Interventional Cardiology, 2005 (vol. 4), issue 2

Editors&

8217; foreword

Frakční průtoková rezerva, šedá zóna a lékové stenty

MUDr. Petr Kala Ph.D

Interv Akut Kardiol. 2005;4(2):59

Original articles

PLASMA NT-proBNP: A SENSITIVE MARKER OF THE CLINICAL STATUS IN PATIENTS WITH ACUTE HEART FAILURE

Radek Pudil, Miloš Tichý, Jaroslav Gregor, Rudolf Praus, Václav Bláha, Jan Vojáček, prof. MUDr. Jaroslav Malý CSc

Interv Akut Kardiol. 2005;4(2):70-73

The aim of the study was to compare clinical symptoms, plasma NT-proBNP levels, cardiothoracic ratio and echocardiographic parameters in patients with acute left ventricular failure. Study population consisted of 96 patients (pts) (67.63 ± 10.77 years, 45 females), 9 of them had symptoms of lung oedema, and 6 of them had cardiogenic shock. The study showed a significant increase in plasma NT-proBNP in all patients (8 575.89 ± 9 665.02 pg/ml, vs control group 91.27 ± 76.63 pg/ml, p < 0.001). Significant differences have been found in plasma NT-proBNP levels depending on the degree of clinical severity (in pts with lung oedema 9...

DIABETES MELLITUS AND ACUTE MYOCARDIAL INFARCTION IN PATIENTS AT A CORONARY UNIT IN 2003

Radka Adámková, Stanislav Janoušek

Interv Akut Kardiol. 2005;4(2):75-78

Introduction: Diabetes mellitus (DM) is one of the major risk factors of atherosclerosis and also of acute myocardial infarction (AMI). Aim: In our work we compared the patients with DM and without this diagnosis (NDM), who were admitted to Coronary Care Unit (CCU) with AMI, in terms of their clinical course. Methods and study group: All 414 patients with AMI admitted to CCU of the Internal Cardiology Clinic of University Hospital in Brno within the year 2003 were analyzed retrospectively. Common statistical tests were used for this analysis. Results: 133 (32 %) patients with AMI also had DM. The mean age of all patients with AMI was 67±12 years...

ILIAC PTA AT A CENTRE PERFORMING BOTH CORONARY AND NON-CORONARY INTERVENTIONS

MUDr. Dušan Kučera, Miroslav Homza, Martin Válka, MUDr. Vladimír Čížek, MUDr. Václav Procházka, Renata Kacířová

Interv Akut Kardiol. 2005;4(2):80-84

The aim of presentation: Retrospective assessment of primary and secondary iliac percutaneous transluminal angioplasty (PTA) success rate and its coincidence with coronary artery disease (CAD). Patients and method: 442 iliac PTAs for stenosis or occlusion were performed in 343 patients out of 3 267 non-coronary interventions since 1999. 309 patients were evaluated retrospectively and 398 iliac PTAs were done. To assess the correlation between peripheral artery diesease (PAD) and CAD, we evaluated the patients treated in the year 2003, when we performed 872 DSA of lower extremities and 448 coronary angiographies. Results: Primary success rate of PTA...

IMPACT OF THE PRIMARY PCI ON ACUTE LEFT VENTRICULAR CHANGES IN ANTERIOR WALL AMI

MUDr. Petr Kala Ph.D, MUDr. Martin Poloczek, Miroslav Vytiska, Tomáš Brychta, Petr Neugebauer, Petr Jeřábek, Otakar Boček, MUDr. Mgr. Jiří Pařenica

Interv Akut Kardiol. 2005;4(2):85-89

Summary: At present primary coronary intervention is the most effective method of treatment of acute myocardial infarction with ST elevations (STE-AMI) in reducing the risk of cardiovascular complications in short and long term outcome. The development of left ventricular (LV) systolic dysfunction after AMI and its negative remodeling that are often associated with chronic heart failure, however, remain a problem. The aim of this work is to assess the acute influence of mechanical reperfusion with primary PCI on the left ventricular systolic function measured by angiographic criteria. Methods: Prospective evaluation of 83 adult patients with the average...

Reviews

LABORATORY ASSESSMENT OF HAEMOSTASIS IN CARDIOLOGICAL INTERVENTIONS

prof. MUDr. Jaroslav Malý CSc, Miroslav Pecka, MUDr. Petr Dulíček Ph.D, MUDr. Martin Blažek

Interv Akut Kardiol. 2005;4(2):90-92

Currently a number of clinical conditions are known, in which it is necessary to maintain coagulation decreased. On one hand, these medications can be life-saving, on the other hand, their inappropriate dosage can be life-threatening. Therefore it is essential to adhere to strict indications, intervals monitoring and the recommended therapeutic range when administering these medications. Laboratory monitoring of parameters of haemostasis during antithrombotic treatment or prevention in cardiology is a fundamental prerequisite for successful cardiologic intervention.

