Renální denervace - dočkáme se jejího rutinního použití v léčbě arteriální hypertenze?Editorial k článku Bulava A. Pozice renální sympatické denervace v nefarmakologické léčbě kardiovaskulárních onemocnění. Interv. Akut. Kardiol. 2022;(21)4:208-215.

Tomáš Zelinka

Interv Akut Kardiol. 2022;21(4):199-200  

Infective endocarditis in Complex Cardiovascular Center in Pilsen: patients' characteristics and microbial spectrum

Martin Brada, Richard Rokyta

Interv Akut Kardiol. 2022;21(4):201-207 | DOI: 10.36290/kar.2022.028  

Aim: To assess the set of patients with infective endocarditis (IE) in Complex Cardiovascular Center (CCC) in Pilsen and evaluate changes in microbial spectrum and prognosis of patients. Methods: We used a retrospective analysis to identify 109 patients with the diagnosis of IE according to modified Duke criteria, who were hospitalised in CCC in Pilsen from May 2011 to April 2019. This eight-year time period was divided into two four-year intervals to compare the changes in the set of patients. Results: The study included 85 men and 24 women. 56 patients (51 %) had native valve endocarditis (NVE), 35 patients (32 %) had prosthetic valve endocarditis...

Role of renal sympathetic denervation in non­‑pharmacological treatment of cardiovascular diseases

Alan Bulava

Interv Akut Kardiol. 2022;21(4):208-215 | DOI: 10.36290/kar.2022.024  

Renal sympathetic denervation (RDN) is a method that has experienced its rise and fall in the treatment of pharmacologically-resistant essential arterial hypertension, and its firm indications for the treatment of this disease have not been defined yet. Modification of sympathetic activity, however, is in the centre of attention in the treatment of some other pathological conditions. From the pathophysiologic point of view, it is certainly so in the treatment of heart failure, atrial fibrillation, and some types of ventricular arrhythmias, as well as in the case of some other diseases, to a greater or lesser extent. The aim of this article is to review...

Difficult situations in the assessment of aortic stenosis

Kateřina Linhartová

Interv Akut Kardiol. 2022;21(4):216-218 | DOI: 10.36290/kar.2022.023  

The assessment of the severity of aortic stenosis relies primarily on echocardiography. If discordant parameters are found, measurement errors should be excluded, aortic valve morphology and calcification should be evaluated by CT, and left ventricular response assessed. Pitfalls of aortic stenosis quantification and the role of cardiac amyloidosis are discussed.

Transthyretin amyloidosis of the heart: Why should it be kept in mind?

Tomáš Paleček, Barbora Chocholová, Lenka Roblová, Petr Kuchynka

Interv Akut Kardiol. 2022;21(4):219-224 | DOI: 10.36290/kar.2022.031  

In recent years, there has been a significant increase in diagnosed cases of patients with transthyretin amyloidosis (ATTR) of the heart, predominantly with the acquired form of ATTR, also referred to as wild-type ATTR (wtATTR). This is due to the possibility of non-invasive diagnosis of ATTR based on the combination of a clearly positive finding of scintigraphic examination using technetium-labelled bisphosphonates (most often DPD scintigraphy) and a negative result of laboratory tests for AL amyloidosis. It turns out that wtATTR is not a rare cause of heart failure or arrhythmias, particularly of conduction disorders and atrial fibrillation, in elderly...

Mobile aortic thrombus as the cause of recurrent ischemic stroke: diagnosis and treatment

Marie Špilínková

Interv Akut Kardiol. 2022;21(4):225-228 | DOI: 10.36290/kar.2022.027  

The presence of a mobile thrombus in a nonaneurysmal aorta is a rare clinical entity that is usually discovered after embolic, mostly fatal or devastating, complications. Cases have been reported of peripheral limb ischemia, renal dysfunction due to embolism into the renal arteries, myocardial infarction, stroke, or macroembolism with critical limb or visceral ischemia. Due to the low incidence of mobile thrombus, there is no uniform treatment strategy. The characteristics of embolization, thrombus location, and patient's clinical status all play a key role in choosing the optimal approach. In the case reported here, the therapeutic plan was established...

Coronary physiology assessment: a routine method in a modern catheterization center

Kristýna Hlaváčová, Jan Kaňovský, Ivona Kask, David Pospíšil, Martin Hudec, Petr Kala

Interv Akut Kardiol. 2022;21(4):229-239 | DOI: 10.36290/kar.2022.036  

Hemodynamic examination of coronary lesions using both hyperemic and non-hyperemic indices is currently a routine part of invasive procedures in catheterization laboratories. The most frequent indication for hemodynamic assessment is to clarify the functional significance of angiographically borderline lesions. Fractional flow reserve is used to assess the degree of functional impairment of the epicardial arteries. Coronary flow reserve is used to describe the hemodynamic condition of the coronary vessels and microvasculature. The microcirculation itself is characterized by the index of microvascular resistance. Thanks to the dynamic development of...

PARADISE-MI Angiotensin receptor - neprilysin inhibition in acute myocardial infarction

Jiří Vítovec, Lenka Špinarová, Jindřich Špinar

Interv Akut Kardiol. 2022;21(4):240-242 | DOI: 10.36290/kar.2022.037  

The PARADISE-MI trial compared the efficacy of sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, versus the ACE inhibitor ramipril in patients with acute myocardial infarction and reduced left ventricular ejection fraction. The trial included and randomized 5,661 patients. The primary endpoint was composite: death from cardiovascular causes or incident heart failure (hospitalization for heart failure or symptomatic outpatient heart failure) and was consistent in the two study groups, with no statistical significance.