be checked remotely, most check-ups are still carried out during outpatient visits. So far, a cost effectiveness analysis of remote monitoring has not been performed in the Czech Republic.Patients, methods: A retrospective analysis was done using the files of 217 patients that had undergone pacemaker replacement between 2002 and 2005. All visits from 2002 to 2015 were analyzed. Using a pharmacoeconomic model, a cost minimization...

Use of OPCAB in Czechia 2010-2015: Have we learned any lessons?

Jan Hlavička, Tomáš Vaněk, Jiří Jarkovský, Klára Benešová

Cor Vasa 2018, 60(4):e393-e399 | DOI: 10.1016/j.crvasa.2018.01.005  

Introduction: Off-pump coronary artery bypass grafting (OPCAB) is a well-established technique for coronary revascularization, which is used worldwide as well as in the Czech Republic (CZ). However, the number of patients undergoing this procedure varies from department to department. We wanted to see if the very latest publications regarding off-pump coronary revascularization had changed the way the procedure was viewed by Czech heart surgeons.Methods: Data from the Czech National Register of Cardiac Surgery were used to evaluate trends in the number OPCAB cases, in patients with ischemic heart disease, and to analyze the factors that surgeons...

Bridging anticoagulation therapy

Štefan Volovár, Radka Tancošová, Richard Rokyta

Cor Vasa 2018, 60(4):e400-e406 | DOI: 10.1016/j.crvasa.2018.04.002  

Oral anticoagulation therapy is used in patients with various diagnoses to reduce the risk of thromboembolic events or to induce a hypocoagulation state to facilitate dissolution of a thrombus. In clinical practice we often encounter anticoagulated patients, many of whom have been diagnosed with nonvalvular atrial fibrillation. Each year a significant number of these patients undergo a medical procedure, which, in some cases, requires temporary discontinuation of anticoagulation therapy. However, without anticoagulation therapy, the patient is at increased risk of thromboembolic events. Therefore, parenteral anticoagulants with fast onset and rapid...

The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Summary of the document prepared by the Czech Society of Cardiology

Robert Čihák, Luděk Haman, Miloš Táborský

Cor Vasa 2018, 60(4):e421-e446 | DOI: 10.1016/j.crvasa.2018.05.001  

Acute purulent pericarditis caused by Clostridium septicum

Daniel Šulc, Martina Vaněrková, Martin Radvan, Eliška Míšková, Iva Kotásková, Jiří Bednář, Petr Němec, Tomáš Freiberger

Cor Vasa 2018, 60(4):e407-e411 | DOI: 10.1016/j.crvasa.2017.02.003  

Acute purulent pericarditis is a life threatening disease with a high mortality. It has a low incidence; approximately 1% of all cases of pericarditis. In the Western world the most common aetiology are staphylococci, streptococci and pneumococci, while the mycobacterial aetiology is more common in developing countries.We describe the case of a 71-year-old man suffering from liver cirrhosis with an acute purulent pericarditis. The organism responsible for his pericarditis was Clostridium septicum; a Gram-positive obligatory pathogen, commonly associated with gastrointestinal tumours. Despite the prolonged, targeted antibiotic therapy, the infection...

Anomalous left coronary artery from the pulmonary artery: A rare case diagnosed in an adult

Veronika Fendrychová, Jiří Ondrášek, Tomáš Zatočil, Martin Poloczek, Šárka Bohatá

Cor Vasa 2018, 60(4):e412-e417 | DOI: 10.1016/j.crvasa.2017.02.005  

ALCAPA syndrome (anomalous origin of left coronary artery from the pulmonary artery) is an extremely rare congenital cardiac anomaly associated with high mortality rate at young age. If undiagnosed and uncorrected, the affected individuals rarely survive beyond infancy. This article reports on a 45-year-old asymptomatic man with the ALCAPA diagnosed thanks to a detailed cardiac examination that followed the finding of the left bundle branch block and a decreased left ventricular systolic ejection fraction. Although coronary angiography and computed tomography are considered to be the key diagnostic methods for ALCAPA, in this case the diagnosis was...

Surgical management of idiopathic constrictive pericarditis

Serkan Burç Deşer, Semih Murat Yücel

Cor Vasa 2018, 60(4):e418-e420 | DOI: 10.1016/j.crvasa.2017.03.005  

Constrictive pericarditis is defined as impaired diastolic cardiac function leading to heart failure, progressive fluid overload, systemic venous congestion and reduction of cardiac output. Both ventricles affected by the constriction, however, symptoms of right heart failure dominate. The congestive heart failure and normal left ventricular systolic functions are seen in the presence of constrictive pericarditis. Pericardiectomy is considered as the mainstay treatment method for constrictive pericarditis. Here we present successful pericardiectomy of a 68-year-old female.

Jan Vojáček, Jiří Kettner, Jaroslav Dušek a kolektiv - Klinická kardiologie

Prof. MUDr. Jiří Vítovec, CSc.

Cor Vasa 2018, 60(4):521  

Petr Bartůněk - Klasik českého lékařství profesor MUDr. Bohumil Prusík, DrSc.

MUDr. Pavel Jerie

Cor Vasa 2018, 60(4):522-523  

Pan profesor Jan Pirk oslavil sedmdesátiny

Michael Aschermann

Cor Vasa 2018, 60(4):524  

Editorial Board

Editorial board

Cor Vasa 2018, 60(4):i | DOI: 10.1016/S0010-8650(18)30082-1