Stabilní ischemická choroba srdeční a role perkutánních koronárních intervencí

Michael Želízko

Interv Akut Kardiol. 2018;17(3):138-139  

Rozhovor s panem Michalem Vieweghem
Editorial

Kamil Sedláček

Interv Akut Kardiol. 2018;17(3):141-142  

Incidence and prognosis of patients with arrhythmogenic right ventricular dysplasia

David Šipula, Milan Kozák, Jiří Plášek, Miroslav Homza

Interv Akut Kardiol. 2018;17(3):144-147 | DOI: 10.36290/kar.2018.013  

Objective: To monitor the proportion of patients with the diagnosis of arrhythmogenic right ventricular dysplasia (ARVD) indicatedfor ICD implantation.Method: The authors describe the incidence of ARVD in a population during a six-year period and monitor the clinical manifestationsin patients with this diagnosis as well as the examination methods and, subsequently, the rate of arrhythmias.Results: Our cohort comprised 6 patients with ARVD, with all of them having symptoms indicative of a haemodynamically significantventricular arrhythmia manifested by syncopal or presyncopal states. As evidenced by echocardiography, all the patientshad right ventricular...

The use of autologous bone marrow stem cells in the treatment of heart failure

Leoš Pleva, Pavel Kukla, Kateřina Vítková, Václav Procházka

Interv Akut Kardiol. 2018;17(3):148-151 | DOI: 10.36290/kar.2018.051  

Heart failure is a major chronic illness, resulting in high morbidity and mortality. The most frequent cause of heart failure withreduced ejection fraction is coronary artery disease. Although revascularisation of ischaemic myocardium leads to improvementsin contractility of viable myocardium and systolic function, it can not restore the viability of an already necrotic tissue. In our review,we focus on the use of autologous bone marrow stem cells in the treatment of patients with heart failure due to ischaemicmyocardial injury.

Fabry disease and its cardiac involvement

Lenka Roblová

Interv Akut Kardiol. 2018;17(3):153-157 | DOI: 10.36290/kar.2018.052  

Fabry disease (FD) is an X-linked lysosomal storage disorder that results from a deficiency of α-galactosidase A activity. This enzymaticdefect leads to the progressive accumulation of glycosphingolipids throughout the body and causes multiple systemicproblems including neurological, ocular, cutaneous, renal, and cardiac manifestations in the classic type of FD. The majority ofpatients with this disease have cardiac involvement that is mainly manifested as left ventricular hypertrophy (LVH). A cardiac variantof FD with late-onset isolated cardiac manifestation has also been recognized. Recent studies have revealed that the prevalenceof FD in patients...

The revival of catheter-based renal denervation?

Ján Rosa, Jan Kvasnička, Jiří Widimský jr.

Interv Akut Kardiol. 2018;17(3):159-163 | DOI: 10.36290/kar.2018.020  

Catheter-based renal denervation is currently not a routine method in treating arterial hypertension. The most recent studiessuggest possible effectiveness of multi-electrode systems in reducing blood pressure in the short term. However, evidence is stilllacking that the method is effective in reducing blood pressure in the long term as well as that it reduces morbidity or mortalityrates and is cost-effective given the costs associated with the procedure itself.

Timing surgery in mitral regurgitation: defining risk using stress echocardiography

Martin Troubil

Interv Akut Kardiol. 2018;17(3):164-168 | DOI: 10.36290/kar.2018.010  

Mitral regurgitation (MR) is the second most common valvular disease requiring surgery. Proper identification of surgical candidatesand optimising the timing of surgery are key in management. For primary MR, this relies upon a balance between theperi-operative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potentialrisk of irreversible left ventricular dysfunction if intervention is delayed. For secondary MR, recognition that this is a highly dynamiccondition where MR severity may change is key, although data on outcomes in determining whether concomitant valveintervention is performed with revascularisation...

