K využití vysoce senzitivních troponinů v klinické praxi

prof. MUDr. Radek Pudil, Ph.D.

Interv Akut Kardiol. 2013;12(1):6-7  

Potřebují lékaři lékařskou etiku?

doc. MUDr. Jiří Šimek, CSc.

Interv Akut Kardiol. 2013;12(1):3  

Hemodynamic and echocardiographic changes in patients with liver cirrhosis treated

Radek Pudil, Rudolf Praus, Petr Hůlek, Václav Šafka, Tomáš Fejfar, Martina Vašatová, Jan Vojáček

Interv Akut Kardiol. 2013;12(1):8-11  

with transjugular intrahepatic portosystemic shunt Purpose: Liver cirrhosis is associated with hyperdynamic circulation which can result in heart failure. Transjugular intrahepatic portosystemic shunt (TIPS) due to increase of cardiac output is a stressful stimulus for cardiovascular system. Therefore, new methods for early detection of heart failure are needed. The aim of the study was to analyze the effect of TIPS procedure on hemodynamic. Material and Methods: 55 patients (38 men and 17 women, 55.6 ± 8.9 years) with liver cirrhosis treated with TIPS were enrolled in the study. Echocardiography was performed before, 24 hours, 7, 30...

Vztah mezi automaticky detekovanými komplexními frakcionovanými elektrogramy a místy ukončené dlouhodobé perzistentní fibrilace síní při katetrové ablaci

Martin Fiala, Dan Wichterle, Veronika Bulková, Libor Škňouřil, Renáta Nevřalová, Jan Chovančík, Jaroslav Januška, Jindřich Špinar

Interv Akut Kardiol. 2013;12(1):12-18  

Úvod: Komplexní frakcionované síňové potenciály (CFAE) mohou poskytnout vodítko při ablaci perzistentní fibrilace síní (FS). Tato studie hodnotila vztah mezi automaticky detekovanými CFAE v srdečních síních a místy, v nichž došlo k ukončení dlouhodobé perzistentní FS ablací. Metodika: Padesát konsekutivních pacientů podstoupilo stupňovanou ablaci dlouhodobé perzistentní FS. Před ablací byly vytvořeny elektroanatomické mapy levé síně (LS), pravé síně (PS) a koronárního sinu (CS) s automaticky detekovanými CFAE. Stupňovaná ablace se snahou obnovit sinusový rytmus jako ideálním cílovým momentem výkonu se provedla s použitím jednobarevné elektroanatomické mapy....

Optimized current antitachycardia programing of implantable cardioverter-defibrillators

Lukáš Krýže, Domenico Grieco, Josef Kautzner, Kamil Sedláček

Interv Akut Kardiol. 2013;12(1):21-26  

Previous randomized controlled trials have shown that the implantable cardioverter–defibrillator (ICD) provides a significant mortality reduction in patients at high risk of sudden cardiac death. Despite technological advances, ICD patients still face a high incidence of therapies delivered for causes other that life-threatening ventricular arrhythmias. These unnecessary and inappropriate therapies, apart from being painful and psychologically disturbing, may also result in fatal tachyarrhythmias. A high proportion of unnecessary and inappropriate shocks is the result of a conservative and aggressive ICD programming. In this review we...

Biochemical markers of myocardial necrosis in the current clinical practice

Tomáš Janota

Interv Akut Kardiol. 2013;12(1):28-33  

Current laboratory diagonosis of myocardial necrosis due to myocardial infarction or any other cause is based primarily on examination of myocardial troponins. Moreover, their plasma concentrations are now the cornerstone of myocardial infarction diagnosis. They became earlier and earlier marker with increasing sensitivity. The negative predictive value is virtually 100%. However, elevated levels of troponins are not exclusively caused by myocardial infarction. New problem is an interpretation of frequent mild elevations in healthy or seemingly healthy persons. An effort to use routinely other early markers of myocardial necrosis has taken...

Routine combination of dual antiplatelet therapy with proton pump inhibitors -

Jan Bultas, Debora Karetová

Interv Akut Kardiol. 2013;12(1):34-41  

are we not throwing the baby out with the bath water? Antithrombotic therapy involves an increased risk of bleeding, with gastrointestinal bleeding being particularly feared. Thus, antiplatelet therapy is often administered concurrently with proton pump inhibitors (PPIs) that reduce the risk of bleeding. Papers dealing with platelet functions as well as meta-analyses of clinical studies suggest a lower effect of antiplatelet therapy when clopidogrel, acetylsalicylic acid (ASA), or dual therapy are comedicated with PPIs. In terms of clopidogrel therapy, there is a relative consensus among papers testing platelet aggregability in treatments using...

Early prosthetic valve endocarditis requiring reconstructive reoperation - could it have been avoided?

Ingrid Porubčinová, Adrián Kolesár, Štefan Porubčin, Ingrid Schusterová, Pavol Török, František Sabol

Interv Akut Kardiol. 2013;12(1):43-46  

We present a case of a 34-year-old asymptomatic male who was admitted to the Department of Cardiac Surgery of Eastern Slovak Institute of Cardiac and Vascular Diseases in Kosice for moderate aortic regurgitation in the region of the bicuspid aortic valve and dilatation of the ascending aorta in order to receive surgical treatment. Due to an allergy to penicillin, the patient was given fluoroquinolone as part of short-term antibiotic prophylaxis and, subsequently, underwent aortic valve replacement with a mechanical prosthesis. On the fourth post-operative day, blood culture was obtained from the patient due to fever and methicillin-resistant...