Uzávěr PFO: současný přístup
PFO-closure: the current approach

Ivo Varvařovský

Interv Akut Kardiol. 2019;18(1):6-7  

Vitamin D deficiency in patients with acute coronary syndrome

Elena Shytova, Larisa Mikhailova, Robert Bogachev, Anastasia Kozel, Vitaly Ankudovich, Ulyana Dobrynina

Interv Akut Kardiol. 2019;18(1):8-11 | DOI: 10.36290/kar.2019.015  

Background: Recent studies have shown that the functions of vitamin D are abundant, including its impact on the development of coronary artery disease (CAD). Aims: Assess the serum vitamin D level in patients with acute coronary syndrome and compare with a group of healthy volunteers. Subjects and methods: It is a cross-sectional observational study. Study subjects are patients with acute coronary syndrome. Exclusion criteria are the presence of diabetes mellitus, autoimmune diseases and malignant tumors. The control group included subjects without any cardiac disorders. Between August 2017 and November 2017, 50 patients with ACS and 22 healthy volunteers...

Experience with recanalization of difficult chronic total occlusions

Vojtěch Novotný, Ivo Varvařovský, Tomáš Lazarák, Jan Matějka, Vladimír Rozsíval, David Vindiš, Milan Plíva

Interv Akut Kardiol. 2019;18(1):12-17 | DOI: 10.36290/kar.2019.002  

Aim: Percutaneous coronary intervention (PCI) for coronary artery chronic total occlusion (CTO) has been a rapidly evolving branchof interventional cardiology in recent years. The article presents our two-year experience with the development of a dedicatedCTO programme, while focusing on stratification of CTO difficulty depending on the J-CTO scoring system and the role of theproctor in the learning curve.Material and methods: The study cohort comprised consecutive patients who underwent PCI for CTO at our centre during theperiod from 08/2016 to 10/2018. The following aspects were studied: the basic patient characteristics...

Challenging situations in evaluating aortic stenosis

Hana Línková, Róbert Petr, Eva Pašková

Interv Akut Kardiol. 2019;18(1):18-22 | DOI: 10.36290/kar.2018.017  

Aortic stenosis is the most common primary heart valve disease in adults and an important cause of cardiovascular morbidity and mortality. Up to 40% of patients with aortic stenosis have discordant Doppler-echocardiographic findings, the most common of which is the presence of a small aortic valve area (≤ 1.0 cm2) suggesting severe aortic stenosis, but a low gradient (< 40 mmHg) suggesting nonsevere aortic stenosis. In clinical practice, three subpopulations of patients with severe aortic stenosis and low gradient are distinguished: a/ “classical” type with a low gradient, low flow and low left ventricular ejection fraction: b/...

Nonatherosclerotic coronary artery diseases

David Horák

Interv Akut Kardiol. 2019;18(1):23-27 | DOI: 10.36290/kar.2018.021  

Cardiovascular diseases including ischaemic heart disease account for major morbidity and mortality. In western societies, atherosclerosis is certainly the leading cause of coronary artery disease. However, some less frequent diseases that can also affect the coronary arteries should not be neglected either. This involves a wide range of various diseases. They include congenital coronary artery anomalies, spontaneous dissections (often associated with fibromuscular dysplasia), myocardial bridging, and various systemic inflammatory diseases that can affect the coronary arteries in different ways. The diagnosis is mainly based on imaging studies. The...

The use of optical coherence tomography in acute coronary syndrome

Tereza Nováková, Petr Kala, Lenka Prýmková, Jan Kaňovský

Interv Akut Kardiol. 2019;18(1):28-31 | DOI: 10.36290/kar.2018.019  

Acute coronary syndrome as an acute form of coronary artery disease is one of the most important causes of patient morbidity and mortality. Its most effective treatment method is percutaneous coronary intervention (PCI) routinely using angiographic imaging. Currently, the most accurate assessment of coronary artery morphology is provided by optical coherence tomography (OCT), an intravascular imaging technique. The main application of OCT has been shifting from mostly scientific use to almost routine practice in recent years, particularly in patients with acute coronary syndrome. Optical coherence tomography is, except for a few limitations, one of...

Heart rhythm disorders in children, current topics in paediatric arrhythmology

Peter Kubuš

Interv Akut Kardiol. 2019;18(1):32-38 | DOI: 10.36290/kar.2019.016  

The first part of the a article summarises the mechanisms, diagnostic techniques, and management of the most common arrhythmiasin children. In the second part, current topics in paediatric arrhythmology are discussed: catheter ablation, arrhythmias in patientswith congenital heart disease, implantable devices, foetal arrhythmias, inherited primary arrhythmia syndromes, and genetic testing.

Single coronary artery and sudden cardiac death

Jakub Zápeca, Martin Gřiva, Zdeněk Coufal

Interv Akut Kardiol. 2019;18(1):40-42 | DOI: 10.36290/kar.2019.004  

Congenital coronary artery anomalies are rare in the population. Patient, 57 years, was resuscitated from cardiac arrest at theairport. Coronary angiography demonstrated the left coronary artery originating from the right sinus of Valsalva and coursingbetween the aorta and the pulmonary trunk. If this anomaly is manifested as sudden cardiac death and the patient survives,a surgical correction is recommended. The question is whether implantable cardiover-defibrillator should be implanted.

PCSK9 and the ODYSSEY trial

Jindřich Špinar, Lenka Špinarová, Jiří Vítovec

Interv Akut Kardiol. 2019;18(1):43-44  

In the year 2018, the ODYSSEY OUTCOMES trial was presented that completed a long-term programme with alirocumab. The ODYSSEY programme consists of 9 clinical trials, of which a pooled analysis was performed. The aim of this analysis was to evaluate the data on the efficacy and safety of alirocumab in patients who had DM and concomitant atherosclerotic CV disease. The Odyssey Outcomes trial included 18,924 patients in secondary prevention who had experienced an acute coronary syndrome within the previous 12 months; the mean follow-up duration was 2.8 years and the primary endpoint occurred in 1,955 of them. The primary endpoint occurred in 903 (9.5...

ATTR-ACT Study: breakthrough in the treatment of transthyretin cardiac amyloidosis

Tomáš Paleček, Jan Krejčí

Interv Akut Kardiol. 2019;18(1):45-48  

AL (light-chain) amyloidosis and transthyretin-related amylodosis (ATTR), either hereditary or senile, lead to clinically relevant cardiac disease. Recently, increased attention is paid to senile ATTR due to its increasingly frequent capture. ATTR also represents an example of the disease manifesting as heart failure with preserved ejection fraction due to specific etiology. So far, treatment of ATTR amyloid cardiomyopathy was based on conventional heart failure therapy; orthotopic liver transplantation or combined heart and liver transplantation was indicated only in few cases. Tafamidis is a TTR-stabilizer that prevents its dissociation and thus...

Proper conduct and modern etiquette

Daniel Šmíd

Interv Akut Kardiol. 2019;18(1):49-50