MITRAL VALVE REGURGITATION IN PATIETS WITH LOW EJECTION FRACTION

Petr Pavel, Jan Vojáček

Interv Akut Kardiol. 2005;4(2):94-96

Syptomatic mitral valve regurgitation of both ischaemic and nonischaemic origin imparts a haemodynamic burden on the left ventricle and is a significant negative prognostic factor. Decision making whether to correct valve regurgitation or not is still under debate. Mitral valve repair may improve left ventricular function after surgery not only in patients with structural valve disease, but also in selected cases secondary to ischaemic heart disease or dilated cardiomyopathy. Correction of moderate IMR in patients submitted to CABG is therefore currently carried out, although this issue remains controversial. Mitral valve repair is superior to mitral...

Case reports

COMPLICATED CORONARY INTERVENTIONS. WHEN IS EARLY ENOUGH? WHEN IS TOO LATE?

Josef Šťásek, Dušan Černohorský, Josef Bis, Miroslav Brtko, Pavel Polanský, Jan Vojáček

Interv Akut Kardiol. 2005;4(2):98-102

The authors discuss the issue of complex coronary interventions in high risk patients on an example of four case reports. In this group of patients, it is possible to perform PCI successfully, but a higher incidence of serious complications has to be taken into account. The authors claim that new systems of circulation support might improve the outcomes of high risk PCI.

LEFT ARM EMBOLISM AS A RARE COMPLICATION OF ENDOVASCULAR STENTGRAFT PLACEMENT FOR TYPE B AORTIC DISSECTION

Martin Pleva, MUDr. Dušan Kučera, Miroslav Homza

Interv Akut Kardiol. 2005;4(2):103-107

Endovascular treatment of type B aortic dissections and their ischaemic complications became the domain of interventional angiology in the last decade. The aim of this procedure is stabilization of the descending thoracic aorta by stentgraft implantation and overlap of the primary entry tear. Management of visceral and lower leg ischaemic complications is provided by stent angioplasty and rarely by intimal flap fenestration. We present a case report of a rare complication of distal left arm embolisation after stentgraft placement.

ACUTE VENTRICULAR SEPTAL RUPTURE AND SUBACUTE CARDIAC FREE WALL RUPTURE OF THE LEFT VENTRICLE - MECHANIC POSTINFARCTION COMPLICATIONS

Hedvika Černá, Pavel Jebavý, Jan Škvařil

Interv Akut Kardiol. 2005;4(2):108-110

The authors describe two cases of patients with mechanic complications during acute myocardial infarction. The first patient was solved by complicated direct PCI for acute inferior myocardial infarction, clinically suspected acute ventricular septal rupture was proved by ventriculography. An urgent surgical repair of ventricular septal rupture was performed. The patient died on the day after surgical intervention due to progression of cardiac failure and multiorgan dysfunction. The second patient was admitted for acute anterior myocardial infarction, a deterioration of haemodynamic state occurred after a short time due to cardiac free wall rupture...

AORTIC DISSECTION MANIFESTED AS ISCHAEMIC STROKE

MUDr. Jitka Kobrlová, MUDr. Martin Schmoranz, MUDr. Jana Budková

Interv Akut Kardiol. 2005;4(2):112-113

We report the case of an 81-year-old woman with type A aortic dissection which presented as painless and manifested as ischaemic stroke. Various clinical pictures, diagnostic algorithms and therapeutic options of aortic dissection are discussed.

THROMBOLYTIC TREATMENT OF ACUTE SUBMASSIVE PULMONARY EMBOLISM

Daniela Žáková

Interv Akut Kardiol. 2005;4(2):115-118

Acute pulmonary embolism is the third most common cardiovascular disease with very high mortality. The prognosis of acute pulmonary embolism is dependent on the degree of haemodynamic status of the patients. Risk factors include right ventricular dysfunction, elevated plasma levels of cardiac troponins and brain natriuretic peptide. Based on these factors we can identify a group of patients with higher recurrence rates of embolism and with higher mortality. According to some authors, the thrombolytic treatment in this group of patients is more effective than conventional heparin treatment, although there is no clear evidence and the approach must be...

PERFORATION OF THE HEART WALL AND INFECTIOUS ENDOCARDITIS IN A PATIENT WITH PERMANENT PACING

Jitka Vlašínová, MUDr. Lubomír Křivan Ph.D, MUDr. Milan Sepši

Interv Akut Kardiol. 2005;4(2):119-120

Perforation of the right ventricular wall and infectious endocarditis are well known complications of permanent pacing. In our presentation we report a patient in whom both of these complications occurred within three months after primoimplantation. Attention is paid to the diagnosis and therapy of these complications.