Edoxaban – its properties and role in antithrombotic prophylaxis in atrial fibrillation

Michal Černošek, Martin Fiala

Interv Akut Kardiol. 2018;17(3):169-172 | DOI: 10.36290/kar.2018.018  

Anticoagulation is an integral part of comprehensive care of patients with atrial fibrillation. In addition to vitamin K antagonists(VKA) used for years, more recently novel anticoagulant drugs have been increasingly prevailing, with edoxaban being the latestto have been approved for use. It is a drug with a favourable pharmacological profile, simple dosing schedule, minimal seriousinteractions, and efficacy confirmed by large randomized trials. Moreover, the safety and efficacy of edoxaban has been shownin the population of elderly patients as well as in those undergoing electrical cardioversion.

Coronary intervention in STEMI without stent implantation

Tomáš Kovárník, David Zemánek, Jan Pudil

Interv Akut Kardiol. 2018;17(3):173-176 | DOI: 10.36290/kar.2018.025  

On the basis of two case reports, the authors discuss the possibility of percutaneous intervention in patients with acute myocardialinfarction without the use of a stent. The technique described involves restoring arterial patency by using thromboaspiration and,once a favourable finding has been confirmed by means of optical coherence tomography, the lesion is left to heal spontaneously.

Intracoronary administration of thrombolysis in patients with ST elevation myocardial infarction and a massive intracoronary thrombus

Ahmad Zohoor, Alexander Schee, Tomáš Kovárník

Interv Akut Kardiol. 2018;17(3):177-180 | DOI: 10.36290/kar.2018.053  

Primary percutaneous coronary intervention (PCI) is currently a widely preferred reperfusion strategy for myocardial infarction therapydue to superior results compared to thrombolytic therapy. However, the presence of massive intracoronary thrombus in patients withmyocardial infarction is often associated with adverse procedural results, including failure of aspiration and failure of reperfusion. Administrationof a low dose of intracoronary thrombolysis in patients with myocardial infarction with ST elevations and massive thrombusafter insufficient PCI and thrombectomy resulted in decreased thrombotic burden, improvement of epicardial flow and perfusion.

The FOURIER trial: evalocumab in secondary prevention

Jindřich Špinar, Lenka Špinarová, Jiří Vítovec

Interv Akut Kardiol. 2018;17(3):181-184  

Elevated LDL cholesterol (LDL-C) concentration is an independent risk factor for cardiovascular morbidity and mortality aimedat by numerous therapeutic interventions. However, despite maximum possible treatment with statins, a wide range of patientsfail to reach satisfactory control. It is these patients who can now be offered modern treatment with proprotein convertasesubtilisin-kexin type 9 (PCSK9) inhibitors. The FOURIER trial involved 27,564 patients with established cardiovascular diseasetreated with a maximum tolerated statin dose who were randomized to receive evalocumab or placebo. The reduction in LDLcholesterol levels with evalocumab was...

The EXSCEL trial: effect of exenatide on cardiovascular safety

Jiří Vítovec, Lenka Špinarová

Interv Akut Kardiol. 2018;17(3):185-187  

The EXSCEL clinical trail compared exenatide, a GLP-1 receptor agonist, and placebo among patients with type-2 diabetes withor without previous cardiovascular disease. The trial tested the safety hypothesis (non inferiority) and efficacy hypothesis (superiority).Exenatide, administered once weekly, was noninferior to placebo with respect to safety (P < 0.001 for noninferiority) butwas not superior to placebo with respect to efficacy (P = 0.06 for superiority).

The EUCLID Study (Ticagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease)

Debora Karetová

Interv Akut Kardiol. 2018;17(3):188-190  

In patients with symptomatic peripheral artery disease, ticagrelor was not shown to be superior to clopidogrel in the reductionof cardiovascular events during a 30-month follow-up period; the only significant difference between the groups was in the rateof ischemic stroke. The rates of major bleeding were similar among the patients in the two trial groups.